What Really Matters
By Arthur Kleinman

Rating: 9 on a scale of 10
Writing: Good
Length: Medium
Copyright: 2006

Review

This was a sort of seductive book for me. At first, I was a little tentative, as I progressed through it I found it more and more interesting, and after I finished it, I found myself talking to people about it repeatedly. The author is a seasoned psychiatrist, researcher and an anthropologist with some years behind him. This book is a collection of stories about people he has known throughout his life and the 20th century. He presents them in a form I would call  testimonials of a sort. He has sought out people, from his experience, who were faced with significant moral problems in their lives. He presents the stories in a first person and second person voice, frequently allowing them to describe first hand what happened and how it was resolved by them, with a modest amount of his own commentary.

He briefly introduces some ideas about moral issues and what will happen in the book, then moves right into the stories. I found each story quite engaging. A world war veteran with issues regarding war atrocities where his soul was at stake, a humanitarian worker who specializes in going to the worst of the worst places where her eventual "desolation" stimulates him to write this book, a physician who grew up in China and only came here after about age 68 describing the convolutions of his life and the struggles of a society bereft of a soul, a pastor with chronic pain and a past involving issues of sexuality, an artist who loses everything sinking into the lower levels of society with heroin abuse and how she recovers, a city sewage system worker, a Jewish kibbutz leader, and a physician from the early 20th century W.H.R. Rivers.  Each story has a point to make about how we resolve moral issues in our lives over the course of time. These are short stories on each person, given in the persons own voice often, with sufficient detail to let you know about their life and how they reached the point of a difficult decision and then how they resolved it, or not. Each story covers many years of each person's life. We are privileged to hear the "long view" of each person. I truly felt like it was a privilege to hear this perspective of time. So often, I interact with people over short time frames and it is difficult to get the big life picture of how they grow, develop, struggle, become aware, and find resolution to the issues life presents them with. This is a book a young person can't write.

As a practicing internal medicine physician in mid-life, I am just beginning to see the long view with patients, family, and friends. This book explores the importance of people working through their life issues involving moral choices and how these choices relate to their position in society, their political condition, their cultural meanings, social experience, and their internal subjective response to it all. We all face issues of  "loss, threat and uncertainty", and the question is raised as to how we deal with the moral issues that are present in all of these situations. We all live in a context, and an important part of anyone's context are the moral issues raised in that context and how we deal with them.

I especially like his focus on people who seemed fairly ordinary. He does not present people who have become famous. He seems to want to get across the point that normal people face significant moral issues and how they deal with them makes a big difference. It is important for us all to find balance in our moral worlds of life. He discusses at times the idea of the anti-hero. I found this interesting and useful to understanding some of my own tendencies. I like his comment early in the book that heroic acts able to change society are rare. However, protest, resistance, "perturbing and disturbing the status quo, are, at best, the most ordinary people like us can achieve." The heroic quest is attained by most of us in ordinary ways, and by many as the anti-hero, for whom there will be no applause beyond grudging recognition that our voices are necessary, but annoying still. I can live with that.

This is an easy read, but it is deceptively enveloping once you start. The issues raised are compelling. Enjoy this book and consider your own story.

All opinions are mine. Copyright 2010 Curtis Climer

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