of all health care dollars. the author examines the obstacles that the chronically ill face, including the limits of medicine, skepticism about many illnesses, and criticism that many have diseases that could be prevented. this is about 45 minutes. [applause] >> hello. thank you all so much for being out there tonight. so much of the writing process takes place alone or in my case when the rest of the war of the sleeping. so it is really nice, at this point in the process, to be able to be out and connect with readers and see people, especially at the to greek menu. it is nice to see it kind of come full circle because when i was a graduate student i was here all the time. so it is nice to be here. so i am going to talk briefly about the book itself overall and then read to passages. then hopefully we will have some good discussion and answer

questions. so two questions i have been getting a lot lately on why this book and why now. quite simply, we cannot afford to ignore chronic illness. the estimated 1,303,000,000 patients, as you just heard, live with chronic illness. by 2025, that number is expected to reach 164 million. chronic illness is responsible for seven of every ten deaths, as well as three-quarters of all health care spending. but it is so much more than that. so much more than the statistics and the economics. chronic illness is not something -- chronic illness is not something that happened to other people. the numbers tell us it will happen to most of us were people that we love, and there are still underlying assumptions and misconceptions about it than a problematic. for example, there is still this idea that people who are sick our sector they're own fault. we can look at current examples of hiv aids or type two diabetes

to get a sense of that. in this underlying idea that people with chronic illness are somehow weaker. this is certainly amplified in the way that we treat women in pain, for example. often told that their pain is either in their heads or that they should simply plastered. this medical historian porter asserts that disease is a social development no less than a medicine that combats it. this is true centuries ago. when disease was thought to stem from an imbalance of pottery -- bodily fluids, infectious plagues were blamed on divine retribution. when people with tuberculosis were shipped off to the sanatorium or when diseases like multiple sclerosis was considered nervous or hysterical the source. we will see many instances where despite the origins of illness the ways in which society response to the not so far apart.

in the kingdom -- "in the kingdom of the sick" is a social history of chronic illness in america because i found it was impossible extricate the experiences of living once physical illness from the competing forces of culture, social norms, and technology that surrounds patients. inevitably, this became as much a social history of activism as it is a social history of disease. it was equally hard to tease out advancements and treatments and research from the patients in the advocates who fought so tirelessly for them. it is a chronological book that, for the most part, focuses on world -- post-world war two america, which was a time of irresistible progress. between antibiotics and vaccination, we had more control over acute infectious diseases. we began to think that we were just one step away from caring everything. it was at this point while we were living long enough that we were not dying from communicable disease that chronic disease

began emerging as the public health priority. as you heard in the intro, i am a lifelong patient myself. these experiences informed the writing of this book. i have a rare genetic respiratory disease, priories ciliary dyskinesia which is enough still, some people say peace cd as well as other chronic illnesses. i also teach writing for the health sciences at northeastern and chose the book's title from a susan sontag quote from an essay that i forced my freshman to read. alan @booktv on this is the men's side of life. everyone who was born holds dual citizenship in the kingdom of the well and in the kingdom of the sec. although we all prefer to use the get passport, sinner later each of us is obliged, at least for a spell, to identify ourselves as citizens of another place. so for me, writing this is a sort of blurring of all of these

different divisions and crossovers. as a health and science writer, writing instructor as well as a patient. so that is a little bit about the book in the context of that, but the first passage i will read is from chapter four, and as i mentioned, this is a chronological but that after some brief historical background picks up in the 1940's and 50's's. in the early chapters i explore a patient's right to medical ethics, and the various social justice movements of the 60's and 70's. the civil rights movement, the disability rights movement, and the women's health movement and their influence on a chronic illness and modern-day doctor/patient relationships. of all the major themes in this book, the relationship between gender and on this is, perhaps, the most compelling or resident. the shadow of hysterical elena still lingers today in it the it is all in your head mentality contributing significantly to delays in diagnosis and treatment of many chronic and autoimmune disorders, particularly in terms of chronic

