Merry & Bright, book #32

I was about half way through this book before I realized I had read it before, but it was a quick read and every so often it's fun to hold an actual book!  

Merry Knight is pretty busy these days. She’s taking care of her family, baking cookies, decorating for the holidays, and hoping to stay out of the crosshairs of her stressed and by-the-book boss at the consulting firm where she temps. Her own social life is the last thing she has in mind, much less a man. Without her knowledge, Merry’s well-meaning mom and brother create an online dating profile for her—minus her photo—and the matches start rolling in. Initially, Merry is incredulous, but she reluctantly decides to give it a whirl.  Soon Merry finds herself chatting with a charming stranger, a man with similar interests and an unmistakably kind soul. Their online exchanges become the brightest part of her day. But meeting face-to-face is altogether different, and her special friend is the last person Merry expects—or desires. Still, sometimes hearts can see what our eyes cannot. In this satisfying seasonal tale, unanticipated love is only a click away.  (Picture and description from Amazon)

Happy Reading!

O:)

Melissa
 

The Cowboy Christmas Reunion, book #31

 

So I have gotten out of sync with this, but I actually finished this book before Caitlyn's Christmas, for anyone who is counting or cares :)

A jilted cowboy gets a second chance at love when his ex-fiancée returns with her small daughter. When Kade Delgado joins his buddies in a Cowboy Santa program to shower Christmas blessings on old folks and single moms, he doesn’t expect his former fiancée to return to Saddle Springs, in need and with a child in tow. Does God really expect him to treat Cheri the same as the others on his new Christmas list? Cheri Mackenzie has never forgiven herself for the pain she caused Kade by fleeing a week before their wedding, but undoing the past is impossible. Circumstances force her back to her aging grandparents’ Montana ranch, where Kade, now a widower with a toddler, is making himself cheerfully indispensable. When she receives kindness instead of the hostility she surely deserves, she can’t help but pray for a Christmas reunion with the cowboy she’s never stopped loving.Is there any hope for a second chance at love?  (picture and description at Amazon)

Merry Reading!

O:)

Melissa

Unlikely Santa, book #30

 

What would you do if you were mistaken for Santa?  Amish Bishop Christopher Stoltz had no idea a shopping trip with his fraa could change his life. But when young Jaycee Parker mistakes him for Santa Claus, his heart is moved with compassion for the boy and his family. Will this unlikely pair discover more than just a holiday filled with food and gifts?  At eighteen, Englischer Shannon Parker is left the sole caretaker and provider of her three younger siblings. All she truly wants for Christmas is to be able to provide a happy holiday and decent gifts for each of them. Not an easy feat, given that her low-paying waitressing job is their only source of income. When a handsome stranger walks into the restaurant offering kindness, she has a feeling her life will never be the same again.  (picture and description at Amazon)

Caitlyn's Christmas, book 29

 

This book is one Marsha picked out for Book Club and it was a perfect length and story for this month!  It is one in a long series, but I could totally enjoy the story without reading all the others before it.

When an injured cat runs across the road, Caitlyn doesn’t hesitate to rescue the feline. But she isn’t prepared to witness a brutal murder. She slips away, only to lock eyes with the murderer, recognizing him as someone she’d seen earlier. Now the killer knows who she is, too. Caitlyn calls her cop friend Devon Rainer for advice, humbled when he agrees to protect her.  Devon is concerned about Caitlyn’s safety, especially after they return to the scene of the crime to find the dead woman gone without a trace. The escalating attacks against Caitlyn, prove the killer intends to silence anyone who can identify him. Devon’s priority is to keep Caitlyn safe, while finding the killer. Will they survive long enough to celebrate Christmas and their newfound love?  (picture and description at Amazon)

I can't wait to tell you about the next Christmas book I'm reading now!  

Keep Reading!

Melissa

Enchanted Christmas Series, books 26-28

 

Well, I can't figure out how to make these line up side by side so here we are.  But just like sometimes recipes you make don't end up looking like the picture, but they still taste good, that is the important part :)  And these three were all super yummy with great and funny stories and characters.  They were all quick reads and I highly recommend if you want some short Christmas books to read this season.  I will tell you, though, these are only available as Kindle books so you cannot find them at your local library or bookstore.

One Enchanted Christmas (Book 1)

Last December, mystery author Maren Grant had the most perfect night of her life. On a glimmering winter evening, she got to watch the photo shoot for her very first book and ended up on a magical date with the cover model himself—Colin Renwycke.  Fast forward one year. This December, with a looming deadline, restless spirit and her creative spark long since gone, Maren is desperate to get unstuck. And she can’t get Colin out of her head…or his year-old open invitation to spend a couple weeks writing at his family’s farm. Drew Renwycke never planned to come home and take over the Renwycke family farm. But he’s spent too many years watching his siblings unravel, including his brother, Colin, after one terrible family mistake. If moving to Maple Valley, Iowa, renovating an old farmhouse and switching careers is what it takes to put the Renwycke family back together, he’ll do it. But his simple plan upends when a scrappy author lands on his doorstep. And she just might be the key to coaxing his brother home. But what if he wants her all to himself? Drew will have to choose between his Christmas wish and the enchantment of a holiday romance that just might be the happy ending they all long for. (picture and description at Amazon)

One Enchanted Eve (Book 2) 

