found myself for many years after that, probably about 20 years, suffering from depression at a time when we didn't call it depression, but it took a long time to sort through the things that happened here in birmingham and to understand them and to put them into perspective. what made me decide to write the book was just the resurgence of mean-spiritedness that i began to see. i really felt that america had reached a crossroad many years after the bombing of the church. i really felt that america had looked at all of the mistakes we had made in our country and that they were committed to moving forward and a positive way for all the citizens. when i began to realize that things that were contradictory to this, i decided that perhaps we had forgotten many of the lessons that we had learned during the 60s and in many cases we had lost those lessons

but in other cases we had forgotten. so i decided that i would and recapture the memories of a 14-year-old after the bombing of the church. ..

>> we are delighted to nine to be speaking with the professor dr. howard markel just by introducing the of their first let me say it my a particular culture you always begin talking about yourself under any circumstances. [laughter] which is related to furry but in any case it is called narcissism i am about to fly off to bet this to this location going immediate the two the airport i find myself addicted to strawberries to come back with the raging case of

tuberculosis which is not a related to the professors wonderful first to book the first of which was award-winning quarantine the eastern european immigrants and the epidemic of 8092 that johns hopkins press pomp -- published in 1997 and also when terms travel that have invaded america says the 1900. and deion is also the publisher of at "an anatomy of addiction" i am delighted to tell you the barnes & noble book stole at -- bookstore is still in existence that deserves a round of applause and to have the book back on the table to be purchased after words. professor howard markel at distinguished professor and a professor of pediatrics and communicable diseases as

professor of history, health management and policy, a cut -- psychiatry in for the history of medicine at university of michigan he reminds me of a new yorker cartoon where there was a latin american general standing with various stripes and it said president of the republic, president of excederin. [laughter] versatility is extraordinary and it is telling new professor markel is not only a practicing clinicians but also a historian, a pediatrician and his work for many years in a clinic with adolescence with addiction so he is a triple threat the way he approaches the extraordinary topic of completely luminous figures. her sigmund freud and william halsted both for

reading at max the shrieking at six. he approaches this not only from the point* of view but also can tell an extraordinary story. he approaches a scholar the history of medicine but also a clinician with experience if you will of the seduction of the wonder drugs with a means to work in a clinical culture where when new drugs and new techniques are discovered, people feel a sense of trying to use them wisely how far they can go and what they will do. when radiology was first brought into being, what it produced was a raging said of disaster is. radioactive and could not get through airport security any more. we that as of me, the fact

of the matter is a very few people could combine a real clinical experience for the desire for cure with a sense of new technology of wonder drugs in the real history of the archives and a dam a wonderful storyteller combined to give us all the not just my dollars these things and planning for the department of defense. and then serves as the principal historical consultant on in for this centers for disease control. also off their tutus scholarly articles from "the wall street journal" to "new

england journal of medicine" and rights quite literally and and has been on all matter of television programs and this is being taped by c-span for booktv. so please try to catch it if you want to watch it a second time if you want to miss my a introduction c-span.org or and mezzo that it is not to compete with michigan football but a couple of minor points please now turn off your cellphone. second, after a brief conversation will open this up. there is a microphone in the middle it in seven days

yourself in mind that it is being taped in professor markel was from the institute of humanities for the book was originally conceived and early drafts were produced i can now call you howard if i may? tell us about the two at six. what brought you to think of the two people to put them in one book? >> i want to direct cultural history of addiction. it is a new concept in madison of medical history. it comes from roman law so what it meant in antiquity by zero do a great deal of money, i could not pay you back you would take me before i judge and in it would make me your slave or

addict if that i love the idea that i could be something as a slave as extraneous but not until the twenties or thirties that doctors started to think about addiction the modern definition is using a substance not only with great to and grave consequences' you know, it and will hard you but you do it anyway. where you can of use it to harm but you lose the control. and opium started the ball rolling and doctors or to prescribe morphine and opium it is an incredible painkiller but nobody knew it was creating the morphine or opm eaters once the

hypodermic syringe was invented the cow was out of the barn door so in the 1880s there was interest in a brand new drug called cocaine and the coca leaves have been used by the aborigines for millennia but finding out the way to chemically take the leaves to come up with the powder that is wearable and dispensable took some time and that happened 1884 and touted nonmedical and it -- journal's as the great miracle cure tuberculosis, said dyspepsia and even morphine addiction and a young man named sigmund freud who was not yet sigmund freud was studying to become a neurologist in vienna

looking at the hospital that was the place of all the world greatest doctors in surgeons but not so great if you're a patient and more of a place where the diagnosis was key because we did not have a lot of treatments back then. that is where hand washing was first discovered to be an important issue something some doctors are working on learning but freud became very interested and did so not only because he thought this could make my name not only to become a professor for neurology you have to discover something to be really great. i love learning about that because he was an ambitious medical student very eager

