Dark Money: The Hidden History of Billionaires Behind the Rise of the Radical Right By Jane Mayer

Jane Mayer is an award winning investigative reporter who writes for the New Yorker Magazine.

This book is long and somewhat repetitious but it presents a clear undeniable exposition that shows how our free democratic government, founded on checks and balances is being corrupted by a small group of very wealthy individuals. Multi-millions, if not billions of dollars are being used, often secretly, often with the pretense of tax-free donations, all which are funneled to individuals and organizations with the main purpose of supporting the interest of the super wealthy people who control these funds. This is a clear evasion of existing tax laws with the goal of lowering tax rates for billionaires and multi-millionaires, who often believe they should be paying lower tax rates than the middle class. There also is a campaign to change government regulations to favor their business holdings.

The undisputed leaders of this calculated, spending of “dark money” are brothers, David and Charles Koch, two of the richest men in the world who continue to expand their wealth through their massive holdings in fossil fuel and chemical industries. They lead a group of extremely wealthy men including Richard Mellon Scaife, heir to the Mellon Banking and gulf oil fortune, the Coors family who founded Amway, John Owen and his family also from the chemical industry and many others. It is not surprising that this group also denies and disputes the established scientific reality of climate change and the threatened dangers to our planet. This well-documented book, with extensive references and bibliography exposes the nefarious actions and manipulations of the relatively small group of very rich people who have a radical conservative agenda.

The Citizens United ruling by the United States Supreme Court, allowed the Koch brothers and other ultra conservatives to make unlimited contributions to independent expenditures. This meant that these groups could support political action committees that were officially not tied to particular candidates in any way. The Citizens United, Supreme Court decision also allowed that there could be unlimited spending for candidates, as long as the candidate was not involved with how the money was spent. This ruling sent a message to the wealthy and their political operatives that when it came to raising and spending money for political candidates, they could act with impunity. Soon, hundreds of millions of dollars from Koch and his wealthy colleagues were flowing to support their favorite candidates. This opened the floodgates for all special interest groups, mainly from the ultra right, including foreign corporations, to spend money without limit in the US elections. The details, including names, secret deals, etc. are all documented throughout this book.

A further example of how this group of wealthy conservatives scammed and manipulated government elections throughout the country is how they use the federal law pertaining to the IRS tax code known as 501(c)(4). This regulation allows tax-free donations to organizations that are exempt from paying federal taxes if they are listed as a civic group or are operating exclusively for the promotion of social welfare or they are a local association of employees with limited membership. These organizations are allowed to engage in unlimited lobbying as long as it pertains to the organization’s mission. Sometimes, the organization would be set up as a charity and it would be able to receive tax-free donations. Other times, when the donations were not deductable, the donors would write them off as business expenses. Many of these organizations received the funds under the guise of having honorable, civic concerns but actually closer examination showed that many of them were non-existent as a functioning organization but were rather just a post office box run by a few individuals well-connected to the Koch brothers and their friends who would furnish huge amounts of money through these organizations in support of political candidates in state elections and in the House of Representative, who were pledged to advocate for the needs of their donors.

One of the really eye-opening subjects covered in this book is the description and documentation of how conservative donors have tried to influence and gain control of higher education in America. The seminal event, which precipitated and motivated these actions, was the famous show of “Black Power” during an uprising at Cornell University in April 1964. As some of you may recall or may have read about, 80 black students marched out of the student union with their clenched fist held high in the Black Power salute and several of them were brandishing guns. The pressure brought on university officials because of this action led to the acceleration and planning to establish undergraduate black studies programs at Cornell and then subsequently at other universities. In response to these actions and in order to counter them, one of the wealthy billionaires, John Owen set up a mechanism to begin to funnel funds to various universities throughout the country, often hiding the exact source of the money. Funds went to universities to establish think tanks, special studies departments, endowed professorships, all geared to the ultra conservative agenda. Part of their goal was to establish courses in universities that would teach conservative economic theories, lecture students about the “climate change myth”, teach theories and write books that expounded lowering taxes for the rich and reducing financial support for the poor. All of these one-sided ideas would have caused benefit for donors of these huge funds. This was a secret agenda and millions and millions of dollars were brought into universities throughout the United States. This movement, plus the pouring of money into the election process began to allow conservatives to develop an increasingly large constituency, which gained strength in the state government and also allowed the ultra right to gain seats in the House of Representatives of the US Congress. The subsequent Republican congress limited President Obama’s ability to develop his agenda and is now also expected to play a major role in the 2016 election.