pain conditions. i just talked about all of this in a robust response that continues to pour and shows just how many people are affected by this. for example, women are three times more likely to develop auto immune diseases. into and have more times more likely to develop remote arthritis. four times more likely that chronic fatigue, and nine times more likely to be diagnosed with fiber myalgia. not only of the more likely to develop pain, but there are more sensitive to it. research shows that women are more likely to have there been dismissed as emotional or psychogenic. when they are treated, it is often less aggressively than men, and women are likely to be described it -- prescribed antidepressants where men would receive painkillers for the same symptoms. most chapters in the bookstore with a more introductory narrative segment where patients experience a context for the history in the analysis to

follow. that is what i will be reading right now from chapter four. in this passage from the women's health movement in patient empowerment you will hear from molly share cornwell, a young woman with groans disease, which is an autoimmune disease of the gastrointestinal tract as well as most mclaughlin who is another young woman who suffers from chronic fatigue, fiber myalgia, and a host of, but conditions. you'll also hear from dr. sarah woodman, a psychiatrist to specializes in treating patients with chronic pain as well as dr. gerald right, an internist down the road at beth israel who has done a lot of research and writing of the early aids movement. so of the share cornwell is a 20 year-old woman living with crones disease. when she first began her diagnostic journey, she was a middle school students to my pain. she underwent a variety of tests for endoscopy is to perry and follow as x-rays hopeful that

each step with bernard closer to an answer. when the test and consultations initiated her while the test -- while the tests and consultations initiator into the world the patient had, they also signaled the start of an unfortunate but all too common cycle. dealing with the dismissal of her persistence system -- symptoms. she was told she had reflexed disease, when their problems continued, so the tension. as the years went on, dismissal took on a more problematic and, as a physical symptoms were attributed to her emotional problems. at the time my parents and our told my symptoms were caused by stress. i heard this for years right up until i was diagnosed as an adult. in fact and i have heard is so often that until last year i was convinced i was making myself sick because i could not control my life or even worse, that i was making a my symptoms for attention. this story line evokes outdated

images of emotionally raw women attended to with smelling salts and placed in darkened rooms. images that are ingrained in historical attitude toward female patients, hysterical patients. the term hysteria originates from the greek word his direct, which means move, and it was once believed that hysteria was caused by that will wondering for the body. victorian-era doctors attribute hysteria to an inbound @booktv balance between sexual organs and the brink of problems we regard today as associate with a motif of hormonal fluctuations were also prominent in the diagnosis of hysteria. the context of this victorian era belief reaches back much further in history. as we know, many of perceptions of women painted them as weaker versions of men. the monthly cycle was catalog as evidence that they were near a leaky vessels inferior to men in ways both physical and emotional .

unfortunately, this association between hormones and character is one that follows women while -- well past mitty will or even be modern times. for alysian the doubt about her symptoms chipped away at her confidence, which combined with her age and the accompanying assumption that and people are not supposed to be sick exacerbated the underlying problem. by the time she entered college, which is when she had what she no-no's was her first true slow and she was also experiencing a worsening of reflex disease. whenever i saw the university health center doctors about esophageal pain in the abdominal pain they tended to focus just on the reflex, she says. al was felt timid around doctors, particularly men, which they often work. my fears about my made up symptoms caused me a lot of anxiety when needed the checked out. usually i minimize my pain because i did not want to be perceived as whiny in the week.

a fact -- the fact that i minimized it made easier for doctors to routinely dismisses, she says. melissa, another patient with chronic fatigue and fiber manager, considers lack of confidence to have been instrumental part of her long and unproductive diagnostic journey. if i was a shy and quiet 15-year-old rider mother into every appointment, she says, originally because the brain fog may concentrating in remembering difficult. they just did not take me seriously in any way, she says. part of it and nih. being young, shy, and unsure, i had to stick up for myself. i often found that i made and implemented tears. for years it did not occur to me that i could argue with doctors' results. i was a good girl, she says, a hard-working straight a student.