to please and somehow i could identify the remembered a a medical student very well i remember the desire to succeed not knowing if i would and also had a very good friend who was a very talented physiologist the love to dissecting -- dissecting the cadavers developed such a raging infection well before antibiotics, that he developed a tumor that causes phantom pain of the unimaginable levels and he tried everything steadying stand scripps in calculus and physics nothing worked

until he found morphine then he became a raging addicted and sigmund freud was called to his room many time when he was in delirium so the connection not only can i discover something but health, it was a wonderful and powerful combination. fast or, frayed wrote the paper about this there is a great irony there because freud was on cocaine but he missed the critical issue. it is a wonderful and a static. do you ever see lourdes cotte show they put their finger and it? they realize it will not the gums and it knows anything. so afraid to miss that whether he was too high or too anxious but a friend of

his eye he discovered that and that changed the world the ada to have a local anesthetic that would never knew effectively was front-page news around the world not just medical schools. a man who read about that shortly after it was reported was a man named william halsted. he became the greatest surgeon ever. he was the boy wonder of new york what is now columbia college and had brilliant ideas of wound healing and operating under a clean circumstance the back then

surgeons were wearing old coats steered with blood and pus and dripping elbows into the surgical wound in insurance would hold sutures in their mouth and then handed to them. it brings up the joke it was an operational success that the patient died. so he is always looking for perfection in he read the paper of the anesthetic properties he started to do experiments except most people did it on themselves although he injected it or sigmund freud smith.org took it with water. he wanted to see how far he could go. and within a matter of weeks he was the cocaine addict as well as the the assistance

and students. but halsted stopped going to meetings in class this i forgot to mention also using the surgical rubber glove. he was called down to the waiting room that the tibia bone was broken so badly was coming out of the skin in the 1880s you rarely survive that because of the infection and he was so high on cocaine he walked away from the table and said i cannot do this. then the next few months he was high on cocaine and tell his friends tried to do an intervention but i was so enchanted because they were

remarkably high performing at six that this proves the notion they should have felt better it was a human disease all people are prayed to the disease and it had to do with a miracle drug that was supposed to help people not harm them. iraq's a dental at six this nobody's as i will take the her when to become a raging addict every person is the author of their own story but i became addicted to this story in valhi was thinking of writing about other people if i am that

compelled surely somebody else must be bent and new the gentlemen and likely they never met to i understood where they came from in their ambitions and i have great empathy and i wanted to document their stories but with the broader issue to look at it as a human disease is not us if cable-tv it is a very serious problem for the individual and the family is in those who love the individual and society at large of the biggest problems facing society today. >> another thain the book does this give somebody a

lends on the seduction of clinical practice what it means to live with something that is new and could you talk a little bit more about that? that is why it is beautifully organized with two medical people as opposed to others could you talk about that? >> what it is not well known to most people but the academic atmosphere is not very exciting place to be there is the thrill of discovery how can i make this better? hospitals dollar fell

fell -- filled with ambitious people who want to change the world. so you always look for something but none of us seem to be aware of the old morality play playing over and over of the miracle cure the miracle procedure that does not turn out so miraculous and we only learn that after using it on quite a few people and the reaction and that happened with cocaine. by the 1890's it is still the human beings that are cocaine addicts but that thrill of discovery for popular consumption and personal advancement is the engine that drives the temple that we all benefit from today's. >> the way in which we come

to find out there is a limit of understanding only by bumping your hands is it like a wall the realize. >> that is very true for my own goals to do things that would seem like they were outlandish but that is the separation coming with of patient in front of you and that is a huge issue. won a great interest said what separates man from the animals is a desire to take drugs and it is true. [laughter] it is true. we want something to make our lives better to make my sciatic pain next, make us less service, that we all

want a simple bill. that is a very human phenomenon that has conspired the quest to heal ourselves. >> what makes this fantastic is the way they you'll carry out these two characters. and halsted seem to constantly be on and off the wagon so tell us about those differences you cannot find two people and a hospital more at odds or different then i a psychiatrist and a surgeon. they are a different species. i did read not realize for years it is not a complement

but being very different their different people and freud was a young jewish fellow and was told frequently the different points during the training that he did experiment quite a bit with cocaine and he nearly killed a patient and i intergraph that as his bought them. he wrote about that in the interpretation of dreams that is our midstream in this will men was an e n t you had a theory that all fees the days physiologically ideas could

be removed with healthy supplies of cocaine. one of the patients was sigmund freud taking quite a bit to the point* he had to have a hot knife to burn a hole in his nasal tissues city could brief. and he left and she nearly died and freud had a dream and interpreted it that i am such a good physician and so conscientious that's when my patients go sour i feel bad for them. he was intel himself the same big lie that my addiction is not that bad. but yet to at some level he misstep known not only did he not almost kill somebody his career would have been ruined. not just to say that would be malpractice but no sigmund freud as we knew him