This book review has just touched upon a few of the highlights or should I say low points of what is documented in Jane Mayer’s book. It is ongoing and actually is quite depressing. However, it is really very important that every American citizen should be aware of the corruption of our political system with the behind the scenes, hidden history of secret deals with dark money.

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COMPELLING EVIDENCE  – by Steve Martini

Published in 1992

A friend of mine mentioned that he is a big fan of Steve Martini who has written 13 bestselling novels in which the main character is a lawyer and has some very exciting courtroom scenes. Since I have enjoyed a few of John Grisham’s novels and I am always drawn to a movie or a TV program with a good courtroom action, I decided to explore this series. I chose Martini’s second novel and the first one in the 13 published books that has this main character, attorney named Paul Madriani.

Compelling Evidence was published in 1992. It did not disappoint me. The author opened the story with a detailed and what appeared to be a very knowledgeable description of a prisoner being executed in a gas chamber as a death penalty was being carried out.

The story progressed as the reader was introduced to Paul Madriani. It was through his eyes that we view this captivating story. It puts the legal profession front and center as just about all the characters are lawyers. The victim of the current case in point is Ben Porter, a honcho of a large successful law firm. His wife, Talia is his accused murderer of him. We learn early in the story that Mr. Madriani had once worked at the Porter Law Firm and even had an affair with Talia. Mr. Madriani ultimately becomes her chief defense attorney and so the plot develops.

All the characters and details of this story are woven together quite skillfully. Although there is a lot of “lawyer talk”, the readers’ knowledge and background is never taken for granted. Through the narrative and the dialogue, we are always kept in the loop and are well-educated. We meet the district attorney and his staff and we clearly understand their role as well as the role and obligation of the police who had investigated the crime. When we are introduced to the judge, we not only appreciate his role and obligations but also get insight into his personal issues (he does not want anything to go wrong because a mistrial would reflect badly on him). We are not only given a good description of what is happening when there are various motions but we gain insight into the various opposing forces of this legal battle and what they are trying to accomplish. We come to understand the basic legal tenets of why no one accused of a crime is expected to take the stand to testify and how a jury is strictly instructed not to hold such a refusal against them.

Reading this novel is like taking a class in law school except we are caught up in the plot that rivals a TV courtroom or movie story. I must admit that we also were given a dose of cynicism from the author’s experience. For example the statement that popped up at an appropriate place threw me for a loop. Cases are won or lost not on the truth but in the predominance of perjury attended by witnesses on the stand who lie with impunity and then walk away. Shortly later, the author stated The law is no instrument for divining the truth.

In the end, I had a very enjoyable and educational experience. This 1992 novel was Steve Martini’s first novel in this series and I understand the fourteenth book is due out in May of 2016, I cannot help wondering if the author may have even raised his game with additional novels under his belt.

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Fate and Furies by Lauren Groff

Apparently, people either love or hate this book. If I hated it maybe that would have meant it had some special emotional meaning to me, which I don’t believe was the case. I certainly did not love it.

The main protagonists are a married couple, Lotto and Mathilde. They are seemingly very much in love but as often is the case there  is much more than meets the eye. Lotto was an actor turned into a successful playwright. In such a situation it would be expected that we might better understand him through his plays. We are presented with many pages of his plays which don’t really provide any great insight into him. We understand Mathilde as we learn more things about her earlier years, which gradually unfold throughout the book.