After years of mistakes and regret, Colin Renwycke finally has a plan: Hone his baking talent at the Denver Culinary Institute and embark on a new career as a pastry chef. If he's lucky, he might even manage to earn back his family's respect. But despite his skills in the kitchen, Colin's a mess in the classroom and his ongoing disasters are proving too much for his prickly instructor. If he loses his spot at the school, he's out of backup plans.  Culinary school instructor Rylan Jefferson has the chance to reclaim her dream of running her own bakery. But she only has until Christmas Eve to come up with the perfect recipe to impress an eccentric investor. She has no time for holiday parties or family plans . . . and especially not for the unruly student baker who couldn't follow a recipe if his life depended on it.  But Colin has the one ingredient Rylan needs most—talent. Lots of it. And when he makes a proposal that just might solve both their problems, Rylan can't say no—even if it does mean traveling all the way to Iowa. It just might be that the snow-covered plains and a charming small town full of postcard Christmas cheer are exactly what her hungry heart needs . . . along with a man who is much more than he seems. (picture and description at Amazon)

One Enchanted Noel (Book 3)

Seb Pierce isn't exactly a cowboy, but after fifteen years on a ranch in Texas, he might as well be. And he'd do just about anything to keep the rancher who took him in so many years ago from losing his land...including returning to the wealthy roots he's long since abandoned. Seb agrees to work for his stern grandfather for one year in return for an early draw on his inheritance. But he never expected the agreement to land him in a quirky small town in Iowa at Christmas-time, renovating a dilapidated theater...and running into a woman he never thought he'd see again. She might not remember him, but he remembers her. After too many years away from her hometown--and too many failures to count--Leigh Renwycke is finally back in Maple Valley and living the stable life she used to wish for. If only she could shake the old restlessness that used to get her into trouble. When Seb Pierce waltzes into her world and begs for her help planning the theater's holiday reopening, it could be the solution to her discontent. If she pulls it off, it might be enough to jumpstart a new career...and to prove once and for all that the new-and-improved Leigh is here to stay.  But between old secrets and new sparks, restoring a town treasure in time for Christmas may not be as easy as it seems...especially once Leigh learns the truth about Seb. (picture and description at Amazon)

Happy Reading!

O:)

Melissa

Christmas at Pebble Creek, book #25

 

Sorry Vannetta, but this one was a snooze fest.  The only thing good about this was that i figured out how to ready my Kindle books on the computer at work (on my lunch break) ~ ask my how! :)  But really, I knew it would be short, it was only 25 pages, but I literally read it in 20 minutes or less.  And there was no conflict, no turmoil, no nothing .... <yawns>

Heavy snow blankets the southwestern Wisconsin Amish community as nineteen-year-old Grace Miller closes the schoolhouse for Christmas break. She’s looking forward to having extra time to help the family prepare for the holiday, and she is hoping to get a few more drawings in of the beautiful, snowy Pebble Creek landscape. Her courtship with Adam Lapp is going on six months, and Grace can’t wait to give him his present: a blue-and-brown buggy blanket she crocheted for him. Yes, this Christmas is going to be especially joyful. Yet, amid the cheer of snowshoe outings, church potlucks, and holiday festivities, Grace is given a bittersweet reminder of the Christmas story. Grief is present with celebration, and though the future is rarely certain, she is given a heartwarming glimpse that God knows our needs before we do and will provide. (Picture and description at Amazon)

I've already started my next one and it looks much more promising!

O:)

Melissa

Strands of Truth, book #24

 

This book took a while to read, but I thoroughyly enjoyed it!  I finished up at the nail salon while I was getting my nails done, which was tricky, but I told Steven [my guy at the salon :)] "I'm not being rude, but she just got kidnapped and I gotta figure out what happens!!"  

Harper Taylor is used to being alone—after all, she grew up in one foster home after another. Oliver Jackson finally took her under his wing when she was a runaway teenager, and now Harper pours her marine biology knowledge into Oliver’s research as his business partner. But she’s never stopped wishing for a family of her own. When a DNA test reveals a half sister living just two hours away, Harper is shocked. She meets with Annabelle, whose story is strikingly similar to her own. Is it just a coincidence that both of their mothers died tragically, without revealing their father’s name? When Harper’s business partner is attacked, his son Ridge steps in to help. Ridge still sees Harper as a troubled teen even all these years later, but he soon finds himself working with her to uncover dangerous secrets that threaten to destroy them all. Ridge and Harper must unravel her past before they can have any hope for the future. Harper’s childhood is resurfacing—but will the truth save her or pull her under? (picture and description at Amazon)

It's November, which means its time to read Christmas books!

O:)

Melissa

The Sea Keeper's Daughters, book #23

 

Sometimes you never know what you will get with Lisa Wingate, but this one is a keeper!  Amazing story, great characters, and the end that you did not see coming will shock your pants off!

From modern-day Roanoke Island to the sweeping backdrop of North Carolina’s Blue Ridge Mountains and Roosevelt’s WPA folklore writers, past and present intertwine to create an unexpected destiny.  Restaurant owner Whitney Monroe is desperate to save her business from a hostile takeover. The inheritance of a decaying Gilded Age hotel on North Carolina’s Outer Banks may provide just the ray of hope she needs. But things at the Excelsior are more complicated than they seem. Whitney’s estranged stepfather is entrenched on the third floor, and the downstairs tenants are determined to save the historic building. Searching through years of stored family heirlooms may be Whitney’s only hope of quick cash, but will the discovery of an old necklace and a Depression-era love story change everything?  (picture and description from Amazon)

Happy Reading!

O:)

Melissa

A Castaway in Cornwall, book #22

 

It has been a good, long while since we have read any Julie Klassen, but she did not disappoint.  While I had forgotten how deep and thorough her text is, it did not dissapoint in the least.  I'm always amazed at how detailed her books are!  Most of the settings in her books are in England and for a girl who lives in Minnesota, she can take you to that cold, windy beach in Cornwall in a heart beat!