but along this time he had the dream that his father died and he said by the way i put the cocaine precious side. there is no evidence and he tells you what he wants you to know so he probably stopped using cocaine october 1896 then he was smoking oral cigar's leading to oral cancer than to his death but now assigned to the insane asylum twice come my going there, back then was a very scary place. he even signed his name on the registry he was so ashamed and demoralized william stewart and then a / for his last name should have been because of what

his name should have been and shame and hiding is a sign of the disease and he was brought to johns hopkins by his friend william welch they had tens of money in the greatest medical school of the world and give a huge amount of money by johns hopkins and he said to halsted, i will review with me to baltimore you will live with me and so he did. he was operating on dogs but working on all sorts of experimental things. what type of suture helps that? had you cut the intestines apart but then so them to gather? anybody was ever gotten off of an operating table has halsted to think for that.

he must have had the weight of that less on his shoulder to is he knew he could never resurrect a career again. one other thing that i neglected to mention that butler hospital they decided to treat him with another drug which was morphine. of the reverse. he actually became cocaine and morphine addict he used morphine on a daily basis the rest of his life and sometimes his hands are too shaky to operate or he was too stoned and you could never get a hold of him after 4:30 p.m. because he would be home and there is very good evidence to suggest to go on a cocaine binge on and off for the rest of his life but he had to live a double life literally the world's greatest surge in every

doctor in the world what does halsted say? but yet to he had us secret of a raging drug addict. those are not to parallel lives but they have problems as a result of their substance abuse. >> halsted at certain moments was shaking so much he had to ask an assistant to do so the patient up. >> he was so slow to close they said the patient 10 this to yield three hours before halsted closes the wooed. [laughter] but there was times he was those shaky but whether he was on cocaine or on days or withdraw from morphine that morning or a hung over is hard to figure out but his residence loved him because

they could operate and the chance to cut. they blamed it on his cigarette consumption. but that does not seem likely. one of the chief resident said we did not like when he stopped smoking cigarettes because we did not get as much operating room time because he was cutting down on substance abuse. he also go a while there are minutes in the archives that the trustees are saying where is halsted? he would have been fired under any other circumstance of the was anybody else but yet to whether people knew or did not know, he was unable to to continue the path for the rest of his career. >> going beyond the book you have written elsewhere on as scott fitzgerald so they

cure raises deep in the book obviously one does not want to romanticize it is purely an artifact to allow the imagination to soar but on the other hand, a lot of wonderful material that you allude to what the way in which ambition is so unsettling. for wade coming from the position had been neither many oh no. status sit-in he had something there way team to find out, not only as your work as a writer but the clinician what about ambition and talent and addiction and? >> there are many untalented

attics -- addicts. the insensitivity and an ability to tolerate pain, up perfectionism all sorts the psychic scars are risk factors. not for an addictive personality but if you meet the wrong drug at the wrong time there is scions about three to sebastian you whenever a problem with this drug we may turn on the switch in your head said tiny touch another substance it is the wheels of misfortune genetics psychic your physical trauma of the drug itself because this shooting up far more than

sniffing lowered tasting and then the addict fall short by with talent i reject the notion that drug abuse cause is great news. what these two men did stitch by stitch, in fact, i write it was in spite of the addiction that i think the true greatness comes from. there may be as part gore whenever but to carry it out to, that is work and the practicing at it cannot do that because your she is too busy taking drugs.

is cat and mouse that the addict plays a lot of talented people seem to have a lot of issues of great ambition who could become a great artist was such a difficult world unless they thought they had agreed this in them and this upsetting and angry voice to say you have not done enough. you have to do more. that you have to have that to achieve greatness. a lot of the alcoholic's i have written about. >> you go beyond the buck

and how you specify addiction with madmen not are all beijing addicts. another example 2:00 in the morning with the presentation to at 6:00 you don't have an idea and the cocaine is there to even you out how do they have that broader sense of dependency? >> if you use it hot to libya's not only consequences but if you lost control of knowing it will harm rio to still see get

out despite all the warnings , but it is a very hard they like pornography it is hard to describe it but you know, it when you see a but those who spend too much time denying it because nobody wants to say i am an alcoholic or i am a addict but if you start to utter the words in the secret part of your brain you probably have a problem. when i talk with others others, there is a problem here. surely you must admit to taking cocaine five times a day to finish your ideas are some morning until night

night, that is a problem that is not what normal birth people do. that is how i like to look at it. when you put the negative words like an addict then you get into defense of the best. denial, lying, as symptoms of addiction because you want to predict -- protect that whether alcohol or whatever you don't want anybody to interfere with your best friend. >> when perfectly prepared to believe clinical practices in art there is another question i their specific brain pathways? what can you see biochemically?

