Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts

Friday, April 13, 2018

Running is my Therapy by Scott Douglas


Rating: WARTY!

This from an advance review copy for which I thank the publisher.

This author runs to help relieve symptoms of depression, and this book is intended to support and disseminate that idea. I think that's a good idea in principle, and I wanted to like and recommend this book, but the more I read of it, the less I liked it. It came across as being way too pushy and preachy, and even strident in its premise that running and only running (as opposed to other forms of aerobic exercise) can bring salvation. I know the author is very enthusiastic in his convictions, but this felt too much like evangelism, propaganda, and elitism for my taste.

The author does quote some studies to support his thesis, but when I looked up some studies myself, they didn't specify running! They specified aerobic exercise. For example, https://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110 says quite clearly, "We don't know exactly which exercise is best. Almost all of the research has looked at walking, including the latest study." It adds a quote from a Dr McGinnis who says, "It's likely that other forms of aerobic exercise that get your heart pumping might yield similar benefits." In addition to quoting a study which talks only of aerobic exercise and then immediately translating 'aerobic' into 'running', the author tends most often to quote people he knows, but anecdotes are not studies, and most of the people he knows seem to be professionals - lawyers, accountants. and so on. I saw no quotes from people in less ethereal professional jobs, such as teachers, and none from your everyday people who work in anonymous office cubes and on factory floors, who may not enjoy the freedom other people have to be running. This smacked strongly of elitism to me.

The author does say that aerobic exercise works differently for different people so your results may not be as advertised. In my amateur opinion, no one should consider it to be an alternative to medical treatment without discussing it with qualified medical personnel. Maybe it can replace your meds, maybe it can reduce your dependence on them, or maybe it will not help at all; only a qualified medical practitioner can advise you on that score and on the advisability of running for any individual in view of whatever their health status may be, but as long as you're physically capable, no harm will come from talking a little exercise of one sort or another, and it can bring much good.

While I think this book has some great ideas and suggestions, the feeling I got was that this author was so enamored of running that he rather forgot that there are other ways to get exercise and 'generate those endorphins'. It seemed to me that he was taking a rather narrow view of exercise. Running does get your blood flowing, but it is also quite high impact exercise and can carry with it potential for injury and for damage to joints and bones, so any program of exercise should be undertaken with care, and unless you're reasonably physically fit to begin with, it's always wise to consult your doctor before embarking on anything that's unusually strenuous as compared with your normal habits.

At one point the author discusses evolution and how humans evolved to chase down prey, but this is a truly dim view of our history. Humans did not run five or ten miles every day. They doubtlessly walked a heck of a lot more than most of us ever do nowadays, and they ran if they had to, but they never went jogging except as a means to get from A to B. They spent their time trapping and foraging. There's was no way they could run down a four-legged animal. They could stampede an animal into a trap, or kill it by employing subterfuge, but to equate them to modern runners and claim this is what we evolved to do is patently nonsensical. We gave up our claim to being any kind of running paragons when we stood up on two feet.

On top of this, there may be issues with running - your neighborhood may not be a safe one for running in, and it's also known that running can be hard on legs, feet, and joints, yet by the time I pretty much quit this book - over half way through - I had read not one single negative assessment of running or even caution from this author. Everything was positive and hunky-dory. Anything from ankle sprain, to Achilles tendinitis, illiotibial band problems, ligament tears, shin splints, and plantar fasciitis are all on the menu for runners, but not a single one of those terms appears anywhere in this book. We hear a lot about runner's high, but not a word about runner's knee (patellofemoral pain syndrome). I have to wonder just how rose-tinted those eyeglasses are that this author evidently wears. Note that if you run with correct form and good (read expensive!) shoes, you can stave-off the worst injuries, but any runner might be subject to any one of these problems at any time.

On the topic of endorphins, there needs to be clarification. Endorphins are generated by the body as a result of physical stress and injury (in other words, as we were just discussing, running damages your body!), and while exercise does increase endorphin levels in the blood, they don't tend to pass through the blood-brain barrier, which means they don't affect your brain much. They do affect your body and this in turn can lead to a good feeling about yourself because you're essentially running your own internal morphone factory - duhh! Also, note that endorphins affect different physiologies in different ways and you may well have to run for an hour before you generate significant endorphins, so a short run isn't necessarily going to work for you. Note though that there are other chemicals that are active in the brain, and this is what might help mental faculties and relieve symptoms of depression.

These chemicals are actually a result of the body experiencing stress or pain, which might explain why walking doesn't work as well in generating the chemicals, but any aerobic exercise that gets your heart rate up ought to do the same trick - such as riding a bike - either stationary or outdoors - or dancing, or weight-lifting (kettle bells, for example), or playing a sport, or having sex - or even eating chocolate, although that's hardly an exercise! The advantage of running is that it doesn't need special equipment as long as you have suitable clothes and a decent pair of running shoes, but you can lift weights using anything around the house that's easy to pick up, (but also heavy enough!), or swing kettle bells or a safe, home-made equivalent, such as those larger paint cans with handles (pad the handles first!). You can cycle without a bike by holding your legs up and moving them in a cycling motion, and mixing that with flutter kicks, so running isn't the only option, and other options do less damage!

In terms of negative effects of running, which you really won't read about here, https://www.active.com/health/articles/why-too-much-running-is-bad-for-your-health">Active.com reports:

In another observational study, researchers tracked over 52,000 people for 30 years. Overall, runners had a 19 percent lower death risk than non-runners. However, the health benefits of exercise seemed to diminish among people who ran more than 20 miles a week, more than six days a week, or faster than eight miles an hour. The sweet spot appears to be five to 19 miles per week at a pace of six to seven miles per hour, spread throughout three or four sessions per week. Runners who followed these guidelines reaped the greatest health benefits: their risk of death dropped by 25 percent, according to results published in the journal Medicine & Science in Sports & Exercise.
so, as in all things, moderation! Forget about enduring the pain and being tougher - run smartly if you run, but not too smartly! Think about that! The tortoise beats the hare even though it doesn't look as pretty.

Mental acuity can improve even from simple exercise. An article in Britain's The Guardian from June 18th, 2016 reported that "German researchers showed that walking or cycling during, but not before, learning helped new foreign language vocabulary to stick" and "Just 10 minutes of playful coordination skills, like bouncing two balls at the same time, improved the attention of a large group of German teenagers." It also reported:

The runner's high - that feeling of elation that follows intense exercise - is real. Even mice get it. It may not be due to an "endorphin rush", though. Levels of the body's homemade opiate do rise in the bloodstream, but it's not clear how much endorphin actually gets into the brain. Instead, recent evidence points to a pleasurable and pain-killing firing of the endocannabinoid system: the psychoactive receptor of cannabis."
The author does mention this endocannabinoid system, and it's really quite interesting, but as always it was from the biased angle of running that he addresses things, not from 'walking or cycling'.

