Sudden Death and the Myth of CPR
by Stefan Timmermans
Temple Univ. Press
272 pp.; $22.95, paper

There are roughly 400,000 sudden deaths each year in the United States. Among patients hospitalized on general medical or surgical floors who receive cardiopulmonary resuscitation (CPR), only about 15 percent are estimated to survive. For those who receive CPR outside the hospital setting, estimated survival rates are even more pessimistic, dismally ranging from 1 to 3 percent. Of those few who do survive long enough to leave the hospital, most studies show significant neurological deficits in at least half of them.

By contrast, a 1996 analysis of resuscitation on three popular television shows found unrealistically high survival rates. For ER, Chicago Hope, and Rescue 911, immediate survival was an absurd 75 percent. Long-term survival was an equally astounding 67 percent, With such a gap between reality and fantasy, Stefan Timmermans's Sudden Death and the Myth of CPR is a timely expose of a resuscitation system badly in need of reform.

Extensively researched and footnoted, Timmermans's book is also pragmatic. Catalyzed by some deaths in the author's close-knit family, followed by extensive research reading, Timmermans's project ultimately included numerous interviews with sundry professionals involved with CPR and Advanced Cardiac Life Support (ACLS) resuscitation procedures (called "codes").

Indeed, Timmermans did not merely interview physicians, nurses, paramedics, chaplains, and ER technicians but journeyed out of the classroom to become incarnationally involved in the resuscitation community, observing 112 resuscitative efforts in emergency departments of two hospitals over a fourteen-month period, wearing a beeper so he could be paged to the hospitals when a "code" was coming in via ambulance. He also did volunteer work in one of these hospitals, formed friendships with staff members, learned CPR, and took an emergency medical technician course.

Nevertheless, hanging around health care professionals is no substitute for being one, and this book occasionally suffers from lack of insight that can only come from working within the field. Because of this, some of the conclusions and many comments made about emergency department resuscitations should be taken with a grain of salt. Among other things, the book (especially chapter 5) makes the mistake of treating "social inequality" as a synonym for "unjust." Timmermans falsely implies that the social value of a patient (e.g., a young patient or socially prominent citizen versus an elderly patient or one suffering from a drug overdose) affects their chances of survival by influencing the aggressiveness of the resuscitative effort.

Fortunately, this book is on the whole balanced and insightful, bringing a welcome challenge to the perceived success and prevailing dogma regarding "universal" CPR. Timmermans persuasively argues for selective use of CPR where it is more likely to be successful (as in hypothermia, drowning, or electrocution) and withholding CPR to allow death with dignity for others (as in terminal health conditions such as cancer or advanced cardiac disease). He proposes reforms for a resuscitation system that is currently both very expensive and highly ineffective. As a resource for recounting historical development of resuscitation techniques over the last few centuries, this book is first-rate. And for anyone undergoing CPR or ACLS training, it provides a valuable corrective to the overly optimistic expectations generated by such courses.

—David Graham

The Book on the Bookshelf
by Henry Petroski
Alfred A. Knopf
290 pp.; $26

Scripture says in Ecclesiastes 12:12, "Of making many books there is no end." The most recent book by Henry Petroski is a book about books, and the making of books, that offers many delightful insights into the long history of both books and bookshelves. Petroski takes his readers on a journey from ancient scrolls to electronic books. This instructive study is peppered with charming and intriguing anecdotes. For bibliophiles and bibliomanics, and ordinary readers too, this is a book not to be missed.

Petroski, the author of such engaging books as The Pencil and The Evolution of Useful Things, is a professor of engineering and history, but he could well be called a philosopher of culture, with a distinctive gift for helping his readers to see the uncommon within the common. While focusing on the particulars of the book and the bookshelf, Petroski always has an eye on the larger context: "The bookshelf, like the book, has be come an integral part of civilization as we know it, its presence in a home practically defining what it means to be civilized, educated, and refined."

There are treats on just about every page. Readers who love words and their meanings will feast on the meaning and history of such common terms as volume, scroll, codex, book, parchment, lectern, and press. The word "press" at one time not only described the mechanical device that printed books but also was a term for the bookshelf itself. The reader is taken on a journey through libraries that were open only during the day because candles and books are a combustible mix. Numerous illustrations complement the text, including the incongruous image of books chained to their bookshelves.

It is a commonplace that the Reformation and the printing press contributed to the first information revolution. Not so well known is the initial adverse effect the Reformation had on libraries and books in England, where hundreds of monastery libraries—varying in size and importance from Christ Church, Canterbury, with its 2,000 volumes, to small houses with little more than the necessary service-books—were dispersed.