seven most interesting stuff is neurochemistry and addiction and the addiction and vaccine to form the antibody and then neural pathways because you literally -- literally change the anatomy there is a pleasure center called the limbic system is not that big of the space some of my friends the brain is not even that big but once you start three wiring you want to get more because those like cocaine pools the neurons into having large amounts of dopamine that tells us to smile on a sunny day to enjoy our spouse or

our children and it is a trojan horse because there is so much you feel positively euphoric than nothing else can match it and the wires changes and there is wonderful imaging studies to show this that the addicted brain even 10 years after recovery show recovering addicts pictures of cocaine that part of the brain lights up. you have changed the biology of that individual which is one of the many reasons that treating the disease is so difficult. a lot of the nagging in a lot of patience to make it very difficult. >> following that

description this is my last question. 24 this century has went from newspaper to everything else anew spade the interdiction and had you think of that? >> the idea of new addictions the old definition not only as substance bayou physically withdraw from you physically withdraw to the point* you could die cocaine was not considered addictive because they did not see physical withdrawal and although there is quite a bit psychologically. marijuana was not considered addictive because they did not with drawled. but you do at the much

slower period of time but that has changed now yibin behavior gambling gambling, internet, i had a medical school professor that said everything in moderation including moderation we have to be careful not to unleash the addict within because there is too much exercise. so what we try to understand is there are so many new culprits every year that we are subjected to whether a behavior or a drug and so many enemies out there looking for us. >> before i open it up is there a piece of the book he would like to mention? >> you clearly read the book

[laughter] let me just remind you because of the nature of the taping please be at liberty to go for maligned. >> two very different kinds of questions. could you say something about the halsted family life if he married zero oil what is the involvement one way or another with his addiction and? and the other question. >> i will ask you to repeat it too. >> i forgot. [laughter]

>> halsted came from a very partitioned family his mother was an old and new jersey family in his father was the york family living a very wealthy life nearby a neighbors to the roosevelt family. he was a textile merchant but on many charitable boards also a trustee of the college of physicians and surgeons that helped him to get into medical school and rarely crack day book. his mother and father seem to ignore the children and they've been in the care of a governess in his father would give fire in brimstone sermons of what he did wrong

every night and refers to his childhood as nightmarish handymen ran away at one point*. a very a cold and distant and difficult relationship. he did marry and had several close relationships that are hard to do define 100 years after the fact but he did marry the one o are nurse when she caught his eye doctors roussel still dipping their hands in the corrosive chemicals which was very caustic to the skin and developed a terrible skin rash from the fingertips to the elbows and that was the inspiration for the rubber glove. halsted went to the good year company to gave a design then the other

doctors said this could be good but to they had an on relationship. they had dinner together but never breakfast considered very god herself they went away to her family is a staged every summer and nobody knows what went on there. he did not have many close friends or dinner parties because he was so fastidious that coffee had to be ground just sell that he drove mrs. halsted crazies of it was so lonely life and particularly after the etch addiction was discovered he changed from gregarious to extremely difficult who hated to have eye contact.

medically that is fascinating if you are high on cocaine you will bullet the people's love your eyes and if you are high and more feign it makes them 10 point* and i can only speculate did anybody make eye contact? there are very smart doctors who could figure that out. >> i remember the second question. >> okay. >> when did the government first assume some responsibility for regulating individual use of drugs. >> an excellent question. i talk about this quite a bit the regulation of drugs controlled substances was not in anybody's imagination in. you could do that for many years until 1914 when there

was such an alarming epidemic of addiction that congress passed the control act of 1914 that started the bull -- ball rolling a controlled substance is. that has only been refined but even by the 1890's there is a lot of medical literature of the problem of morphine addicts on and on. it did not begin in two days until relatively late. >> by the way, i don't way to get in line. >> from the event it does relate to the last answer my

understanding is that african-american men the 18 eighties, led dock workers were given cocaine to increase their productivity in terms of working on the docks. i wonder if this came about through a conversation of drugs in the black community but to have these workers who were given 10-- cocaine to increase productivity than lear lefty addiction they unleashed on a community. did the company give them cocaine? how did it work? >> yes. of the ada giving workers

cocaine or the tea or the leaves are the bridges, many beverages were very popular one was the wind with coca leaves and marriott became the first cocaine woman on earth and the other is coca-cola but not just african-americans and dock workers but other layperson's through south america as well goes way back four days before a clunky stores giving farmworkers in migrant workers as many coca leaves as they could because that improved endurance and allowed them to tolerate high altitudes per god doesn't do anything with blood oxygen that makes you less aware and the issue of medicating your workers or

slaves to work harder to cause an enormous problem not just for those individuals but society at large. very shortsighted stuff but yes it was rather common. women and in america where more likely to become morphine addicts than men six/four were the odds because for every so-called woman's complaint from a stroll disorder from postpartum depression, a well-meaning dr. wed say here you go and they created been the at sixth that way what is called a long day's journey that is about his mother who became a morphine addict accidentally after the birth of eugene when she went in to post bardem