Set adrift on the tides of fate by the deaths of her parents and left wanting answers, Laura Callaway now lives with her uncle and his disapproving wife in North Cornwall. There she feels like a castaway, always viewed as an outsider even as she yearns to belong. While wreckers search for valuables along the windswept Cornwall coast--known for its many shipwrecks but few survivors--Laura searches for clues to the lives lost so she can write letters to next of kin and return keepsakes to rightful owners. When a man is washed ashore after a wreck, Laura acts quickly to protect him from a local smuggler determined to destroy him. As Laura and a neighbor care for the survivor, they discover he has curious wounds and, although he speaks in careful, educated English, his accent seems odd. Other clues wash ashore, and Laura soon realizes he is not who he seems to be. Despite the evidence against him, the mysterious man might provide her only chance to discover the truth about her parents' fate. With danger pursuing them from every side, and an unexpected attraction growing between them, will Laura ever find the answers she seeks?  (picture and description from Amazon)

Keep Reading!

O:)

Melissa

A Distant Shore, book #21

 

My mother in law was kind enough to let me borrow this so I wanted to read it before I started our next book club book.  When I first started it I did not like it at all, the story was just so sad.  But it was more like a flashback ~ you had to understand what happened to see where they were in modern times.

I feel like the description on the back did not truly define what the book was about, so I felt disappointed and confused.  In the end, it was a good book, just that it all wrapped up in a pretty little bow, almost too perfect.

She was a child caught in a riptide in the Caribbean Sea. He was a teenager from the East Coast on vacation with his family. He dove in to save her, and that single terrifying moment changed both their lives forever.  Ten years later Jack Ryder is a daring secret agent with the FBI and Eliza Lawrence still lives on that pristine island. She’s an untainted princess in a kingdom of darkness and evil, on the brink of a forced marriage with a dangerous neighboring drug lord, a marriage arranged by her father.  This time when Jack and Eliza meet, there’s a connection neither of them can explain. Both their lives are on the line, and once again, the stakes are deadly high. Can they join forces in a complicated and dangerous mission, pretending to have a breathtaking love…without really falling?  Sometimes miracles happen not once, but twice…along a distant shore.  (picture and description from Amazon)

So excited to get started on our new book club book!!

Keep Reading!

Melissa

Secrets of Willow Springs (book 1) , book #20

 

Read this for book club.  No one liked in especially.  Don't waste your time.  

Why?  Well, the story line could have been really great but it was not developed out enough.  The amish names were too generic and similar and I kept getting confused about who was who.  I had to make a cheat sheet.  There is one in the front of the book, but it would have been tricky to go back and forth on the paperwhite.  You already know how it is going to end ~ in general ~ by the middle of the book, but I stuck with them thinking the how they got there would be better, but it was not.  

And the end?  It just stops!  No closure, no ~ so what happens?? This is book 1, but I got the idea book 2 was just going to start up a few years later and not even go back to cleanly wrap up the mess left at the end of book 1!!

Secrets from the past come to light in this Amish Fiction Book. Her family’s hidden history could destroy her. Will forgiveness set their future free?  Emma Byler can’t wait for her sixteenth birthday and to experience a taste of freedom. With her Amish Rumspringa relaxing some of her usual restrictions, she’s desperate to spend time with a special boy. But she fears tensions at home and her father’s increasingly short-temper could make him pull back the reins.  Sixteen years ago, Jacob Byler made a promise. But as his daughter’s celebration draws near, he dreads the emotional upheaval she’ll go through when she learns the truth. And all he can do is pray that God will grant him the courage he needs to come clean.  As Emma tries to deal with her father’s worsening behavior, she’s forced to keep her own confidences. And Jacob reaches the breaking point when his son befriends a youth who could topple the whole house of cards.  Will honesty shatter the close-knit family, or will their faith help them open their hearts?  (picture and description from Amazon)

Nothing to see here ... just keep going ...  :(

Doing Life with Your Adult Children : Keep your Mouth Shut and the Welcome Mat Out; book #19

 

This book has been sitting my by bedside for a while and I decided it was time to pick it up and read it.  Luckily, we haven't had too much trouble yet, but its good to be prepared.  Most of it was basic stuff, but still good.

If you have an adult child, you know that parenting doesn't stop when a child reaches the age of eighteen. In many ways, it gets more complicated. Both your heart and your head are as involved as ever, whether your child lives under your roof or rarely stays in contact.  In Doing Life with Your Adult Children, parenting expert Jim Burns helps you navigate one of the richest and most challenging seasons of parenting. Speaking from his own personal and professional experience, Burns offers practical answers to questions such as these:

Is it OK to give advice to my grown child?

What's the difference between enabling and helping?

What boundaries should I have if my child moves back home?

What do I do when my child doesn't seem to be maturing into adulthood?

How do I relate to my grown child's significant other?

What does it mean to have healthy financial boundaries?

How can I support my grown children when I don't support their values?

Including positive principles on bringing kids back to faith, ideas on how to leave a legacy as a grandparent, and encouragement for every changing season, Doing Life with Your Adult Children is a unique book on your changing role in a calling that never ends.  (picture and description from Amazon)

Now that I have a REAL job where I get up and leave by 6:30 I'm not sure if I'll be able to read as much as I like to, but you can't keep a good reader down! :)

Keep Reading!
O:)
Melissa

Bridge to Haven, book #18

If you will remember from last time, I read a Karen Kingsbury book. So I decided to keep up the "old school" authors and read this book I've had sitting around.  It was a classic Francine River and I throughly enjoyed it, once I got into it.  I felt like the cover art and summary on the back was a little decieving, almost spoiler alert, because what it talked about didn't happen until about halfway through the book.  Other than that, it was one I "consumed" pretty quick ~ again, as is par for the course for her books!   

