Title:
Lackey, Mercedes, and James Mallory. 2007. When Darkness Falls: The Obsidian Trilogy, Book 3. Tor Fantasy.

Rating:
8/10

Summary:
(Warning: Spoilers!)

The third and final book in this series not surprisingly picks up where the second left off – Knight-Mage Kellen Tavadon, the elves, and the few allies they have been able to muster are locked deep in the heavy winter snows resulting from interrupted weather patterns (Book 1) and are recovering from their battles with the shadow elves and their attempt to discern how The Endarkened are gaining control of Armetheliah (Book 2). The allied forces are weak following these events and spend the first part of the book recovering and developing plans for what to do next. Vestakia is tasked with communicating with the crystal spiders found in the cave just cleared of shadow elves that seem to know the location of the final enclave. Cilarnen, with the help of a collection of High Magick books provided by the elves, has begun developing his abilities as a High Mage and is tasked with various responsibilities, including keeping an eye on Armetheliah through scrying. It’s during his scrying that he figures out the details of Queen Savilla’s plan with Anigrel to remove the magical wards on the walls of Armetheliah to allow her into the city. Anigrel is, meanwhile, trying to convince Lycaelon, Head Mage of Armatheliah and Kellen and Idalia’s father, to form an alliance with The Endarkened, something that would have once been blasphemy to the human High Mages, but with Anigrel’s recent machinations framing the Wild Mages as the enemy, is becoming more appealing.

Due to a lack of communication with Sentarshadeen, the elven capitol city, the leader of the allied armies, Redhelwar, eventually decides to send Kellen with a large portion of the army to Sentarshadeen to find out what is happening and to determine what the army’s next move should be. Along the way Kellen is to clear out and prepare a cave for refugees fleeing the advance of The Endarkened.

Jermayan, meanwhile, is tasked with transporting the elven women with child to the Fortress of the Crowned Horns with Ancaladar, his bonded dragon. In the process of accomplishing this task they arrive in one elven city to find it under siege by the forces of The Endarkened. With Jermayan and Ancaladar’s help the elves abandon the city and flee to the next elven city for protection, losing many elves and supplies in the process, but suffering fewer losses than they would have had they stayed.

Eventually Vestakia is able to discern the location of the last enclave of shadow elves, and it turns out to be the very cave where Kellen is headed, Halacira. Unfortunately her discovery is too late to warn Kellen, but his growing war experience and Knight-Mage insights make him wary enough entering the cave that he doesn’t suffer major losses as he and his forces clear the cave of shadow elves.

From the cave, Kellen continues on to Sentarshadeen to find that Andoreneil, king of the elves, has been stricken with the latest weapon of The Endarkened – plague. Andoreneil is near death, which is why there had been no directions given to the army. Jermayan, relaying all of the events to each division of the army, helps Kellen realize that the goal of The Endarkened is to divide the army, thus weakening it and keeping the allies from seeing the true goal of their enemy – Armethaliah. Once Kellen realizes this and realizes that the real goal of The Endarkened is to take Armethaliah, dividing the two strongest elements of their enemies – humans and elves – Kellen realizes he needs to reunify the army and march on Armetheliah. The problem is that the bulk of the army is over a massive mountain range and it is still deep winter, meaning it will take months to transport the army to Sentashadeen and weeks from there to Armetheliah, which will be too late. Jermayan and Ancaladar offer a solution, but it will cost them deeply – they can cast a spell that will allow the army to teleport to Kellen’s location but Jermayan and Ancaladar will likely die as a result. Recognizing the urgency, all agree that they must do this and only through the intervention of a mysterious force, The Great Hunt, are Jermayan and Ancaladar spared, though their supply of magic is forever exhausted.

With the army united and under Kellen’s direction, they march on Armetheliah. On the way they detect the army of The Endarkened, also marching on Armetheliah. Just before they reach Armetheliah, they observe a small convoy leaving the city – it is Lycaelon and Anigrel. They are headed out of the city to meet with their new allies, The Endarkened (who are demons). The Endarkened, meanwhile, have cast spells that make them look like they are humans, which is not their true form. Realizing what Queen Savilla intends, to capture Lycaelon and sacrifice him in order to bring a demon god into the world making her unstoppable, Kellen sends his forces after The Endarkened, but fails to save his father from the clutches of Queen Savilla.

The initial skirmish ends rather quickly, but it is just the beginning of the battle to come. Cilarnen, with the help of the unicorns, devises a spell that will bring down the wards protecting Armetheliah, a gamble that will allow the allies into the city to hopefully convince the human High Mages to join the allied army and fight The Endarkened. Cilarnen’s spell works and the city wards are removed, allowing Kellen’s forces access to the city. Cilarnen, Jermayan, and Idalia all enter the city and hold a meeting with the remaining members of the High Council who are now leaderless and unable to make decisions without Lycaelon and Anigrel. Luckily, Cilarnen’s father, who was banished from the Council when Cilarnen was banished from the city, steps in and pushes the Council to action, giving aid to both Kellen’s forces outside the city and to Idalia and Cilarnen, who both have tasks to perform if the allies are to win.

Cilarnen’s task is to recast the ward spells on the walls of Armetheliah to prevent The Endarkened from entering the city. Idalia, meanwhile, must figure out a way to save her father from Queen Savilla. Queen Savilla’s magic relies upon sacrifices, and the spell she plans to cast requires the sacrifice of a king or leader, thus only Lycaelon will be sufficient for her sacrifice. Idalia works with the Council to develop a plan to save Lycaelon.

