January 27, 2022


The Heart of Caring: A Life in Pediatrics. By Mark Vonnegut. Seven Stories Press. $25.95.

     Sensitive, concerned, knowledgeable thinking delivered in a style that can charitably be described as uneven – that, in essence, is Mark Vonnegut’s The Heart of Caring. As a pediatrician, Vonnegut has patient-focused attitudes that are defiantly old-fashioned, and feelings about kids and parents that, if not 100% demonstrably true, are most definitely heartfelt: “All parents want to be good parents. …Feed the baby. Keep the baby warm. Change the baby’s diapers. …People are all helpless babies who don’t last long or do well without care.”

     Vonnegut is at his best when telling stories of specific patients and what he learned from them, such as a baby named Adeline who was born with trisomy 13, “which is so rare that most people haven’t heard of it” and which leads to a projected lifespan of six months. This girl lived to age 23, “far and away the oldest patient with trisomy 13,” and “taught me more about pediatrics than anyone else.” Vonnegut is much less effective when using examples of patients such as Adeline to make societal points: “Adeline and other children born with genetic diseases are what insurance companies call ‘high utilizers.’ They send us lists of our ‘high utilizers’ as if there was something we could or should be doing about them.”

     Certainly Vonnegut’s feelings about insurance and about medical care in general are clear in The Heart of Caring: “Parading cute, unfortunate children across our TV screens to ask for money is disturbing. …It would be way less expensive to just take care of sick people.” This is on-the-side-of-the-angels thinking, but it is not necessarily realistic. And Vonnegut’s views, especially although not solely about insurance companies, sometimes cause him to become shrill to the point of producing paragraphs that are thoroughly muddled: “Nurse practitioners (NPs) and physician assistants are called ‘physician extenders.’ Innovation that’s all about money and hardly, if at all, about healthcare is dishonest. That NPs are often good clinicians is a lucky break. Doctors who had questions about expanding the role of NPs were dismissed as money-grubbing, obstructionist cranks. To the best of my knowledge, there were no clinical studies or pilot programs, and no one ever mentioned the billions of dollars that would fall into the lap of the insurance industry.”

     Far better and more meaningful for readers than trying to sort out exactly what Vonnegut is trying to say in that section and others like it is paying attention when he talks about patients he has seen and what he learned from seeing them. There is the case of an 11-month-old Haitian girl with tuberculosis of the brain and spinal cord – the result, it turned out, of HIV infection, which at the time (1980) was not yet known. There is the case of harvesting a baby’s bone marrow to provide a transplant for his older brother. There is the baby born with bones so fragile that, at birth, he had more than 100 fractures. There is the child who throws up after eating eggplant but keeps being fed eggplant because his mother is sure he cannot be allergic to it. And the child who is allergic to Christmas trees.

     The stories of these children, of the difficulty of diagnosing and treating them, of the care and commitment that Vonnegut and other pediatricians display day after day, patient after patient, under arduous and often frustrating circumstances – the stories of the doctors’ successes and failures, of the things that uplift them and depress them – these are the elements of The Heart of Caring that are exceptionally involving and that will stay with readers long after they finish the book. But they fit uneasily with a level of advocacy that, however well-intentioned, often makes the book descend into a screed that seems out of touch with reality and that shows Vonnegut longing for an idealized, idyllic past in which medicine in general and pediatrics in particular were perfect: “Having gone to medical school meant something. We practiced cost-effective care because it was the right thing to do and protected our patients from ineffective care. We didn’t need carrots and sticks any more than our patients needed co-payments or deductibles.” The Heart of Caring shows, again and again, that Vonnegut has been and remains a concerned, knowledgeable and effective practitioner. But it also shows, again and again, that he is not a policy maker, not a solutions-oriented analyst of modern medical practices, and not really interested in fixing the admitted imperfections in the American medical model – only in complaining about it to the point of far-too-frequent incoherence.


Light in a Time of Darkness: Music of Vaughan Williams, Ulysses Kay, Bach, Wayne Barlow, George Walker, and Haydn. Buffalo Philharmonic Orchestra conducted by JoAnn Falletta. Beau Fleuve. $15.

Songs by American Composers: Edouard Lippé, Wayland Rogers, Richard Pearson Thomas, Gwyneth Walker, Lee Hoiby, John Duke, Patrice Michaels, and Leonard Bernstein. Michelle Areyzaga, soprano; Dana Brown, piano. 4Tay Records. $20.