depression i know what to judge except the boss is on the docks but with the doctors, they were not thinking it through in did not have enough information to unwittingunwitting ly create a epidemic that we never recovered from. >> i wonder what you do with the question of what influence did 1/2 on four aids theories in terms of his work gain productivity and how much she put out and the time in which he produced them and the kind of work he produced. it is interesting to me that for '08 is a lot of psychic boundary management it is

all about compartmentalization and so low that is an intriguing question but i know in your book you seem to carefully avoided making these types of calls all arguments because they are dangerous i am sure you get the question and defame there is any value of the role of addiction in his work? >> i think there is but you could go too far. it is never 1 + 1 = two. it is always 1 + 1 = 57. there are issues than freud's life that cocaine really sparks an interesting idea that he writes about

this to his fiancee and later his wife. in paris learning about neurology he is also taking an agreed to deal of cocaine that he needs to feel more uncomfortable at the party's to say i feel so strong i could not down the gates of the temple. tried to break into academic medicine and says i could find it fascinating when i do take cocaine it unleashes ideas that i thought were locked away in my brain forever. but yet if you look at his letters, he nearly killed of that and at some point* he got the idea that this

substance is too toxic i have to come up with something else that was free association but that said freud was very compartmentalized. he had reasons to do that it was a very shameful station activity he was very career oriented but he never came to grips remarkable of the man who was so understanding and that tells me he is just like every other aspect but the notion of the inability to come to grips is something we see all the time in the world of addiction. to have been influence, to be sure, is part of his life as his background, love of books and antiquities but to have a reduction that all

ideas flow from a long line of cocaine, it is too simplistic and i don't think it is intellectually appealing. >> howard, one finger reader could get from your book is you tell the story so well that it looks like crusades own partial contributes to the theory of sublimation because it is the idea that wreaks havoc because it is primitive and basic and it is raised up to a higher level and that is what happens. >> and the interpretation of dreams the first dream is a cocaine dream of using three. his substance abuse is part of the story of trade. but i hesitate and always sorry about i had when the

patient said i am such a better writer when i am my. i said bring it and and let's go over it. i am a better driver. >> for sure. >> it may seem that way to you at the time but that is not how it works for, but there are parts of it that so many historians because it is addiction or substance abuse. the need to understand all want to write the book to understand the influence is it the only one? no. but it is part of the story. >> can you please speak to the idea of food says an addiction and that you cannot give up completely?

>> we all must eat to survive for crow you do not need to smoke, etc., etc.. a lot of study did the doctors, olivia are finding is the very similar pathways lightning of various of the brain are there but how you control that it is a very different challenge and very difficult and extra load of problems for those who suffer from it and we desperately tried to figure out and obese people. i don't have an answer but i have devolve with my own thinking that there are many things we will find out that are addictive we may not

even call it that but it causes serious problems. >> thank you very much. i am very amazed at the different disciplines you have mastered. >> that is debatable. >> i have a lot of appreciation for what you have done and this is a brilliant presentation and i am fateful to you. still steve jobs just died and the whole world is morning including my friends hidden nigeria of the have the ipod and the iphone

but one of them has said to me comment did he take dead drug when he was young and come out to say it is one of the three greatest things. have you seen that drug in the u.s.? [laughter] is it possible or even useful for those who want to be successful to goats tried drugs? if you have tried something like this did your past.

>> that is a tough question in. steve jobs, rest in peace, used lsd supposedly is not addictive but very dangerous nonetheless. for every story of zero wonderful acid trip i have heard 24 1/3 be detrimental experiences with lsd. i don't know everything are have a lock on the truth i only know what i read, see, experienced and what i treat so many more train wreck stories, wreckage of human life, i human relationships relationships, work, through substance abuse those stories that i hear don't be

much to be and certainly don't want me to recommend to anybody. that may have worked for him he may believe that and he also maybe wrong that made steven jobs steve jobs and also that made him a remarkable worker as his life was apple and i doubt he was on acid trip during much of the greatness is not exactly an experiment but from too many sad stories that to the perfect experiment this substance abuse the plight of addiction because of delays comes out bad. the results are always the same and i cannot predict

you or you will not have a problem but you'll also all of you will or won't but as a physician who wants the best for you and your health, if you don't play with that i can guarantee you will not have a problem. . .