To those who matter in 1950s Hollywood, Lena Scott is the hottest rising star to hit the silver screen since Marilyn Monroe. Few know her real name is Abra. Even fewer know the price she’s paid to finally feel like she’s somebody.  To Pastor Ezekiel Freeman, Abra will always be the little girl who stole his heart the night he found her, a wailing newborn abandoned under a bridge on the outskirts of Haven. Zeke and his son, Joshua—Abra’s closest friend—watch her grow into an exotic beauty. But Zeke knows the circumstances surrounding her birth have etched scars deep in her heart, scars that leave her vulnerable to a fast-talking charmer who lures her to Tinseltown.  Hollywood feels like a million miles from Haven, and naive Abra quickly learns what’s expected of an ambitious girl with stars in her eyes. But fame comes at a devastating price. She has burned every bridge to get exactly what she thought she wanted. Now all she wants is a way back home.  (picture and description from Amazon)

If you haven't read any of Francine's book, please go here and make a list!!  You need to read them all!!  These are the ones I highly recommend:

Redeeming Love

The Masterpiece

The Atonement Child

The Scarlet Thread

The Lineage of Grace series

And the Shofar Blew

She also has a new one coming out in February of next year I can't wait to get my hands on!  

 

The Lady's Mine

Happy Reading!!

Melissa

 

When We Were Young, book #17

 

Hhm.  What to say about this book.  While at first in Book Club we read A LOT of Karen Kingsbury, in the last 5 years or so we have not read as many.  She is a very prolific writer, and we even once went to see her speak.*  But I think her books for a while just got too much too fast.  She has written well over 100 books in the last 30 years.  

This one, I just never could figure out.  There were flashbacks, flash forwards, present time, a lot of story lines .... but I persevered.  I think I might like to pick up another one of her books, one that is not part of a series.  I have read several of her stand alones and they were good, so I might give her another shot.  

What if you could see into the future and know what will happen tomorrow, if you really walk out that door today. Pay attention. Life is not a dress rehearsal.  From their first meeting, to their stunning engagement and lavish wedding, to their happily-ever-after, Noah and Emily Carter seemed meant to be. They have a special kind of love—and they want the world to know. More than a million adoring fans have followed their lives on Instagram since the day Noah publicly proposed to Emily. But behind the carefully staged photos and encouraging posts, their life is anything but a fairytale, and Noah’s obsession with social media has ruined everything.  Distraught, Emily reaches out to her friend Kari Baxter Taylor and tells her the truth: Noah and Emily have decided to call it quits. He is leaving in the morning.  But when Noah wakes the next day, everything is different. Emily is gone and the kids are years older. Like Scrooge in A Christmas Carol, bizarre and strange events continue throughout the night so thatNoah is certain he’s twenty years older, and he is desperate for a second chance.  Now it would take a miracle to return to yesterday.  When We Were Young is a rare and beautiful love story that takes place in a single day. It’s about knowing what tomorrow will bring if you really walk out that door today—and the gift of being able to choose differently.  (picture and description at Amazon)

*Funny story about when we met her.  This must have been in the early 2000s and I was still part of the OG Book Club that met during the day.  [It started in the day, then some ladies who couldn't meet during the day started a night one.  Then all the ladies who went to the day one got jobs, so it fizzled out and now I go to the night one.]  There were about 10-15 of us going in two vans to somewhere in Alabama to hear her one night.  I guess I wasn't paying attention, I was just so excited to have a night out away from the kids.  I thought we were going to see Francine Rivers, another popular author at the time.  I even brought my Francine River book for her to sign!  But no one ways anything about it til we get there that it is Karen Kingsbury we are seeing, not Francine!  SMH  

But here is the interesting thing ~ it was actually Francine Rivers who inspired Karen to start writing more Christian fiction and not the other books she was writing.  

Keep reading!

O:)

Melissa

Red Like Crimson, book #16

 

Well, since I was at a loss about what to read next, I chose this one because it is by an author I typically like and the whole "Red, White and Blue" theme sounded July-ish.  But boy was I disappointed!  This must have been one of her earlier books because the others I remember reading of hers were much better.  Also, the Red, White, and Blue referred to seasons, as in red leaves (fall), white snow (winter) and blue (??).  

I must have gotten this book when I first got my Kindle.  To stock up there was this website that had tons of books for $5 or less.  I can't find this on Amazon at all.  Interesting note: The series is now called Red, White, and Blue Weddings but when I found it on Good Reads it was called Allegheny Hopes; which makes sense as well since all three stories take place in Pennsylvania.  It appears to have first been published in 2007, then republished in 2015.  It was probably rebranded then with a new fun cover and series title, but you would have thought that after Janice's success with her later books that were published by then they would have done some editing on the content of this one.  Don't get me wrong, the story itself is sweet!  It just seemed to be pushing the "red like crimson" theme in your face so much I thought I would scream.  Also, the child in this book is supposed to be 8, however she talks more like she is 5-6.  Just really hard to get into this one.  I'll not be reading the others.

