will air live on booktv. let us know about back fairs and festivals in your area and we'll be happy to add them to our list. you're watching booktv on c-span2. with top nonfiction books and authors a weekend. booktv, television for serious readers. >> host: the name of the book is "of empires and citizens: proamerican democracy or no democracy at all? " amaney jamal prefer at princeton is the author. professor jamal, let's start with the question that you ask on the back of this book, which is why has democracy been slow in the middle east and the arab world. >> guest: the book tackles this question head on, and what i do in the book is try to take on a lot of the both academic explanations why we haven't seen democracy in the region as well

as the more popular explanations about why we haven't seen democracy in the middle east. so let's start with the popular explanation. often times people say that there's something unique about the religion of islam or the culture of islam that has prevented true democracy in the region. so this is something that i engage with seriously in the book and first of all i argue well probably some truth to that but let's look at the empirical record. look at the number of muslim countries worldwide inside the middle east and outside the middle east easily you can say about 60% of those countries have democracy or transitioned towards democracy. so, -- >> host: i just want to say, an example. >> guest: well turkey is considered a democracy indonesia, all muslim majority countries. the problem is when we look at countries the arab world. there seems to be this strong correlation between authoritarianism or lack of

democracy, and arab muslim countries. why is it that the arar muslim countries have not democratized. so there's probably something unique about the arar world. then we say, what is going on here? why haven't the countries in the arab world dem mock triesed as other countries have late lattin america, africa former soviet union, eastern europe, those country, although they're still liberalizing about they're making significant incremental gains towards something that was better than the authoritarian stalemate. so then we start breaking down the key explanations that pertain to the arab world, and those center around two explanations. again, there's the culture of islam argument or the culture of authoritarianism argue. and then there's the political economy argument. with the political economy argue.

it's most salient, which is basically arguing that where you have oil resources or resource minerals like in many countries in the arab world and the gulf region, those resources have benefited authoritarian regimes to solidify their role and basically redistribute resources in ways that undermines a democratic social contract, if you may. so in other words, now citizens are getting very generous benefits from the regime but in exchange they're not betting democratic opening. so there's this implicit, if you may, social contract, political contract between regimes and citizens that instead of exercising voice we will give you resources but you don't have to exercise voice to attain the resources. unlike the western democratic experience where citizens that mobilize to make demands to expand the franchise and to expand redistribution and whatnot. so in the book i can see to

this. i say perhaps it explains some of the author tarean durability but not all of it. even in the gulf countries where we have a lot of oil resources, there's variation in the levels of authoritarian jim, kuwait is far more democratic than let's say, saudi arabia, so we need to also understand and be able to explain that variation. so what i do, peter in the book is i look at a variety of cases where i want too understand why, again, we have this authoritarian stalemate, and what i argue is that in countries in the arab world, that are imbedded in these hegemonic, patron-client relationships with outside actors that play the role of the patron, these countries are countries where you're least likely to fine democracy. what does this mean? it means that a lot of the countries where we see the least

democracy are the strongest allies to the united states. and so this is perplexing. everybody thinks where the u.s. is involved is we we should see more democracy. however, if you look at the u.s. geostrategic relationship with the arab world our relationship has privileged geostrategic interests, which translates into above and beyond democracy, and we know democracy can be very unstable and induce instability. so we haven't -- we the united states, have preferred stability and have prioritized stability over democracyization, and i show this throughout the book and i capture it with case studies and attitudes and things of that sort about what citizens think about this relationship between the u.s. and the regime, and here's the tricky issue, where here's where i introduce a little nuance into a debate that has been very much sort of

exaggerated as, oh, you have the u.s. and you have the arab or muslim world, and arab and muslim don't like the u.s. and the u.s. doesn't like the arab muslim world. so you have this conflicting relationship, but a love-hate relationship where the u.s. needs the arar polled the arab needs the u.s. i say, no no, no, this is much nor nuanced and dynamic relationship between the u.s. and arab countries and arab citizens. it's not lost on the ordinary citizen that in order for these countries -- if you look at the arab world today, they probably enjoy even despite all the oil wealth on average, you see negative growth rate oar at least very minimal growth rate in terms of a economic development. you have huge and dire economic problems. when we look at the arab spring and what were the factors inducing or shaping the arab spring and the grievances underlying the arab spring and protests, most of the grievances were economic.