>> do you have any feeling or opinion about the legalization of drugs? >> that's a tough one. the united states of america is the biggest consumer of illicit drugs in the world, and while marijuana is the most commonly abused substance, cocaine is number two. that doesn't begin toking the for -- to account for the legal drugs like alcohol nor account for a new epidemic of prescription drug abuse and sedatives and on and on. every time they buy a drug, they are harming many people they never see because it's a whole industry of slavery,

criminality, bloodshed, and tragedy. the guy who's senatorring a line on a football saturday, i feel good, has harmed people without knowing it or acknowledging it. legalizing drugs is a very thorny issue. prohibiting drugs is an equally thorny issue. we tried prohibition in many shapes and form in this country, not just with alcohol most famously, and in the early part of the 20th century, but also the controlling of substances as well, of narcotics as you said or cocaine or miles per marijuana, and even the places where they are legalized like the netherlands and such, it's not disney lander -- disneyland there either.

there's collateral damage. the desire to escape, to feel good, and so i think it's a much deeper social question and debate that we all have to have. americans and people around the world -- how do we want to handle this public health crisis? in a thoughtful, non-punitive, medically correct, caring way as well as a legal and social issue, and i don't think we've come even close to having that conversation. it's not a pro or con, but a lot of gray area in between. i thank you for bringing up that question, because i think we have to have all the time. >> that's great. >> so my question relates to the, like, you talked about cocaine comes out, and it's a very powerful drug, the wonder drug, and after the addiction, it's basically, my understanding is completely disappeared from

clinical use, but obviously it had really powerful qualities. my question is in your professional opinion, are there, like, appropriate applications of cocaine in a clinical setting that have been lost because of some of the misuse in the past. >> well, actually, cocaine is still used to this day as a local aesthetic by ear, nose, and throat doctors. a similar drug like novocain are synthetic versions of that that don't cause euphoria, but anyone who has been to the dentist, has cocaine to thank for that because it's the same process that was discovered and wrote about called nerve block aid, and it blocks the nerves' sensation to pain. there's wonderful versions, but to this day at the university hospital down the street, there's one ear, nose, and throat procedure where they used a liquid cocaine solution to

paint the area they were operating on, so we have not lost that, the problem isn't -- no one went into a raging cocaine fit because of anesthesia, but for other reasons, and that's the issue. it's a seductive drug, by the way. there's a wonderful experiment years ago with a group of rats that had little cages and buttons and press for pellets of morphine or heroin, and they'd get high, wake up, have water, get high again, but they lived. with the cocaine, they had to have it until they died. that goes to the trojan horse. it's such a powerful drug of fooling the brain into a euphoric sense that it wants it again and again that it's a very

dangerous substance to play with. >> regarding the legality or illegality of drugs or setting aside that, the availability of it, i can probably go within ten blocks of where we are sitting and find any drug in the world that's available. >> yeah. >> so the problem is probably as bad as it can be from a medical or societal stand point. therefore, making it legal probably wouldn't increase the number of addicts. >> no, no. >> but might do away with the social problems that are tending to it being illegal. >> yeah. >> the other thing in mind was freud analyzed himself, but never his drug use? >> no. that's a wonderful question, and that's where, in fact, i

remember having this conversation with danny, and i stole a line of his, and i put it in the book that was he was subject to the same big lie that every addict tells him or herself every day. i don't have a problem. you have a problem. i don't have a problem. he never came to terms with that. for him, the principle addiction was masturbation, which that's the only times i hear the words i love you and i believe them, but he never came to grips with what cocaine did to his relationship with his wife, with his children, the fights he had. freud was famous for loving some -- he said it in the interpretation of dreams. i often love and hate the same person, but not necessarily at the same time. really rigorous fights with his former colleagues and teachers.

on and on and on of disrupted behaviors and could never say in a moment of truth, oh, maybe i had something to do with it, maybe my substance abuse had something to do with it, and so he had all of these layers of denial and explanation to compartment -- compartmentalize that away which is death to the addict. if you can put it away and take it out in secret, that causes 5 lot of problems. here's the irony. the man known in history as the searcher for self-truth never, many my opinion, was able to dellive into that -- dellive into that -- delve into that particular truth in his life. yes, ma'am? >> i read somewhere that they observed addiction first

treating gladuaters, and they were the official doctor of the roman army. i can't remember the exact words, but said something to the effect that it was better for people to endure pain than to become addicted because -- >> he did. >> to drugs, and if you could -- do you know what drugs he was observing? >> it was probably poppy, the sap from that, which becomes opium and then becomes morphine and all the rest since then, so it was probably that. there's many doctors and observers who worried about all of these substances in realtime whether it was a first or second century ad or the 1500s or the 1700s, worried about the grip that the substances would have, but they were lone, quiet voices

in a deafening roar of let's go for it, and that was the problem. that's been the problem. >> but you said something about the use of substances by soldiers. i'm sure you're aware of the use of dolphines they were called by the nazis of the third reich. do you have knowledge of that? i just read it numerous places that the german soldiers were given an an fete mean discovered by nazi doctors. >> right, right. >> i mean, there's a widespread widespread -- i also read that that polian soldiers were given a ration of vodka. >> oh, yeah, yeah. >> there's a long standing use