i was determined to be a good patient, to do everything they tell me to do, because this was my only son of getting better. i would say was about six years into things, midway through college, i finally decided it was up to me and not up to them. something was making me worse, i could stop doing it, even if the doctors told me i should keep doing it. if i could go back, which aims at, the sense that they have all the control, not me, she says. honing in on one of the most important elements of the milk patient could, the balance of power in the doctor/patient relationships. as a psychiatrist working with men and women in pain, dr. sarah woodman reminds us that this imbalance of power and skepticism has far reaching routes. historically, when women have reported medical symptoms these are not taken as seriously as one man described plants. for example, she says our research to show that when men and women both reported

equivalent cardiac symptoms, men receive more thorough evaluation and for equivalent cardiac disease, men receive more aggressive and definitive treatment. solomon reporting pain may be more likely to be dismissed or have her symptoms downplayed. there are some medical illnesses that are unique to women, she adds. for example, pelvic pain disorders are significantly under searched and can be difficult to find the issues with the proper retraining in clinical experience to treat them. the lack of training in clinical experience perpetuate the cycle. if women are not diagnosed correctly because of their physicians don't know what to look for, the symptoms worsen, which can have profound emotional effects as well. from there it is not a huge leap to write their pain are symptoms off as hysterical or psychogenic . when thinking about the

challenging and often unsatisfactory experiences that patients have had with physicians, dr. joe writes, he is part of it as the process is struggling with the power relationship that happens will begin to doctors. from the perspective of patients , they feel that i have social power until i walked into this room. we see positions we are sick and vulnerable, and their assessment of what is wrong with us has the potential to validate or denigrate our experiences. activists have questioned the dynamics of what happens in and examine. there is a real tension about what we want from our doctors and for medicine the doctor says. it is very hard for people to just generally make that individual experience political. it is what people with disabilities did. is what feminist it. is of people with aids did when each of those sets of people revised their relationships with their doctors.

putting individual experience into a broader context and enabling change to happen. and then the second passage that i am going to read from should scare us a little bit. it is in chapter seven which is actually pretty much modern-day in terms of chronology. and it looks at technology and social media. so, we can look at the influence of research, and we can look at better treatment and more refined surgical methods and the diagnostics. all of these have yielded significant increment -- incremental break used for patients of chronic illness, but we cannot overlook the importance and impact of the internet and what i call health two. zero technology which is really any social meal or internet platform that allows patients to connect with each other and as well connect with health care providers in exchange health information. patients blog and connect with each other that way. they share experiences and

advice. they access and share resurge. they advocate, and more and more being able to share information immediately and have it spread by early sets up a division between the old guard of established medicine, which moves at a much slower and inevitably slow pace car research and publication verses the new guard of social media. you can imagine if you were the cdc and your working tirelessly to combat the association between vaccines and optimism and to bring about the evidence based medicine to prove that there is no link. you can imagine trying to compete with jenny mccarthy, who is the new guard. so that is the challenge that we face in terms of accessing and sort of sifting through what is good information and what is bad. so this exit is from chapter seven, as i said, which is called into the fray, and it deals with patience and the digital age. terms of the larger historical scope of the book, as i

mentioned, we started right in post-world war to america. irresistible progress era where we have a little bit hubris of medical science and really did believe that it was on the cost of -- cost of caring everything. it was the gold standard and what tell us all we needed to know to feel better. now there is a really compelling pendulums would -- shift. if you concerned patients circles the science itself and the integrity of the science itself is what is being questioned. in this chapter i examine priceline disease and autism within the context of how social me in the internet have altered the course of advocacy. and what these examples illustrate in terms of a larger complexities of present day on this. so, as you can imagine, chronic lyme and on his arm of very complex topics. books and books have been written about each of them, so i really do try to keep a narrow focus in this chapter and look at how the internet and social media has changed this and what we see this same trajectory, you know, two decades ago without these tt the story is a

work. so the following chapter, chapter eight looks at the e-patient movement. and they are empowered to make cook, enabled, and engaged. but to satori medicine. as an aspirational model for working for change and collaboration with in the medical system. that is really how individuals can be more informed of consumers and advocate for themselves. sometimes to work outside of the medical system. subchapter aid is within madison, and chapter seven is sort of how these groups have had to work around it. so in this passage you will hear from jennifer crystal who is actually here at emerson now. she could not be here tonight because he is in class, but she is a writer working on a book about lyme disease, and she has suffered from chronic lyme for years. so this is a little bit of her

