Author Amitava Kumar.

Part investigative journalism and part political commentary, Amitava Kumar’s latest book “A Foreigner Carrying in the Crook of His Arm a Tiny Bomb,” is a thought-provoking, incisive, and intelligent look at America’s war on terror and its linkages to terrorism in India. As two of the world’s largest democracies, both the United States and India aggressively pursue individuals and organizations they see as real or imagined threats to national security. Both nations have endured horrendous attacks from jihadists — September 11 in the United States and the attack on the Indian parliament and the terror attack in Mumbai in November 2008 — that have served to justify and validate the nation state’s policing of its borders and its methods of detention and interrogation of suspected terrorists.

Kumar takes an interesting approach to his subject. He profiles two South Asians, Hemant Lakhani and Shahawar Matin Siraj, who have been indicted of conspiracy to commit terrorist acts. Siraj, a Pakistani immigrant was indicted in a plot to bomb a New York subway station and Lakhani, an Indian American, for conspiring to sell weapons to al-Qaeda. Kumar carefully profiles these men not with the intent of proving them innocent or dismantling the case against them but to examine how these charges were developed against each man. Unlike the popular media image of a terrorist master-mind, what emerges is the portrait of two naïve, bungling men who were embroiled in a complex conspiracy that neither seemed to have the wit and intelligence to commit. Both men were indicted based on evidence developed through police informants whose role involved active provocation of the conspiracy. Even if Kumar had simply focused on these two men and their stories, this book would have been an important one; however, Kumar extends his discussion to analysis of terrorism investigation and prosecution in India. His recounting of the story of Geelani, a professor of Arabic, indicted of conspiring to attack the Indian parliament is chilling. The description of the torture methods, the violation of individual rights, and complete power of the surveillance state raise questions about how far can a country go to protect itself. What justifies Abu Ghraib, Guantanamo, and the treatment of Kashmiris?

Kumar’s reportage is a compelling read; his portraits of different men — Siraj, Lakhani, Geelani, Prakash — rendered with the deft hand of a talented writer. He is careful to explore the many dimensions of each case and to provide a nuanced and balanced picture. At the same time, he levels a searing critique of the practices of nations that pride themselves on their democratic principles. As he notes in his conclusion, “The slow, calm procedure of law hides from us the brutality of the state and the horror of war.” It leaves the reader wondering, how much does a citizen really know about the brutality of the nation state that claims to be guided by law? Reading Kumar’s book is definitely a step in educating the citizenry.

Physician, professor and author Siddhartha Mukherjee.

With the narrative skills of a novelist, the vastly sophisticated understanding of anatomy, chemistry, and biology of a scientist, and the ability to knit events and people together with the skill of a trained historian, Siddhartha Mukherjee writes a monumental biography of cancer.

The “Big C” — the disease that is feared by most and upon which scientists and senators declared a war in the mid-twentieth century is here the fascinating focus of a monumental narrative that examines how for centuries clinicians and scientists have tried to understand, explain, and cure the devastating disease. Mukherjee is a cancer researcher, physician, and professor at Columbia University who begins his narrative with the ancient Egyptians, Hippocrates, and Galen and takes the reader to the late nineteenth century and through the twentieth when cancer treatment and research become increasingly important to modern science and medicine.

Mukherjee’s narrative encompasses the efforts of many scientists and doctors who take different approaches to treating cancer. From the work of Halsted who performed radical surgeries to “extirpate” breast cancers and Sidney Farber who used anti-folates to choke cancer cells in children with ALL (acute lymphoblastic leukemia) to the development of chemotherapy, radiation therapy, and targeted cell therapy Mukherjee carefully explains the different theories, approaches, and big questions that animate cancer research. Is there a universal cause for cancer or is cancer a heterogenous disease? Do viruses cause cancer? What is the amount of chemical toxins that can be used on a patient before cancer can be controlled? The questions are many. Even if Mukherjee had simply explained all these developments to the common reader, this book would be very valuable. But Mukherjee goes further. This is the story not just of a disease and its mysteries but also the story of numerous scientists—brilliant men (yes, cancer research is a field dominated by men) who toiled ceaselessly and obsessively in dark corridors of hospitals and labs pursuing the elusive answers to their questions. This is the story of a brilliant socialite, Mary Lasker, and a politically astute physician, Dr. Sidney Farber, who mobilized a nation and its politicians to declare a war on cancer and to raise funds for research, coordinate the work of many scientists, and raise awareness about the people and families who suffered. This is the story of patients like Carla, Germaine, and Einar Gustafson (aka “Jimmy” of the Jimmy Fund) and thousands of unnamed individuals who suffered from the disease, who participated in clinical trials, and who survived or died in the process. This is also the history of scientific research, the ethical issues involved in such work, the consolations and sorrows of scientific discovery, and more often than not the story of serendipitous discoveries, partnerships, and encounters that constitute a relentless search for methods of defeating the “Emperor of all Maladies.”

