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		<title>The Empusium by Olga Tokarczuk </title>
		<link>https://medhum.org/review/book-review/steven_field/the-empusium-by-olga-tokarczuk/</link>
					<comments>https://medhum.org/review/book-review/steven_field/the-empusium-by-olga-tokarczuk/#respond</comments>
		
		<dc:creator><![CDATA[Steven Field]]></dc:creator>
		<pubDate>Mon, 24 Mar 2025 14:43:58 +0000</pubDate>
				<category><![CDATA[Book Review]]></category>
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		<category><![CDATA[Olga Tokarczuk]]></category>
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		<guid isPermaLink="false">https://medhum.org/?p=9748</guid>

					<description><![CDATA[A Gothic, feminist horror novel blending folklore, philosophy, and suspense in a tuberculosis sanatorium before World War I.]]></description>
										<content:encoded><![CDATA[
<h4 class="wp-block-heading"><strong>Back to the Mountain</strong>&nbsp;</h4>



<p class="wp-block-paragraph">Shortly before the outbreak of The Great War, a young engineering student arrives at a tuberculosis sanitorium high in the mountains of Central Europe. Over the course of his visit there he will share many meals (and drinks) with some of the other patients, a group which will include among others a Catholic conservative and a liberal humanist; there will be long, leisurely after-dinner discussions of varied philosophical topics; temperature charts will be compared; and he will become intrigued by a mysterious woman who is also a patient.&nbsp;&nbsp;</p>



<p class="wp-block-paragraph">And no, this is not <em>The Magic Mountain</em>.&nbsp;</p>



<p class="wp-block-paragraph"><em>The Empusium</em> is the latest novel from the Nobel- and International Booker Prize winner Olga Tokarczuk. The author subtitles her book “A Health Resort Horror Story,” which is exactly what it is. But it is a horror story which the author has cleverly folded into not just the setting of Thomas Mann’s novel, but the setting and certain elements of the plotline, all of them slightly altered, but recognizable. In fact, recognizing them is part of the fun of this well-plotted, rather Gothic tale.&nbsp;</p>



<figure class="wp-block-image alignright size-medium is-resized"><img fetchpriority="high" decoding="async" width="300" height="300" src="https://medhum.org/wp-content/uploads/2025/03/Screen-Shot-2025-03-22-at-21.12.32-e1742692956220-300x300.png" alt="" class="wp-image-9752" style="width:280px" srcset="https://medhum.org/wp-content/uploads/2025/03/Screen-Shot-2025-03-22-at-21.12.32-e1742692956220-300x300.png 300w, https://medhum.org/wp-content/uploads/2025/03/Screen-Shot-2025-03-22-at-21.12.32-e1742692956220-150x150.png 150w, https://medhum.org/wp-content/uploads/2025/03/Screen-Shot-2025-03-22-at-21.12.32-e1742692956220.png 400w" sizes="(max-width: 300px) 100vw, 300px" /><figcaption class="wp-element-caption">Olga Tokarczuk </figcaption></figure>



<p class="wp-block-paragraph">As the novel opens Mieczysław Wojnich, a young Pole from Łwów, has arrived at the tuberculosis sanitorium at Gӧbersdorf, in Lower Silesia (currently Poland, formerly Prussia), to be treated for his illness. There is no room at the main building, so he is assigned a room at Opitz’s Guesthouse for Gentlemen, where he meets his fellow (male) patients, who come from various Central European cities and differing viewpoints, but who seem to agree on one thing: the general inferiority of women. Philosophical discussions, which often take place over or after leisurely meals and the consumption of a magic mushroom-laced liqueur called Schwӓrmerei, range widely over several topics (war, language, the nature of reality) but most of the time are intensely misogynistic—what is the purpose of women? Do women have smaller brains than men? Do women’s bodies belong to the State? Have any great discoveries ever been made by women? Should women even be educated at all? (Tokarczuk helpfully includes an appendix to the novel in which she notes that all of the quotes of her characters on this subject are paraphrased from quotes by well-known prominent authors of the past, from Augustine of Hippo to William Butler Yeats) &nbsp;</p>



<p class="wp-block-paragraph">Things at the sanitorium go badly from the beginning of Wojnich’s stay. He stumbles upon the dead body of a woman laid out on a table, who turns out to be the wife of the guesthouse proprietor, and his companions tell him surreptitiously that she may have been murdered. He hears noises—voices—coming from empty rooms, and cries in the night from outside the guesthouse. An art student who is terminally ill confides that “people die here,” and not just from tuberculosis; every November, apparently, a young man disappears in the surrounding woods, only to have his body turn up ripped to pieces. And what exactly is going on with those woodsmen in the forest, anyway?&nbsp;</p>