Meanwhile, outside the gates, Savilla’s son, Prince Zyperis, has decided to engage Kellen’s forces in a full-on assault, believing he has them trapped against the walls of Armetheliah. And knowing that the wards are down, he believes his forces can then take Armetheliah. A massive battle ensues. The allies are woefully outnumbered, but thanks to Kellen’s insight from his Knight Magery, the allies not only repel the initial assault but hold their own and eventually seem to be gaining the upper hand. The battle rages for hours, giving Cilarnen sufficient time to raise the city wards, though he nearly dies as a result of the energy expenditure. Once the wards are raised, Prince Zyperis realizes that he has failed his mother and she will likely execute him. Believing he has one chance to redeem himself, he goes for Kellen, believing that the capture of the leader of the enemy forces may appease his mother’s anger. The battle between Kellen and Zyperis, quickly joined by Kellen’s closest friend, Shalkan, is the climactic component of the larger battle as they are basically locked in a stalemate given each other’s abilities and powers.

Meanwhile, Idalia’s plan for saving her father finally comes to fruition. She tells everyone that she knows a spell that will transport Lycaelon inside Armetheliah, but doesn’t tell them that the spell requires a specific price – someone must take his place. That someone is herself. Just as Queen Savilla is about to sacrifice Lycaelon (after she tore Anigrel’s heart out – he thought he was going to be rewarded by becoming her lover), Idalia casts the spell, swapping herself for Lycaelon. Savilla stabs her, not realizing the switch until it is too late. The gods of the Wild Magic use Idalia’s sacrifice to send out a cleansing spell that wipes Endarkened taint from the earth, destroying most of the demons in the process (though it isn’t entirely clear if Savilla and Zyperis are killed, but it seems like they are). Idalia’s sacrifice ends the battle and is the climax of the book. The cleansing magic immediately stops the spread of the plague and begins to restore life to the many areas that The Endarkened had tainted with their evil presence.

Jermayan, Idalia’s lover, realizes her intentions, but too late. And Kellen feels the sacrifice and realizes what has happened. Kellen rushes to the altar where she was sacrificed only to find Jermayan has already arrived and taken her body away in despair.

With The Endarkened defeated, their forces retreat and run, trying to escape the allies. Inside Armetheliah, Lycaelon suffers a nervous breakdown, realizing he has been saved by the very children he disowned and was betrayed by the child he adopted as his own. He resigns from the Council, leaving it leaderless. Cilarnen’s father lobbies hard for Cilarnen to replace Lycaelon as the head of the Council, and after some negotiation, it is agreed. Cilarnen is then able to begin making reforms, which are sorely needed in Armetheliah, to prevent them from falling prey to the wiles of someone like Anigrel again.

Kellen, meanwhile, turns control over the armies back to Redelhwar. Redelhwar gives him one more assignment – take whatever soldiers are willing and track down the remaining elements of The Endarkened’s forces and destroy them. When he is done, he should report to Sentarshadeen. Kellen does, spending the next couple of months tracking down the remnants of The Endarkened’s forces and destroying them.

Once complete, he returns to Sentarshadeen for Idalia’s funeral. He is then tasked with one final assignment, to return to the Fortress of the Crowned Horns and escort the women and children back to their homes. Upon arriving at the Fortress he finds Ancaladar sunning himself outside the fortress, suggesting Jermayan is inside. Upon entering Jermayan reveals the final twist of the book – the Wild Magic returned Idalia’s sacrifice with a gift, she is reincarnated as the child of Andoreneil. As she was betrothed to Jermayan, he was destined to live the remainder of his long elven life (about 1,000 years) alone, but with Idalia reborn (they know because of her distinct birth mark, which the new child has), he need only wait another 20 years or so before she is old enough for them to actually marry.

After the excitement of this realization, Kellen exits the Fortress to find Shalkan and Vestakia. Shalkan tells Kellen that his mage price, to remain celibate for a year, has now been paid (it’s been over a year since he was forced from Armetheliah and it was Shalkan who helped him escape; see Book 1). He is now free to express his romantic interest. A subplot running throughout the book is Kellen’s repressed desire to be with Vestakia, which he could not act upon without being killed by Shalkan for violating the mage price. Free, he embraces Vestakia and they ride off together. The End.

Review:
In the second book, the tedious aspect was the incessant brewing of tea. While brewing tea doesn’t end in the third book, it’s not as prominent, which is nice. But a different component takes it’s place, adding a bit of tedium to the book – the time and efforts involved in passing information back and forth between elements of the army. This probably takes up about 1/5th of the book. While it also adds a bit of realism, it does slow the book a bit.

Another component of the book that was a bit problematic was the whole notion of The Great Hunt. It seemed to be introduced as an aside, but was primarily used as a deus ex machina to ensure that Jermayan and Ancaladar didn’t die after casting their teleportation spell. What The Great Hunt was and why it was needed just wasn’t very well-developed.

Aside from these minor criticisms, I really liked the book. It’s engaging, well thought-out, and compelling. In fact, when Idalia died, I was really kind of distraught. It’s made clear in Book 1 that this will ultimately be a mage price she has to pay, but when it happened I felt it. And while it was clearly cheesy that she was reincarnated – making it so none of the main characters perished – it actually choked me up. While none of the main characters die, many secondary characters do, which also adds a bit of realism to the book. Though it does almost start to become predictable who is going to die – whoever becomes Kellen’s second in command will die (kind of like the red shirts in Star Trek). But the deaths are never dismissed and Kellen suffers each of them greatly.

