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Because he can't reach the hospital in a winter snowstorm, Dr. David Henry ends up assisting his own wife in the birth of their twin children at his clinic with the help of his nurse, Caroline. The boy is fine; the girl has Down symdrome. While his wife is as yet unaware, he gives the girl baby to Caroline to take to an institution. Norah, his wife, remains unaware that she give birth to two children, yet is haunted by some sense of loss she can't name. Caroline, unable to leave the baby in an unappealing institutional setting, makes a snap decision to keep her. She leaves town, renewing communication later with the baby's father, and raises her as a single mother until she meets a man who is willing to marry her and love Phoebe as a daughter.

Only after Dr. Henry dies suddenly does his wife discover the existence of her daughter, through photographs sent to him over the years by Caroline, and then a visit from Caroline and Phoebe. Sadly, but with a will to choose life on strange and demanding terms, Norah and her son, Phoebe's brother, choose to enlarge their circle of family to include a loving relationship with Phoebe, clearly her own person, and the woman and man who have cared for her.

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A brooding book that sounds the death knell for optimistic views on humanity's progress through civilization, Civilization and its Discontents begins with a recapitulation of Freud's disdainful views on religion as a psychological salve and then goes on to challenge enduring platitudes about human society: that civilization has emerged as a simple marker of progress of mankind over nature, protects us against suffering, and guards our liberties and happinesses. Comparing the development of civilization to the development of individual psychologies, he sees in both an essential conflict between eros and thanatos, between the desire to be with other people and the violence committed (or wished upon) other people.

Given that civilization is a process of negotiating and structuring communities, it must also be a way of controlling and repressing both violent and libidinous instincts; it does so not only through its laws but by infiltrating our own psychologies, which Freud discusses through the filter of his structural theory (where the instinctual, unconscious drives of the id are reined in by the ego under the fierce supervision of the inwardly aggressive superego). Freud's psychological perspective is to try to make sense of individual guilt, conscience, and remorse in the broadest social context as the products of this compromise between eros and thanatos, between the individual and the group, and between satisfying one's own instinctual drives and a broader community's needs. While some of his views are redolent of turn-of-the-century anthropology, his focus on guilt, aggression, and the murderous instincts towards extermination are very much prescient, charting the next decade and a half's fall into civilization's darkest hour.

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This novel begins as it ends - as an interior monologue, a soliloquy only the reader hears. Paula Hook, married 25 years to her husband Mike, who is asleep beside her throughout the entire novel, is reflecting on the discussion she and her husband have decided to have with their fraternal twins on their sixteenth birthday (June 10, 1995), which is the "Tomorrow" of the title. Although the book begins with "tomorrow" yet to come, it ends on "today" around dawn. The twins, Nick and Kate, have no idea that this revelation--that they are the products of artifical insemination (AI), i.e., that Mike is not their biological father--is forthcoming.

Paula Campbell and Mike Hook met casually but experienced love at first sight, despite Mike's making the sexual rounds of Paula's friends and roommates. Mike was initially a biologist but becomes a publisher of popular biological publications. Paula is a director in an art gallery in London. Both gradually become more successful and prosperous, have infertility problems and undergo AI. The discussion with the twins never takes place in the novel, which ends at dawn.

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This book chronicles four meals, tracked from the production of the food through to the preparation and consumption of the meals themselves. The first is a fast food meal eaten in the car, the quintessential American meal consisting entirely of industrially farmed produce. Pollan then goes on to have an industrial-organic meal, an organic pasture-grown meal, and finally a meal containing only products that he foraged, hunted, and cultivated himself. Throughout, he looks closely at how economic and commercial values have supplanted ecological ones in the cultivation and production of the food we ingest. In addition to attending to the social and political dimensions of the American diet, Pollan also notes the effects of this diet on public health, from rising levels of obesity through to the antibiotic resistances developing in herds of cattle living in pens in their own manure.

