Do No Harmdo no harm is a gift of a book bestowed upon us by Henry Marsh, an accomplished British neurosurgeon. These linked stories eloquently describe life as the person who holds others’ lives in his hands. With 35 years in practice, Mr. Marsh has insight into all aspects of providing medical care. (In the UK, surgeons are referred to as “Mr., ” so please allow me to refer to this renowned physician as Mr. Marsh.) He shares his accomplishments, fears, and failures. He boasts, gripes, mourns and vents.Mr. Marsh takes us inside the skull, behind the orbits, into the brain. We join him on a fascinating anatomic journey as he incises through to the meninges, the spine, and the pituitary gland. We are riveted by the urgency of his patients’ conditions such as brain tumors, aneurysms and trauma. We are pulled along hoping that all of his patients do well, but he leaves us with no illusions.  These are stories of life and death and the mistakes even the most experienced surgeons make.

Not only patient outcomes lie at the heart of Do No Harm. Mr. Marsh also describes the challenges he has faced as son, father, husband, medical colleague and customer of the UK’s National Health Service (NHS). There is much dark humor in the aggravation he describes dealing with NHS management and computerized health records. Will there be beds for his patients? Will he be able to coax the NHS computer system to show him the patients’ brain scans? He admits to an arrogance that has mellowed over time, but we see that he continues to be an opinionated force wherever he goes. One of my favorite chapters is “Infarct,” where he confronts how medical care and bureaucracy impossibly conflict.

In Mr. Marsh’s beautiful descriptions of his days, as he cycles to work, evaluates patients, instructs new surgeons, and waits to enter the “operating theatre,” we appreciate his dedication. His powerful introspection illuminates how medicine is a “craft.” Enmeshed in the combination of art and science exists a huge human element with alternately confident and nervous providers striving to develop their skills to provide the best treatment for their patients. As in a lecture he has delivered internationally, “All My Worst Mistakes,” Mr. Marsh is willing to share his experiences so that others can grow from what he still hopes to learn.

Mr. Marsh never loses perspective on his fallibility as a surgeon no matter the fame he has achieved. As an example, he has worked extensively in Ukraine providing care to its medically underserved population. Documentaries have been made about him and his service. Still, he writes “of surgical ambition and of my failure” and reminds us that diagnosis and treatment plans are filled with “uncertainty” and that “patients become objects of fear as well as of sympathy.” As a reader, I am grateful for his honesty and generosity as a neurosurgeon and author.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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being mortal“I learned about a lot of things in medical school, ​but mortality wasn’t one of them,” writes Atul Gawande, MD, in Being Mortal:  Medicine and What Matters in the End. Given that the two certainties of life are birth and death, how is it possible that medical training does not include education about preserving a patient’s well being at the end of life? How did survival at any cost begin taking precedence over the quality of one’s final days?
When the time comes to make difficult medical treatment decisions, it can be nearly impossible to see past the immediate choices. When a friend or loved one can no longer care for her/himself, the realities of nursing home and assisted living facilities may defeat even the most dedicated patient advocate. The time to read  Being Mortal is before these life events happen, and they will happen, in some form, to nearly all of us.

In Being Mortal, Dr. Gawande describes his efforts to improve delivery of end-of-life care and what he learned from the experiences of patients, friends and family members. There are no simple reasons for why we struggle with preserving quality of life as we age and experience failing health. There are certainly no easy solutions. Dr. Gawande addresses these complex questions with concise, elegant and insightful prose. The book is at once personal and prescriptive for improving the lives of the sick and the aging. His presentation and formulations are direct but he makes it clear it won’t be easy either for our society or for each of us individually.

Dr. Gawande and both his parents are physicians. When Dr. Gawande’s father is diagnosed with cancer, the treatment options become so complicated that even a family of medical professionals loses track of chemotherapy choices and which course of treatment will best match the end-of-life wishes Dr. Gawande’s father had expressed. His father wanted to be a person rather than just a patient. Like so many of us, he wanted to live out the end of his life on his own terms.

