For anyone with a healthy fear of death, disease or antibiotic-resistant bacteria, the idea of spending more than an hour in a hospital—let alone a day or a week—is deeply unnerving, about as terrifying as being forced to swim naked in a tank of leeches. It’s not just the in-your-face possibility of death at any moment, around every corner. It’s the stench of bodily fluids, the click and suck of oxygen machines, the boredom of waiting, the drama of waiting, the migraine-green hue of everything and, of course, those ubiquitous hand sanitizers that seem to do little beyond reminding you just how germ-ridden your local hospital is. No wonder the wild, life-and-death world of modern hospitals gets woefully little attention from the press.

Fortunately for the journalist Julie Salamon—as well as for those of us who fear hospitals yet crave information about them—she doesn’t seem to suffer from any crippling hospital neurosis. Indeed, in September 2005, Ms. Salamon, a former Wall Street Journal reporter and author of the Hollywood classic The Devil’s Candy (1991), blithely embarked on a yearlong reporting mission at Maimonides Medical Center in Borough Park, Brooklyn. Granted broad access to roam the halls and eavesdrop on conversations by the hospital’s brass, she embedded herself within the gears of the bureaucracy, observing everything from board meetings and budget discussions to emergency room shifts, bedside vigils and several profoundly disturbing cancer deaths. (After reading the story of a 24-year-old Hispanic mother suffering from lung cancer, I almost had to pop a Xanax, or five.) Once she’d collected a year’s worth of interviews, she bundled the whole experience into Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids.

Despite its turgid subtitle, Hospital is not exactly a Grey’s Anatomy-style bodice ripper. (Or should we say, scrubs ripper?) Sure, it’s populated by some deeply kooky characters, like Dr. Cowboy Boots, the 63-year-old cardiothoracic surgeon with a Hemingway complex and leather boot fetish, and Pamela Brier, the waifish hospital president who flits around in Issey Miyake and eagerly doles out constipation advice. But Hospital is above all an earnest book, a sober examination of the workings of a decent local hospital that strives to compete with the Big Boys across the river—the Weill Cornells and the New York University Medical Centers—but often resembles nothing so much as a modern-day Tower of Babel.

The Tower of Babel aspect is of particular interest to Ms. Salamon, who dedicates chapters, if not verse, to the challenges of running a neighborhood hospital in a neighborhood (Borough Park and environs) that just happens to be cluttered with Orthodox Jews and devout Muslims, immigrants from China and immigrants from Russia, Haitians, Pakistanis, Bulgarians and dozens of other fractious, if not warring, ethnic groups. In fact, Hospital at times reads more like a book about the trials and exhilarations of 21st-century urban diversity than about, well, a hospital.

“It took just a few visits to see that Maimonides was … a petri dish of the post-9/11 world,” Ms. Salamon writes early on. And then several pages later: “There were rabbinic edicts to contend with as well as imams and herbalists and local politicians.”

Ms. Salamon milks this cross-cultural mayhem, citing it, along with various other mundane sources of contention (such as “anal-compulsive bosses” and “recalcitrant and greedy insurance-reimbursement systems”), as the force that through the green fuse drives Maimonides. Call it a chaos-theory analysis of the hospital. There’s no great villain, no overriding source of trouble or cause of evil, just a complex combination of individuals, egos, interests and cultures all rubbing up against each other, creating sparks.

“Every day at Maimonides,” Ms. Salamon writes, “I was reminded that the ‘health-care system’ wasn’t anonymous or abstract; it was the sum of individual human successes and failures, each of which could build or destroy.”

This approach has its virtues, in that Ms. Salamon comes off as an unusually balanced observer, at once loving and critical. But it also has some serious drawbacks, beginning with the fact that it doesn’t always translate very well into dramatic action or compelling narrative. Despite Ms. Salamon’s best storytelling efforts, Hospital sometimes feels diffuse, meandering. The stakes just don’t feel terribly high.

Part of the problem might be the enormity of the task she has set herself, but another part is that Ms. Salamon doesn’t seem to have embarked on her Maimonides adventure with any particular passion for the desperate, raw world of health and hospitals—a fact that she admits on the first page: “While I had visited hospitals often enough for the usual reasons, and had even been a candy striper in high school,” she writes, “I had no special interest in them.”

And yet, for all this, Hospital does offer rewards to its readers, including some classic New York characters and deeply affecting scenes. In fact, the book is not unlike the portrait Ms. Salamon draws of Maimonides itself: flawed, frustrating but capable of inspiring profound emotion.

Lizzy Ratner, now a freelance writer, was formerly a reporter at The Observer. She can be reached at books@observer.com.

It’s hard to believe it, but our little baby is growing up. Prozac has just turned 20.

It’s been quite a heady two decades for our favorite mood-boosting pill, a regular Drew Barrymore kind of childhood, with books and articles and wanton declarations accompanying each stage of its precocious life. There were the wide-eyed Listening to Prozac years, the wild and fawning Prozac Nation years, even the troubled teenage years when it was dogged by accusations that it caused everything from suicide to impotence.

Now, as Eli Lilly’s famed mood-booster prepares to enter its third decade, a new book has emerged from the pharmaceutical haze to weigh in our modern drug obsession: Charles Barber’s Comfortably Numb: How Psychiatry Is Medicating a Nation. As the title suggests, it has little in common with the lusty exuberance of the early pro-Prozac anthems that promised heaven in a little green-and-ivory pill.

This is a morning-after kind of book, a sober, light-of-day treatise determined to puncture the myths behind our love affair with “cosmetic psychopharmacology.” If its conclusions are not always as fresh or mind-shattering as one might hope, it nonetheless arrives in our pill-happy midst not a moment too soon.

As Mr. Barber writes, “The current environment is such that a twenty-one-year-old college student can delineate, with a curious combination of pride, shame, and indifference, the last five years of her life by the drugs she was taking in the pages of New York magazine. No longer does one measure out life with coffee spoons, as did T. S. Eliot’s Prufrock, but with Adderall and Percocets.”

Mr. Barber comes by these observations honestly enough, through a mix of observation and vicarious experience. A lecturer in psychiatry at the Yale University School of Medicine, he honed his mental-health skills in New York City’s homeless shelters, where he worked for 10 years with some of the city’s most desperate and tortured mentally ill. These were not your typical neurotic New York types suffering from “garden-variety existential angst,” but the deeply, relentlessly unmoored. And yet, Mr. Barber noticed, they weren’t the ones who were being lavished with psychiatric attention. Instead, it was the “worried well”—the striving Upper East Side professional, the Soccer Mom from Winterset, Iowa—who were being bombarded with Zoloft ads and prescription slips as if their psyches, success and eternal happiness all depended on it.

Mr. Barber explains: “As the SSRI revolution has worn on, it has become increasingly clear that the wrong people are taking the medications.” (For the record: SSRI is shorthand for Selective Serotonin Reuptake Inhibitor and refers to the class of depression-busting drugs that burst onto the market with Prozac in 1988.)

