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pharmaceuticals and routes of delivery, clinical monitoring, cannabis dependence and psychological/adverse side effects. Dr. Smith has a holistic and hands-on approach to advocacy and evalua- tion of the appropriateness and effectiveness of medical cannabis use, as opposed to signing off on a recommendation for patient use and leaving follow-up to dispensary staff. The most illuminating and challenging chapter in the book reviews the discovery and function of the endocannabinoid system (ECS) in 1990. Dr. Smith succinctly describes what is known about this neuro- modulatory system of ligands, receptors, agonists, and neurotransmit- ters and how they're modulated by endogenous and phytocannabinoids. Suffice it to say, "The ECS is involved with a variety of physicologic processes including appetite, pain sensation, mood, memory, gastroin- testinal functions, inflammatory response and immune function." Beyond the accessible technical descriptions, Dr. Smith makes a point of including several relevant and practical clinical scenarios with helpful talking points that lend themselves to conversations with colleagues and patients. Among them, "Question about How Medical Cannabis Works…What can you tell your colleague in 30 seconds?" and, "Anxiety and Pain-Related Insomnia…What cannabis regimen would you recommend?" Dr. Smith's advice is col- legial without being demeaning or pedantic. At the outset, Dr. Smith set out to write a serious medical text- book for educating medical students and clinicians about safe, effec- tive uses of medical cannabis, when appropriate, as part of a monitored clinical course of therapy. It's high time for nurses and doctors to separate the stigma from the science so they can help their patients make informed decisions regard- ing the use of medical cannabis. To that end, Dr. Greg Smith's engaging and thoughtful book, Medical Cannabis, will be an indispensable resource, in order to prepare for the questions that are sure to come from patients and other members of the community this election year. (Author's biographical note: Dr. Smith earned his medical degree from Rush Medical School in Chicago, and a Masters of Public Health from Harvard University. He completed residency training in Preventive Medicine at Walter Reed Army Medical Center. Since leaving the U.S. Army with the rank of Major, Dr. Smith has been in primary care practice in California, Georgia, and Florida for the past 25 years. He first trained on use of medical cannabis in California in 2000, and has made medical cannabis and CBD oil part of his prac- tice since that time.) —DeAnn McEwen, RN On Living By Kerry Egan Riverhead Books, 2016 In this extraordinary book, hospice chap- lain Kerry Egan fulfills her promise to Gloria, one of the many patients she visit- ed as they were dying, to "tell her stories." We get to hear Gloria's revelations, and the insights Egan gleaned from spending time with people who understand that they don't have a lot of time left on this earth. Sometimes her patients convey direct nuggets of wisdom to Egan, and sometimes Egan learns those lessons through observation of the patient and the person's relationship with others. Those unfamiliar with the role of hospice chaplain, like myself, will appreciate how Egan spends a little time explaining exactly what type of work she does with the dying. Perhaps even you, as a nurse, may not know entirely what chaplains do. To the casual observer, Egan spends her time listening to and talking to her clients, mainly about their families. Later, Egan realized that people talk about their families because "that is how we talk about God. That is how we talk about the meaning of our lives. That is how we talk about the big spiritual questions of human existence." But what Egan actually does for these people is create a sacred, safe space with them to confront the truth of their lives, to reflect on these difficult thoughts, and perhaps scrape together some meaning or peace from these experiences—though there may well not be any meaning to be found. Though she is not dying, Egan well understands how hard this can be; as a new mother, she survived a long period of medication-induced psychosis after an emergency C- section surgery that not only made living hard and prevented her from caring for her baby, but forced her to question her very identi- ty and existence even after she finally recovered. "For a long time, I thought my own life experiences marked me as strange and cursed," writes Egan. "But after hearing so many stories, I came to realize that I was like everyone else, and that while my experiences might be unique to me, the pain was quite ordinary, and I was not alone in it. That was more healing than anything else." As Egan writes, this is a book about living, not about dying, and through her well-told stories, she shares many insights into this messy business of life, both the pain and suffering as well as love and joy. She learned from Gloria that secrets and shame prevent you from being your authentic self and preclude Good Things That Might Have Been. She learned that it's a waste to spend a lifetime hating our own bodies and, rather, to appreciate the very state of being embodied. She learned that people must have hope, and that regret is inevitable and not something to be entirely avoided. "Hope is the belief that better things are possible. Regret shows us what those bet- ter things we hope for are." She learned that change is constant, and our identity is always evolving. She learned that you cannot judge or reject others' reality, because it's cruel to reject "the person's attempt at making meaning of the experience." She learned that dying is just a verb—something one does—and is not an identity or who people are. And she learned that love is healing, not only to love others but to know that one is worthy of love and to receive love. Sadly, as a chaplain, she also learned when her efforts weren't working. "When the story never changes—when someone tells the same story the same way, over and over, I get nervous as a chaplain," she explains. "When my questions elicit no new answers, when my prayer seems to bring no comfort, when there are never new connec- tions with other things the speaker has seen or learned or thought or experienced, when there is never any reflection about what hap- pened, when the person does not even seem to know I'm there as he tells the story again and again, the same way each and every time— that means that the story is stuck, and the suffering is immobile. It means that there is no meaning to the loss. And if that loss is the story that defines your life, it can mean there is no meaning to life." These are all profound concepts to grapple with, and I think reg- istered nurses who care for patients and families going through the most difficult times of their lives, through life-and-death situations, would enjoy this book very much. But apart from any relevance this book would have to the nursing profession, it stands on its own for the wisdom it offers. —Lucia Hwang J U LY | A U G U S T | S E P T E M B E R 2 0 1 6 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 N A T I O N A L N U R S E 17