Delivering healthcare to billions of the world’s poor

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A review of Pharmacy on a Bicycle: Innovative Solutions for Global Health and Poverty, by Eric C. Bing and Marc J. Epstein

@@@@ (4 out of 5)

Despite the widespread conviction that the state of the world is deplorable and getting worse by the day, the human race has made measurable, even dramatic progress in some important ways. The collective state of our health is the most telling example. In part because of the eradication of smallpox, the near elimination of polio, and the significant recent progress on HIV/AIDS, humanity in general is living longer and healthier lives. Average life expectancy at birth in India around 1950 was 38 years; today it is 65. In China, it was 41; today it is 77. Over the same period, average life expectancy in the United States has risen from 65 to approximately 80. Numbers can be misleading, but these tell a compelling story.

Building on this amazing success story, major institutions — the United Nations, the U.S. Government, and the Bill and Melinda Gates Foundation, for example — have invested billions of dollars in recent years, targeting specific diseases, promoting the use of vaccines, and building public health infrastructure in developing nations. All these admirable efforts promise to continue the favorable trend in healthcare that has unfolded over the last half-century.

However, there is a hidden dimension in this picture. As Eric Bing and Marc Epstein explain in Pharmacy on a Bicycle, billions of poor people living in rural areas all too frequently fail to gain the benefit of these advances in healthcare. It’s fashionable to look on the world today from the perspective of the cities, but in spite of the massive migration of the last several decades, nearly half (49%) of the world’s population still resides in rural areas. Great numbers of these people live far from transportation hubs, often hours or even days of walking from the nearest road. It’s to these billions of people, nearly all of them desperately poor by American or European standards, that Bing and Epstein turn their attention in their illuminating little book.

Pharmacy on a Bicycle rests on a single, fundamental premise: “Most poor outcomes [in healthcare] are caused not by lack of effective medicines or medical know-how. The ability to prevent and treat many of these diseases inexpensively has been available for a very long time. But getting the right remedies to the right people in the locations where they are needed, in a way they will use them, and at a cost they can afford is continually a challenge. This is not a scientific problem. It’s a business challenge.”

Bing and Epstein argue that humankind has never before been in such a good position to meet this challenge. The costs of many widely-used drugs have fallen dramatically, and scientists have greatly simplified the treatment of many diseases by combining multiple drugs into single capsules or tablets. Extremely cheap diagnostic techniques that provide nearly instant assessments are now available. Through telemedicine, a single well-trained physician can now offer her or his expertise to much larger numbers of patients. The widespread use of clinical checklists and the application of franchising to the healthcare industry have both improved access and lowered costs. And new business models, successfully piloted in many countries, using bicycles, motorcycles, and trained village-level representatives, make it possible for healthcare agencies and for-profit companies to overcome the “last mile problem” that has traditionally limited most of the benefits of the market economy to population centers. “We are now at a tipping point to make lasting global health impacts,” the authors write.

One of the most promising recent developments is the now near-universal access to cell phones; by next year, the number of mobile phones is expected to be greater than the world’s population. “Mobile phones are now being used for patient education and awareness, treatment compliance, health care worker training, data collection, disease and epidemic outbreak tracking, and diagnostic and treatment support.”

Pharmacy on a Bicycle is intended to spark much wider adaptation of these advances by making them more widely known. The book presents a seven-point implementation model called IMPACTS, which encompasses innovation and entrepreneurship, maximizing efficiency and effectiveness, coordinating with partners, accountability, creating demand, task shifting (e.g., empowering nurses to take on some doctors’ responsibilities), and scaling. The book includes an abundance of excellent examples that bring these deadly-sounding prescriptions to life.

Eric Bing is an M.D. who also possesses a Ph.D. in epidemiology and an MBA. He’s the director of global health at the George W. Bush Institute at Southern Methodist University. His co-author, Marc Epstein, is an eminent and much-published professor of management at Rice University in Houston whose previous teaching posts were at the Harvard and Stanford business schools and INSEAD (European Institute of Business Administration).

