Book Reviews

The King of the Mountain
by Arnold Ludwig, M.D.

Reviewed by Nat Sandler, M.D., Lexington.

Arnold Ludwig, M.D., Emeritus Professor of Psychiatry at the University of Kentucky has recently published his tenth book, King of the Mountain. This book is a result of an 18 year study and review of political achievement. Dr. Ludwig profiles every ruler of a recognized country during the 20th century for a total of 377. These are studied in great detail.

He also shows the similarities between the alpha-male behaviors of apes and human political leaders. Both types of leaders are more forceful, have larger families, have more wealth and command deference from others. Both primate leaders and human leaders show the same characteristics. Both fill a vacuum. These leaders “talk” more forcefully, demand more attention, and the “people” under them become submissive. Increased dopamine enables dominance.

Dr. Ludwig compares six different kinds of leaders, examining in great detail their characteristics, childhood, and mental stability to predict their later success. He has even created a political greatness scale. This is based on common traits found in the greatest rulers of all times. He found 12 to 18 percent of the rulers he researched died violent deaths. He found 98.6 percent were male. Two hundred million deaths have occurred in the 20th century from wars and social policies attributed to its leaders. War, in Dr. Ludwig's opinion, is an expression of alpha-maleness; a higher percentage of women in power could well lead to a more peaceful world.

I have known Dr. Ludwig for over 30 years, and this book is an excellent example of his scholarship. Dr. Ludwig is a masterful teacher, recognized researcher, and brilliant writer.

King of the Mountain was published by the University Press of Kentucky in 2002.

Electroboy: Memoir of Mania
by Andy Behrman

Reviewed by Rif S. El-Mallakh, M.D., Louisville

This book is a well-written autobiography about a gentleman affected with bipolar disorder. It is a brave and brutally honest account of this man's journey through mental illness. Easy to read, it is likely to attract the attention of a large number of people with bipolar illness. Most patients who read it will be able to identify with at least some aspect of Mr. Behrman's life. In addition to his graphic description of both mania and depression, the author also recounts his obsessive systems, agoraphobia, and extensive substance abuse.

Reportedly, he saw several psychiatrists who either missed the bipolar diagnosis, or made the proper diagnosis, but prescribed in a way to precipitate antidepressant-induced mood cycling. These are events that too many people are familiar with and can apply to their own course of illness. Nonetheless, there are problems with this book that would prevent me from recommending it to most patients.

The book is presented from the patient's point of view. With no attempt to be objective, Mr. Behrman's substance abuses with their destructive consequences are interwoven with his mental illness. He gives the impression that drug-related problems are manic behavior and all drug seeking is an attempt at self-medication.

The account avoids the issue of prescribed and unprescribed drug-related worsening of Mr. Behrman's condition. Consequently, not only does it miss a great teaching opportunity, but actually it misleads readers into attributing all abnormal behaviors to the illness and relating his ultimate stabilization only to having "found the right combination of medicines."

Electroboy is an engaging book that does a good job relating the life disruption of mania. From a treating psychiatrist point-of-view, it is not an ideal book to recommend to many patients.

Electroboy was published by Random House, in 2002.

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