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When I graduated from high school in 2008, the U.S. was plummeting into a financial collapse that tanked the rest of the world’s economy as well. By the time I graduated from college in 2012, the descriptions of most entry-level positions began, “Must have at least five years of relevant experience.” And no one really had any advice about what to do with the massive, overwhelming problem that was and is student debt.

In 2021, as graduates face not only economic hardship but also the pandemics of poverty, racism and COVID-19, good advice is equally hard to find. The past year has taught them that stability is the illusion, while change and upheaval are the norm. Facing an uncertain future means figuring out how to navigate big changes.

In Letter to a Young Female Physician: Notes From a Medical Life, author Suzanne Koven explores her own personal crises and growth, weaving them within the story of her practice as an internist, or doctor of internal medicine. Koven discusses her struggles with image, identity, sexuality and weight and sees these things as inextricably tied to her desire to be someone important: a doctor. Yet, what Koven discovers is that despite succeeding and becoming a doctor, she failed to overcome the impostor syndrome that plagued her even before she held others’ lives in her hands.

In this way, Koven’s story speaks to the impostor in all of us. Koven writes that “even the most blameless patient, the victim of an accident or a random illness in no way related to anything that person did and in no way preventable by them, feels shame.” We’re all victims of senseless suffering—an economic collapse, a pandemic. These shared traumas reveal our shame; but Koven advises us not to ignore or try to defeat it but rather to allow it to shape us into better, more empathetic people.

By contrast, Your Turn: How to Be an Adult by Julie Lythcott-Haims falls into the more traditional, practical advice category. With frank, straightforward counsel and to-do list chapter titles, Your Turn gives advice that all of us—adults, young adults and children—need to hear.

Citing the work of bestselling psychology researchers and writers like Lori Gottlieb and Brené Brown, Lythcott-Haims’ book advises young people to take chances and find what makes them happy, rather than following a prescribed path to success. Perhaps the most moving passages are the “don’t just take it from me” stories collected from various friends, acquaintances and pen pals. In a world that feels so isolating, reading these deeply intimate stories reminds us why we long to live in community with one another and how doing so truly helps us survive and thrive.

The greatest takeaway from both of these books isn’t the advice they provide but their acknowledgement that we all need each other. Alone, we’re more susceptible to our own shame and self-doubt. Yet here we are, longing not for some sort of undefinable success but simply to be in each other’s presence again. To be sure, many obstacles still stand in the way of our ideal lives; for example, no one envisions a pandemic as the perfect start to adulthood. But sharing our stories is the first step forward, as these tender, inspiring books make clear.

The greatest takeaway from both of these books for burgeoning adults isn’t the advice but the acknowledgement that we all need each other.

Florence Nightingale and Dorothea Dix loom large as women who reformed health care in the 19th century—in the fields of nursing and mental health, respectively—but Elizabeth and Emily Blackwell have remained largely unrecognized for their roles in medical history. No longer, though, for Janice P. Nimura’s compelling biography The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine reclaims the sisters’ enduring contributions to medicine and to women’s history.

In breathtaking prose and exhaustive detail, Nimura chronicles the lives of the Blackwell sisters—their childhood in England, their immigration to America, the challenges they faced as they made their way in the medical profession and their eventual establishment of institutions that would provide both access to quality medical care for women and a place where women could study medicine in order to practice it.

Attracted to healing as a teenager, Elizabeth saw medicine as a noble vocation, but as she sought to embrace her calling she encountered resistance at almost every turn. Eventually she was able to graduate from Geneva Medical College in New York, becoming the first woman in the U.S. to earn a medical degree, after which she set up a practice in New York City. Emily followed in her older sister’s footsteps, attending Rush Medical College in Chicago and the Medical College of Cleveland, where she became the third woman in the U.S. to receive a medical degree. In 1857, the two sisters founded the New York Infirmary for Indigent Women and Children, and in 1868 they opened the Women’s Medical College in New York City, where Elizabeth taught courses on sanitation and hygiene and Emily taught obstetrics and gynecology. By 1900, the college had trained more than 364 women, and the sisters’ work led to thousands of women becoming educated in the medical field. 

Nimura’s compelling biography not only recovers the lives and work of Elizabeth and Emily Blackwell but also provides a colorful social history of medicine in America and Europe during the mid- to late-19th century.

Janice P. Nimura’s compelling biography The Doctors Blackwell reclaims two sisters’ enduring contributions to medicine and to women’s history.

Environmental hazards such as chemicals, additives, pollution and allergens abound in today’s world. We are bombarded by them on a daily basis, yet for most of us, our bodies are able to filter out these foreign substances. But for some people, who call themselves “sensitives”, these bodily processes break down over time, causing people to develop an oversensitivity known as environmental illness, or EI.

Oliver Broudy (The Saint) investigates this condition in a multilayered way, weaving history, science, nature, health and psychology into a narrative with a good old-fashioned road trip as its backbone. Broudy chronicles his journey with a sensitive named James to find Brian, also a sensitive, who has gone missing and just happens to be a leader within the EI community. The two men drive to Snowflake, Arizona, a kind of “sensitives headquarters.” Here they hope to get more intel on Brian, and Broudy hopes to interview Liz, the community’s main “contact.”