The author’s style reminds me of my early encounter with the classical writers which I did not  particularly understand and was not especially moved to figure them out. Perhaps this is my shortcoming. Another way of describing the style of the author is to say it is very pretentious. There were many metaphors which where not decipherable and seemed “cutsie”.  Sometimes while I was trying to figure them out, I felt I lost to some of the story line. Many authors successfully jump back and forth into different points in time, but usually there are some reference to where the particular chapter is taking place as well as the time period. This was not so with this book. I found that the time and place were not immediately obvious and therefore the readers may be  trying to figure them out rather than focusing on the plot.

Perhaps the most interesting aspect of the book is the presence of “secrets” in the lives of the characters. Often these secrets when they are present contain something about their biological origin and/or secret sexual encounters. Why these secrets are so meaningful in a particular narrative is that they are often the doorway to some interesting psychological dynamics. I believe that with this book, the author would  knock on the door but then not clearly deliver on this possibility. Overall, I would say that this book was not my cup of tea.

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Getting The Most From Your Therapy by Jeffery Smith, M.D.

Instead of a written review of this book, I have conducted an interview with Dr. Smith in a podcast. Please click the following line to hear this broadcast: Interview with Dr. Jeffery Smith.

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The Rosie Effect by Graeme Simsion

This is a sequel to The Rosie Project by the same author which in my opinion did not add anything to the first book. The main character, Don Tillman, a professor of Genetics from Australia who now is working at Columbia Medical School in New York has married Rosie, a combination PhD and medical student, who was the object of his attention in the first book. Rosie is now pregnant and Don’s reaction to this situation occupies much of the attention in this sequel. As we previously noted, I think it is fair to say that Don has a condition that might be called Asperger’s syndrome. He is obviously a very brilliant man who is extremely logical and analytical but he doesn’t quite get the meaning of feelings and emotions although he does clearly love Rosie. Don will make a spreadsheet to analyze any problem. Think Mr. Spock from Star Trek. Rosie is concerned whether Don will be able to relate to their impending child (designated at BUD for baby under development).

In an attempt to gain insight and understanding of young children, Don attempts to shoot some videos of children playing in the park. This leads him to be picked up in the park by the police for suspected pornographic intentions. This develops some interesting storylines that are clever but not brilliant enough in my opinion to become a page turner. For the most part, the author seems to be going over the same ground as in the first book. Don’s way of thinking is logical and seemingly without any psychological defenses. He says what he thinks and this allows for insightful if not amusing comments. He has a few loyal friends which allow some focus on interesting ideas about infidelity and friendship bonds between these guys. Every new character who appears in the book is described by Don by his analysis of their BMI (body mass index) which is amusing but wears thin after a while.

The first book, The Rosie Project presented an original character through whom the author could reflect on many human foibles. The author developed a base of loyal readers who might be expected to embrace the return of this character in The Rosie Effect. For me, the first book was good enough.

The Wright Brothers by David McCullough

We all know that two wrongs don’t make a right. So when I showed my 9-year-old granddaughter this book that I was reading and asked her if she knew what it was about, she gave me the riddle, “What do two rights make?” An airplane of course.

David McCullough, two-time Pulitzer Prize winning author for Truman and John Adams has taken on two additional American heroes, Wilbur and Orville Wright. McCullough had a trove of documents to work on, mostly now residing in the Library of Congress and in museums in the Wright Brothers hometown of Dayton, Ohio. Obviously there were no instant messages, iPhones, or e-mail correspondence during their lifetimes and like many of their contemporaries, they wrote numerous letters and kept extensive diaries. McCullough mined these sources as well as the newspapers and magazines of that era.

Wilbur was four years older than Orville. They had two older brothers and a younger sister and there were two twins born in between Orville and Wilbur who died at birth. Their father was a Bishop in the Church of the United Brethren of Christ who traveled a great deal. Their mother, who it was said to had given them their mechanical ability, died three years before their first flight at Kitty Hawk in 1902. The family was very close and supported each other. Katharine, the sister, who was a teacher shared very much in the Wright Brothers’ success and traveled with them at the time that they received worldwide acclaim.

