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14 J U L Y / A U G U S T 2 0 0 5 C A L I F O R N I A N U R S E After closely examining the calamity, Bar- lett and Steele have a common-sense remedy. "Study after study has concluded the most practical and cost-effective way to provide quality health care and to restrain costs is a single payer system." Now it's up to all of us to get there. —Charles Idelson DIABESITY: THE OBESITY-DIABETES EPI- DEMIC THAT THREATENS AMERICA—AND WHAT WE MUST DO TO STOP IT, by Francine R. Kaufman, MD, 336 pp., $27 M ost consumers, including most nurses, have heard something about the in- creasing weight of Americans and the corresponding rise in cases of Type 2 diabetes, the form of the disease where your body does- n't produce enough insulin or your cells ignore the insulin. And many are also aware of the growing numbers of children being diagnosed with this disease—what used to be called Adult Onset diabetes. In fact, nearly two-thirds of Ameri- can adults are overweight and one-third is obese. Almost a third of American youth are overweight, and more than 15 percent are obese. While some are surprised, few seem alarmed. But public health officials are downright panicked, and so is Dr. Francine Kaufman, a pediatric endocrinologist and past president of the American Diabetes Association. Her book, Diabesity, should sound that alarm loud and clear. Kaufman's insight comes from her years in practice as well as her own childhood experience living with a grandmother who had diabetes. She has seen first hand the devastating effects this disease can have. The relationship of obesity to the development of diabetes became apparent to her early in her career. She is pas- sionate in her commitment to changing the course of what por- tends to be an epidemic of diabetes and heart disease in our lifetime, affecting younger and younger peo- ple across the globe, and her passion comes through in her writing. She deftly takes the reader through the progression of diabetes, from the years before diagnosis, through the reality of patients and their families coping with the increasing de- mands of full-blown diabetes and its accom- panying vascular disasters. Throughout, she weaves personal stories showing diabetes' human dimensions with the science and eco- nomic realities of this disease. Her writing is accessible to any reader—patient or profes- sional—whether she is explaining the Pale- olithic contributions to our predisposition for storing fat in times of plenty, or discussing the medication regimen required to prevent com- plications of diabetes. Not only is this book a primer on the scope and impact of diabetes on individuals and society, it is a guide to being proactive, to taking action as an individual, as a consumer, as a parent, or as an advocate for social change. As nurses, no matter what our areas of specialty or expertise, we are sure to en- counter diabetes in one form or another. Every nurse could learn more about how to prevent, treat, or advocate on behalf of those who have diabetes by reading this book. Iron- ically, we need look no further than photos from this magazine to see that nurses as a group are challenged by the very same issues as our patients when it comes to dia- betes prevention. We are as overly well-nour- ished and under-exercised as the rest of America. Our greatest challenge as nurses may be to lead by example. Experts now pre- dict that one-third of all Americans born after the year 2000 will become diabetic. To stem that tide, we can't afford to become statistics. Dr. Kaufman's book, a pair of walking shoes, and time to use them will give us a good head start. —Michelle Mason-Chadd, RN ENRON: THE SMARTEST GUYS IN THE ROOM, a documentary by Alex Gibney T his is a smart, well-researched, and regrettably funny doc- umentary from director Alex Gibney chronicling the rapid rise and even faster fall of Houston-based Enron Corp. based on the eponymous 2003 book by Bethany McLean and Peter Elkind. If you can excuse a few hokey graphics and occasional MTV- style editing, this film provides the average American with a grip- ping account of the decisions leading up to and consequences befalling those in charge of that monumental mess better known as Enron. This is a tragic tale for a number of reasons, not the least of which are the tens of thousands of former Enron employees who gave years of service and ended up with virtually nothing. No pen- sion, no retirement. Enron executives, specifically Ken Lay, Jeffrey Skilling, Andrew Fastow, and Lou Pai ostensibly promoted a culture that encour- aged, if only on the surface, everyone to ask, "Why?" Amazingly, nobody ever really did ask why, except for one or two whistleblowers— most notably Sherron Watkins, a former Enron vice president. For some insight into human behavior, the film maker turns to the 1961 Mil- gram study at Yale University, an experiment in which scientists tested just how obediently and how far ordinary people would go to pun- ish subjects through electric shocks if directed to do so by an authority figure. Here's Gibney's answer to the Why? in Enron's case: There was entirely too much money to be made. The traders were having a field day manipulating and controlling the California energy grid. Ac- cording to the film, the California energy "cri- sis" was manufactured to generate obscene amounts of money for Enron. Of special interest is a moment at the end of the film when it is revealed that Ken Lay met with Arnold Schwarzenegger in May 2001