Overall, the series was engaging. After reading Books 1 and 2 I found myself wondering how the story ends. I read Book 2 a year after Book 1 and was planning on waiting a year to read Book 3, but my flight to England offered a prime opportunity to do a little pleasure reading, so I only waited 6 months. Having finished the trilogy, I’m glad I happened upon it. It’s a well-developed universe with compelling characters and a generally logical (with some exceptions) plot. I highly recommend the series for fans of fantasy writing.

Reference:
Harris, Sam. 2005. The End of Faith: Religion, Terror, and the Future of Reason. W. W. Norton.

Rating:
8/10

Review:
I probably should have read this long ago considering my research interests, but I’m finally just getting around to reading it. Given the title of the book, you’d think the focus would be more along the lines of secularization and how faith/religion is declining (at least in the developed world). But the book is actually more of a diatribe against religion that is more in-line with Christopher Hitchens’s book’s title God is Not Great: How Religion Poisons Everything.

The primary focus of the book is Islamic Fundamentalism and its connection to terrorism. In fact, the book begins with an account of a suicide bomber in Israel destroying a bus filled with Jewish civilians. However, the book ranges widely, from the Catholic Inquisition to the Holocaust to Buddhist spirituality. With the exception of the last topic, all of the topics covered are covered with the aim of illustrating how religion is irrational, dangerous, and generally threatening to stable social life and the future of humanity.

Knowing what I do about Sam Harris and at the risk of coming across as an elitist I can’t help but describe The End of Faith as an extremely well-written undergraduate Senior’s Thesis. As someone who does original research on religion, it seemed to me that this book does not cover any new ground; the book makes no original arguments (except maybe the Buddhist spirituality stuff I’ll come back to shortly). I’d love to have undergraduate students of Mr. Harris’s caliber, but it does seem as though the book is basically a collection of very good undergraduate papers written for various classes: philosophy, history, religious studies, and cognitive psychology. I don’t know that this is really a criticism of the book as it’s likely only a small percentage of people would criticize the book this way; there are only a few thousand people who research religion at more advanced levels. Thus, for most Americans (i.e., the 90% or so who do not have advanced degrees and the other 9.99% of those who do who don’t research religion) this book likely does push their knowledge of religion/irreligion forward. Thus, despite the fact that this book would not get Mr. Harris tenure in a philosophy or religious studies department, it is a great book for spreading awareness of these issues to a broader audience.

Another criticism I have with the book is the double-standard used for criticizing religions. Mr. Harris recognizes that there are moderate and even liberal Christians (though he condemns both of them as enablers of fundamentalism, which probably isn’t fair). But when it comes to Islam, he basically asserts that all Muslims are literalists, that all support suicide bombings and terrorism, and that none of them are even remotely ecumenical. Later in the book he provides evidence that counters his own erroneous assertion when he discusses survey results examining attitudes toward suicide bombings in predominantly Muslim countries. In most of the countries the number is below 50%. The implication: there are moderate Muslims and there are even ecumenical Muslims. Building on this, most of the experts on terrorism today agree that the best way to reduce the spread of terrorism is not to get rid of religion altogether (though that may work eventually), but rather to push religious extremists to become more moderate and tolerant (e.g., see the work of Mark Juergensmeyer). That approach seems far more realistic than simply getting rid of religion altogether. By not seeing this as a viable and more realistic alternative, Mr. Harris is painting a false dichotomy: Either you’re religious and support terrorism, or you’re not religious and don’t. This is, of course, a ridiculous over-simplification of how to deal with the problem of terrorism.

The last major problem I have with the book is one Mr. Harris notes has been a common criticism by his primary fan base, atheists: he frames Buddhist meditation as a form of empirical self-realization. While there is some evidence that meditation helps with health and stress, I fail to see how self-realization can be empirically analyzed. Additionally, it does seem as though he applies a double-standard to Buddhism, letting the rather violent past of Buddhism (e.g., Tibet, Thailand, etc.) slip by with virtually no discussion. His response to this criticism in the edition I read doesn’t really address what I believe are poignant criticisms of his Buddhist favoritism.

Overall, I think the book is compellingly written, but it doesn’t break new ground and suffers from some serious problems. However, Mr. Harris must be credited with bringing many of these arguments into the mainstream. Despite the problems, I would recommend this book for those looking for a better understanding of why some people are leaving religion.

Reference:
Brown, Dan. 2009. The Lost Symbol. Doubleday Books.

Rating:
5/10

Review:
I wouldn’t necessarily consider myself a fan of Dan Brown’s novels, but I have read the two previous novels in the Robert Langdon series and enjoyed them sufficiently to be interested in the latest book. Events conspired to bring the book into my home (my Mom brought it when coming to visit) just as I was getting ready to take a flight across the U.S. for an academic conference in Denver. Facing the prospects of a 4 hour flight (both ways) and having to choose between reading a book for work or a Dan Brown novel, I chose The Lost Symbol. I’m not sure I made the right choice…

As with The DaVinci Code and Angels & Demons, Robert Langdon, the world’s foremost symbologist (whatever that is) is minding his own business when he receives a call and ends up sucked into a plot to reveal the hidden mysteries of, this time, Freemasonry. Freemasonry does, of course, have a close connection to the U.S. and was likely influential in some of the early architecture of Washington D.C. Thus, The Lost Symbol becomes a romp through Washington D.C. as building after building and symbol after symbol are loosely connected to Freemasonry, often through strange machinations that are likely untrue.