When Adrianne found out she was pregnant eight years ago, she made the decision to leave Bible school and raise her child alone. Staying would have prevented her boyfriend from fulfilling his God-appointed mission in life. But every day since, she has regretted her decision. Chris-rejected, confused, and heartbroken-finished school and soon found himself in Nicaragua, loving life as a missionary. But the void left by Adrianne's unexplained departure remains. When Chris returns to the States for a friend's wedding, is his unexpected meeting with Adrianne a coincidence or a "God incidence?" Can they put aside the past and embrace a future together as a family? (photo and description at Good Reads)

Despite all I said about it, what was fun was that we just started planning our trip to Philly for October and this book takes place in Philly!!

Keep reading, even after you read a bad book!  There are plenty of good ones out there!

O:)

Melissa

Bookshop by the Sea, book #15

 

Just finished this sweet book in about 3 days.  Got some sad news and needed to do my modus operani (retreat somewhere else in my brain, either in a book or TV series).  This was a quick, fun read to fit the bill and served its purpose!  

Sophie Lawson should be enjoying her sister’s wedding day. But nothing could have prepared her to see the best man again. After her mother became bedridden and her father bailed on the family, Sophie found herself serving as a second mother to her twin brother, Seth, and younger sister, Jenna. Sophie supported her siblings through their college years, putting aside her own dream of opening a bookshop in Piper’s Cove—the quaint North Carolina beach town they frequented as children.  Now it’s finally time for Sophie to follow her own pursuits. Seth has a new job, and Jenna is set to marry her college beau in Piper’s Cove. But the destination wedding reunites Sophie with best man Aiden Maddox, her high school sweetheart who left her without a backward glance.  When an advancing hurricane strands Aiden in Piper’s Cove after the wedding, he finds the hotels booked to capacity and has to ask Sophie to put him up until the storm passes. As the two ride out the weather, old feelings rise to the surface. The delay also leaves Sophie with mere days to get her bookshop up and running. Can she trust Aiden to stick around? And will he find the courage to risk his heart?

Just trying to decide what to read next!!

O:)

Melissa

Twelve Patients : Life and Death at Bellevue Hospital, book #14

 

So when New Amsterdam first came out, Katie and I were taken in immediately!  I loved the characters and the story lines and everything.  When we realized it was based off a book, she put it on her Christmas list and promptly got it that December.  I was anxious to read it as well, but life got in the way.  She read it and enjoyed it, evidently more than the TV show because she lost interest in it.  

I finally had the chance to start reading it while on break this time, but I had to pace myself.  It has some really intense events, people, insights, etc that you can only handle about one chapter at a time.  So I would read a chapter in between the other books I was reading.  Katie wouldn't let me highlight or underline or "dogear" the pages on quotes I really liked, so I got little sticky flags and filled the thing up.  Below are all my quotes from the book, but on Facebook I'm only posting about 1-2 at a time.  I'm really hoping people read them and soak in it for a while.  

In the spirit of Oliver Sacks and the inspiration for the NBC drama New Amsterdam, this intensely involving memoir from a Medical Director of Bellevue Hospital looks poignantly at patients' lives and highlights the complex mind-body connection.  Manheimer is not only the medical director of the country's oldest public hospital, but he is also a patient. As the book unfolds, the narrator is diagnosed with cancer, and he is forced to wrestle with the end of his own life even as he struggles to save the lives of others. (picture and description at Amazon)

Chapter 1 The One Strike Law

p. 6 ~   Referring to a doctor who worked in correctional medicine at the Tombs, a prison in Manhattan “...[Dr. Heyman] knew that the game of life could change quickly for anyone and the only difference between the rich and his patients was that the rich had options.”

Chapter 2 Tanisha

p. 30 ~ “Tanisha’s mother had been a victim herself of a mother who had been a gang member, drug user, and petty dealer who didn’t actively abuse her children so much as neglect them.  Feral was the term ACS used in a report that had been shared with Tanisha by a social worker when she was a young teenager.  Tanisha had no idea what feral was.  She had thought it was an animal, a pet tiger.”

p. 33 ~ “Tanisha showed no emotion when I shook her hand and asked if she minded if I sat in with Francesca [on call child psychiatrist].  She nodded ok, looking me directly in the eyes.  It made me feel vulnerable.  This sixteen-year-old, five-foot-one Dominican Haitian teenager with a thick Bellevue chart from multiple hospitalizations, evaluations, emergency room visits, and psychological testing was rapidly sizing up the two adults in the room who would be evaluating her and making some determinations about her future.  I switched roles with Tanisha and felt the weight of her “chart” on all of us … “

p. 34 ~ “ ‘Why did you run away from the foster home in Bushwick?’

‘I did not run away.  I left of my own free will at a time of my choosing.  I never ran.’

‘Sorry, I didn’t mean run away in that way.  Why did you leave?’

…..

Carefully calibrated, Tanisha responded, ‘ACS has sent me to so many s***holes, with so many a**holes that want to f*** with me or f*** me.  Just who should you be interviewing?’ ”

p. 40 ~ “I watched her through the glass.  [Emily] was so young. As she sat drawing with Tanisha and the younger child, I found it hard to believe that she’d be medicated for most of her life.  In fact, watching them, I was struck by how very difficult it is to grow up in our environment.  Both of these young women thought actively about dying, about taking their lives.  Money did not cushion all the blows.”

p. 42 ~ [Tyrone] was on the waiting list for the state hospital.  There had been too many failures sending him home and to alternative “residential” homes in the archipelago of child and adolescent facilities.  What was his future?  His life trajectory?  Next stop adult psychiatric unit, or Rikers Island, or a mix of both?  You don’t need to be a soothsayer to see into the future.

p. 48 ~ Emily and Tani were from opposite poles of the universe.  A product of abandonment at birth, Tani had ricocheted like a pinball around a system desperately trying to find a safe haven.  In her sixteen years, she’d had a couple of loving experiences between forced death marches in enemy territory.  Emily was picked up by a car service and driven to her private school, then sat down to dinner overlooking a backyard with a Bach clavichord playing in the background.  And yet barely out of first grade she was melting down and unable to regulate her emotions.  