Perhaps it is a screen memory (an unconscious one constructed in retrospect) but the brothers recalled their father bringing home a toy for them when they were quite young which was a helicopter which flew with twisted rubber bands and suggested that this possibly was the origin of their interest in flying. A first-grade teacher remembers Orville sitting at his desk with bits of wood and telling her he was making a machine of a kind that he and his brother would fly someday.

Wilbur and Orville were obviously extremely bright although they never went to college. They opened a print shop while in high school and went on to open a bicycle store where they made and sold bicycles. This was the environment in which they began working on a flying machine.

McCullough traces with the accuracy of the historian that he is, each step of the Wright Brothers journey. Initially building a glider and then the development of intricate wings that could do special movement that the brothers meticulously developed. He describes the addition of the motor and propeller. We learned about the people throughout the world who were trying to be the first in flight and their relationship with the Wright Brothers. This book focuses mainly on an approximate a 10-year period from Kitty Hawk to the glorious flights in Paris and New York.

Overall, there seemed to be great camaraderie between the various pioneers of flight throughout the world with the Wright Brothers. However, there were some conflicts and some patent disputes that the Wright Brothers had with other flyers of the day. Ultimately, there was tremendous acclaim for the Wright Brothers. I think it is worth quoting the words of President Taft upon presenting the Wright Brothers with some awards in the White House. He said:

I esteem it a great honor and an opportunity to present these medals to you as an evidence of what you have done.I am so glad perhaps at a delayed hour to show that in America it is not true that “a prophet is not without honor save in his own country.” It is especially gratifying thus to note a great step in human discovery by paying honor to men who bear it so modestly. You made this discovery by a course that we of America like to feel is distinctly American – by keeping your noses right at the job until you have accomplished which you had determined to do.

According to McCullough there was rarely friction between the Wright Brothers themselves. They were a well oiled team who understood each others’ strengths and worked very smoothly together. While their relationship was detailed very clearly, what seemed to be missing was their personal lives. Either the author chose not to include any special social interactions or there essentially were none. It is hard to believe that there is no mention of any girlfriends or romantic interests. When Wilbur died in 1912 at the age of 45, Orville and his sister Katherine moved into a new house with their father. Orville became involved in their business details which now were quite complicated as the famed inventor. When at the age of 59 his sister decided to get married, Orville was reported to be very disturbed and negative about her plan which she carried out anyway.

I, probably like most of you, take flying for granted. I am more concerned about the arrival time, legroom, and how I should occupy myself during the flight. David McCullough’s book provides an unforgettable tribute to the brothers from Dayton, Ohio who made all of our flights possible.

What She Left Behind

By Ellen Marie Wiseman

This book is composed of two interweaving stories. Clara, a woman who lived in the 1930s was committed to a mental institution against her will based on her wealthy father’s unhappiness about her Italian immigrant boyfriend and her refusal to marry the rich guy that her father picked out for her. The other story is about a current day teenager named Izzy who is a foster child of Peg and Harry after having lived with several previous foster parents since her mother unexplainably murdered her father. Peg is working on a museum project examining newly discovered suitcases of belongings of former patients (including those of Clara) of a now closed psychiatric facility, in order to gain some understanding of their lives. Izzy helps out with this project and finds the diary of Clara and becomes interested in her life.

Being a psychiatrist, I was initially drawn to this book with the idea that I would gain some insight into the lives and treatments of psychiatric patients living in the first half of the twentieth century. This was the case and it included vivid description of the treatment that was done at that time such as ice baths, insulin shock therapy and electroconvulsive therapy (ECT).

Although I never worked in a state hospital, when I toured them in the late 1960s, such treatments except occasional ECT under humane conditions were things of the past. As far as the possibility of someone spending most of their life committed to a mental institution based on the word of her father when she clearly did not have a mental illness, I would like to think that this would not have been possible. Certainly, in modern times from my experience someone being hospitalized against their will would have to go through a legal hearing with the patient being assigned an attorney if they don’t have one. Once in a hospital with treatment with modern-day medicines (which were not really available until the 1950s) most mental illness can be put at least in temporary remission with such treatment. Today, there would be reviews by multiple doctors with no mandate to keep the person in the hospital against their will unless they were a danger to themselves or others due to a mental illness. I would hope that nothing like Clara’s situation could occur today. Obviously, I can’t speak for every state hospital in the United States and certainly things were different in the 1930s.

