The son of Holocaust survivors who were left profoundly distrustful of the world, Daniel Gottlieb describes himself as an innately optimistic child who grew up to become a practicing psychologist. He had married and was raising two young daughters when a bizarre accident left him almost totally paralyzed. In hospital, imprisoned in a motionless body, his head held in an iron vise, wishing for death, he heard the voice of a woman standing beside his bed. She said she had heard he was a psychologist. She was ill, in despair, and thinking of suicide. Could she talk to him?

Gottlieb writes that her need of him just then saved his own life and marked the turning point toward his recovery.

He resumed family life and his professional practice, but his dire physical situation continued to frustrate him. When he unskillfully hit the wall with his wheelchair, he vented his anger by ramming the wall again and again. “Daddy’s hitting the wall,” his children chanted. As the scenario was repeated, eventually he himself learned to recite those words as he banged into the wall: “Daddy hit the wall, yes, Daddy hit the wall,” slowly absorbing the truth that his situation would not change. One feels the painfully slow opening through which a new quality of feeling can emerge. If it’s true that the only thing that can change is one’s attitude, Gottlieb makes it clear how much that change can cost.

Letters to Sam is addressed to his young grandson, who has been diagnosed with a form of autism. He wishes to leave Sam some words that may one day renew the memory of their relationship and help Sam to live his own difficult life. Sam will need to cope with other’s people’s summary judgments of his condition, just as his grandfather has had to. Sam, too, will need to accept his situation.

Gottlieb writes that “wishing for something doesn’t mean there is a problem that needs to be fixed. It means there is an ache inside. . I think most of us have more longing for love and closeness than can ever be fulfilled. The question is: how do we live with the longing?” He advises Sam, who is having a hard time giving up his pacifier, “. . . almost everything we become attached to we’ll eventually lose.” That’s painful, but “please don’t grab at something to take away the pain.” Again, he writes, “I want you to know that being different is not a problem, it’s just a fact. But feeling different is a problem.”

He tells Sam of a dream in which God gave him a tiny three-millimeter piece of the universe to care for. At first offended by the miniscule size of his place, he gradually realizes that he’s been given the task of a lifetime.

One deep tone sounds throughout the book. Gottlieb speaks often of acting out of the realization that another human being needs something that he is able to give—his clients and now Sam. This recognition of being needed displaces his self-pity and self-reproach and opens up a whole field of work.

I found myself turning repeatedly to the photograph on the book jacket of Sam and his grandfather—the little boy, his eyes alight with feeling, his arm around the neck of his smiling grandfather.