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A thriller that delivers both excitement and insight about the war in Afghanistan

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A review of The Shadow Patrol, by Alex Berenson

@@@@ (4 out of 5)

 The cottage industry in spy thrillers encompasses a wide range of quality, from those that offer up cheap thrills with one-dimensional characters facing off in unreal circumstances to those, many fewer, that rise into the realm of literature, illuminating the human condition. The finest of the lot, such as Graham Greene and John Le Carre at their best, stand with other exemplars of modern fiction. Alex Berenson’s writing doesn’t quite measure up to them, but it comes close. His most recent novel about the adventures of soldier-spy John Wells, The Shadow Patrol, explores the tragic dimensions of the U.S. war in Afghanistan, from which no one leaves ennobled.

John Wells has left the CIA and his long-time love, his agency handler, Jennifer Exley, and is living in rural New Hampshire with Anne, a local cop. When his old CIA boss, Ellis Shafer, asks him to return to action in Afghanistan, where he spent so many years undercover inside Al Qaeda, Wells leaps at the chance. The agency’s Kabul station is in crisis. A Jordanian physician, having established a credible cover as an ally, has murdered the CIA’s top brass in the country by setting off a suicide vest. Now, in addition to the chaos that results when replacements for the top officials prove unequal to the task, reports have surfaced that the station has been penetrated by a Taliban mole. Wells’ assignment, to learn the identity of the mole, brings him and the CIA into conflict with the hierarchy of the Special Forces and eventually into a one-on-one test of wills with a Delta sniper who holds the key to the mole’s identity.

Returning years after his last visit to Afghanistan, Wells finds the country, the war, and the agency, all profoundly changed by the billions of U.S. dollars spread about the countryside and the years of unrelenting killing. Cynicism and greed have spread throughout the country like a virus.

When Wells checks into the CIA station in the capital, a senior officer tells him, “First off, understand the strategic situation’s a mess. We’re playing Whac-a-Mole here. First we had our guys in the east, and the south went to hell. Now we’ve moved everybody south, and the east is going to hell. And by the way, the south isn’t great either. This quote-unquote-government we’re working with, it’s beyond corrupt. Everything’s for sale. You want to be a cop? That’s a bribe. Five to ten grand, depending on the district. . . to become a patrolman. You want to be a district-level police chief? Twenty, thirty thousand. At the national level, the cabinet jobs are a quarter million and up.”

While there’s nothing in this monologue that we haven’t learned from news reports and the numerous nonfiction books about the war, this matter-of-fact informality drives home the point more clearly than any “objective” report could do. In fact, Alex Berenson was a New York Times reporter before he turned to full-time writing. As a reporter, he covered the occupation of Iraq, among other big stories, and he brings a reporter’s instinct for news and the value of obscure details to make a story come to light. In The Shadow Patrol, the intimate conversation and inner dialogue of American troops highlights the mind-numbing reality of war much more clearly than any nonfiction account could possibly do.

One of the most revealing passages in the book comes in the course of Wells’ conversation with the same CIA official who spoke of the corruption caused by the influx of U.S. dollars. Wells has asked “So how many officers do you have?”

“We’re close to full strength now. Six hundred in country.”

“Six hundred?”

“But you have to remember, only a few are case officers. More than two hundred handle security. Then we have the coms and IT guys, logistics and administrative . . . and the guys at the airfields, handling the drones. Fewer than forty ever get outside the wire to talk to the locals. Of those, most are working with Afghan security and intelligence forces. If you’re looking at guys recruiting sources on the ground, it’s maybe a dozen. . . . The security situation is impossible. Only the very best officers can work outside the wire without getting popped, and even then only for short stretches.”

This is today’s CIA.

Berenson has devoted significant effort to researching the agency, the reality of the war in Afghanistan, the heroin trade, the art of the sniper, and other elements in this clever and compelling story. The Shadow Patrol – the sixth in Berenson’s John Wells series — is a superb contemporary thriller that delivers both an exciting tale and down-to-earth reporting on the Afghanistan war.