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The book is split into three parts, the Analytic Part, the Synthetic Part and the Theoretical Part. The Analytic Part begins with an excellent synopsis of earlier theories of comedy, joking and wit, followed by a meticulous psychological taxonomy of jokes based on such features as wordplay, brevity, and double meanings, richly illustrated with examples. This section ends with Freud's famous distinction about the "tendencies" of a joke, in which he attempts to separate those jokes that have tendencies towards hidden meanings or with a specific hidden or partly hidden purpose, from the "abstract" or "non-tendentious" jokes, which are completely innocuous. He struggles to provide any examples of the latter. In the midst of his first example, he suddenly admits that he begins "to doubt whether I am right in claiming that this is an un-tendentious joke"(89) and his next example is a joke that he claims is non-tendentious, but which he elsewhere studies quite intensely for its tendencies. Freud uses this to springboard into an exploration of how a joke involves an arrangement of people - a joketeller, an audience/listener, and a butt, often involving two (the jokester and the listener) against one, who is often a scapegoat. He describes how jokes may be sexual, "stripping" that person, and then turns towards how jokes package hostility or cynicism.

The synthetic part is an attempt to bring together the structure of the joke and the pleasurable tendencies of the joke. Why is it that jokes are pleasurable? Freud's answer is that there is a pleasure to be obtained from the saving of psychic energy: dangerous feelings of hostility, aggression, cynicism or sexuality are expressed, bypassing the internal and external censors, and thus enjoyed. He considers other possible sources of pleasure, including recognition, remembering, appreciating topicality, relief from tension, and the pleasures of nonsense and of play. Then, in a move that would either baffle his critics or is ignored by them, Freud turns to jokes as a "social process", recognizing that jokes may say more about social life at a particular time than about particular people; he turns this into an investigation of why people joke together, expanding on his economical psychic perspectives with discussions of social cohesion and social aggression.

In the third part, Freud connects his theories of joking with his dream theories in order to explain some of the more baffling aspects of joking (including how jokes seem to come from nowhere; how we usually get the joke so very quickly, even when it expresses very complicated social phenomena; and why we get a particular type of pleasure from an act of communication). He ends with an examination of some of these themes in other varieties of the comic, such as physical comedy and caricature.

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Sandeep Jauhar, M.D., Ph.D. is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York. Thus, one can assume that he is an accomplished cardiologist and administrator. It was not always so. This memoir flashes back to 10-15 years earlier when the author was casting about for a career, finally settling on medicine almost by default; it follows him to medical school (at Washington University in St. Louis) and then centers on his first year of residency training at Cornell's New York Hospital in Manhattan -- the internship year.

We learn in the introduction to the book that the author will speak freely of self-doubt about career choice, constant anxiety and feelings of inadequacy, exhaustion, and disillusionment. Which indeed he does. But Jauhar first discusses his family background: born in India and emigrating with his family to the USA at age 8; father holding a Ph.D. in plant genetics, now writing academic textbooks and still regretting that he had not been able to afford his dream of becoming a doctor; mother helping to support the family as a lab technician; older brother, Rajiv, a mentor and competitor, charming, self-assured, and unquestioningly headed for a medical career; sister, Suneeta. Sandeep (the author) undertakes graduate work in theoretical physics but as he nears completion of his doctoral degree, realizes that he probably does not have what it takes to be successful in the field. When his girlfriend, Lisa, becomes seriously ill, he begins to (re)consider medicine as a career. Against the advice of his parents who are now convinced he is a dilettante, he applies to medical school and is accepted.

Disillusionment began during the first two years of medical school: "In graduate school I had never learned to memorize . . . But now I couldn't rely on logic and reasoning; I had to commit huge swaths of material to memory" (32). He considered quitting to become a journalist, a profession that had always intrigued him, but which had been discouraged: "my father made it clear that journalism and writing were never to be considered career options because they offered no security" (33). Yet, amazingly, he was awarded a summer fellowship just before starting medical school that placed him in the Washington, DC office of Time magazine; the contacts he made then allowed him to work as a student reporter for the St. Louis Post-Dispatch during medical school and led ultimately to his ongoing and current position as a contributing medical essayist for the New York Times.