Chapter 4 Beso de Angel

p. 89 ~ “Neither of them or their families had any financial resources.  It was day-to-day, every day.  Everyone worked at whatever job was available to pay the bills that kept coming in for rent, for food, schools, cell phones, electricity.  Chicken or pork was a once-a-week treat.  … The tiny bit left over went for an emergency fund for health care.  Inflation in Mexico was very simple.  You had to run faster every three months to stay in the same place as the peso bought less and the government removed its subsidies for corn, gas, and petroleum.  It was a kind of slow torture.  A quarter of a turn of the screw and then another.”

p. 104-5 ~ [Due to the cartel and drug problems in Mexico] “ “I am more worried about unemployment and the young people, though.  What will they do to support themselves?  How will they live? I couldn’t even support Octavio, my own son in my own business.  … The corruption is everywhere in government and could spread to the men who cannot support their families, who cannot afford a house or an apartment, a girlfriend. If you cannot afford to get married to have a family, you are creating a different kind of desperation.’ “

p. 105-6 ~ “ ‘I hate the narcos, but I can see where things are going.  Where the pressure is.  Without jobs or a future, what are you going to do? Just how do you survive? Maybe if I was a young guy like my son I would go to the States and take the risk.  It is kind of like a prison staying here if you are a man like Octavio.  So what is the difference, really?  I see my grandchildren and don’t see what they will do, where they will live.  Who will they marry and how will they bring up children?  We can barely bring them up.  … The U.S. news reviles us, makes fun of us, makes us into thieves and criminals.  Who are the criminals exactly? If Mexico is a criminal state or at risk of becoming one, why sell us advanced military assault weapons at border depots? Why launder the narco money in the biggest U.S. banks? Why purchase billions of dollars’ worth of drugs?’ “

p. 107 ~ [in regard to the grandchildren mentioned above] “Both children had obvious severe developmental delays in language and skills from benign neglect.  They were never abused; they had food and decent clothes, and a loving household.  The energy required to read to them, talk with them, and participate in meaningful activities for their age did not exist.  The time, effort and money required if they were to socialize with their peers, or take part in activities that might engage them both mentally and physically, were unavailable.”

p. 108 ~ “[Octavio] had survived the human traffickers, the desert, terrible loneliness, and extreme working conditions to send a few dollars home to his family.  His hope was to someday have his own concrete-bunker-like home with a couple of rooms on the empty lot next to his parents’ house.  A rogue cell had not obeyed molecular signals to stop unbridled DNA replication.”

p. 109 ~ “In a world that is increasingly stressful and less predictable,  more economically challenging and politically less governable, medicine is still about looking after the individual who seeks care.

“The return to Mexico for a dying young man and his young wife was our opportunity to take the caring as far as we could.  How people die and how we participate in their deaths is as much about us as about them.  Our own humanity is at stake.  In a society that is increasingly mesmerized by efficiency, measurement by numbers and a bottom-line mentality that extols profit and wealth over any human value, the risk is now clear to everyone I work with.  When health care is now measured by a ‘medical loss ratio,’ and the percentage of spending on health care is considered a ‘loss,’ then we really are lost.”

Chapter 5 The Qualification

p. 123 ~ “A few hours later, the tox screen came back positive for alcohol, benzos, OxyContin, marijuana--and PCP.  This was the sort of OD we normally see rolling in from the ghetto or with pimply teenagers from New Jersey suburbs in their parents’ black Benz SUV.  Not from a guy who owned a floor in the Dakota.” [expensive apartments in NY]

Chapter 6 A Heart for Rabinal

p. 141 ~ “Her sister had been a highly trained nurse in a Guatemala City hospital and was hardwired for trauma and decision making on the fly.  Like many immigrants who were lawyers, doctors, PhDs, and accountants, but here drove taxi cabs or worked in homes and back offices.”

p. 145 ~ “Clara talked openly and clearly.  She had a story to tell and an audience who was not going to judge her.”

 

p. 152 ~ “ ‘It is not possible under any circumstances, Doctor.’  She was emphatic and clear.  I heard No way.  ‘There is no one who can care for the children.  My parents are old and need help.  My own kids are struggling and barely keep their heads above water.  But even more important, I will not send them to Guatemala.  There is simply no future for them there except more of what we went through.  They are much better off here as orphans of the state.’ “

p. 155 ~ “ ‘I understand, Doctor.  My heart is failing and there is not  much time left.  How  much do you think?’ Time is all relative.  Prediction of death in medicine is notoriously difficult.  One the other hand, it would be a copout not to answer her question.  She had to make arrangements.  And she wanted to live.  Despite the difficulties in her life, the few pleasures it had offered her, she had been happy listening to stories in the middle of the night at the laundry, seeing her sister, watching her son and daughter grow up.  She was thankful for the kindnesses of people who were taking care of her.” 

p. 157 ~ “I was physically in the room but mentally in another zone as Renee ran her meeting.  I drifted back to my first conversation with Lenny.  I was pissed off and tried not to show it.  Why shouldn’t she get a heart? The undocumented could donate organs.  And did at appallingly regular intervals as young, undocumented workers accepted high-risk jobs.  But they couldn't receive organs, even when donors (like siblings) were ready to donate and physicians were willing to operate for free.”