citizens cannot find adequate jobs especially the youth sector. the youth sector that is educated and looking for a better life, better opportunities, is not finding adequate employment. so they were on the streets protesting in egypt in tunisia, in jordan and other countries and they want better economic opportunities. it's not lost on this generation of citizens that want better economic opportunities that their economies need to be globally integrated into the world scale. right? so where economies are better integrated into the world scale where you have trade, foreign direct investment, corporations, multinational corporations coming in and investing in countries, you're creating economic and employment opportunities. citizens although they may not like the united states or don't like or appreciate the u.s. policies in the region, they do see the geostrategic you tilt utility and benefit from having closure relationships with the united states. so citizens are looking to the

united states, and what the united states is signaling in terms of figuring out whether or not the way they engage their regimes or contest their regimes oar demand regime change, whether this is going to be beneficial or not for the u.s. geostrategic interests. does that make sense peter? is it a bit complicated? it is complicated. in other words, you take a country like egypt, right? and you had an overthrow the egypt which led to the compile of -- you had a debate. you a had mohammed morsi electioned by a democratic majority, slightly so, and then a debate ensues about whether or not the muslim brotherhood of egypt is going to be beneficial not only to egyptians but if you look at the debate, even to the united states. it was a debate about whether the muslim brotherhood can be a

actor, a movement that the u.s. can trust, that the u.s. can work with that the u.s. can establish a geostrategic relationship. furthermore, the conversation also was expanded to and whether or not mohammed morsi could play egypt's instrumental roll in the region could they maintain the piece treaty with israel could morsesive and the muslim brotherhood continue their regional influence as they did under mobarac and it wasn't lost that this debate was unfolding and people were worried whether morsi could honor agreements peace grandmas, trade agreements, economic agreements, military agreements with the united states. right? so the idea is that people weren't necessarily only assessing assessing the morsi government against its own domestic record

all right they adjusted the tax rate or were expanding employment opportunities. these were issues but the international dimension of this and the regional dimension of this, while looking at the u.s. geostrategic preference, also played into that assessment. so the argument in the book is that where the u.s. is more deeply imbedded in the arar polled, whether in jordan, egypt, saudi arabia, the palestinian national authority today, the gulf countries, all of these countries where the u.s. is playing an important role citizens are going to look at the united states and where they might believe that their opposition movements are not going to be pro american or not going to have close relationship is with the u.s., it's in those countries where you might see a less push for democracy. >> host: something else i took from the book, in a sense did the u.s. write off tunisia and

egypt and allow the arab spring to happen? is that a fair statement at all? sunny think the arab spring took the united states by surprise. i don't think anybody in middle east academic circles or policy circles predicted the arab spring was happening. i think everybody regular -- every regime oar administration in the u.s. was banking on stability. i think we in the middle east establishment became very comfortable talking about authoritarian durability of the middle east. we were all taken by surprise. once the arar spring unfolded, you think a driven like tunisia where the u.s. doesn't have a very strong relationship you see the debate there about ali's compile, were not mired with this debate about what will the opposition look like in tunisia. right? what will a future tunisian

government, led by the muslim brotherhood or any other political movement what will that look like? i think we were far more concerned about what was going to happen in egypt. if mubarak steps down who will replace mubarak? if the muslim brotherload -- immediately the debate shifted to, will the military stay intact in egypt and will we still have those close relationships with the military in egypt in will the united states have close relations with the military, and the second debate that ensued was will the muslim brotherhood win the election, and a lot of peel argued in the early days of the arab spring there's no way the muslim brotherhood will win elections. that was the implicit consensus. when the muslim brotherhood did in fact win the election the debate shifted to, can the muslim brotherhood play the role of what we the united states have comfortably believed our

egyptian allies and counterparts should play in the region? and there's a wheel history. the military history the treaty with israel is important, the regional role that egypt plays, the regional role that egypt plays vis-a-vis other neighbors. so the debate can morsi uphold agreements in ways that will make the u.s. comfortable. i believe that the u.s. generally tries to give the morsi government the benefit of the doubt, but the fact that when we military coup did happen in the egypt, the u.s. more or less sided on the side of the coup, sort of indicates maybe it wasn't as comfortable with the muslim brotherhood and the morsi government as we thought they were. >> host: amaney jamal, the u.s. policy has been to push democracy in iraq. is it successful? is it -- what's the result? >> guest: the result unfortunately has not been

