Lorin Kleinman   Reading, writing, and occasionally eating.

Even very good progressives tend to assume that some topics do not merit  discussion, that there is only one side to the story. That side is often described as evil. Evil has always struck me as a not entirely useful idea: all human behavior is part of a spectrum–even if at the outer limits thereof–and to deny that is to remove the possibility of an explanation, and with it, the possibility of a solution.

Human carnality very definitely occupies this spectrum, and in The Other Side of Desire:  Four Journeys Into the Far Realms of Lust and Longing, Daniel Bergner explores some of its further outposts, examining foot fetishists, sadists, pedophiles and amputee fetishes.

While making no excuses for criminal or harmful behavior, he demonstrates that these “devotees” are often driven by extreme and nigh-uncontrollable  impulses.  Bergner manages to show the humanity of people to whom it is often denied, never simplifying or demonizing. Of the paraphiliacs he depicts, only the sadistic fashion designer (of strikingly ugly latex clothes) comes off as wholly unsympathetic.

At the harmless, foot fetish end of the spectrum, he suggests there may be real advantages: people whose desire is intensely focused in one area may have a capacity for a kind of joy that eludes most people. This does not prevent the foot fetishist described in the book from being utterly tormented by his desires. Curiously (and unnecessarily) he appears no less tormented than the pedophiles depicted in a later chapter.

Bergner makes clear that even harmful behavior can be disturbingly close to the normal part of the spectrum. He cites a study in which twenty-one percent of participating men described an attraction to small children, and seven percent said that they would abuse a child if assured of not being caught. This is clearly a far higher percentage of the population than just those convicted of crimes against children.

The definition of perversion has shifted a great deal over the centuries.  Many practices once considered barbaric are now entirely accepted, and vice versa. (Bergner observes that until the late nineteenth century, the legal age of consent was ten.) Bergner believes pedophilia to be harmful, but does not otherwise take a position on the morality of these practices.  The sadistic designer claims that her services to her clients–including, in one extreme case, roasting a man over hot coals–are therapeutic;  Bergner leaves it to the reader to decide whether she is dangerous or merely eccentric. (Either way, she is highly unusual: most paraphiliacs are men.)

Of the four categories, I found amputee fetishes, unexpectedly, the most unsettling.  The ethicist Gilbert Mailaender describes the sense we have of the body as something whole and sacred (Larissa MacFarquhar discussed this in the New Yorker, with reference to the horror many feel at voluntary kidney donation), and I think that this is true. So the paraphiliacs’ explanations don’t quite convince: a preference for amputees does not to me appear equivalent to another man’s preference for blond hair. Bergner’s attempts  to humanize his subjects would have succeeded better here, had he explained–if it is possible to explain–what it is that deadens this instinct in some people.

While occasionally harrowing, and not for the faint of heart, this is a fascinating and enlightening tour of the netherworlds of sexuality–which ultimately suggests that we may all have more in common than we think.

Note: Why is this not more detailed?  Oh please.  My parents might read it!

Banvard’s Folly: Thirteen Tales of People Who Didn’t Change the World*, by Paul Collins

Paul Collins, whom I first encountered in Believer Magazine, writing about Anna Sewell and Lucy Grealy, here tells a wonderful story of thirteen people who appeared destined for greatness but ended up entirely forgotten.  “Sixpence House: Lost in a Town of Books,” his account of a year that he and his wife spent in a book-mad Welsh town, is also delightful.

*There’s a longer description here.

Eccentric Islands: Travels Real and Imaginary, by Bill Holm

This is a magical series of essays on islands real and imaginary that Holm, a Minnesota poet, has visited. “Call Me Island. Or call me Holm. Same thing,” he begins, in one of the most beguiling introductions to an author I have ever read. Eccentric Islands is a wise, funny, warm-hearted masterpiece.

Why We Buy: The Science of Shopping, by Paco Underhill

Underhill is a kind of anthropologist of shopping, and this book is both an explanation of how we behave in stores, and an account of his decades investigating consumer behavior.  Deeply fascinating.

Remember that point, in recent years, when we all started to notice something strange? Houses were more and more expensive, interest rates were lower and lower, and most of us knew someone who had no money, but was still given a large mortgage. And then there were all the stories of people buying houses with no money down, and interest-only payments for three years. How exactly were these people expecting to make principal payments in three years? And why was anyone lending them money?

In The Big Short, Michael Lewis explains that all of this was just the tip of an iceberg: an iceberg floating in exceedingly murky water. There were reasons for all of the bad mortgages. The people making the mortgages were selling them, so they didn’t care how bad they were. The mortgages were being bought by companies that bundled them and turned them into bonds—which they were able to sell, so they didn’t care how bad the mortgages were either.

