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DEATHS OF DESPAIR AND THE FUTURE OF CAPITALISM

An alarm every bit as urgent as The Jungle and a book that demands immediate attention.

Noted Princeton economists Case and Deaton, a winner of the Nobel Prize, examine the effects of income and educational inequality on public health. As Beth Macy’s Dopesick carefully chronicled, there is a disease afoot in the land, born of economic anxiety, manifested in addiction and self-destruction. Building on a Brookings Institution paper of 2017, Case and Deaton give a name to this epidemic. In 1900, they write, the leading causes of death were infectious diseases such as tuberculosis and cholera. Writing before the unexpected onset of COVID-19, the authors mark the current leading causes as heart disease and cancer. However, especially among the poor and those without a four-year college degree, “the risk of dying in midlife from suicide, accidental drug overdose, or alcoholic liver disease” is markedly higher than in better-educated and more affluent cohorts. Thus the “deaths of despair” of the title, self-inflicted and generationally bound—for, as the authors note with grimly precise data, the chance of such a person’s dying at age 45 in 1960 were half again as high as in 1950, and in 1970 more than twice as high as in 1960. “The later you were born,” they conclude, “the higher your risk of dying a death of despair at any given age.” The epidemic of deaths of young people today to gunshot, cirrhosis, fentanyl and opioid overdosing, and such causes is sober testimonial to the authors’ mathematical reasoning. Non–college educated whites born in 1980, the authors write, are four times more likely to commit suicide as their college-educated white cohorts. Interestingly, the epidemic is not affecting other ethnicities in nearly the same numbers. What has affected nearly every group, however, is another manifestation of despair: obesity, which yields pain and often self-medication, especially among “those who are not at the top.” An alarm every bit as urgent as The Jungle and a book that demands immediate attention.

Pub Date: March 17, 2020

ISBN: 978-0-691-19078-5

Page Count: 312

Publisher: Princeton Univ.

Review Posted Online: April 5, 2020

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WHEN BREATH BECOMES AIR

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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ONE DAY, EVERYONE WILL HAVE ALWAYS BEEN AGAINST THIS

A philosophically rich critique of state violence and mass apathy.

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An Egyptian Canadian journalist writes searchingly of this time of war.

“Rules, conventions, morals, reality itself: all exist so long as their existence is convenient to the preservation of power.” So writes El Akkad, who goes on to state that one of the demands of modern power is that those subject to it must imagine that some group of people somewhere are not fully human. El Akkad’s pointed example is Gaza, the current destruction of which, he writes, is causing millions of people around the world to examine the supposedly rules-governed, democratic West and declare, “I want nothing to do with this.” El Akkad, author of the novel American War (2017), discerns hypocrisy and racism in the West’s defense of Ukraine and what he views as indifference toward the Palestinian people. No stranger to war zones himself—El Akkad was a correspondent in Afghanistan and Iraq—he writes with grim matter-of-factness about murdered children, famine, and the deliberate targeting of civilians. With no love for Zionism lost, he offers an equally harsh critique of Hamas, yet another one of the “entities obsessed with violence as an ethos, brutal in their treatment of minority groups who in their view should not exist, and self-­decreed to be the true protectors of an entire religion.” Taking a global view, El Akkad, who lives in the U.S., finds almost every government and society wanting, and not least those, he says, that turn away and pretend not to know, behavior that we’ve seen before and that, in the spirit of his title, will one day be explained away until, in the end, it comes down to “a quiet unheard reckoning in the winter of life between the one who said nothing, did nothing, and their own soul.”

A philosophically rich critique of state violence and mass apathy.

Pub Date: Feb. 25, 2025

ISBN: 9780593804148

Page Count: 224

Publisher: Knopf

Review Posted Online: Dec. 14, 2024

Kirkus Reviews Issue: Jan. 15, 2025

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