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A new biography serves up Jerry Brown, once over lightly

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A review of Trailblazer: A Biography of Jerry Brown, by Chuck McFadden

@@@ (3 out of 5)

If you wrote a novel about a guy like this, who was the son of a popular and successful governor; dated a rock star; married for the first time at age 67; twice served as governor of the country’s largest state, four decades apart; talked the voters of a notoriously anti-tax state into raising taxes substantially; ran for president three times; spent three years in a Catholic seminary, studied with Zen masters in Japan, and worked with Mother Teresa; and . . . well, you get the point. Would anyone believe this? No doubt they’d think you’d gone, as my British friends say, barking mad.

If, instead, you wrote a biography of this curious phenomenon, you’d need it to be a lot longer than a couple of hundred pages, right? And, of course, you’d need to spend days in face-to-face interviews with the guy, if only to get a solid sense of whether he’s for real. How could anyone possibly do justice to him otherwise? Well, Trailblazer is 248 pages long, one-third of them taken up with notes and other backmatter, and the author never managed to interview his subject. That, in a nutshell, is the problem with Trailblazer, Chuck McFadden’s new biography from Berkeley’s University of California Press of the impossibly self-contradictory  Governor Moonbeam.

Don’t get me wrong: Trailblazer is a well-informed portrait of our Governor, written by a man who reported on his ups and downs for many years as a Sacramento political reporter for the Associated Press. As an introduction to Jerry Brown for anyone who doesn’t remember his early days in politics or is too young to do so, Trailblazer works. McFadden, now retired, retains numerous contacts among the working press in California, whom he quotes extensively in the pages of this book, adding considerable insight. His writing is clear, his understanding of the extraordinarily complex politics of this nation-state is impressive, and he brings the story of Jerry Brown up to the present moment. It’s just that a reader would have wished for something more — something new and fresh that a truly in-depth study of the man’s life and work might have brought to light.

If you know little or nothing about our second Governor Brown, you’ll learn that he has long been accustomed to being “the smartest guy in the room”; that, as a politician, the fundamental contradiction in his life is the give-and-take between idealism and pragmatism; that the women in his adult life, Linda Ronstadt in the 70s and his wife Anne Gust for the past two decades, have smoothed over the rough edges in his personality and brought a considerable measure of balance and stick-to-it-iveness to his conduct; and that he may well be one of the most skillful politicians this state has ever seen. Is this enough? You be the judge.

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Isabel Allende’s latest novel is a triumph

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A review of Maya’s Notebook, by Isabel Allende

@@@@@ (5 out of 5)

Pick up a copy of Isabel Allende’s new novel, Maya’s Notebook, and get ready for a wild and wonderful ride through the years and up and down the length of the Western Hemisphere. Though structured as a coming-of-age novel of young Maya Vidal, recounting the four seasons of her twentieth year, Maya’s Notebook ranges from the glorious madness of Berkeley, where she was born and raised, to the back alleys and casinos of drug-addled Las Vegas and an Oregon rehab center for incorrigible teenagers, to the magical solitude of an island off the Chilean coast. Along the way in this wrenching journey you’ll find yourself drawn back in time to the CIA-inspired coup that overthrew Chilean president Salvador Allende and the murderous repression that followed for seventeen years under the late unlamented Augusto Pinochet. Maya’s Notebook is a tour de force. Only a writer of Isabel Allende’s maturity and rare skills could pull together all these disparate threads and weave them together so artfully into such a pleasurable, and often laugh-out-loud funny, reading experience.

