LitMed: Literature Arts Medicine Database

I Have Some Questions for You

Makkai, Rebecca

Last Updated: Jul-24-2023

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

I Have Some Questions for You begins with the visit of Bodie Kane to Granby, the upscale New Hampshire boarding school that she attended on scholarship far from her home in rural Indiana. Back then she was a sullen out-of-place grungy adolescent, but now she is a successful journalist, famous for producing a podcast about the careers of women in Hollywood. She is a successful alumna and has been invited to teach a mini-course on podcasting during the mid-winter break. The life she leaves behind on the flight from Los Angeles is meta-stable, poised between a divorced husband living comfortably next door (he helps with child rearing) and a mysterious Israeli lawyer with whom she is having an on again-off again affair.

Bodie’s arrival at Granby triggers the resurfacing of complicated and painful memories of her time in high school. She asks each student in her class to make a podcast as a class project. Bodie suggests to one of them that she look into the death of Thalia Keith, who was found drowned in the school pool the night after she appeared in a play performance. Omar Evans, the school’s Black athletic trainer, was arrested and convicted of the murder after minimal investigation by the school or the local police. Thalia, the campus dream girl and object of adolescent desire, had been Bodie’s mismatched roommate the year before the murder. Bodie has deep suspicion about who killed Thalia and why it happened, all centered on a charismatic drama teacher. The predatory shadow of this abusive teacher hovers over the book from start to finish. The story unfolds in the wake of the #MeToo movement. But she is also uneasy about how the judicial system has mishandled Omar’s case and hopes the podcast may unearth new evidence that might cause Omar’s case to be reopened and exonerate him. But nothing in this deeply layered novel proceeds in a straight line. Her divorced husband becomes the subject of a social media attack for presumed sexual misconduct, and Bodie is forced to react. Old friends reveal new secrets. Established history is seen in a new light. What Bodie thought she knew about people is upended. The ending is neat but satisfying. Rebecca Makkai does not just have her finger on the pulse of our time – she is able to bring it fully to life.

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The Netanyahus

Cohen, Joshua

Last Updated: Jun-13-2023

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Let’s get it out there at the start: this is one wild and crazy book. It is built on a fictionalized account of a meeting that actually took place between the literary critic Harold Bloom and Benzion Netanyahu, the father of the current Prime Minister of Israel. Around this seemingly nondescript event, Joshua Cohen has created an amalgam of at least five simultaneous narratives packed into 237 antic pages.

First, there is the story of the uneasy life of an assimilated Jewish academic, Ruben Blum, the much less illustrious stand-in for Harold Bloom. He is trying to find domestic tranquility and career advancement while teaching in the history department at a small liberal arts school, Corbin College, without completely submerging his Jewish identity.

Then there is the family saga. Ruben’s wife, Edith, is bored in the boondocks. His daughter Judy, who aspires to get admitted to a top tier university (anything but Corbin), is totally focused on getting plastic surgery on her unsatisfactory nose. Blum’s in-laws, who are affiliated but barely practicing Jews, visit the Blums for Rosh Hashana and express their disappointment that Ruben is raising his family so far from the New York City metropolis. Ruben’s parents, who are more observant, visit the Blums for Thanksgiving. The visit deteriorates into the usual family squabbling and miscommunication, and ends on a macabre, comic note. Judy agrees to a day outing with her grandfather but is not ready at the appointed time. Her grandfather knocks on her bedroom door and Judy yells that it is stuck; he then rams the door open with his shoulder and the swinging doorknob smashes right into Judy’s nose, a convenient rhinoplasty (imagine another author who would have the chutzpah to use a classic anti-Semitic trope in such a hilarious way).

Now add a tale of academic intrigue and infighting. Blum’s life becomes complicated when he is asked to chair the search committee that is charged with the decision whether Corbin College should hire Benzion Netanyahu, an unknown Jewish scholar. Blum has to navigate the difficult passage between an objective assessment and satisfying what he thinks the administration wants him to do. Cohen captures the power dynamic of faculty meetings and visiting lectures with all their bombast and jockeying for position.