p. 158 ~ “The heart for Soraya came shortly after she was accepted into a transplant program in NYC. The evaluation team at the transplant at the transplant program adopted her immediately.  They fell for her graciousness, her smile, her ‘gracias a Dios.’  They fell for her life from Salama to Tapachula, the coyote transfer to a gang of human traffickers.  The night laundry work and the catch in her breath several years ago.  I think they fell for the fact that in her entire life she’d had only a few weeks, maybe a few months, of happiness.  Sometimes one person stood for all of the others who didn’t make it.”

p. 159 ~ “We had moved heaven and earth to get her a heart so she could have some years that were joyful and lived without fear and the threat of death, rape, or harm to her children.  … She would never have thought she would have any time of enjoyment in her life.  She never entertained a fantasy of happiness, satisfaction, or relationships; she never thought that anything was owed her.”

  

Chapter 7 Four Generations

p. 168 ~ “ ‘A lot of people would choose to do nothing. It is an okay decision.  Sometimes doing nothing is the harder decision to make.’ “

p. 169 ~ “ ‘But you have to operate on him, it is his only chance.  He will die otherwise.’ The internists were adamant.  The surgeon responded just as adamantly: ‘We operated on him for a valve infection and heart abscess and put in a brand-new plastic valve eight months ago.  He chose to inject himself again and reinfect his valve.  Not me, I didn’t choose to reinfect him.  He will die from this surgery.  That is a  near certainty.  I don’t want to be his undertaker.  I am just a surgeon.’ “

p. 174 ~ “Were the members of this multigenerational family victims of their own irresponsible behavior, an inability to make the ‘right’ health decisions for themselves and their kids? No one forced them into White Castle or Wendy’s.  No one else loaded up baskets with high-fat salty snacks in the neighborhood bodegas or carts in C Town supermarkets.

“But, I thought, that does not explain the epidemic nature of this disease.  What about the trillion-dollar industry that overproduces food in gargantuan quantities and fights for every square inch of the attention of every consumer around the world?  It targets young consumers using social media experts who test colors and songs and pay off sports figures and media stars to hawk their wares.  There’s no gun to anyone’s head, but there is a brain trust of uber-advertisers, marketers, psychologists, sociologists, anthropologists, food scientists, and brain researchers unlocking the secrets to taste and pleasure.  They study brain-based neurohormonal control and the environment to create vast demands for their products.  What’s the difference between this kind of addiction and the cultivated addictions to nicotine, cocaine, crystal meth, or heroin, for that matter?  This is real translational research from the National Institutes of Health bench laboratories to the corporate marketing strategies to your neighborhood food store.”

p. 178 ~ “How could I, or any doctor, treat a medical disease that was essentially a public health catastrophe? … How do we put a stop to the obesity epidemic that is killing patients globally in massive numbers?  Just talk to your neighborhood pediatrician.  My peds colleagues were becoming internists as obesity and its medical ‘side effects’ became ubiquitous.  Obesity and its Siamese twin Type 2 diabetes were obvious correlates of calorie-dense foods, from Agent Orange-colored chips to the vast dead sea of colas. ‘Pouring rights’ put sodas within the reach of every school kid and hospital patient, all in exchange for the pathetic amount of bribe money that went to school districts and municipal budgets starved for tax dollars.  These predatory practices of focused advertising consciously, purposefully, put populations at risk.”

p. 179 ~ “This experience in my office was repeated in millions of office visits by millions of patients with similar efficacy.  The zero-effect dilemma.  The magnitude of the obesity epidemic and the failure of medical weight reduction interventions has outsourced the ‘problem’ of dieting and weight management to the innumerable diet ‘authorities.’  It has spawned a multibillion-dollar industry that has ballooning as fast as the obesity epidemic itself.  With depressing and predictable regularity, studies have replicated the irrefutable facts.  Dieting has a very limited effect on weight loss that is at best moderate and transient.  The traumas and stresses of everyday modern life can be assuaged by instantaneous food gratification.  For anyone experiencing a bad day at the office, domestic tension, parenting challenges, and financial downturns, food is one of the sure ways we can get some relief no matter how transient.  Then we push Repeat a few hours later.”

p. 187 ~ “We did the best we could with each patient in our hands.  And yet I wondered what we could do to prevent our patients from getting these preventable diseases.  We always said our job was not to solve world hunger, just take care of the patient in front of us.  Where exactly did our responsibility start and where did it end?”

Chapter 8 The Singularity

p. 197 ~ “The line between health and illness is a thin line, very thin  You never know which side of the line you will be one and when or who will be there to look after you.”

p. 221 ~ “Despite existing as long as humanity, mental illness has not escaped strong public and private censure, stigma, and shame. Psychiatry as a profession was and is seen as something less than a hard science built on biopsies, CAT scans, and blood tests.  Its bible of diagnostic categories, the DSM (not going on its fifth iteration in committee), is a phenomenology of signs and symptoms bundled into disease states.  It is used by insurance companies for billing purposes and as a justification for disability claims, insanity defenses, access to Social Security, longer time for SAT exams, early retirement, and World Trade Center compensation.  If you don’t fit in a category, then you don’t exist as an entity.  Thus the ‘fight’ to be legitimized as an illness continues in the back rooms of lobbying groups and in the psychiatrists’ committees themselves: Legitimization follows funding, and powerful players in the field control funding.  It is a work in progress very much embedded in politics and payment systems.”