successful. in many ways if you look at the problems right now in iraq in syria, especially we isis, a lot of scholars and academics place it back to what happened with the u.s. invasion of iraq especially with the u.s. privileging a shia majority government while not taking into account sunni grievances in iraq, gave and fueled movements like isis that mobilized on this kind of like sunni consciousness, this sunni sectarianism gave those movements fuel. so it's really quite unfortunate and i think until we can resolve what is going on with isis right now, isil and syria, and in iraq the future of democracy in iraq is still very much questionable and debatable. >> host: syria, jordan saudi arabia nondemocracies. is democracy in your view, a

laudible goal? >> guest: i think -- >> host: in those countries. >> guest: if we look at public opinion in the arab world look at the grievance structure in the arab world there's two things going on. one is the dire economic circumstances for many citizens in these regions. again, the region as a whole is on average above the median gdp in the world. there is wealth in the region but the wealth is not equal live distributed. it's concentrated in the gulf. there's a lot of poverty, a lot of unemployment, and this is a huge source of grievance. when we have these type of grievance structure, it's going to fuel instability. so, if you're the united states, you're looking at this -- if -- the united states is saying, we have a crisis in syria and iraq. we have a sectarian regression in many arab countries. we certainly don't want to destabilize the region right now anymore. you have the ongoing tensions with iran and hezbollah and

lebanon fueled in this area of conflict so people want stability. when you think to look at the average citizen on the street in the arab world, that citizen wants economic opportunities once political opportunities as well. so that citizen would benefit from democracy, but is also cognitive of the fact that democracy might mean regime change and regime change means unstable and instability might even alienating whatever go relationship you might have now with storm actors especially the united states. so i think right enough if we go in and ask people about how to assess this situation, given the fact of what has happened where egypt is considered unsuccessful, as a democracy, where yemen is falling apart, libways a failed state. syria is in a civil war that can least for a at least five to seven more years at least. then you have isis. the average arab citizen is saying things are really lousy and as long as my country is

holding it together i'd rather sort of like just watch and see what happens rather than push for more democracy right now. it's not because the average citizen doesn't appreciate or respect democracy. i think they're worried about what democracy might mean. it might mean instability internally oar might mean external alienation from outside, and this is the region that can't afford either of those option jazz professor, one of the countries you looked at in "of empires empires and citizens" was morocco. seems to be some relative stability there. is it because of geographical location, et cetera? >> guest: i think in morocco you have had basically a king that has realized there were a lot of tensions, a lot of grievances in morocco, so he expanded gradually in terms of allowing for some political reform, trying to economically reform the country, although we haven't

seen the positive gains coming out of that so the grievance structure is still very -- there are lot of grievances still underlying morocco but nevertheless morocco is stable, and citizens are look at the stability sass an asset. morocco has good relations with the europeans and with the americans. nobody wants to rock that stability and open up feign -- if there's regime change wilt be a more islamist leaning government to pour and will that government alienate in the monarchy when the man no, okay is in dire need of strong economic ties with europe and the u.s. i don't anybody is willing to push the envelope further. >> host: is the u.s. all the elephant in the room in the middle east? >> guest: i get this question quite a lot. it is. the u.s. figures in a lot of conversations and debates. as does europe to a lefter extent, but the u.s. is certainly dominant and it's

not -- i think where there is a little misconception, it's not that everybody is focused or obsessed with eunited states when they talk about the u.s. role in the region but if you look at the u.s. role in the region, since the cold war, u.s. is more economically entrenched in in the middle east more militarily entrenched in the middle east than it has ever been and all the talk about us leaving the middle east or the u.s. leaving the middle east the u.s. is still very much on the ground in the middle east both militarily and economically so the u.s. is entrench fed the middle east as well into what's your background. >> guest: my background, i'm an arab american. i was born and raise nets the u.s. but my parents immigranted from palestine. >> host: where were you raised? where did grew to could. >> guest: i was ratessed in the united states and also grew up on the west bank. i finished high school on the west bank. >> host: where did you good to college. >> guest: i went to college --

graduated ucla, my undergreat what, and then grad waited the university of michigan for my ph.d. >> host: how long haveow been at princeton and that do you teach. >> guest: this ills now my 13th year at princeton. i teach politics of the middle east. >> host: and when students come in what do you hope they take out of that class? >> guest: so, it's really funny. on average i get a -- the majority of my students really know very little about the middle east and they want to learn about the middle east. so my primary goal is to teach about the politics of the middle east. i often get other students students who come in who think that okay, as you know, middle east politics is a very -- can be a very pollarrizing field so i'll get students with very determined and set viewpoints about the conflict. they'll come in to see whether or not i'm going to reinforce that viewpoint or i'm going to argue against their viewpoint.