That same article also reported that:

Yoga teaches the deliberate command of movement and breathing, with the aim of turning on the body’s “relaxation response”. Science increasingly backs this claim. For example, a 2010 study put participants through eight weeks of daily yoga and meditation practice. In parallel with self-reported stress-reduction, brain scans showed shrinkage of part of their amygdala, a deep-brain structure strongly implicated in processing stress, fear and anxiety.
so quite clearly it's not just running which can have beneficial effects, and yoga is about as far from aerobic as you can get!

While running works - and if its your thing, then go for it, it's not the only thing that works well and I felt it misleading of this author to push running almost as though there's no real alternative. This was one of my biggest problems with this book. According to https://www.livestrong.com/article/490163-negative-effects-of-running-on-the-body/:

As many as 40 to 50 percent of runners experience an injury on an annual basis, reports a 2010 paper from researchers at the Moses Cone Family Medicine Center in North Carolina in "Current Sports Medicine Reports."
That's worth thinking about if you choose to run as opposed to undertaking some other aerobic exercise.

When I quit this book (apart from skimming a few of the later pages), it was at a point where the author has a section titled Runners Really Are Tougher. His thesis here is that runners are better at managing and holding up to pain and I have to ask, why is that important? Depression carries its own kind of pain, but it's not of the physical variety this author is discussing, such as would be experienced from an injury say, so I have to ask how is proving how tough you are relevant either to the author's aim in writing this book or to anyone in general?

Yeah, if you're planning on signing up for the Navy Seals, then by all means revel in your toughness, but there's no need to "man-up" and withstand pain when we have abundant medical remedies for combatting it. Nor is there any call to subject yourself to self-induced pain from running (or any other source) if another alternative works, or if running less gets you your healthy high without running your body into the ground - which is going to leave you low. For me, this section was the last straw and it struck me as one more absurdist foray in a book that bothered me by the very fact that it was so determinedly blinkered in its approach.

I have to say a word about wasted space in this book. Once again we have a book where whitespace rules, and if only the publisher had been wise enough to use smaller margins and fewer blank pages, the book would have been significantly shorter and thereby saved the lives of a few trees if it went to a long print run. Even if you avoid the dead tree version and go for the ebook - a longer book uses more energy to travel the Internet, so you don't get to win that way. I think it's time that traditional publishing ideologies gave way to reality. Trees right now are the only things doing anything to combat greenhouse gasses, and to slaughter them so wantonly is irresponsible.

There was an odd story at the end of this book which nevertheless shows how debilitating depression can be. The author talks about reusing plastic bags for groceries, and for whatever reason, he washes them, and one time he simply stopped because he saw no point in it. I have to wonder why he uses plastic at all when sturdy reusable canvas shopping bags will work just the same and not employ oil byproducts in their manufacture. That's what I use.

But the point is that the anecdote is exemplary in showing how irrational and unpredictable depression can be, so if a regime of regular aerobic exercise works for you, then go for it! If that involves running, then this book may or may not be of help, but from my perspective, and while I wish the author all the best, I cannot in good faith recommend this.


Wednesday, April 11, 2018

Let's Play Yoga by Márcia de Luca, Lúcia Barros, Bruna Assis Brasil, Ana Ban


Rating: WORTHY!

This is from an advance review copy for which I thank the publisher. Note that there is a website for this book if you want to take a look at that before deciding whether this is for you! It's at http://www.letsplayyoga.com.

This book is translated from Brazilian by Ana Ban, and it's a fun and colorful book with some playful illustrations and a diverse cast of kids shown doing yoga poses. It begins with a lot of well written and fun advice on what yoga is all about and how it should be approached. Anything which encourages kids to be mindful, thoughtful, considerate of themselves and others, and to stay limber in a safe way, is to be recommended in my opinion!

The book is easy and gentle, and it has a lot to say about how yoga arose and what it's all about without going into too much detail on any one topic; then it goes on to show some simple yoga poses which any kid can work at. Not that it's treated as work! The authors talk of it as play, which is a great approach, because this should appeal to any kid. The book is very portable, too. it worked as well on my phone as it did on my tablet, although I have to say that some of the pages were a little hard to read not because of small text (the pages enlarge), but because of a bright green page background with off-white text! But that was only for a couple of pages.

On a personal note, I tried a yoga class one time, a while ago, and I was so disappointed in it that I never tried anything else along those lines! Unlike this book, the instructor didn't offer anything about the history and practice, and he gave no preparation, no advice, and no stretching. His sole purpose seemed less aimed at teaching us than it was at showing off what he himself could do. He offered no suggestions as to a daily regime or organized system for people to follow, and the entire class felt like a waste of my time.

I could have used a book like this when I was a kid, as well as in place of that class! It was nice to read a thoughtful and useful introduction to it. I was pleased to discover that something like this was available, aimed at kids, and which takes a holistic approach to the entire practice, discussing it in some detail but not too much, and advising kids to enter into it gamely, confidently, but cautiously, so no-one accidentally injures themselves by trying things too quickly, too strenuously or too enthusiastically!

Kids are not urged to try to get everything right from day one, but to enter into it in a spirit of can-do, and to keep practicing until the stretches and poses become second nature. It covers mindfulness, breathing (which an be employed in stressful situations away from the yoga mat!), and the poses or sanas. It's perfect for kids who may have problems exercising, because they're not required to do everything at once or to do it perfectly, or to run marathons! All they're asked is to give it a try, and to simply do as well as they can.

It's a nice philosophy to go with some nice relaxing exercises that will juice your joints, limber your limbs, spark your spine, and generally make you feel like you're doing a little something to make life better. There's nothing back-breaking or too hard here, so any child ought to be able to join in. To that end I would have liked to have seen the admirably diverse group of kids pictured here also include someone who was overweight or perhaps handicapped in some way to show that this can be done by everyone to the limits of their individual abilities and restrictions. All you need is a yoga mat - or something that will work as one - comfortable clothes, bare feet, and a willingness to give it a try! I think this is a great book, and I highly recommend it.


Sunday, April 1, 2018

The Angry Chef's Guide to Spotting Bullsh*t in the World of Food by Anthony Warner


Rating: WORTHY!

Erratum:
“...repelling into your body...” I believe the author meant 'rappelling'.

This is from an advance review copy for which I thank the publisher.

