We are a nation of immigrants, and every immigrant to these shores brings a story. What they have in common is this: things were bad in the country of origin, from being denied an education to having your family slaughtered in front of you. Once they get to the US, things are going tough, then less tough, and finally you get to grab your own version of the American Dream. Secrets of Success by Dr. Alexander Karat, a successful physician with his own clinic in NYC, is a valuable contribution to the genre, with an important difference: where most such bios describe a straight rags-to-riches narrative, Dr. Karat’s is a rollercoaster. Or, perhaps, put in the terms of his profession, it is a cardiogram with wild peaks and valleys. From the opening phrase, “Alexander (Sasha) Karachunov was born on August 26, 1954, in the town of Armavir, Krasnodar Region, in the south of Russia,” you can tell there is no room for pretense in this memoir. It is a Soviet Horatio Alger story: a boy living in a cold-water one-room flat with his single mother rises to the top, in his case the Kirov Military Medical Academy in Leningrad, an elite medical school; and does so without a bribe or a phone call - something that even people in his home town find hard to believe. Never slowing down, Alexander grabs every reward the school has to offer - student society, advanced courses, and finally the gold medal (the equivalent of summa cum laude) and a spot in the postgraduate program. Success has many fathers, they say, but in Karat’s case it took just one mother, a WWII veteran who volunteered to combat on day one and finished the war as the commander of an anti-aircraft artillery battery - and ruined her health, too. She inculcated the boy with a simple code: Work hard, don’t stray, stand for truth, don’t give up, and the reward will find you. He stuck by it, and it worked. But she also gave him unexpected advice: rather than settle for a cozy spot in post-grad, go and serve - in the Northern Submarine Fleet, of all places. He followed the advice. The golden boy with summa and dozens of published papers turned into a humble ship doctor. But not for long; soon he would perform the kind of surgery that 30 years later would win him applause from top US surgeons at NYU. From that point on, it is up and up: as he garners every award available, from two academic degrees to professorship at the same academy to numerous publications and more gold medals at international competitions. But a boy who succeeds by hard work and talent never learns to be cautious, and in Soviet Russia it becomes his undoing. After a stint in Afghanistan he makes some politically dubious remarks - and down he goes. Now, then, America, where all his medals fail to set him apart from the rest of the huddled masses. Once again, Alexander does not give up; if he mixed cement in his native town at the age of 14, he can do it in Brooklyn at 40, too. Evenings, he hits the books - and does it again, acing every exam thrown at him by the Boards. Though nothing turns out so simple: neither residency nor the final licensing exam nor getting a job and starting your own business and protecting it from organized crime. Alexander Karat was not born with a silver spoon in his mouth and got nothing handed to him on a silver platter. But then he is not the kind of guy who goes for the silver - he goes for the gold, time and again, whether crawling home with an untreated broken leg after a gymnastics tournament or doing 126 hours of residency nonstop. As we read about the peaks young Alexander had to climb, from the famed Military Medical Kirov Academy in St. Petersburg, where a provincial boy without connections, living on less than a ruble a day, suddenly finds himself among classmates with high-ranking fathers from the military and Party elite, to the residency at NYU Medical Center, where he once again finds himself among rich kids half his age who already know how an American hospital works - it is hard not to conclude that Alexander’s stubbornness and phenomenal capacity for hard work go back to those wintry streets of Armavir where he had to haul buckets of water home from a street pump. Karat’s story of his rise and fall and rise again abounds in made-for-Hollywood drama: now he operates on the nuclear submarine commander 500 meters under sea - all alone, no anesthesia, no nurses - don’t try it at home. Now he is about to be recruited by British Intelligence Service in Gibraltar. Now he is operating under mujahideen fire in Afghanistan. Now he saves a patient at NYU. Finally, in Brooklyn he stands up to the Russian mobsters trying to take over his business. And then he stands up to Hurricane Sandy - and NYC Parks & Departments, too. Nothing breaks Dr. Karat. You’ll never get bored with this book. And it would do you good to learn from his life, too.