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Oncology Times:
doi: 10.1097/01.COT.0000445625.15018.88
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Books: ‘BROTHERS EMANUEL: A Memoir of an American Family’ by Ezekiel J. Emanuel

Young, Robert C. MD

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REVIEWED BY ROBERT C. YOUNG, MD
REVIEWED BY ROBERT C. YOUNG, MD
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As the story goes, when Maureen Dowd of the New York Times interviewed medical oncologist Ezekiel (“Zeke”) Emanuel after his brother Rahm's election as the first Jewish Mayor of Chicago, she requested that she meet their mother “to find out what she put in your cereal.” This memoir is Zeke's family biography, giving his view of the answer.

After finishing the book, though, this reader was left with a persistent feeling that it had not captured the full explanation. That three Jewish boys from modest backgrounds from the hardscrabble streets of Chicago could grow up to become successful in medicine, politics, and business should not be remarkably surprising. Indeed, while Jews make up only two percent of the American population, they account for about a third of the Supreme Court, a third of American Nobel Laureates, and two-thirds of Tony-Award-winning composers and lyricists.

What is striking in this case is that all three of these high achievers were brothers.

Zeke's book makes it easy to understand why they all turned out liberal and cause-oriented. Their grandfather was a rough-and-tumble union organizer. Six months after their mother was born, their grandmother joined a protest against Hitler. Their strong-willed mother followed in her parents' footsteps. She was by her own description, “a lie-down-in-the-street kind of person,” and was a frequent organizer and demonstrator for the Congress of Racial Equality and anti-war causes.

The family was close-knit but steeped in the tradition of rowdiness, raucous debates, and screaming arguments. One gets the impression that the family-dinner table discussions were actually loud and profane exchanges during which the primary goal was to prove that the other speaker was wrong. The debates were full of phrases like “you're an idiot, and here is why.” “Offense is the best defense” was his father's view.

All this provides ample explanation for their liberal politics, aggressive styles, and fierce desire to win. Still, that doesn't explain why all three succeeded.

Perhaps it was just my personal reaction to the story, but it was troubling that the strident, protest-driven, cause-oriented family raged against injustice while actually living rather well. Their mother took the boys on picket lines against the Chicago Board of Education while the boys attended a private day school. Their lives were enriched by travel at young ages, with the finest education paid for by a hard-working and very successful pediatrician father who was several times in the book referred to as a “cheapskate.”

Zeke describes clearly the bi-polar, survival-of-the-fittest atmosphere, with the boys constantly competing for attention, comparing results, fighting, and engaging in loud debate, contrasted with an environment where each boy felt loved, safe, secure, and valued. The boys were allowed to make their own choices and express their own views. They had great freedom to explore their neighborhoods unsupervised, which bred self-reliance and individual responsibility.

It is striking how deeply the boys were involved with the adult world through protests, debates, and travel before they were even 10 years old. Zeke's first anti-war letter to the editor of the Chicago Tribune was published when he was 13.

While the book explains much about the family and the boys' early life, it still falls short of clearly explaining the success of the threesome. While it could be chalked up to a statistical accident, one suspects it is more than that.

Amy Chua (author of Battle Hymn of the Tiger Mother) and her husband Jed Rubenfeld, both Yale Law School professors, suggest a credible explanation in a New York Times opinion piece (1/25/14, “What Drives Success?”http://nyti.ms/OuZ5Xd).

They describe three characteristics as being highly correlated with success: (1) A superiority complex—a deep seated belief in their preeminence; (2) Insecurity—a sense that one must struggle against inadequacy; and (3) Impulse Control—the ability to delay gratification.

Chua and Rubenfeld argue that all three characteristics must be present and that one or two alone are insufficient. They describe this in detail in their new book, The Triple Package. The book is controversial because of its focus on racial or cultural groups in America. I have not read the book and will not comment on the controversy. That said, the concepts presented in the NYT opinion piece seem quite applicable to the lives and experiences described in Brothers Emanuel.

All three brothers were intensely competitive, convinced of their own abilities, and all had a passionate desire to succeed. All three had traits that caused them painful feelings of inferiority. All three felt it impossible to satisfy their mother. Zeke was “obsessed with beating the other bright students.” Rahm was uncomfortable with his diminutive size and interest in ballet. Ari was burdened with dyslexia and hyperactivity.

As for “impulse control,” having lived in an impulse-driven environment, they have each managed to channel these impulses and learned how to deal with others. They have achieved delayed gratification in their educational as well as their career paths. Viewing the book from this perspective seems to more fully explain the triple package of the Brothers Emanuel.

Zeke is a workmanlike writer. While not blessed with the lyrical skills of certain full-time biographers like Pat Conroy or Joan Didion, he nonetheless tells a straightforward story. The book is more descriptive than penetrating—perhaps because, as he says, “we were never encouraged to articulate our deeper feelings; our discussions of how we felt generally were expressed in monosyllables.”

If you are looking for a biography of an oncologist, you need to look elsewhere. The only mention of oncology appears in three paragraphs on page 258 of the 272-page hardcover book.

Perhaps all biographies leave the reader only partially fulfilled. In the opening of this book is a 1904 quote from Mark Twain: “An autobiography is the truest of all books; for while it consists mainly of extinctions of the truth, shrinkings of the truth, partial revelations of the truth, with hardly an instance of plain straight truth, the remorseless truth is there, between the lines.”

RANDOM HOUSE, 2013, ISBN: 081298126X, AVAILABLE IN HARDCOVER, PAPERBACK, KINDLE, AND AUDIO EDITIONS

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