Oprah chooses "Wellness: A novel" by Nathan Hill as new book club pick

Oprah Winfrey has selected "Wellness: A novel" by New York Times best-selling writer Nathan Hill as her newest book club pick.

Winfrey announced her choice on "CBS Mornings" Tuesday. It is Hill's second novel, following the success of his earlier work, "The Nix," released in 2016.

"Wellness: A novel" looks at a 20-year relationship between Elizabeth and Jack, from their initial meeting as lonely students in Chicago in 1993 to their turbulent marriage in 2014. 

Winfrey said the book poses thought-provoking questions about the authenticity of the stories we tell ourselves, the nature of love and the pursuit of happiness.

"It's basically a love story gone wrong," Winfrey said.

The story, set mostly in Chicago's Wicker Park, initially felt familiar to Winfrey but gradually took unexpected turns, impressing her with Hill's "modern, contemporary, vibrant" storytelling style.

Hill said his inspiration behind the book came from a short story he wrote nearly two decades ago, contemplating the lives of two people who crossed paths and fell in love while getting glimpses of each other through apartment windows in New York City. As he revisited the concept years later, Hill said he began to question the naïveté of projecting fantasies onto strangers. 

"They're maybe kind of idiots, like projecting these fantasies onto the other people without even knowing them. And it made me wonder what would've become of these people, you know, if we tracked them, if they got together, if they got married, if they became parents. What would happen to them? So I started writing that," Hill said.

The book also delves into the idea of algorithms and how they shape our lives, especially in today's digital world. Hill said that a section of the book presents the viewpoint of social media algorithms and how the stories we believe can significantly influence our realities.

"Everybody believes stories about themselves. They believe stories about the people in their lives, about the world. And because we're fallible, some of those stories are gonna need amendments and some of those stories are going to be wrong. And so, believe what you believe, he says, but believe lightly, believe with curiosity, believe with humility. I think that's kind of at the heart of the book," Hill said. 

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Read an excerpt below. Follow along with the reading schedule at OprahDaily.com.

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Excerpt 

TWO PATIENTS suffering from lower back pain visit an acupuncturist. The acupuncturist performs a long consultation with each patient that involves examining their tongue's color and shape and general tumescence for telltale signs of ill health, then measuring the rate and depth and force of their heartbeat in both the left and right wrists simultaneously, then pressing fingers into important pressure points searching for signals of bodily disturbance or bio-imbalance.

And during this authoritative-seeming examination, it is explained to the patients that the specialized and tiny stainless steel acupuncture needles inserted precisely into the relevant nodes and meridians along their spine will
unblock essential life forces, stimulating the body to release its effervescent healing energy, which will ultimately cure their back pain. Both patients agree to undergo treatment, but only one of them actually receives acupuncture.

The other patient is secretly given a placebo treatment, the acupuncturist only pressing the skin of the back with a toothpick, which mimics the sensation of the needles' light prick but without their customary puncture. Thus, both patients believe they received real acupuncture. And it turns out that over time, both of them have exactly the same chance of being cured of their back pain. It turns out that it doesn't really matter whether they received real acupuncture or sham acupuncture-the outcome is the same.

Which, according to Dr. Otto Sanborne, proved that acupuncture - or at least the version of acupuncture practiced in the capitalist West- was fake. "Merely a placebo" was how Sanborne described it in his final report to the FDA, after the Wellness team had completed its study of a statistically significant number of lower-back-pain sufferers and found that the success rate of real acupuncture and fake acupuncture was basically identical: around 44 percent.

Sanborne dispatched thisreport with great relish and then treated the office to celebratory drinks at a nearby bar after work; whenever he discovered some new phony treatment or nonsense medicine, he tended to be jolly for weeks, and when he spoke about this - especially after a few whiskeys - his eyes got wide and his face grew crayon pink, such was his exhilaration at exposing the mind's follies.

But that day, at the bar, Elizabeth found herself turning over the results in her head and thinking that the most interesting thing about the acupuncture finding was not necessarily that acupuncture had failed to perform any better than placebo.

No, for Elizabeth, the most interesting thing was that placebo had actually performed quite well. This was not long after Elizabeth's "unraveling" at the grocery store, and her subsequent triumph with the United Airlines gig, and so she'd already been thinking about the utility- not to mention profitability- of using placebo rather than eliminating it.

For here was a back- pain treatment that required no surgery, no addictive drugs, nothing more expensive than a toothpick, had no side effects, and was successful almost half the time. It was the very definition of a quality medical intervention. And if a treatment was this effective, should we really worry about whether it was, technically, real? It made her wonder if instead of eliminating lies, maybe she could, somehow, harness them.

Perhaps people weren't suckers for falling for a placebo. Perhaps falling for a placebo could be, in certain cases, helpful, useful, even ideal. Example: oysters are not, in any real scientifically reproducible way, aphrodisiacs. If you give someone a dozen oysters and then measure their brain chemistry, you will find none of the specific hormones or neurotransmitters of sexual arousal.

