An impassioned indictment of a broken system and its enablers and necessary reading as the pandemic intensifies.
The award-winning Yale historian launches a broadside against the American health care system.
“The day that had just begun, December 29, 2019, could have been my last.” So writes Snyder about his hospitalization and subsequent poor treatment over the next few months, experiences that left him enraged at the state of health care in America. “In five hospitals over three months,” the author found himself with a front-row seat to the beginnings of the coronavirus pandemic. He took detailed notes during his time as a patient, and he clearly shows a health care system far more interested in profits than health, a system that follows the dictates of computers and algorithms rather than any one-to-one relationship between doctor and patient. Snyder delivers a scathing critique of this “grotesque” and “ludicrous” system as well as a government response to the pandemic that he dismisses as “magical thinking.” Indeed, the Trump administration’s “unwillingness to test did not mean that we were healthy, only that we were ignorant,” and the “focus on a foreign source of ‘fault’ meant that no one here was to blame. When no one bears responsibility, no one has to do anything.” The author meticulously documents the health problems he suffered—among many others, a burst appendix, tremors, and “an abscess the size of a baseball in my liver”—seemingly all of which were ignored or misdiagnosed by doctors. Snyder compares the impersonalized, economy-driven care he received in American hospitals with the far more nurturing treatment he and his wife had experienced during a childbirth in Austria, a procedure that was both “intimate and inexpensive.” Ultimately, writes the author, “our botching of a pandemic is the latest symptom of our malady, of a politics that deals out pain and death rather than security and health, profit for a few rather than prosperity for the many.”
An impassioned indictment of a broken system and its enablers and necessary reading as the pandemic intensifies.Pub Date: Sept. 8, 2020
ISBN: 978-0-593-23889-9
Page Count: 192
Publisher: Crown
Review Posted Online: July 13, 2020
Kirkus Reviews Issue: Aug. 1, 2020
A deeply learned dive into the frightening visions of technocrats past and present.
The noted historian and New Yorker staffer looks into a future ruled by machines.
Thirty-odd years ago, writes Lepore, liberal democracies of old were being transformed into both authoritarian or autocratic regimes and by “automatocracy, rule by automation, government by machine-driven computation, prediction, and persuasion.” In this pointed rejoinder to Hannah Arendt’s Origins of Totalitarianism (1951), which foresaw a world in which humans were essentially superfluous, Lepore charts a long history that extends deep into the “machine age,” beginning in the 17th century, which saw “the artificial as existing not only outside the natural but above it, an improvement upon it.” In this conception, humans were fallible, while machines faithfully and unfailingly obeyed the rules set for them. A logical progression followed in the 1920s with the rise of the Technocracy movement, a variety of fascism widely accepted in the U.S. that held that far from being free and equal, humans should be governed by scientists and engineers who alone “have the intelligence and education to understand the industrial operations that lie at the heart of twentieth-century life.” It’s a short hop from there to the present, with tech billionaires pushing AI and, in the case of the influential “self-described ‘neo-monarchist’” Curtis Yarvin, a dictatorship aided by it. In all this, Lepore writes, it is not just the human animal that suffers but all animals and all habitats, which can only worsen with the incessant demands for energy, rare earths, and water that AI requires. And what “humans crave, in that artificial world, is nature,” a nature that is increasingly silenced. This undemocratic world, benefiting only the wealthy at the expense of all else, is a prison of screens and keyboards from which, she writes memorably, “What is required is to imagine an escape, and then to conduct it.”
A deeply learned dive into the frightening visions of technocrats past and present.Pub Date: Aug. 25, 2026
ISBN: 9781324098423
Page Count: 320
Publisher: Liveright/Norton
Review Posted Online: May 18, 2026
Kirkus Reviews Issue: June 15, 2026
PERSPECTIVES
PERSPECTIVES
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
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
PERSPECTIVES
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