Brief Book Reviews: October 2025

Popular Books Relevant to Mental Health

The Urge: Our History of Addiction

Carl Erik Fisher; Penguin Books, 2022

400 pages; $13 (paperback)

Reviewed by Edmund S. Higgins, MD

In the first year of his psychiatry residency at Columbia University, at the age of 29, Carl Fisher was given a choice. He could go to a special rehab program for impaired physicians, or he would lose his medical license. Reluctantly, but not without some final attempts to weasel out of rehab, he went voluntarily.

Fisher, now an assistant clinical professor of psychiatry at Columbia University, has written a fabulous book about addiction. It is actually 2 stories in one. Most of the book describes the history of addiction: the prevailing attitudes, as well as changes in treatment. The other story is the author’s personal struggle with addiction and his redemption.

Fisher presents several interesting aspects of addiction history—conceptualizations of the problem which changes with time and then change back. For example, is addiction a social-cultural-spiritual problem or the result of a brain disease? Is addiction a weakness of character or beyond the subjects control? Does punishment help? Is treatment effective? It depends on which decade you live in. Furthermore, he presents a background to addiction that is especially relevant for prescribers—most addictive substances start as medical treatments, the very definition of iatrogenic.

Fisher’s problem started innocently enough and did not seem to impede his education. But it got worse after medical school. He was able to get a doctor to prescribe Adderall and started smoking cannabis. He dabbled with a little cocaine. By the time he was in his psychiatry residency, he was blacking out, missing appointments, and lying about the root cause of his behavior. It is a well written story of an impaired physician, and a reminder that, “there, but for the grace of God, go I.”

Lit: A Memoir

Mary Karr; Harper Perennial, 2010

432 pages; $8 (paperback)

Reviewed by Edmund S. Higgins, MD

Mary Karr started her writing career as a poet and branched into prose. Her words are poetic, but we can understand what she is saying. Karr has written a marvelous story that encompasses coming-of-age, romance and rejection, dealing with a difficult mother, and struggling with drinking that has gone awry. It is the textbook definition of a good story—conflict and resolution with compounding conflicts and resolutions—written with brilliance and humor.

Of interest for psychiatrist is the overarching story of Karr’s alcohol problem. The chapters about her acceptance and working through a “dry drunk” phase provide insightful examples of the difficult path to recovery. This is a fabulous book, worth reading twice.

Beautiful Boy: A Father’s Journey Through His Son’s Addiction

David Sheff; Mariner Books, 2009

352 pages; $9 (paperback)

Reviewed by Edmund S. Higgins, MD

BeautifulBoy is a story about addiction from the perspective of the parent. It is really about 2 obsessions. Nic, the son, is addicted to methamphetamine, and David, the father, experiences a relentless, all-consuming worry about his son. Nic was an exceptional young man (hence the title), but lost control of his life when gateway drugs led to his discovery of methamphetamine. It went downhill from there. The author tells us about the overwhelming anxiety he experienced and his endless attempts to find a solution. It is any parent’s nightmare.

One of the biggest problems with memoirs are the author’s failure to govern their own voice.It is like the speaker who has too many slides. This book is infused with that problem. The basic story is gripping and filled with a father’s painful compassion; however, there are too many side stories which do not enhance the arch of the story. Otherwise, it is a book psychiatrists should find as a helpful case study of a family’s struggle with substance use disorder.

Dr Higgins is an affiliate associate professor of Psychiatry and Family Medicine at the Medical University of South Carolina.