Dr. Gawande is a perceptive investigator known for his articles in New Yorker ​magazine. He has explored such hypotheses as the one in which lessons learned at the Cheesecake Factory and applied intelligently can improve the quality of medical care. He looked at the Cheesecake Factory’s profitable mass production of food people want to eat and their excellence in creating satisfied customers and analyzed how the same management philosophy could improve patient care and hospitalization outcomes. He has published two essay collections, Complications: A Surgeon’s Notes on an Imperfect Science​​ and Better: A Surgeon’s Notes on PerformanceBetter: A Surgeon’s Notes on Performance.His writing explores his practice of general surgery, the challenges of applying medical technology humanely, and issues of medical ethics.  In The Checklist Manifesto: How to Get Things Right he proposes changes to healthcare delivery that can minimize medical errors.

Now, with Being Mortal, Dr. Gawande gives us a book that should be required reading for all healthcare providers. It’s a book to be read before or during decision making regarding nursing home placement, cancer care planning, and terminal illness management. It’s a book that explores what gives our lives and our mortality meaning.
Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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raindrops rollThere is something about summer and water. Rain water, ocean water, pool water, all kinds of H2O. One of the miracles of the natural world, and an essential requirement for life. One in nine people lack access to safe water. Howard County residents are fortunate in our easy access to clean, refreshing water, lying within the watersheds of two major tributaries to the Chesapeake Bay. We all appreciate the beauty and the science behind the water cycle, and its importance to our well-being.

With lyrical words and striking images, April Pulley Sayre celebrates rain.”Rain plops. / It drops. // It patters. / It spatters.” From the beginning of a storm to the return of the sun, this splendid presentation reveals the wonder of water. Short, rhythmic lines, often only two words but rhyming or alliterative, are set one to a page against an amazing photograph. Sayre’s close observations, many in an ordinary garden, will lead readers and listeners to look closely at her photographs and at the world around them. Insects shelter from a shower; drops cling to flowers. There are tiny reflections in the globules. Raindrops bend down grasses, highlight shapes and band together. Some of the pictures harbor secrets. Preschoolers can appreciate the poem and pictures, but older children will appreciate the facts in the concluding “Splash of Science,” going on to describe “Raindrops Inside You,” connecting the reader to the water cycle.

June and July offer us many opportunities to enjoy rain storms from the safety of our balconies, decks, and front stoops. Celebrate the return to earth of the clean, safe water.

all the water in the worldLots of picture books introduce young children to the water cycle, but few have such an infectious beat and eye-catching illustrations as this title, which begs to be read aloud. “Where does it come from? / Water doesn’t come. / It goes. / Around. That rain / that cascaded from clouds / …then slipped into rivers / and opened into oceans, / that rain has been here before.” Children encountering the scientific concepts for the first time may need help understanding how, exactly, Thirsty air…licks…sips… guzzles water from lakes and oceans. Little ones will respond immediately to the noisy, delicious sounds and rhythms in the words as well as the kinetic energy in the beautifully put together digital illustrations. Playfully arranged type adds to the visual fun while giving cues for the reader. On the final spreads, a mothers hair swirls into a wave of water that becomes a joyful spiral of living creatures, all reinforcing the simple, profound message: our lives depend on water.

The water cycle is a great way to expose young children to science in a fun way. HCLS has a variety of experiment books for all ages.

bringing the rain to kapiti plainVerna Aardema’s illustrated retelling of a traditional Kenyan folktale is reminiscent in rhythm and repetition of The House that Jack Built. The illustrations are evocative of African artwork, stylized and dramatic. This tale of a shepherd shooting a hole in the clouds to water his herd is lighthearted in its delivery, but it also conveys on a child’s level the trouble that dry seasons can bring to a poor farming community. This is good for children growing up in a wealthy industrialized society where clean water is available at the turn of the tap. Stories like this one may open their understanding to the fact that other people do not have access to the resources they take for granted. Grownups will remember this as a Reading Rainbow book.