The romp through D.C. interweaves with a strange subplot involving Noetic “science”, a field of inquiry solidly falling into the realm of quack-pottery and pseudoscience (see this Wikipedia entry: Princeton Engineering Anomalies Research). One of the main characters, Katherine Solomon, claims to have uncovered the remarkable ability of human thought to alter the physical world just by thinking about altering it, which she, of course, fails to use throughout the book (if it actually worked, it would have saved everyone involved in the story quite a bit of trouble).

As is the case with most stories, there is some pivotal element of conflict that drives the action. The Lost Symbol includes such an element, but it is such a remarkable disappointment that it quite literally deflates the entire book once you find out what it is. Basically (spoiler alert), the antagonist in the book, Mal’akh, joined the Freemasons under false pretenses and filmed all of their initiation rights secretly. He has now edited the rites in such a fashion that they portray Masonry negatively and the film includes footage of a lot of notable Washington D.C. politicians. He sends the video to the CIA and says he’s going to release it to the public unless Robert Langdon translates a map to the “Hidden Mysteries” of Freemasonry for him by midnight. This leads Inoue Sato, the head of the CIA Office of Security, to enter the fray, first helping Robert Langdon find the mysterious pyramid with the map, then chasing him down once he flees. That Mal’akh has threatened to release his edited film of Freemasonry initiation rights isn’t revealed until almost the end of the book, but Inoue Sato shows the video to a number of people to get them to help her track down Langdon and the map, claiming this is an issue of “national security.”

When I finally learned what the “national security” issue was, I literally laughed out loud. This “national security” issue allows the CIA to fly blackhawk helicopters all over D.C. in the middle of the night and no one seems to mind. It also allows heavily armed, nightt-vision wearing CIA agents to traipse through buildings, parks, and subways without anyone so much as raising an eyebrow. All of this happens before the reader is told what the national security threat is, probably because you would find the response so over-the-top you’d stop reading if you learned about it later.

If people in the U.S. don’t know about Freemasonry now, telling them about it isn’t going to change anything. Perhaps my view of Americans is a bit cynical, but I think Americans are too jaded to care that many of the top politicians are involved in rituals that involve dressing up in funny robes and pretending to kill each other. If Freemasons want to spend their time doing that, I don’t think anyone but the most ardent conspiracy theorists will care.

Oh, and Brown also reveals what the “Hidden Mysteries” are in the end – The Bible. Wow! The only way the story could be a bigger disappointment is if the Hidden Mysteries turned out to be something even more unintelligible, like, say, the writings of Franz Kafka or Cleon Skousen.

So, why five stars if the book is so bad? Well, Brown is a good writer. He makes you want to know how the book is going to end. As a result, you are entertained, even if it is just entertaining disappointment after entertaining disappointment. If you want to read a novel you know will disappoint, but may entertain you in the process, The Lost Symbol is a book to consider.

Citation:
Ernst, Edzard, and Simon Singh. 2008. Trick or Treatment: The Undeniable Facts about Alternative Medicine. 1st ed. W.W. Norton & Co.

Rating:
10/10

Review:
Few non-fiction books I have read are as well-written and as clear in their message as is Trick or Treatment. I believe this book should be required reading in high school.

The book begins with a chapter on the importance of scientific thinking, illustrating that most people use scientific thinking every day in their lives – they develop a theory, gather evidence, then determine if their theory was correct (e.g., Is my child sick? Is the cake done?). But one area where critical, scientific thinking is not always used is in healthcare. This book is about the widely accepted but nonscientific practices often referred to as “alternative” or, worse, “complementary” medicine. The definition the authors use for alternative medicine is, “any therapy that is not accepted by the majority of mainstream doctors, and typically this also means that these alternative therapies have mechanisms that lie outside the current understanding of modern medicine. In the language of science, alternative therapies are said to be biologically implausible” (p. 1).

The authors also discuss how it is determined whether or not an intervention or treatment (e.g., a drug or procedure) works in science. The “gold standard” is a randomized, double-blind, clinical trial with the following characteristics:
1. A comparison between a control group and a group receiving the treatment being tested.
2. A sufficiently large number of patients in each group.
3. Random assignment of patients to each group.
4. The administering of a placebo to the control group.
5. Identical conditions for the control and treatment groups.
6. Blinding patients so that they are unaware to which group they belong.
7. Blinding doctors so that they are unaware whether they are giving a real or a placebo treatment to each patient.

If you’re unfamiliar with science, the book explains why such an approach is necessary. You need two groups to which people are randomly assigned in order to determine whether the intervention has any effect. But the control group receives a placebo (an inert version of a drug or sham procedure) to account for our brain’s ability to both help us heal and convince us that we are healing simply because something was done, regardless of the intervention’s actual scientific merits. Both the researchers and the patients must be blinded as well to insure that there is no difference in treatment of patients, which can bias the results. In short, the randomized, double-blind, clinical trial is the gold standard because the results from such trials are the most reliable of any scientific approach. Thus, the book, as it reviews alternative medicines, relies on such trials where available. It should also be noted that practitioners of alternative medicine do conduct their own “research”, but it rarely meets the criteria laid out above for sound research. In fact, there are numerous peer-reviewed journals for alternative medicines that allow these people to “publish” their research then cite their research to lend legitimacy to their mostly illegitimate work. So, practitioners of alternative medicine have done everything they can to imitate legitimate science except actually use the standards that legitimate scientists use to determine whether their interventions work. Alas, the average person may not be aware of these subtleties, which is why this book should be required reading!