Next, fold in a robust novel of ideas. Blum reads lengthy letters of recommendation written by Netanyahu’s peers in support of or in opposition to his application for a faculty position. Netanyahu’s lecture outlines his thesis on the origins of antisemitism and the critical turn towards a racial definition that arose in the wake of the Spanish Inquisition. Of course, the story of antisemitism cannot be divorced from a dark reading of Jewish history. This is all based on academic work of the real Benzion Netanyahu.

Finally, there is the clashing cultures story as the Netanyahu family deals with the snow and cold winter weather in upstate New York and living in close quarters with Americans who they barely understand. The climax of the book involves an overheated adolescent encounter between Judy and Yonatan Netanyahu, the future Israeli hero who will be killed in the 1976 raid that rescued the hijacked hostages in Entebbe. Benjamin (Bibi), the Israeli Prime Minister, also runs across the pages of this fanciful novel but there is no intimation of what fate has in store for him 60 years in the future.

The Netanyahus is a raucous unpredictable book, one that that in all likelihood will not be comparable to anything you have read before."

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All Our Names

Mengestu, Dinaw

Last Updated: Mar-30-2023

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

All Our Names is a novel built around two overlapping but non-parallel narratives. In one, Isaac, a young man, has recently arrived in the United States from Uganda where he had moved from his rural village to study literature at a university in Kampala. After a few complicated years in Kampala, he appears unannounced in the small town of Laurel in the Midwest with not much more than the shirt on his back. The explanation for his sudden arrival will emerge over time. Helen, a young social worker, is assigned to his case, and despite their cultural dissonance, they fall deeply in love. Their physical and social disparities serve as strong attractive forces, like the opposite poles of a magnet. There are obstacles to their relationship -- their own inherent human weaknesses, the ingrained racism of the Laurel community, and the mystery surrounding the Isaac’s past. They are both smart but lonely people who are uncertain about how open they can be about their relationship, whether they can be seen holding hands while walking the streets or even sharing a cup of coffee in a café.

The second narrative details Isaac’s friendship formed in Africa with a fellow student at the university and their gradual but inevitable involvement in the armed rebellion against the corrupt regime governing their country. There is miscommunication and violence in both narratives. They end with separation of the partners – the social worker and the immigrant and the two African men, one who stays in Africa and meets his tragic end there and the other who comes to America

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Our Missing Hearts

Ng, Celeste

Last Updated: Mar-21-2023

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Celeste Ng’s Our Missing Hearts is set in the not-too-distant future, in the wake of the Crisis that has ineradicably altered American society. After several years of steadily worsening economic downturn and hardship, there is slowly escalating social unrest. Random political violence erupts across the country. A protester is killed and public opinion is inflamed. In the press and social media, China is blamed for the turmoil. This unleashes a wave of discrimination and persecution of Asian Americans. Emergency laws are passed to restore order and to penalize Asian Americans and their sympathizers for purported anti-American behavior. A punitive program is implemented to remove children from parents who are viewed as enemies, real or potential, to the state.

The story centers on a precocious 12-year-old boy, Bird Gardner. His mother, Margaret Miu, of Chinese ancestry, is a little known poet who wrote a slim volume of poems several years before the social fabric began to fray. Without her knowledge, one of the poems, “Our Missing Hearts”, has been adopted as a literary slogan by an underground anti-government resistance movement She is targeted by anti-Asian extremists and harassed by law enforcement. Rather than have her son “replaced,” the government euphemism for removing children from families deemed disloyal and putting them into foster care, she makes the wrenching decision to abandon him and the husband she loves dearly and goes into hiding for three lonely years. She is haunted by the pain of all the removed children and devises an act of protest. It is modeled on the public works created by current Chinese artists using gunpowder and other unusual materials. Her goal is to increase awareness and hopefully termination of the “replacement” program. Her hope is to trigger mass protest and the return of the removed children to their grieving families. The narrative moves inexorably to an unbearably sad ending.

