What Else I'm Reading

I don't just have a strange and unQuakerly passion for the British Navy of two centuries ago; I read other stuff, too. I've read a few thought-provoking books lately; thought I'd do some short blurbs. (I don't get as many comments on book posts as I do on others, but I have a couple of readers who say they like them best, so I persist.)

Portfolios of the Poor, by Daryl Collins et al.

Researchers followed families in Bangladesh, South Africa, and India that live on the equivalent of $2 per person per day, or less. Using interviews and detailed financial logs, and following families for periods of a year or more, they were able to build a complex picture of how people with such limited means, and often very unstable incomes, manage their finances using a mix of lending and borrowing from various sources, saving, and pooling of resources. The book is very detailed and ultimately more technical than I needed--it is aimed at helping shape microfinance programs that fit well with how people are already using money--and I ended up skimming the second half, but I learned so much from what I read. One thing that came through very strongly was how smart and knowledgeable people are; reading an interview transcript as a woman talked about how she decided whether to meet an unexpected need for a lump sum by borrowing or by spending down savings, I was struck by how familiar the argument was from my own financial decision-making. One of those books that gives me what feels like a meaningful glimpse into the lives of people I otherwise mostly know only as stereotypes.

A Time to Keep Silence by Patrick Leigh Fermor.

A reprint of a memoir about the author's soujorns in European monasteries during the years after World War II. I was sometimes irritated by Fermor, sometimes charmed by his descriptions; every once in awhile his tone-deaf reactions to monastic life reminded me of the Humbug in The Phantom Tollbooth, who could swim all day in the sea of knowledge without getting wet. My own experience with monks is of going on retreat at a small monastery, only seven monks, only a few decades old, so I did find his descriptions of visiting larger, more ancient European monasteries very interesting. I think the thing from this book that will stick with me longest is how shocked I was that the monks were not exempt from military service in WWII; when he visited, many of the monks he met had served. I would like to find some writing or memoirs about or by these fighting monks.

Patience With God: Faith for People Who Don't like Religion (or Atheism) by Frank Schaeffer.

Frank Schaeffer is an interesting guy; the son of a well-known evangelical preacher, as a young man he followed in his father's footsteps and was already a nationally-known speaker when he found himself changing in his faith and practice. He's now Catholic. One thing I like about his writing is his insider view of what it's like to be someone like, say, Rick Warren. He has a great passage I wish I'd copied about his belief that a preacher who gets to that top, public, money-rolling-in level simply cannot help but become a hypocrite; it's much deeper and better than that and perhaps someday I'll re-read enough of the book to find it again.

I really enjoyed his humor-filled yet rigorous takedown of the recent Christopher Hitchens, Richard Dawkins style of militant atheism, and the book would have been worth reading just for the kitschy joy of finding out about the gospel walnut, a witnessing tool Schaeffer's mother used to carry and accost people with on subway trains.

The latter part of the book is essays on various writers; I found this section much less interesting. It felt padded, and thematically out of sync with the rest of the book.

In the Realm of Hungry Ghosts: Close Encounters with Addiction by Gabor Mate, MD.

Mate (I am ignoring the accent in his name because I don't trust blogger to cope with it) is a doctor who for twenty years has been the house doctor for a residential program for addicts in Vancouver. The interesting and controversial thing about the program is that it's not rehab; it's just a home for people who have nowhere else to live. His book is a surprisingly fast read for all that it is 439 pages long (not counting the appendix and index), and includes stories of his patients, his own theories about addiction and why he has come to believe what he does, and his policy wishes for treatment of drug addicts. Mate discounts the genetic element that may be present in addiction in favor of a belief in the impact of early environment. In addition, he believes that addictions are extremely intractable. For these reasons as well as more pragmatic cost/benefit type reasons, he believes in compassionate care for addicts; he wishes (and I keep saying that because he says right up front he doesn't believe the kinds of programs he would like to say will ever be accepted on a wide scale) for programs that would go beyond even needle exchanges to, say, places where addicts can actually shoot up on site, in clean, sanitary places and with medical support for overdoses nearby. He is a big fan of one such pilot program in Vancouver, which would have been closed down by now except that the BC Supreme Court ruled that it fell under the necessary medical care Canadians are constitutionally entitled to, and of a similar pilot program in England that resulted in dramatic reductions in crime, improved social relations, reduced incidence of injury and disease, and increased housing and job stability among people who nonetheless continued to be addicted to heroin. These programs are examples of the kinds of "harm reduction" programs Mate would like to see become widespread.

Mate advocates for a level of compassion and respect for addicts that most of us would find challenging, especially since he asks us to have that compassion and respect even for addicts who choose to continue using. It's dramatic, really no small thing he's calling for, hard even for someone like me who is pretty good at compassion, I think. Harder still for most; in debates when Mate mentions that the safe injection site program I mentioned above had probably saved 25 lives the previous year through prompt medical attention in the case of overdose, he has regularly gotten the response that saving the lives of addicts is nothing to gloat about, that they are better off dead and we are better off without them. But Mate shows you the full personhood of some of the addicts he's known, the parts of their lives that are worth saving.

I learned a couple of things about drug abuse I hadn't known before. One is that the American War on Drugs has exerted so much pressure on other nations that even countries that used to have more progressive policies have backed off on them (this is apparently especially true in England). Another is that narcotics withdrawal is worse for a developing fetus than it is for a newborn baby; for this reason, Mate and his colleagues often counsel pregnant women who hope to stop using during their pregnancy to stop cocaine and its related drugs, but not to dramatically reduce their intake of narcotics. Usually he tries to switch such women to a methadone program, and then the baby can be withdrawn from drugs after birth. A couple of stories he tell of women who hoped to get off drugs during pregnancy and then keep their babies are heartbreaking.

I don't know how much to believe of Mate's model of addiction, which is very different from the widely-accepted disease model. I am intrigued by a model of treatment that focuses on harm reduction rather than on abstinence. And even though I found Mate grating sometimes, I think anyone who can work with a population this disenfranchised for two decades and maintain his commitment and compassion is worth listening to.