There was another aspect of Clara’s case was particularly disturbing to me in that the psychiatrist in charge of her care was depicted as a mean, cruel, selfish man who was mainly responsible for Clara’s lost life. I felt it was an unfair indictment, which suggested all psychiatrists of that time might have been of the same cloth. I understand that the author has the creative choice to develop characters in whatever fashion she chooses. I probably would not be complaining if the character were a dishonest lawyer who did unsavory things in the interest of an interesting storyline but nevertheless, I felt that this book was stigmatizing my profession.

There was particular theme of this book, which also had a special interest to me. Three characters in the book were driven to try to understand their early origins. Izzy, understandably could not fathom why her beloved mother murdered her father. This ultimately led her to empathize with a schoolmate who had some parental trauma. It contributed to her mission to find Clara’s daughter who was essentially separated from her at birth, and hand over her mother’s diaries so she could know about her mother’s story. Clara’s daughter led a life of yearning to know what happened to her mother and Clara similarly went through life wanting to know what happened to her daughter. This is a variation of a theme, which I have seen played out in many people’s lives as well as in some interesting movies. Persons, sometimes separated at birth or when they are quite young often yearn to know their biological parent or parents with whom they may have had no relationship for decades. I have reflected on the psychodynamics of these issues in a psychiatry blog that I write. Therefore, I was particularly interested to see how they played out as major motivating factors in the characters in this book.

I believe the author Ellen Wiseman has created an intriguing story that will hold the interest of the reader whether or not you come from a psychiatric background.

One Plus One By Jojo Moyes

This is a road story about three plus one unlikely characters. There is Jess, a 20-something single mom, her maybe 12-year-old daughter, Tanzie and her teenage misfit stepson who was recently bullied. The plus one is Ed, a mid-30’s guy who Jess met when she cleaned his house in her job as a house cleaner and also drove him home one evening from the pub, where she works in the evening, after he drank too much. Tanzie is a math wizard who has the opportunity to win a scholarship plus expenses if she does well in the Math Olympiad in Scotland (They all live in England). Ed who is usually called Mr. Nicholls offers to drive Jess and family to Scotland after he sees them on the road when their car broke down on the way there. There is also a large droopy dog, Norman, who is along on this road trip so it is really three plus one plus one.

Jojo Moyes has a writing style that holds our attention with details of an interesting backstory about each person, which also shows their unique personality. We get insight into how the characters were developed. It turns out that they are all troubled. Jess and the kids all had difficult childhood experiences. Ed, while successful in business now has to deal with a recent personal relationship, which threatens to drastically change his life. They are all in the car, driving only 45 miles an hour on their way to Scotland because Tanzie gets sick when the car goes over that speed. As they putter along, their feelings unravel to the reader.

I believe that the magnetism that draws us to this book and makes you not want to put it down is that there always seems to be a glimmer of hope for each of them individually, as well as a group. But as exciting and hopeful as the story swings for them, there are circumstances, which challenge or devastate that hope. There is the wish for a fairytale ending but yet, it is a book about real life.

There is also great potential for this book as a movie with outstanding roles for in-depth character portrayals, which could even include some R-rated scenes. There is passion, love, poignancy, moral and ethical dilemmas. There is even an important role for a dog. But don’t wait for the movie, this will be a great read.

Moving On – A Life by Oliver Sacks

I never read any of his books other than this biography. I read about many of them. I don’t recall hearing him speak in person although I believe I attended one of his lectures at the American Psychiatric Association meeting. I was familiar with many of the places that he spoke about in New York, San Francisco and Los Angeles and I even had some friends and colleagues who knew his analyst, David Shengold. Although I was never anywhere near being in his league as a clinician, writer and brilliant mind, his areas of interest had always fascinated me. So I guess you can say in reading this book, I had a certain amount of kinship and empathy for him although in many ways he was miles apart from my world.