story and how it fits into this greater historical scope. for jennifer kristol, a 33 year-old woman living with lyme disease and two of its go infections, life changed dramatically with one tiny tick bite in the summer of 1997. theick season right now. that's really relevant, right? it was a summer or for her sophomore year at middlebury college and she was working in a camp in maine. i remember the day and everything changed the summer camp, she says. i came into the dining hall after a long morning of life guarding, driving his debug and chasing campers around in the sun. suddenly the room started this been. i got dizzy and shaky and my hands were climbing. everything seemed very far away, as if i were looking through a tunnel. they can't nurses immediately suspected dehydration, when they heard how well i have been hiding all day, they realized there was having a low blood

sugar reaction. that episode was the first of many commands in ahead diagnoses of hypoglycemia. i had never heard of it. it did not make any sense to me or j any of my doctors, why would suddenly develop it, but no one seemed overly concerned with finding the answer, she says. it would be years before crystal entered doctors would tracer symptoms back to that summer and to a tick bite him about as it turns out, that is not at all unusual when it comes to lyme disease. the controversy surrounding the diagnosis of chronic lyme and the schism that has caused to the patients to say they have it and the factions of the medical community who disagree with the diagnosis, the sense and the treatment represents what is now a well-established pattern run becomes a chronic illness. patients report symptoms that are hard to explain and a space opens up for questions and skepticism. the tinting answer is to let

science clear up this confusion for us. since unlike many of its contemporary illnesses there is quantifiable evidence of lyme disease, except when there isn't . as an infectious disease, line is more common in hiv aids and in its own rate, is as politically mired. it is the most common vector-borne illness in the country, meeting transmitted through bite. in between 1992 and 2006, reported cases of lyme disease more than doubled topping in almost 250,000. according to some estimates, up to 20,000 new cases are reported annually. although many patients and experts think the numbers are actually much higher, since line is often mistaken for chronic fatigue, fiber myalgia, rummage or arthritis, multiple sclerosis, and so on. the politics, patients' advocacy community which adapted quickly to the social media million and

its challenges to evidence-based medicine all make crime a revealing portrait in present-day illness. along with highly debated topics like the association between optimism and vaccines, these medical dramas have played out on line in real time for much of the past decade. comments and postings often complementing of replacing all together the protests of decades past. in the case of chronic lyme and other conditions, it is not so much that the research is just emerging. instead, often their research exists but is the strength of the science of self that is an issue. technology helps fuel criticism and analysis for better and for worse. in the 21st century, mobilization and protests often take place virtually. technology unites people with like minds and light causes. the rapid, a dramatic shift to a digital world has influence talent where we work, how we

spend our leisure time, and how we transform bought into action. consider the arabs bring movement. by of -- help the movement spread the message and helped the outside world data was going on . while digital advocacy has not turned the virtual collaboration in to enter person protest in the dramatic ways that the arabs bring example shows, it is still had an enormous influence on changing how we find, use, and spread information. for example, 80 percent of internet users, keep in mind about three-quarters of all u.s. adults are users, have surged on line from information on any f-15 health

topics such as a specific disease or a specific treatment. and 34 percent of internet users have utilized blocks, websites demand online youth groups to read commentary about other people's health experiences. as currently controversies over diseases like chronic lyme illustrate, we have come a long way from the may 20th century hubris' over medical sciences give ability. instead of believing medicine and science can and will conquer most of what ails us, many of us are questioning in. in turn, these same patients and advocates face increasing scrutiny. now virtual collaboration and defamation sharing offer patients and groups many benefits, but the flip side of this mobilization comes with the condition. the message must be accurate and the information reliable. think you. [applause]

hopefully you guys have some questions. we have some time for questions at the end. if anyone has any. yes. the you have a question? >> do you really believe that man a medically started and women? >> that is a great question. i don't believe that there medically stronger. i believe -- [inaudible] >> the question was to mundelein believe that man a medically stronger, right? is that you said? >> yes. >> i believe that there physiologically different. i believe that our bodies are made differently, certainly, and that influences how medicines work, how the diseases that we get an that influences how people perceive us. but i don't think that there medically stronger. i just think that we have different needs and different problems. good question. very brave. other questions?