<p class="wp-block-paragraph"><em>The Empusium</em> works on many levels. It is an homage to <em>The Magic Mountain</em>, but it is definitely not a retelling of <em>The Magic Mountain</em>. The allusions to Mann’s novel are multiple: the pre-World War I setting at a sanitorium in both novels; the fact that both Mieczysław Wojnich and Hans Castorp are engineering students; the philosophies of Settembrini and Naphtha in the <em>Mountain</em>, analogous to the conservative and humanist positions taken in <em>The Empusium</em>; the close childhood relationship between Castorp and Pribislav Hippe (<em>Mountain</em>) and Wojnich and Anatoly (<em>Empusium</em>), in each case bonding over a pencil. And as in <em>The Magic Mountain</em>, there is a narrator who occasionally breaks the fourth wall; verb tenses in <em>The Empusium</em> shift repeatedly from third-person singular past tense to first-person plural present. These are not subtle, nor are they intended to be.&nbsp;&nbsp;</p>



<p class="wp-block-paragraph">Allusions aside, <em>The Empusium</em> is its own story, and a totally different narrative. It is a horror story, a revenge story, a wryly feminist tale of the supernatural set in a place hopefully of healing but also of chronic illness and the ever-present specter of death. Tokarczuk builds suspense slowly, bit by bit, with increasing tension. Almost from the beginning there is the undeniable sensation that something is very wrong at Gӧbersdorf, although it’s hard to pin down exactly what it is. Wojnich often has the feeling that he is being watched. The story line draws from a tradition of folk horror, and specifically from the notion that bad things can happen to “city people” when they are out in the country, among the “old ways.” &nbsp;</p>



<figure class="wp-block-image alignright size-large is-resized"><img decoding="async" width="671" height="1024" src="https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-671x1024.jpg" alt="" class="wp-image-9749" style="width:280px" srcset="https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-671x1024.jpg 671w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-196x300.jpg 196w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-768x1173.jpg 768w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-1006x1536.jpg 1006w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-1341x2048.jpg 1341w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL-1320x2016.jpg 1320w, https://medhum.org/wp-content/uploads/2025/03/61wlR88sdPL.jpg 1524w" sizes="(max-width: 671px) 100vw, 671px" /></figure>



<p class="wp-block-paragraph"><em>The Empusium</em> is also more than just a horror story, and an important aspect relates to the misogynistic attitudes mentioned earlier. Tokarczuk takes a position on the nature of male-female relations (perhaps the use of a sanitorium as the setting is meant to suggest that misogyny is an illness infecting educated society). In this book “civilization” seems to be identified with maleness, and maleness is located in the sanitorium and the guesthouse, a controlled environment with its dining rooms and drawing rooms and intellectual conversation—and in the medical world, since this is a facility for medical treatment— and it is here that women are demeaned. The forest, on the other hand, is the home of the Tuntschi, female figures created by laborers out of sticks and moss and other forest detritus. It is a place both beautiful and enchanting—and dangerous. Men venture into the (female) forest, and the forest—in the form of the Schwӓrmerei, which Wojnich describes as redolent of mushrooms, moss, and earth—is brought into the guesthouse; boundaries are porous. Male and female, the guesthouse and the forest each have their secrets…and Wojnich is the last to know. But Wojnich has a secret of his own. &nbsp;&nbsp;</p>



<p class="wp-block-paragraph">And the title? A word created by the author. Empusa, in Greek mythology, was a shape-shifting female spirit who seduced young men, drank their blood, then devoured them.&nbsp;&nbsp;</p>



<p class="has-palette-color-5-background-color has-background has-small-font-size wp-block-paragraph"><strong><em>The Empusium</em></strong><br>Olga Tokarczuk <br>Riverhead/Penguin Random House, New York, 2022 <br>302 pp. <br><br>Web photo by <a href="https://unsplash.com/@marekpiwnicki" target="_blank" rel="noreferrer noopener">Marek Piwnicki</a> </p>



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		<title>Kairos by Jenny Erpenbeck </title>
		<link>https://medhum.org/review/book-review/howard_trachtman/kairos-by-jenny-erpenbeck/</link>
					<comments>https://medhum.org/review/book-review/howard_trachtman/kairos-by-jenny-erpenbeck/#respond</comments>
		