Mr. Barber dedicates a good chunk of Comfortably Numb to proving and re-proving this disconnect between the people who should be taking antidepressants and the ones who actually do—call it the Prozac paradox. Citing a dizzying torrent of statistics, he douses readers with facts like “in 2006, 66 percent of the global antidepressant market was accounted for by the United States” and “the [pharmaceutical] industry spends an unholy $22 billion a year to market directly to doctors, which is the equivalent of about $25,000 per physician per year.” It’s enough to make you wonder whether the nation should just check itself in to the Cirque Lodge rehab center for a couple of months.

Not surprisingly, pharmaceutical companies take a good chunk of the blame for our pill mania, but modern-day “biological psychiatry,” with its belief in brain-chemistry-as-destiny, also comes in for criticism, as does managed care, suburban alienation, “emotional entitlement” and that distinctly American desire to feel, in Pink Floyd’s words, “comfortably numb.” In fact, if there’s any criticism to be lobbed at this section, it’s that Mr. Barber throws too many variables at readers, delving in minute detail into some while glossing over others with a few well-chosen clichés.

The idea, for instance, that women are twice as likely as men to be taking antidepressants is intriguing, disturbing and well worth exploration. But creating a cipher patient named “Julie” who “examines her face in the mirror and sighs” as she pops her nightly antidepressant as a way of explaining the phenomenon does little for the reader beyond making her want to roll her eyes.

Lapses like this are unfortunate, because Comfortably Numb has valuable information to impart, not just about our collective pharmaceutical drug addiction but also about promising non-drug therapies that have been largely overlooked because, let’s face it, they are neither as sexy, simple or lucrative as prescription mood-fixers. Drawing on a mix of history and science, Mr. Barber delivers a useful survey of these therapies, followed by some philosophical musings about our flawed approach to suffering in this country. In another era it might have been called “A Valediction Permitting Mourning.”

“We’ve embarked on a uniquely American process of emotional sanitation,” he writes. And he adds, pointedly, “A certain measure of depression is absolutely appropriate to this world.”

If this final section sometimes sounds a bit preachy, it’s preaching with a worthy purpose, at least. When 16 percent of the inhabitants of a small town in Iowa start taking antidepressants, as was reported by the state’s largest insurance company in 2002, it’s worth wondering whether some part of our cultural psyche is seriously out of whack. And when traces of Prozac and Valium begin showing up in our reservoirs, as has reportedly happened at Lake Mead, in Nevada, we probably should feel a bit freaked.

Besides, any book that helps diminish the chance that we’ll be subjected to another Elizabeth Wurtzel-style SSRI opera should be lauded and applauded.

Happy birthday, Prozac nation.

Lizzy Ratner, now a freelance writer, was formerly a reporter at The Observer. She can be reached at books@observer.com.

And then, halfway through dinner, the topic of the Jan. 3 Democratic caucus arose. The guests mentioned that they were supporting Hillary Clinton; the hosts revealed that they were backing Barack Obama; and before they knew it, their chummy little party had taken on the tone of a World Wrestling Entertainment championship match. Tempers soared. Voices barked. An elbow jutted dramatically into the salad bowl. During one particularly heated moment, the other couple’s male half even wagged his finger in Mr. Tate’s face, accusing him of being “judgmental” and “unfair to Hillary.”

“We were like a tag team when we were fighting,” said Mr. Tate, 34, referring to his and his wife’s debating prowess, as they hovered in the relative calm of a Union Square Starbucks several days later. “It’s like you feel like you’re prepared for battle.”

Battle is the byword these days among New York’s chattering Democrats. On one side, there’s the Hillary supporter who feels that she is the most pragmatic choice for the job; on the other, there’s an Obama believer whose misty-eyed faith in the senator is exceeded only by his (or her) penchant for criticizing Mrs. Clinton. “I have been involved in literally almost every presidential primary in New York State since 1968,” when Robert F. Kennedy faced off against Eugene McCarthy, said Ethan Geto, a veteran political operative and gay rights activist who ran Howard Dean’s New York campaign for president in 2004 and is currently supporting Mrs. Clinton. “And since 1968, I have not seen this kind of emotional intensity.”

The dueling partisans may function remarkably well in their daily lives as lawyers, bankers, dog walkers. But mention their candidate’s name in passing—simply start to form the breathy openness of the letter H!—and strange, Pavlovian things begin to happen. They snarl at each other in restaurants, snipe at each other over e-mails, bloviate on sidewalks and generally behave as if this endless nomination process were in fact an extended group therapy session, a wild free-for-all for their ids.

“My friend started asserting that Hillary’s probably going to win and that she’s tremendously experienced and qualified, and I kind of just lost my shit,” said a political insider in his late 20’s, who wound up in an hourlong sparring session with two female friends shortly after the New Hampshire primary, and who asked not to be identified for fear of offending the Clinton campaign. “I just became irrational and insane, denigrating this woman. … I haven’t gotten into a political argument in, like, five years!”

‘A Phallic Woman’

It’s when Mrs. Clinton and Mr. Obama clamber into bed between couples that things get really ugly. One minute you’ll be lying next to each other, innocently discussing preschools or gym memberships and the next—stony silence! The disagreements might be substantive, delving into the minutia of Mr. Obama’s Social Security rhetoric, or the implications of Mrs. Clinton’s vote to label Iran’s Revolutionary Guard Corps a “terrorist organization.” But then there are the endless rounds regarding “experience” and “charisma” and “tears” that make couples who only months earlier vowed to love each other “for better or worse, richer or poorer” suddenly start to wonder whether they shouldn’t have added a clause about “for Hillary or Obama, New Hampshire or Iowa.”

“Watching the results come in of the New Hampshire primary, I was despondent, and my wife was overjoyed,” recalled a 30-something, pro-Obama journalist named Andrew, who lives near Gramercy Park with his Hillary-lovin’ bride, and asked that his full name not be used because he sometimes covers politics. “It was one of those moments where we looked at each other, and it felt as though maybe we didn’t know each other quite as well as we thought.”

For Andrew and his wife, who have been married roughly a year, the essence of this conflict boils down to the fact that “she really thinks he’s a cheap huckster, and I think that Clinton is a cold-fish manipulator,” he said. Sometimes, he confessed, this has made him wonder whether he harbors a latent “discomfort about the idea of a woman president,” which, in turn, makes him “really uncomfortable.” On one occasion, all this agita spilled over into a drunken yelling match. But mostly, he said, it just hangs out on their couch with them, “a generalized kind of tension every time the TV’s turned to MSNBC.”

It was MSNBC that pitted renowned race scholar Michael Eric Dyson against his wife, the preacher and political commentator Marcia Dyson, on Hardball With Chris Matthews late last August.

Professor Dyson is an impassioned Barack booster who has spent the past few months penning odes and essays to the man he hopes to call president. Ms. Dyson is a Clinton backer of such ardor that she preached her way through the country last fall as part of a pro-Hillary “faith tour.” They began their confrontation civilly enough, but within minutes, he was talking over her, punctuating his points about Mr. Obama’s prescience about the Iraq invasion with a sharp up-down gesture. Meanwhile, she was calling him “Michael” with the unmistakable tone of annoyance particular to wives asking their husbands to do the dishes for the 1,000th time.