Chapter 10 Index of Suspicion

p. 272 ~ “Undocumented immigrants are summarily convicted of a misdemeanor and deported or spend a few months in detention.  The next offense is a felony with up to twenty years in prison.  As the US is facing a prison crisis domestically while state budgets reel from the loss of tax receipts from an enduring recession and it can no longer afford to keep 2.5 million under lock and key, a parallel private detention system is growing in hundreds of sites in rural America, competing for jobs and political favors, off the radar screen for most of Americans.  Tough justice for complex socio economic problems that are not amenable to tough-justise solutions.  Just as the War on Drugs has not solved the ‘drug problem’ and has ignited a reign of violence in our neighbors to the south.  Here I was talking to one of the warriors.”   

p. 273 ~ “A nurse’s aide, Sharma, came into the room. … [of the patient above] Sharma had been in exile for many years in a Nepalese transit camp for displaced Tibetans.  The 1959 Chinese invasion of her Himalayan country left her an orphan. ...

“She [Sharma] trained as a midwife in the sprawling camp filled with international NGOs and through ‘fate’ was befriended by an evangelical couple visiting from Michigan. They sponsored her application for asylum and helped her settle in a community.  The growing Tibetan enclave in Queens--covering more square blocks and surrounded by Indians, Pakistanis, Colombians, Peruvians--became her home.  The final maneuvers of perilous journeys to the US through a hundred different back channels, each with a unique story.  The trickles of people from distressed areas around the globe were a message in a bottle--wars over land, oil, diamonds, rare minerals, timber, grazing rights, religion, population explosion, water, environmental degradation, drugs, and shattering local economies. And the petty thugs like Beltran [the patient above].  He was not Pablo Escobar negotiating to pay off the sovereign debt of Colombia for immunity.  I wondered if Beltran knew anything about her {Sharma] story, and what he would say if he did.  A deadly contagious disease [TB] had brought us all together.”  

Chapter 11  The Unloved Woman

p. 286 ~ “Alicia became a paragon of alternative treatments and Googled advice: trips to Chinatown for homeopathic cures, acupuncture, qigong to tai chi.  These measures were testimony to the persistence of her symptoms and my utter inability to help her.  The feeling that the medical ‘arsenal’ might be part of the problem and not part of the solution nagged at me.”

p. 289 ~ “You have to work your way backward.  The patient has the symptom, say, chronic back pain.  After testing you see there is no physiological there there.   Everything is normal, from the point of view of the medical establishment.  Some patients are reassured momentarily.  The evaluation relieves them.  Others bail and seek all the alternative therapies and healers.  For others, it’s frustrating because we have not found the underlying problem.  The pain remains unexplained. …

“There are many layers, like an archeological dig.  On the top layer we have the physical complaint--say, back pain or headaches.  The patient goes to the doctor and, hopefully, gets the diagnosis.  Many doctors stop there after running some tests or prescribing some medication.  Or they kick the ball to another specialist,  For the patient, though, this label has real function.  ‘I can’t go to work because I have a back spasm.  I need to be alone because I have a migraine.’  The label offers legitimization; it carries rights and privileges.  Others might even look after them or help them out.

“A deeper evaluation, however, reveals depression and anxiety, the most common expressions of psychic distress.  This is an almost universal manifestation of dis-ease--thus the huge market in antidepressants.  The fastest growing market.

“But another level down we see the effects of self-medication--alcohol abuse, drugs, and often violence in the home.  This is harder to talk about, and to treat.  Most doctors don’t go near this.  

“The next layer down reveals a lack of love and intimacy.  These go hand in hand with a lack of self-esteem, shame, and a deep sense of humiliation.  Humiliation is the well that everything comes from.  The anger comes from that humiliation and underlies everything else.  It’s the propellant.”

Summary 

Men externalize anger and turn it outward, as aggression.  Homicide is the perfect expression of the humiliated disrespected male.  They find it better to kill and be incarcerated than suffer the pain of shame

Women internalize their anger, not allowed to express it, turn it on themselves with depression, cutting, eating disorders, suicide attempts, and trips to the doctor.

p. 294 ~ “ ‘All my other doctors got sick of me.  I could tell.  They would refer me and refer me trying to get rid of me, making up some kind of excuse or other.  It was a game.  I would tell them a symptom I made up and the predictable referral would appear.  Plus I got side effects all the time from the meds they were handing out like candy.  A conjuring trick you doctors do, you know.’ I knew.

“ ‘You have not ordered anything on me in two years.  Not one test, nothing. … How come?  You don’t play the game, how come?’

“ ‘I don’t think you have anything worrisome.  I think you are a pretty healthy woman.  I am here to listen and offer something when I think I have something to offer you.  I think  you have suffered a lot at some point in your life.  You are talking to me with your body, and listening is my treatment.’ “

Chapter 12 Collateral Damage

p. 324 ~ “We were at the end of the road now with what we as physicians could do for Abraham Ramirez.  How many pints of blood had he received? One hundred? More? When was enough enough? How do you decide?  Who decides?”

p. 327 ~ “I walked through the emergency room doors and reflexively tuned out the surroundings, retreating to a parallel zone to eliminate the pain, the engine noise, the insistent whine of an exhaust fan.  A helicopter was coming in low for a landing at the waterside mini terminal when I switched mental channels.  I hadn’t processed the day and things were hanging loose and unresolved from too many angles.  How much more heartache could I absorb and not turn into a robot or a madman?”

Happy Reading!

O:)

Melissa