and that's not what we do in my class. my class is designed as a learning experience and i have a really nice exercise, actually in the class, especially for the students who come in with very solid or very hardened viewpoints about the middle east. we do a gee bait, an exercise where the students participate in a debate and i ask the stunts what side of the debate they want to argue and once they assign themselves to a particular side or particular issue, then i ask all the students to switch roles so that you end up having to argue and debate the side you didn't sign up to debate and that has proven to be an extremely educational experience. and i'm really happy. the students come out with a much more deeper appreciation for not only the nuance and the politics of the region but appreciation for conflicting viewpoints if you may. >> host: professor, as we're

speaking here, benjamin netanyahu is speaking to the u.s. congress in washington. we often hear from our callers on c-span that israel is the cause of so much of the conflict in the middle east. do you agree with that? >> guest: i think to say that all the problems in the middle east can be attributed to israel is also like -- a grow grotesque overstatement of the dynamics underlying the politics of the region. there's a resource wealth issue u.s. policies and strategic interests in the region and the way they manifested into actual policies you have this extremist problem with isis to say it's all israel no; having said that the ongoing israeli occupation of the west bank and gaza in my opinion, especially the west bank has not helped move the middle east forward. and so the occupation on its own is an issue nat i think -- well,

now needs to be addressed. and it's leaving -- leaving it as it is without any clear road map where the conflict is going i think is not helping the region it's not helping the united states in the region. it's not helping move the region forward. >> host: who designed the book jacket and what are you trying to convey here. >> guest: so, the book jacket was designed with my colleagues here at princeton university press, and what we were trying to convey is that you have a strong military u.s. presence in the middle east. >> host: and the jets at the top? >> guest: that's the military presence. that's the u.s. >> host: that's the u.s. all right. so, back to the book. in summary, "of empires and citizens" somebody picks this up what do you want them to learn? sunny want.

>> guest: i want them to learn there's much more going on in terms of middle east politics than what you're going to see onen -- a clip from fox news for example. this book tries to capture a lot of debates and a lot of arguments, bring it together in a nuanced way to say look, here is how all these factors play out. domestic factors religious factors, reile factors international factors, and brings it together in a way to explain why we see authoritarian durability and we we possibly will see more democratic evolution. so that is what the book hopes to accomplish. i think it does accomplish that. and it really nuances our understanding what is going on in the region. >> host: amaney jamal, princeton politics professor and here is her book. this is back to on c-span chance.

>> the author of princeton university professor keith wailoo. how do you write a political history of pain. >> guest: that's a wonderful question. so, my background into the hoyt of medicine and i've always been perplexed by the fact that we have such a hard time treating people in chronic pain in america. that is to say debates about whether too much medication promotes drug addiction how to measure pain, not something that is easy, but what i realized is a started to do the research on why this area of medicine has been controversial is how it intersects with deep and divisive issues in american society. about how you measure pain. how too you decide who is in pain and who is not. the story really becomes highly politicized way before the 19 --

today it becomes politicize nets '50s when we establish a disable provision in social security in 1956. eisenhower era. and the question before physicians is, okay, we know what a disable looks like but is pain a disability? is chronic pain something that is not easy to measure, a disable that should be compensated by the federal government? and immediately the question when physicians are asked this question, they see it as a political question, about the size of government. they seive it as a political question having to do with welfare. see it as a political question having to do with liberalism. what it means to build a society that treats pain immeasurable quality, as real. you see it politicized when reagan comes comes into office as

the president in early 1981. one of the first things he does is he turns to his secretary for health and human services and he says we need to start reducing the social security disability role and the first group of people they begin to identify as illegitimate welfare claimants are people who are claiming pain as the source of their disability. so, there you have the problem of how pain is political from the outset and becomes even more politicized in the context of this battle that is waged between liberals about how you build a compassionate caring society, and how government programs should be there to provide comp passionate relief and consecutive conservatives who are suspicion that by creating that society you are catering to dependens, you are building a welfare society that is unsustainable, that costs too much and it turns out that the

linchpin the key question at the heart of so many of the liberal and conservative battles over the last 70 years is the question of who is in pain are they really in pain, what degree of relief do they see serve, and if we create too much relief are we building a society of dependence? or are we building a compassionate society? so it turns out that that's how you write a story, a history of pain as a political history. it's a history that i didn't set out to write. it's a history that as i started to do the research about this topic in medicine, took me into politics and then ultimately took me, surprisingly, into the law. that is to say when there are pitched battles between liberals and conservatives over whether disability should be extended to people in pain, when those

people hundreds of thousands of them are removed from the disability roles, they sue. this issue ends up in court. and it's the courts that ultimately have to decide how to measure pain who is in pain, and who deserves relief and that's the story really at the core of the book. how it is that pain is at once a medical concern and at the same time a intensely debated political concern and also a legal issue that ultimately it's the judges who decide, not the doctors, not the scientists. it's the judges who decide who is in pain. >> host: how many people are currently on social security disability generally, and of that what percentage are there because of pain? >> well, that is a very difficult question to answer for the reasons that have to do with co morbidity, that is, pain is only one feature of a a site of ail.