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Tomorrow and Tomorrow and Tomorrow

Zevin, Gabrielle

Last Updated: Dec-12-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Among the many binaries that can be used to describe people, an easily observable one is how seriously they take the games they play. There are those who play basketball or Scrabble to simply relax and enjoy the camaraderie of their playmates. And then there are others for whom games are invested with considerably more significance, where winning in rotisserie baseball or a golf match becomes a statement about their core values, the meaning of life itself. Gabrielle Zevin’s wonderfully engaging novel, Tomorrow and Tomorrow and Tomorrow, is dedicated to those who proudly include themselves in the latter category.

The novel spans nearly thirty years and centers on three exquisitely drawn characters who are brilliant and appealing and whose raison d’etre is to design and promote the best computer games. Sam and Sadie are intellectual outliers from vastly different backgrounds. Sam’s Korean single parent mother is an actress wannabe, and he is actually raised by loving grandparents who own a pizza store in Koreatown in Los Angeles, while Sadie grows up in a supportive family of high achieving professionals. They meet by chance while Sadie is in junior high school. As part of her required community service, she visits Sam while he is hospitalized to treat a horrific leg injury (I am leaving out crucial details about how that happened). Sadie is drawn to Sam – her more than 900 hours of visits break the record of service time donated – and he in turn is able to overcome the chronic pain he endures and to open himself up to someone else.

A genuine bond is forged between the young adolescents that resurfaces a few years later when they bump into each other unexpectedly in a Cambridge subway station. Sam is a student at Harvard and Sadie is studying at MIT. They are both computer geniuses and in the early 1990s there is no better way to leverage their knowledge than to design innovative and complicated computer games. They are able to program games that combine literary structure, musical background, and state-of-the-art color graphics in the service of a narrative environment that challenges the intelligence and sustains the interest of the player. Joined by a common friend, Marx Watanabe, Sam’s roommate at Harvard, who becomes their devoted and creative producer, they develop a game called Ichigo, a tale of a child lost at sea who must find his/her (a key part of the game) way home. The game is based on the famous wood block print, “The Great Wave” by Hokusai and becomes an international bestseller. They are vaulted into the world of the rich and famous.

The novel chronicles their professional struggles over the following decade to maintain the same high level of creativity and mass appeal. Conflicts arise about assigning credit for their creations and dividing up the public accolades and recognition. There are the expected strains that are bound to develop in such a closely knit team of creative collaborators who are working 24-hour days to meet unrealistic production deadlines. And of course, there are complicated interpersonal relationships that develop that in such a high-pressure workplace. There is true joy, but it is always mixed with intense feelings of envy and nostalgia for simpler times. Other partners and love interests enter the story. But among this intriguing cast of characters, Sam is singularly complex, and his leg injury and chronic disability are crucial elements in the plot; he suffers from severe phantom limb pain and ultimately he is forced to have his damaged lower leg amputated. How he copes with his disability, real and imagined, alters the arc of the story to a significant degree. Sam cannot escape his feelings of being an outsider, even as he feels himself drawn to Sadie. The imaginary computer game world leaks into reality. Violence dramatically intervenes in the story and ineradicably alters the course of events (no spoiler alert). The novel that focuses on the creation of a virtual reality has a lived-in texture and fullness. I anticipate that most readers will find the ending to be satisfying, an exquisite expression of the complexity of human fate and interpersonal relationships.

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Wayward: A Novel

Spiotta, Dana

Last Updated: Sep-29-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Dana Spiotta is one of my favorite authors, so I was poised to read her latest novel, Wayward, when it was published last year. As expected, it captures the zeitgeist perfectly and is marked by Spiotta’s wide-ranging wisdom, versatile knowledge, and literary creativity.

