Combating unnecessary back surgery
by Seth Rogovoy

GREAT BARRINGTON – Today we look at unnecessary back surgery, an unnecessary dictator and a totally unnecessary exercise in literary one-upsmanship.

New Yorker

Does your back hurt? Are you considering surgery? Wait! Before you go under the knife, be sure to read Jerome Groopman’s expose of back surgery, “A Knife in the Back,” in the April 8 issue of the New Yorker.

Lower back pain is widespread in the U.S. According to Groopman, “roughly two-thirds of all Americans will experience significant lower-back pain at least once during their lives.” Many of those who go to a doctor seeking relief from their pain have it ascribed to degenerated disks that can somehow be repaired or helped with surgery.

Yet Groopman says that plenty of people who report no back pain show the same disk degeneration that shows up on the CT and MRI scans of those complaining of back trouble. “Given that degenerated disks are often found in people who are fully functioning,” writes Groopman, “it shouldn’t be assumed that they are always the cause of the trouble.” Besides which, the majority of people who undergo spinal fusion surgery wind up with backs that hurt as much afterwards as they did before.

Back pain can originate from any of various organs. “The various muscles, tendons, bones, joints, and ligaments of the lower back all contain sensory nerves that can transmit messages of pain through the spinal cord and up to the brain,” writes Groopman. Which ones get diagnosed and treated – as with so many medical ailments -- often depends on which specialist you visit. “The culture of medicine fosters lucrative networks of referrals and procedures which discourage a critical examination of their value,” writes Groopman.

I have a dear friend who underwent painful back surgery over a year ago. His back still hurts him, although he finds that by controlling his weight precisely, he can virtually eliminate the pain. Clearly, we need to learn more about the causes of back pain and, except in extreme cases where there is no question of cause and effect, be very wary of getting stabbed in the back.

Warning to those who like me are weak of heart and stomach: this article contains graphic descriptions of back surgery that you might want to skip over.

The Atlantic Monthly

“Tales of the Tyrant” by Mark Bowden in the May issue of the Atlantic Monthly should be required reading for anyone who is made queasy or uneasy by President Bush’s saber-rattling against Saddam Hussein.

Bowden offers chilling descriptions of what it’s like to take a meeting with Hussein. Even if you are a government official, you are subject to a strict body search, after which you are handed a pencil and pad and instructed to write down everything Hussein says to you and to say nothing to him unless asked a direct question.

Bowden recounts the events behind the 1979 coup d’etat in which Hussein seized control of the government from his fellow Baathists on the Revolutionary Command Council, condemning fully one-third of them to death as traitors and spies at a staged conference in Baghdad. “This chilling performance had the desired effect,” writes Bowden. “Everyone in the hall now understood exactly how things would work in Iraq from that day forward…. One man now controlled the destiny of their entire nation.”

The intimate portrait of the life of the Iraqi dictator and what it’s like to be in his presence can leave no doubt in anyone’s mind that this is a dangerous man and the world would be a better, safer place if he was to leave it. Had an article like this appeared about Adolf Hitler in 1935, a world war could have been averted and millions of lives saved.


In the March/April issue of Book magazine, an all-star panel of authors, actors, singers, critics and academics, including Russell Banks, Charles Baxter, Henry Louis Gates Jr., Michael Chabon, Shirley Manson, Michael Ondaatje, Tracy Kidder and Rod Steiger take part in a silly but harmless game: to select the 100 “best” characters from 20th century fiction.

Hovering down near the bottom of the list are such memorable characters as Saul Bellow’s Augie March, A.A. Milne’s Eeyore, V.S. Naipaul’s Mr. Biswas and J.K. Rowling’s Harry Potter.

Mid-list characters include John Irving’s T.S. Garp, E.B. White’s Charlotte, Ernest Hemingway’s Jake Barnes and Albert Camus’s Meursault.

The top 30 includes Philip Roth’s Alex Portnoy, Joseph Conrad’s Kurtz, Joseph Heller’s Yossarian and Richard Wright’s Bigger Thomas.

Just missing the Top 10 are Vladimir Nabokov’s Lolita, Ralph Ellison’s Invisible Man, Franz Kafka’s Gregor Samsa and Truman Capote’s Holly Golightly.

The top 10 includes not one but three characters invented by James Joyce: Stephen Dedalus, Molly Bloom and Leopold Bloom. Also Harper Lee’s Atticus Finch, Edith Wharton’s Lily Bart, John Updike’s Rabbit Angstrom and Nabokov’s Humbert Humbert.

As for the top two fictional characters since 1900, you’ll have to buy the magazine to find out.

[This column originally appeared in the Berkshire Eagle on April 6, 2002. Copyright Seth Rogovoy 2002. All rights reserved.]

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