Archive for 2009

The Audacity To Win by David Plouffe

November 28th, 2009 — 5:57am

Audacity to WinThe Audacity to Win: The Inside Story and Lessons of Barack Obama’s Historic Victory by David Plouffe

Newly elected President Barack Obama encouraged his 41 year old campaign manager to write this book and tell the story of his presidential campaign which two years previously was quite improbable. It is the story of Barack Obama, a newly elected US Senator who and his close brilliant political advisor David Axelrod who brought in his junior partner to join their team and ultimately take the reigns of one of the most remarkable political campaigns in modern history.

Axelrod and Plouffe with perhaps several other close senior members of their team such as Ed Gibbss who became Obama’s Press Secretary put together a smooth running campaign machine which built an Internet network of millions of dedicated volunteers and contributors, the like of which has never been seen before. This certainly dwarfed the short lived Howard Dean Internet campaign of several years previously as well as that of any of his primary opponents or that of John McCain.

While the size ( in both persons and amount of money raised ) was quite unique, it was the free flowing frequent communications to this network, the discipline to stay on message and the confidence in their clear electoral strategy which probably best characterized the ingredients which made them so successful. They were experienced people who knew that they could not allow any leaks to the press and that they had to do their own polling and focus groups, which they did quite frequently. They paid meticulous attention to detail as professionals should do and they had intense prolonged daily conversations among their small group which of course included the candidate himself. Plouffe described the importance of these evening conversations where the every twist and turn of the campaign was analyzed and discussed usually among a very small group.

Of course the victor writes the history which will most likely stand as the record. The story does ring true and is consistent with what we know happened. The should be no contesting the information of how the troops were deployed and the money spent as that is on the record. Obama’s two major opponents Hillary Clinton in the primary and John McCain are for the most part treated and described with mostly respect and admiration. However their campaigns are at times depicted as inept , making blunders and miscalculations. Mark Penn one of Hillary’s most important advisor is shown particularly as making major mistakes.

Since Plouffe was so close to the candidate a and family during the campaign does seem to be some insight into the character and sincerity of belief of both Obama and his wife Michelle. Both candidate and campaign manager came across as caring people who loved their families deeply but accepted the necessary rigors of the campaign because they really believed that Obama had something special to offer which country needed at this time.

One of the most memorable lines in the book was at the time that the Reverend Wright inflammatory remarks became a factor in the campaign. It was at this time , the campaign advisors changed their previous position that it was not necessary for Obama the first black candidate to talk in any depth about race. Obama wanted to give an in depth speech about race and what it meant to be a black American running for President. He also felt he had to do the major writing of the speech. However there was little time to prepare and this major address. Plouffe recalls asking Obama if he felt he could pull it off. Obama relied , “ Don’t worry I have writing this speech for the past 30 years”

The book clearly spells out so many of the nuances of their strategy both in hard fought primary against Hillary Clinton and then the election campaign against John McCain. Each phase was mapped out in advance in a very thoughtful manner. IN the primary it was essential that they win Iowa which was the first and most important by their standards in order to get them clearly in the ballgame. They brought in a army of volunteers as well as mobilizing young people in the state. Similarly in the actual election campaign, the strategy was to win every state that Kerry had won in his previous unsuccessful election bid 4 years ago as well as specific additional electoral votes from states in which they thought they would stand a chance of winning in order to needed to bring them over the 270 mark was worked out in great detail. They left no detail unplanned. In fact they had several scenarios, which were determined to achieve so guarantee victory. How they conceptualized each subsequent state and how they calculated every convention delegate and ultimately the super delegates and then each block of electoral votes was a work of art or at least a work of political genius. For example , Nebraska is a rare state that divides its electoral votes. Plouffe calculated that Nebraska would go Republican except one small area in the state labeled Nebraska 2. Therefore this area was specifically targeted. And funds and volunteers were funneled into this one part of the state Although ultimately it was not needed for the landslide victory on election nite, the campaign Plouffe got great satisfaction in winning Nebraska.