The development from the lectern to the bookshelf; the varieties of bookshelves, including movable stacks; the natural "enemies of the book" (water, dust, and light); "shelving etiquette," which has changed throughout the ages: all this and more Petroski treats with clarity and wit. The book concludes with an appendix which offers 25 different ways to organize and arrange books on the bookshelf. For the lover of books and for the larger bookish Christian community, Petroski's text provides ample opportunities to see the God of providence at work within the history and culture of the written word.

—Robert M. Woods

English Medieval Books: The Reading Abbey Collections from Foundation to Dispersal
by Alan Coates
Clarendon Press/Oxford Univ. Press
211 pp.; $70

In 1121, a priory following the Cluniac order was founded in the town of Reading, about 40 miles west of London, by King Henry I. In 1123 the house became an abbey, remaining active until the Dissolution of the Monasteries by Henry VIII. Alan Coates's monograph recounts the history of the abbey's books: what they were, how they were acquired, how they were used, and what happened to them when the collection was dispersed. His concise account offers insights into Christianity in England over a span of four centuries, as well as illuminating the intellectual history of that period, for here we get a sense of the "furniture of the mind."

Glossed books of the Bible and patristics predominated, but beginning in the thirteenth century the range of holdings broadened to include works on canon law and music, among other subjects. And it was during this time, Coates reports, that "numerous 'study aids' entered the Reading collections"—including a concordance, an innovation that had a great impact on Bible study. (The first concordance of the Bible was compiled between 1230 and 1240.) Nine plates of manuscripts complement Coates's text, fragmentary and yet tangible presences that make it easier for the reader to enter imaginatively into an alien world.

—JW

David Graham is a physician in Knoxville, Tennessee. Robert M. Woods is a Fellow for the Morris Institute for Human Values.

Western Bookshelf

In The New Western History: The Territory Ahead, edited by Forrest G. Robinson (Univ. of Arizona Press), seven scholars from other disciplines (mostly environmental science, American studies, and literature) examine the recent historiographical explosion on matters Western. The contributors agree that "the New Western History is a force to be reckoned with," but otherwise their assessments of the field differ widely. In "Clio Bereft of Calliope," Robinson laments the extent to which the New Western Historians have overlooked Western literature. He accuses the historians in question of lumping such literary greats as Willa Cather and Wallace Stegner together with the ideologically driven history of previous generations and "discard[ing]" all of it.

Like Robinson, Krista Comer wants the New Western History to pay more attention to literature, but her take is otherwise quite different from his. In "Literature, Gender Studies, and the New Western History," Comer argues for the incorporation of women writers and feminist literary theory in the New Western History. Comer develops this thesis further in her book, Landscapes of the West: Gender and Geography in Contemporary Women's Writing (Univ. of North Carolina Press). Here—in addition to championing writers such as Pam Houston, Barbara Kingsolver, and Terry Tempest Williams—she tries to situate the emergence of what she calls the "new regionalism" in a larger theoretical context. Postmodern theory has posed particularly sticky problems for students of the American West, Comer suggests, and the new regionalism arose as an "antidote" to postmodernism.

Western writers receive plenty of attention in two recent books by Richard Etulain, director of the Center for the American West at the University of New Mexico. In Re-imagining the Modern American West: A Century of History, Fiction, and Art (Univ. of Arizona Press), Etulain paints in broad strokes, sketching "the main cultural-intellectual contours of the twentieth-century American West." Here readers meet Western historians Old and New, Native American novelists (such as Louise Erdrich) and Chicano writers (such as Rudolfo Anaya), writers both familiar (Amy Tan) and lesser known today (Mary Hallock Foote), the painters of the Taos-Sante Fe area, and a host of others.

Re-imagining the Modern American West is a feast; Etulain has laid out a cultural smorgasbord, and the reader comes away not only with a renewed respect for Western art and writing, but also with a keener understanding of the "diversity" that has been such a rallying call for New Western historians. Far better than the essayists in Robinson's volume, Etulain, because he follows the novelist's rule to show rather than to tell, conveys the importance of integrating literature into the historiography of the West.

In the slender Telling Western Stories: From Buffalo Bill to Larry McMurtry (Univ. of New Mexico Press), Etulain's lens is more narrowly focused. Here he examines the ingredients of Western stories—and by stories he means not only works of fiction but also history books and dramatic performances. From the 1860s to the 1960s, Etulain suggests, the way people told Western stories didn't change much. Frederick Jackson Turner's frontier thesis, Buffalo Bill Cody's Wild West show, and popular dime novels all drew on the same stock images: heroic cowboys, dastardly Indians, vigilante justice, and so on. But then came a new generation of Western stories and storytellers. Here, like Robinson, Etulain focuses on Wallace Stegner, who, especially in his 1971 Pulitzer Prize-winning novel, Angle of Repose, "broke with the continuing fascination with the frontier West and gravitated toward a more complex regional West."

—LFW

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