What better way to start out All Fool's Day than to review a book about idiotic diet fads? In a world where women in particular and especially in the west, are made to feel ugly and worthless if they do not conform to the fashion magazine, television, and Hollywood 'standard' of beauty (i.e. thin as a rake and endowed with hourglass curves and unnaturally flawless skin), you can't blame people for wanting to trim themselves a little, but there are far too many immoral rip-off artists willing to step up and offer snake-oil and quakery to women who have, their entire lives, been primed and weakened to buy into anything which will get them into conformity with the idiotic heights that society seeks to impose upon them.

While it does no-one harm to exercise appropriately and eat wisely, the diet business is a sixty billion dollar industry in the USA alone and yet people are fatter now than they've ever been. That should tell you how fraudulent the whole thing is. However heavy or light your body is, it has a natural weight that it likes to stay close to and it will fight you with some very effective hormones if you try to force it out of that zone. That's not to say it can't be done, but the road to that end is paved with misery, failure, and a constant struggle.

You know things are bad if even Walmart voluntarily steps-up and decides to remove one if its beauty and fashion magazines from the check-out aisle because it's been deemed too obsessed with women being sexualized. If you take a look at those magazines, they rarely have a cover which doesn't mention diet, looks, and/or sex. These magazines are known for air-brushing flaws out of women's skin and Photoshopping them to make them look even thinner than they may already be. Children are bombarded with these images every time they pass through the checkout. On the one side are the magazines essentially telling women how ugly and fat they are, and on the other side of the same aisle are the calorie-laden candy bars and potato chips. That ought to tell you something about how schizophrenic we are in this world of body image which we created for ourselves.

When I requested this from Net Galley I had never heard of the Angry Chef, but the idea of it amused me. I was really pleased to learn that not only does the Author have BSc degree in biochemistry from Manchester University, he's also very much a scientist in his approach to analyzing fad diets, and he gives no quarter in tackling them one after another in this volume, pointing out in no uncertain terms how idiotic and baseless they are.

In Part One 'Gateway Pseuodscience', he covers an important topic: the difference between causation and correlation. Just because something occurs at the same time as something else doesn't automatically mean one was caused by the other. He attacks so-called 'detox' diets and alkaline diets, and he covers the topics of regression to the mean, and 'the remembering self'.

In Part Two we learn about 'when science goes wrong' and meet Science Columbo, coconut oil, the paleo diet, antioxidants, and...sugar! (Its not as bad as you think!). Part Three brings 'the influence of pseudoscience', featuring a history of quacks, the power of ancient wisdom, processed foods, clean eating, and eating disorders. Part Four takes us into 'the dark heart of pseudoscience' and educates us on relative risk, the GAPS diet, and cancer. Not ethat some of his titles and opening paragraphs are laden with sarcasm, so beware that you may think you're having your bias confirmed as you seem to be led in one direction, only to discover that your destination is elsewhere.

If I had three complaints, the first would be that the print version is a tree-slaughtering device if it goes to a long print run, because it has unnecessarily wide margins and generous text-spacing, No-one wants to see a page that's literally black with text, but a wiser publisher - one which actually cared about trees and climate change, could have narrowed the margins and shorted the book considerably by doing so.

My second complaint - be warned - is that the language is a little on the blue side and unnecessarily so in my opinion. There are four-letter words distributed throughout the text, not commonly, but often enough. I thought that was entirely unnecessary. I have no problem with such words in say, a novel, but in a non-fiction book of this nature, I think that language can be dispensed with and thereby reach a wider audience in doing so. It amused me that the cover was so prim and proper that it included an asterisk in the title - like that really disguises what the word is? Seriously? I know an author has no control over the cover when they turn over their book to a regular publisher (which to me is a travesty), but they do have a lot of say over what's inside that cover.

The third issue was that the book was a little long-winded for my taste (336 pages, of which - if you exclude the prologue and the epilogue which I always do), runs to some 286 pages of main text. The extra pages include end notes and two appendices, but the rest of the book was a bit rambling at times. Overall though, I enjoyed it. I loved the exposure of fads and quackery (Gwyneth Paltrow comes in for a well-deserved hammering) as well as a host of less well-known figures in the world of food faddism. The book contains a solid introduction to the scientific approach in which far too many of us are lacking, especially in the USA, land of fundamentalism, conspiracy and fad. The principles learned here can be applied outside the narrow field of diet and food, and I recommend this one as a worthy read.


Sunday, January 21, 2018

Terminally Illin' by Kaylin Andres, Jon Mojeski


Rating: WORTHY!

This was a beautifully drawn and colored, and very amusingly-written bittersweet story about Kaylin Marie Andres who was diagnosed with Ewing's Sarcoma in 2008 at only 23. Instead of succumbing to paralysis and mute acceptance, she chose to fight it tooth and nail with determination and humor, and not only went on with her fashion career, but also created a graphic novel to illustrate her fight with an amusing graphic story.

The book begins with her going for her first treatment and ends with the promise of a visit to a fantasy-land cancer fun park. There never was a sequel because Kaylin had to endure four major surgeries and attendant radiation treatments to four different areas of her body. And she died a year ago last November at the age of 31.

This book is probably one of the best memorials she could have because it was an awesome read and I highly recommend it. The last entry in her blog was five days before she died - on the day before she was due to fly back home for the last time. Hopefully this graphic novel will serve as a lasting inspiration to others.


Saturday, January 13, 2018

Chance by Kem Nunn


Rating: WARTY!

This is form an audiobook I got form my library after having watched season one of the TV show which is based on this book and actually follows it pretty closely.

Overall, I though that this was a worthy read, but I have to qualify that by adding that this author is so in love with his own turn of phrase and with repetitive philosophizing that he spoils the story in some places. The worst example of this was during what ought to have been a gripping climax, when the final showdown comes between the corrupt detective and the, let's face it, equally corrupt doctor. In stead of letting the pace pick up and making it exciting, this author slowed it down and went off into endless rambling diversions which caused me to skip pretty much the whole of that section instead of enjoying it as I was hoping to. Kem Nunn does not know how to write a thriller.

I did not like Eldon Chance, the so-called "neuropsychologist" either. That actually is a profession, but to me, the name sounds like it was made up by a writer who didn't know medicine too well! Chance was just as corrupt as the detective who was the villain in this story. As a doctor, Chance sees people to evaluate them for legal purposes: court cases, last will and testament contestations, and so on. When he meets Jaclyn Blackstone, he falls for her - which is to say that he just wants to jump her bones; he doesn't really fall for her in any other way, or at least if he does, it's not apparent from the writing.