In order to be sold, the bonds had to be rated by one of three rating agencies. In a reasonable financial system, the most ambitious business students would aspire to be rating agency analysts. As it is, these analysts are some of the lowest-paid and least-respected employees in the financial world. The smartest and most talented people on Wall Street are never at the rating agencies. (They tend to become bond traders.) These agencies are paid to rate bonds by the very companies that produce the bonds. As mortgage bonds were a new kind of bond, they needed help understanding them. So the same companies also explained the bonds to the rating agencies. None of this was illegal: in fact, it is standard procedure.

Not surprisingly under the circumstances, a great many of these bonds (which increasingly consisted of utterly worthless mortgages) were rated triple A, the highest possible rating. Bonds consisting of the very worst mortgages received a triple B rating. But financial companies soon realized that triple B-rated mortgage bonds could in turn be bundled into another financial product, a collateralized debt obligation (CDO). Presented with CDOs, the rating agencies tended to give them triple A ratings—which suggested that they were as safe an investment as U.S. Treasury bonds. Shockingly, very few people, at any level of the financial world or U.S. government, understood that the ratings—and the bonds they described—were worthless.

This is a book about many things, but it is particularly a story of incentives, and the calamitous effects of incentivizing irresponsible behavior. In a system in which virtually everyone had an incentive to do the wrong thing, almost everyone did: and almost everyone, from mortgage lenders to the Fed, failed to understand that disaster was imminent. The Big Short describes the very small—and very eccentric—group of people who saw it coming.

The cast of characters begins with Steve Eisman, a socially inept hedge fund manager who turned cynic after witnessing a flagrant case of fraud on which the government refused to take action. Mike Burry is a brilliant hedge fund manager who is virtually incapable of human relationships, a problem which he blamed on his glass eye but turned out to be undiagnosed Asperger’s syndrome. Charlie Ledley and Ben Hockett were two rather aimless friends who proved to have an uncanny ability to work the financial markets. Greg Lippmann was a cynical Deutsche Bank bond trader who realized that the market was unsustainable.

They shared a key insight: that the market was going to collapse, and therefore the only safe bet was a bet against it. (To short a bond is to bet that it will lose value.) Michael Lewis rivetingly describes how they first made, and then won, this bet, becoming extremely rich in the process.

Recently–at Politics & Prose Bookstore, at an entertaining event with Michael Lewis–Joel Achenbach said that this book had undermined his belief in capitalism, and asked if we should all become socialists. It was a joke, but it’s also a fair question. Lewis depicts a system in utter disarray, where financial products are too complex to be understood by either buyers or sellers; the agencies in charge of evaluating these products are both under-valued and embroiled in a serious conflict of interest; and there are no incentives to encourage responsible behavior. All of this links the health of the U.S. economy to a large gamble in which virtually no one has any idea what he is doing. It is to be hoped that this book will help foster a movement toward a sane financial system.

Open google and type in “HeLa cells,” and a million and a half hits appear. This is because these cells are used and known universally throughout the medical world: far, far more than any other cell line. What has been much less well known is that HeLa stands for Henrietta Lacks, the woman from whom the original cells were taken. In The Immortal Life of Henrietta Lacks, Rebecca Skloot–a born storyteller–set out to tell both stories, Henrietta’s and the cells’.

In 1951, Henrietta Lacks, a poor African-American woman living in Baltimore, was diagnosed with a virulent form of cervical cancer, and began receiving treatment at Johns Hopkins. During the same period, scientists had been trying to culture an “immortal” cell line: a line of cells that would survive for an extended period of time in the laboratory. All of their attempts had failed.

Without the knowledge of Henrietta or her family (a common practice), doctors took samples from her cervix and sent them to a lab to culture. Several days later, it became clear that they had finally found an immortal cell line–HeLa, as it was named, following the conventions of the time, multiplied rapidly and was virtually indestructible. By the time Henrietta died, eight months later, her cells were famous.

In the intervening years, HeLa cells were used for everything from the development of the polio vaccine to testing how cells survive in space. But Henrietta’s family did not learn of the cell line until decades later, and then were repeatedly frustrated in their attempts to pry information from the medical world, which rarely told them anything, and provided information of only the most technical kind.

The family’s difficulties were exacerbated by both their scientific illiteracy and their timidity about challenging doctors. Neither is a condemnation: in a country where the reality of evolution is still being debated, the Lackses’ failure to understand cells is hardly shocking. Nor is it surprising that they felt unable to stand up to the vastly better-educated doctors at Johns Hopkins.

Nonetheless, one of the most haunting passages in the book describes a conversation between a Hopkins researcher and Henrietta’s husband Day. Day believed the researcher to have said that Henrietta was still alive at Johns Hopkins and being experimented on. He asked no questions of the researcher, and issued no demands. The value of both scientific literacy and a middle-class sense of entitlement is compellingly clear.