     The title of the new Beau Fleuve recording of the Buffalo Philharmonic Orchestra under JoAnn Falletta is supposed to help listeners focus on music as emotional uplift during the multi-year COVID-19 pandemic. The intent is good and much of the playing is, too, but the underlying concept is on the strange side. By and large, the music heard here is not the sort that brings shafts of light to an undeniably dark time. Bach’s Brandenburg Concerto No. 6, for example, is the darkest of the set, dropping violins altogether and therefore giving the viola-led music a sense of seriousness and, yes, darkness – a better choice to proffer light in a dismal time would have been No. 2, with its prominent trumpet, or No. 5, with the brightness of its harpsichord. Similarly, Haydn’s Symphony No. 44 is known as the “Trauer,” meaning sorrow, grief or mourning – certainly an apt feeling in a pandemic-ravaged world, but not exactly one designed to bring anyone light and comfort. Symphony No. 48, known as “Maria Theresia,” dates to the same time period and leaves a far more festive impression, and there are plenty of other Haydn symphonies that could more readily counter a pandemic mood – which No. 44 mostly reflects. The Bach and Haydn performances here are fine, but neither of these composers brings out the best in Falletta or her orchestra: this is not an ensemble dedicated to period performance and not one especially sensitive to some of the delicacy and nuance of these specific works. The playing is certainly heartfelt and undeniably professional, but in neither work’s case is it very idiomatic – with the result that some of the power of both pieces is vitiated. On the other hand, Vaughan Williams’ Fantasia on a Theme by Thomas Tallis, which is also a dark-hued work, comes through very well indeed, the Buffalo Philharmonic’s strings sounding full and warm and Falletta pacing the music with just the right combination of forward emphasis and emotional heft. The three remaining pieces on the disc are lesser and shorter works, although each is effective in its own way. Pietà by Ulysses Kay (1917-1995), here receiving its world première recording, features some lovely English horn material (played sensitively by Anna Mattix) that recalls Sibelius’ The Swan of Tuonela. There is woodwind beauty as well in The Winter’s Passed by Wayne Barlow (1912-1996) – here the oboist (Henry Ward) is crucial for mood-setting, and the piece is shorter and somewhat less dour than Kay’s. And Lyric for Strings – Lament by George Walker (1922-2018) has a gentle, crepuscular quality with considerable wistfulness and a welcome feeling of peace – which is more than a little disturbed when Walker’s work is followed on the disc by Haydn’s symphony, which concludes the CD. Certainly music, which helps so many people get through so much, is most welcome in a pandemic-ravaged world, where a great deal of life seems constantly askew. The specific pieces on this CD, though, do not really provide as much light as the disc’s title would lead listeners to expect, and for which they have every right to hope.

     The purpose of a new release from 4Tay Records is not to create a specific mood but to display a specific combination: of words written by women and music created by American composers. This is politically correct, perhaps, but not especially meaningful in any musical sense: if the words-and-music combination gets through emotionally to listeners, the audience is scarcely likely to marvel at the gender of the writer or the provenance of the composer. So what Michelle Areyzaga and Dana Brown really have here is a rather tenuous organizing principle – the question being not whether the works conform to the plan but whether they reach out effectively to anyone who may hear them. The answer is that, in the main, they do, thanks to the composers’ use of material whose quality and underlying musicality have resulted in its being set effectively at other times and by other people. Emily Dickinson’s poems get more use here than work by anyone else: Dickinson’s words appear in three songs by Richard Pearson Thomas (born 1957), five by Lee Hoiby (1926-2011), and seven by Gwyneth Walker (born 1947). These composers’ settings differ in significant ways: Thomas uses vocal decoration that occasionally emphasizes and occasionally distracts from the words; Hoiby focuses on elucidating the words’ meaning and gives the piano a mainly decorative role; and Walker makes the words even clearer than Hoiby does, showing a real understanding of the rhythmic nuances of Dickinson’s poetry. In all three cases, what comes through most strongly is just how well Dickinson’s sometimes-disjointed verse communicates a series of emotional touchpoints, usually with a single focus in a single poem but sometimes with quicksilver changes of mood and thought. The Dickinson songs are the strongest offerings on the CD, although Areyzaga and Brown provide all the material on the disc with equally committed performances. There are a couple of pieces here whose words seem inevitable in songs: How Do I Love Thee (Elizabeth Barrett Browning) as set by Edouard Lippé (1884-1956) and What Lips My Lips Have Kissed (Edna St. Vincent Millay) as set by John Duke (1899-1984). More interesting than these is Hoiby’s The Waltz, with words by Dorothy Parker and a rhythm that insists it is in three-quarter time even when it is not. Also among the single songs here are To My Dear and Loving Husband (Anne Bradstreet) as set by Wayland Rogers (1941-2020); La Luz (Gabriela Mistral) set by Walker; and A Julia de Burgos (using de Burgos’ words) by Leonard Bernstein (1918-1990). All these are short pieces that make just a brief impression. Mistral’s words are better served in Tres Poemas de Gabriela Mistral by Rogers, the third and most extended of which is especially tender and gently warm. The least successful works here are two by Patrice Michaels that focus on Supreme Court Justice Ruth Bader Ginsburg, who was the mother of Michaels’ husband. The celebration of Ginsburg has reached cultlike status in some corners, but neither of Michaels’ songs (one with words by Ginsburg herself, the other with words by Anita Escudero) has much to offer on a strictly musical basis – they are political screeds, advocacy pieces far more than musical ones. It is not to their benefit that they appear on this disc among so many better works. Indeed, most of the disc is better, which makes the recording a worthwhile and well-performed exploration of numerous texts using some distinctive musical approaches that, by and large, treat the material with respect and understanding.