The problem is that he's the doctor here, which makes him a quasi-authority figure, so though she is technically is not his patient as it's generally understood, he is in a professional relationship with her and it would be flat-oout wrong to get involved. Worse than this, she is a sick woman. She has multiple personality disorder and it's entirely unethical to take advantage of that and of her vulnerability. That said, it's hardly the "steamy affair" the book blurb extolls. Worse than this in a different way, by becoming involved with her, Chance has undermined any reliability his professional diagnosis might have had should people find out about his behavior. This could actually harm Jaclyn Blackstone.

She's not only vulnerable as a patient; she;'s also the victim of an abusive and somewhat codependent relationship. She's married to, but separated from a detective in the San Francisco PD. As Jaclyn Blackstone, she is afraid and seeking to avoid her husband, but as Jackie Black, she willingly has rough sex with him. When the detective discovers that Chance is hoping for a chance with her, he makes veiled threats.

Here is where I really took a dislike to Chance. Instead of thinking of his family and backing-off, he continues to actively pursue Jaclyn, leaving his young daughter open to retaliation by the detective. At one point he spends a weekend with Jaclyn, with his phone turned off (turning it off and forgetting to recharge it are constants in Chance's life), and when he finally gets back on the air, eh discovers his daughter is in hospital having OD'd. That's the kind of lousy, selfish, absentee father he is. We never see him interact with his daughter except in reaction to something.

Chance is also separated from his wife and they're divorcing. In order to try and raise some money, he sells some antique furniture after having had it tarted-up to look like it's all original, by a guy named Dee (real name darius Pringle, but you'd better never call him darius to his face). Dee is a big tough guy who lies about his military experience, but who nonetheless is a very dangerous man. He and Chance form an awkward friendship and partnership in trying to get one-up on detective Blackstone, but until the climax. it's like everything Chance does is ill-conceinved and doomed to failure.

For me, Jaclyn and Dee were fascinating people, and even detective Blackstone was more engaging than Chance, but we only got to know about them through Chance interactions, as it were. Dee and Jaclyn both have amazing stories to tell but that's not what we got unfortunately. I was sorry about that, but even so, we got enough of them and enough of a decent story for me to rate this a worthy read.


Thursday, November 9, 2017

Adventures in Veggieland by Melanie Potock


Rating: WORTHY!

Subtitled "Help Your Kids Learn to Love Vegetables with 101 Easy Activities and Recipes", this was an awesome book. It's beautifully presented, colorful, full of pictures, and it's aimed at persuading kids in the 3 - 8 age range to eat their greens. My feeling is if you follow this and that doesn't succeed, then nothing will! Not that I have three to eight year olds to test it on, but I sure intend to try some of these recipes. The blurb says the book "features 20 vegetables" although some are technically fruits (which the author makes clear in her text, which is full of interesting snippets). The book is divided up by season, so there's going to be something all year to try.

I liked the way she incorporates games into the cooking and offers hints, tips, asides, and advice, always explaining why she suggests this method rather than that method. I found the book to be an engaging read just for those items, regardless of whether you try the recipes, but why wouldn't you try them? They sound great! I loved the way she incorporates suggestions about which part of the food preparation that kids who are younger and kids who are older can help with. Obviously this is common sense, but it doesn't hurt to get a reminder when it comes to kitchen safety and good hygiene practices.

I would not recommend this for the phone! The text is too small to read and if you enlarge it, the page is randomly jumping all over the place forcing you to reselect the area you were reading. It's readable on that device, but a nuisance. Obviously, it's really designed as a print book, but it worked fine on a tablet. I really liked this and I recommend it.

You can never over-estimate the importance of good nutrition for raising healthy adults-to-be, but in doing so, one cannot afford to overlook the element of stress which so few health books address. I'm happy to recommend one that automatically seeks to eliminate stress by making cookery - and eating - fun!


Sunday, October 1, 2017

Mis(h)adra by Iasmin Omar Ata


Rating: WORTHY!

This is from an advance review copy for which I thank the publisher.

Based on her own experiences as someone who endures epilepsy, this graphic novel tells the story of Isaac, an Arab-American student struggling with trying to get a college education while coping with the disruptive effect of epilepsy in his life. He's not doing very well, but he has an underlying current of hope, which keeps him moving towards a brighter future - and not one that's made bright merely from a pre-seizure aura.

The story is intriguingly done through the use of visual metaphor (as well as in the text), and often in the very graphic form of scimitars all directed at poor Isaac. The despair and exhaustion he suffers from constantly being at risk of a seizure, and from his inability to get even his own father to believe him when he talks about his problem, is palpable in this story. It's almost despairing and exhausting to read it.

At times you want to shake him out of his lethargy and inertia, but at the same time you realize this is such a knee-jerk response that you want to slap yourself. It's at that crux that you realize how debilitating this is; it's not that Isaac is stupid, or lazy, or incompetent, it's that this illness has such a crippling hold on him that he's all-but paralyzed by it.

Most of us tend to associate seizures with flashing lights as depicted in the Michael Crichton novel The Andromeda Strain but this is an ignorant view which completely neglects the serious role that less specific preconditions such as tiredness and stress, inter alia, play in triggering a seizure - and the danger of harboring a narrow definition of 'seizure' is also brought to light. A friend of Isaac's lectures him about letting his friends help instead of shutting them out, and this straight-talk marks a turning point in his life.

This was a moving story, a fiction, but based on real truths, and it was illustrated with startling colors and bold depictions. I liked it and I recommend it, and I would definitely look for future novels from this author.


Saturday, July 1, 2017

The Last Surgeon by Michael Palmer


Rating: WARTY!

This novel sounded from the blurb a lot better than it turned out to be in the oratory, and John Bedford Lloyd's reading of the audiobook did not help one bit. His voice was just wrong. I feel bad for writers who get stuck with the wrong reader for their audiobook. I think more writers need to read their own work, or the audiobook publishers need to get in some new talent instead of obsessively-compulsively resorting to old school readers. Just because someone is an actor, for example, does not mean they can read an audiobook worth a damn.

The story is about a surgeon named Nick Garrity, who is of course a vet who suffers PTSD, and who heroically devotes his life to offering medical treatment to the homeless form his camper-van clinic in Washington DC. As if that's not heroic enough, he's searching for his best friend from his military days (which begs the question how they're ever fell out of touch if they were best friends).

Nick is about to be rescued and validated by the hot Jillian, whose kid sister Beth appears to have committed suicide, but Jillian doesn't swallow that, and I didn't swallow this. Of course there's an inevitable government conspiracy, and the villain is so utterly absurd that I was surprised to find he didn't wear a long black cloak and twirl the ends of a waxed his mustache. Instead he just waxed people. The whole story was too much and took far too long to get going, and Nick was absurdly heroic. I can't recommend this.