s. so, pain is a feature of disability but pain is not a necessary component of disability. so, if i were to say, 400,000 people, another person might say, well, that's 400,000 only encompasses pain as sayingents feature of disable. ...

>> the degree of pain you're experiencing is highly subjective, it's very personal. you and i may be experiencing the same pain but you may tolerate it differently than i do. and it's these questions of intersubjective understanding, trust, believability that inevitably intersect with the broader judgments about who's in pain and how much we should believe them and how much relief they deserve. so the numbers of people on disability vary across time. unquestionably, it is rising dramatically in the 1950s -- since the establishment of social security disability benefits, pain does become a reason why people seek disability in the 1960s. in some ways pain is seen as one of the, one of the ways in which the disability system grows in the 1960s and 1970s.

it's a vexed question that you just asked. it's historically vexed and it's still vexed today. how many people are really in pain, what degree of pain, and how present are they in the disability system? >> host: how controversial in 1956 was the disability program? >> guest: it was hugely controversial. and in a way it has its own political origins. in 19 -- late '40s, '50s harry truman proposes national health insurance. he says, you know, we shouldn't be debating whether soldiers have insurance, we should be debating whether americans have insurance. eisenhower comes into office, and eisenhower's an old soldier and one of the key questions before him is whether the veterans benefits provisions have grown too expansive or whether they're not expansive enough. the ama sees the veterans

administration they identify the v.a. as the thin end of the wedge of developing socialized medicine. and so the ama looks at all of these questions of government medicine disability, pawn as legitimate disability and they, physicians in general but the ama in particular, see this as a trojan horse. the first chapter of my book is called the trojan horse of pain. they see this as a political question. and when eisenhower is compelled really by a crafty senate leaderer named lyndon johnson aided by another crafty legislator named john f. kennedy who's in the senate to consider this disability provision he himself is looking at re-election. he knows this is a very powerful

and it's an issue that much of the american public supports. this is pre-medicare, of course. and he also sees the ama on the other side who sees this as the thin end of the wedge of socialism. now, one of the interesting thing about eisenhower is he wasn't an i'd log and -- idealogue, and he really understood that in signing this legislation he was really helping to insure his re-election. it was never really in doubt but he was in some ways boxed in by a very crafty legislator and a crafty senate leader. and it's he who reluctantly signed this legislation in 15956 establishing -- 1956 establishing this disability benefit. the ama thought of this as heresy. they thought this was a terrible decision. and physicians abhorred it not only because they abhorred socialized medicine as they called it, but because they thought -- and rightly so i

think -- that it put physicians in a new role of being gatekeepers to relief. it's the physician who would have to determine what true pain was, what extent a pain meant relief, and it's there -- they were the ones whose opinions on this topic -- which they rightly understood was not conducive to scientific analysis -- it's their opinions that would be constantly called upon in determining whether this patient or that patient was deserving of relief. so it really was a controversial topic from the outset. and it only continued to be so as the disability system grew from the 1950s through the '60s into the 1970s. >> host: what about the affordable care act? has it affected how we look at pain? >> guest: well that's another fascinating story. buried deep deep in the

affordable care act is a provision on pain relief which has its own history which i touch on in the conclusion of the book. and the way i would tell the story of this is that in -- after many many years of controversy not only about disability benefits, the growth of the welfare society but debates about pain relief at the end of life that pushed oregon to establish death with dignity legislation and new debates emerging around fetal pain, so you might say pain becomes part of the cultural battles between left and right over whose pain matters and whose pain deserves relief in the 1990s. after a long time of these kinds of politicized discussions, in the early 2000s there are politicians on the left and