>> at think he made very clear the difficulty of having these types of disease is diagnosed. i am interested in, since you're a person who has won, what is the day to day like if you are chronically, consistently not feeling well. >> well, that is such a good question, and that thing that i should preface that by saying that the question was actually what is it like day-to-day to live with something that is not telling awake. personally, my philosophy is that the universal of the illness in ads as far more than busy specifics the vinous. so if you're not feeling well because you have pain, you're not feeling well because, you know, you have overwhelming fatigue. you're not feeling well because, you know, you're a diabetic and your blood sugar is out of control. the larger point is that you're not feeling well and are not able to participate in life the same way, i think what makes chronic illness challenging is

that it is this brave face where some days you're well or maybe more well and other days you are not all, and i think from a societal standpoint that is hard to understand. how can you look okay today? you don't look sick. i mean, that is a big line that people who are chronically ill gate. you don't look sick. that is part of the challenge, and i think that it is just a question of negotiation, i think. you learn early on when you have a chronic illness that you need to make choices. you're not going to have the same energy or the same endurance and stamina, so you have to pick and choose what is going to get the best from your reading. you know, some things have to slide. but i think it is the waxing and waning that is actually more difficult because most people, fortunately i hope, and not miserable every day every minute of every day and once you get that tasted feeling better it is harder to adjust to falling back down again. other questions?

yes. >> in what ways can you put the medical facilities promoting the use of technology in improving the patient experience and medicine overall? >> that is a great question. is about how all medical facility, utilizing technology from our research standpoint are from a social media -- >> the doctor patient and research. either way. >> i think that there is a really good move in right now for collaborative care, and there is actually a rallying cry in the desperation move in right now to let patients helped. there is an increase understanding of the need for collaboration so that the patient is the best narrator of his or her symptoms and that think you're seeing more of that. you're seeing more engagement, you know, institutionally. the cdc, for example, has a pretty active twitter feet. hospitals are live tweeting surgery's. it is a good example of this

emerging interface where they do want to connect and they do want to share their research. u.s. seeing a lot more actual research articles are accessible on line quicker instead of waiting months and months. soak the democratization of that information is huge. absolutely. i saw another hand. >> kind of the same point above the collaborative care model, but have you learned anything about any differences and training of physicians or nurses are any schools that are taking on a more collaborative approach in the training of their care providers? >> that is actually another really great question. i think we are seeing a lot more , and this is on the patient voice. you know, you can look at columbia university, for example, really well established programn era of massive -- madison, having all their medical students read patient stories and write their own stories because there really

backs of the belief that if you can empathize with suffering you will be a better provider and will be able to get more from your patience. that is one example. you know, if we look at complementary alternative medicine, which millions of americans use, but only 60, 61 percent admit to their doctors that the use, there has been a big surge in medical schools that are training people to -- physicians to understand, even if there is evidence based madison, it would like to be to ignore laws of the patients are doing it, so we should talk about it. adding social media training in general, the way that patients use that is on the rise, and there's actually a really great but it was just published. it was all about how physicians and health care providers can use social media for better patient care. actually it was just discussed. so just published a new book about that. so i think there is a lot more understanding of the need for

the patient voice and for collaboration. i think we are seeing it in mainstream media more, and that is a good thing because it does trickle down. so if you look at the column in the new york times, the patient column, that is usually about bringing in the patient voice, so there is also a lot more riding from the frontlines, as it were, and so i think any time there is a great nursing anthology that just came out, and i wish i could think of the name of it, but we're having people talk about the stories and empathy. trickle-down because fundamentally what it is is about respect. it is respecting what both parties bring. the medical and physiological expertise plus the experience of your symptoms. any other questions? yes. >> to many people with chronic illness experienced depression? >> yes. yes. it is -- it is called bitmaps of