		<dc:creator><![CDATA[Howard Trachtman]]></dc:creator>
		<pubDate>Fri, 21 Feb 2025 14:18:36 +0000</pubDate>
				<category><![CDATA[Book Review]]></category>
		<category><![CDATA[Video]]></category>
		<category><![CDATA[Berlin]]></category>
		<category><![CDATA[Berlin Wall]]></category>
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		<category><![CDATA[betrayal]]></category>
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		<category><![CDATA[East Germany]]></category>
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		<guid isPermaLink="false">https://medhum.org/?p=9562</guid>

					<description><![CDATA[A haunting, claustrophobic novel exploring obsession, power, and control against the oppressive backdrop of East Germany’s final years.]]></description>
										<content:encoded><![CDATA[
<p class="wp-block-paragraph">Beware, this is a very, very depressing book. <em>Kairos</em> is dark and foreboding. It will upset you from the start, and it will not leave you feeling any better when you are finished. But it will prod you to think, it will rattle around in your brain like an unwelcome guest who does not know when to leave. I predict it will challenge you to ponder how you would behave more than any other book you are likely to read in the near future.&nbsp;</p>



<p class="wp-block-paragraph"><em>Kairos</em> is the claustrophobic story of an affair between a 19-year-old woman and a married man more than 30 years her senior. Nothing unique in that situation. But this clandestine relationship unfolds against the backdrop of the last years of the German Democratic Republic before the sudden collapse of the Berlin Wall. This too is familiar territory &#8212; from novels like John LeCarre’s <em>The Spy who Came in from the Cold</em> and Ian McEwen’s <em>The Innocent</em> to popular movies like <em>The Lives of Others</em>. What makes <em>Kairos</em> different from anything that I have read about this period is the microscopic view it provides of the dysfunctional relationship between Katharina and Hans and the larger vision of reality that emerges.&nbsp;</p>



<p class="wp-block-paragraph">Their initial meeting is a completely chance encounter on a bus in Berlin as they shove to board it and escape the rain. They spy each other immediately and within a few pages are sleeping together. Hans is a married broadcast journalist who seems to have found a secure niche for himself despite state control of the press, while Katharine is a student in theater arts. Literary May-December romances are not uncommon, but the rushed and secretive meetings between the two lovers quickly move into less comfortable terrain. Katharine becomes increasingly insecure and less assertive in her interactions with Hans. Violent sadomasochistic behavior intrudes into their space, and Hans becomes more domineering and demanding. This is not a fuzzy tale of two star-crossed lovers who pine longingly for one another; this is obsessive territory. Over time, distrust and suspicion and mutual cruelty invade the lovers’ trysts. When Katharine leaves Berlin for a period of academic study in Frankfurt, it triggers exaggerated accusations of betrayal by Hans. He blames Katharine for being unreliable and not fully committed to their relationship and calls into question her loyalty to him. There is lots of sex and coded signals and furtive meetings to avoid detection by Hans’ wife and son. But the mood becomes chillier and more tense with each turning page. Eventually, the political uprising across Germany and Eastern Europe ruptures the novel’s narrow field of vision and alters the contour of their illicit relationship. &nbsp;</p>



<p class="wp-block-paragraph">The novel is bracketed by two efforts at historical reconstruction, accomplished by mining written records from the period. This highlights the power of literary narratives to frame our lives, something that <em>Kairos</em> accomplishes so successfully. The plot is spare but Jenny Erpenbeck has created a novel that is very thick with the lives of the two characters, and it is that richness of texture and intimacy, disturbing as it might be, which causes the book to reverberate in your memory long after you put it down.&nbsp;</p>



<p class="wp-block-paragraph">Why is that? What <em>Kairos</em> accomplishes better than other books I have read in recent memory is its ability to bring to life the impact of our social and political environment on our inner lives. The tautness of Erpenbeck’s writing, the novel’s ominous and suspicious atmosphere, are a direct reflection of what it might have been like to live in East Germany after the Iron Curtain descended and the Berlin Wall was erected. The East German domestic spy service, the notorious Stasi, infiltrated everyday life. Anyone could be an informer and everyone could be informed on. Petty offenses against the Communist party, minor disagreements between colleagues about policy, and trivial comments among friends about current affairs could quickly escalate into charges of treason, of being an enemy of the state. No one knew exactly what could provoke a summons to a closed room interrogation and a prison sentence.&nbsp;</p>