right -- orrin hatch on the right, others on the left -- who say, you know, one of the things that is not being addressed is proper end-of-life care that's not politicized. and so in the course of the period leading up to obama's election, there is actually an attempt to write what you might call bipartisan legislation dealing with the fact that we don't do a good job of taking care of people at the end of life in pain, that so much of pain medicine has been politicized both at the bedside and broadly in politics that we're not doing a good enough job. and in the early years of the affordable care act, in the crafting of the legislation there's a desire to enfold this pain relief provision into the affordable care act. and in early years in early stages of the affordable care act there was a lot of funds set aside for public education a

lot of funds set aside for physicians' education on these issues that physicians themselves aren't adequately educated on. and in the course of crafting the aca -- because, of course the extent of the new legislation was the source of much debate -- many of the, many of the appropriations set aside for this were stripped out. and what was left in the affordable care act is a call to the institute of medicine, iom, to do a study as if we needed another study to look closely at why we don't deliver pain medicine in the way that we ought to, pain relief in the way that we ought to in this country. so the aca the affordable care act actually has a pain provision, but it's a weak example of what can what congress can do to address this issue in terms of physician education, in terms of public

education about the pros and cons of aggressive pain relief. and in some ways i think we are back to where we were previous to the aca which is their enters now in -- their interests now in returning to this question of how we adequately deal with this issue that's a source of enormous contentious debate both in politics in disability in law and in government. >> host: professor wailoo, how much pain medication is out there? >> guest: the rate of rise of prescriptions and use of oxycontin is skyrocketing. it's hard to actually say how much quantifiably, but if you look at a graph which i have in this book of the rise of pain relief drugs in the 1990s through 2000s it really outstrips all other class of drugs.

and oxycontin -- which is the topic of my last chapter called "oxycontin unleashed," -- is, you might say, an example of where we are today in the pain debate. to put it really in a nutshell i would say that there are those in metropolitan society who -- in american society who are undermedicated undertreated because of the anxieties about drugs like oxycontin and there are those who are overmedicated. we have a society today where you have two faces of the pain problem. people in urban america without access to pain relief drugs because their pharmacies don't carry them because of concerns about drug diversion and too liberal access to main medication. so in some ways one of the problems we have in the management of pawn in -- of pain

in american society is we tend to go from one extreme to the other. either we think the problem in american society is too little relief too little medication, not paying attention to people in pain as in not treating people at end-of-life pain adequately, or those who feel that the real problem is that there's too much oxycontin, there's too much relief there's too much liberal access to medicines. and we go back and forth in our society without -- and we kind of just go from one extreme to the next. and one of the main challenges going forward is how we figure out a way to deal with drug diversion and oxycontin as the major problem in pain medicine abuse today while not subjecting people who really need oxycontin because of chronic arthritis and other infirmities access to the medicines that they need. and that's not that's not a challenge that we have really

grappled with at one time. what we've done is we've tended to look at one problem or the other problem without looking at both together. and that's going to be a real challenge in terms of public policy and in terms of really adequately dealing with people who need relief. >> host: is there any estimate on how much pain fraud costs? >> guest: it's very difficult for me to tackle a question like that because the issue has been so highly politicized over the course of the last 80 years. there are no good estimates. so even in the era of the passage of the 1956 disability act, this is a question that physicians said they tackled. physicians would say, you know, the real problem with establishing a disability benefit is that it will promote you're monetizing pain and

you're promising some form of monetary compensation for pain. and regardless of whether we believe that pain is minor, chronic, severe or truly debilitating, we are creating a monetary compensation system. and there's some physicians who would say even if pain is real, it's in some ways fraudulent to provide relief because it caters to people. i mean, there's a kind of heavy moralistic overlay to anxieties about pain. so your question how much pain fraud is there, well imagine how -- how would one decide to argue -- to answer that question? how really can you answer that question in a context where, i mean certainly there's pain fraud, right? there's certainly people who claim to be in pain when they're not in order to collect disability benefits. the question is where does

minor pain fall? where does sporadic pain fall? where does chronic pain that's at a low level fall on one's estimate of what constitutes fraud? and where does pain that is tolerable for me but intolerable for you fall on our measure of fraud? i mean, these are the kinds of tricky cultural social ethical, moral and political questions that physicians and disability judges have had to answer since the establishment of the system. and i am reluctant to give you an answer because i know that the answer is filtered through the lens of politics, cultural bias, ask you might -- and also economic concerns. a lot of the concerns about this question about how much fraud there is isn't a question about truly measuring fraud, it's a question about the cost of our

disability system. as it grew the argument for fraud grew as well. it's hard to argue that, you know in a society where we are aging we are living longer we're dealing with chronic debilitating diseases, the rise of chronic pain is a by-product of an epidemiological and demographic transformation in developed countries. so to say that pawn fraud has -- pain fraud has grown is a blurring, it's a question that's hard to answer in the context of an aging society. we're very proud of the fact that we have people who live into their 80s and 90s. we're not surprised that people who live into their 80 and 90s experience more pain.

