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Book Reviews
I was 28 years old, a new arrival in inner-city Brooklyn from rural Illinois. The foreign-born neurology resident asked me where I was from. "Illinois," I replied. "Is it much different from here?" he asked. "A real culture shock for me. The noise, the traffic, the inner city-it's going to take some getting used to. And where are you from?" "Afghanistan." "Oh," I said. "Is that part of Iran?" Explaining he had been raised in Kabul and graduated from medical school there, his mandatory first year of practice consisted of a journey on foot into the mountains toting a medical bag with a few pills, syringes, and vials. He had to deliver medical care without a laboratory, without an imaging department, and without a pharmacy or any staff. I was embarrassed by my naïveté regarding other cultures. The Afghan neurologist was my introduction to the diversity of nations, religions, and people who had recently immigrated to New York. And as anyone who has visited New York knows, that city is a unique place where diversity of culture is the rule. However, few people are aware that Queens (the borough which includes JFK and LaGuardia airports) has 58 distinct neighborhoods in which a total of 138 languages are spoken; or that Queens Boulevard only allows 60 seconds to cross its 12 lanes of traffic; or that more than 70 people were killed crossing this street in the past ten years.1 One writer called Queens Boulevard "the human bowling alley." The theme weaving the stories in Crossing the BLVD together is that many immigrants to contemporary New York have lives filled with challenges as daunting as crossing those 12 lanes of traffic. Warren Lehrer and Judith Sloan chose to live in Queens and thereby learn about the cultures represented nearby. Crossing the BLVD is the product of the two years Lehrer and Sloan spent collecting the stories of new immigrants--79 individuals who arrived in the USA during the ten years from 1992 through 2002. The authors accurately describe their effort as "a search for migration stories, culture, and soul." As a collection of interviews, BLVD is worth purchasing and reading; but it is far more. It is a montage composed of colorful photos, world music (on an accompanying compact disk), and astonishing first-person narratives of people who hail from every imaginable point on the globe. Lehrer and Sloan take us down sidestreets into bodegas, family-owned restaurants, places of worship, and homes of the book's subjects. The photographs accompanying each story show personal treasures, memorabilia, clothing, and art. Each section begins with a map of the subject's home country superimposed over a map of the Queens neighborhood where the person resides. Who is Interviewed? The authors interviewed people as varied as the following examples:
Their stories are spellbinding, and the art is captivating. Although not an "art book," BLVD is a work of art--a unique contribution to both art and literature. Beyond its literary merit, the book has special interest to those of us in health care, because recent immigrants bring special problems to medical practice: They require us to blend science, sensitivity, and cultural understanding into medical practice. Without this understanding, we frequently stumble on a mixture of potentially unusual biomedical disease and major somatization problems. (How often is a question about torture part of our Review of Systems?) A book like BLVD can help us meet the needs of this special population by using both creativity and compassion. For a sampling of what awaits the reader in this amazing volume, visit the Web site: www.crossingtheblvd.org/. Reference
Eric Schuman, MPAS, PA-C, is a physician assistant from Kaiser Permanente Northwest in the departments of Family Practice and adult and pediatric neurology. He is a member of the Advisory Board of The Permanente Journal and moderates the headache message board at http://members.kp.org. E-mail: eric.schuman@kp.org.
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