The first alternative medicine they discuss is acupuncture. They give a lengthy history of this alternative medicine, but this short quote I think covers it adequately, “The first detailed description of acupuncture appears in the Huangdi Neijing, a collection of writings dating from the second century BC. It presents the complex philosophy and practice of acupuncture in terms that would be largely familiar to any modern practitioner. Most importantly of all, Huangdi Neijing describes how Ch’i, a vital energy or life force, flows though our body via channels known as meridians. Illnesses are due to imbalances or blockages in the flow of Ch’i, and the goal of acupuncture is to tap into the meridians at key points to rebalance or unblock the Ch’i.” (p. 43). In short, acupuncture claims to work by inserting needles into energy meridians to rechannel the flow of Ch’i.

Ironically, acupuncture was virtually extinct in the West in the early 1900s. It became widespread in China after the Communist revolution not because it works but because Chairman Mao promised cheap healthcare for everyone and he couldn’t provide cheap, Western, allopathic (or scientific) healthcare for everyone. So, he advocated acupuncture. He then engaged in a propaganda campaign to convince the Chinese it works. That propaganda leaked out of the country and found a home among the gullible in the West, leading to an increase in acupuncture (p. 46).

So, what’s the verdict on acupuncture using good, scientific tests? “[T]here is no significant evidence to show that acupuncture is an effective treatment for any of the following conditions: smoking addiction, cocaine dependence, induction of labour, Bell’s palsy, chronic asthma, stroke rehabilitation, breech presentation, depression, epilepsy, carpal tunnel syndrome, irritable bowel syndrome, schizophrenia, rheumatoid arthritis, insomnia, non-specific back pain, lateral elbow pain, shoulder pain, soft tissue shoulder injury, morning sickness, egg collection, glaucoma, vascular dementia, period pains, whiplash injury and acute stroke” (p. 77). Any perceived effect of acupuncture on these conditions is purely placebo.

One of the things that makes this book particularly compelling is that, while the authors are clearly skeptical of alternative medicine, they report the scientific findings, even if they may not agree with them. Thus, they do note that there is some questionable evidence that shows that acupuncture may be effective in treating, “pelvic and back pain during pregnancy, low back pain, headaches, post-operative nausea and vomiting, chemotherapy-induced nausea and vomiting, neck disorders and bedwetting” (p. 79). However, keep in mind that even these assertions of efficacy are couched in very tentative terms, as those reviewing the evidence (the Cochrane review) say that the quality and amount of evidence is not convincing (p. 79). What’s more, recent research employing better controls contradicts even these tentative positive findings, suggesting that any affect of acupuncture is purely placebo (p. 81)

That the results are placebo is not at all surprising given the fact that the proposed mechanism of acupuncture is completely non-sensical and wholly without scientific merit. There is, of course, no evidence of Ch’i or meridians in the human body. In short, when high quality trials are conducted using a comparable and convincing placebo (i.e., sham acupuncture), there is no effect beyond placebo. What’s more, acupuncture is not without its risks, “treatments can result in minor pain, bleeding or bruising, but these adverse reactions are only minor: they occur in roughly 10 per cent of patients and are transient. Slightly more serious side-effects include fainting, dizziness, nausea and vomiting, but again these events are rare and are usually associated with anxious patients who may have a fear of needles. Although most patients may accept such risks as an unsurprising consequence of being pierced with needles, there are two very serious adverse effects that patients should consider in advance of visiting an acupuncturist. The first of these is infection. This is a concern because there have been several documented cases of patients contracting diseases such as hepatitis… The other serious risk to patients is the danger that needles might puncture and damage a major nerve or organ. For example, needling at the base of the skull can lead to brain damage, deep needling in the lower back can damage a kidney, and there are over sixty reported cases of punctured lungs, known as pneumothorax” (p. 183). So, before you say that a placebo benefit is some benefit, keep in mind that there are a number of risks associated with this practice and no benefits beyond placebo.

The second alternative medicine discussed is homeopathy. Homeopathy, while surprisingly widespread in the U.S., isn’t widely recognized by the name “homeopathy”, even though homeopathic remedies are on the shelves of pretty much every pharmacy in the U.S. As with acupuncture, the authors give a short history of homeopathy, which was developed in the U.S. by Samuel Hahnemann who “experimented with other treatments and obtained the same sort of results: substances used to treat particular symptoms in an unhealthy person seemed to generate those same symptoms when given to a healthy person. By reversing the logic, he proposed a universal principle, namely ‘that which can produce a set of symptoms in a healthy individual, can treat a sick individual who is manifesting a similar set of symptoms’. In 1796 he published an account of his Law of Similars, but so far he had gone only halfway towards inventing homeopathy. Hahnemann went on to propose that he could improve the effect of his ‘like cures like’ remedies by diluting them. According to Hahnemann, and for reasons that continue to remain mysterious, diluting a remedy increased its power to cure, while reducing its potential to cause side-effects” (p. 95). The basic idea is, you give sick people something that would make a healthy person sick with the same symptoms and that will cure them. But, you don’t actually give them any of the substance that would cause such a reaction. Instead, you give them a diluted version of it.