The book takes place in Syracuse shortly after the election of 2016 (although Donald Trump is never mentioned by name). Sam, the central character in the novel, feels caught in an increasingly unsatisfying marriage. Triggered by her post-election anxiety, she abruptly decides to leave her husband Matt and daughter Ally. On a whim, she purchases a rundown old-style house in a poor neighborhood in Syracuse and moves in to live as a 53-year-old woman on her own, intent on starting a new life. Matt is disconcertingly understanding and supportive, but Ally cannot abide her mother’s abandonment of the family. It is an unwanted distraction from her single-minded devotion to excel in high school and to go to a top-tier college.

Sam works as a volunteer near her new home at a historical site that is dedicated to Clara Loomis, a fictional woman who left her family (shades of Sam!) to join the Oneida community, an egalitarian retreat based on equality between the sexes but also fuzzy notions of eugenics and human breeding. Sam works her way through some edgy women’s groups in search of friendship. She tries to mingle with her neighbors, who are quite different than the people she encountered in her suburban environment. But Sam’s life is complicated. She realizes that her mother, a self-sufficient creative 80-year-old woman, is probably dying from an undisclosed illness. She feels increasingly distant from the daughter that she loves so intensely, a problem that her defection to the inner city has only made worse. And Ally has her own precocious story, a secret life, which is told from her perspective, but which is tightly linked with her mother’s narrative of inner growth.

Sam witnesses a police shooting of a Black adolescent, an immigrant from Somalia, while walking near her house during a restless night. While Sam struggles to find a way to articulate what she saw and help achieve some degree of justice for the victim, she experiences an unexpected “assault.” No spoiler alert, except to say that the ending gathers the narrative stands together and is quite satisfying. It is grand in scope and affirms the value of simple human endurance.

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Behold the Dreamers

Mbue, Imbolo

Last Updated: Jul-05-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In the basement of the apartment building where I live, down the hall from the small exercise room, there are two plain wooden bookcases. Each one has five shelves, and they are filled to overflowing with books that people have finished reading and that are now available for the taking. The books cover the gamut of fiction to history to self-help and everything in between. Under pressure to unclutter our apartment, I have added about 30 books to this library. The books do not come with any recommendation and so there is no way to know if the original owners liked the book or got rid of it because they could not get passed the first chapter. I am a frequent borrower. About two weeks ago, I scanned the shelves again and on one of the lower shelves, I noticed this book by Imbolo Mbue. I remembered that one of her books had been selected by the editors of the New York Times as one of the Best Books of the year 2021 so I picked up this earlier book. Two weeks later, I am here to report that I am glad I did.

The novel is a moving story of two families whose fates get intertwined in the year 2008. One family is a couple, Jende and Neni Jonga, with their 6-year-old son. They have recently come to the United States from Cameroon. They chose to try their luck in New York in the hope of escaping the dreary life that they see in their future if they stayed where they were. The other family, Clark and Cindy Edwards, is a wealthy couple living in a posh apartment on the upper East Side of Manhattan. They seem to have it all -- health , wealth, and the freedom to do whatever they want. Clark is a high-level executive at Lehman Brothers, and he interviews Jende for a job as his chauffeur in the opening chapter. Jende gets the job, and it is a game changer for the Jongas. It gives Jende the self-confidence that he is a traditional provider for his family and allows Neni to enroll in school and actualize her goal of becoming a pharmacist. For both of them, they can feel more comfortable with the idea of a growing family. They have received their ticket to the American dream.

However, while the Edwards are the picture of success to all who see them at the glamorous parties and fund raisers they host and attend, there are cracks beneath the surface of their dream life. Clark is working 16-hour days to try to stave off the imminent bankruptcy of Lehman and the financial collapse that will follow in its wake. Cindy is a psychologically traumatized person who struggles to keep her family whole and provide a loving and safe haven for her two sons. Ultimately, Clark is forced to leave Lehman and take up a job at Barclays Bank. His wife suspecting infidelity ultimately succumbs to drug and alcohol abuse. The Jendes lose their financial footing and are forced to confront the question -- where will they be best able to live wholesome lives of meaning and self-worth? They have to decide whether to persevere and try to make things work in New York or whether to return to their native country, Cameroon. The book ends with a question from the Jongas’ older son to his parents, “Home?” Mbue artfully asks this same question to her readers.

