Nonfiction Book Review: I Contain Multitudes

**Ed Yong, I Contain Multitudes: The Microbes Within Us and a Grander View of Life (2016)**

When I was asked to contribute a “book I should have read” to Keeping Up with the Penguins, this one sprang to mind. And spurred by that reminder, I did finally read it!

I can now recommend it to everyone for a good dose of actual scientific information, given the current state of anti-microbial hysteria. As you may already be aware, wiping out all microbial life in an area gives a free playing field for aggressive, resistant microbes to grow and become even more resistant, unchecked by the more benign ones that would normally surround them. It’s really, really not a great idea.

We need to find other ways to live with our invisible friends (and foes), other than spraying everything with disinfectant. When faced with a scary and overwhelming threat, that reaction is natural — and sometimes may be warranted — but as an overall policy, it’s already backfiring. (Did you know that 90,000 people in the US die each year from infections they pick up in the hospital?)

We need to learn more about how the microbial world really works, and about the interconnectedness of all life, before wildly destroying what we don’t even understand. The threats are real, but so is the potential to counter them in more life-enhancing ways.

Just a few of the things I learned from this book include:

Microbes are everywhere, in vast numbers, and they play extremely important roles in the living world. No microbes, no life as we know it.
Their discovery via the earliest microscopes started with wonder and open-mindedness, but then changed to a warlike narrative of “kill the bad bugs” that still haunts us today.
There aren’t actually good bugs and bad bugs. The same microbe can play different roles even within the same organism. The key is for larger organisms to develop ways to manage and live with a variety of microscopic life.
Symbiosis — living together — is a principle that is rooted within our very cells, the structure of which came about long ago through one microbe absorbing another that then gave it an energy boost and an evolutionary advantage.
There are incredibly weird and fascinating examples of symbiosis in the natural world, enabling organisms to resist toxins, fight off unwanted invaders with antibiotics, and even glow in the dark. Biologists are just beginning to understand these relationships.
The “microbiome” makes an important contribution to evolution, which is based not only on an organism’s own genome but on the microbes it inherits or acquires — something that can cause sudden and dramatic changes in evolutionary processes that are usually much slower and more gradual.
Microbes may play a role in treating mood disorders, obesity, antibiotic-resistant infections, and other ailments. The possibilities are very exciting, but a lot more research is needed, so don’t start doing your own fecal transplants.
Breastfeeding plays a unique and surprising role in forming an infant’s microbiome for life.
Sterile, microbe-free mice (used for lab experiments) are bizarre and unhappy creatures.

Ed Yong is a fine guide to this complex topic, with a clear and engaging style that can speak to non-scientists without undue oversimplification — something that is unfortunately often done in the popular press. Aggressive calls for extermination and overhyped touting of probiotic health cures are both too extreme and short-sighted. To counter this, we need to learn more, to have our eyes opened to the hidden world that lies all around and within us. Our life on earth truly depends upon it.

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Back to the Classics: The World I Live In

Helen Keller, The World I Live In (1908)

When I read Helen Keller’s The Story of My Life, I was intrigued by one of the last letters quoted in the book, written to a college professor who found her compositions too derivative and wondered when she would write of her own unique experiences:

I have always accepted other people’s experiences and observations as a matter of course. It never occurred to me that it might be worth while to make my own observations and describe the experiences peculiarly my own. Henceforth I am resolved to be myself, to live my own life and write my own thoughts when I have any…

The World I Live In could be seen as the fruit of this intention, and it is a remarkable piece of work. Composed from essays published in Century Magazine between 1904 and 1908, with an added final chapter, it is an extended meditation on the sensory and mental world inhabited by a deaf-blind person, and a rebuke to those who believe that because she cannot see and hear she cannot be fully human, perhaps does not even exist.

She responds with Descartes’ formulation, “I think, therefore I am,” and it’s clear that thought is her light, that her ability to think is in no way impaired by sensory deprivation. Her lucid, carefully constructed, and often playful prose guides us through her realm of experience, bringing us to understand how a condition that seems so alien and threatening can reveal aspects of our common humanity, our spiritual core.

Keller defends her choice to use visual and auditory imagery in her writing, arguing that she can by analogy comprehend many concepts related to the five-sensed world — just as we understand non-sensory concepts like love, faith, mercy and justice that we have never seen with our eyes. She can “see” a friend just as we do — not with her eyes, but with the inner vision which is what we really mean by that expression.