arthritis grew, chronic arthritis grew as a new phenomenon in the wake of an aging society. to start to ask the question how much arthritis pain is fraudulent and how much of it is true pain is to ask ask a highly political question that is about really the cost of care and not necessarily about, you know whether we can truly evaluate whether arthritis, rheumatoid arthritis is a true problem, how painful it is and whether disability benefits are required for the relief of such people. >> host: professor wailoo, what's your job here at princeton? >> guest: at princeton i have several jobs. i'm a faculty member in history where i teach on drugs race and drug policy. i teach on the history of medicine. i teach about these fraught

discussions between science, technology and medical innovation and their social and cultural and political implications. i teach about those issues historically through the 19th century, through the rise of the fda and until today so that the debate about how we should regulate oxycontin is part of what i teach as history. i also teach in the woodrow wilson school of public and international affairs and there i teach on a wide look at public policy questions, from the present back into history. i teach about the role of courts in health care reform, so that's something that we're living with literally right now. but it's also part of the history of how courts have modified legislation maybe extending it or sometimes reducing its scope in service of broad or kinds of concerns --

broader kinds of concerns. so i teach about the role of courts and the role of legislators and the role of executives in shaping health care policy. i've brought together -- so those are the kinds of things that i do here both in the public policy education, but also history. >> host: how'd you get here? >> guest: how'd i get here to princeton? i moved here from princeton about five or six years ago -- >> host: from where? >> guest: well, i was at rutgers, and before then i taught at the university of chapel hill, university of north carolina at chapel hill. at chapel hill i've always, you know my background as a scholar is in the history and sociology of science. so it's inherently multi-disciplinary. it's a field which is historically grounded. it says that, you know, you have to be able to see contemporary issues from a long perspective, put them in perspective. my first job was in a medical school as well as the history

department at chapel hill. so teaching professionals how to think about health care and health care reform. when i landed in chapel hill, bill clinton was just elected president, and we were thrown into a discussion about the role of government in health care reform. when the health care reform died in the clinton administration, the next concern that students had was the role of the private sector hmos in tying the hands of clinical -- clinicians from making medical decision making. so i've worked at the intersection, you might say, of history and policy for a long time. at rutgers i worked at an institute for health care policy and history, and here i straddle once again history and public affairs. so i came here about three -- about four -- five or six years ago really recruited to do what i do. and i also play a role in the history of science program as well. so i like to think that i do -- i'm half in about three different places here at princeton. >> host: and originally from

guyana? >> guest: i'm originally from guyana in south america that's right. emigrated here when i was 8 as a young boy, grew up in the bronx and new york city, so a proud new yorker although i move today new jersey when i was in high school. >> host: keith wailoo, "pain of political history," is the title of his book, and here is the cover. >> is there a nonfiction author or book kwr0u like to see -- you'd like to see featured on c-span? >> even from the beginning we understand that our vision of of war is, for most of us, is not having been to war, but having heard about war having seen about war, having read about war. we're playing images of war.

i think sometimes of the myth about athena's shield. pester yous needed to defeat -- [inaudible] but anybody who looked directly at gorgon would turn to stone. iowa teen ya gave him the shield, he was able to look in the shield and see the reflection and then he could outwit and defeat him. that's what we do when we go to movies. movies are a kind of mirror. they mirror reality. in the beginning, most films -- we're talking about now the beginning of cinema itself, 1895 is the first recorded films and they really ran about 60 seconds. this one was an american film, and it was called "tearing down the spanish flag," 1898, of the spanish-american war. it was in the news. people couldn't get enough of it. and imagine being able to see it, being able to be there. well, that wasn't exactly true. they weren't there. the people who made the movie,

what they did was to take a camera up to the rooftop of new york city and to film a spanish flag being lowered and replaced by an american flag. and in the background was not really havana but a billboard kind of picture of havana that made it look as if we were there. so it was footage but it was a war film none the he is and it was extraordinarily popular. it was the kind of thing that people put their nickels in in the nickelodeon to watch and they watched it over and over and over again. american war films have always been a little bit of please and a little bit of teach. propaganda to the teach side. i remember mary poppins said a spoon full of sugar helps the medicine go down. there are movies that have a greater propaganda feel -- you can think of the green berets

