Nuland SB:

Lost in America: A Journey with My Father, 212 pp, New York, Alfred A. Knopf, 2003 ($24.00)..

At the moment, Americans are intrigued with the childhood struggles of other people, especially if they are immigrants (or first generation products) from Ireland or holocaust-affected regions of Europe. In spite of all the family deformations, the narrators typically end up with successful careers and fulfilled lives. And good writers from the medical ranks enjoy a special regard within this genre because their readers assume an added and special dimension, that these authors understand the chemistry and physics that make people tick. Sherwin B. Nuland, M.D., an emeritus clinical professor of surgery at Yale University, has already published several successful socio-medical books, and his Lost in America is bound to find a wide audience.

This short book can be pleasantly consumed in a weekend. It is a completely factual account, to the extent that there is no declaration otherwise, even with regard to possible name changes for peripheral characters such as Nuland's girlfriends. It reads like a novel in terms of gripping opening, tension, and skillful timing in the release of information, all presented in a smooth narrative style. Notwithstanding the title, the discourse is primarily autobiographical. His father, Meyer Nudelman, was a Russian Jew who arrived in 1907, on his own, and was never assimilated in terms of American culture or even language. Sherwin and his older brother Harvey officially changed the spelling of their surname while the author was in high school. After the premature death of their mother, the boys were nurtured by a maternal aunt, influenced by their maternal grandmother, embarrassed and needled by their father, all living in the same Bronx apartment. The interactions are at times novel, pitiful, solemn, wrenching, and even humorous, but never boring. The climacteric of Meyer's illness is expertly rendered.

Many of us would have been interested in some family portraits, but there is no illustration except for the unidentified, partial figures on the dust-cover, presumably Sherwin and Meyer. There are some troublesome paradoxes with regard to medical education and practice. For instance, Nuland dismisses the basic sciences (biochemistry in particular) as being of minor consequence to a medical education. He thus joins the throng of naive freshman, but it does not sit well with his more mature mantra about being totally prepared to understand the patient, at all levels.

Dr. Nuland tells us that he was driven to write this book by an attempt to evaluate the relationship with his departed father. He elects not to analyze the overall thesis, ‘I will never know the cost of being Meyer's son.‘ We are left to reach our own conclusion, and that is part of the charm of his contribution.