January 20, 2022


Puzzlooies: Disaster Master. By Jonathan Maier and Cara Stevens. Illustrated by Kristen Terrana-Hollis. Random House. $7.99.

Puzzlooies: Don’t Feed Fluffy! By Russell Ginns. Illustrated by Jay Cooper. Random House. $7.99.

Puzzlooies: Oliver and the Infinite Unknown. By Russell Ginns and Jonathan Maier. Illustrated by Michael Arnold. Random House. $7.99.

Puzzlooies: Welcome to Escape City. By Jonathan Maier and Russell Ginns. Illustrated by Nate Bear. Random House. $7.99.

Laser Moose and Rabbit Boy 4: As the Deer Flies. By Doug Savage. Andrews McMeel. $9.99.

     Ridiculousness rules in some books, where it is really their sole reason for being – no matter how carefully the books are positioned as “brain games” or “think pieces.” To be sure, there are things to solve and things to do in the Puzzlooies series – heck, “puzzl” is right in the series’ name – but the purpose of figuring things out is merely to take preteen readers deeper into madcap adventures and eventually out of them. The Puzzlooies creations (singular Puzzlooey because why not?) are designed like note pads, opening from the bottom as the venerable Mad Libs creations (which Puzzlooies distantly resemble) have for decades. Tying the multiple-author, multiple-illustrator series together are four gender-balanced, race-balanced “zany, brainy kids” who show that ridiculousness knows no male/female or ethnic boundaries. The stories introduced by these kids (Eunice, Maralee, Ray and Clinton, if it matters, which it does not) combine Mad Libs elements with choose-your-own-path book structure with a bunch of bad puns, various follow-the-path and find-the-words and solve-the-crossword activities, an occasional destroy-the-book element (portions of pages that must be cut out and arranged), a factoid here and there, and plenty of non-factoids everywhere (Vampire Lava Bats, for example). In each book, the story starts with a setup written just like, well, a story, but soon evolves (or devolves) into a series of “oops” moments that readers explore by solving some sort of puzzle. Disaster Master, for example – the Puzzlooey with the Vampire Lava Bats – starts with a girl named Sammy Chipper in a town where City Hall drops into a sinkhole, a traffic accident results in a bolognado (a tornado made of bologna), a volcano is about to erupt, there’s a squid attack, and…well, you get the idea. If you don’t get the idea, you will get it by solving the various puzzles – drawing lines to connect lunchmeats, solving a code based on nautical items, following arrows that lead in different directions through letters of the alphabet, moving along a circuitous path that covers both sides of a page so you have to keep flipping the page back and forth to follow it, and so on. There are answers at the back of each Puzzlooey, but the puzzles are designed to be simple enough to keep readers going through the story. This is true in each book. For example, there is Don’t Feed Fluffy! This is about an utterly adorable little critter that belongs to two scientists named Grunderblunken and that, when fed, becomes as big as a Great Dane covered in feathers and prickly needles and is described by pet sitter Leo as a “goldablabamoomoo,” which is about as coherent as the story gets. Then there is Oliver and the Infinite Unknown, in which Oliver’s sister, Monica the “ultra-genius,” creates a portal to nowhere or anywhere or everywhere or something like that, and soon Oliver – who habitually fixes things messed up by Monica’s over-enthusiastic brilliance and creativity – is watching dinosaurs ride scooters and meeting future people who tell him, “Have a zemzumulous day.” There is also Welcome to Escape City, in which a school team of checkers champs (the Tinsley Termites) mysteriously winds up in a mysterious city with mysterious signs and pathways and other mysteries that must be solved before such things as a galloping swing set and crab-walking set of monkey bars capture them or confuse them or, well, something. One giant checkerboard and one visit from aliens later, everything works out fine. In fact, absurdities of all sorts turn out to be the climaxes of all the Puzzlooies books, and that is the whole point of the series: it is ultimately pointless. For harmless fun with mild doses of puzzle-solving included, the books are fine – although if adults think young readers might want to go through them more than once, it is necessary to make copies of the cut-up-these-pages elements before the cutting-up starts.