Along the way Broudy provides informative commentary about EI, a disorder that can be intensely painful, irritating and maddening, leading those who experience it to develop a range of illnesses and idiosyncrasies. He provides a myriad of theories, expert opinions and patient feedback, highlighting the fluidity of EI’s impetus and evolution.

As the two men thread their way through the western U.S., Broudy describes in vivid detail the sparsely populated outposts that seem frozen in time and the desolate landscapes with rock formations rising up out of the earth as “wrinkled battlements surrounded by the dross of their own crumble the way an autumn tree is ringed by leaves.” Learning about EI is fascinating and even infuriating, but the excursion and bonding experience between the author and his travel companion is even more intriguing. Over miles of open road, Broudy and James learn more about each other and themselves, and the reader is educated about a chemical threat that is “woven into the fabric of everyday life.” The Sensitives: The Rise of Environmental Illness and the Search for America’s Last Pure Place is one road trip you’ll want to take.

Environmental hazards such as chemicals, additives, pollution and allergens abound in today’s world. We are bombarded by them on a daily basis, yet for most of us, our bodies are able to filter out these foreign substances. But for some people, who call themselves “sensitives”, these bodily processes break down over time, causing people to develop an […]

In her new memoir, The Lady’s Handbook for Her Mysterious Illness, Sarah Ramey writes about the 2012 day her music video featuring her alter ego, Wolf Larsen, premiered on NPR. It starred a red-lipsticked, vibrant version of herself, and it went viral online while she remained ill, exhausted, frustrated and alone at home.

This moment is but one of many, many times Ramey struggled to put on a happy face while her reality was much more painful. She is what she calls a WOMI, or “woman with a mysterious illness.” In the last 30 years, instances of autoimmune illnesses have tripled, and our medical system has not yet developed a respectful, effective way of working with such patients. Instead, skepticism and dismissiveness (the classic it’s-all-in-your-head response) is the norm, writes Ramey, and people, predominantly women, are staying sick.


ALSO IN BOOKPAGE: Read our interview with Sarah Ramey.


Ramey’s angry about that, and she explains why with intelligence, humor and impressively thorough and far-ranging research into the various ailments that stem from trauma, exposure to harmful chemicals, consumption of unreal foods, overuse of antibiotics and more—diseases that defy easy diagnosis and a straightforward cure. They’re often invisible, too: WOMIs may look great even as they feel their worst, and that only increases the doubt among medical professionals, or even family or friends.

Ramey shares her own personal health journey, including conventional and alternative treatments; strategies she’s tried that have brought relief (or haven’t); and what she’s learned about the immune system and the gut. She also makes an impassioned case for profound change in our health care system, which, she argues, is out of balance because it lacks consideration and compassion: “We excel at acute (heroic, eliminate the bad guy) illness and can’t for the life of us solve chronic (heroinic, root system) illness.” She urges readers, especially those who are WOMIs, to be open to sharing their stories and asking for change, in an effort to bring about a cultural shift before it’s too late—since what we’re doing now clearly isn’t working for millions of people.

The Lady’s Handbook for Her Mysterious Illness is a stirring and inspiring rallying cry, an engaging and often harrowing personal story (or, as Ramey quips, “a kicky memoir about my gyno-rectal disease”) and an eminently worthwhile read.

In her new memoir, The Lady’s Handbook for Her Mysterious Illness, Sarah Ramey writes about the 2012 day her music video featuring her alter ego, Wolf Larsen, premiered on NPR. It starred a red-lipsticked, vibrant version of herself, and it went viral online while she remained ill, exhausted, frustrated and alone at home. This moment […]

Sarah Ramey’s The Lady’s Handbook for Her Mysterious Illness is at once a comforting embrace and a call to arms for people (mostly women, alas) who experience mysterious chronic illnesses. The book is a figurative finger, trembling with rage, pointing directly at the deeply held sexism at the root of so many problems in American health care. It’s also a funny, honest, often beautiful recounting of the author’s personal journey through illness after illness after illness, during which she maintains her hope and optimism. 

Ramey spoke with BookPage about her powerhouse memoir in a call to her home in Washington, D.C.—an auspicious conversation, considering that getting her book to publication has been such an astounding journey, thanks to years of health challenges. “I wrote it over a 15-year period,” she says. “It’s so funny—someone told me I’m the most overdue author they’ve ever encountered!”

“It became clear that mine was not a psychological condition. It was a problem in the psyche of the doctors—the programmed assumptions, unconscious bias, prejudice against this type of patient, particularly against women.”

That’s impressive in its own way, of course, but Ramey used the delay as an opportunity for more research, and thus more potential for greater impact. “In the beginning, nobody was talking about [the things I was writing about],” Ramey says. “I don’t think the microbiome was even mentioned in the original proposal, and gut health was not yet a common term . . . but as every year has gone by, it’s come more and more into the mainstream. . . . I learned so much in that interim period.”