Funding was essential in order to support their staff , Internet operation and to buy expensive TV adds and arrange events in each of the states. They made a very difficult decision NOT to accept federal funding which would have been something like 85 million dollars. Instead they would forgo that and try to raise even more than that amount through their Internet campaign mostly from small contributions. They ultimately achieved about twice that amount and the decision paid off for them. However it was a difficult one to make since they had initially made statements that they favored public funding of presidential campaigns If you accept federal funding you can’t accept additional funding so your supporters rather than give to the candidate would then give money to the Democratic National Committee ( DNC) or the Republican RNC in the case of McCain. . These entities then function as an Independent Expenditure and are not allowed by federal law to communicate with the candidate about strategy or coordinate their efforts so they mount an independent campaign plan. So in the end McCain who accepted federal funding had 85 million from them and the RNC raised 250 million which they could spend without coordination with McCain’s campaign.. Obama by not accepting federal fund could raise as much as they could (with the usual limitations of 2300 from individuals. Obama raised at least 450,000 million for his campaign since he did not accept federal funding. The DNC raised less than half that amount which they could spend for him but not with his coordination. So Obama out raised McCain by a significant amount and could much better coordinate the strategy and spending.

The Obama campaign from the very beginning made decision on what seemed best for Obama and was less influenced by what things cost. For example they spent the money to utilize Mile High Stadium so he could accept the nomination in a larger and more dramatic venue. At the conclusion of the campaign they bought air time for a 30 minutes speech to the American People about the economy and other significant issues rather than short less substantial advertisements. Most of the time money was no object for them

Plouffe is deservedly proud of how he set up and coordinated his close to five million volunteers. Not only could he repeatedly go back to them for contributions which they responded but he utilized them to get across any message that was needed at whenever it was needed. He communicated with his net work on a almost daily basis which means he could provide speaking points on any issue that came up. This mean t that there could be an immediate response to any question raised and the network of people would be speaking to their neighbors and co-workers the next day on message . The volunteers appreciated being kept in the loop and were very responsive when they were asked to knock on doors, write letters, make phone calls or even give more money.

In the end it was a real grassroots campaign and the Internet was the soil in which it grew. It was conceptualized by a team led by a brilliant young man who shared his boss’s vision and with odds against them in the starting gate but i they had the audacity to win.

Comment » | H - Humor, P - Political

Last Town On Earth by Thomas Mullen

October 19th, 2009 — 2:23am

Buy now on Amazon: The Last Town on Earth

I was bothered by the title of this book since it isn’t really accurate. Perhaps it is meant to imply that the people felt as if they were in the last town on earth but that wasn’t really the case either. I kept expecting the story to somehow be something that it wasn’t.

It was a novel set in the northwest US in about 1917-1918 during WWI and the outbreak of the devastating flu epidemic. The location is Commonwealth, which is a town, formed around a mill but which had a special commune or kibbutz flavor since the owner of this factory organized the town to be a cooperative, paying fair wages, with one general store and a quasi town government, which would meet if there were issues to discuss.

The big issue is the deadly flu epidemic. The town, which is out of the mainstream and main roads, decides to isolate or quarantine itself from any outsiders by setting armed guards at the entryway into the town. The story evolves as two young men confront some soldiers who have strayed their way and desperately need to enter the town. The only way to prevent them from entering the town and possibly contaminating everyone with this dangerous flu is that these young guards  might have to be to shoot them.

The author develops these characters as well as other town people so you know where they are coming from; you have a sense of their values and beliefs and appreciate their moral dilemmas when it comes life and death decisions, which they have to make. These were not everyday people as they each had their own journeys to this town but nevertheless you could put yourself in their shoes. This is the vehicle of the book.

Although the premise and unique qualities of the book did hold my interest, I did not find myself as invested in the characters and the stories as I frequently do with books that I immensely enjoy. I could put the book down and I can’t classify it as page turner (or a button pusher in the case of my Kindle.). The author did surprise me at times with twists in the plot and evoked emotions when people did not do well with disease that was descending upon them.

The book did get me to reflect on several issues.

