Why We Sleep by Dr. Matthew Walker

I decided to read Dr. Matthew Walker’s Why We Sleep for two reasons: 1) to continue stretching beyond my comfort zone and exploring science writing and 2) to see what it had to say about the relationship between trauma and sleep. While I rarely remember my dreams, it turns out I twitch a lot in my sleep, disturbed. Sometimes, I wake up in the middle of the night with my mind racing and my feet clenched. What work is happening in my sleep, I wondered.

It turns out the body processes memories during sleep. During sleep, the brain processes and organizes new memories. The first evening of sleep after learning information is the most important night for retaining that information. So if you study for a test two days before the exam, but get bad sleep the night after you studied, you won’t retain the information as well as if you had gotten good rest. You can’t “catch up” on sleep later. When it comes to learning, sleep is an all-or-nothing game. Dr. Walker’s writing also suggests that REM sleep is important for processing memories, taking the sting out of traumatic memories and retaining the wisdom in them.

The book does a convincing job arguing that sleep is an undervalued and crucial part of our health. While many people know we’re supposed to get eight hours of sleep, it’s revealing to read how much we lose when we give up a night of rest. A lack of sleep shoots down your work productivity. It leads to dementia, cancer, heart disease, among other health issues. It even increases your appetite, making you more likely to munch, nibble, and gorge throughout your day.

The book includes damning critiques of the United States’ school system, the US military’s use of sleep deprivation as a form of torture, and the medical school residency requirements. We senselessly deprive adolescents of the proper amount of sleep, and we’ve known it for decades now. Waking adolescents up at 7am for school is the equivalent of waking adults up at 4 or 5 am. It’s incredibly frustrating the United States keeps sticking to archaic systems like early bird school schedules and inches, feet, and so forth. When it comes to sleep deprivation, Dr. Walker convincingly argues that it’s a form of torture, ineffective in drawing reliable information from suspects. Perhaps most insanely, when it comes to med schools, Dr. Walker relates how the person who designed residencies for med students was literally addicted to cocaine and built an absurd system that robs many med students of proper sleep, literally causing deaths through medical mistakes. Our body has spent millions of year optimizing its sleep patterns, Dr. Walker argues. It is ill-advised to attempt to break out of our bodies natural rhythms.

The book includes excellent tips for getting better sleep, some of which you’ve probably heard before: stick to a consistent sleep schedule, even on weekends, don’t drink caffeine in the afternoon, don’t exercise before bed, don’t look at electronics before bed. Others are more surprising: 1) heavily drinking alcohol robs you of REM sleep and might mess with your breathing at night.

The book was cleanly and thoroughly executed, although not all the information was incredibly engaging. I recommend the book for anyone interested in neuroscience or sleep.

Inheritance: A Memoir of Genealogy, Paternity and Love by Dani Shapiro

I had the blessing of participating in a book group made up of medical professionals for work and consequently binge-listened to Dani Shapiro narrate her memoir Inheritance on Audible. Shapiro earnestly narrates the rupture she experienced after a genetic test made her realize the father that raised her is not her biological father. Hailing from a very traditional Ashkenazi Jewish family, the discovery carries an atypical amount of cultural consequence. The memoir narrates Shapiro’s journey tracking down her biological father, an aged, accomplished doctor who was promised anonymity when he donated semen as a medical student. Shapiro also spends the bulk of the memoir unpacking the spiritual and psychological “trauma” (Shapiro’s word) she experienced as a result of the test results.

If that last sentence sounds like an overstatement of the psychological fallout of discovering you have a different biological parent at age fifty-four, most of the medical professionals agree with you. It’s hard not to side-eye when Shapiro talks about her “trauma” as a matter of “survival” several times throughout the text. Shapiro doesn’t help herself by being rather harsh and misunderstanding of her biological father’s initial reluctance to invite her into his life. Many in the group, me included, felt as if Shapiro was rather myopic, failing to see things from other perspectives, be it her mother’s, social father’s, or biological father’s. It’s not that discovering a family secret that morphs the matter of your identity wouldn’t be painful, difficult, and disruptive. It’s just that Shapiro taxes her readers patience by belaboring the issue and failing to approach the new information with curiosity rather than aversion.

It’s not even as if Shapiro didn’t have good people supporting her throughout her journey. Her mother’s surviving friend wisely told her, regardless of biology, “your father is still your father.” A rabbi tells her she could choose to view the test results as a form of cultural exile and unbelonging or as finding an additional home. Shapiro glides over these attempted interventions into her identity crisis, instead choosing to continue to ruminate over her innate sense of being different and not belonging.

While there are great moments of humor in the written version of the text, Shapiro’s earnest delivery sucked the joy out of those moments in the audio book. At one point, Shapiro describes how her childhood photo was used in a Christmas ad, which many found hilarious (including members of her family) because she comes from a very traditional Jewish family, for example. It wasn’t until the book group that realized how funny that moment was, because of Shapiro’s delivery really dampened the effect.

A frustrating narrator isn’t necessarily a bad thing for a book or group discussions, however. It can give a group something to pick apart.

The power of this text lies largely in the conversations it opens in regards to medical ethics and family history. The facilitator of our group mentioned that when she teaches this book to undergrads they erupt with stories of familial scandal. This book can help open discussion about non-traditional parentage, which is much more common than we think yet often secret and unspoken. The book also is a great conversation starter about medical ethics, including the recent artificial insemination fraud scandals that have received national coverage. It is disappointing that Shapiro chose to narrate her personal journey without including a more journalistic and researched history of artificial insemination and other related practices. This book is more about Shapiro then it is about medical ethics to a fault.

I recommend this book for anyone interested in memoir and medical ethics.