Running head: BOOK REVIEW

Book Review
Shantel Bishof
Touro University Nevada

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How is the person (population) in this book oppressed or
marginalized?
William Lee, nicknamed Bill, is a thirty one year old white male living in
New York City. Bill becomes involved with a growing number of shady
associates who continually help introduce new and/or vast amounts of
various drugs into his life. Bill begins with morphine use, here and there, just
to see what it is like. His story progresses with increased drug peddling, petty
theft, and drug use throughout a span of five years. Bills life experiences
and acquaintances continually give him a reason to flee his current place of
residence. His looks as well as actions give each new community a
stereotypical assumption of him, labeling him a junky. Living this shady
lifestyle puts Bill and his wife and children (although rarely mentioned), at
risk, giving reason to move from state to state, and eventually influence his
choice to flee the country. Although Bill continually attempts to quit his
addiction, he eventually always gives in to the temptation and begins using,
time and time again. Bill is constantly in trouble with the law and flees to
Mexico in an attempt to start a new life. Once in Mexico, Bill begins to
experiment sexually with younger males, and is constantly on the lookout for
his next new fix. He eventually ends up losing his wife and family due to his
choices. The story concludes with Bills attempt to head South in search of
the next biggest thing, a new drug that promises to stimulate latent
telepathic powers.
Reflecting on the person/population in the book; describe the
impact that oppression or marginalization has on the concepts of
occupation (participation, performance, engagement, balance,
repertoire, etc.).
The efects of drug use and addiction on Bills life are consuming
beyond measure. Throughout the book, Bill continues to consume any and
every drug he is able to get his hands on. Unfortunately for Bill, his social
group, friends and acquaintances are those who continually present and
provide new drug opportunities. Bill makes several attempts throughout the
book to seize his drug use and get clean. These attempts occur
intermittently throughout the five year period, but never prove to be
successful despite longer periods of being clean and drug-free. Bills choices
afect all concepts of occupation in a negative way. His addiction interferes
with an important biological process called homeostasis or normal balance
of the body. The brain is what controls this function and makes adjustments
to maintain a balanced, well-functioning biological system. His consistent
drug addiction/abuse leads to changes in this balance which quickly disrupt
his ability to participate in daily activities, perform to his best abilities and
engage in any aspect of his life other than the drug opportunities presented
to him on a daily basis.

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Ironically, the brain's wonderful ability to be so adaptive causes significant
changes to the brain's functioning. These changes account for many
behaviors associated with addiction. The powerful need to obtain drugs or
continue harmful activities despite the harm to the individual or their loved
ones, the difficulty of quitting an addictive drug or activity, and the
obsessive, all-consuming nature of addictions such that little else in life
matters, are all associated changes. This addiction causes the brain's
balance to change to accommodate the addiction, further increasing the
need of the addictive substance for the brain to maintain some type of
balance. Bills repertoire is significantly changed with this newly acquired
addiction and he eventually loses grasp of all roles that were once important
and meaningful in his life. Depending on the type of drug he was abusing at
the time, many aspects of his life were efected, ranging from decreased
concentration and ability to focus to increased paranoia, irritability and
aggressiveness; all of which inhibited his ability to be successful in daily life
events.
How did the book challenge or change your assumptions regarding
this population?
Growing up in a home of drug abuse, I was able to recognize many of
these traits and aspects of Bills lifestyle as typical for this type of population.
Reading this book and feeling as though I was living through Bills
experiences with him, opened my eyes to a bigger picture regarding drugs
and the toll they really take upon an individuals life. Although many of the
experiences he talked about were what I would have expected, I do have an
assumption that was changed based of of the knowledge I gained from
reading this book. I have always been fairly quick to assume that if someone
really cared about their life and their family they would make the right choice
and do what needed to be done to make sure that they were not bringing
more hurt or anguish into the lives of themselves and their families. Bills
story helped to change this assumption, and I honestly feel that it helped me
to gain a better grasp on the true efects of drug abuse on a person, their
mind and their choices. Bills constant struggle to try and stay clean and the
consistent presentation of new drug opportunities shed light on a diferent
aspect of drug addiction for me. No matter how much someone cares about
themselves or their families, I now understand that drug addiction is not just
something that happens to someone or a well thought out choice, it will be
something that that individual will struggle with for the rest of their lives.
Although many individuals may overcome their addictions, it is not
something that just changes over night. I understand more clearly that the
individual will have to make a conscious efort on a daily basis to choose to
do and be better than the day before. I am able to acknowledge this concept
more so now than ever before and I acknowledge and admire my family
members that make the choice on a daily basis to not let drugs back into

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their lives. This book has helped open my mind to the diversity involved
within various communities today, and has also increased my knowledge and
understanding within this population in order to help better treat those
struggling with drug abuse, to the best of my abilities.
As an occupational therapist, how will the insights that you gained
from this book affect the way that you interact with future clients as
occupational beings?
As an occupational therapist, I believe that it is necessary to have an
open mind and heart to many various experiences, trials, tribulations and
populations. Something such as drug addiction, for an individual that has
never chosen this path, may be hard to comprehend and could lead to a
difficult understanding of ones struggles throughout life based on their
current trials. I believe that my experiences to date have allowed me to
involve a diverse amount of knowledge when interacting with and accepting
other individuals and their lifestyles. The insights I have gained from reading
this book will help to further increase my understanding of the efects of
addiction on an individual and their ability to participate and be successful in
their life. All individuals have a battle to fight and although mine may be
diferent than others, I know I will be more willing and accepting of situations
with an increased desire to help the individual succeed and accomplish their
life goals. I recognize the difficulty and struggle within making a change
regarding addiction and feel as though my life experiences and the current
knowledge I have gained from finishing this reading will only increase my
ability to help each individual to the best of my abilities without judgments
and assumptions beforehand.
How does oppression occupational injustice impact receipt or
distribution of services for this population?
As occupational therapists, we accept that there is a link between
engaging in meaningful and purposeful occupation and positive health and
well-being, but a problem arises when we understand that access to
meaningful and purposeful occupation is not universal and is in fact very
challenging to many groups of people. Being a drug addict is a very complex
problem and presents barriers to every activity of daily living, from the most
basic of human needs such as restful occupation and eating to accessing
education and employment. Often times, those with a drug addiction are not
willing to, or do not understand their addiction to the full extent. Many of
these same individuals may be embarrassed or too prideful to seek the help
that they need and deserve. And all too often these individuals are not made
aware of the services that may be available to them. Individuals are
incarcerated and released on a consistent basis without the appropriate
presentation of the opportunities available to work with an occupational

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therapist and gain the knowledge and tools they need to be successful in
their daily occupations. Occupational therapy is not often recognized as a
field of practice within the corrections system and is starting to decrease in
the mental health field as well. There are many marginalized populations
outside of the traditional settings that could benefit from the specialized
skills and services involved in occupational therapy. I believe that pioneering
for occupational justice is one of our callings as occupational therapists and
there is obviously still much work to do in this arena in order to help these
individuals obtain the skilled treatment and service they need in order to be
a more active participant in their everyday life.