Monday, May 15, 2017

LGBTQ-Inclusive Hospice Palliative Care by Kimberly D Acquaviva


Rating: WORTHY!

This review is based on an advance review copy for which I thank the publisher.

This amazingly-named author is a tenured associate professor at the George Washington University School of Nursing, and evidently knows her stuff. I'm not a health-care professional, but I have worked closely with nurses in two different hospital environments, so I was familiar with the kinds of things she discusses here, and the importance of getting them right. She's also a doctor - of the PhD variety (in Human Sexuality Education) rather than the MD variety - and has a master's in Social Work and a BA in sociology (all from UPenn). She's also been a Fulbright scholar, so clearly she's on top of her game when it comes to the material she goes into here, and she pretty much covers the gamut of required learning when it comes to the treatment (in the broadest sense) of people from the LGBTQIA community.

The chapters cover these topics:
Self-Awareness and Communication
Sex, Gender, Sexual Orientation, Behavior, and Health
Understanding Attitudes and Access to Care
The History and Physical Examination
Shared Decision Making and Family Dynamics
Care Planning and Coordination
Ethical and Legal issues
Patient and Family Education and Advocacy
Psychosocial and Spiritual issues
Ensuring Institutional Inclusiveness
But what was really impressive was how often the author steps outside the box to point out areas you might never even have considered might be relevant or important. She's definitely given this topic some considerable thought, and I doubt there are many questions you could come up with which aren't at least touched on here.

The book is written for academics, but it's very accessible and straight-forward throughout. It contains a glossary, references, and an index. Overall I recommend it. If I had a reservation about any of this, it was that, as usual, this type of book seems to have been written solely with a print version in mind, and the e-version coming in a poor second, so while I am sure the presentation and formatting of the print version is excellent, the e-version which I got left a lot to be desired! I am hoping, as I write this, that the advance review copy I had was a quick and dirty conversion for reviewers, and that if there is to be a ebook, it will be a lot better than this, because frankly the e-version was awful!

The errors and poor formatting of the e-version made for a really irritating read. You may call me a prima donna if you wish, since I don't care what you think of me, but my expectations are low when it comes to the quality of e-versions of ARCs. Even so, there really is no excuse for a sloppy review copy like this. Reviewers aside, it's an insult to the LGBTQIA community, and any reviewer would be perfectly justified in failing a book in this condition. I know Amazon offers a truly crappy Kindle app, but even it can do better than this would lead you to believe!

I'm not a professional reviewer despite the shields with which Net Galley has honored me, and I realize that we amateurs can't expect to be treated like professional reviewers and get a pristine copy, much less a print copy, but we do deserve a certain minimum level of respect, especially if we're expected to enjoy a book and be persuaded to feel inclined to review it favorably! personally, I ditched Smashwords as a publishing platform because they're insanely anal and too-often inconsistent for my taste, but I have to agree in principle with their approach to pristine ebooks, because it does matter!

However, for me what's most important is the overall book - not the cover, the gloss, the blurb, or the hype, but the interior, and what it says (or what the author clearly intended it to convey in the version they worked on!). What saved this book for me was that it's far too important to fly off the handle over poor formatting in review copy, so while I recommend it, I am going to point out examples of the main flaws I saw here for the record in the hopes that they will be fixed before any e-version is published.

Tables are not represented well in this version. Some of them appear right in the middle of the text with no separation, such as table 1.1 in the self-disclosure section. The result of this is that the table appears as though it's a part of the text, causing some sentences to end right in the middle, and then resume later, such as "...wife, though her eyes were dry..." in Chapter I step 5. There was a really bad example at location 593: "If you notice the patient appearing agitated or impatient each time a family My dad moved in with me over the Christmas holiday in 2012." 'Family' was completed three paragraphs later with 'member'. The 'My dad' portion was evidently an insert for a side bar or something like that.

There were also other oddball mixtures, such as Location 679 where there was a book reference and copyright notice to this book and author right in the middle of the text with what looked like a page number (38), but it's hard to tell what that was since there are no easily discernible page numbers in this e-version of the book. I don't read introductions (or prologues, prefaces, etc). I think they're antiquated, but as I was swiping past the intro to get to chapter one, I noticed that the lower case Roman numerals for the page numbers were in the middle of the screen rather than at the top or bottom. Some text was randomly in red "ink" such as " What are your goals related to the treatment and prevention of adverse effects of treatment?"

So, while I was disappointed that the presentation was not better, I was delighted with this book, which from my non-professional, but not uninformed PoV, looks to be an invaluable addition to resources any health care professional can call upon to enable them to do a better, more empathetic, and more caring job. The rainbow can only get brighter.


Friday, February 17, 2017

How to Catch the Tooth Fairy by Adam Wallace, Andy Elkerton


Rating: WORTHY!

Gorgeously illustrated by Andy Elkerton, this was a riotous book about a cocky and adventurous little tyke who people are evidently trying to catch to take all her quarters, but she gives no quarter! She's too smart for them and knows all their tricks. It also dispenses sneaky teeth health advice along the way.

Written in rhyme, we learn of this pink haired tooth fairy who collects an average of 300,000 teeth in a night. She wears old time aviator clothes and rides a toothbrush! And she's very fast. I can't predict whether your kid will like this or not, but I loved it!


Thursday, January 28, 2016

A Cure for Madness by Jodi McIsaac


Rating: WORTHY!

Erratum:
"...take it to my Rob." should be "...take it to my Uncle Rob." maybe?

This novel was a roller-coaster of "Do I like it?" or "Do I not?" I started out liking it, started going sour on it around 40%, and then came back to it, so despite several issues (which are not easy to discuss without giving away too many spoilers) I decided, overall, that this is definitely a worthy read. Let's talk!

This was an advance review copy, for which I am grateful, and it’s in first person PoV which is typically horrible for me. 1Pov is so full of self-importance and self-aggrandizement, and it’s 'all me all the time', which can be sickening to read. It limits the story to the narrator's PoV, which is too restrictive, plus it gives a huge spoiler away - you know for a fact that no matter what happens, the narrator isn’t going to come to any serious harm because they're telling the story and they wouldn't be able to, had they died during it, so all suspense in that regard is lost. In this case, the author managed to carry this PoV without nauseating me, so I'm also grateful for that, but I felt that this caused a problem with the ending, which is rather hard to discuss without giving things away that I don’t want to spoil. I'll try to discuss it briefly later.

The basic story is told by Clare, who is living happily insulated (by the entire width of the continental USA!) from her family and the town in which she grew up on the east coast. The sudden shooting death of her parents drives her back. She is now the legal guardian of her brother Wes, who has some serious mental issues very much tied to Biblical matters, in particular, angels versus demons. This is not, however, a paranormal story; it's a sci-fi one with some elements of dystopia tossed into the mix.