     Pointlessness is also pretty much the only point of the Laser Moose series, featuring Laser Moose, a moose whose eyes shoot lasers, and Rabbit Boy, a faithful-companion type who is a rabbit. Also in the fourth series entry, As the Deer Flies, are Gus the wolf, who wants to invent a machine that will help him communicate with birds because, after all, why not? But he makes the mistake of enlisting the help of Cyborgupine, the brilliant but nefarious porcupine-cyborg villain, and things get exceedingly silly, if not particularly surprising or dramatic, from then on: Cyborgupine secretly changes the mind-interpreting machine into a mind-exchanging machine, one result of which is a deer trying to fly, which explains the book’s title. Okay, none of this makes even an iota of sense, and Doug Savage’s serviceable cartoons, which are basically fine, never have the kind of “wow” factor that would make the art a big reason to engage with the book. Nor is the soft-pedaled “moral of the story” of any special interest: it turns out that Rabbit Boy, even though he is small, can do heroic things because, again, why not? It is worth pointing out that Savage does not include in this book any flashbacks to the foundational story of how Laser Moose came to be, you know, Laser Moose, so anyone not already familiar with and interested in the character – or his buddies and nemesis, whose backgrounds are also not “flashbacked” – may be a tad confused by all the goings-on. The result of all this is a (+++) book that never pretends to be more than a romp. Well, actually it does pretend to have some significance, but not in the story itself: after “The End,” there are seven pages about tree rings, because the climactic battle in the story is fought at the Old Oak, the oldest, biggest and strongest tree in the forest. And the last of those seven pages is a guided activity: readers can create “tree rings” representing their own lives. That is actually a pretty neat idea, but is scarcely the reason anyone will become engrossed in As the Deer Flies. In fact, the book is never engrossing, nor is it meant to be: it is simple, simply silly fun, and as such may be just the thing to give young readers some respite from the cares and concerns of everyday, non-laser-powered life.


Beethoven: Piano Concertos Nos. 3 and 4—transcriptions for piano and string quintet. Hanna Shybayeva, piano; Utrecht String Quartet (Eeva Koskinen and Katherine Routley, violins; Mikhail Zemtsov, viola; Sebastian Koloski, cello); Luis Cabrera, double bass. Naxos. $11.99.

Beethoven: Piano Concerto No. 1; Symphony No. 2—transcriptions for piano and string quintet (Concerto) and for string trio (Symphony). Hanna Shybayeva, piano; Animato String Quartet (Floor Le Coultre and Tim Brackman, violins; Elisa Karen Tavenier, viola; Pieter de Koe, cello); Bas Vliegenthart, double bass. Naxos. $11.99.

Beethoven: Piano Concertos Nos. 2 and 5—transcriptions for piano and string quintet. Hanna Shybayeva, piano; Animato String Quartet (Inga Våga Gaustad and Tim Brackman, violins; Elisa Karen Tavenier, viola; Pieter de Koe, cello); Bas Vliegenthart, double bass. Naxos. $13.99.

     This is a fascinating foray into Beethoven’s piano concertos and also, truth be told, a rather weird one. The musical moving force here, and one of the few consistencies in the three Naxos CDs, is pianist Hanna Shybayeva, who is interested in exploring some lesser-known nooks and crannies of the musical past. These transcriptions certainly qualify. They result primarily from a collaboration between Sigmund Lebert (1821-1884), a well-thought-of pianist and pedagogue, and composer Vinzenz Lachner (1811-1893) – whose brother Ignaz (1807-1895) is remembered for chamber arrangements of a number of Mozart’s piano concertos. Those arrangements, and the ones of Beethoven heard on these discs, are very much of their mid-to-late-19th-century time: music lovers wanted to hear great works, recordings did not exist, and full-scale performances were infrequent and often inconveniently located – but the piano was developing rapidly, becoming increasingly popular in many homes, and private performances by string players (families and friends) were well-established (much of Schubert’s music was written for just such get-togethers). These circumstances paved the way for accurate, if simplified, versions of works such as Beethoven’s piano concertos – versions that could also be used as study scores by aspiring pianists.