How diluted, you ask? “The bottom line is that this level of dilution is so extreme that the resulting solution is unlikely to contain a single molecule of the original ingredient. In fact, the chance of having one molecule of the active ingredient in the final 30C remedy is one in a billion billion billion billion. In other words, a 30C homeopathic remedy is almost certain to contain nothing more than water” (p. 99). As noted above, you can purchase these “potions” or “magic pills” in most pharmacies. What you are purchasing is, of course, water or a sugar pill as there is nothing in the remedy if Hahnemann’s principles of dilution are actually followed.

Given the proposed mechanism (like cures like) and level of dilution, this alternative medicine should immediately become suspect as these two ideas run completely counter to modern, scientific thinking (p. 100). There is no evidence that either of these ideas has any scientific merit whatsoever. What’s more, when high quality clinical trials have tested homeopathic remedies, they have been shown to be no more effective than placebos (p. 139). In short, homeopathy is scientifically unsound and pure quackery.

The third alternative medicine examined at length in the book is chiropractic. Chiropractic is the most widespread alternative medicine in the U.S., where nearly $3 billion is spent on this therapy every year (p. 147). It’s so widely accepted that even some health insurance companies cover chiropractor visits (p. 147). So, what is it? As with the previous two alternative medicines, the authors provide some history, beginning with it’s founder, Daniel David Palmer in the late 19th Century,“The chiropractic approach to medicine emerged towards the end of the nineteenth century with a radically new view on health. The founders of chiropractic therapy argued that poor health was due to subluxations, by which they meant slight misalignments of the vertebrae in the spine. In turn, they believed that subluxations interfered with the flow of so-called innate intelligence (akin to a life force or vital energy), which then led to health problems of all sorts” (p. 147). By aligning the spine, it was claimed that all sorts of health problems could be cured, including: asthma, bedwetting, clumsiness, ear infections, gastric problems, hyperactivity, immune-system problems, learning disorders and respiratory problems (p. 180). Chiropractors will also “treat” children and even infants (p. 180).

There has been some change in the chiropractic profession over time, as some chiropractors (called “mixers”) have started to incorporate elements of mainstream medicine (p. 166). But the majority of chiropractors (somewhere between 70% and 80%) remain “straights,” claiming innate intelligence and spinal alignment can cure all sorts of ailments. Even so, the scientific evidence suggests that chiropractic is completely ineffectual for anything other than back pain (p. 167). And when compared with conventional medicine when it comes to the treatment of back pain, it is “just about as effective (or ineffective) as the other” (p. 156). It should be noted here, of course, that science-based medicine does not have good treatments for back pain. Thus, to say that chiropractic is as effective as science-based medicine is really to say that neither of them are very effective at treating back pain.

Chiropractic actually warrants additional criticism beyond simply being scientifically unsound. Chiropractic is big business and is often used simply to enrich the practitioner, “chiropractors, particularly in America, have earned a reputation for zealously recruiting and unnecessarily treating patients. Practice-building seminars are commonplace and there are numerous publications aimed at helping chiropractors find and retain patients. In many cases the emphasis seems to be placed on economics rather than healthcare: the chiropractor Peter Fernandez is the author of a five-volume series called Secrets of a Practice-Building Consultant, which starts with a volume boldly titled 1,001 Ways to Attract Patients and ends with How to Become a Million Dollar a Year Practitioner” (p. 170). In short, chiropractors can’t treat anything other than back pain, and they are not very good at that, but they can empty your wallet!

The last alternative medicine to receive lengthy treatment in this book is herbal medicine. The authors admit that herbal medicine is much trickier to examine because there are clearly medicinal properties in plants – plants have all sorts of drugs in them (p. 196). But herbal medicine practitioners, like other practitioners of alternative medicine, do not subject their practices and “medicines” to the rigors of scientific inquiry (p. 197). What’s more, herbal medicines are generally not regulated and there is no safety control; you don’t know what you’re going to get in a bottle of herbal medicine. In short, herbal medicines may or may not affect you, but they stand about as good of a chance of negatively interacting with other medicines you are taking or causing other negative complications as they do in helping you.

So, given the stunning lack of scientific support for alternative medicines, why do people use them? For some, they have run out of options from conventional medicine and are willing to try anything. But for many others it is ignorance compounded with the misinformation of practitioners of alternative medicine who are often motivated more by money than helping people. What’s more, alternative health practitioners, to bolster their market position, are often critical of mainstream science, hoping it will garner them more clients. Obviously such an approach is not in the best interest of public health, but lining their pocketbooks and fleecing the naïve is more important to many practitioners of alternative medicine than is actually improving the lives and health of people.

The authors ultimately suggest that alternative medicines should be held to the same scientific standards as is conventional medicine (pp. 281-282). Doing so would go a long way toward reducing quackery and the fleecing of the naïve. I whole-heartedly agree.

Overall, this book is superb. I recommend it without qualification. Everyone should read it. It is written at a very understandable level, includes many intriguing stories (e.g., George Washington was killed by alternative medicine practitioners), and is well-sourced. This book should be in every home library.

Note: The book also includes short blurbs on an additional couple of dozen alternative medicines, providing a very brief summary of what it is and what the scientific evidence is for those practices. That section makes for a very useful guide.