This business of guardianship was my first issue because it made no sense. Clare is in her thirties (nice ot get a sotry abotu an older woman, so kudos for that!), and as such is a responsible adult, but Wes is also an adult, and he's being discharged and is planning on moving into his own apartment, so I don’t get why he has a guardian, and nothing in the text made this clear to me. He's either fit to live his own life or he isn’t. This was further confused by the fact that Wes's uncle lives right there in town, so why is he not the guardian? Clare has made it perfectly clear that she wants nothing to do with her hometown and hasn’t been back there in a decade or more. To me it made no sense, not even as a ploy to bring Clare back to town; she's coming back for the funeral anyway!

Yes, the funeral! Clare discovers that her mom and dad were shot by a family friend, who also then shot himself. When she flies back for the funeral, and to take charge of Wes, she encounters some bizarre behavior among the patients at the hospital and pretty soon it becomes clear what's going on. A prion disease hilariously named Gaspereau has sprung up, and is very dangerous. It makes people behave psychotically. Why Gaspereau? I have no idea. I found it hilarious because I kept thinking of The Tale of Despereaux, so I couldn’t take the name seriously. Couldn’t it have been named something else? Please?! This disease made little sense because it supposedly wasn't airborne (although prions can go that route), yet it was spreading ridiculously fast - too fast to be credible for the vector it took.

The real issue for Clare however (apart from her backstory secret which explained a lot), was that Wes appeared to be immune, and so his presence was forcefully demanded back at the hospital so they could use him to find a cure, or at least a vaccine. This was the second thing which made no sense to me. Clare shared the same genes that Wes did, yet absolutely no interest was shown in her. As desperate as these people were to get a quick fix for this epidemic, it made no sense that Clare would not have been considered. This leads me to my third problem, which is that Clare wasn't very smart, and was, frankly, a bit juvenile for her age and rather selfish. I did manage to explain away the latter two problems - to my satisfaction anyway! - when I learned her back-story, but the first was harder to excuse.

I don’t demand a genius in my female main character, but I do require that they're not painfully dumb, or if they start out dumb, that they smarten-up over the course of the story. Clare never really did, although she came through for me in other ways, which is one reason I am rating this positively. Clare wasn't the only dumb cluck. Not even the trained medical staff considered every option. I've worked with medical staff and this was a bit of a stretcher for me to swallow; however, I enjoyed the overall story so much that I was willing to overlook these issues, even the one with the 'fluffybunnies' password!

Yes, the password was hilarious, but Clare didn’t even ask if it had any capital letters or number substitutions for letters. When the password appears in print, you can see what it is, but when it’s merely spoken to you, you have no idea about punctuation or the fine details. Clare should have asked since she was not reading this novel! Or Kenneth ought to have explained it was "all one word, all lower case." It’s a minor point, but too many such points can spoil the credibility of a novel.

The ending was a bit abrupt. I would have liked more, but maybe short and to the point was better. I had ot read it twice to make sure I got it, and I gather i am not the only reviewer who was in this position. That said, I have to refer back to my problems with first person PoV. I think it was the wrong choice here. I freely admit that I typically think it's the wrong choice, but it can work. Here though, I think third person would have been a better approach, because a first person story-teller made little sense given the ending. That's all I'm going to say on that topic!

The funny thing about the ebook - which, by the way had no horrible formatting issues, thankfully - was that it announced on my phone's Kindle app that there were 4133 locations, but it would not let me swipe past location 4129. Wait - there are four secret locations? Is this evidence that there really is a government conspiracy? What are they keeping from me about this novel?! LOL! It was an amusing 'end' to a very readable story. When all is said and done, I recommend this as a worthy read.


Wednesday, November 25, 2015

Of Better Blood by Susan Moger


Rating: WORTHY!

"Four times a day I drop the baby." That's about as powerful a first sentence for a novel as you can get. This is the kind of novel (of which I read an advance review copy) that makes it worth plowing through a host of drab and sub-standard ones. This one took me to a new place, and that's what it's all about. Set in 1922, sixteen-year-old Rowan Collier immediately takes the stage - and quite literally. She's an actor in a "play" designed for the sole purpose of promoting eugenics. Note that while I loved this novel, I never said it was easy to read, or that there were no horrible things in it. Be warned.

The novel is historical fiction, but it is historical. The main elements of the tale told here are fictional, but the Aryan roots running through it were not only a tragic fact that led right into Nazi pogroms, those same dangerous, unscientific, and idiotic beliefs run through a certain segment of society today, hidden only under a thin veneer of civilization.

This is yet another first person PoV novel - and with flashbacks, to boot! Normally I don't like either of these, but in this case it worked. It wasn't intrusive. It didn't keep reminding me that I was reading a novel, and I'm grateful to the author for that. The novel was not only readable, it was captivating. The two main characters, Rowan and Dorchy are illuminated with the consummate artistry of a medieval scribe. You cannot help but want to know everything that happens to them. I would pick this novel up intending to read a quick chapter, and find myself still sitting there, glued to the screen, five chapters on.

Rowan first appears as an actor, after a fashion, and dropping the baby doll is her job. She has to show to the audience how incompetent and inept - how unfit - she is as a human being, but this is not how life began for her. Rowan began life without any handicap, not even poverty, but now she has one, thanks to polio, so naturally she plays a teenage handicapped girl in this play performed at a fair. Even today religious ignorance would have children prevented from being vaccinated against this this scourge with the same horrific results Rowan endured.

There's no sympathy for her condition, or for the condition of the character she plays, Ruthie-who-drops-a-baby. Even off the stage the people she's with think of her as thirteen-year-old incompetent Ruthie. The play is titled "Unfit Family" and is clearly written by an ardent fan of the eugenics movement. Just as things were getting interesting, though, I was suddenly snapped back to 1914, which I resented! The seesaw whiplash effect pervaded the first few chapters, but soon, and surprisingly, I grew used to it. It takes quite a bit to have a first person PoV novel, with flashbacks, and make me like it, so this was a good sign!

Despite the crippling scars polio left her with, or more accurately, precisely because of these scars, Rowan is an exhibit of the New England betterment Council, of which her sister Julia is an avid member, as was her dad, who has not been home since he went off to fight World War One. The problem is, she's not a member in good standing, and that isn't meant as a sick pun. She's really a possession, now. In her father's absence, which might be better described as his non-benign neglect, and her sibling's cold indifference to her kid sister's plight, Rowan ended up not staying at the hospital where she had been slowly making a recovery, but at a cruel and sick home for "the crippled" where the only treatment she got was maltreatment. Being a prime exhibit of what's wrong with humanity was, therefore, actually a step-up from that, for Rowan.