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The Dawn of Everything: A New History of Humanity

Graeber, David; Wengrow, David

Last Updated: Jun-09-2022

Trachtman, Howard

Primary Category: Literature / Nonfiction

Genre: History and Social Sciences

Summary:

In this age of intellectual sub-sub-sub-specialization, it would be unfair to say that people have completely abandoned grand narratives in their discipline. There are still brave souls who are willing to take on the big picture and try to synthesize what is known in their field as well as allied areas into a cohesive all-encompassing story. Stephen Pinker is a prominent example of someone who has leveraged his expertise in psychology and linguistics to fashion upbeat histories of humanity. But it would be fair to say that it is unusual to encounter a book that takes on the world and confidently asserts, “I think you have it all wrong.” To possibly be correct in the claim would be rarer still. This book by Graeber and Wengrow falls squarely into that small category.

The book has a bittersweet back story that only adds to its appeal. It represents the result of a decade long collaboration between Graebner, an anthropologist, and Wengrow, an archeologist. It originally started as pure academic fun between two colleagues but quickly escalated into a serious dialogue that culminated in a book with 83 pages of notes and a 63-page bibliography. Sadly, Graeber died unexpectedly at age 59 of necrotizing pancreatitis shortly after completing the work and did not live to see its publication.

The book has attracted a great deal of attention because it takes on the accepted grand narrative of human development, namely, a linear evolution from a primordial state of innocence and equality to a society in which hierarchy and inequality are hard wired into existence. The key step in this transition is the move from small groups of hunter-gatherers to agriculture-based groups that gradually grew in size and became more centralized in structure. This resulted in the prioritization of private property and the consolidation of the population into cities that mandated top-down control. Regardless of whether you invoke Rousseau as your intellectual guide or Hobbes as your rationalization for a powerful sovereign state, the traditional view is that you will reach the same endpoint, the loss of equality. Graebner and Wengrow challenge this “myth.” Their operational method is to examine the scientifically sophisticated data that have been gathered by archeologists from prehistoric sites around the world. They conclude that the prevailing view shortchanges human inventiveness in framing how people have chosen to live and undermines our freedom to reconsider the way society is organized. As an example of the scope and originality of the book, in the second chapter, they argue that this Enlightenment notion of “noble savages” and steady linear progress may have arisen among the French intelligentsia in the 18th century in response to the interaction of North American Indians with the French in the New World. Heady stuff that you thought you would not have to think about after college.

The book is loaded with facts and details about burial grounds, temples, houses, and playing fields that archeologists and anthropologists use as the ground truth in their work. They document how there was great variability and fluidity in social structure over course of the year in prehistoric times, demonstrating that though men and women could not control their environment they could do their best to adapt by alternating between planting and food gathering before there were “farms.” In contrast to the view that agricultural groups, with their need for defined plots of land, created the notion of private ownership, they cite real world evidence from places as far flung as Poverty Point in Louisiana to the Australian Western Desert that the sacred realm was the origin of individual possession. They contrast in great detail the lifestyles of communities living along the west coast of North America, in the region from Washington State to northern California. The evidence is clear that while the northern communities were hunter gatherers, patriarchal, more warlike, and more ostentatious, those in the south were characterized by a less showy land-based public sphere and a more peaceful demeanor that was reflected in a greater role of women in defining the activities of daily living and social structure. The communities were not isolated and had contact with one another, underscoring the fact that the ways of life were active choices and not passive default modes. The start of farming was gradual over thousands of years and was not a revolutionary change, and prehistoric communities could switch their mode of sustenance in the face of changing circumstances.

I will not have to take a final examination on the book so I cannot say that I can repeat the names of all the Amerindian communities living in middle America along the Ohio and Mississippi Rivers or recount the details of all the artifacts of and rites performed by the Mesoamerican civilizations. Graebner and Wengrow discuss an incredible number and variety of archeological sites throughout Eurasia and Africa, in addition to those in the New World, so I have to take the authors’ recitation of the facts on faith. I am sure that some of their interpretation is open to question by experts in the fields. But Graebner and Wengrow will certainly get you thinking.

