Reading time: 8 minutes
Never trust anyone who has not brought a book with themLemony Snicket
Indeed, reading 82 books this year was only possible by bringing them with me wherever I went.
I read while I scarfed down oatmeal in the morning. I read during the last few waking moments of each day. I read whenever I received even a modicum of downtime at work, to both pass the time and fill my head with yet more knowledge.
Surely there is some degree of admiration that accompanies the distinction of reading a large amount of books in a single year.
Finding time to read consistently when so many stimuli vie for our attention is perhaps an accomplishment in itself. Compared to the seemingly endless hits of dopamine proffered by one’s Facebook, Twitter, or Instagram feed, reading can appear unfulfilling and altogether lifeless.
The dangers of social media notwithstanding, the practice of reading can help substantially to improve our ability to comprehend the beliefs and desires of others, promote empathy, encourage civic participation, and lower the risk for dementia.
Among the 82 books I read this year are some that have radically shaped my thinking about the progress of our species, the organization and stratification of modern civilization, and the role I endeavor to embody in society as a physician.
The economist Tyler Cowen calls such revelatory texts “quake books,” as they shake the epistemological foundations of one’s views and ideas.
Fissures form between a rigid world of unchallenged assumptions and biases, and a dynamic arena in which cherished beliefs and schemata face the scrutiny of evidence and inquiry.
Those quake books in 2018 included,
Sapiens, Yuval Noah Harari
Bullshit Jobs, David Graeber
Being Mortal, Atul Gawande
Elon Musk, Ashlee Vance
Leonardo da Vinci, Walter Isaacson
Ready Player One, Ernest Cline
A fair warning: this 443-page tome might turn you into a nihilist, a vegan, and an atheist.
In combining insights from anthropology, economics, history, political science, and sociology, Yuval Noah Harari presents a number of revelations about the evolution of our species and the constituents of modern society.
Members of Homo sapiens surely possess dominion over our planet, but, as Harari asserts, are not the only animals on Earth that matter. The high degree of intelligence and consciousness we enjoy resulted from the serendipity of natural selection.
Our elevated position in the animal kingdom, thus, is anything but deterministic. Simply put, we are bipedal apes with well-developed prefrontal cortices and an incredible capacity for language.
Sapiens captures the fundamental social constructivism that constitutes human culture as well as the lack of inherent purpose or meaning to the existence of humanity.
The following excerpt provides one compelling example:
“The American founding document promises that if humans act according to its sacred principles, millions of them would be able to cooperate effectively, living safely and peacefully in a just and prosperous society… Yet the only place where such universal principles exist is in the fertile imagination of Sapiens, and in the myths they invent and tell one another. These principles have no objective validity.”p. 108, emphasis mine
As an extension, Harari discusses “imagined orders,” which have likely existed since the inception of our species.
Given that no set doctrine carries inherent legitimacy, despite what might be claimed, members of a cooperative group agree to some collection of principles or rules, which are held to be morally just, well-reasoned, divinely inspired, or capital-T True.
So long as no one admits these orders are imagined and they are engrained in groups through successive generations of socialization and education–compulsory in most modern societies–these orders perpetuate and become almost imperceptible.
While these imagined orders have the capacity to engender great suffering and strife–the Spanish Inquisition immediately presents as one example–they have also provided for tremendous advances in quality of life among our species.
Modern-day capitalism, one of the most widespread imagined orders, has allowed millions, if not billions, of humans, to escape the vicissitudes of extreme poverty and enjoy a higher level of financial stability and well-being.
(This is to say nothing of the rapid environment degradation since the start of the Industrial Revolution or the economic and social inequities that still pervade global society.)
Despite the noted merits of free markets, the Puritan-capitalist society around which the West is largely organized is not beyond reproach.
In Bullshit Jobs, David Graeber exposes the advent of “bullshit jobs” in advanced Western economies, which he defines as work that is
so completely pointless, unnecessary, or pernicious that even the employee cannot justify its existence, even though as part of the conditions of employment, the employee feels obliged to pretend this is not the casep. 22
Laissez faire capitalism espouses the principles of efficiency and competition, yet has curiously given rise to positions that produce remarkably little value in society, if Graeber’s convictions hold true.
Among the five types of bullshit jobs are,
- flunkies, who make others or an organization appear more important, but contribute little to its value;
- e.g. social media managers
- box tickers, who perform work that merely allows an organization to say it’s doing something it’s not;
- e.g. individuals who write in-house newsletters that are read by no one
- taskmasters, who make up work for others to do;
- e.g. most supervisors
- goons, who exist because other organizations also possess goons and have a markedly negative impact on society
- e.g. corporate lawyers
The fifth type of bullshit job, duct tapers, inspired my post on medical scribes earlier this year and gave it a new hermeneutic under which to analyze this novel phenomenon in health care. Duct tapers fix problems that ought not to exist because of incompetence, negligence, or malice elsewhere in an organization.
Graeber eventually comes to advocate for anarchism as the coda of Bullshit Jobs. Dismantling the modern capitalist state might reduce the incidence of bullshit jobs, but could potentially lead to myriad problems and reduce the aggregate quality of life for humanity.