Maya Vidal is (of course) an unusual young woman. As she describes herself at the outset, “I’m nineteen years old, female, single — due to a lack of opportunity rather than by choice, I’m currently without a boyfriend. Born in Berkeley, California, I’m a U.S. citizen, and temporarily taking refuge on an island at the bottom of the world . . . I’m five-ten, 128 pounds when I play soccer and several more if I don’t watch out. I’ve got muscular legs, clumsy hands, blue or gray eyes, depending on the time of day, and blond hair, I think, but I’m not sure since I haven’t seen my natural hair color for quite a few years now.” Her father is Chilean, an airline pilot, “handsome as a bullfighter and just as vain,” her runaway mother a Danish flight attendant whom Maya long fantasized was a Laplander princess.

Why does this striking young woman find herself on an island in Chiloe, where she’s taller than everyone else? Therein lies the tale. On arriving, when she meets her designated host, Manual Arias, an aging sociologist friend of her grandmother, Maya introduces herself by saying, “Hi! I’m on the run from the FBI, Interpol, and a Las Vegas criminal gang.” Only deep into Maya’s Notebook does it become unmistakably clear that she’s not joking.

Maya is raised by her grandparents in a sprawling house in Berkeley. The great love of Maya’s life is her grandfather, her Popo, her grandmother’s second husband, Paul Ditson II, a huge and compassionate man as black as she is white, a professor of astronomy at UC Berkeley. In exile in Chile, her constant companions are the old sociologist whose tiny home she shares; the local schoolteacher who suffers from unrequited love for the lonely old man; and a lame dog christened Fahkeen the day Maya arrived when a cab driver hears her try to get rid of the beast, yelling “Shoo! Get away, fucking dog!”

Almost in passing, Allende tosses out unforgettable passages. Berkeley is “that gritty, radical, extravagant city, with its mix of races and human pelts, with more geniuses and Nobel Prize winners than any other city on earth, saturated with noble causes, intolerant in its sanctimoniousness.” The school where Maya’s grandparents sent her “taught using an Italian system of experimental education in which the students did whatever the fuck we wanted. The classrooms had no blackboards or desks, we sat on the floor, the teachers didn’t wear bras or shoes, and everyone learned at their own pace.”

Maya’s Notebook is Isabel Allende’s 19th book. Allende, a long-time Bay Area resident, is Chilean, a first cousin once removed of the late president (not his niece, other than in the Spanish vernacular). Clearly, she’s spent a lot of time in Berkeley.

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Drones, mercenaries, and targeted murder: the new strategy of the CIA

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A review of The Way of the Knife: The CIA, a Secret Army, and a War at the Ends of the Earth, by Mark Mazzetti

@@@@ (4 out of 5)

When Chou En-Lai, then #2 to Mao Tse-Tung, was asked for his perspective on the historical meaning of the French Revolution, he is said to have replied, “It’s too early to tell.”

As we’re beginning to understand now, George W. Bush engineered a revolution of a different sort in the misguided steps he took to “end terrorism” in the years following 9/11. The country’s military establishment gained trillions of dollars in new spending within a decade, and our intelligence agencies (16 of them at last count) mushroomed in size. Even more important, the White House profoundly changed the rules under which both the Pentagon and the CIA operated, layering onto an already bloated military-industrial complex additional hundreds of billions of dollars in contracts to private companies, enabling the Pentagon to operate virtually at will, even in countries where the U.S. was not at war, and shifting the CIA’s strategy from gathering intelligence to “enhanced interrogation” to killing suspected terrorists — all without making changes in the Pentagon’s procurement policies to reflect the passing of the Cold War more than two decades ago.

In The Way of the Knife, Mark Mazzetti sums up the situation as follows: “Prior to the attacks of September 11, the Pentagon did very little human spying, and the CIA was not officially permitted to kill. In the years since, each has done a great deal of both, and a military-intelligence complex has emerged to carry out the new American way of war.”

As Chou En-Lai would clearly agree, the long-term impact of these dramatic policy changes is impossible to see. Unmistakably, though, the values embodied in our Federal government changed under George W. Bush — and Barack Obama has continued on the same course into his second term, even stepping up the use of drones for targeted murder. This doesn’t bode well for a U.S. foreign and military policy supposedly grounded in humanistic assumptions.