But it is the description of her other senses, of the world of touch, smell, and taste that she lives in, that is most fascinating and mind-expanding. Her finely differentiated, sensitive observations made me feel how blunt and unrefined my own sensory experience normally is, how I go through my colorful, sounding world without truly seeing and hearing it. Perhaps it is I who am handicapped, rather than Helen Keller, who perceives so much through the faintest vibration in her environment.

In the NYRB Classics edition, the essays along with their coda, the prose-poem “A Chant of Darkness,” are followed by the earlier essay “Optimism” (1903) and the autobiographical sketch she published at the age of twelve, “My Story” (1894). An introduction by Roger Shattuck explains the circumstances of publication and points out elements of note in each work and in Keller’s thought as a whole.

At under 200 pages, it’s a compact but rich encapsulation of the life and ideas of an individual whose true achievements have been little understood or appreciated. I hope that it may become more widely known, and spark our own rehabilitation of the senses we possess but do not fully use, guiding us toward the practice of joyful creative activity that Keller so beautifully demonstrates.

Back to the Classics Challenge: Classic by a Woman Author

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Nonfiction Book Review: The Body Keeps the Score

**Bessel van der Kolk, The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma (2014)**

In keeping with my resolution to read more nonfiction this year — ideally, not only memoir or biography — I made my way through this book in the first couple of months of 2020. It took time because I wanted to read slowly and take in all the information, but the hours were well spent. For anyone who wants to know more about how our bodies and minds deal with traumatic experiences, this is an essential resource. And in light of current events, we’re going to need it more than ever.

The author is an expert on the treatment of trauma, director of The Trauma Center in Boston for over 30 years. The first half of the book deals with the psychology and neurochemistry of trauma, with many fascinating discoveries unfolded in a clear and accessible manner, easily understandable by the layperson. The second half goes briefly through a number of therapies that Dr. van der Kolk has found to be of use in treatment, each of them engaging the wisdom of the body in some way.

For “the body keeps the score” throughout all of our life experiences, and our bodies store vital information and knowledge that we cannot access through intellectual thinking alone. The talking cure, predominant in psychotherapy for more than a century, simply is not enough. The reasons why become clear when we start to understand how the brain actually works, thanks to recent advances in this field.

Putting those discoveries at the service of human beings who want to heal themselves and return to a life of relationship, rather than being trapped in a traumatic past, is the mission of the book. Unfortunately, along with some amazing stories, we also read of resistance to change from the establishment. Research is not done into some very promising fields, funding is not given, diagnoses are not accepted, and harmful patterns are reinforced — including the over-administration of medications that should be only part of a whole therapeutic program.

It’s a human tendency to suppress symptoms rather than truly addressing underlying issues. The latter is far more difficult, because it means stepping out into the unknown, and into an encounter with much that is frightening and unsettling in our unhealed selves. The medical establishment, like society as a whole, is not very supportive of this work. But there are brave, pioneering people who are doing it anyway, fighting their way out of the nightmare of trauma — and there are researchers and therapists who have found ways to help them.

The need is immense, because such experiences are far more common that you may imagine. They cause untold harm as they reverberate throughout life with destructive force, shattering relationships, impacting future generations, laming our potential.

This cycle of trauma must be stopped. We owe it to ourselves and our society to take up any path that can help us to do this, even if it runs counter to our habitual notions and assumptions, even if we must change ourselves in fundamental ways.

Mind and body are a whole, whose complex workings belie the crude and simplistic ideas with which we often delimit them. There is still so much to learn and to explore, but a book like this gives me hope that we are making at least some steps in the right direction. At its center is real respect, caring, and awe for the human process of recovery. And it is my belief that it is through such a humanist science that our world may be truly healed.

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Doctors playing God: Awakenings

**Oliver Sacks, Awakenings (1999/1973)**

Of course I’ve heard of Oliver Sacks, author of many books with intriguing titles (The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, Seeing Voices, etc.). But in spite of hearing that Sacks was a terrific writer about fascinating topics out of his practice as a neurologist, I managed to avoid actually reading these works for many years.

Until, while questing for something short and inspiring to read this summer, his little book Gratitude — barely even a book, just a compilation of four brief essays that originally appeared in the New York Times — caught my eye. I polished it off in an hour, was captured by the intelligent and compassionate mind that spoke there, and looked for more.

Awakenings, his second published book, was one I had heard about; I had vague impressions from when the Hollywood movie came out, with Robin Williams and Robert De Niro. I haven’t seen that either, but the premise of patients coming out of a decades-long pathological “sleep” sounded interesting. So I checked it out and dove in.