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When We Cease to Understand the World

Labatut, Benjamin

Last Updated: May-09-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Historical Fiction

Summary:

When we think of genetics and pedigrees, we expect our traits and characteristics to be passed down in a predictable pattern from parents to children. In his book Far From the Tree , Andrew Solomon labels this transmission from one generation to the next as vertical identity. However, his book focuses on circumstances where inheritance follows what he calls a horizontal pattern. In these cases, the offspring have an inherent or acquired trait that is foreign to their parents. They land far from the anticipated spot under the tree canopy and are dramatically different from their parents. He or she must acquire their identity from a peer group that is outside the parents’ experience. One chapter in Solomon’s book focuses on genius as seen through the lens of the violinist Joshua Bell and his family. Most of us would gratefully welcome a child of genius whether in science, architecture, or music and embrace the apple that landed far from the tree. Reading Benjamin Labatut’s riveting book might cause you to rethink this thought experiment.

Nothing will quite prepare you for the literary world that Labatut has invented. It is a unique blend of fact and fantasy, an incremental layering of fictional conceits on known historical details. A stream of people from history pass through the book, some deservedly famous and others more obscure. But all of them are possessed of genius. All of the characters lived through the turbulent first third of the 20th century when quantum mechanics revolutionized the traditional understanding of physics. They confronted the challenge that this new knowledge presented to the grand view that people had held about how the universe was designed and operated.

The book opens with Fritz Haber, whose research on nitrogen fixation chemical reactions provided the basis for the production of fertilizers, pesticides and explosives. Haber’s work had diametrically opposite effects on the course of history. On the one hand, he enabled dramatic increases in agricultural crop yields and prevented global hunger. At the same time, his discoveries increased the carnage in World War I and yielded compounds that led to innumerable deaths by asphyxiation in the trenches in no-man’s land and, later, in the Nazi death camps. There is Karl Schwarzschild who was able to solve Einstein’s equations in the general theory of relativity while fighting in the German front lines during World War I. He identified the potential existence of black holes, Schwarzschild singularities, long before Stephen Hawking made them famous. Alexander Grothendieck, considered the most influential mathematician of the last hundred years, also passes through the pages of Labatut’s book. After an extraordinarily creative career in which he totally upended established concepts in geometry and number theory and other mathematical fields, he ended up abandoning his life’s work. He devoted himself to Buddhism and, retreating to a secluded village in the Pyrenees, he lived out his last years alone and unrecognized. Erwin Schrodinger is forced to enter a Swiss sanatorium to convalesce from tuberculosis. While there, under the influence of a teenage girl similarly afflicted with tuberculosis, he derives his wave equation and the Psi function to explain the wave-particle duality of light and matter. Even Schrodinger is perplexed by this discovery. He cannot reconcile himself fully to the truths of quantum mechanics and spends the rest of his scientific life trying to unify it with Einstein’s Theory of General Relativity. Finally, towering over the narrative is Werner Heisenberg. He agonizes over the discrepancy between the Newtonian physics that he has learned in the university and what he is uncovering in his research into the subatomic realm. He is overcome in a semi-mystical vision and articulates the uncertainty principle. Heisenberg realized that his matrix mathematics put an end to the stable universe created by the Enlightenment in which everything is governed by rational laws of nature and observable cause and effect.

By focusing on these men (sadly, not a woman among them) of uncommon genius, Labatut vividly illustrates how the gift of deep insight drives intense scientific creativity but also agonizing psychic pain. It is as if the awareness of hidden truths is inextricably linked to human suffering. This summary may sound pedantic and unbearably heavy. Only if you enter into Labatut’s unique literary space will you appreciate the inventiveness and intelligence of this overpowering book, all 191 pages of it. It is well worth the trip.