Mark Mazzetti makes an important contribution to exploring the near-term consequences of one of these phenomena in The Way of the Knife, which dissects the massive shift in CIA priorities from the Clinton era to the Obama Administration. The “secret army” of the book’s subtitle is the CIA’s paramilitary capability that sends Navy SEALs, Army Rangers, or, increasingly, mercenaries on secret missions around the world and uses drones to murder terrorist suspects. Mazzetti focuses much of his attention on the dysfunctional American relationship with Pakistan and to a lesser degree on the secret wars in Yemen and Somalia. However, he makes it clear that the U.S. is now conducting undeclared wars in a great many more countries — and hiding that information from the American public. “The residents of the Oval Office have turned to covert action hundreds of times, and often have come to regret it,” Mazzetti writes. “But memories are short, new presidents arrive at the White House every four or eight years, and a familiar pattern played out over the second half of the twentieth century: presidential approval of aggressive CIA operations . . . “

In touching on the highlights of the CIA’s history from its founding after World War II to the present, Mazzetti reveals the agency’s schizophrenic attitude toward the use of calculated murder in its operations.

For many years, especially under the directorship of Allen Dulles in the 1950s, the CIA was little more than a reincarnation of its predecessor (where Dulles got his start), the OSS of “Wild Bill” Donovan. As we now know, the CIA was involved in overthrowing governments (Iran in 1953, Guatemala in 1954, Chile in 1973, probably among others) and in frequent attempts to assassinate heads of state, including Patrice Lumumba (Congo), Fidel Castro (Cuba), Nho Dinh Diem (South Vietnam), and Salvador Allende (Chile). When all this nefarious activity came to light in the 1970s in the landmark Senate hearings headed by Senator Frank Church, then-President Gerald Ford outlawed assassination and the CIA’s Directorate of Operations, which included most of the agency’s bad boys, was shackled by unsympathetic new directors named to clean up the mess.

By 2001, the OSS-inspired use of paramilitary operations and targeted killing that had dominated the CIA in its early years was ancient history to the new generation who had already advanced into positions of leadership. The radical course-shift demanded by the Bush White House turned the agency upside down again. And the dramatic expansion of the drone war by CIA director Leon Panetta (“the most influential CIA director since William Casey during the Reagan administration”) completed the transition of the agency into a paramilitary force.

The Way of the Knife is thoroughly researched and skillfully written by a Pulitzer-winning reporter for the New York Times. The book’s highlights include the protracted tales of several colorful figures caught up in the unfolding of the secret wars, including former top CIA official Dewey Clarridge, a Virginia horsewoman named Michele Ballarin, and several senior Pakistani intelligence operatives. If you’re interested in the ups and downs of the U.S. intelligence establishment, you’ll find this book just not essential reading but entertaining as well.

I’ve read and reviewed a fair number of other books on closely related topics in recent years. Among these are Wild Bill Donovan: The Spymaster Who Created the OSS and Modern American Espionage by Douglas Waller here, Top Secret America: The Rise of the New American Security State, by Dana Priest and William M. Arkin here, Counterstrike: The Untold Story of America’s Secret Campaign Asainst Al Qaeda, by Eric Schmitt and Thom Shanker here, and The Longest War: Inside the Enduring Conflict Between America and Al-Qaeda, by Peter L. Bergen hereTop Secret America is the most dramatic and most important of this lot.

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A novel of suspense set in Dublin that will keep you guessing until the end

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A review of The Silver Swan, by Benjamin Black

@@@@ (4 out of 5)

The Booker Prize-winning Irish author John Banfield, aka Benjamin Black, writes a series of offbeat crime stories about a Dublin-based pathologist named Quirke. The Silver Swan is the second of the five novels he’s written to date. It’s also the first that I’ve read — and it won’t be the last.