“I don’t want you two crazy kids coming back here and getting into divorce court next week,” said Mr. Matthews, whose more recent comments about the role Bill Clinton’s philandering played in catapulting Hillary to where she is today spurred such outrage from feminists that he was all but forced to offer a public apology. “Are the two of you going home together?”

Ms. Dyson looked at her husband, then turned back to the camera with a coy smile. “We have separate cars,” she said with the crisp finality of a bedroom door slamming shut.

“This is the best reality show in town!” declared Meghan Daum, the novelist, feminist and Los Angeles Times columnist, addressing how Ugly Hillary and Obamaville have stepped in to fill the television dramas zapped by the Writers’ Guild strike. She said she was still sorting through a pile of e-mails received in response to a Jan. 12 column that satirically suggested that Mrs. Clinton follow the man-trapping guide The Rules if she wants to win voters’ sympathy. She had intended the column to poke at the way women’s desire gets policed—the way they’re not supposed to “want it.” Readers pounced. “Every time I write about Hillary, people go crazy,” Ms. Daum said.

“The emotions just run so high.”

How to explain the way men, in particular, react to Mrs. Clinton: suddenly irrational, wildly gesticulating, a bit...high-pitched?

Dr. Susan Jaffe, a psychoanalyst and psychiatrist with an office in midtown Manhattan, thinks some are clearly confused by Mrs. Clinton’s shawls-and-pantsuits persona. “She might be seen as a phallic woman, because she needs to be strong and to stand up for herself and obviously to stand up for everyone else,” Dr. Jaffe said. “That can be very threatening to some men, and when men feel threatened, sometimes they worry about being castrated.”

Thy Neighbor�
�s Candidate

Yet men are not the only ones who feel threatened by the figure of Mrs. Clinton. Susan Morrison, an editor at The New Yorker (and former editor in chief of this publication), recently published an anthology of pieces by women writers, Thirty Ways of Looking at Hillary (Harper, $23.95), largely inspired by her perception that women often have an even thornier relationship to Mrs. Clinton than men.

“Anytime I went to a cocktail party or a dinner party, the conversation somehow got around to Hillary and the volume was just raised,” Ms. Morrison said. “People got contentious about her and waved wine glasses around. She pushes a greater variety and more complicated set of buttons in women than she does in men.”

Susan Cheever, a novelist and contributor to Ms. Morrison’s book, suggested that Mrs. Clinton has roused the feminist movement from the comfortable slumber in which it’s been languishing since the 1970s. “If there’s contention around her, it’s coming from that hidden injustice that we don’t even talk about,” Ms. Cheever said

Daphne Merkin, a literary critic who wrote an essay called “The Ballad of Bill and Hill” for Ms. Morrison’s book, often finds herself defending Mrs. Clinton to female friends that support Mr. Obama. “I thought her appeal would be to an older generation of women, women of 50. Women who would think, ‘Oh, here we come, what we’ve worked for all these years. Here it is,’” she said. “Instead they kind of pull back and feel that this is not the kind of woman that they wanted to be represented by. There’s a sense that she represents only one side of women, like the side that women wear pants. … In some ways, women are holding her accountable to aspects of the female personality that are stereotypical. We like her, yes, but we’d like her more if she wore a more flattering wardrobe. We’d like her more if she emoted more.”

For all this, it’s worth noting that Mrs. Clinton’s two biggest primary victories, those in New Hampshire and then Nevada, came with a sudden surge of sisterly support. And some voters have managed to turn the strange intensity of this campaign season into a bonding experience.

Sarah Fisher, 29, organizes the New York Hillary Rodham Clinton Meetup Group. She fell for Mrs. Clinton about two years ago, after reading her memoirs about those difficult Bill years, and she coos admiringly whenever she talks about her. “I couldn’t imagine being betrayed by someone you loved so much but still be able to get up and be able to get to work every day,” she gushed. “God, the strength of this woman is just incredible.”

Ms. Fisher has managed to avoid politically heated brawls among her close friends and family members. “My fiancé just happens to support Hillary, too,” she said.

Meanwhile, in a handsome brownstone on East 61st Street, literary couple Gay and Nan Talese have been enjoying their own kind of shalom beit thanks to Mrs. Clinton’s main Democratic rival. “Were all for Barack Obama,” said Mr. Talese, who is 75. “It could be that people who’ve been around marriage a long time—and have been around Hillary, in a way, a long time—don’t have the clash that might be in the younger couple. It’s just not an issue in conflict.”

The writer was careful to point out that his support of Mr. Obama comes from his desire to fulfill the delayed promise of the 1960’s civil rights movement, and doesn’t make him Hillary-hostile. Same for his wife.

“She’s the one that’s been to those little fancy lunches that women of power have, if not of color, and she even bid on Hillary’s book a couple of times,” he said. “She didn’t get it, but she’s disposed towards Hillary Clinton and probably would vote for her. Except she ain’t.”

When the renowned paleontologist Neil Shubin announced in 2006 that he’d discovered an ancient fossil with an uncanny resemblance to a “missing link” between fish and land-dwellers, creationists responded with all the fury of pissed off-apes. Jumping, hooting and thumping their chests, they denounced the discovery as secular “propaganda” and trashed Dr. Shubin’s creature, named Tiktaalik, as nothing more than a desperate, pro-evolution publicity stunt.

“With the continued invalidation of the corrupt theory of neo-Darwinism in the eyes of many, and school boards nationwide taking a favorable look at intelligent design, it is not surprising that evolutionists are scrambling to enact damage control,” wrote Frank Sherwin, a “creation scientist,” in a news post for the Institute for Creation Research shortly after the story of Tiktaalik landed on the front page of The New York Times. “Enter an alleged ‘missing link’ that some are saying reveals one of the greatest changes in the field of zoology.”

Now, nearly two years later, Dr. Shubin has come out with his riposte, a book titled Your Inner Fish that is bound to send his anti-evolutionist foes into fits of pre-primate rage. This isn’t because Your Inner Fish is a particularly strident or polemical work. Written in a clear, patient voice, it keeps its God-delusion comments to a minimum while somehow managing to go 200 pages without ever mentioning the E-word. (Instead of “evolution,” Dr. Shubin uses Darwin’s more delicate term, “descent with modification.”)

But for those readers still raging over the idea that humans might be descended from “lower order animals” (like, say, monkeys), Dr. Shubin’s book suggests an even more terrifying possibility: It offers a rigorously empirical exploration of how humans evolved from microbes into men and women, with some vital contributions from jellyfish, sharks, flies and, of course, Tiktaalik-like hybrids along the way.

Indeed, if there’s one message of Your Inner Fish, it’s the “exceptional similarities” between creatures as distant and disparate-seeming as Homo sapiens and, say, Paracoccus denitrificans, a humble bacteria bearing a remarkable resemblance to the mitochondria buried in all human cells.

As Dr. Shubin writes, “All animals are the same but different. … We may not look much like sea anemones and jellyfish, but the recipe that builds us is a more intricate version of the one that builds them.”

Or, in practical terms: Don’t expect to see Mike Huckabee curling up with this book.