The edition I read in e-book form is the latest of many incarnations. A preface explains some of the transformations the book has gone through: adding footnotes, removing them, putting them back in again; going back to the original stories after further developments; weaving in further developments in neurology, science, and medicine, including chaos theory; adding notes on the stage and film incarnations of the story; and more.

It’s an unwieldy mass of material, and exactly the kind of book I prefer to read in print versus the electronic version. With all the footnotes, cross-referencing, and a glossary of medical terms, it would have made it much easier to flip back and forth, and to maintain awareness of the place of the parts within the whole. If it hadn’t been such a fascinating story at the core, I probably would have gotten frustrated and given up. Probably I will buy a print copy, because I want to go through it again and take it in more thoroughly.

“When is she going to get to that actual story?” you are probably asking. Yes, like Sacks, I am making you wade through a lot of prefatory and explanatory material — probably because that’s how I experienced the book. Pushing all this aside, at the core are twenty case studies of individuals who went through a bizarre, little-remembered epidemic of “sleepy sickness” that erupted worldwide along with the more famous influenza epidemic in the early twentieth century. This viral disease fatally disrupted their brain activity, pushing them into states of torpor and/or of manic inability to sleep; many died, or were left permanently disabled. While some seemingly recovered, later they began to display symptoms of Parkinsonian syndrome, particularly disruptions in movement and speech.

As they became less and less able to function, often needing round-the-clock nursing care to survive, these people were placed in institutions for “hopeless” cases. To one of these institutions near New York City Oliver Sacks came as a young doctor in the 1960s, and there his work with these post-encephalitic Parkinsonian patients changed his life.

In a stroke of fate, Dr. Sacks was present at the moment when a “wonder drug” was discovered that roused these patients out of their decades-long fixation and immobility. L-DOPA, which works to elevate dopamine levels in the brain, at first seemed to promise total, almost instant recovery. People leaped out of their wheelchairs and sang and danced with joy.

But then so-called “side effects” set in, as the medical establishment likes to call unwanted or adverse drug results that are fully as much a part of the treatment as the results they are aiming for. Pulled between extremes of manic and torpid behavior, the patients felt themselves to be walking an ever-narrowing path that became a tightrope over an abyss. Different titrations and schedules were tried, and sometimes a precarious balance was reached that allowed some individuals to have a higher-functioning life for their remaining years.

When that didn’t work out, though, the results were often terrible and tragic to behold. Patients who had to be taken off the drug were left in a state far worse than they had been in before. Frequently they lost the will to live, or went mad, descending into a hellish hallucinatory state. Some were quietly euthanized, mercy killings that also meant the doctors need no longer observe the results of their tampering. One has to wonder to what extent the risk of doing such damage is warranted by the desirable results that sometimes, unpredictably, come about.

Great moral questions indeed are raised by this story. For me, frequently it resembled a horror story, a Frankenstein-tale of men enchanted by the Godlike powers they can achieve through the intellect, without the deeper knowledge of what will result from their experiments. Is it right to tinker with human subjects like this? What truly is the nature of consciousness, of life and death? In our quest for a better life on earth, what harm do we do through unawareness and egotism? Is it enough to have good intentions, or should we also be striving for higher knowledge, for the wisdom that sees the whole and not just isolated, disconnected parts?

For Dr. Sacks, there are no easy answers, but as he portrays his own struggle and his own “awakening” we gain a sense of how one morally striving person has engaged with these questions. He speaks against the tendency of modern medicine towards a mechanistic view of the human being, and movingly describes his own human encounters with his patients, encounters that inspired in him an awareness of the person who lives beyond statistics, beyond symptoms, beyond paralysis and speechlessness. He is filled with wonder when he observes the strange experiences his patients are subjected to, and humbled by what they need to call up in order to face their existence day after day.

Such an attitude is one we can all strive to emulate, even if we are not physicians. We will all do harm at times, often out of the best intentions, but let us not obscure the real, living human being with our fixed, mechanistic thoughts. The call to awaken to this power and this responsibility was for me the real message of the book.

I’ll certainly be reading more by Oliver Sacks; there is so much to learn from these kinds of stories, pushing us beyond our “normal,” safe ways of experiencing the world. Have you read anything by him? What is your favorite?

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I’m on the Ruminate Blog

Ruminate Magazine is a wonderful publication I’ve recently discovered, which explores the creative and contemplative aspects of life through fiction, nonfiction, poetry, and art.

I’m honored that a book review of mine was accepted as a guest post on the Ruminate Blog! You can check out my review of The Sixth Extinction there today. I hope you’ll have a look, and come back here to let me know what you think.