     The Lebert/V. Lachner concerto transcriptions were created in this environment, but have had virtually no existence outside it: these recordings are their first ones. As musical tastes changed, full-scale performances became more widely accessible, and audiences came to know works in their original orchestrations, transcriptions such as these fell by the wayside. And that is a bit of a shame, as these well-played and well-paced performances show, because while the transcriptions are certainly pale versions of the original concertos, they possess a level of clarity and lightness that makes them worthwhile to hear on their own and that also shows elements of the concertos’ structure quite clearly and to very good effect. A guidepost for all this is the transcription of Beethoven’s Symphony No. 2 included on the disc containing Piano Concerto No. 1. The symphony transcription was made by Beethoven himself, and for the highly limited instrumental complement of piano trio. The challenges of doing this are obvious, yet Beethoven clearly found the piano-trio instrumentation adequate (if not ideal) for this symphony, despite the work’s seriousness and comparatively large scale (well beyond that of No. 1 although not close to that of No. 3, the “Eroica”). Hearing Shybayeva and members of the Animato Quartet play the symphony as a trio is a genuinely refreshing experience: certainly Beethoven knew precisely how he wanted the symphony to communicate, exactly which musical lines he wanted emphasized, and how he could assign the non-string portions of the score to a piano trio. Obviously this version does not hold the proverbial candle to the orchestral one in terms of scope, fullness of sound, or use of orchestral sections. But it is fascinating to hear the symphony in this guise, and to know, thanks to this skeletal-but-elegant version of the work, just how Beethoven himself saw the crucial and less-crucial elements of the score.

     The pleasures are analogous but different in the Lebert/V. Lachner arrangements, created decades after Beethoven’s death. Although designed for student or family performance, the concertos as heard here are not minimized in complexity or compromised in style: the transcribers retain the piano part (which is expanded in some places to incorporate some of the material originally written for orchestra), and the orchestral material is sensitively apportioned among the five string instruments, with the inclusion of double bass giving the music more heft than it would otherwise have.

     Because the transcriptions were designed for in-home or student use, the specific performers are less important than might otherwise be the case. But the performer element is a part of the oddity of this generally admirable set of discs. The musicians are all based or trained in the Netherlands and are all more than equal to their parts. But the actual sound of the CDs lacks consistency, not because of recording technology but because of inherent differences in the way chamber groups play together and the way their particular instruments interact. And the release sequence of the three CDs is itself hard to fathom. The first disc includes the third and fourth concertos, with Shybayeva accompanied by the Utrecht String Quartet. The second CD has the first concerto plus Beethoven’s trio arrangement of Symphony No. 2, and here Shybayeva plays with the Animato String Quartet. The third CD includes Piano Concertos No. 2 (actually the first to be written) and No. 5 (the last one created); here the quartet has the same name as on the second disc but a different complement of players. There is thus a certain feeling of hodgepodge about this whole project, which is a shame.

     Turning to the discs’ booklets for explanation does not help, and in fact confuses matters further. The three 16-page booklets are arranged differently, give different amounts of attention to the music vs. the performers, are differently laid out, and are inconsistent (and even inaccurate) in some particulars: for example, the first two refer to “the famous Cotta edition of Ludwig van Beethoven’s piano concertos,” while the third uses the same language but says “piano sonatas.” And this is not a matter of mistranslation, although the translation from German is inelegant at best, since the same translator is responsible for all the English versions of the notes.

     It is unfortunate that these three discs, taken together, produce an overall feeling of sloppiness or simply lack of caring in the production of the music, because the music itself is definitely worthy of being heard, even at a time when performances of the original versions of the concertos and Symphony No. 2 are ubiquitous and readily available (and a time when at-home amateur chamber-music gatherings are extremely rare). The Lebert/V. Lachner concerto transcriptions are a part of music history, perhaps little more than a footnote in it, but they are interesting in their own right as well as in the way they make it possible to hear Beethoven’s piano concertos with, as it were, a different set of ears.