April 10, 2008


The First Year: Heart Disease—A Patient-Expert Walks You Through Everything You Need to Learn and Do. By Lawrence D. Chilnick. Da Capo. $16.95.

Puppy Chow Is Better Than Prozac: The True Story of a Man and the Dog Who Saved His Life. By Bruce Goldstein. Da Capo. $25.

      Both these books contain lifesaving information, presented in both cases by people with firsthand knowledge of their subjects. But the tone of the two books is worlds apart. The awkwardly titled-and-subtitled The First Year: Heart Disease, which actually has not one but two subtitles (the second being, “An Essential Guide for the Newly Diagnosed”), is a thorough, to-the-point guidebook that starts with day-by-day information, then has chapters numbered by the week, and then moves onward through Month 12. A lot of the basic information here can be gleaned from the end-of-chapter “In a Sentence” boxes. The one for Day 1 reads, “Although you may have inherent risks for heart disease, your contributing risk factors can be controlled and diminished if you take responsibility for this task.” For Day 6, “Recovering from a heart attack requires a mixture of physical and emotional rehabilitation; however, more than anything, it requires motivation and willingness to modify your negative health behaviors.” For Month 2, “You have a second chance to rebuild your life and body, and to begin you must take inventory of the risk factors and negative behavior to begin creating a plan.” These examples make it clear that the counting of days, weeks and months does not refer literally to a specific day, week or month after a diagnosis of heart disease, and that the underlying message from Lawrence D. Chilnick – who had a heart attack at age 48, the same age at which his mother had had one – is to take heart disease seriously and take control, to the extent possible, of elements of your life that contribute to it. Chilnick does not pretend that this is easy – it may be tremendously hard to stop smoking, for example, and may seem nearly impossible to limit stress in your life. But it is even harder to have a heart attack and know that you could have done something that would have made it less likely. Chilnick provides a lot of material that is readily available elsewhere, such as a Body Mass Index table in a section warning against obesity. But he also provides a first-person experience of living with heart disease, and helpful information on life-changing elements of it – for instance, the potential difficulty of air travel when you must carry multiple medicines with you at all times. Heart-attack patients and their families are likely to find Chilnick’s personal experiences especially useful, such as “My Story: Rehab Reality” and his discussion of “Returning to Sex and Intimacy.”

      Bruce Goldstein’s approach in Puppy Chow Is Better Than Prozac could not be more different. This is a 100% first-person account, and it is a harrowing one. Goldstein was a twentysomething advertising executive in New York City when he developed significant symptoms of manic depression – now usually called bipolar disorder. In a chapter called “Sunday Afternoon with Satan in Central Park,” for example, he remembers, “I saw Lucifer, the fallen angel, surrounded by flames. …I thought of all the evil in the world. The wars. The manslaughter. I tried thinking of something else – anything else – but I couldn’t change the channel. I couldn’t shut it off. Something much larger was forcing me to think these horrible things. ‘Get outta my head! Get outta my head!’ I pleaded. I looked up in the sky for hope. But all I saw were gargoyles.” Doctors treated Goldstein as his condition is usually treated nowadays, with drugs, but the medicines left him feeling as if he was “pulling myself out of a chemically unbalanced coffin.” And his severe mood swings never really let up – until, after a series of misadventures that he shares in detail, he listens to one piece of advice from his psychiatrist that he has previously ignored: to get a dog. Putting aside all the understandable worries – he can’t even take care of himself, so how can he take care of another living thing? – Goldstein gets a black Labrador retriever puppy (symbolically taking to himself “the Black Dog,” which is what Winston Churchill called depression). He eventually names the dog Ozzy, after a serious of hilarious getting-used-to-each-other incidents before the pup has a name at all. The chapter titles of the book chart Goldstein’s progression, from “Moping Manic on a Moped” and “Mom, I Don’t Want to Go to Life Today” to “Tour of Doody,” “The Summer of Puppy Love” and so on. The eventual ending of the book, in which Goldstein meets the woman who will become his wife – making sure she knows all about his bipolar disorder and the now-110-pound-Ozzy – is almost ridiculously tear-jerking, and at the same time so life-affirming that it is tempting to recommend that everybody with a mental disorder rush out and get a dog immediately. But that is not Goldstein’s point at all: he tells the story of what worked for him, not what will necessarily work for others. But he tells it with such heart that it is impossible not to wish for an Ozzy for everyone.

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