I loved this book and all of Dr Cooke's efforts to stop the HIV and opioid epidemic in Austin, IN. This doctor wrote of his start as a doctor in a small community as a family doctor but as he was seeing more patients, he begins to realize how many are addicted to drugs, with those resorting to a life of crime, prostitution, and other methods of obtaining drugs.

I thought that Dr Cooke did a nice job of describing his battle with trying to get the appropriate resources for his community, as well as his attempts to help for the various people that he had come in contact with. His book was thought-provoking in the area of needle exchanges and harm reduction. He made some valid points about addicts getting help for fear of getting arrested instead of the help that they needed. He made a point for compassion instead of criminalization and saw the rates of drug use and HIV cases decline.

As a Hoosier resident, I only hear about the epidemic and the needle exchange in Scott County on the news, but this book went way beyond the media to describe the how's and the why's. I'm disappointed in the apathy of some of those Dr Cooke came into contact with, including a politician I had always supported, but am encouraged by other politicians and people who want to get to the root of the problem, instead of merely applying a band-aid.

I received this book for free from Tyndale Publishing and Netgalley in exchange for a review.

As a public health worker myself many of the topics discussed in this book were not new for me. It was interesting to learn about the Austin crisis from a source who was on the front lines as they worked to find solutions that worked long term. Many of the lengthy generalizations and explanations of drug use and rehab practices felt more like a lecture. I found myself most intrigued and inspired by the specific stories and events of the Austin epidemic, and how they were willing to be there for the patients forming supportive relationships with many in the community.

I received a complimentary copy of this book. Opinions expressed in this review are completely my own.

One Lone Voice in the Howling Wind

This is the story of William Cooke, a physician called to serve in the small town of Austin Indiana. His story is one of hope, sadness, frustration and despair. He desperately tries to help people in this small town. He soon finds that his resources are stretched to the breaking point and that he needs help from other agencies or his small clinic will not survive. He finds getting these resources can be hard work to obtain and that sometimes the hinder as much as they help.

When an outbreak of HIV occurs he gets some help with this outbreak but there is no help to solve the underlying problems in the town that contribute to the outbreak. Those affected can be treated if they can be found, but most are intravenous drug users and do not want to be found or treated. The drug problem of prescription painkiller opioids is an epidemic in itself. Until the underlying problems of the addicted can be addressed and treatment methods found the HIV epidemic will not be solved.

He starts working with Health Districts , churches, social agencies and other helpful programs to provide treatment for HIV, drug addiction, counseling, food, clothing and human compassion for those afflicted by addiction. In order to treat they must be found and this means their trust must be gained. He starts a clean needle program to help with the HIV epidemic. This brings him much push back from the community and a few dire threats but he pushes on with his HIV clinic amidst the turmoil.

His dedication is not without personal troubles as his time away causes his first marriage to end in divorce and also causes some problems in his second marriage which he is able to work out with a caring wife.

This story is about a small town in Indiana, but it is a problem in almost every state. America is set upon by a horrible epidemic of opiod addiction. It is the biggest epidemic ever causing so many to feel despair and worthlessness. We must try to control the drugs causing this epidemic, treat those afflicted and find the causes of the addiction and address them in order to win this war on drugs across our country.

I think everyone should read this book and I highly recommend it. You will learn so much about this epidemic that you never knew and the underlying causes.

Thanks to William Cooke, Tyndale House Publishers, and Netgalley for allowing me to read and review and advanced copy of this book.

I was able to read an early copy of this book through NetGalley in exchange for an honest review.

I have mixed feelings about this book.

I am a Certified Advanced Alcohol and Drug Counselor and for that reason was drawn to this book. The vast majority of the information provided on substance use I was already aware of, but I also ascribe to the belief that genuine care and relationship with your client can have the biggest impact in their treatment.

The main issues I have with this book were the dialogue surrounding some of the information the author claimed to find out about addiction (mainly in Chapter 8). This dialogue felt very contrived and did not seem to be genuine. The quote in the beginning of the chapter is from Johann Hari and his book Chasing the Scream, which is one of the most definitive and influential books of recent years in the field of substance use. So it really bothered me when the author was talking about studies that were described in-depth within Hari’s book like it was something he just happened to stumble across or someone else brought up spontaneously. It felt disingenuous and would have been better if the author had just cited Hari rather than create this hokey dialogue with his father and his wife. A similar example is when the author discusses going to a conference and being confronted to explore the role of race within the war on drugs and then talks about going to a hotel and doing a google search that just happens to provide the same quotes that were made well known over the past few years through Michelle Alexander’s book The New Jim Crow and through the documentary 13th. Also, talking about systemic racism being to uncomfortable to learn about before bed is privileged and gross.

It was also frustrating that the author would bring up topics such as race, the bill of rights, etc... but did not do more than a surface exploration of these issues and this glossing over seemed to miss the real significant deep issues in these areas. If you are not going to engage in real work in this area it may be better to reserve your opinion. One example is when he talks about the stigma of use and availability of care being related to individual bias and prejudice instead of acknowledging the larger systemic issues that pit people against each other. That is reminiscent of blaming individuals for pollution because they don’t recycle when the vast majority of pollution is created by major corporations and industry that is not within the control of an individual.

Some of the things that I liked about the book was the information specific to the situation in Austin and the role the state government played in this. I think this is important information for the public to know. This is a topic I have read up on a few times but have not found this level of information on how this situation took place and was handled anywhere before. I also appreciate that the author was open about things that were mishandled and things that different organizations did that were blatantly wrong.

I also appreciate the authors use of his faith in his story and feeling compelled to engage in this work and being open to where this led him. It did get rather preachy towards the end, which is something to be careful of in working with people in any type of therapeutic capacity since it is not ethical to push your beliefs and also sometimes pushing faith that someone has lost due to past trauma can be more harmful.

Overall, I wish the book had focused more on the HIV crisis and how it was handled since this appears to be the area that the author is the most knowledgeable about.

The biggest take-away from this book, for me, was to remember to not focus on the tip (“iceberg”) of a problem but to look deeper into the causes. People are multifaceted and need individual, long-term care.

This book was about a doctor who dedicated his career to serving the people of Austin, Indiana and his fight to specifically help people with drug addiction get compassionate and thorough care.

I really wanted to like this book. I like the premise, but the delivery was way too statistic and politically driven. (Math and political science…not my thing). To be honest, I found myself wanting to check all the statistics, but had no motivation to spend the time doing that. I prefer a more story-based account of how things happened, than one full of political maneuvers. If you like numbers and politics, and also like a little bit of a story line, this book is for you.

And in the description of the book, it claims this book is written in the “vein of Hillbilly Elegy, Dreamland, and Educated.” Out of those three titles listed, I have only read Educated, and if I compare Canary in the Coal Mine to Educated, they are definitely NOT alike. Educated was easy to follow, Canary in the Coal Mine was full of names, politicians, and agency names that it was hard for me to keep track of who was who.

On the plus side, there are a lot of great resources listed in the back of the book for those connected with drug addiction on any level.

This book was just really hard for me to get through. I was rooting for the patients and Dr. Cooke, but just couldn’t appreciate the way the story was presented. And if I wasn’t committed to reviewing this book, I would have stopped reading it about half way through. Hence, my two-star review.