elite. nothing the rates are higher in the sort of -- what they're calling neglected pain disorders. particularly for women because if you don't know what is wrong with you and the people who don't believe you and are not working because you're sick in bed and people are telling you you're crazy, you will be depressed. it is a vicious cycle and is actually something else was just writing about the other day. there is going to be a new diagnosis in the ds in b5 which is the diagnosis manual for mental health. and the new diagnosis is going to be semantics condemn this order are basically if you're a patient to have at least one physical symptom for six months coupled with what they consider heightened anxiety or hyper focused on his symptoms are hyper -- categorize as much on this. there are people have depression

that often it is as a result of their and treated emesis. yes. question in the back. >> illness is usually associated not only with mental disorder but not logical disorder. hal is a separated in this society, neurological disorders, affecting chronic illness, mental illness. diane neurologist, when you go, mental diagnoses, which -- how it works. >> the question is about sort of the distinction between neurological disorders and mental on this. i think that is -- i mean, that is a really tough one to navigate. i think -- you know, i think there are many and neurological disorders the present with similar symptoms, so if all goes

back to, are you getting the appropriate diagnosis early enough to get a break here, working with people who are committed to finding a what is really wrong with you. and in the challenges, if we're talking about the stigma that exists with physical illness, the stigma is even greater. so i think that that muddies the water little bit. >> following upon the last went to jamaica my that people are going to be prioritized as having mental illness, but since there not being taken seriously, how does that beneficial? of them more likely to seek treatment if they have a diagnosis? >> if they have a diagnosis of -- >> of like a mental illness. someone sang have been six -- 646 wants, focusing on it and am hyper aware of it, you're saying the dsm is going to have a category for that saying that you might have some sort of mental on this. who does that benefit? >> well, no one really. i mean, i think it was well-intentioned, the boy behind

it, and i spoke to a lot of the people who were on the committee that did the dsm before and actually are very critical of this particular manifestation. and the point was to try to catch the people who need mental health intervention, but the problem is, the application of it, i mean, millions of americans. i think it is up to 7 percent of the population stands to be potentially misapplied with this diagnosis. so it is -- it is contentious, certainly commend the thing that there is a lot. for women who are already told, it is just kind of a nightmare. >> exactly. >> the health coverage. >> welcome made could be exempt they could get, they now have a pre-existing condition that is diagnosed, that can also cause problems. conversely it could also increase the stigma and the workplace and employment if they're diagnosed as having a mental illness. a different kind of stigma, certainly, but -- is?

>> it seems like their is a risk with a new diagnosis of people with serious illnesses being misdiagnosed as having a mental illness. has there been any research on that the you are aware of how many people would fall into -- who would have something like ms are disease or diabetes might fall into. >> that is a good question. is there any research that could show the potential danger of this classification to make there has been one field study so far. it has shown -- i think it was -- i forget the exact statistics. think it was 7 percent of the population his stand seeing this classified. however, then that study patients with eyebrow myalgia, heart disease, and cancer or actually captured as having mental illness instead of physical conditions. so that is -- and there was one study, and have a link for in the article i wrote, but the

exact breakdown of that i cannot remember. those were the three conditions that were missed and that word -- these patients were all told that there are mentally ill, not physically ill. yes? >> how would that affect conditions that are so difficult to diagnose like chronic fatigue ? ammine committee could suffer from chronic fatigue for a long time before being really diagnose appropriately. and even like fibroma alza and lime disease if the doctor is not on top of it. so you could have that for a year, two years. it might fall into that. >> and that thing goes to the patients to are at the greatest risk, absolutely. there are already hard to diagnose, already lacking diagnostic material and lab work that can give you the answers, so they are already predisposed to not be taken at face value. they are sort of not responsible narrators of their pain anyway.

so there at the greatest risk. >> right now, what is the best way to diagnose lyme disease? a special blood test? >> that is actually not in answer. there is a blood test for it. the western blot. but what many patients say and advocacy groups say is that the standards for that test are not as complete and thorough as the need be, so it misses a lot of people who have it perry posted a lot of people don't get tested because you don't always get the bull's-eye rash. so there is this very characteristic rash that signals line disease, but many people don't get it, and the symptoms are survivors that, you know, you have sort of a warm joint are a key or tired. that could be a lot of things. so it is very complicated, and there is a lot of internal conflict of interest, things that are being tossed around in terms of product line and the parameters of the testing.