Internship for Jauhar unfolds as a series of anxiety-provoking encounters with patients and humiliating encounters with his physician superiors. Feeling inept and inadequate, he stumbles along and worries that he is harming patients. There is too much to keep track of, too many "little things that I find burdensome" (91). "Having so much to do was bad enough, but not knowing why you were doing what you were doing was terrifying . . . Patients were needy, their demands overwhelming . . . Everyone seemed to know how the place worked except me . . . The ecology on the wards was hostile; interactions were hard-bitten, fast paced" (112-113). He is in constant doubt and conflict about his career choice. Even his private life is affected -- his girlfriend Sonia, still a medical student, comes from a medical family, is strongly motivated and secure in her career choice, which aggravates his own sense of insecurity. (Reader, he married her.)

Midway through internship Jauhar suffers a herniated disk. He tries to tough it out without taking time off but his stint as "night float" at Memorial Sloan-Kettering hospital, which specializes in treating cancer patients, proves too difficult-- up all night trying to tend to the severely ill and "taking care of patients about whom you knew next to nothing" (154). He takes a brief leave followed by a reduced schedule. He recognizes that his problems are emotional as well as physical -- he is depressed. But gradually, as his neck problem improves, as he recognizes that medical professionals are actually able to help patients feel better -- his neurologist and physical therapist had "provided hope and comfort to me at a vulnerable time" (181)--, as he makes a house call to a dying patient, as his essays are published in the New York Times, and as the season moves to Spring, his depression lifts and he looks forward to his work.

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The author's mission is to investigate, understand, explain, describe, and puzzle over the nature of phobias -- his own, and that of other sufferers. Allen Shawn is a composer, pianist, and teacher, and is a member of a gifted family: his brother, Wallace Shawn, is a playwright and actor; his father was William Shawn, for many years editor of the New Yorker Magazine. As a musician and academic, Allen Shawn is "successful." And yet, his life is severely limited by agoraphobia, "a restriction of activities brought about by a fear of having panic symptoms in situations in which one is far from help or escape is perceived to be difficult" (13). The author interweaves sections that summarize his extensive readings on the fight-flight reaction, evolution, brain and mind, Freud's theories on phobia--with his personal history, especially as he believes it relates to his phobia.

Shawn's descriptions of how he experiences agoraphobia are vivid and informative, detailing the situations that trigger his physiologic symptoms of panic and disconnectedness: driving on unfamiliar roads, any kind of travel that is unfamiliar, walking across or on the edge of open spaces, traveling across long bridges, being in enclosed spaces (claustrophobia). The agoraphobe, he writes, "feels at risk, as if at risk of sudden death or madness" (14). Shawn tells about what he must do in order to strike out on unfamiliar trips, that is, when he gathers up the courage to take them. He must venture up to the point where panic sets in, turn back, then on another occasion repeat the process but attempt to go further, pushing through the panic, until, one day, he can make the entire journey without turning back. Sometimes he never makes it to the desired goal.

The author points to several different factors that seem to predispose people to phobias: heredity, unconscious imitation of a phobic parent, upbringing. In his own case, in retrospect, his father showed symptoms of agoraphobia. Shawn discusses the underlying repression that was pervasive in his household -- his father carried on a long-term relationship with a woman while remaining married. Shawn's mother knew about the relationship from early on but any discussion of it was forbidden, even after it became common knowledge.