One of them is the great fear that contagious diseases can instill in everyone including healthcare workers. Before we knew exactly how HIV was transmitted, I recall the fear in hospitals when patients with HIV were admitted and required procedures, which might spill blood. I published a study about the attitude of nurses in working with such patients. There was great fear and at time avoidance of patients by doctors and especially pregnant nurses. During my work in disaster psychiatry we had to think through the psychosocial problems we might encounter if an enemy might release a contagious agent or a harmful toxin somewhere in this country. What if a school were contaminated? Would we let the parents into the school or keep them out.? Would we not let family members visit contaminated people in the hospital if the illness was highly contagious. How close would we let staff get to the patients? We thought there should be lots of video communications. We also knew the fear and anxiety could be greater than the actual threat to life (although that could be problem also). During a saran gas attack by terrorists in the Tokyo subway a while back, 100 people were affected and a handful were killed but over 5000 people who were not affected appeared in panic state at local hospital overwhelming their ability to evaluate them.  The importance of presenting clear information to the public in what is called risk communication has been  studied by researchers. They have concluded that there needs to be a balance of truthful information put out through the media, but yet put out in a manner that would minimize tendency towards mass hysteria. The public has to trust the spokesperson i.e. Mayor Giuliani giving information about potential future terrorists during 9/11. There are special techniques which he used and experts in this field have studied.

The book also  made me redouble my efforts to try be sure that we personally get the swine flu vaccine having already received the regular flu vaccine.

Another issue that I thought about was how Conscientious Objectors were treated during WWI. Apparently it was true that a certain number were actually treated harshly and beaten as depicted in the book. I know that during WW II COs did serve as medics as was the case in the VN war where I was a psychiatrist and had opportunity to evaluate a number of them who were either discharged or who clearly were assigned to noncombatant duty. I did not hear of any cases of physical abuse to them. The book touched idea of the anti-war movement in the WWI as well as in other wars or in the VN was which I was most familiar. One of the characters Rebecca who was shown to be suffragette as well as antiwar activist was a recurrent voice in the book.

When an author can stimulate thinking and discussion in a number of areas around the theme of the book he or she has made a worthwhile literary accomplishment.

My final conclusion is that in my opinion this is a good first novel but not a great one.

Comment » | FG - Fiction General

The Guernsey Literary and Potato Peel Pie Society by Mary Ann Shaffer and Annie Barrows

September 4th, 2009 — 5:53am

The Guernsey Literary and Potato Peel Pie Society by Mary Ann Shaffer and Annie Barrows

Guernsey Literary and Potato Peel Pie SocietyI found this a delightful book which told about a place I never knew existed and presented another refreshing story of the courage that people have shown during occupation by the Nazis during World War II. The book also captured how the love of books and reading can sustain people .There is wonderful character development including insight into romance and love. The unique use of letters written by the various people in the book to tell the entire story, allows time to flow quickly and works extremely well.

The setting is shortly after World War II, British writer Juliet Ashton receives a letter from a person who lives on Guernesy which is in the English Channel and had been occupied by the Germans during the war. Through a continued series of letters she learns about the Guernesy Literary and Potato Peel Pie Society and the various people connected to it. She finds out about Elizabeth the main creative force behind this group who during the occupation had a love affair with a caring German Captain and was willing to risk her life to help others .Juliet eventually has a prolonged visit to Guernsey and we are drawn further into the story by reading her correspondence which includes her editor and others whom she is close to back on the mainland. There are interesting twists and turns which involve a small child, a concentration camp survivor, hidden romantic feelings ultimately expressed and some previously unknown and now valuable letters from Oscar Wilde which had been written to the grandmother of one of the people on the island when she was a small child.

This novel stands on it’s own as a most enjoyable work of fiction which shows how the best in people can come out in the worst of times.

However as I read it, I found myself wondering if I would have experienced the book any differently had I been aware to what degree there was truth to the real story behind Guernsey Island. Suppose Guernsey Island didn’t really exist. OK then perhaps it is just a metaphor for the bravery of the British people during WWII. What about if in fact it was really known that most of the people on Guernsey island were collaborators? Was this story really based on people who bravely lived on this island? Was courageous Elizabeth who is the central character of this book based on a real person or an amalgam of some such people? Does it make any difference at all? Would it matter at all, if the Diary of Ann Frank instead of being a true story was just a novel purely of someone’s imagination?