Rowan's real recovery begins when she meets Dorchy, a feisty carny girl, who brings Rowan out of her shell and the two become firm and fast friends. But the deck is stacked against these two, and life hasn't done dealing them spades yet. Their story continues and seems to be downhill until a remarkable turn-around enters, stage right, engineered solely by the girls and some friends. This is both a heartening and a heart-breaking read, but I think this - or something like it - ought to be made as compulsory as sterilization was for those "unfit" children. They who cannot remember the past are condemned to repeat it.

Eugenics had some surprising adherents, such as Thomas Edison, Winston Churchill, Margaret Sanger, Linus Pauling, Marie Stopes, Robert Heinlein, HG Wells, Theodore Roosevelt, Nikola Tesla, Alexander Graham Bell, Woodrow Wilson, and George Bernard Shaw, and some not so surprising, such as Adolf Hitler. By the time this pogrom had been curtailed in the USA - and not until the 1970s, believe it or not - some 60,000 people had been sterilized. This is an engrossing way to learn a little about those pernicious and self-serving attitudes, even if it is fiction.

The real story here though is young adult power. Rowan and Dorchy are their own law and their own powerhouse. Refreshingly, the author seems to have instinctively understood this and left them to it, and it worked. They didn't need some guy to validate them or fix them or save them. There were some guys, and one was even named Jack, but they were friends, and that's all they needed to be. This story was about Rowan's strength, and about her admirably taking charge of her own destiny, and anything that buried her in a romance would have destroyed the power of this story. I whole-heartedly recommend this as a worthy read.


Sunday, June 28, 2015

Ghost Boy by Martin Pistorius with Megan Lloyd-Davies


Title: Ghost Boy
Author: Martin Pistorius with Megan Lloyd-Davies
Publisher: Thomas Nelson
Rating: WARTY!

Martin Pistorius might have chosen a better title for his autobiographical book. Ghost boy is a very common title (B&N lists at least half a dozen), and that's not even Martin's face on the cover as far as I can tell. Why isn't his picture there? Why not a before and after kind of cover? I know that writers don't get a say in their covers unless they self-publish, but you'd think a publisher might have more clue than this.

The book was co-written by novelist and ghost-writer Megan Lloyd-Davies, so it's one of those novels where it's really hard to be sure who said what and whether that description or turn of phrase was really the author's - it was really something he honestly felt, or endured or experienced, or whether the ghost writer simply chose to dramatize it that way. It was an interesting read in parts, and no one in their right mind can deny the horrors through which this author went, but in the end, I can't rate it a worthy read and I am not sure I can properly explain why.

It didn't feel like a satisfying read to me even though it starts out horribly and has a happy ending. Indeed, it feels very much like a fairy-tale, except that it's true. That said, the book seemed a bit jumbled, and it jumped around way too much for me instead of giving me a smooth narrative, and a clear idea of what was happening and how things were regressing or progressing. I was never quite sure where I was in the story or which Martin I was reading about at any given time unless there were obvious indicators in the narrative. It was too easy to lose track of time period, and this negatively impacted the impact, as it were.

There were things in it which bored me and which I skimmed, and there were other things which I felt were not discussed, or were discussed inadequately and glossed over instead. There were some commendably harsh and cruel truths in these pages too, humbling truths; truths which make you doubt the decency of humanity, but in the end I felt like I didn't read a satisfying story. I didn't know this guy, and didn't really have a good idea of his life, or of him. Despite what it did deliver, it felt shallow and superficial to me, and this is why I can't say this was a worthy read, and I'm sorry for that because people need to read books like this, in order to know what horrors can come - and the biggest of these wasn't even his condition, it was the way he was treated when he had it. A story like this deserved a better telling.


Wednesday, October 15, 2014

Chump by Rusty Reeves


Title: Chump
Author: Rusty Reeves (website not found)
Publisher: Reeves (website not found)
Rating: WARTY!


DISCLOSURE: Unlike the majority of reviews in this blog, I've neither bought this book nor borrowed it from the library. This is a "galley" copy ebook, supplied by Net Galley. I'm not receiving (nor will I expect to receive or accept) remuneration for this review. The chance to read a new novel is reward aplenty!

Not to be confused with author Rusty van Reeves, the author of this novel is a forensic psychiatrist, and the novel is about a fictional Texan, Beauregard Peebles, who was educated at Princeton and is now in his third year at medical school. Beau decides to take up the so-called white man's burden and save the black community from itself, one family at a time. The amount of arrogance and sheer gall it takes to do this ought to be no surprise at all to anyone who's met a senior med student or two. Nurses worship them almost as much as they worship doctors.

He is laboring under the delusion that he will be honoring Princeton's motto: Princeton in the nation's service and in the service of all nations, and after a really educational introduction to Ob-Gyn and L&D, he decides he can salvage them poor black folks and turn around the impoverished African American community which serves up the kind of female patients he's recently been dissing and making racists comments about behind their back. In short, he;s a chump, and worse than that, he;s a moron.

His "in" to the locals is a friend - after a fashion - whom he met playing basketball, a black kid named Tyranius Roosevelt. "Doctor" Peebles wants to see if he can bring about a change for the better in the life of his young drug-dealing friend and his family. He fails and learns nothing from his disastrous interference in their lives.

I found it hilariously hypocritical when the author has his main character say, on page 218, "Rule number two, no insults or name-calling. That's hurtful and solves nothing." This is his advice to the family when they all have a show-down, and this comes from the monumentally hypocritical "doctor" who has, throughout the novel, routinely and shamelessly embraced grotesquely disparaging comments about African Americans (although not directly to them, and mostly under his breath or in his own deranged mind). I had never actually liked the Chump, but at this point I started actively disliking him, which is never a good sentiment with which to imbue your readers.

Chapter 29 p244 starts in some weird-ass form of "Ebonics" which took this story - which was already heading seriously downhill - way over the edge for me. I wasn't about to start reading that. It went one for two whole chapters. I couldn't even begin to get back into it after that, not even in the hope that there might be some point to this drivel. It simply wasn’t remotely interesting. I did finally understand the title, though: I'm a chump for even reading this.


Monday, September 15, 2014

The Face Transplant by R Arundel


Title: The Face Transplant
Author: R Arundel
Publisher: Publisher unspecified
Rating: WARTY!