He was born in England to a Jewish family. Two of his cousins were Al Capp, the famous cartoonist and Abba Eden, a famed Israeli Prime Minister. One of his brothers was schizophrenic and we can’t help wondering if his desire to crack the code on the workings of the brain may have had its origin with that experience. Both his parents were physicians and he has early memories of hearing them discuss interesting cases. His father thought it was a shame when a case  was written up in the popular press but his mother was a great storyteller. No doubt it was at his parent’s knee that he became fascinated by case histories.

The reader of this book will benefit by his ability to tell good stories. At times he jumps around and he may lose you with the exact time sequence but that will be a small price to pay for an interesting story of a brilliant man who led his life, well lived, his way.

It was his misfortune to be born gay at a time when it was considered to be a choice, rather than an inborn destiny that we know it is today. It is sad to hear that after he had his first sexual experience, he had none for the next 35 years. It was heartwarming to see that he fell in love and was able to live a happy intimate life with a man in the twilight of his life.

In a small way, I could relate to his early fascination with the working of the brain and the scientific advances that were occurring, as he was completing medical school and making the decision to become a neurologist. This was approximately the time that I was in college in the late 1950s. I had participated in a special project where we implanted electrodes into the brain of a cat, in which we could then record after the cat had recovered from surgery and resumed it’s relatively normal life. There were situations where we could tell in advance when the cat was going to make a decision, based on the brain waves before the cat made them. It was very tempting for me because of this experience to want to choose a career in neurology but for me, clinical psychiatry beckoned and that became the direction that I took. We are all fortunate that Dr. Sacks followed his interest in the workings of the brain.

When Dr. Sacks came to the United States, he was in his ‘20s and his first stop was San Francisco where he became an intern at Mount Zion Hospital. Not only was this young doctor quite fearless on his motorcycle but he was also fearless in his self-experimentation with LSD, PCP, later known as Angel Dust and who knows what else. I am sure his experience with mind altering drugs at this time paved the way to his lifelong study of the brain and the workings of the mind.

He dropped a tidbit taking place during this time period about how he got out of the draft. I know firsthand that young doctors were subject to being drafted into the military during both the Korean War and the Vietnam War. It was in 1968 that he said that he persuaded the draft board that he was not suitable material for the draft. I wonder what this was all about.

As someone who has worked in academia, I was particularly interested in what he had to say about one of his first jobs working in a clinical research lab. He reports that on his own, he made observations that he felt merited a write-up for a journal. When he wrote his first paper and it was accepted for publication, his boss was furious and fired him and then according to Dr. Sacks used some of his data which the boss claimed was his own for another publication. I have seen similar situations where there is conflict between the young person and the father figure. I can’t help wondering what would have happened if Sacks had tried to collaborate with his boss. In later years, he described getting along well with his colleagues and sharing data and theories but on the other hand, there seems to be a certain lone wolf quality and approach to his ultimate final products. I really can’t say if he was generous in allowing co-authorships with younger colleagues when he was the famous established author.

His life in Southern California was particularly fun to read about, since he had a house in Topanga Canyon, which is near the area where I now live. He reports zooming around on his motorcycle and it was obviously quite different than it is now, trying to get around on the busy freeway. He reports that he became the doctor of sorts to the Hells Angels, as well as being a Venice Beach bodybuilder.

He really seemed to come into his own once he came to New York. One might have expected him to join the full time faculty at one of the many outstanding medical schools. Instead, he decided to become the peripatetic neurologist by being a consultant to the Beth Abraham Nursing Home , the Little Sisters Nursing Home, both known as “ Manors,” among other places. It was here that he made his groundbreaking observation on post encephalitic patients who received L-DOPA and have their “Awakenings,” often temporary but revealing great insight into the workings of the brain.