<p class="wp-block-paragraph">&nbsp;It is in this stultifying environment that Katharine and Hans’s relationship takes shape and it is against this sweeping historical background that we confront and must try to understand their thoughts and actions. Katharine is young but seems deadened by life on the dreary East German side of the Berlin Wall with its brutalist architecture and its color spectrum ranging from shades of gray to shades of gray. For her, even a destructive relationship with an older man, a spiteful and hurtful one at that, may have provided a glimmer of hope for a “real” life. Hans has survived under the Communist regime and achieved a modicum of fame and fortune. But we can only speculate on the cost. Erpenbeck makes it clear that the price was high. The humanity of both main characters has been stunted by their reaction to living in a police state and by internalizing the distrustful depersonalizing actions of the government’s internal espionage apparatus. I suggest that Erpenbeck’s accomplishment is to show how the political environment can influence personal patterns of behavior.&nbsp;</p>



<p class="wp-block-paragraph">How would we have held up if forced to live under such conditions? Would one have had the courage to speak truth to power or would one have hunkered down, kept a low profile, and avoided confrontation with the state? What would we have resorted to in order to protect ourselves and our job, family, and friends? Could we have maintained our humanity and dignity? Katharine and Hans lived with these unbearable dilemmas every day and their personalities were gradually warped under the relentless pressure.&nbsp;&nbsp;</p>



<figure class="wp-block-image alignright size-large is-resized"><img loading="lazy" decoding="async" width="688" height="1024" src="https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-688x1024.jpg" alt="" class="wp-image-9565" style="width:180px" srcset="https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-688x1024.jpg 688w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-202x300.jpg 202w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-768x1143.jpg 768w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-1032x1536.jpg 1032w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-1376x2048.jpg 1376w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL-1320x1964.jpg 1320w, https://medhum.org/wp-content/uploads/2025/02/71Od-25mmPL.jpg 1613w" sizes="auto, (max-width: 688px) 100vw, 688px" /></figure>



<p class="wp-block-paragraph">It is easy to devalue the lives of others living in the former East Germany or Soviet Union, or current China or Iran, where men and women are forced to remain in countries that interfere with the freedom to think and express oneself and where every thought and action is under surveillance. But it would be a mistake. We should not lose sight of external factors in this country that threaten our individuality and our humanity. Whether it is political uniformity and social tribalism or blind use of the tools of artificial intelligence, we too must recognize and address the social forces that could impact on how we interact with the world and behave to one another. Like the Stasi in East Germany, these forces have the real potential to diminish our stature as moral agents.&nbsp;&nbsp;</p>



<p class="wp-block-paragraph">Neither main character in <em>Kairos</em> is easy to identify with and it is hard to muster sympathy for the plight of either one. But our distaste for Katharine and Hans is tempered by the knowledge that their souls have been distorted, damaged almost beyond repair, by a state that has flattened the complexity of human individuality into a file of incriminating notes based on informer reports. I suspect it may be especially hard for a woman to read this book and suffer along with Katharine as she is manipulated and physically and psychologically abused by Hans. But one cannot escape the reality that Hans too is a victim. Quality literature like <em>Kairos</em> does not aim to rationalize human behavior. What it can do is contextualize fictional characters and in doing so make us understand what some of our fellow human beings are going through a little bit better and with a little more sensitivity.&nbsp;</p>



<p class="wp-block-paragraph">&nbsp;</p>



<p class="wp-block-paragraph"></p>



<h5 class="wp-block-heading">Winner:  International Booker Prize 2024</h5>



<p class="wp-block-paragraph"><strong>A Q&amp;A with Jenny Erpenbeck and translator Michael Hofmann </strong></p>



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<iframe loading="lazy" title="A Q&amp;A with Jenny Erpenbeck and Michael Hofmann | The Booker Prize" width="1310" height="737" src="https://www.youtube.com/embed/zciDuKu1Cqg?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe>
</div></figure>



<p class="wp-block-paragraph"></p>



<p class="has-palette-color-5-background-color has-background has-small-font-size wp-block-paragraph"><strong>KAIROS</strong> <br><strong>Author</strong>: Jenny Erpenbeck <br><strong>Publisher ‏ : ‎ </strong>New Directions; First Paperback Edition (May 14, 2024) <br><strong>Hardback</strong>: 2021, Penguin Verlag <br><strong>Paperback</strong>: 304 pages <br><strong>ISBN-10 ‏ : ‎ </strong>0811238539 <br><br>Photo by<a href="https://medhum.org/author/lucy_bruell/"><strong> Lucy Bruell</strong></a></p>



