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Lost
in America: A Journey With My Father
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By Sherwin B Nuland, MD
Review
by Vincent J Felitti, MD
New
York: Alfred A. Knopf; 2003. ISBN 0-375-41294-8. 212 p; $24.00
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Sherwin
Nuland, MD, is an accomplished surgeon; he started as Chief Surgical
Resident at Yale University School of Medicine; later, he won the National
Book Award (in 1994) for How We Die.1 His recent,
short autobiography, Lost in America, differs from any autobiography
I have ever read.
This book
is about the shame felt by a poor immigrant's son for his family. In
particular, it is about the revulsion felt by a loyal son for his father--and
the damage sustained by his family as they changed cultures from Russia
to New York City to seek The American Dream. The book is also
about the intense effort of a bright young man to escape from the often
embarrassing, occasionally warm world of his Jewish immigrant family
in the Bronx to the "goyish" world of the Ivy League.
Nuland's
autobiography is the story of the author's long day's journey into night.
Professional success was followed by personal failure and divorce; ultimately,
Dr Nuland became intractably depressed and suicidal to the point of
accepting electroshock therapy, which was the alternative to frontal
lobotomy, another treatment option offered to him during his serious,
year-long hospitalization. Lost in America is a book written
with such unsparing openness and honesty about the author's own feelings
and motives that most readers will probably relate to it in several
ways.
The following
passage from the Introduction conveys a sense of the book and illustrates
the author's skillful way of describing his close-yet-distant, isolating
relationship with his father: "My father's power and the weakness
that nurtured it have accompanied me all the days of my life. I have
struggled to be the un-him-to be the opposite of what he was-and
in the struggling I have faltered and fallen many times. His lingering
power over me has been the source of much of my weakness; I have responded
to the threat of his weakness by seeking to find ways to resist it-to
be so powerful against it that I am unassailable by that great portion
of himself that he has left within me. And in the process, I have instead
become rather more like him than less."2
Dr Nuland's
life is the story of a man's lifelong response to his father's rages
and to the shame of his father's progressively unsteady gait, a condition
associated with occasional bouts of pain that struck like lightning.
The basis for these symptoms provides a medically interesting sidelight
that is almost a relief from the intensity of the author's life story.
This story is of a life spent trying to understand itself. The book's
memorable opening quote, attributed to Philo of Alexandria, is also
a fitting close: "Be kind, for everyone you meet is fighting a
great battle."
For physicians,
Lost In America is meaningful because it is so easy for us to
make ourselves unassailable with what we know.
References
- Nuland
SB. How we die: reflections on life's final chapter. New York: Knopf;
1994.
- Nuland
SB. Lost in America: a journey with my father. New York: Knopf; 2003.