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The Genetic Lottery: Why DNA Matters for Social Equality

Paige Harden, Kathryn

Last Updated: Mar-28-2022

Trachtman, Howard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The Graduate is a movie classic from what seems like a bygone era. It is accompanied by great music by Simon and Garfunkel and has one of the most famous one-word lines in cinema history. When Benjamin Braddock is wandering aimlessly around the pool at a graduation party thrown in his honor, a friend of his parents asks him what he plans to do with his post-collegiate life. Another family friend jumps in and volunteers, “Plastics.” There are many who will also give a one-word answer to any medical school graduate searching for a career – Genetics.

In this important new book, Kathryn Harden provides staunch support for the key role of genetics in health, disease, and in human well-being. She provides a remarkably clear primer on genetics in accessible language. Harden begins with statistical issues like the normal distribution and Bayesian priors. In her capable intellectual hands, she uses analogies that effectively move the teaching agenda forward. With recipes as a framing image for genetics, she demonstrates the relationship between the coding material in the DNA nucleotide sequence and the actual building blocks, namely the proteins that do the heavy lifting inside cells. Concepts like genetic recombination, linkage disequilibrium, and monogenic versus polygenic disorders are introduced and make perfect sense. She then builds on this foundation to consider genome-wide association studies (GWAS) which represent the powerful tool that has been introduced to explore the relationship between genetic endowment and health. That is where things start getting complicated.

When people think of medical genetics, they usually have classical Mendelian disorders in mind. They are caused by mutations in a single gene that disrupts a protein pivotal to normal health. Examples are sickle cell disease, hemophilia A, or muscular dystrophy. However, many health problems like hypertension that are associated with significant global disease burden are polygenic. This means that they are caused by less dramatic mutations in a number of genes that in the aggregate lead to the disease. Harden details how quantitative assessment of the contribution of these minor variations in a large array of discrete genes enables the formulation of polygenic risk scores (PRS) for these conditions. These measures provide estimates of susceptibility to developing other polygenic conditions like obesity, cardiovascular disease, and diabetes.

As a psychologist, Harden’s work focuses on the application of PRS to non-medical aspects of human behavior such as impulsivity, attentiveness, job satisfaction, and executive function. The waters remain relatively calm until Harden’s fellow psychologists venture into the realm of educational achievement and lifetime income status. Harden methodically reviews relevant studies that have been done with siblings, twins, adoptees, and family trios. She dissects them and highlights when investigators have misinterpreted their data. There is a steady drumbeat of data, almost too much at times. But the overall consensus that emerges is that PRS and other measures of heritability continue to show a genetic component for these psychosocial outcomes in large population studies. The challenge that Harden raises is how to incorporate this knowledge about genetics into a better understanding of these aspects of human behavior and if and how to address abnormal manifestations.

Questions remain concerning how genetics “causes” these changes and how to interpret the findings. What is determinative? Is it genetics i.e., nature, or is it all environment i.e., nurture? There are those, like Harden, who advocate for thoughtful analysis and utilization of all the GWAS data. She highlights the difference between use of PRS to assess outcomes within populations versus between populations. In sharp contrast, there are others who resist the introduction of genetics into psychology. Pointing to the sordid history of eugenics and its degeneration into the creation of racial hierarchies, the opponents of the Harden’s work dismiss it as unscientific at best and destructive at worst. Harden makes a compelling case for the validity of the science and a spirited defense of the thoughtful use of genetics dismiss it as unscientific at best and morally repugnant at worst.

Harden provides a strong defense of the science and statistical methods and offers a spirited argument that without acknowledging the role of genetics in human achievement, society will be unable to thoughtfully address inequalities and restore balance. Her work touches on many other pressing issues including human autonomy, agency, freewill and the role of government intervention. She outlines a social agenda that acknowledges the importance of genetics as a contributing factor. But it incorporates a recognition that its distribution in the population is solely a matter of luck and does not serve as the basis for a hierarchy of human worth. I leave it to readers to judge for themselves the validity of her proposals, but her commitment to making this world a better place is not in question.

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