of drugs for soldiers by one purpose or another. just comment on that. >> better living with chemistry has been with us for a long, long time, and the early uses of cocaine was for endure -- endurance was for soldiers in the 1700s. it's been with us for quite some time. >> hi. >> hi. >> i'm interested in the control of behavior or the influence of behavior by one's self as well as by an outsider by saying this person can obviously benefit from changing their behavior from this to this, and i'm wondering what insight you may have on effective means of doing that. >> that's a fascinating question. as a pediatrician, i wonder when you are with your children and they exhibit certain behaviors that seem somewhat potentially

problematic, my daughter's not here, so i'll tell a story about her. she's 11 years old, greatest kid in the world, very ambitious in her classwork, 6th grade, and wants all a's. now, i was that kid. i know what she's going through, but i never told her you need all a's, and i worry about that behavior because if she doesn't because sometimes she's not going to and has not, you start feeling bad about yourself, about perfectionism, to the point where you hurt cubed -- so bad that you might fall prey to something that makes you feel good. i just said that the other night. she was talking about not getting an a, and i said, you're a great kid. it doesn't matter what your agreed is, and you're going -- grade is, and you're going to be a great adult. we need to do that as parents,

adults, and mentors in ore society. you know, there's so many things in society that are deciding to bring you doubt, tear you down, and not enough to pick you up. i think that's our job as part of the community. perfectionism is chilly base we're humans. no one's perfect. i screwed up 20 times before i got here today, and i'll probably do that 20 more times. that doesn't mean i can do that all the time or use that as an alibi, but it means we have to learn how to love each other and ourselves a bit more, and that's something we're losing and have to be very careful about. >> if i could just tweak that with a sentence. part of what you're bringing up to mention that is the need to associate compulsion from addiction; right? >> yes, yes. >> especially in popular culture of america, they were thought of as the same.

>> yeah, yeah. >> they have to do obviously with this sense of internal resolve which is very difficult to stop. >> yeah, i'll beat it, i can do it, and sometimes you can't. nobody wants to hear that in their internal head or internal. i do too. we have to work on that. >> first, i just wanted a quick comment on the use of psychostimulants in the military. in world war ii, it's particularly bad in japan, not only in the military, but in war related industries to increase production leading to the drugs like cocaine, and that's still going on today. >> right. >> in the military. this is not an old story or confined to germany. >> right. >> my question has to do with the difference in sort of the time course of addiction, and my impression is freud's problem

was, in terms of the years of use was relatively time limited. >> right. >> others it was a lifelong episode or problem, and you mentioned to sort of very obliquely, there was differences in the route of administration they used. >> i don't know that i said it clearly, but -- >> there's large literature at the rate of which drugs get to the brain not only influences their acute effects, but long term effects in changing the brain and so on. >> yeah. >> might that be a factor that accounts for their natural history? >> absolutely. cocaine is a drug of abuse if you're writing about it, is that it's guaranteed, almost guaranteed, to be a dramatic story because the window from abuse to addiction to bad stuff is very small. alcoholism on the other hand, you can be using for quite some time before everything erupts,

and even opium abusers can go for some time, but the route of administration is very important. now, if i had no medical ethics and 5 lot of rope and a lot of drugs, i could make everyone in this room an addict within a week using the right substances and the right routes of administration, and foid, as i said earlier, tended to either mix a little bit in water and drink it and brushed his nose what we call today snorting or sniffing cocaine, which is, by the way, not a terribly efficient way of taking cocaine. you lose 95% of the kick, only 5% is bioavailable by snorting it. it's a very wasteful way of using your drug, and, you know, most drug addicts like most bang for their buck, and they learn

quickly not to do that. crack cocaine, smoking cocaine is a wonderfully efficient way of taking cocaine because the lungs contain a football field in area of blood vessels that the drug will transfer over and then go right to the brain, and similarly injecting it is a superb direct route to the brain, so it's, you know, the difference between, wow, and wow! , and the more you go wow! the more you go to that substance. the route is critical to how quickly your addiction progresses. that's true of those who were an injection drug users for both cocaine and for morphine. he was never able to kick it. freud probably contained it to a 12-year period. >> i want to recommend to you all this great book, "an anatomy

of addiction" by dr. and professor howard marcel. thank you for coming, and i want to thank you c-span and on behalf of the institute for humanities and the book fair, lsna, and the hatcher library, thank you, howard. >> thank you. [applause] >> for more information, visit the author's website, howardmarkel.com. >> the idea that climate change change -- when the green's used that phrase, what they want you to think is subliminally manmade climate change, and this is where we dispute it.

those on my side of the argument. catastrophic manmade climate change, if you look at the intergovernmental panel on climate change's reports over the last 20 years, the ipcc has grown increasingly shrill in its predictions about manmade climate doom, but in that period, no convincing evidence has been produced to show that human influence on climate is so significant or dangerous that we are all going to fry. on the contrary. global warming actually stopped or flattened out, you know, over ten years ago now.