it is actually very controversial to treat chronic lyme because the standard line of treatment for chronic lyme is long term i've the antibiotic therapy, which is expensive and comes with its own risks and drawbacks. so there are many people who will not treat or who are conversely in danger of losing their medical licenses for long-term ivy treatment in patients. so very contentious. absolutely. any other questions? okay. thank you all so much for coming out. it is great to see you. [applause] >> for more information visit the authors website. laurie edwards writer dot com. >> what fascinates me about the situation in afghanistan in '78 and '79 was just how different it was from what we face today.

many things are radically different. there are no radical leftist parties or secular parties in afghanistan today. that has all been pretty much wiped out, but in the 1970's those are really the powerful forces in afghanistan. the president, much of the 1970's was a secularist modernizer not unlike the shot of a round, and he was replaced by the afghan communists who began trying to remodel society according to their own utopian design. and they very quickly ran aground with that. the whole country rose up against them, and that is why the soviets had to come in. what is amazing is the way that that invasion and the almost on ending civil war that has followed compounded by the u.s. intervention in 2001 and after has completely wiped out that old afghanistan that we saw in the 60's and 70's that was

really the radically different. >> revolutionary is on call market revolutions, the pope visits poland, and cracks start to appear in communist countries. christian carillon 1979, sunday at 9:00 on after words, part of book tv this weekend on c-span2. >> i right. i stopped the first night in new york with richard miles, my first stop. he very kindly came to the plane and took me off. he took me to stay with married reduce mother. as she had this fantastic house in new york. she took me in my first night. i had flown 17 hours across midlantic. it was on a jet, a fixed-wing plane. we ran out of food, of course. and i believe, you know, little children. spend the night at an extraordinary house and then she put me on a plane

to minnesota, and i had not even looked at a map. and did not know where minnesota was. i had no idea. i was just flying west. my father, when he put me on the plane in london and handed me a bottle of brandy. he was crying. tears pouring down his face when he put me on the plane. he gave me this bottle. what was the brandy for? of course when i get to minnesota, 6 feet of snow and i had two babies, i knew what the bottle of brandy was for. [laughter] that was a great experience because i immediately -- we had this wonderful little prefab house the the tennant provided, and spy has been said to me you can't do that. and i said to my have never slept in a when it -- with a window close to my life. the whole thing froze up. they had to come unfreeze them. and then we had a wonderful, very, very different, but i was trying.

people were exchanging to in a fish casseroles. i had never seen to an official or casseroles. i was doing my best. and the -- the friend of mine, a psychiatrist in alice in california. gni were laughing about the of the day because we had these wonderful houses. working in a vacuum. you know, that. it was not an easy -- not an easy life, but it was all right. the first night debt it took me to the pity would lead to buy food. of course in england we had no food. the winter of 46 had been simply terrible, and there was nothing in the shops. you could not buy anything, and i got into the big league with lee and i was completely overcome with all the food. i could not cope with all the packaged food. i'd never seen a can and chicken packed up like that, you know, just running around in england.

[laughter] i had no idea what to buy. and it the woman who was then a pediatrician said, well, you must break the carrots. the man next door was a texan. he wanted to take me fishing. this is the language story. and so as i was leaving his house i turned to him and said, will you knocked me -- would be about five in the morning. he said, there is nothing else rather do. i had no idea when i had said. but the language was really quite funny. he put a call. are you through. the woman hangs up and it. ♪ to ameritrade mes are connected. it is a completely different language. >> you can watch this and other

programs online at booktv.org. now on that book tv, steven harper -- stephen harper, adjunct professor argues that the law profession is in need of reform. mr. harper argues that there is an over abundance of lawyers and reports that, according to estimates by the bureau of labor statistics, 45,000 law students graduate each year, and 73,600 legal jobs will be created this decade. this is about an hour. >> it turns out that lawyers -- by the way, what i am going to do is talk from between yourself minutes. i'll stop center if you start nodding off, and then what i hope happens is that fai