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IN PAIN

A BIOETHICIST’S PERSONAL STRUGGLE WITH OPIOIDS

A harrowing cautionary narrative that speaks to patients and physicians alike on the ugly reality of the enduring opioid...

A debilitating accident prompts a man’s descent into opioid dependence.

Rieder (Toward a Small Family Ethic, 2016, etc.), the assistant director for Education Initiatives at the Johns Hopkins Berman Institute of Bioethics, retraces the aftermath of a traumatic 2015 accident that shattered his foot and forced him to endure six grueling surgeries. Eventually, the author was sent home with a stockpile of opioid painkillers for his excruciating pain. Rieder doesn’t skimp on the grisly post-surgical details, including “the boiling pain of carved tissue” or how “coming out of anesthesia was basically the process of discovering how awful it was to be conscious.” Sprinkled among the chronological chapters of his recovery are fascinating sections in which the author discusses the historical narrative of opioids, racial differences in pain assessment, and the intricate mechanics of physical pain, that “fiery, boiling, acidic” suffering that Rieder knows well. As he recovered, his physician advised him to wean himself off the high doses of oxycodone he was taking. The author describes weeks of agonizing withdrawal symptoms, including insomnia, nausea, cold sweats, and terrifying emotional darkness, which, as a new father to a young daughter, left him unable to care for her at home. Though he fortunately overcame his opioid dependence, Rieder believes he is one of the lucky ones and that improved withdrawal management and behavioral intervention programs must be mandated in hospitals to “help patients escape the grip of this medication.” Later in the book, the author takes a critical detour to skillfully address the primary challenge facing opioid-prescribing physicians: initiating dependency while dutifully attempting to alleviate severe patient discomfort. Rieder recognizes in himself—and others, including his mother, who had knee replacement surgery—the dilemma facing the medical community: treating patients in pain with dangerously addictive medications responsible for killing thousands yearly. With this smart, riveting, real-life account, the author proves himself a convincing and effective advocate for opioid use reform.

A harrowing cautionary narrative that speaks to patients and physicians alike on the ugly reality of the enduring opioid epidemic.

Pub Date: June 18, 2019

ISBN: 978-0-06-285464-3

Page Count: 320

Publisher: Harper/HarperCollins

Review Posted Online: March 24, 2019

Kirkus Reviews Issue: April 15, 2019

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NIGHT

The author's youthfulness helps to assure the inevitable comparison with the Anne Frank diary although over and above the...

Elie Wiesel spent his early years in a small Transylvanian town as one of four children. 

He was the only one of the family to survive what Francois Maurois, in his introduction, calls the "human holocaust" of the persecution of the Jews, which began with the restrictions, the singularization of the yellow star, the enclosure within the ghetto, and went on to the mass deportations to the ovens of Auschwitz and Buchenwald. There are unforgettable and horrifying scenes here in this spare and sombre memoir of this experience of the hanging of a child, of his first farewell with his father who leaves him an inheritance of a knife and a spoon, and of his last goodbye at Buchenwald his father's corpse is already cold let alone the long months of survival under unconscionable conditions. 

The author's youthfulness helps to assure the inevitable comparison with the Anne Frank diary although over and above the sphere of suffering shared, and in this case extended to the death march itself, there is no spiritual or emotional legacy here to offset any reader reluctance.

Pub Date: Jan. 16, 2006

ISBN: 0374500010

Page Count: 120

Publisher: Hill & Wang

Review Posted Online: Oct. 7, 2011

Kirkus Reviews Issue: Jan. 15, 2006

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INTO THE WILD

A wonderful page-turner written with humility, immediacy, and great style. Nothing came cheap and easy to McCandless, nor...

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The excruciating story of a young man on a quest for knowledge and experience, a search that eventually cooked his goose, told with the flair of a seasoned investigative reporter by Outside magazine contributing editor Krakauer (Eiger Dreams, 1990). 

Chris McCandless loved the road, the unadorned life, the Tolstoyan call to asceticism. After graduating college, he took off on another of his long destinationless journeys, this time cutting all contact with his family and changing his name to Alex Supertramp. He was a gent of strong opinions, and he shared them with those he met: "You must lose your inclination for monotonous security and adopt a helter-skelter style of life''; "be nomadic.'' Ultimately, in 1992, his terms got him into mortal trouble when he ran up against something—the Alaskan wild—that didn't give a hoot about Supertramp's worldview; his decomposed corpse was found 16 weeks after he entered the bush. Many people felt McCandless was just a hubris-laden jerk with a death wish (he had discarded his map before going into the wild and brought no food but a bag of rice). Krakauer thought not. Admitting an interest that bordered on obsession, he dug deep into McCandless's life. He found a willful, reckless, moody boyhood; an ugly little secret that sundered the relationship between father and son; a moral absolutism that agitated the young man's soul and drove him to extremes; but he was no more a nutcase than other pilgrims. Writing in supple, electric prose, Krakauer tries to make sense of McCandless (while scrupulously avoiding off-the-rack psychoanalysis): his risky behavior and the rites associated with it, his asceticism, his love of wide open spaces, the flights of his soul.

A wonderful page-turner written with humility, immediacy, and great style. Nothing came cheap and easy to McCandless, nor will it to readers of Krakauer's narrative. (4 maps) (First printing of 35,000; author tour)

Pub Date: Jan. 1, 1996

ISBN: 0-679-42850-X

Page Count: 320

Publisher: Villard

Review Posted Online: May 19, 2010

Kirkus Reviews Issue: Oct. 15, 1995

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