we are entering a period of cooling, and i think we need to remember that if you look at human history and look at what man has done in times of cooling opposed to times of warming, society, civilization flourishes in times of warming. we are designed for warm weather. it's not that we can't cope in colder climates. weir very -- we're adaptable. there'sigloos and things like that. i'd like to live in california. it's not the political climate. it's the weather climate. it's nice and warm. we are drawn to warmer weather. warm weather solves two of our main problems -- how to heat ourselves and how to feed ourselves. in periods of warmth, you can grow things like wheat at higher

latitudes to help feed the world. the first part of my book "watermelons" covers this science of climate change, but i'm not a scientist, and that's not the part that really, really interests me about this whole debate. it's where these ideas come from. it's the sociopolitics of climate change, if you like. if the science is flawed, how come so many people believe in it? i think one reason is that i think there is built into our dna this innate catastrophe and every generation believes that somehow it will be the last, it will be the one that so shapes the world that it will destroy it through its own evil, and if

you look at religions through the ages, what it is about, what they're all about in one way or another, is atoning the sins to try to appease the gods. you know, the aztecs dealt with this by sacrificing people and sucking blood out of their hearts, their still beating hearts. in medieval times, they did it by wearing hair shirts and flat themselves, and today, they impose taxes on flights and forcing everyone to use crappy flickering light lightbulbs that give you a headache. >> watch this and other programs on booktv.org. next from burmingham, alabama.

we visited sections throughout the southeast. >> well, the fijis are a soccer team of refugee boys from 15 or more countries around the world that have experienced conflict, and they live in outside of atlanta, georgia in a little town called clarkston. they are mostly from african countries, but countries like liberia, burundi, sudan, and also in my book, there's a young boy from kosovo, from bos bosnia, from iraq, and afghanistan. they come through formal refugee resettlement programs through

the united nations, and then they are passed through the care of resettlement agencies that handle their relocation and help them get a foothold in this country, and those are organizations like the international rescue committee and other notary public-government organizations. >> how do those resettlement programs work exactly? >> basically the agencies get a stipend or get a budget for refugee families, and the government admits them and sort of hands them over to the care of these agencies and theoretically the agencies find a home for them, a place to live, try to help them with job placement, possibly language skills. there's a lot of debate about how well the agencies actually do that, but they're pretty low an resources, so there's not a lot of resources given to the

organizations resettling refugees in the country. >> what about the town of clarkston? how was it picked? >> it's an interesting town. it's a square mile, the town line, a perfect circle, and basically a little suburban town outside of atlanta with middle class family, and the train rolls through town like it did at the turn of the 19th and 20th centuries, and in the late 80s and 1990s, they began to place refugees here for three reasons. the first was because they had cheap housing, a lot of apartment complexes that were run down and had some variable apartments. the public transportation grid is important because refugee families don't have cars, and -- or the money to buy cars, and then finally, it was close to atlanta which for a long time was a big growing, booming

economy that could theoretically give the hope of employment. the process of resettlement for refugees is incredibly difficult, incredibly traumatic. they flee lives of violence, placed in a little down no one's heard of not knowing the language or culture, given 90 days of government assistance, and it's very, very difficult. i think it's especially difficult for the young people because they sense that, you know, they go to the public schools, they sense they are different, sort of outsiders in this mainstream culture. they try to adapt, start to dress like american kids, learn english, listening to american music, go home, and their parents say, you know, what are you doing? we don't dress like that or talk like that. you have to respect where we came from. they ricochet between two worlds that won't accept them for who they are. that's one thing that's

interesting about clarkston. in the apartment complexes, there's people from all these different countries that have been resettled there, neighbors can't speak to each other. they don't know each other's languages, but the children, whether or not they speak to each other in the common language, they have a game that they play in common, and that's soccer, so soccer games just sort of pop up in parking lots, in open lots around the complexes and the empty fields around town, and it's really this -- it becomes a sort of public square in a way for people from all over the world to actually interact with one another despite the fact that they seemingly have little else in common. all sorts of things are happening with the fujis. they purchased a property just outside of town to try to build a school and home for their program. there's a lot of information about that on their website, which is fujisfamily.org.

they have started a girls' team. they have a full-time school for refugee youth, so the program is expanded, and continues to impact young people in clarkston. >> how did you first hear about them? >> i heard about the fujis in a casual conversation with someone working in the resettlement. i was in atlanta giving a talk, had a conversation with a gentleman, asked what he did for a living, and he said we settle refugees for the international refugee committee, and i think as a southerner, somebody who grew up in alabama, i was immediately curious how that was going. how's it work to take people from 70 #-plus country -- 70-plus countries and put them in a relatively small southern town, and as i learned more about clarkston, i saw it as a time machine in a wayf