In the acknowledgement, Afterword and in some published interviews with Annie Barrows co-author who finished the book after her aunt Mary Ann Shaffer died in 2008 during the final rewrite we learn a little about the origins of their creative effort.

Ms Shaffer had briefly visited Guernsey and was delayed in the airport. During that time she read and collected numerous books from the airport store. We also learn that she was a great story teller and we see she was a very fine writer. I was still curious as to how much was her own imagination and how much was founded on the real people who lived through that time. I had a brief correspondence with the Ms. Annie Barrows. She was kind enough to write to me after being forwarded a note that I wrote to Ms Mulligan who had published an interview with her and offered to tell the true story of the Wilde letters if she was asked.

Dear Mr. Blumenfield,

Ane Mulligan passed your email along to me. The characters we placed on Guernsey are fictional, which means they are composites of people we have known, heard of, or imagined. Elizabeth is not based on anyone on the island. Mary Ann was deeply interested in the Resistance fighters of WWII, in particular a Danish boy named Kim Malthe-Brun, so Elizabeth has some attributes of his, but much of her is imagined.

There are stories of heroic defiance on Guernsey, as well as of daring escapes and infiltrations. I got a lot of information from a book called Islands in Danger, by Alan Wood, which was published in 1955. Mary Ann was partial to a book called Liberation by Nick Machon. There is an Occupation Museum on Guernsey as well as numerous websites about the Occupation, if you’d like to find out more in a non-fictional vein.

Sorry about the Oscar Wilde letters–it’s an utterly fictional episode. Mary Ann adored Oscar Wilde.


I appreciate my curiosity being satisfied. Perhaps my continued reflection on this book is a tad more enjoyable knowing for sure that there were real heroes on this real island. I may even check out the author’s favorite sources and who knows perhaps we will get a chance to stop over during some future trip to Europe.

Comment » | FH - Fiction Historical

The Book Thief by Markus Zusak

September 4th, 2009 — 5:50am

The Book Thief by Markus Zusak

The Book Thief by Markus ZusakMy initial experience with the book was somewhat negative. First, finding the book in the teen department of Barnes & Noble seemed somewhat curious. I had difficulty getting in to the book as the style and narrative seemed unusual and in retrospect perhaps uncomfortable as it seemed to be written from the point of view of an angel of death. Perhaps after about 50 pages I was comfortable with the book and was being drawn in to it although I could still easily put it down.

I also felt an early identification of Liesel with my seven year old granddaughter who has recently fell in love with words and books. This connection began to give me an added emotional attachment to the characters and the story which I usually have anyway to a holocaust book. I felt the author was making a meaningful insight to me as he spoke about Kristolnacht and clearly conveyed how the Nazis were bent on destroying words and the ideas behind them perhaps just as much as they were displacing their frustrations and hate on the Jews. As the book progressed – it became a page turner for me. The author used an interesting style of foreshadowing the events coming in each chapter which toyed with my anxiety and concern about the characters but yet I couldn’t be sure what was going to happen. I began to realize that I was developing great empathy and caring for the characters who were German non-Jews. I desperately wanted the characters who went off to fight the allies to survive. When the Jews were marched through the streets on their way Dachau Concentration Camp – I was accepting the idea that most of the observers were neutral and of course the main characters were heroic in wanting to give them bread.