Debi and I have a background that provided us with a lot of information about pregnancy and childbirth, so we thought we were at least somewhat knowledgeable about having children (yeah, not really).  I teach a class on the Sociology of Human Sexuality (using this text: Understanding Human Sexuality), so I knew the basic outlines of what to expect as far as pregnancy goes.  Debi is a health and medicine guru who spends a lot of time perusing PubMed and has for years as part of her job.  Granted, she knows a lot about what can go wrong with pregnancy, particularly when it comes to genetic problems, but in order to know what is wrong you have to know what is “normal.”  So, combined, we thought we knew quite a bit about pregnancy, childbirth, and child development.

To add to that, I’ve read a few books on the topic and skimmed a couple more:

• The Complete Idiot’s Guide to Pregnancy and Childbirth
  • When they say “Complete Idiot” they really mean someone who is not at all knowledgeable about pregnancy and childbirth.  This book basically just covered the stuff I cover in my class, but not quite in as much depth, so not much new stuff here for me.
• The Pocket Idiot’s Guide to Fatherhood
  • Again, the title suggests the target audience – those who know next to nothing about pregnancy, childbirth, and being a dad. There were a couple of useful things in here that I hadn’t considered, but otherwise it wasn’t any more informative than the class I teach.  If you’re going to read either of these, I’d go with the first one, which has more information for both mother and father.
• Be Prepared: A Practical Handbook for New Dads
  • As a former Boy Scout, I really liked this book.  It does have some good advice and it covers lots of thing you wouldn’t think of otherwise, but it does it in a very humorous way that clicked for me.  I’d recommend this one.
• The Joy of Fatherhood: The First Twelve Months
  • I’m actually still reading this one as it gives suggestions and an outline of what to expect month-by-month for the first year.  It’s a nice book to have on hand just so you are aware of your child’s developmental milestones.  I’d also recommend this one.
• How to Make a Pregnant Woman Happy
  • This book is actually meant to be skimmed as it is designed to address specific issues when they come up.  So, if there is a problem with, say, swelling feet and ankles, you turn to that chapter and it tells you: (1) What is normal, (2) what you can do to help, and (3) and when you should get medical help.
• The Baby Owner’s Manual: Operating Instructions, Trouble-Shooting Tips, and Advice on First-Year Maintenance
  • This book is similar to Be Prepared in that it turns pregnancy, childbirth, and childcare into something more understandable by men (I hate to stereotype, but it’s kind of true).  It’s kind of like a car owner’s manual, but for babies.  Since I’ve never been that into car’s, Be Prepared resonated more with me.  But engineers out there may get a kick out of this one.

Additionally, Debi has read several books:

• On Becoming Baby Wise: Giving Your Infant the Gift of Nighttime Sleep
  • This book talks about what you should do to get your child to sleep through the night.  FYI, parents who get more sleep are a lot happier with their choice to have a child and with their relationship (reference available upon request).  Without committing the ecological fallacy, we are hoping this is true and that we can get Toren to sleep through the night.  We’ll see.
• New Mother’s Guide to Breastfeeding (American Academy of Pediatrics book)
  • Debi read this, then re-read it.  Considering all the problems she had producing milk (see below) and getting Toren to latch properly, she probably has this book memorized.
• Caring for Your Baby and Young Child: Birth to Age 5 (American Academy of Pediatrics book)
  • We actually received this one for free when we signed up for the Baby Club with our local Publix (kudos to them for sending an American Academy of Pediatrics book).  This book is enormous and covers a lot of stuff.  Plus, it’s from the APA, which means it’s based on peer-reviewed literature, which we always like.  Debi has skimmed through a large section of this already.

In addition to the above books, we’ve read, combined, dozens of peer-reviewed articles and spent quite a bit of time online searching through forums and other websites.  One website I’ve found particularly useful is www.babycenter.com.  If you sign up and fill in the requisite information on their website, including the expected due date, they will send you weekly emails telling you about how your unborn child is developing and what you can expect.  And once the baby is born, they continue to send you weekly emails with information on developmental milestones, etc.  Together, I think Debi and I have read almost every page on that site.  It’s a nice, kind of passive way, to have information delivered to you.  (NOTE: It is ad supported, but some of the deals they have are pretty good.)

So, we’ve tried to become fairly knowledgeable about having a child.  But all of the above aside, there are a few things that no resource has mentioned.  So, here’s “What we’ve learned having a child”…