His book, by the same name became a New York Times bestseller for 26 weeks and was made into a screenplay by Harold Pinter and into a great movie in which he was played by Robin Williams. This was followed by a number of other world famous books such as The Man Who Mistook His Wife For His Hat, Hallucinations and many others

In his heart and soul, it was clear that he was a storyteller. His understanding of neurology allowed him to listen and observe his patients and make insights that were not only fascinating but were important scientific advances for his time. He was also able to educate the public with his ability to write and make his case histories come alive as real people with unusual problems. He was unbelievably prolific and accumulated thousands of diaries filled with observations of his patients and of the people that he met and interacted with. He became friends and corresponded with some of the great minds of his time, such as Francis Crick (of  the DNA guys Watson and Crick) and Stephen Jay Gould as well as Gerry Edelman, author of the groundbreaking book, Neural Darwinism which Sacks explains in great detail in the biography.

Although I don’t think he mentioned it his book, I read elsewhere and that some of the subjects of his writings didn’t like that they were described in a manner in which t they could be recognized. Perhaps he didn’t get what we now call “informed consent.” He obviously wrote because of his love of the subjects he wrote about as well as because of the love that he had for these people whom he got to know.

One of the most important subjects of his writings that he definitely had permission to write about was himself. When he severely injured his leg, he was able to write a book titled A Leg to Stand On. In his waning years, he developed a melanoma in his retina. This stimulated him to enlarge upon his earlier observations about vision and consciousness. No doubt , he developed a personal attachment to the people he wrote about but he seemed to be also writing for the personal gratification and acceptance of himself and his works. He related a situation where due to one of his books receiving bad reviews, he went through 3 months of being severely depressed .

Oliver Sacks certainly lived his life to the fullest, He received much recognition for his work. He was also recognized by the Queen of England and honored with the designation of Commander. Not only did he receive much satisfaction from his many accomplishments, but he was able to share so much of his thought process and insights with the people who read his papers and books. He passed away a few months ago (August 2015) but I’m sure that his stories and observations will live on for many generations.

A Common Struggle: A personal Journey through the Past and Future Mental Illness and Addiction   By: Patrick J. Kennedy and Stephen Fried

This is a story, told in the first person of Patrick J. Kennedy. It is really two stories presented to us simultaneously. It is about Patrick Kennedy, son of Edward Kennedy and nephew of JFK and Bobby Kennedy. He has been a US congressman from Rhode Island for eight terms and was one of the staunch advocates for parity legislation, for mental illness, and addiction. Yet at the same time that he was leading the fight in the United States Congress to bring about these major changes in our healthcare system, he himself was secretly battling mental illness and addiction.

An important part of his personal story was a discussion of alcoholism in his family. Not only was the author an alcoholic but his brother, mother, and father, Ted Kennedy also struggled with this condition. It is significant that all of them except his father ultimately recognized their problem and entered various programs to help themselves. His mother battled alcoholism for a prolonged period of time and yet her condition was not recognized by family members despite the fact that they knew about several hospitalizations and treatment programs that she had undergone.

One of the most revealing insights about his father that he revealed in this book is how Ted Kennedy was traumatized by the tragic death of his three brothers, JFK, Bobby Kennedy, and his oldest brother, Joe Jr., who was killed in World War II. An additional major trauma for Ted Kennedy was the death of the young woman in Chappaquiddick, an incident well covered by the press.

It was not a simple pathway for the author to recognize his own problems. Even after a period of therapy with Psychiatrist Peter Kramer, author of the well known book (Listening to Prozac). Kennedy felt this treatment was helpful but did not eliminate his addiction problem or allow full acceptance of his bipolar condition. He vividly described how he would convince himself that he didn’t have any problems if he didn’t drink in public or take “illegal” drugs.

Patrick Kennedy served in the Rhode Island legislature and was elected as the youngest member of the US Congress in 2004 during a period that his addiction and mental illness was hidden from the public. It was also pretty much hidden from himself.