FORTUNATELY FOR DR. Shubin, there are still enough adherents of reason and science to appreciate Your Inner Fish’s surprisingly titillating evolutionary anatomy lesson. Part research memoir, part biology course, the book begins with the author’s quest to find one of the long-sought prizes of paleontology, a fossil that bridges “one of the great transitions in the history of life: the invasion of land by fish.” For nearly a decade he dedicated himself to this search, spending his winters doing research and his summers digging in the Canadian Arctic while fending off polar bears and praying the food supply wouldn’t run out. Who knew paleontology could be such a manly sport?

Then, in 2004, while excavating a mound of 375 million-year-old rocks on Ellesmere Island, Dr. Shubin and his team stumbled on their fossil El Dorado: a strange hybrid animal that seemed to straddle several species. With the scales on its back and its clear fin webbing, the creature had the definite traits of a fish; but with its flat head and neck, as well as its incipient wrist and arm bones, it looked uncannily like an early land-living tetrapod.

In deference to the Inuit on whose land the fossil was found, Dr. Shubin and his colleagues named the new species Tiktaalik roseae—“Tiktaalik” means “large freshwater fish” in Inuktitut. The scientists, however, came to a slightly different conclusion: The fossil was a “beautiful intermediate” between land- and water-dwellers, a fish with the first signs of the limbs, head and neck that would eventually evolve into some of the appendages we recognize as parts of us.

“This fish doesn’t just tell us about fish; it also contains a piece of us,” writes Dr. Shubin. He adds, “Seeing Tiktaalik is seeing our history as fish.”

As the book’s title suggests, this is the central conceit of Your Inner Fish, an idea repeated so relentlessly that, by the final page, it’s hard to look at your hand without seeing the faint traces of a fin lining its edges. Nor does the book stop here, at our history as scaly creatures of the deep; our inner fly, sponge and sea anemone are also excavated in all their wild, unexpected detail.

Who knew, for instance, that “the essence of our head goes back to worms, organisms that do not even have a head”? Or that every “limbed animal” possesses a gene called Sonic Hedgehog that helps differentiate our digits and shape our limbs “from shoulder to fingertip”? Who even knew there was a gene called Sonic Hedgehog, after the video game?

Your Inner Fish is full of these surprises, wacky factoids that help propel the book through some of its drier sections—which do exist. So, even as we wade through the descriptive mire of gene interactions and fly experiments, we also get to delight in odd little facts like humans “are a package of about two trillion cells assembled in a very precise way” or “our sense of smell allows us to discriminate among five thousand to ten thousand odors.”

The result is a book that probes deep into the heart of what we are, pushing well past our inner fish to reveal something even more mysterious and profound: our Darwin-loving inner geek.

books@observer.com

Lizzy Ratner, now a freelance writer, was formerly a reporter at The Observer.

It was a beautiful Wednesday afternoon in early October, and all up and down Park Slope’s Seventh Avenue, women were busy being mommies. There were a few nannies, and four fathers stumbled about. But mostly it was mothers—a solid 50 or so—dutifully juggling life and babies while managing to look at once earthy and graceful, not a Britney among them.

This is the good life for a certain caste of New York woman, the aspirational endpoint as brought to you by Maclaren and Cookie magazine. But watching the parade of moms it was hard not to wonder, at what point did child-bearing become such an inescapable component of the New York woman’s dream? And at what point did New York City, historic refuge for the quirky, carefree and childless, turn into a Den of Procreation?

“It’s like a cult,” said a 34-year-old not-yet-parent named Alison who works in advertising and lives with her husband in Lower Manhattan. “It’s like a cult, complete with the required reading, the clubs, the gurus, the dues, the inclusion, the excommunication, the hierarchy.

“And the pressure,” she continued, “starts in the missionary position.”

Raised on the old baby-versus-career debates, women of Alison’s generation always anticipated that the big discussion would be about if they wanted kids, not whether they planned to have three or even four. Certainly when they chose to settle in New York, a town that regularly undershot the national birth rate and was proud of it, they had reason to expect that they were not on the soccer-mom track.

But sometime during the past few years, something strange happened to these historically reticent reproducers. They freaked out, got busy and turned themselves into mascots for the new maternity. In just five years, between 2000 and 2005, the number of children under five living in Manhattan ballooned more than 32 percent, according to Census figures.

It probably didn’t help that in 2006 the Centers for Disease Control issued guidelines recommending that all women of childbearing age be considered “pre-pregnant,” chomp folic acid and avoid smoking. In 2001, the American Society of Reproductive Medicine launched a “protect your fertility” campaign, complete with posters of baby bottles in the shape of quickly draining hourglasses. Meanwhile, the fashion industry has been churning out empire-waist dresses and billowy blouses that make even the skinniest ingenues look like expectant mothers.

Somewhere along the way, the powerful feminist idea that having children was a choice disappeared into the trousseau chest.

Over in France, a similar fertility push, which has helped give that country the highest birthrate in Europe, has sparked something of a backlash in the form of a best-selling book by a writer and psychoanalyst (naturalement!) named Corinne Maier. Titled No Kid: 40 Reasons Not to Have Children, the book is part angry manifesto, part modest proposal urging adults—and above all women—to remain “without descendants.”

“No children, no thank you,” writes Ms. Maier, 43, in the conclusion of No Kid, which is currently being shopped to American publishers. “Women, the future of our country depends on you. The last freedom is to say, ‘I prefer not to.’”

Ms. Maier has caused quite a commotion in France, not the least because she already has two children of her own. (Talk about giving Junior a complex!) But No Kid has raised some valid questions, like, why are people so eager for women (particularly white, nonimmigrant women) to have babies these days? And why, when they do, does it have to be “the most beautiful thing in the world?”

“For women it’s compulsory, you have to be delighted,” Ms. Maier told The Observer in a phone conversation. “We have to work hard, be perfect and be ready,” she added, to sacrifice everything to raise the perfect child.

But back here, in radical old New York, there has been little public discussion among pre-pregnants of the rising pressure to procreate. In this age of “mom”-inism, where success is grand but motherhood is holy, women who declare they don’t want kids are considered self-haters or throwbacks.

This worries veteran feminists like Gloria Steinem. “We’re certainly not in an O.K. place,” said Ms. Steinem, who herself chose not to have children and said she never regretted it. “Whether women can decide for themselves whether to have children or not is the single biggest component of our health, our economic status, our education, our ability to control our own lives.”

One might ask: When will we get our own backlash? In our brave new world, in which everyone from Nicole Richie to Curtis Sliwa’s quintagenarian sister is getting knocked up, no one is exempt from the baby squeeze. Fifty-five-year-old women who’ve never had kids now get told, “It’s not too late!”, while some gay men and women, suddenly surrounded by baby-happy friends, have now begun complaining about the pressure to reproduce.

“When did I wake up and become Bridget Jones?” asked Stephanie, a 37-year-old editor and member of No Kidding!, a social group for adults who, yep, don’t want kids. “I’ve had the experience of having two women not even want to date me because I don’t want to have kids.”