Nonetheless, the book inspired me to undertake a brief study of anarchism, in particular anarcho-primitivism, which led me to a compelling article by historian Jared Diamond entitled “The Worst Mistake in the History of the Human Race.” Recommended reading.
Few books carry as many insights or actionable steps for health care providers as Being Mortal. As a physician-in-waiting, I recommend the book to all pre-medical students as well as those already in the field of medicine. (A more complete list of recommendations exists here.)
Atul Gawande weaves a narrative from the experiences of patients facing end-of-life decisions, the history of palliative care and assisted living facilities, and recent findings about the dying process and the role played by health care providers.
In the process, Being Mortal explores the very nature of human life. How we choose to die, as well as how we let others choose to die, says just as much about how we choose to live.
Much of our subjective sense of well-being emanates from the degree of efficacy and purpose we feel. When the process of dying is better managed, not just better medicated, one is able to experience not only a good death, but a good life to the very end.
Gawande also includes three models for physician-patient relationships, first introduced by Emanuel & Emanuel (1992).
These models include,
- Paternalistic— physicians possess the critical knowledge and expertise to make the right choice for our patients, who are passive and assend to recommendations
- Informative— physicians provide vital information to patients, who are then wholly responsible for making the decision
- “This relationship works best when the choices are clear, the trade-offs are straightforward, and people have clear preferences.”
- Interpretive— physicians help patients determine what is best for them based on their values and priorities
Musk is an increasingly controversial figure and arguably an ass wipe of a human being. Despite the less appealing elements of his personality, I’ve long admired his Herculean work ethic and intense focus on prolonging the existence of humanity by combating climate change and making our species multi-planetary.
This biography, the only which Musk has authorized, showcases the extent of his determination and vision.
In his thirties, for instance, he is quoted as saying,
“If there was a way that I could not eat, so I could work more, I would not eat. I wish there was a way to get nutrients without sitting down for a meal.”
Where Musk falls short of my admiration is in his widely-reported disregard for individual humans. His focus centers on the whole of our species, putting the cart squarely before the horse.
Leonardo da Vinci
In today’s world of full-time work, corporate rat races, and fifteen-seconds of social media fame, to achieve the breadth and depth that da Vinci did in a number of topics is extremely enviable.
A cursory glance at Leonardo da Vinci’s Wikipedia entry would’ve told you as much, however. Walter Isaacson’s sweeping biography, meanwhile, sheds light on da Vinci’s motivations, shortcomings, and major insights, a feat only made possible with an exacting study of the reams of notebooks da Vinci left behind.
As Isaacson makes clear, da Vinci’s drive lay not in fame or wealth, but in a deep fascination in how the world around him worked and changed over time.
He believed strongly in the experience and wisdom of those around him, assembling long lists of questions he hoped to ask his friends and acquaintances about different phenomena in nature.
Da Vinci also observed the multiplicity of analogous forms that exist in nature, such as the “branching pattern that could be found in trees, in the arteries of the human body, and in rivers and their tributaries.”
Perhaps Leonardo’s greatest flaw was his reluctance to publish his findings. One prominent example comes in his discovery of the aortic sinus, a dilation that sits just above aortic valve and assists in the flow of oxygenated blood out of the heart.
Though he drew incredible diagrams showing the aortic sinus, he never disseminated his work in a meaningful way. The structure was only found by the Italian anatomist Antonio Maria Valsalva some 200 years later. Accordingly, the aortic sinus is sometimes called the sinus of Valsalva.
Ready Player One
While Ready Player One is fictional, unlike the other quake books this year, the imaginary worlds created by Ernest Cline ignited my imagination unlike any other novel I’ve recently read.
In the mid-2040s, amidst a dystopian world of energy crises, overpopulation, and social unrest, the overwhelming majority of the population escape to a hyper-realistic virtual environment called OASIS for hours each day.
The ecosystem of OASIS maps directly to a user’s retina, who also wears an array of haptic sensors, providing for full-immersive gameplay. Users can explore distant galaxies, live out movie plots, fulfill fantasies, and defy all known laws of physics.
The captivating design of OASIS is to say nothing of the equally engaging plot of Ready Player One. An unlikely hero attempts to track down an easter egg hidden within the virtual reality by the deceased creator. The finder inherits a fortune of $300 billion, which, honestly, might not buy much in 2045.
Steven Spielberg adapted the novel into a film of the same name in 2018, which earned some critical acclaim.
There were a number of books that registered lower on my intellectual Richter scale, but were nonetheless thought-provoking and flush with novel perspectives. Those books include:
- The Undoing Project, Michael Lewis
- The Nightingale, Kristin Hannah
- Just Mercy, Bryan Stevenson
- Shoe Dog, Phil Knight
- When Breath Becomes Air, Paul Kalanithi
- Conspiracy, Ryan Holliday
- The Emperor of All Maladies, Siddhartha Mukherjee
- The Sports Gene, David Epstein
You can read about the success I accomplished in my other New Year’s resolutions in 2018 here.