Book Review

What Really Matters – Living a Moral Life Amidst Uncertainty and Danger
by Arthur Kleinman.
Oxford University Press, 2006.
Hardcover, $28.00.
Reviewed by Jeremy Daniels (

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Harvard psychiatrist and anthropologist Arthur Kleinman’s newest book, What Really Matters, is harrowing in its accounts of how people come to terms with nearly unworkable life situations. Kleinman begins with considering what living a moral life may mean, and through narratives, shows how different people live morally through wrenching situations. Kleinman’s focus is educational, asking in the book’s introduction, “[c]an we learn anything from the stories of people who have tried to live moral lives in very different settings, amidst particular kinds of dangers and uncertainties, that can help us do the same?” The answer, of course, depends on the reader’s ability to recognize the magnitude of the narratives presented, and the effort to internalize the meaning in each chapter.

Being drawn in by the narratives was not difficult, but I found coping with the reality of some of them was much harder. Kleinman begins with the story of a severely depressed war veteran, struggling with the atrocities he had seen and committed during his earlier life experience as a soldier. The man’s pain, depression and inability to come to terms with his actions in battle are harrowing because of their bald authenticity and horrendous nature.

The subtle reflection of what the man (given the name Winthrop Cohen) did- and why-gives the book its chilling power. The story is told in a fashion that encourages reflection. Winthrop (a war criminal) presents his case in a way that caused me to wonder “what would I have done in the same situation?” This led me to a haunting understanding of how little we sometimes know about ourselves.

Kleinman  provides accounts of people striving in all kinds of situations for what matters to them.  We are presented with Idi, a French-American working with refugees in Southeast Asia and sub-Saharan Africa, while struggling to make sense of her life and the lives of those she has chosen to help. Then there  is the case of Yan Zhongshu, a Chinese physician immigrated to the United States, who struggles to make sense of his inter and intra-personal conflicts that resulted from China’s Cultural Revolution. Chronic pain patient and Protestant Minister Charles Jamison describes how attaching meaning to his pain allows for a fresh understanding of his moral reality. An account which left a mark long after I had finished the chapter was the story of a woman who, having bounced back from a period of illegal drug use and poverty to beat her drug habit and become a successful entrepreneur-artist, found out she is HIV-positive. These narratives are not to be taken lightly.

The author also presents an illuminating account of his own moral struggle, and how a Brooklyn sewer-worker and Israeli Zionist help him to find his own moral path in our world. Lastly, Kleinman presents a historical case of moral ambiguity in challenging circumstances: the influential W.H.R. Rivers, who, like Kleinman, is an anthropologist / psychiatrist.

In conclusion, Kleinman has written   a book that you should not borrow  from any library; it deserves a permanent place on the bookshelf of any one concerned with understanding people for what they are. In his  nearly-surreal narratives that dive deep within peoples’ souls, Kleinman gives us  a rich learning opportunity that we are all the better for having pursued. What Really Matters is an authentic book, dealing with authentic people and situations that matter to all of us who invest the time and effort it deserves.

Published: January 18, 2007