His colleagues in the US Congress ultimately became aware of his attempts to hide his drinking problem. Kennedy describes an important event for him when in 1996, Minority Leader, Dick Gephardt, offered him the prestigious chairmanship of the Congressional Campaign Committee on the condition that he stop drinking. This made him realize how he was denying that he had a problem that was known to others.

It wasn’t until 2005 that he publicly admitted that he was suffering from a mood disorder that was being treated by a psychiatrist. While his own struggle continued, he became more effective in his advocacy in the US Congress. One misconception he believed had to be clarified concerned Nancy Reagan’s “Just Say No” campaign against drugs. He felt that this missed the main point that addiction is not something you can simply say no to, just as you can’t say no to cancer. It is a disease and by implying you can just say no stigmatized people who have the genetic propensity to have this disease.

As much as the story of Kennedy’s recognition of his own illness of addiction and mental disease and how he battled it is quite enlightening, the battle for a definitive bill in the US Congress is just as revealing.The events leading up to the 2008 Wellstone and Domenici Mental Health Parity and Addiction Equity Act are quite interesting and complicated. They are also quite personal to Patrick Kennedy. It took place at the time that he was relapsing to alcohol and painkillers and also was having an exacerbation of his bipolar condition. While Patrick Kennedy was one of the leading champions in the House of Representatives for this legislation, his father, Ted Kennedy, was a major supporter of this bill in the US Senate. This was also at a time that the senior Kennedy was dying of a brain tumor. Compromises had to be made in the bill and the Senate was reluctant for the legislation to be as comprehensive in various aspects and details of the bill as was wanted by the House of Representatives. There also was a question how the legislation would deal with the new surge of mental health problems occurring in soldiers returning from the war. There was a concern that it should cover PTSD as well as addiction in the returning servicemen. Patrick Kennedy described the dramatic moment that his dying father came to the senate floor to vote for the final version of the bill to the applause of the US Senate.

Even with the passage of this extraordinary legislation, the battle for adequate parity for healthcare support was far from over. The proof and the success of this landmark bill would depend on the implementation by the federal and state governments and certain local rulings are expected to eventually reach the Supreme Court. The 2016 presidential race can certainly also be expected to impact the success of implementation of this legislation. As of this writing, it appears that the Republican candidates may be reluctant to support the implementation of this legislation and provide funding for new programs.

Patrick Kennedy decided to leave the United States Congress in 2010. Since departing from Congress, he has continued to be a leading advocate to bring about implementation of the 2008 legislation for mental illness and addiction. In this regard, among many other things, he has worked with two important organizations in which he plays very active roles. The Kennedy Forum (kennedyforum.org) gathers experts in mental health and addiction and holds important conferences that they hope will ensure implementation of the 2008 legislation. They are also committed to promoting a translation of neuroscience into the preventative and treatment interventions for mental health and addiction. The second organization in which Patrick Kennedy is involved is One Mind (onemind.org), which is dedicated to the promotion and support of “brain health” and creating a fast track for treatment. Their current focus is on new approaches to treat and cure PTSD but they look forward to applying solutions for all brain disease including depression, Parkinsons, ALS, dementia, Alzheimer’s disease, and addictions.

Patrick Kennedy does not bemoan problems. He is clearly a man not only with a vision but with plans and solutions. He concluded his book with a scorecard of how we should rate our public officials who have the opportunity to pass legislation and make changes. Also at the end of the book, he had a section for people who are dealing with their own mental illness and addiction. He tells them not to be alone in this struggle and how important it is to get treatment. Finally, sandwiched in this book was a series of photographs of many well known members of his family. It brought back many memories to this reader of the great accomplishments of many members of the Kennedy family and of the tragic events that they experienced.

It should be noted that at the time that Patrick Kennedy wrote this book, he was three and a half years sober. He has shown that he is a very accomplished and insightful man. I believe we are going to hear a great deal about him in his advocacy. He has provided in this book a valuable historical account of the reasons to fight for the proper care of mental illness and addiction. I am sure he has a bright future and many people will benefit by his skills and his passion.