Molly Peacock, the poet and feminist, can relate. At 60, she has never had a child—in fact, she wrote a memoir called Paradise, Piece by Piece about her decision not to have a child—but she can still imagine the day when someone will nudge her in the ribs and wink, “There’s still another chance for you!”

“You can’t get out from under it,” she said. “I really can understand how a younger woman can just feel like this blanket’s been thrown over her head.”

“Even my sluttiest friends are having kids now,” said Alison, the pre-parent, “which is alarming.”

In her new book, The Terror Dream, the feminist Susan Faludi (also without child) argues that the procreation push is part of a creepy post-9/11 gender narrative, an extension of the ongoing, nationalist effort to promote hearth, home, and female fragility: “a concerted effort to promote this … idea that women would and should reproduce as a way of consoling the nation,” as she put it to The Observer.

Or maybe it’s just capitalism at work.

“I think that it’s just such a clear extension of affluence, that people can afford to have children become an extension of themselves,” said Janice Min, editor in chief of Us Weekly and the mother of two young children.

Ms. Min knows a thing or two about today’s fetus frenzy. Hollywood, after all, is one of its chief purveyors, a land in which everyone from 17-year-old Keisha Castle-Hughes, who appeared heartbreaking and prepubescent in Whale Rider, to 45-year-old Marcia Cross of Desperate Housewives seems to be sporting a belly.

Forget Katherine Hepburn, who famously chose not to have children in order to focus on her career. These days, it’s pregnancy that earns an actress ink.

“It’s almost un-American at this point to say you don’t want children, especially from an image perspective,” said Ms. Min, who spoke to The Observer the day her magazine broke the news of Jennifer Lopez’s pregnancy. “It’s almost like saying you’re a communist.”

Asked about her magazine’s own role in this phenomenon, the editor cited audience appetite. “There just seems to be this endless, bottomless desire to see celebrity offspring,” she said. The postfeminists of today, she said, no longer sees kids as “some sort of personal setback.”

Certainly it’s not a bad thing that motherhood is no longer stigmatized. But it all smacks a bit of the 1950’s—albeit spiffed up with Gucci baby carrier, Juicy maternity jeans and wooden toys from Germany. “I think there are ways in which these Bush years feel like the Eisenhower years,” mused Ms. Peacock, the poet. Then she offered a ray of hope.

“Of course, that’s the generation of women who produced Betty Friedan,” she said, “the generation who produced The Feminine Mystique.”

But after an initial joke or two about how much longer it takes a girl-candidate like her to get dressed than the menfolk in the race, Hillary seemed to have a new routine for The View’s target lady demographic: the sister soldier chipping unthreateningly, if valiantly, away at one of just another of those barriers that all women face in one way or another.

Sitting in front of a giant V – for The View, of course – she spoke of the fact that “there still is probably a tougher standard for women” but she just tries to do the “best she can.” And in a play that seemed to come straight from the Girl Scout handbook, she spoke of the old grannies and young girls who have been moved by her campaign, as if to say, yes, she might be running for the most macho job in the land, but she’s just a girl like us, trying to make some change. Call her the Girl Scout in Chief.

“All these women in their 90's come to my events,” she said. “Sometimes they’re in walkers, sometimes they’re in wheelchairs, like a daughter or a granddaughter will bring them. And then when I go around shaking hands, they’ll say something like, ‘I’m 95 years old and I was born before women could vote and I want to live long enough to see a woman in the White House,” she concluded to applause and appreciative murmurs from the audience.

And then, turning her attention to the younger girls, she said: I’ll hear a father or mother lean over and say to a little girl, see honey? You can be anything you want to be. And I get that sort of welled-up feeling…”

As a routine, it seemed to be yet another flawless Clinton production, an ingenious – and admittedly, appealing – way to reach out to The View vote while neither scaring them off nor appearing so Martha Stewart one minute that she couldn’t go on to discuss her China policy the next. It was Steel Magnolias feminism at its best.

There was, however, one moment in all of this when it became clear that even warm and fuzzy feminism can still be complicated.

“Who’s going to be the first Lady?” asked Barbara Walters with what sounded like some genuine curiosity.

For a moment Hillary looked startled, or perhaps a bit miffed, but then, with the giggle and a sigh, she picked right back up with the sisterhood thread.

“Give a busy woman a job -- I’ll probably have to do all that as well,” she said with a sisterly eye-roll.

The audience ate it up.

But in recent weeks, Ms. Wilson has begun to entertain an idea that would seem to run counter to many of the twists and coils of her political DNA: She may vote for Mrs. Clinton in New York’s Feb. 5 presidential primary.

“I genuinely think she’s the man for the job,” Ms. Wilson said.

“With Hillary,” she said, “you get a Dragon Lady who you know can slay dragons.”

This may not be the kind of frothy endorsement most presidential contenders covet. But within the world of liberal-leaning Hillary skeptics, where Mrs. Clinton is resented for everything from her Iraq vote to her perceived political pandering to her “maddening caution” (as one critic phrased it), Ms. Wilson’s decision represents a palpable shift.

Certainly, there are plenty of staunch liberals who still get queasy at the mere thought of pulling the lever for Mrs. Clinton. But as the bloom has faded from the Obama rose, and as Mrs. Clinton has solidified her image as the “inevitable” nominee, a segment of New York liberals are yielding.

This movement stems in part from a tentative warming among some Hillary critics. But it also comes from a sense of stolid resignation among others—a kind of self-vaccination against an unwelcome reality. Some Democrats experiencing this conversion describe a mix of symptoms that sounds uncannily like vertigo.

“It’s hard to describe the feeling that some liberals have towards Hillary’s nomination,” said Fred Gooltz, director of strategic messaging for Advomatic, a left-leaning Web development and strategy shop founded by members of the Dean For America Web team. “It’s not as cut-and-dry as, I used to hate her but now I love her. It’s a complicated mix of feelings.”

Jason Wojciechowski, 30, another online media activist and onetime Howard Dean supporter, put these feelings in sharper terms.

“My biggest moral dilemma is, can I put very much support behind someone about whom I think, ‘People are dead because she’s not doing her job’? Because she’s not being a leader on the issue?” asked Mr. Wojciechowski, referring to Senator Clinton’s ongoing opposition to a full U.S. withdrawal from Iraq.

Nonetheless, he has found himself inching in her direction.

“It’s gone from pretty close, but probably Obama, Edwards, Hillary, to Edwards, Hillary, Obama,” Mr. Wojciechowski said, listing the order of his presidential preferences. “So she knocked Obama out of the top spot, but she still couldn’t take Edwards down.”

In a way, Mr. Wojciechowski’s evolution is indicative of something larger happening, in particular, with early, actively liberal supporters of Mr. Obama. The Illinois senator was, until recently, seen as perhaps the one Democratic candidate capable of launching a Howard Dean–style insurgency against the Clinton establishment. He was the one who was supposed to restore Camelot. He was the one who was supposed to be audacious. He was the one who was supposed to give voice to a whole new political generation.