DISCLOSURE: Unlike the majority of reviews in this blog, I've neither bought this book nor borrowed it from the library. This is a "galley" copy ebook, supplied by Net Galley. I'm not receiving (nor will I expect to receive or accept) remuneration for this review. The chance to read a new novel is reward aplenty!

I had the hardest time ever getting into this. From the first paragraph on page one, it made no sense. Indeed, it really began with the title which indicates one special event, but in this novel, face transplantation was pretty much production-line. Inside, I found the text to be extraordinarily dense and uninformative, which was paradoxical because there was virtually no conversation, only huge amounts of info-dump. Despite this, and after many pages, I hadn't the first clue what was going on here or what this novel was actually about.

Yeah, it was about face transplants being performed under guard, about identities and conspiracies. It was about a face being stolen in a canister, but apart from this loss of face, what was happening here? I have no idea. Whose face was it? I had no idea. Was it the president's face? A celebrity's? An important politician's or a leader of industry or a criminal's? I had no idea.

Why were face transplants being routinely performed? I had no idea. I kept trying to focus on what the text was saying, but it kept blowing me off, and while I'm sure I missed something in that thicket of prose, I have no idea what it was, and I really don't care.

Why was it so critical that this particular face was missing? I had no idea, and worse? I didn't care about that either. I didn't care about any of the characters or about what was going on, and I had no interest in reading on through this dense undergrowth of wild text to find out. I just wasn't interested in these confused and confusing, running, frantic people or in their problems.

This was bad, bad writing if it can't command my attention even for a few chapters. There was one paragraph which went on unbroken for the span of four screens on my Kindle, and I have no idea what it was supposed to be telling me! Take a look at the blurb, which is of the same nature - one long uninterrupted paragraph.

I gave up on the novel after about ten percent because this was all work, with no reward. If I want to work this hard for my entertainment, I'll play a sport. You should not have to work-up a sweat to be pleased by a novel - not a good one anyway - and life is too short to waste on a story which refuses to give you a thing, or which only begrudgingly gives, in return for your willingness to try reading it.

In some ways, this novel borrows heavily from the movie Face Off, and it makes the same mistakes that movie made: it's a lot harder to combat rejection and graft versus host disease than the stories pretend, and it's not just the face. It's arguably much more the bone structure underlying the face which gives the face its appearance than ever it is the face alone. You can't just slap person A's face onto person B and have B look and act exactly like A did, and have the face look normal and work perfectly from the off! Nor would having a robot helping you do the work have any effect on the biology and micro-chemistry of the transplant.

So why did I pick this up? Well, I liked the movie Face Off which obviously inspired this novel, and I actually knew a health-care-giver named Sarah Larssonn (the one I knew was a different spelling, and she wasn't an anesthesiologist; she was a nurse who married one!), so I was interested despite the density of the blurb. I didn't realize that the novel would be written exactly like the blurb, or that it would give so little in return for my reading it. I can't recommend this one.

Update one year later!

This is a weird one. I first got this as an advance review copy from Net Galley, and reviewed it negatively back in May 2015. Then I completely forgot all about it. It was worked on some more by the author and I picked it up for free on Amazon, not realizing I had already read this! Net Galley says it's been completely re-written and if we liked the earlier version, we will love this. I'm sorry but that "logic" simply doesn't work! I did read it, coming into it like it was a new novel (since I'd forgotten it), and I had just as many problems this time as last time. It's still not a worthy read!

One of my initial problems was the info dump, which has gone, but now the novel is completely stripped bare of virtually all description - it's largely a series of conversations, often long enough that you lose track of who is saying what. Moreover, the plot isn't any better. This business of face transplanting (for the purpose of having people become unrecognizable spies) still makes zero sense. Unless they have a DNA transplant, they're still the same person, will still need the same anti-rejection meds, and a simple sampling of facial and body DNA will reveal the ruse.

On top of this there were numerous formatting issues in the Kindle app version of this novel on my phone. Lines ended midway across the screen and continued on the next line - or the next line but one. Speech from different characters was mixed on the same line as is evident in these examples cut and pasted directly from the Kindle app version:

Matthew looks at Liam's smooth narrow face. "You have my vote.""You don't have a vote. You're not on university council.""Well, you know what I mean."

"ALS, Lou Gehrig's disease. I just can't believe it. Look at you. Beautiful, strong . . . I can't believe it." Sarah, "I don't look like a person with a progressive neuro-muscular disease.""Exactly.""I don't feel like one either, not at this point." Liam finally speaks.

"Dr. Tom Grabowski, one of the best research surgeons of his era, has died of a heart attack.""Where?"

The voice is that of a young woman. It is calm, confident, and reassuring. Without skipping a beat, Matthew says, "Hi, what should I call you?""I am Alice.""Hi, Alice." Kofi says, "I did all the computer programming. Alice has some facial recognition and voice commands."

The medical knowledge is still poor and too deus ex machina to be believable. At one point, when a legitimate partial face transplant patient has tissue dying because of poor circulation, the doctor says, "I'm not sure it will survive. I'll start antibiotics." If the tissue is all but dead from poor circulation, what's the point of antibiotics which are way over-used anyway? There has been no suggestion that there's an infection, just that the tissue is dying! Antibiotics are not going to help, and are contra-indicated if there is no evidence that infection is playing a part. If the dying tissue is to be excised, then perhaps we can allow that the doctor started prophylactic antibiotics in prep for surgery, but this isn't what's implied in the context of this statement.

The novel is written in the present third person tense which makes it sound weird to me, but that's okay. The problem was that the author sometimes forgot, and used past tense, such as around 10% in, where there was a bit of a flashback, but when we come back to the present, the past tense was still briefly employed.

One last problem is a pet peeve of mine - that every female character is described as beautiful (or as some variant of that word). We get, "Celerie is stunning." (yes, there's a character named Celerie). Another example is, " She is thirty-four, but doesn't look a day over thirty". I found this kind of thing uncomfortably often. It's a form of objectification - as though a women who isn't explicitly beautiful is an ugly hag and not worth our time. I resent that approach and I see it disturbingly often from writers - even from female writers. It needs to stop.

Unless the character's beauty (and indeed physical appearance in general) plays an important part in the story, it's really irrelevant what he or she looks like. Naturally writers put in a description for the benefit of readers, but if you think about it, it's really not necessary. Readers can and ought to be allowed to make up their own mind about how a given character looks. A smart writer will put in a hint or two and leave the rest to the reader. Anything more is a form of telling rather than showing, and I'm surprised that more reviewers don't pick up on it. There's nothing wrong with offering some sort of a description if you feel you must, but I think it's better to be vague. At least, let's agree to cut it out with the 'stunning' and 'beautiful' crap.

In short, I still don't consider this novel to be a worthy read.