Regarding the column on influential books: What a great idea! Having come to medicine via a rather indirect route (my wife was in pre-med, so why not?), I can't say that medical literature had a great influence on my career path, although I've long been a “fan” of Osler and had the privilege of practicing in a community with Earl Nation, a great enthusiast of Osleriana.
My embracing the ideals of medicine came pari passu with my medical education and extracurricular activities during the tumultuous ′60s. (By the way, it may be very Old School for the reading of anything to have had a profound effect on our lives. I wonder whether the younger generations take reading very seriously—but I hope I'm wrong.)
▪ The Making of the Atomic Bomb by Richard Rhodes. This is the single best book I've ever read. It combines the narrative flow of a great novel with remarkably lucid explanations of nuclear physics. The colorful personalities (Bohr, Oppenheimer, Teller, et. al.) emerge and diverge in their inexorable march towards a rendezvous with cataclysmic horror, the first—and I hope last—military use of nuclear weapons. Without resorting to polemics the author lays out for the reader this extremely troubling episode in the Cavalcade of Human Folly. The book is both a study in (I believe) the misapplication of science and the nature of unbridled human curiosity that motivates scientists to test a device when they don't truly know whether it will proliferate a chain reaction in the atmosphere and destroy the planet.
▪ Goodbye to All That by Robert Graves. Another chapter in The Cavalcade of Folly, this is the great English poet's rather understated autobiography of his service in World War I. Graves survived the war without a scratch despite constant participation in combat. With dispassionate, almost dry objectivity he puts the reader in the trenches and recreates the unimaginable conditions of that long ago war “to end all wars,” which we only dimly grasp through grainy, jumpy black-and-white newsreel films. I read this book in high school and was motivated to rethink the jingoism and empty slogans that propel countries into senseless wars. In fact, I shared the message of this book with my draft board once upon a time and following a good deal of struggle eventually was classified as a conscientious objector.
▪ Guns, Germs, and Steel by Jared Diamond. Having majored in zoology and wondered why for many years thereafter, at last I encountered a reason in this marvelous, eclectic blend of philosophy, biology, and anthropology. In making sense of recent human evolution Diamond explains the conundrum of the encounters between Old World and “new” from which the indigenous people were decimated.
The book is a marvelous synthesis that incorporates even the author's amazing knowledge of New Guinea subcultures gained during his studies of the local fauna. The technological revolution of the West was a consequence of the ease of diffusion of information among cultures arrayed along the accessible routes that spanned Europe and the Far East. Suffering from the lack of flow of information from north to south the Incas and other pre-Columbian civilizations were no match for a handful of disease-infested, gun-toting Spaniards. The Catholic clergy (Fr. Las Casas, for example) who helplessly bore witness to these rampages were horrified at the systematic destruction of civilizations in the relentless quest for material wealth. Perhaps there's a message here for contemporary America.
H. Rex Greene, MD
Medical Director Dorothy E. Schneider Cancer Center San Mateo, CA