By the conclusion of the story I of course was fully on board with the idea that all war is terrible and I felt very badly that most of the characters had been killed. I was touched that Liesel and Max had survived and were together. But what did they do with their life and did they feel guilty about what had been done to the Jews? The author who obviously was not Jewish said that he wrote the story based on memories of stories that his parents have told him from Austria and Germany and he wanted to show that not all Germans were bad. I found this quote from him on the Internet:

One day, there was a terrible noise coming from the main street of town, and when she( his mother) ran to see it, she saw that Jewish people were being marched to Dachau, the concentration camp. At the back of the line, there was an old man, totally emaciated, who couldn’t keep up. When a teenage boy saw this, he ran inside and brought the man a piece of bread. The man fell to his knees and kissed the boy’s ankles and thanked him…Soon, a soldier noticed and walked over. He tore the bread from the man’s hands and whipped him for taking it. Then he chased the boy and whipped him for giving him the bread in the first place. In one moment, there was great kindness and great cruelty, and I saw it as the perfect story of how humans are.

Therefore I reflect that at best this 30 year old author is an apologist for the Germans of the Nazi era and at worst has little appreciation for what really happened in the holocaust. Therefore I find myself negatively inclined toward him and what he had to say. He is a talented writer and wrote a great book . I am glad I read it but I wouldn’t recommend it to everyone and I am not sure to whom I would urge that they should read it. I recognize that this is a very personal reaction but it is the way I find myself feeling at this time.

Comment » | FH - Fiction Historical

Loving Frank by Nancy Horan

September 4th, 2009 — 5:38am

Loving Frank by Nancy HoranLoving Frank by Nancy Horan

This is an historical novel based on the love affair of famed American architect Frank Lloyd Wright and a married woman Mamah Cheney. They met when Wright was asked by the young Cheney couple to design a home for them in Oak Park, Illinois, a suburb of Chicago in 1903.

The author appears to have impressively researched the material on the subjects of the novel as described in the afterword and in interviews with her. Whether she has accurately captured their inner thoughts ,conflicts and all the circumstances of their relationship is not as important to me as is the discussion that she is stimulating about marriage, love, loyalty to children, the effect of divorce on children, feminism and the relationship between men and women. This is quite an accomplishment for a first novel.

Mamah Cheney, college educated with a masters degree, writer, fluent in several languages, mother of two small kids, realizes she shouldn’t have married Edwin who is a nice enough devoted hardworking husband. She is now smitten with Frank Lloyd Wright, self centered, creative, brilliant architect who designs buildings to blend with nature. He also has small children and is married to Catherine whom he feels doesn’t understand his special qualities . Mamah and Frank who appear to deeply appreciate one another, fall in love and go off together. Although it is difficult for her, Mamah is able to leave her children to her husband who cares for them with the help of a live- in single sister and a housekeeper. She and Frank live in Europe for awhile and eventually settle in Wisconsin where Frank designs their new residence called Taliesin (from the Welsh word meaning “shining brow” as it is built into the brow of the hillside instead of on top of the hill). Wright is of course is known for his “organic architecture” Ultimately Mamah has some visits with her children but has essentially abandoned them for most of their early childhood. Frank visits his children periodically in Chicago but is basically out of his house living with Mamah in Wisconsin.

The story unfolds mostly through Mamah’s eyes and thoughts. The reader is not only swept up in the story but is given ample opportunity to identify with Mamah and the excitement of her life .She has clearly made a mistake in her decision to originally marry Edwin. She now sees the opportunity to rectify her big false step by living out a life in love with rich fulfillment in so many ways with Frank. The author’s empathy for her is quite palpable in the book as well as in the epigraph she chose for her novel from Goethe, “One lives but once in the world.” At the same time the main character in the book wonders about the decisions that she and Frank have made as well as the implications for their spouses and children. . Many of her own ideas are honed and clarified as she meets Ellen Key,
Swedish feminist and agrees to translate her writings for an American readers. While Mamah strongly agrees with just about everything Key asserts , she did have some qualms with her statement: “The very legitimate right of a free love can never be acceptable if it is enjoyed at the expense of maternal love.”

In the novel and apparently in real life this affair was considered a front page scandal in the Chicago newspapers which of course greatly impacted on the participants. The criteria for a public airing of such an affair may have changed in the past one hundred years. It now appears to have to be a popular movie or television star or a major politician but there is no shortage of such front page stories. As I write this piece today the TIME magazine cover story “Unfaithfully Yours” is examining The marriage of Mark Sanford governor of South Carolina and his wife Jenny, former senator and former presidential hopeful John Edwards and his wife Elizabeth, former governor of NY Eliot Spitzer and his wife Silda and reality TV parents of eight kids Kate and Jon Gosselin. The men in each of these high profile marriages chose to have extra-marital affairs with lesser known women.