However, if you take a couple who believes that oysters are, in fact, aphrodisiacs, and you have them get all dressed up for a date night where they will be eating oysters together, and they go to a nice romantic restaurant that is famous for its oysters, and they pay a good amount of money for those oysters, and then you do a brain scan, you will find that their relevant glands have become hormonal geysers. In other words, by believing a story that was technically untrue, they created an elaborate ritual around that story, which had the effect of making the story true.

Or here's another one: chicken soup does not have any intrinsic properties that can cure the common cold. But when chicken soup is administered to a sick child by a caring mother who serves it with deep parental authority, the duration and severity of the child's cold will, generally, lessen. Or the fact that absinthe never actually contained any hallucinogens. This even though all those great writers and artists of Paris - Baudelaire, Rimbaud, van Gogh, Manet, Toulouse-Lautrec - swore that it did.

They all made poems and paintings about hallucinatory visits from "the green fairy" despite the fact that, scientifically speaking, absinthe had no special mind-altering qualities beyond that it was alcoholic.

So how to explain these sincere collective accounts of hallucination? Elizabeth's theory: if you make absinthe a marker of insider status among an intellectual bohemian set that's rebelling against a repressive culture - in particular a culture that considers the drinking of absinthe decadent and degenerate - and if you then build an elaborate ceremony around reveling in the degeneracy of drinking absinthe that involves a special absinthe glass and a slotted absinthe spoon with cubed sugar set atop the spoon that is dissolved slowly drop by drop using exactly the correct ratio of absinthe and ice water in order to allegedly release the absinthe's hallucinatory essential oils, and if, further, you then expect and believe that this whole long ritual results in a concoction that will give you strange visions upon drinking enough of it, then, indeed, it probably will.

It was the ritual that was important - the acupuncturist's thorough examination, the couple's elaborate date, the mother's comforting home remedy, the ceremonial mixing of the absinthe.
It was in these observances that the placebo effect activated and materialized: the transubstantiation of belief into reality, of story into truth, a metaphor made flesh.

Elizabeth called this phenomenon the "meaning effect," a term she much preferred to "placebo effect." Because to say that these effects arose from placebo implied that they arose from nothing- for that's what placebo traditionally was, an inert substance, literally and intentionally useless- when in fact the placebo effect was elicited by the strong sense of significance and substance surrounding the placebo itself: the context, story, ritual, metaphor, and beliefs associated with the placebo. e placebo effect was, in fact, the brain's response to finding meaning.

"Why not use it?" Elizabeth asked Sanborne that day at the bar. "Why not use placebos to help people?"

He frowned at her from behind his whiskey tumbler. Elizabeth continued: "If a placebo provides real relief, what's the big deal? Shouldn't people use whatever works for them?"

"But how do you know it was the placebo that caused the relief?"

"What else could it be?"

"Regression to the mean. e body's search for homeostasis. Feeling pain in your back is just a normal part of life, and it tends to come and go, naturally, sometimes waning immediately after it feels most severe. Therefore, if someone seeks out acupuncture at the moment the pain is worst- "

"Then they'll believe it was the acupuncture that cured them."

"When in fact they were going to get better anyway, on their own."

"I don't buy it. I interviewed these patients. Some of them had been suffering for months. They'd taken painkillers and muscle relaxants, they'd done physical therapy, they'd tried exercising differently, sleeping differently, and nothing worked. Then they tried acupuncture, and presto. Something about that worked."

"It worked because of a lie."
"So?"

"So when people are making decisions about their health, they should be able to trust that they're not being lied to."

"What if I told you: 'ere is a good chance acupuncture will cure your back pain.' That is not a lie."

"But it's not the acupuncture doing the curing."

"Note that I'm not telling you how it will help, simply that it will help."

"That's lying by omission, my dear."

"What's worse: lying to the patient, or letting the patient suffer?"

He swirled the whiskey in his glass, thinking about this. "Even if it is ethical to help this one individual patient," he said, "the lie is unethical in a larger sense. If all doctors began to prescribe placebos, then all patients would naturally suspect they were getting one, and then patients would doubt all treatments. Which would undermine not only placebos but also real medicine. It can't work. It's not scalable."

"We're not talking about all doctors here, we're talking about you and me. Just us. And we've discovered that the brain is basically a medicine cabinet. We know this. It has incredible abilities to cure illness and relieve suffering, if only we can unlock it. And look what we have: a key. Wouldn't it be unethical not to use it?"

"But perhaps, my dear, that cabinet ought to remain locked."

"What do you mean?"

"Let's say you're right, that it wasn't regression to the mean, that our acupuncture patients somehow healed themselves. We provided the prompt, of course, but the healing was, strictly speaking, endogenous. The cure was inside them all along."

"Yes."

"So if they were capable of healing themselves, why didn't they do it sooner? Why did they need us at all?"

"I don't know."

"I don't either. But doesn't it imply that the pain was, in some way, useful? If the brain can cure the body but chooses not to, then maybe there's a good reason for the pain. Maybe the pain is necessary. Maybe the brain is saving its resources for something even more important, in the future."

"Like what?"

Sanborne smiled, swirled his whiskey, downed the rest of it. "That's for you to discover, my dear. Me? I'm much too old. Retirement beckons, but the work must go on!"