This is not the most easy book to read but it is definitely a very compelling one. Mukherjee is a great narrator and also a brilliant teacher who can lay out the complexities of genetics and cytology and myriad other subjects for the average reader. This is must read for all of us as it is a story of not just triumphs of science but also one that gives us hope. The war on cancer may not be won but there have been decisive victories in this war—the remission rates for once dreaded diseases like several kinds of leukemia, for breast cancer, for Hodgkins disease have increased significantly in the last three decades. Cancer is definitely one of the most complex and fascinating diseases of humans and this book gives the reader a comprehensive and compelling biography.

In “Spick and Span” a nearly 30 year old Gujarati social worker helps her aunt organize a marriage convention in New Jersey while exploring her own different expectations from married life. In “Cheese Guru Kiss”, a happily married father of a teenage son suddenly comes face to face with an old girl friend who is now a celebrity chef and briefly flirts with his past, and in “Ketchup” a father with a toddler remembers his first serious relationship with an older woman while traveling back home to reunite with his wife. These stories are charming and slightly romantic as the protagonist eventually comes “home” happily to his/her choices. Some other stories are surprisingly edgy. In “Piece of Cake” a young photographer journeys to his past to explore his first girl friend’s bouts of eating disorder while his current girlfriend wishes to aestheticize and commodify the sick woman’s relationship with food. In “Will Model for Food”, an English journalist explores the politics of urban redevelopment and homelessness and in “1 900 Hey Baby”, the writer examines the world of phone dating services. A couple of stories examine South Asian women who reinvent themselves in widowhood startling their families and friends by their surprising choices.

Deckha’s stories are impressive for their range of topics and for the variety of characters. Some of the stories are fairly conventional while a few reveal an edginess that is promising. He steers clear of South Asian stereotypes especially given that his topic is mate-hunting—a topic that is so prevalent in South Asian fiction that it is clichéd. As is common with debut collections, there is some unevenness in quality and a tentativeness to voice, but if Deckha produces more stories like “1 900 Hey Baby” and “Ketchup”, his will be a writing career worth following.

“The Checklist Manifesto” is a book that looks at how the modern world has become so complex that even a small error can cause large scale damage and loss of life. Gawande explores how different professionals from pilots to surgeons and structural engineers manage complexity, solve problems and reduce error in their work by developing and using checklists. Gawande began this project when he was invited by the World Health Organization to lead a project to reduce surgical deaths and complications. Given the vast disparity of resources and training of medical professionals in the world, this was a daunting task. The approach that he and his team take is to develop a simple tool—the surgical checklist—which when regularly and successfully deployed during trials at eight major hospitals around the world (including the University of Washington Medical Center in Seattle) led to stunning reductions in complications and death.

The development of such a checklist, however, is not that easy. While Gawande was aware of some local use of medical checklists such as one in Austria which saved a young drowning victim to one used at Johns Hopkins ICU to reduce central line infections in critically ill patients, he explores how other professions develop checklists and deploy them to save lives. He meets with a structural engineer specializing in skyscrapers who shows him how checklists work in that industry and with Boeing engineers who develop checklists for pilots. From these kinds of examples, Gawande and his team build a surgical checklist that develops team work in an operating room, decentralizes power such that the chief surgeon is not an autocrat, and increases communications between team members.

Gawande’s book is evangelical in its intent—his goal is to tell the story of a simple solution to a complex problem and to celebrate its success in a variety of global health situations. He also wants to persuade surgeons, health care policy mavens, and hospital administrators to use the checklist to save many lives. His data is persuasive. In the WHO trial, they studied 4000 patients and expected to have 435 complications (based on their observations of pre-checklist conditions). The deployment of the checklist reduced that number to 277 and spared 150 people from complications and 27 from death.

