cover image How We Live

How We Live

Sherwin B. Nuland. Alfred A. Knopf, $26.95 (416pp) ISBN 978-0-679-44407-7

This latest book by the author of the National Book Award-winning bestseller How We Die could have been titled How We Live. Instead, Nuland, clinical professor of surgery at Yale University, borrows a title used variously by several luminaries of a previous biomedical era (Ernest Starling, Walter B. Cannon and Sir Charles Sherrington) to conceptually encapsulate his contemporary overview of the complex, coordinated processes that sustain the body's exquisite balancing act. Into each chapter, Nuland weaves a clinical story meant to illuminate and focus the subject, and to grip the reader in a drama of the body's sometimes desperate attempts to maintain its internal balance, to stay alive. Communication is the key. ""The total of the entire concatenation of constant messages and fine-tuning answers is the sum of biological life."" Nuland's treatment of topics as complex as cell biology and neurophysiology is accessible, accurate and sprinkled with bits of quotable information (e.g., the body contains ""two and a half square feet"" of cerebral cortex, with ""10 billion neurons and 60 trillion synapses""). The words ""human spirit"" crop up repeatedly and point to what seems to be an overarching intent of the author: to articulate a sort of rational religion of human biology, in which the wondrous workings of the body's molecules, cells and organs are viewed with proper awe, even reverence: ""The unheard din of living is the symphony before which the chorale of the spirit soars in song."" If Nuland occasionally gives in to hyperbole, he is so engaging and informative that he will quickly be forgiven. Illustrations not seen by PW. 200,000 first printing. (May)