Perhaps more important in Allen Shawn's perception of repression is what happened to his twin sister, Mary, who was born with what is now considered to be autism, and mental retardation. Allen felt close to this girl, even though her behavior was unpredictable and baffling. When he was about eight years old, his parents sent her away to a special boarding school without warning Allen, or offering explanations. From then on he rarely saw her; 10 years later she was institutionalized. The family did not speak much about her and her "'exile' . . . added yet another layer of mystification to an already really mystifying atmosphere. It turned out that even in our temperate environment something extremely violent could occur" (177). Not long after that, Allen began to experience severe anxiety in certain situations.

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At dental school. Dave pursued Dana, the amazing and only woman in his class. Now married, they share a high quality private practice and raise their three little girls: Lizzie, Stephanie, and Leah. The ordinary chaos in the office and home of a professional couple is constant, though not insurmountable, and they enjoy the dental dramas of their patients, the childrens’ distinctive personalities, and the challenges of parenting. For example, two year-old Leah suddenly decides Dave is the centre of her universe, she shrieks when her previous favorite, Dana, comes near. The parents handle it together calmly without jealousy.

But Dave notices his beautiful, moody wife is drifting away; more precisely, he thinks she is having an affair. To keep this fear out of the realm of reality and confrontation, he scrupulously directs all talk toward work and kids, until his life is bent around avoiding any serious conversation with her at all. The children are anxious. He grieves for the losses of little things in their shared lives.

But when the family is felled by flu, all other problems recede. In rapid succession, children and parents collapse with fever, chills, and misery. Dave is up several nights with Leah, then he is sick himself just as Stephanie and Dana fall even more seriously ill. Drunk with fatigue and terrified that Stephanie might die, he takes her to hospital. They all recover, and the world seems harmonious. Dave begins to think he had imagined his wife’s distraction until he is jolted back to his worry when Dana vanishes.

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In summer 1962, virgins Edward Mayhew and Florence Ponting take their wedding supper in a hotel suite overlooking stony Chesil Beach on the Dorset coast. Married that afternoon, each is thinking of the bed in the next room. With only a little experience, Edward has waited patiently, but looks forward, enthusiasm mingled with apprehension over his performance. Florence however is revolted and even frightened by the thought of sex, but she does not dare to reveal her fears. They are both embarrassed by the hovering staff, and eventually leave the meal unfinished.

They proceed to the bed. Florence takes the lead which pleases and surprises Edward, but he does not know that she is doing so bravely, to confront the inevitable and get it over with. Their individual thoughts forward and backward through time rehearse their meeting, their love, and the awkward encounters with parents.

It does not go well. Florence races out of the room onto the darkened beach. Edward follows her and they try to talk. She suggests a celibate marriage. He is humiliated and angry. She walks away and he does not call her back. The marriage is annulled and in the last few pages, their lives race by--hers to musical success, his with only one regret.

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Twelve year -old Emaline is riding with her father as he discs their fields, when she sees her beloved dog Prince running dangerously close to the blades. In trying to stop him, she falls off the tractor and her leg is sliced almost completely through. In anger, her father shoots Prince and leaves home. She is rushed to hospital where a series of operations and treatments save her limb, although it is permanently shortened and she walks with a limp.

The fields need seeding. In desperation Emmy’s mother appeals to the local “mental hospital,” and Angus, the crazy man, arrives to help. Emmy is warned to stay clear of him, and neighbours gawk, but she begins to notice his special qualities. He quietly sows the fields with blue flax and yellow mustard rather than the unsellable wheat. He helps fit her with a built up shoe, and he is steadfast though frightened when falsely accused of theft. Yet some neighbours, like Harry Record, cannot adapt to Angus and believe that the family is taking risks. Just as Angus is the object of ridicule, Emmy is mercilessly teased for her deformity by Record’s son, Joey.

One night in a snowstorm both Joey and Angus disappear. Angus has been driven out of town and dumped by Harry Record, but he finds Joey lost in the storm and brings him home. Record refuses to accept his guilt and pleads not guilty. As the book ends Angus is more accepted, but a trial is looming, in which Emmy and Joey will have to give evidence against his father.

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