Like many of the best crime writers, Black focuses on character, atmosphere, and language as much as on plot. The sure hand of a master stylist is very much in evidence in The Silver Swan. You’ll see it in the dialogue, where the individual speech patterns of his characters are distinctive, and in his lyrical descriptions of Dublin in the rain. If you read this book to the end, you might think you’ve gotten to know Quirke, and you may like him. You might also have a sense of Dublin, even if you’ve never been there.

In The Silver Swan, Quirke is approached by someone he knew (and disliked) at university with a strange request: presenting himself as an old friend, Billy Hunt asks Quirke not to do a postmortem on his young wife, Deirdre, who has apparently committed suicide by drowning herself in the ocean. Billy explains that he just couldn’t stand the thought that her beautiful body would be cut up by knives. For no particular reason — Quirke understands irrational impulses, his own among others — he has every intention of granting Billy’s wish until he discovers the puncture mark of a needle on the young woman’s arm. He’s forced to proceed — and learns, of course, that Deirdre was not a suicide.

In a more traditional crime novel, Quirke would probably join his colleagues in the police in a hunt for the killer, no doubt proving himself a far cleverer detective than the professionals. That’s not what transpires in The Silver Swan. Although he worked with a senior officer on another case (the subject of Black’s first crime novel, Quirke has no formal connection to the police, known as the Garda in Ireland. To prevent Billy Hunt from discovering what he has learned from the autopsy, Quirke lies to the Garda and lies on the stand in the coroner’s court, then undertakes his own, private investigation. This effort leads him into a troubling and complex set of interrelationships involving the murdered woman, her husband, her lover, and her lover’s husband, all the while he engages in a verbal minuet with the police inspector who understands perfectly well that Quirke had lied to him about the autopsy.

Oh, it’s a fine mess, in the best Irish tradition! This is a novel that’s likely to keep you guessing until the final pages.

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A funny book reveals more than you ever wanted to know about digestion and its byproducts

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A review of Gulp: Adventures on the Alimentary Canal, by Mary Roach

@@@@ (4 out of 5)

Mary Roach is a funny person, and I mean that in both senses of the word: funny ha-ha, and funny strange. For years now, she’s been writing amusing and often hilarious popular science books about peculiar subjects, including cadavers, the afterlife, the science of sex, life in space, and, now, digestion. Somehow, other science writers have tended to shy away from these topics. (I wonder why?)

So, now, Gulp: Adventures on the Alimentary Canal. 

You can get a pretty good sense of what Gulp is like by reading the table of contents. Check out these chapter titles, for example:

  • The Longest Meal: Can thorough chewing lower the national debt?
  • Spit Gets a Polish: Someone ought to bottle the stuff
  • A Bolus of Cherries: Life at the oral processing lab
  • Big Gulp: How to survive being swallowed alive
  • Dead Man’s Bloat: And other diverting tales from the history of flatulence research

Got the picture? Good. But don’t get the impression that Gulp is just a funny book. It’s chock full of important information as well. For instance:

  • You’ll learn about the difference between a $500 bottle of wine and one that costs $30.
  • You’ll find out what Eskimos think of cats.
  • You’ll know the difference between laundry detergent and the digestive juices in your stomach.
  • You’ll learn which end of the cow its farts come out of.
  • You’ll find out how Elvis Presley, President James Garfield, and Farrah Fawcett really died.

Gulp brims over with surprises. And the truly funny thing is, you’ll actually learn a good deal about the digestive process along the way. Mary Roach knows her stuff. This book is far more than a comic tour de force: it’s actually a superior example of science journalism. Kudos to Mary Roach!

Gulp is Mary Roach’s sixth book-length study. The first was Stiff: The Curious Lives of Human Cadavers a decade ago. Then two years later came  Spook: Science Tackles the Afterlife, and Bonk: The Curious Coupling of Science and Sex three years after that. Her most recent book before Gulp was Packing for Mars: The Curious Science of Life in the Void in 2010. My review of Packing for Mars is here, and the one for Bonk is here.