The writer of the TIME piece Caitlin Flanagan concludes that there is no other single force causing as much measurable hardship and human misery in this country as the collapse of marriage. She concludes that it hurts children, it reduces mothers’ financial security and it has landed with particular devastation on those who can bear it the least, the nation’s underclass. While the characters in the novel or the high profile people mentioned above don’t fit into this socioeconomic class, few would argue that the impact of divorce probably is magnified as you move down this ladder.

While empathizing with any women’s legitimate wish to be happy and live a fulfilled life as she sees fit, let us keep our eye on the impact on the children. The book keeps returning to Mamah’s feelings and obligation to the children. This was a time before shared custodies, single mothers were becoming more common place , let alone same sex parents. Our modern day recent TIME article quotes a 1994 book Growing up With A Single Parent by Sara McLanahan who studied effects of divorce on children from middle and upper income households. . She concluded that “children who grow up in a household with only one biological parent are worse off on average than children who grow up in a household with both of their biological parents regardless of the parents’ race or educational background.”

Before I recently relocated to California I lived and practiced in Westchester county in New York. One of my colleagues was the outstanding child psychiatrist and psychoanalyst Paulina Kernberg who wrote extensively on children and divorce. She believed divorce, was the second worst trauma a child could undergo, exceeded only by the death of a parent. The psychological scars, she warned, lingered, and in many cases a child was better served living in a loveless or contentious marriage than shuttling between separate households. Perhaps one of the most important recent books giving insight into the impact of divorce on children was The Unexpected Legacy of Divorce written by a renowned San Francisco psychologist Dr. Judith Wallerstein with Julia Lewis and Sandra Blakeslee This was a 25 year study of a group of 131 children whose parents were all going through a divorce. She pointed out among other things that over time these now grown children who usually do not a have a model for a successful relationship have to figure out how to find loving partners and to become good protective parents. She also highlighted how the effect of divorce on a child may not appear until this child is in their late 20’s to early 40s. At this time they can have great fears of loss, conflict and betrayal as they choose their own partners. This may lead to self destructive choices in partners. In other cases of course they can learn from their parent’s mistakes and end up with good marriages. However, I don’t know of any research that has been able to systematically study the effect on children growing up with parents who are unhappily married and resent their own decision to stay together for the children

In the course of my psychiatry practice I have seen many women and men over the years who were contemplating separation, divorce or had been through this process. While it is helpful to be familiar with the above and other and writings, I have found that there are so many variables that it serves no value to generalize in regard to any individual in this situation. Each person brings their own history, background, values and emotional template and we must try our best to help them within this context.

One of the advantages to a person who chooses to get help at this cross road in their life is that we can determine if they have a specific psychiatric condition which if treated will make it much easier for them to negotiate this life crisis and make decisions. For example if a person has an untreated mood disorder such as a major depression or a bipolar disorder there could be intense mood changes which are clouding or influencing their decision making processes. Much more complicated but quite relevant could be certain types of personality disorders or patterns which invariably lead an individual to make repetitive unsuccessful or even destructive choices in their lives. Ideally such a person will be able to enter into therapy for a reasonable amount to time before making important decisions which may be hard to reverse. As in most therapy situations, a good therapist will remain neutral, not let their own personal values unduly influence the patient while allowing an examination of the life crisis . One challenging situation which often requires an exception to this completely neutral stance is when the patient ( most likely a women ) is the victim of clear repetitive abuse by her partner and requires positive affirmative encouragement and support by the therapist. to step away from it.

In conclusion I believe “Loving Frank” is an excellent book. It not only tells the story of two very interesting people which ends with the tragic death of one of them, but it stimulates reflection on a whole myriad of personal issues which were as relevant 100 years ago as they are today.

Comment » | FH - Fiction Historical, FR - Fiction Romance

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