But sometime during the summer months, self-described online activist types like Mr. Gooltz and Mr. Wojciechowski began cooling to him. As they described it, there was no single moment of epiphany, but rather a series of events that irked and disappointed—from the senator’s failure to vote against censuring Move On for its “General Betray Us?” advertisement (he sat out the vote) to his less-than-universal health care plan.

“I would say that a lot of the online political operatives who are liberal were holding out hope for Obama, and they have sort of come to the conclusion that he is not the candidate they thought he was,” said Mr. Gooltz, who, like Mr. Wojciechowski, has recently upgraded Mrs. Clinton to second place in his candidate lineup, while downgrading Mr. Obama to third our fourth. “A lot of liberals were hoping he was going to be a somewhat more aggressive progressive.”

Into this void, the Clinton campaign stepped—or, perhaps more accurately, inched and elbowed its way with a series of canny gestures toward the liberal base. These gestures were not of the sweeping “End the War Now” or “Gay Marriage for All” variety. Instead they tended to be subtle: One moment she was voting against censuring Move On, the next her deputy, Howard Wolfson, was defending Yearly Kos, the annual ingathering of the liberal-blogger tribes, against attacks by Bill O’Reilly.

Craig Kaplan, a Manhattan lawyer and longtime donor to liberal Democrats, has not decided to support her yet. But several weeks ago, he came to the conclusion that he might actually want her to win the nomination. The reason? He feels she is the only Democratic candidate who can overcome the Code Red–level threat of a Rudolph Giuliani presidency.

“You have to ask which of the candidates is least likely to lose or most likely to win against Rudy Giuliani,” he said. “In my judgment, this is most likely Hillary Clinton. Therefore, while ideologically and perhaps emotionally I would love to see Edwards win Iowa, the narrower tactical head says, I want a Hillary sweep.”

Even among supporters of other candidates, there seems to be a recognition that the perception of Hillary as the last bulwark against Mr. Giuliani—or Mitt Romney, or John McCain or Fred Thompson—is metastasizing.

As one Obama supporter put it: “Eventually people are going to say, ‘look, I’m going to vote for whoever can beat what I see as a bunch of evil men [who] are going to continue the legacy of George Bush.’”

Yet even before Democrats can make this calculation, they have had to contend with another, more potent force driving them to stop resisting Mrs. Clinton’s candidacy. It’s the idea—or tautology, really—that Hillary Clinton’s primary victory is inevitable and so one might as well vote for her or, at least, resign oneself to her sooner rather than later.

The Clinton campaign has worked hard to cultivate this notion, and several Obama and Edwards supporters have accused the press of helping promote the idea (with articles, for instance, like this one). More recently, certain “facts on the ground,” like the Oct. 3 Washington Post/ABC News poll giving Mrs. Clinton a 33-point lead nationally over her nearest rival, Mr. Obama, have helped lend the appearance of substance to the theory.

The fallout was obvious at the most recent gathering of Drinking Liberally, a weekly mixer dedicated, as its motto says, to “promoting democracy one pint at a time.”

“Personally, I prefer Edwards, but there’s no way he’ll ever get the nomination,” said Charles, a 24-year-old liberal drinker and research assistant at a local nonprofit, as he sat in the backyard of the theater district dive, Rudy’s Bar and Grill. He had a sharp, gunpowder voice that he used to enumerate his disagreements with Mrs. Clinton, and one could imagine him standing at the barricades in another era. As it was, he wasn’t planning to vote for her in the primary, but declared himself resigned to the outcome. “I know Hillary is going to get it,” he said. “It’s a foregone conclusion.”

His friend Adam fidgeted with an empty beer cup. Then, after a brief search for the right words, he said quietly, “If it’s going to be Hillary, I guess I’m O.K. with that. But if it was my choice, I guess I would choose somebody else.”

And yet, ask the 21-year-old actress how she is surviving, and her pale-moon face begins to glow like a nightlight.

“It’s gotten more and more fun, and more and more empowering to be able to have the guts that this character has—to even pretend for a second that somebody has that amount of balls,” she said unleashing one of many long, galloping bursts of laughter (seriously, some lasted seven or eight seconds).

It was a late September afternoon, less than two weeks before the play’s Oct. 4 opening, and Ms. Pill was sitting, slender and unnoticed, at one of the outdoor banquettes of her favorite East Village coffee joint, MUD. Dressed in jeans and a black tank top, with jittery fingers and poised, button features, she seemed to hover somewhere between frail, vigorous and jaunty.

“She’s the most hopeful character I’ve ever played,” Ms. Pill continued. “It’s so glorious.”

Ms. Pill was not being facetious. While her character, Jackie, is no kitten—she is, in fact, a “damaged” kid who is desperate to escape her crappy past by selling off a contested family stamp collection—she’s a remarkably buoyant creature compared to some of the other roles the actress has tackled.

Ms. Pill, you see, has already been around the crazy-character block several times during her three and a half years in New York City. She has played a scrappy girl terrorist in Martin McDonagh’s The Lieutenant of Inishmore—a play that marked her Broadway debut and earned her a Tony nomination for featured actress. She has played the tormented victim of a Lolita-style love affair in Blackbird, an off-Broadway play for which she won all kinds of critical praise and, yes, more nominations (that time from the Outer Critics Circle and Drama League). She has played broken girlfriends and clinically depressed teens and now, with Mauritius, a complicated young woman who also happens to be her first starring Broadway role.

Taken together, it’s enough to have earned her the title, unusual at any age, of genuine stage actress—or, even better, theatrical throwback.

“I have a feeling she was born to this, it’s just one of those things,” said Mr. Abraham, who plays opposite her in Mauritius as a wealthy and thuggish stamp collector—yes, a thuggish stamp collector—intent on prying the stamps from Ms. Pill’s character’s possession. “She’s got the potential to do the Great Roles, and I don’t think I run across that very often—or people who are interested in doing it. It’s what I believe an actor should be doing.”

This, however, is not what most actors are doing, particularly the young ones. In these pantiless times, most pretty lithe things with a spark of talent (or just the delusion of it) hightail it to Hollywood as quickly as they can, glancing toward the stage only when they need a quick credibility fix. The results are often less than happy.

But Ms. Pill, who doesn’t drive and insisted she hates L.A. (“I get honked at when I try to walk down the street!”), has embraced a rather different approach to the whole acting game.

She came to New York in early 2004. She settled in the East Village—first in an apartment with two random British dudes, then in her own place. She made some friends, learned to dodge rats, played foosball. She began auditioning. And steadily, if not slowly, she climbed her way from off-off-Broadway to off-Broadway, to the Great White Way itself. (Can people really use that expression anymore?)

Of course, it probably didn’t hurt that she had built a steady career as a kid actor during her teen years in Toronto. And, to be sure, she has done her share of pixilated popcorn fare, appearing in movies like Confessions of a Teenage Drama Queen as Lindsay Lohan’s dorky sidekick and Pieces of April as Katie Holmes’ prissy-perfect younger sister. (When asked what it was like working with these two tabloid honeys, she said, with an indulgent smile, “You know, I’m just going to give you the ‘They’re both great.’ And, uh … both very sweet.”) At the end of October, she will shine down from movie screens across the nation as Steve Carell’s daughter in Dan in Real Life.