<p class="wp-block-paragraph"></p>
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		<title>Knife by Salman Rushdie</title>
		<link>https://medhum.org/review/book-review/howard_trachtman/knife-by-salman-rushdie/</link>
					<comments>https://medhum.org/review/book-review/howard_trachtman/knife-by-salman-rushdie/#respond</comments>
		
		<dc:creator><![CDATA[Howard Trachtman]]></dc:creator>
		<pubDate>Fri, 27 Sep 2024 20:48:07 +0000</pubDate>
				<category><![CDATA[Book Review]]></category>
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		<guid isPermaLink="false">https://medhum.org/?p=7541</guid>

					<description><![CDATA[
Recovery from trauma isn’t linear. Doctors think in long-term progress, while patients crave quick fixes, hoping for the moment when they’re finally told they’re "fine."]]></description>
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<p class="wp-block-paragraph">Salman Rushdie’s life story is a well-known tale. It has become an allegory of sorts in these tense times of global religious fanaticism. To briefly summarize, Rushdie achieved sudden world-wide fame in his thirties with the publication of <em>Midnight’s Children</em>, a winner of the Booker award in 1981. It is now considered the best novel of all the winners over the 40 years that the prize has been awarded (<a href="https://thebookerprizes.com/the-best-of-the-booker" target="_blank" rel="noreferrer noopener">the Best of the Booker web page</a>). He then authored a fourth book, <em>Satanic Verses</em>, in 1988 that triggered the ire of Muslims around the world who accused Rushdie of defaming the prophet Mohammed and denigrating their faith. A fatwa was proclaimed on Rushdie by Ayatollah Khomeini and the imams in Iran forcing him to live in semi-hiding with 24-hour police protection for the next 20 years in London. In 2006, after nearly 20 years of quiet, he moved to New York and decided to gradually come out of seclusion. Life was good to him and, in 2021, he was married for the fifth time, to the woman of his dreams, the poet Rachel Eliza Griffiths.&nbsp;</p>



<p class="wp-block-paragraph">For nearly two decades after the fatwa was issued, his literary career flourished, and he became a visible spokesperson for freedom of artistic expression. As president of PEN, Rushdie promoted initiatives to protect and promote the careers of writers living in fear under repressive political regimes. In August 2022, he was invited to speak on this topic at the Chatauqua Institution, an adult education and social movement. On a sunny summer morning, as he sat on the stage of the amphitheater to begin a public conversation with his interlocutor at Chatauqua, he noticed a man dressed in black suddenly rise up from the middle of the audience and charge the platform. There was no security at Chatauqua that day or any other day because the violent world had never intruded into the bucolic space of the institution during its entire 148 year history. Rushdie found himself rooted to the spot, frozen and unprepared to defend himself as the attacker stabbed him seventeen times – in his eye, his face, his neck, his chest, his abdomen, his hand. Heroic people charged the stage and subdued the assailant. Miraculously, Rushdie survived and he was helicoptered to the nearest trauma center for emergency treatment. <em>Knife</em> is a meditation on the event, the ordeal of rehabilitation that Rushdie had to endure, and his reaction now that he is healed, and his life is restored.</p>



<p class="wp-block-paragraph"><em>Knife</em> is a visceral book that is grounded in the harsh reality of crazed, religious zealots and painful, tedious rehabilitation. It is different from the magical prose that characterizes much of Rushdie’s writing. The events are described in excruciating detail. One can feel the hurt and sense the worry etched into the pages. It is testament to the many doctors and nurses and therapists who took part in his bodily reconstruction and long convalescence. Most of all it is an inspiring testament to his wife who had the fortitude to be at his bedside throughout the entire ordeal . Rushdie gives her most of the credit for his stamina, the tenacity and resilience that he displayed during the long months after the attack. He substitutes an imaginary dialogue with his attacker in lieu of a face-to-face encounter in prison to express his contempt for his religious intolerance. Rushdie and his wife summon the courage to revisit the Chautauqua stage one year after the attack and achieve some degree of closure on the event.</p>



<figure class="wp-block-pullquote has-palette-color-5-background-color has-background"><blockquote><p>Differences in fame and access to expertise do not ultimately carry the day. Instead, it is how we as individuals, regardless of our wealth or social status, are able to tap our inner strength and utilize the help and support of our loved ones.</p></blockquote></figure>