Take a swim, wade in a stream, stroll in the rain, appreciate the bounty of nature- just don’t take the book into the pool.

Shirley ONeill works for Howard County Library System as the Children’s and Teen Materials Specialist. She cannot believe she actually gets paid to do this job.

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bettyvilleOf all the books you may want to avoid reading on the harrowing topic of old age, dementia, and caring for an elder parent, don’t let Bettyville be one of them. George Hodgson, an editor at Houghton Mifflin, had just about reinvented himself as a New Yorker, when his mother, Betty, began failing. Believing he could return to his boyhood home in Paris, Missouri and quickly get her situated, Hodgson could not have been more confounded. While there, his job was phased out and his mother was rejected from assisted living. No longer would the willful, capricious, and fiercely defiant Betty drive to bridge games, church choir, or the local beauty parlor. That would become Hodgson’s new full-time job – along with staving off Betty’s encroaching dementia.

Ragged scenes of frustration, fear, and sadness envelop them both. But, equally, there are Hodgson’s beautifully rendered memories of feeling loved – not only by both parents, but the small town of Paris as well. The fact that he was a gay son who never had “the talk” with either one did not diminish that love either.

Hodgson’s monumental commitment to his mother, Betty, continues to this day. Lucky for many of us (facing Hodgson’s same future), that he found the inspiration for this small gem.

Aimee Zuccarini is an Instructor & Research Specialist at the East Columbia Branch. She facilitates several book discussions and writes the book reviews for The Maryland Women’s Journal.

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blissEric Weiner spent many years as a foreign correspondent for NPR, and in that time visited many of the world’s countries. His travels frequently took him to decidedly unhappy places – or at least, people in unfortunate situations. A self-admitted “grump”, Weiner decided he would embark on a quest to find the happiest places in the world and, of course, write about it in his book The Geography of Bliss. Beginning at the World Database of Happiness in the Netherlands, Weiner checks out a list of the happiest countries in the world, statistically. His journey takes him to Switzerland, Bhutan, Qatar, Iceland, Moldova (the unhappiest nation in the world, to see what the opposite of happiness looks like), Thailand, Great Britain, India, and ends in America.

How can happiness be measured? According to Ruut Veenhoven at the World Database of Happiness, “you can’t be happy and not know it. By definition, if you are happy, you know it”, and so, you simply ask people how happy they are (p. 12). According to the research, the happiest person ever should be an extroverted optimistic married religious-service-attending educated busy Republican – as people who meet each of those criteria are happier than those on the opposite end of each spectrum. If that doesn’t describe you, well, no worries! The science of happiness seems to be rather subjective. Plus, there’s “reverse causality” (basically the real term for “what came first the chicken or the egg?”): are happy people more likely to be extroverted/get married/go to church/take on more work/etc or does the factor in question make them happy? Well, that isn’t really the question Weiner set out to answer (and it probably isn’t definitively answerable, anyway), he was more concerned with where and why people are happy. The answers to both questions – as much as they can be answered – were not what Weiner expected. None of the usual suspects predict happiness level, not diversity, equality, wealth, income distribution, or climate. Some things are obvious: basic needs must be met (you need food and shelter, for example), and you need enough income to fulfil those needs and not feel stressed, but beyond that… Weiner spent a whole book looking for that answer.

So, what is it? In the end, happiness is a complicated equation. It’s a careful balancing act: add a bunch of culture, some family and friends, a dash of money, a big helping of gratitude and trust, remove envy and excessive thinking. Weiner’s chapter titles give us some insight into his quest; happiness is: a number, boredom, a policy, a winning lottery ticket, failure, somewhere else, not thinking, a work in progress, a contradiction, home. Weiner asks interesting questions and uncovers some interesting approaches to happiness from all over the world. If happiness research piques your interest, The Geography of Bliss will provide you some intriguing food for thought. It’s also an excellent book for group discussion, complete with questions provided by the publisher.