Still, for all this, one gets the sense that movies are not where Ms. Pill’s big passion lies. They are certainly “fun.” They definitely help pay the bills. And they allow an actor to “focus more specifically, which is nice,” she said. But it’s the stage that makes Ms. Pill misty, that turned her from a wisecracking everykid into a dewy thespian as she spoke to The Observer, her eyebrows knitted so tight they quivered.

“I mean, the writing in plays is typically just much better than most other writing, or at least more fun to play, and you get to play with language instead of just, Duh,” she said, unlocking her brows and cocking her head like a latter-day Tara Reid. “But if it’s natural dialogue, there’s a poetry and a rhythm that you yourself are finding. And there’s something really interesting about that.”

If Ms. Pill had not become an actress, she said, she probably would have liked to try her hand at academia. What kind? “Physics. Quantum mechanics. Ya know,” she said with a cool swagger, before dissolving into laughs. And then, more seriously: “I would have liked to have tried to get more into politics, I think. I’d also sort of dreamed of a degree in English too.”

Ah, well. English and politics would have been nice. But the truth is, Ms. Pill has been an acting junkie since almost, well, the beginning.

As Ms. Pill described it, she first got bit by the performing bug when she was 10 or 11. It all began innocently enough, after a “guy who worked at CBC Radio” in Toronto heard her narrate a show for her children’s choir (she also did ballet at the National Ballet School, and retains that telltale posture and willowy figure) and asked her to read for some books on tape he was producing. “I was like, O.K., sure, I can read,” she said, mocking her clueless child self. But soon she was pestering her mother for head shots, an agent, auditions. When she finally landed a job as an extra in Kung Fu: The Legend Continues, she was a “goner,” she said.

“I had the best time,” she recalled. “I fell so hard in love with everything about it.”

Ms. Pill made her first exploratory foray into New York’s theater world toward the end of her senior year in high school. By that point, she had already racked up a sizable list of TV-movie credits as well as Pieces of April (which was set, perhaps not incidentally, in the East Village). Live theater, however, was something completely new.

“I had no idea what I was doing,” she said bluntly of her first audition for a role in the New Georges theater company’s off-off-Broadway production of None of the Above. “I sort of might have said that I had done theater in Toronto, when in fact it was in a church basement, and it was like a camp thing. But I was like, ‘Oh, I am such a pro, you have no idea,’” she said, affecting the dripping accent of a 40-year-old diva.

The ruse seemed to work, or maybe she just had a really good audition, because Ms. Pill got the part, after which came other auditions and other parts. Sometimes the roles fell into place easily. Other times she had to beg—or simply dress up as a boy, take pictures of herself and send them to the director—as she did after auditioning for the Lars von Trier-Thomas Vinterberg collaboration Dear Wendy.

“I wrote an insane letter, and I just begged him to be part of the movie,” she confessed.

Then there were the times when, despite a sizzling audition, she simply didn’t land the part.

“We first saw Alison Pill when she came into audition for Doubt for the role of the Sister James, and she blew us away,” said Mandy Greenfield, associate artistic director of production for the Manhattan Theatre Club, which produced Doubt and Blackbird and is now producing Mauritius. “We were all left with the sensation that we’d just seen someone incredibly special.”

For all that—the sensations, the tingles—Ms. Pill was not cast in Doubt. (Alas, the cruelty of casting directors!) But over the next few years she would work fairly consistently, doing fine if not swell, until she hit the lovely, lucky streak she’s been riding for the past 18 or so months.

The streak began in the spring of 2006, when she made her Broadway debut as Mairead in The Lieutenant of Inishmore. Inishmore led to her first Tony nod, which, despite ending sans trophy, did culminate in a good party and nice dress (though she confessed that she nearly wound up in a terrifying sequined number that made her look “like a choir director from Russia performing at Carnegie Hall”). From there she went on to audition for another Manhattan Theatre Club play, the twisted sexual abuse saga Blackbird, and this time landed the part (opposite Jeff Daniels, no less). “She completely owned that Blackbird text,” recalled Ms. Greenfield. Her lead role in Mauritius followed from that.

THE STORY OF Mauritius is not a warm and fuzzy one. Directed by Broadway veteran Doug Hughes, it follows five rather ruthless characters as they try desperately—and sometimes comically—to cheat, scam and even strangle each other as they all vie for a potentially valuable, but potentially counterfeit, pair of stamps. It’s philately as a blood sport.

Ms. Pill’s character, Jackie, sits right at the beating center of the action. A sullen yet feisty post-teenager (Ms. Pill said that she and Mr. Hughes had decided the character is around 22), Jackie is the one who sets the story in motion, and it is her quest to sell off the stamps—and win herself a new life—that forms the arc of the play. Along the way, she gets knocked around, fights back, falls down, gets back up, falls again. For Ms. Pill, it translates into one long evening of fighting for respect—onstage, that is.

Offstage, it’s a different matter. As she described it, the reality of life behind the curtain resembles something far closer to the peppy fabulousness of theater camp than the dysfunctional slyness of Mauritius. The actors hang out together. They support each other. They sing karaoke, drink champagne, and even do each other’s makeup—or at least, Katie Finneran, the Tony-winning actress who plays Ms. Pill’s half-sister in the play, helps her paint on her eyebrows because “apparently I’m not good at painting on eyebrows,” Ms. Pill said.

And though Ms. Pill is a good 40 years younger than some of her castmates, and though she was certainly intimidated by one or two at first—uh, Mr. Abraham—she now finds herself sharing regular, gushy mutual lovefests with her fellow Mauritians.

“We all leave the stage and we all have a little group hug after curtain call. We go, ‘Mauuuuuuuritius!’” Ms. Pill confessed, before unleashing one of her operatic guffaws. “We’re all such theater geeks. It’s kind of lovely.”

Of course, hugs and karaoke don’t necessarily translate into reviews, and at some point—quite soon, in fact—the actors will have to contend with either the kind or harsh words of the critics. But when Ms. Pill was asked what she hopes for Mauritius, she spoke only in terms of the play. “I want it to loosen up and for us to really just sink into it and accept the fact that we get to take an audience through a really good story that is satisfying,” she said.

As for what her co-stars want for her, it’s pretty straightforward.

“Keep doing theater,” Mr. Abraham advised in his perfectly enunciated baritone. And then, without being asked, he volunteered, “I’d like to work with her again.”

It was shortly after four on a summer Wednesday—not even rush hour—but the six lanes of asphalt lot were already two-thirds full. They were jammed with cars of every shape and origin—with boxy Acuras and slope-backed Subarus, snub-nosed Jeeps and bug-shaped Jettas, braggy Mercedes, rah-rah Fords, and a strange BMW-minivan chimera the color of a fresh picket fence. In the distance, the Manhattan skyline reared up flat and two-dimensional, signifying City. But here, as car alarms twittered and shopping carts squeaked, as shoppers kowtowed to the shrine of their trunks, the vibe was pure car-country nirvana.