The author has conducted an enormous amount of research into the conditions common to what she calls “WOMIs”—a “woman with a mysterious illness” who is “exhausted, gluten-free, and likely in possession of at least one autoimmune disease. She is allergic to . . . (everything), aching from tip to toe, digestively impaired, and on uneasy terms with her reproductive system. She is addled, embarrassed, ashamed, and inflamed. She is one of us.”

Clearly, being a WOMI isn’t an easy existence, not least of all because the inability to diagnose and prescribe a sure fix for these conditions typically leads to skepticism and dismissal from medical practitioners. And it definitely doesn’t help that WOMIs may not always look sick. The number of times Ramey (who has gyno-rectal disease, gut issues and more) has been dismissed, doubted, scoffed at and much worse—botched surgeries and unapologetically cruel doctors, for starters—is staggering.

But Ramey is an engaging and witty narrator, and readers will nod along with her as she describes the arc of her reactions to such treatment. In the beginning, she says, “I was a lot nicer to doctors” who treated her poorly because—well, she needed them. But as time went on and her motives and sanity were repeatedly questioned, Ramey got angry. She began speaking up for herself, and she began writing the book so that other women like her wouldn’t feel alone. (And these women are legion. Autoimmune illness numbers have tripled in the last 30 years.)


ALSO IN BOOKPAGE: Read our review of The Lady’s Handbook for Her Mysterious Illness.


The author says she believes the American health care system can and must change. “It became clear that mine was not a psychological condition. It was a problem in the psyche of the doctors—the programmed assumptions, unconscious bias, prejudice against this type of patient, particularly against women,” she says. “If you can’t prove what’s wrong with you, it’s much more likely you will get swept away. That is part of the culture, and it’s wrong, and it’s very difficult to combat as a single person in the moment because of the power dynamic.”

For Ramey, changing her mindset has been a key part of her adjustment to living with chronic illness. She writes, “In the alternative medicine world, following your bliss is highly correlated to healing.” Thus, rather than pushing through the pain and trying to get better faster, she’s engaged in “a lot of phases of trying to figure out how to make my life as good as it could be within really tight parameters.” That’s included adopting a cat (who was “right here looking at me encouragingly” during our interview), as well as inhabiting her singer-songwriter alter ego, Wolf Larsen, whenever she can.

Ramey says she hasn’t performed in the last couple of years because she’s been having “surgeries and interventions to reconstruct and make things better” in her poor, beleaguered pelvis, “but when things quiet down and this overdue book is out, I’m going to record an album I’ve had written for quite a while.”

She adds, “I’m a hope-monger! I used to say every year, ‘This is the year I get better and do this many shows.’ I don’t do that anymore. I now accept that I’m a studio musician I’m not going to perform live very often, and that’s fine.” (However, her all-female band, GlitterSnatch, does plan to perform at a couple of her book events.)

And when it comes to The Lady’s Handbook for Her Mysterious Illness, Ramey says, “I’m hoping that it can help change the conversation a little bit, the dynamic between the patient and the people around them. A main goal for me is to be another person helping to make this invisible problem visible.”

Author photo © Julius Schlosburg.

Sarah Ramey talks about the intersection of medicine and misogyny, laid bare in her powerful (and, against the odds, hilarious) memoir.

If you aren’t currently among the more than 46 million Americans over the age of 65, with any luck, someday you will be. That’s why geriatric physician Louise Aronson’s Elderhood, a passionate, deeply informed critique of how our healthcare system fails in its treatment of the elderly, is such a vitally important book.

As Aronson explains, American medicine is reluctant to acknowledge old age as a distinct stage of life—one with unique medical challenges but hardly lacking in opportunities for deep fulfillment. Whether it’s the failure, until this year, of pharmaceutical trials to test drugs on elderly subjects, resulting in unanticipated side effects, or the tendency to view the final years of an elderly person’s life only through the lens of illness and disability, our perspective is both shortsighted and flawed. 

Another more profound flaw, Aronson argues, is our medical establishment’s stubborn insistence on treating organs and diseases rather than whole human beings, often prizing science and technology over simple, compassionate care. These efforts typically trigger costly late-life interventions that may be successful in the narrowest sense, prolonging life for a time but often inflicting physical and psychological pain on their recipients that severely compromises their quality of life. Aronson advocates for a new care paradigm, focused on the “optimization of health and well-being,” even when an earlier death may be the consequence. 

Elderhood shares some of its DNA with Atul Gawande’s Being Mortal. But unlike the well-known surgeon, Aronson brings to bear some three decades of geriatric practice, a branch of medicine that didn’t even emerge as a specialty in the U.S. until 1978. She draws extensively on case histories, including moving stories about her father’s final days and her mother’s resilience in facing the challenges of old age. Aronson, who holds a master’s degree in creative writing, is as comfortable drawing on resources outside the field of medicine, quoting poet Donald Hall or novelist Karl Ove Knausgaard, as she is parsing a scientific study. Though the subject of this provocative book is the elderly, its message touches the entire span of human life.

If you aren’t currently among the more than 46 million Americans over the age of 65, with any luck, someday you will be. That’s why geriatric physician Louise Aronson’s Elderhood, a passionate, deeply informed critique of how our healthcare system fails in its treatment of the elderly, is such a vitally important book.

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