• Women can produce blood instead of breastmilk.
  • Yep, you read that right.  Given the fact that none of the regular nurses who helped us while we were in the hospital, none of the OBs in the office where Debi went, and none of the pediatricians who work in the office where Toren goes had ever heard of this, it has to be pretty uncommon.  Only one lactation nurse had ever seen a woman produce blood instead of breastmilk, though some of the other lactation specialists had at least heard of it.  Turns out, it has a name “Rusty Pipe Syndrome” (I didn’t say it has a good name, just a name.)  I actually found the name and information on it via the internet and diagnosed it before anyone else did in the hospital (this isn’t me giving myself props but rather me pointing out how rare this is).  Also, just so other people are aware if they happen upon this page searching for information about this, most websites that mention rusty pipe syndrome say that you can either pump for a day or two to clear up the blood or let the baby drink it if there is just a little bit of blood.  They make it out as though there is just a small amount of blood in the milk and not just blood.  FYI, as is the case with most conditions, there is a continuum of severity for this condition.  For some women I’m sure it’s just a small amount of blood.  In Debi’s case, she probably pumped 15 to 20 ounces or more of almost straight blood from each breast before they cleared up (they started to clear after about 3 to 5 days).  We kept one breastmilk bottle with about 2 ounces of straight blood in the hospital room with us for a couple of days just to show all of the medical personnel who came to visit so they would believe us.  Unfortunately, we didn’t take a picture.  The blood also didn’t completely clear out until about 5 to 7 days after Toren was born.  Yeah, this isn’t covered in any of the books we read.
• Babies can learn to breastfeed days and even weeks after they are born.
  • Yes, it’s easier if they start breastfeeding right away, but if you try hard enough (it is not easy to do), you can make it work up to a several weeks after the baby is born.  Most of the literature Debi read on breastfeeding gave the impression that if you didn’t start breastfeeding the very first day it was next to impossible.  FYI, Toren didn’t breastfeed for almost a week and he is now exclusively breastfed.  So, it’s certainly possible to teach a baby to breastfeed after some time has passed, which was not covered in any of the books we read.
• Breastfeeding can be very hard!
  • Yeah, so, no one will probably listen to me write about this, but I listen to Debi as she does it and the truth of the matter is that it isn’t necessarily easy to do.  From what she’s read, for some women it is.  But it depends both on the baby and the woman.  In some cases, neither the breasts nor the baby want to cooperate.  Ergo, breasfeeding can be very, very challenging. That said, there is pretty good scientific evidence that breastfeeding is much better for your baby than is formula (reduces sickness and is correlated with all sorts of advantages later in life).  If you have the patience, it’s worth fighting for.  But it can be a fight!
• It’s not easy figuring out different baby cries.
  • We’ve read in a number of places that “the sensitive mother will be able to tell what her child wants based on the child’s cry.”  Whoever wrote that line should be shot!  As if new mothers don’t have enough stress trying to be perfect, to then assume that cries are easily distinguished and that you are not sufficiently sensitive if you can’t distinguish between them is just mean.  Sometimes Toren cries as though he’s hungry but he just has reflux.  And sometimes Toren’s cry that seems to indicate he’s experiencing reflux is actually him saying he’s hungry.  It’s not easy to figure out the difference.  We think we have it down, but, of course, that’s when Toren mixes things up.  Argh!  And then occasionally he will cry like he is hungry just to be held by mom and use her as a human pacifier (though we caught onto this and don’t let him get away with it, whch is why we introduced the actual pacifier).
• Kids are remarkably resilient!
  • While Debi’s Mom was here she told us about the advice she received when she was having her kids.  She was told to give her oldest, Brian, canned milk and corn syrup.  For a period, pediatricians recommended that all newborns be bottle fed.  And, parents were supposed to have their kids sleep on their stomachs, not their backs.  All of this advice has changed based on better scientific evidence. The take home lesson: even if you really screw up, your kid will probably be fine!  That doesn’t mean screw up, but be glad there is some leeway here.
• Raising a child is not an exact science.
  • We were in the pediatrician’s office the other day with Toren talking about something.  I don’t remember exactly what it was (it could have been the finer details of baby poop or how to deal with reflux), but whatever it was, the pediatrician basically ended up saying, “Do what works.”  Really?     Really?    My response, “Well, I guess raising a child isn’t an exact science.”  She laughed.  As a social scientist you’d think I’d know better than most that raising a child is not an exact science, but apparently not.  It turns out you can’t simply diagnose a problem and then instantly find the cure in a manual.  Sometimes you just try things and hope something works.  And you may not actually be treating the root of the problem but just one of the symptoms.  I think that’s what happened with Toren and his reflux.  We initially thought he was just gassy and that was why he was so uncomfortable and screaming/fussy.  So, we started giving him Mylocon with every feeding (per our pediatrician).  It didn’t seem to be helping, but we were optimistic that it would.  Then one day it kind of dawned on us that the gassiness could be due to reflux.  It wasn’t like we immediately figured it out – Toren was in pain for a few weeks before we realized his stomach acid was burning the inside of his throat, causing him lots of pain (which is why he was arching his neck and back).  Sure enough even though he was not actually spitting up hardly at all, it was coming up partway and then going back down.  So, we treated the wrong thing for a while, hoping it would work only to realize we weren’t treating the real problem.  Once we figured it out, the solution was fairly simple and appears to be fairly effective (the answer is Maalox, 1 ml per feeding – no more pain, but I’m not an MD, so talk to your pediatrician first).  The Maalox does not actually fix the reflux, but it does neutralize the acid so it is not so painful when it does come up and this has helped the fussiness and screaming tremendously.
• Finally, we don’t actually know anything about raising a child despite our reading.
  • While the initial delivery was pretty dramatic, almost equally traumatizing was when we did finally get to our hospital room and they brought Toren in.  There I was with a wife who had just undergone major surgery and who was still woozy from the drugs and now I had a newborn infant who several hours earlier had nearly died.  Despite everything I read, nothing told me exactly what to do at that moment.  The answer is actually pretty simple: improvise.   As the last point hopefully made clear, this isn’t an exact science.  You do your best, read what you can, and hope it works.  If your child is gaining weight and reaching developmental milestones roughly on time, you’re doing fine.  And even if your child is not, it may not be something you did.  So, do your best, talk to your pediatrician often, and try not to worry too much (you’re going to worry).

Well, I think that does it for Volume 1 of what we’ve learned having a child.  If you can consider realizing that you know nothing the first step toward enlightenment, I think I’ve just taken the first step.  I’d sure like to know how many fracken steps there are though!