As HeLa cells made vast contributions to medical knowledge and large profits for medical companies (though never for Johns Hopkins), Henrietta’s family remained extremely poor, often unable to afford health insurance. Resentment and confusion grew within the family, and Henrietta’s daughter Deborah–Skloot’s lead character, who became a friend to Skloot over the ten years she spent working on the book–was driven almost to a nervous breakdown.

Finally, though, the family began to learn the facts surrounding HeLa. A sympathetic Austrian researcher led Deborah and her brother to a bank of freezers containing their mother’s cells. Deborah warmed a vial in her hands. “You’re famous,” she whispered. “Just nobody knows it.” Thanks to Skloot’s marvelous book, they do now.

Game Change, by Mark Halperin and John Heileman, tells the riveting (and deeply fun) human story of the 2008 election–which was vastly more dysfunctional than anyone knew. As Halperin pointed out recently, it gives one pause to realize that the Clintons had only the fourth most dysfunctional marriage in the campaign: the Edwardses, the Giulianis and the McCains all had exceedingly troubled unions.

Screaming fights in front of the staff abound; spouses are jealous of the candidates’ relationships with their advisers; Bill Clinton behaves like Bill Clinton; John Edwards blatantly carries on an affair; and Elizabeth Edwards, in stark contrast to her public persona, seems to be truly deplorable. And everyone swears incessantly. Only the Obamas–though certainly not depicted as perfect–emerge as genuinely likable characters.

The candidates’ styles were, not surprisingly, reflected in their campaigns. Clinton and McCain both ran operations in which the staff despised each other, and McCain’s campaign lacked even the semblance of real organization. It is shocking that a presidential campaign can be run this sloppily; Game Change observes that Sarah Palin was vetted so hastily that it resembled the selection process for an assistant secretary of agriculture, not a potential vice president. The authors manage to evoke a certain amount of sympathy for Palin, who was put into an enormous role for which she was not qualified, without any preparation, or any organizational structure to back her up. The Obama campaign, on the other hand, was run with tremendous efficiency by people who respected each other and worked together like adults.

By the end, with Edwards abandoned by his party and McCain’s campaign widely ridiculed, it seems clear that Obama got exactly what he deserved.

Many of the loftier things in life rest on surprisingly mundane details. Think of democracy: it’s a very big idea, but can be undone by very small administrative errors. A few years ago in Maryland, a local election official forgot to put the cards needed for voting machines into the supply boxes for some polling places. Those polling places became fully functional hours late. In effect, this means that people were disenfranchised. What that election official needed was a checklist.

In The Checklist Manifesto, Atul Gawande makes the case that most complex situations are helped by checklists. A well-designed checklist, as he envisions it (and as the brilliant checklist writers of Boeing envision it) is not exhaustive, but covers the most important and easily forgotten details of a procedure. Equally importantly, it fosters teamwork among the people performing the procedure, whether they are medical staff in an operating room, or an airline crew flying an airplane. It does so in part by mandating that all participants introduce themselves to each other, which not only creates a sense that they are part of a team, but can also embolden the less-powerful members to speak up when it is important to do so.

Gawande repeats the story of an Austrian girl saved from drowning that he rivetingly told in the New Yorker, and reveals that the hospital which saved her (in an extremely long and difficult series of medical procedures) had attempted to save drowning victims before, but had never succeeded: until they implemented a checklist, a detailed and well thought-out set of protocols for what should happen from the first moment when a drowning is reported.

The building trade is another example. Gawande describes how it has moulded itself in a world grown too complex to accommodate the traditional master builder system (in which one architect had control of all details of the building process). As he points out, it is rather miraculous that so many large buildings manage to go up with so little incident. Builders achieve this, you will not be surprised to learn, through an elaborate system of checklists. Gawande discussed this at the 2009 New Yorker festival.

Gawande also weighs in on heroism in an increasingly complex world. The Miracle on the Hudson, as he describes it, was due not to the sole work of the captain, but instead to the teamwork of the entire crew — which was guided by a set of checklists. Heroism, Gawande suggests, though occasionally the work of a single, inspired individual, derives more often from the disciplined teamwork of a group of people.

The Checklist Manifesto, though less focused on medicine than Gawande’s previous books, continues his work of bridging the knowledge gap between medical workers and everyone else. He is also, as in his past books, quite ready to admit to his own failings. He confesses that he only grudgingly adopted a checklist in his own operating room (he didn’t want to be a hypocrite), but now says that he has “yet to get through a week in surgery without the checklist’s leading [them] to catch something [they] would have missed.”

Sadly, no matter how much evidence accrues for the value of checklists, Gawande describes an uphill battle in persuading organizations to use them. It is to be hoped that this work will help change that.

This is an important book. It shows us how to do things, sometimes extremely important things, better, and that doing things better is not about what we think it is about. In fact, it is often vastly less glamorous and more mundane than we expect. In The Checklist Manifesto, Gawande shows us a kind of perfection. The kind of perfection achievable by flawed, disorganized, easily distracted human beings. It’s a beautiful idea.