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navigating a maze of post-hospital options for full-time residential care. Eventually, Comer assesses the best option is simply to oversee a team of hired in-home caregivers (herself chief among them) and to bring her husband home. "Many times, personal stories involving Alzheimer's gloss over the unseemly details of care," Comer writes. "But I never wanted to embellish or soften the edges around the truth. It does not do justice to the cruelty of the disease." Comer is not only responsible for oversight of her husband's body (the tendency to urinate in public, the need for shin guards as he bumps into furniture), but also preservation of her own physical integrity. As he becomes increasingly violent, Comer is forced to install a home mirror system so that she can see her husband com- ing and have a few extra seconds of offensive strategy time. These anecdotes are heartbreaking reminders of her Alzheimer's-driven new normal. There is also the question, which remains unclear from the book, of where the funds to cover Dr. Gralnick's increasingly expensive care come from, as he has no long-term care insurance or end-of-life documents. We are only aware that Comer must navigate this, too, as she gives up her career. When a newly dating friend asks Comer if she remembers that feeling of being desired and cared for, Comer writes, "Suddenly, it hit me: I did not remember. No one caressed my hair, touched my arm, or called to make sure I was okay." In the constant company of a partner-turned-stranger, her isolation is staggering. Comer acknowledges that not every spouse would go to such lengths under similar circumstances. In fact, she surmises that Dr. Gralnick would not have had the same tenacity of heart, if roles were reversed. But her dedication to her husband is obvious, as she forges ahead through the emotional and physical challenges of caring for a loved one with Alzheimer's. As the years pass, her mother also expe- riences dementia, and Comer becomes a caregiver to two. There is no "happy ending" to the process of an entire life's worth of memories slowly dissipating, along with it the shared experience that bonds people to one another. However, with Comer's will and intelligence, she finds a way to help others, through her personal experience. "I apply the same passion [to caregiving as I do] to my advoca- cy," Comer writes. Over time, she segues her considerable experi- ence with Alzheimer's into a position as president and CEO of the Geoffrey Beene Foundation Alzheimer's Initiative, an organization which promotes early diagnosis, innovation, and national public service campaigns. She is also a cofounder of Women Against Alzheimers. Her appearances in media, including taking a test on national television and discovering that she herself has genetic markers for the disease, have pushed the national conversation forward and helped advocate for patients and families. As the title indicates, Comer's "lost" husband, marriage, and former life have all made way for a "found" role as a leading activist in a critical movement. "Memories warm us. Separated from our memories, good or bad, who are we?" Comer asks. And while she acknowledges that "you cannot have intimacy with another human being without memo- ries," this book is testament to the fact that for Comer, her husband's inherent dignity, as a human being to whom she had made a vow, was enough to inspire a heart-wrenching journey of the ultimate sacrifices we are sometimes capable of making, in the name of love. —Kari jones SMOKING PRIVILEGES: Psychiatry, the Mentally Ill, and the Tobacco Industry in America By laura d. Hirshbein rutgers university Press, 2015 In her book titled Smoking Privileges, Laura D. Hirshbein explores the long and complicated history of smoking among the mentally ill in the United States. A clinical associate professor of psychia- try at the University of Michigan, Hirsh- bein's interest in many of her mental health patients' close and fond attachment to ciga- rettes and smoking was sparked in 2003 by one partic- ular patient, E.K. This 35-year-old man suffered from schizophrenia, sub- stance abuse addic- tions, and numerous other serious health problems. E.K. loved to smoke, and loved to talk to Hir- shbein or anyone who would listen about why he loved to smoke. Hirshbein writes that "over the past couple of decades, it has become increasingly clear that individuals with mental illness smoke at very high rates" and tend to be "hard-core" smokers. Apart from any addiction to nicotine and any biological connection between nicotine and mental health, however, Hirshbein wanted to examine how this "behavior fits into the broader context of the their lives, their relationship with other people and substances in general, as well as their encounters with mental-health providers and sys- tems." She also explores how evolving popular attitudes toward smoking have further marginalized the mentally ill. It's a truly fascinating subject and particularly thought-provok- ing for nurses, and Hirshbein does it great justice. She starts off depicting what she terms the "ecology" of smoking in state mental hospitals of the first two-thirds of the 20th century, which is where the most seriously mentally ill patients resided and were treated. Practically everybody smoked, and she relates how cigarettes and access to matches, lighters, and opportunities to smoke were used as a form of control, punishment, reward, commodity, to facilitate treatment, as substitute for more serious medications, as social cur- rency and signifier of social standing, as a way of friendship and bonding among staff and between staff and patients—you name it. The psychiatric facilities of that time embraced smoking cigarettes as a common culture. Attendants, psychiatrists, social workers, and 16 n a t i o n a l n u r s e w w w . n a t i o n a l n u r s e s u n i t e d . o r g j u ly | a u g u s t 2 0 1 5