with john wayne about the vietnam war -- merely was john wayne's propaganda take on what the vietnam war was. and then we get movies like, say, steven spielberg's "saving private ryan" which you might say that it has some propaganda effects, but it's long after the second world war, and it's mostly a movie about war and about the experience about the feel of war, the image of war. accuracy in film making is a style, it's an option. what you can do when you're making a film -- and all of these directors understood this -- is that you can make a film that gets it right or you can make a film that's entertaining. entertaining always trumps getting it right. there was the sense, and we talked about the vietnam war, it was in the news and people said you don't know exactly what it is. a recent war movie, "we were

soldiers" shows it in a way that a number of people said, oh, that got it right. that really is what happened. on the other hand, you take a movie like "the deerhunter" which is really fantasy that whole idea of russian roulette, there's not -- that didn't happen. yet many people believe that the deerhunter got it right in another sense. so fantasy and realism are styles of approaching the experience of war. and the question is what's it trying to get at and how well it succeeds whether it is fantasy or realism. we have always as a public when we've gotten see war understood it's only a movie. on the other hand, movies have become much more visceral much more spectacular. the idea of going to see a clint eastwood -- you know when you're going to see "american sniper" that you're not going to see a 1940s war movie where the only kind of wounds are upper arm

wounds, clean wounds and people die in bali effect -- ballet effects. what you're going to see is visceral exploding bone fragments and spraying blood. that's the kind of thing that's in there. take an example "m.a.s.h." is about the korean war, but "m.a.s.h." was made during the vietnam war, and the question of what robert altman was doing with that movie is -- it's really more about attitudes, the feeling of the vietnam era toward war. it was the culture of the people who were watching the movie then. and strangely enough, when the movie turned into a tv show what weed had was -- what we had was a womanizer who became a feminist but the attitudes changed in relation to the current culture and what was both accessible and also admirable about people who are in that kind of madness we call

war. the issue of war films often has settled on such issues as is this around anti-war film -- an anti-war film or a pro-war film, and almost no director will say or admit to making a pro-war film. people just aren't happy with wars. nonetheless, within any war there is something to be shown, and there's some kind of courage. "rambo" is an example of a movie that took the vietnam era and, essentially, made it palatable and sellable for the american viewing public. what sylvester stallone taught us was that even though most people were not happy with the way the war was being waged, the way the war worked out the outcome of the war, there was something to be said for individual heroism. now, the individual heroism in a movie like "rambo" is not

necessarily the kind of heroism that you would have actually seen had you been there at that time. well, once again, kids, this is the movies. and what we want to see is sometimes a larger-than-life hero. people said, for example, john wayne was really great at playing john wayne. and his movies the sands of iwo jima is not a realistic movie about iwo jima, a realistic movie about a john wayne kind of hero and what would have happened had he been at an iwo jima that was managed in the way hollywood would have created it. students of film have been taught to analyze film. they see movie in quite a different way than someone who was just watching it in 1944 would have seen it or somebody who was watching it in 1964 would have seen it. each of the, each of the

audiences changes the movie itself. when patton came out, many people believed that patton showed an anti-war, an anti-war feel, and they used that as evidence against waging war and against especially the vietnam war at the time. there were also people, and president nixon among them, who thought that patton was a pro-war. they were dealing with the same exact movie. it became a kind of a litmus test for them, and you could see it and understand when george c. scott comes out in front of that huge american flag how that makes us perceive what were we going to see on the screen itself. or i like them the think -- and the book that a i wrote the research guide to american war films, i was a co-author. i did it with an historian

frank -- [inaudible] i teach film, so we had a really nice movement there. i like people who read that book to see how film influences war how war influences film. and i think it works both ways. i think the image of war on films influences the feelings the attitudes of the people who fight the wars and perhaps even the way that wars are waged. on the other hand, i think that the way that wars are actually waged influences the way that films are made and how it shows it how each new generation of filmmaker brings his or her own special perception to the making of a movie. >> be for more information on booktv's recent visit to galveston, texas and the many other cities visited by our local con at no time vehicles -- content vehicles go to c-span.org/localcontent. >> conservative journalist and author m. statton evans died on

tuesday at the age of 80. in 2007 he argued jost mccarthy did not deserve the bad reputation he'd been assigned by historians, and he said mccarthy was correct in his assessment of the threat posed by communism to the united states during the so-called red scare. this program next on booktv. >> ladies and gentlemen, you don't have to stop eating, if i could just have your attention. ..