by Arthur J. Moss, Forrest H. Adams and George C. Emmanouil- ides. 757 pp. IlIust. The Williams. & Wilkins Company, Baltimore;. Burns & MacEachern Limited ...
BOOK REVIEWS
And a Time to Live. Toward Emotional Well-Being During the Crisis of Cancer. Robert Chernin Cantor. 280 pp. Harper & Row, Publishers, New York; Fitzhenry and Whiteside, Don Mills, Ont., 1978. $12.50. ISBN 0-06-010623-9 Over the last few years dozens of books have been published on the subject of death and dying that discuss the problems that must be resolved to reach the ideal state of acceptance. Points on how to cope with these problems are carefully detailed, and advice is given to the dying person and his or her loved ones to make the transition to this state of acceptance easier. Most books on this subject are richly illustrated with anecdotes and case studies of cancer patients whose main advantage has been that the course until death has usually been reasonably predictable once a certain point was reached. A growing awareness of the fact that cancer patients live before they die and that cancer is often more similar to a chronic illness than a terminal illness has led to the development of a new genre of "how-to" books for cancer patients and their families as well as for the professionals who care for them; Cantor's book is certainly one of the best. From the perspective of a social and clinical psychologist (whose first degree was in dentistry) who has worked with cancer patients for the last several years, Cantor hypothesizes that much of the distress suf. fered by cancer patients is secondary to the disease; they are bewildered and feel overwhelmed by the cancer,
and therefore do not recognize the inherent possibilities of the disease and the concrete tasks to be accomplished in coping with it. This book is focused on helping patients preserve and improve the quality of their lives following a serious threat to its continuance. The emphasis is on understanding and ameliorating the threatening experiences of cancer treatment, yet nowhere are these treatments carefully detailed or specific suggestions given to help patients and families cope with the side effects of treatment. The stress that living with the uncertainty of cancer can pose for patients and their families is not explored. However, Cantor has developed a useful paradigm of the strategies of adaptation and has categorized patients as primarily "reliant" or "autonomous". He has explored the physician-patient relation in a useful way, while stressing the interaction between the physician's skills and the patient's healing potential. The concept of the patient's role and responsibility in his or her illness has become increasingly more prominent, and, while the physician may not accept its premises, it is probably worth understanding, partly because patients are becoming interested in this variant of holistic medicine. The most innovative section in the book is that on family and marital patterns. Although readers may not agree with the types Cantor proposes, his descriptions of four marriage pattems - hare-tortoise, peacemakers, gladiators and parent-child - give valuable insights into the manner in which the stress of cancer is manifest
in certain marital dyads. The physician who is involved with the families of cancer patients may well find that this section offers the book's most valuable insights. Although the book is addressed to patients, families and the medical profession, it will probably be most useful to intellectual patients and their families, mental health professionals and psychologically oriented physicians. It certainly belongs in the library of any cancer centre or hospital that treats cancer patients, as well as in any library available to cancer patients and their families. MARY L.S. VACHON, RN, MA
Assistant professor Department of psychiatry University of Toronto Toronto, Oat.
Heart Disease in Infants, Children and Adolescents. 2nd ed. Edited by Arthur J. Moss, Forrest H. Adams and George C. Emmanouilides. 757 pp. IlIust. The Williams & Wilkins Company, Baltimore; Burns & MacEachern Limited, Don Mills, Ont., 1977. $73.95. ISBN 0-683-06079-1 This is the second edition of an important textbook on heart disease in infants, children and adolescents. Most of the 79 contributors are experts in this field in the United States. The text covers all aspects of heart disease and is conveniently organized into five parts - general cardiology, congenital defects, infectious diseases, connective tissue and metabolic and degenerative diseases, and special problems. The section on general cardiology
CMA JOURNAL/APRIL 21, 1979/VOL. 120 907