Jessica Seipel is an Instructor & Research Specialist at the Savage Branch. She has worked for the Howard County Library System, in various positions, since 2003. When not at work, she spends her time reading science fiction and comics, visiting local breweries, watching horror movies, and playing video games.

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10662095145_08f4655cb6_zI’m ready for summer. Are you? My youngest son is the only one in my family still in school, so I feel a bit guilty each morning when I have to wake him up. His last day of school isn’t until June 19! The other night, though, it was my daughter who woke me up because she was not feeling well. I felt her head, and sure enough her forehead felt warm. Then came the tough part—finding a thermometer, or should I say, a working thermometer. I was able to find two thermometers, but the batteries were dead. Luckily (or so I thought), I remembered that I had sent each of my oldest kids off to college with a first aid bin that included a thermometer. I asked my daughter and my oldest son to find the bin that had their first aid stuff in it. Both of them answered simultaneously, “ I don’t know where that is. I never used any of that stuff. Are you sure you gave it me?” Finally, in the back of the cupboard in the bathroom I found a temporal artery thermometer, which I had a vague recollection of buying. We were not sure if this thermometer was working, but my daughter’s temperature registered almost four degrees higher than mine, so I felt it was safe to say she had a fever. She was also complaining that her neck was bothering her. I started Googling her symptoms and discovered a plethora of possible illnesses, most very unlikely.

I called my sister, who is a nurse, and she said, “It’s probably important to make sure you get a thermometer that you can count on.” As my kids would say “Thanks, Captain Obvious!” In my defense, I thought I had a working thermometer. My sister also reminded me of the risks of trying to diagnose an illness based on information I found on the internet. She told me to call my daughter’s doctor for a professional opinion.

The doctor thinks my daughter’s infection may have been caused by a bite she had gotten on her foot earlier that day in the grassy area at the pool. Anytime you are outside, you are at risk for infection. Most of us spend more time outside in the summer months than we do during the rest of the year. There are things we can do to keep safe and healthy. After all, we survived a long, cold winter– we deserve to enjoy the warmer weather.

Biting and stinging insects come out in force in the summer months. Most bites are harmless and cause only minor discomfort, but some bites can carry disease. One of the things we can do when we are going to be outdoors is to wear insect repellent. It’s prudent to keep your legs and arms covered as much as possible if you are going to be near wooded areas and grasslands or if you are going to be outside at dawn or dusk, when insects are most active. It’s also smart to remove insect breeding grounds, such as standing water, from around your home and to keep your garbage tightly covered. Everyone should get in the habit of carefully checking for ticks after being outdoors. According to the Centers for Disease Control and Prevention, Lyme Disease is the most commonly reported tick-born disease in the United States. You can find more information on bites and stings here. You can also check the library for books on Lyme Disease. If you develop a fever or skin rash, please call your doctor.

If you do get bitten it’s a good idea to have some items in your first aid kit to treat any bites, stings, or skin inflammation. Some of the things to include in your kit are: a flat edged object to remove stingers, tweezers, an instant cold compress, antiseptic wipes, calamine lotion, antihistamine cream, an assortment of bandages, aloe vera gel, and of course, a working thermometer! Make sure you have one kit at home and one kit in the car or to pack in your suitcase. Now is a good time to check your first aid kit(s) and replace any used or expired items. A more comprehensive list of essentials to have in your first aid kit(s) can be found here.

Hopefully, the only temperature above 98.6 degrees that will need to go down this summer is the temperature outside. Have a safe, healthy, fun-filled summer everyone!

Editor’s Note: Please consult your family physician when experiencing symptoms of illness or discomfort. In case of emergency please call 911.

Nancy Targett is an Instructor & Research Specialist at the Miller Branch. She lives in Columbia and is the proud mom of three boys and a girl and a Siamese cat.

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