<p class="wp-block-paragraph">There is much humanity and wisdom in these pages, lessons on how to confront and overcome adversity. One might question what we, mere mortals, can learn from a singular person like Rushdie who was blessed with such an abundance of human and professional resources to draw on as he recuperated from his injuries. However, differences in fame and access to expertise do not ultimately carry the day. Instead, it is how we as individuals, regardless of our wealth or social status, are able to tap our inner strength and utilize the help and support of our loved ones. The task for us all is to draw on our cognitive and psychological reserves and convert life-threatening tragedies into surmountable setbacks. If, like Rushdie, we succeed, then we will have reached a more mature and meaningful embrace of life in all its beauty and complexity. Rushdie’s story played out in the international limelight. The narrative also unfolds every day on countless hospital floors and rehabilitation units the world over as people strive to overcome injury and illness in their own private world. Rushdie’s template is universal.</p>



<figure class="wp-block-image alignright size-full is-resized" id="box-shadow"><img loading="lazy" decoding="async" width="667" height="1000" src="https://medhum.org/wp-content/uploads/2024/09/71zIv7pCGHL._AC_UF10001000_QL80_.jpg" alt="" class="wp-image-7543" style="box-shadow:var(--wp--preset--shadow--natural);width:240px" srcset="https://medhum.org/wp-content/uploads/2024/09/71zIv7pCGHL._AC_UF10001000_QL80_.jpg 667w, https://medhum.org/wp-content/uploads/2024/09/71zIv7pCGHL._AC_UF10001000_QL80_-200x300.jpg 200w, https://medhum.org/wp-content/uploads/2024/09/71zIv7pCGHL._AC_UF10001000_QL80_-600x900.jpg 600w" sizes="auto, (max-width: 667px) 100vw, 667px" /></figure>



<p class="wp-block-paragraph">But for readers of the Medhum website, I suggest that there is an unspoken but instructive message lurking in Rushdie’s story, specifically for health care providers, doctors and nurses both. There were unexpected turns of events during Rushdie’s recovery. It was not an uninterrupted march from near death to healing. He experienced disabling complications from medications that were prescribed for rational clinical reasons, iatrogenic problems. In one case, severe urinary retention requiring repeated painful bladder catheterization, it was only through the astute observation of one of the clinicians that the causative medication was stopped and the problem spontaneously resolved. In another, he experienced symptomatic hypotension, a disabling side effect of one of the drugs prescribed for him. There was a cancer scare when an imaging study performed to assess his urological problems. suggested he might have a lesion in his prostate. He experienced excruciating pain when his eyelids needed to be sutured together to protect his injured eye. In each case, Rushdie was reassured that things were proceedings according to plan and that things should improve with time. Follow up tests were done to monitor the prostate anomaly and confirm improvement in his symptoms but the discomfort and unease lingered in his body and his mind. The anxiety that the problems might not resolve was ever present in Rushdie’s consciousness.&nbsp;</p>



<p class="wp-block-paragraph">Doctors know that recovery from injury or illness is a time consuming process that rarely occurs overnight. They are right to encourage their patients to take the long view of their health problems, to reassure them the treatment is usually a continuing proposition. But even for a highly intelligent patient like Rushdie, the doctor’s confidence in how things were going could never completely allay the fear that his broken body would not heal, and his health would not be restored to what it had been pre-knife attack. Daniel Kahneman and Amos Tversky won the Nobel Prize in Economics in 2002 for groundbreaking studies that explored how people assess loss and gain and make financial decisions. Kahneman expanded on their studies in behavioral economics and proposed that rational thought utilizes two operational modes. System 1 is rapid and instinctive in contrast to system 2 which is slower, more deliberative, and more reasonable. Channeling this work by Kahneman, there may be two systems operating during recovery from bodily injury. Doctors may be employing an analog System 2 method of thought as the disease is steadily halted, reversed, and repaired. Patients, however, live through illness in a binary System 1 approach of thought: sick or back to normal. We physicians would do well to remember that the only words our patients really want to hear from us when they come to us for care are, “You are now fine. We can stop the medications and stop the follow up. You are back to normal.”</p>



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<p class="has-palette-color-5-background-color has-background has-small-font-size wp-block-paragraph"><strong>Knife</strong><br>Salman Rushdie<br>Knopf 2024, 209 pages</p>
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