An evangelical manifesto about checklists and surgery does not sound like the raw material for a best seller. What makes Gawande’s book fascinating to the ordinary reader is his conversational style, his ability to tell gripping stories about surgeries, aviation emergencies (including the 2009 miraculous landing of a US airways flight on the Hudson river), and building processes. His argument about using checklists is persuasive and might inspire other professions to develop their own. Perhaps, the average reader might also want his/her own checklist. A harried parent driving a car load of kids might, for example, want to take a few seconds to ensure that all the kids are safely buckled in their car seats before pulling out of her driveway. Or a constantly traveling professional might want to develop a small checklist to be used before each trip to reduce oversights in planning. This book will likely inspire people to use checklists to avoid errors in their increasingly complex personal and professional lives. More importantly, it will persuade many of us to check if our hospitals and surgical teams use checklists before we commit to any surgical procedure.

Atul Gawande will be reading from his book on May 3 at the Seattle Arts and Lectures, beginning at 7:30 p.m. 105 S. Main St., Suite 201, Seattle 98104.

Dr. Abraham Verghese

Many readers know Abraham Verghese as the author of the memorable “My Own Country” about working as a doctor in eastern Tennessee. My Own Country was an NBCC finalist and 1994 best book for Time; his second work, “The Tennis Partner” was a New York Times Notable Book. “Cutting for Stone” is his first novel. Like his non-fiction, the central focus of this work is also the practice of medicine. The novel’s heroic and compassionate doctors bring to mind W. Somerset Maugham’s “Of Human Bondage”, a work that Verghese acknowledges as having influenced him.

The novel is long and has a complex yet clear plot that spans several decades. The central character and narrator of some sections is Marion Praise Stone, the child of an English surgeon and an Indian nun who meet on board a ship bound to Ethiopia and eventually work at Missing (Mission) hospital in Addis Ababa in the 1950s. Marion and his twin, Shiva, arrive precipitously when the resident obstetrician, Hema, is in the midst of an air crash on her way back from India. Sr. Mary Joseph Praise, the mother, had managed to keep her pregnancy secret even from the father of the children until she went into labor. The absence of the other resident surgeon, Ghosh, compels the father, Thomas Stone, to try and deliver the babies. Even as he is botching the birth and nearly kills one of the babies, Hema arrives, the children are born but their mother dies and their father leaves the hospital never to return. The children are raised by Hema and Ghosh, who eventually marry for one year at a time, and are raised in a household supported by two women—one Eritrean with a daughter of her own and a childless Ethiopian woman. In this gloriously cosmopolitan, eccentric, and multilingual home, the twins grow up each with his own talents but connected by that mysterious ability of twins to communicate. Through the lives of the children, we learn of Ethiopia’s colonial history, the rise of Emperor Haile Selassie, the problems of Eritrea, the crisis of poverty and health care that haunts the people, and the heroic and compassionate abilities of two doctors to serve a people whom they have adopted as their own. The twins both develop a passion for medicine and while Marion studies medicine formally, Shiva apprentices himself to Hema and becomes an excellent surgeon who specializes in fixing fistulas. Both brothers are attracted to Genet, their Eritrean nanny’s child, and their rivalry splits them just as Eritrea rebels against Ehtiopia. Marion is falsely accused of treason and escapes with the help of Eritrean guerillas to America where he trains at an impoverished Bronx hospital. The plot wends its way in near Dickensian perfection to a father –son reunion, a twins reconciliation in a moment of medical glory (an event worthy of tabloid journalism), and the novel ends with some sorrow, some joy, and a lot of plot twists.

A plot summary does not do justice to the wealth of characters and the dense details that make this novel such a wonderful read. The author creates characters who are larger than life and yet painfully human; in a world often short on heroes, this novel offers us a plethora of admirable characters. A word of caution to the skittish reader—if you were a fan of the TV show “ER” and follow the medical details of surgeries on “Grey’s Anatomy” and enjoyed high school biology lab, you will enjoy the gory details of fistula surgeries and effects of volvulus. If not, proceed with caution—the author is a doctor who loves the practice of medicine and makes medical details readable and comprehensible to the ordinary reader, but there is occasionally a little too much realism!

Dr. Abraham Verghese will give a talk as part of Seattle Arts & Lectures on Feb. 10 at 7:30 p.m. at Benaroya Hall downtown. (206) 214-4800 or visit www.lectures.org.