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The most original sci-fi novel I’ve read in years

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A review of The City and the City, by China Mieville

@@@ (3 out of 5)

You may think “Franz Kafka” as you make your way into the depths of The City and the City. It’s definitely not Charles Dickens! As this novel was a favorite of science fiction fans and won the Hugo Award, I was expecting something a little different from what I got — which was a more than generous dose of confusion. 

I’ll say this for The City and the City: it’s truly original. I’ve never read a science fiction novel quite like this.

Tyador Borlu, a detective on the Extreme Crimes Squad in the tiny nation of Beszel, is confronted with the seemingly unexplainable murder of a young foreign woman. In his usual obsessive fashion, Borlu sets out to follow every clue, no matter how unlikely, to bring the woman’s killer to justice. The path he follows is long and tortuous, taking him in unexpected directions where he faces threats  from powerful forces he barely understands.

Nothing quite out of the ordinary there beyond the other-worldly character of Beszel. But wait.

This seems to be present-day Earth, but it can’t be. A country that exists nowhere on your Earth or mine, Beszel lies somewhere in southeastern Europe — the Balkans, perhaps — and overlaps with another unfamiliar small country, Al Qoma. I say “overlaps” advisedly. This is not a tale of two Jerusalems, or two Berlins. It’s much weirder, and therein lies the rub.

The capital cities of these two, often antagonistic little countries, also called Beszel and Al Qoma, aren’t just adjacent to each other. They somehow overlap, simultaneously occupying the same physical space where their sprawling neighborhoods have grown into one another. A more conventional sci-fi writer would probably explain this as the intersection of alternate universes, but there’s no such reference in The City and the City. Instead, Mieville presents this conundrum as a simple fact of life in the two countries, and his novel explores what lies “between” them. This strange set of circumstances dominates life in both countries.

Originality aside, and admittedly it’s fascinating, The City and the City is a flawed work. Mieville never fully develops his characters, not even Borlu, the protagonist. And the book is confusing at times — not to avoid telegraphing essential elements of the plot but simply because the language is unclear. (It took me forever to understand that the word “Breach,” which represents a key concept in the novel, is both a noun and a verb that simultaneously connotes an act, a condition, a place, and a group of people.) The high hopes I had when I read the first half of this book slowly dissipated as I progressed. At the end, I was unsatisfied — and the news that Mieville may write a series of novels based on Borlu and the unique geography of his surroundings is not enough to humor me. 

The City and the City won several literary awards, including a Hugo for Best Novel, and was nominated for a Nebula Award.

China Mieville is a British author, now 40 years of age, who styles himself as a writer of “weird fiction”. He gravitates to fantasy but has set himself the goal of writing a book in every genre. With The City and the City, he can check the box marked “police procedural”.

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Two books I loved recognized by the Pulitzer Prize Board

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Adam Johnson’s extraordinary novel of life in North Korea’s gulag, The Orphan Master’s Son, received the 2013 Pulitzer Prize for Fiction yesterday. The board had awarded no fiction prize last year, creating an unusual level of anticipation about this year’s. I reviewed this richly deserving novel here. Johnson’s haunting story was also a finalist for the National Book Critics Circle Award and was named one of the best books of the year by The Washington Post, Entertainment Weekly, The Wall Street Journal, Los Angeles Times, San Francisco Chronicle, Financial Times, and Newsweek/The Daily Beast. 

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One of my favorite recent nonfiction books, Katherine Boo’s Behind the Beautiful Forevers: Life, Death, and Hope in a Mumbai Undercity, was a finalist for the Pulitzer Prize for General Nonfiction. Here’s my review. This amazing little book was also winner of the National Book Award, a finalist for the National Book Critics Circle Award, and was named one of the ten best books of the year by The New York Times, The Washington Post, O: The Oprah Magazine, USA Today, New York, The Miami Herald, San Francisco Chronicle, and Newsday and was named one of the best books of the year by The New Yorker and People. 

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