“I didn’t realize how much I missed the car until I had it here,” said Lauren Robinson, a 25-year-old dietician with pixie-cut brown hair, a fetching dimple, and a bearded beau who was dutifully loading groceries into her Honda CR-V. The Honda was a relic of her youth in upstate New York, but she had recently brought it to the city after moving from car-hostile Manhattan to auto-friendly Brooklyn. She didn’t really need the vehicle, and, theoretically, she could have grabbed a bus to Fairway. But, as she explained, “It’s just so easy to jump in and drive somewhere.”

“I don’t think you need a car,” she said, “but I think it’s definitely a plus. And it definitely makes me feel more”—she paused to search for the word—“well, not like such a city person.”

Vrrrrrroom!

Ms. Robinson is hardly alone in her secret suburban car lust these days. In fact, for all the talk of the evils of automobiles, she is in decidedly turbo-charged company. From Greenpoint to Red Hook, Inwood to Astoria—across all of the city’s young, lifestyle neighborhoods, really—New Yorkers of a certain breed and background have taken to toting their four-wheeled friends down to the city, dragging them through the streets like well-worn baby blankets. Lured by the musk of vinyl and gasoline, they have lined the lanes of Fairway with out-of-state license plates. They have given their cars names like Ruby, Monty and … Digger. (“I call it my baby,” said Digger’s driver, Michelle Barlak.) And though few would dare admit it, they have made sections of the city seem so, well, L.A.

“Oh, I hope New York’s not becoming L.A.-ified, because I moved to New York to get away from L.A.,” gasped Laura Allen, 24, a giggly SoCal native, right before she hopped into her boyfriend’s white Jeep Cherokee and turned its muscular tires onto the smoothness of Williamsburg’s North First Street.

New York, of course, has always been more of a car town than romantics like to admit. From the earliest days—or at least from as far back as anyone reading this paper can probably remember—Gothamites have used cars, improbably and impractically, as everything from performance pieces and getaway vehicles to status symbols, primal therapy props, bumper cars, mafia-mobiles, and avatars in the giant video game that is New York.

But there is something strange—or particularly strange—about the car culture that has taken root in certain swaths of the city in recent years, sprouting up alongside the former kids of suburbia as they have continued their march across Boerum Hill, the South Slope, Williamsburg, Astoria. As many of these drivers will admit, they wouldn’t keep a car if they lived in the parking-space tundra of Manhattan. But with their move to the boroughs—to the land of “far-flung” specialty stores, parking-space-lined streets, and the accelerated domesticity of brownstone life—they have realized that they can resurrect the customs of their pre-urban past.

Never mind the weird, globally warmed weather patterns or the congestion-clogged streets. And forget the fact that many of these drivers probably came here to escape the cul-de-sac culture of their youth. For reasons both deep and ineffable, these young transplants just can’t help bringing suburbia with them.

The Pro-choice argument

“The day we leased the car and got the keys was like my 16th birthday all over again,” Melissa Walker, a 30-year-old writer, Park Sloper and leaser of a silver Saab 9-3 sport wagon told The Observer in an e-mail message. “I felt a great sense of freedom, like I could go to a beach other than the A-train Rockaways, like I could hit a Rhinebeck B&B at a moment’s notice, like I could go to Fairway and load my groceries into a trunk just like a suburban girl!”

Ms. Walker is a classic example of the post-suburban, proto-urban car chick. Born and raised in North Carolina, she began saving for her first set of wheels when she was 10 years old. When she was 15, she went ahead and purchased those wheels—a 1988 Ford Festiva which she dubbed Ferdinand—despite the fact that she was still too young to drive. At 16, she finally realized her dream when she got her license and, with it, the right to range free and wild across the Circle K-spotted hills of the Carolinas.

“It was definitely the biggest deal in the world,” she said later on the phone.

Ms. Walker might have continued indefinitely in this state of automotive bliss, but sometime after college she moved to New York, where owning an auto simply seemed too expensive and too complicated. For half a decade, she lived her life in the carless lane. But then she met a boy, and the boy also loved cars, and so, when they finally moved in with each other, they decided the time had come—no, not to get married. Or have a baby. The time had come for that other, newer rite of pseudo-urban adulthood: to lease a car.

“We went ahead and did it, and we’re really happy,” Ms. Walker said. “It’s able to give me more choices, in terms of the grocery shopping, or being able to pick up a piece of furniture that I see on Craigslist that I love. I haven’t done that yet, but I always think, I could.

“It kind of softens the inconveniences of the city,” she concluded.

“Convenience” is one of the main mantras of the nouveau automobile set. Convenience—not necessity—since most drivers will acknowledge that they don’t really need a car (few of them live in, say, Canarsie) and they don’t generally drive long distances, unless they’re heading out for the occasional jaunt to New Jersey, Long Island or their parents’ house in Vermont. (According to a spokesperson at Transportation Alternatives, roughly one-quarter of all automobile trips in New York clock in at one mile or less; approximately three-quarters of all trips are five miles or less.)

And yet, while most of them don’t need, they want, because cars, they say, make life feel a little easier, make the city seem a bit more manageable—as if New York, with its 656 miles of subway track, was just another boonies-locked, consumer wasteland.

“I drive out of my way to go to a gym where I can park,” confessed Ms. Allen, the bubbly L.A. girl, who splits her time between writing and bartending at the Lock Inn. “I just think it’s more convenient.”

Ms. Allen delivered this statement as she stood on the corner of North First Street in Williamsburg, clutching the keys to her boyfriend’s Jeep. She had just taken her dog, Roxy, to get spayed at the vet, and the poor beast was stretched across the back seat of the car. Ms. Allen insisted that she wasn’t actually much of a fan of auto culture, that she could easily do without a vehicle and would never have purchased one herself. But as she posed next to her honey’s SUV, flashing a bright smile, all that seemed to be missing from the scene was Seann William Scott and a Continuum Transfunctioner.

This tableau of the cute girl and the big car—with or without the neutered cur—is uncannily common in Williamsburg these days, despite its oddly Teflon reputation as the home of the hipster. While it’s still possible to stumble on the odd, tricked-out hearse or pass a small Tour de France’s worth of bicyclists (biking is big there), gently distressed Volvos—thanks, Ma and Pa!—are equally ubiquitous, as one recent visit revealed.

In the short distance between North Fourth and North Ninth Streets on Driggs Avenue, The Observer counted nine of these family-friendly vehicles glinting in the sun. Most of the them were classic four-door types, but there were also two-doors and wagons, old Volvos and new—a whole menagerie of in-state and out-of-state vehicles littered with everything from tennis racquets to Pottery Barn catalogues to an Atlas of the five boroughs. The total afternoon Volvo-count came to 23.

But perhaps the real sign of the car culture apocalypse—the hint that, when it comes to wheels at least, Williamsburg and Winnetka might not be so different after all—is the sobriety check that cops have set up on Meeker Avenue, near one of the on-ramps to the Brooklyn Queens Expressway. No one can say exactly when the checks began or whether they are a direct response to the influx of postcollegiate boozers. (The New York Police Department did not respond to a request for a comment.) But several sources agreed that they first noticed them sometime within the past year—a floating barricade of police, batons and breath-a-lizers, just like back home!

“I’ve been caught in it twice in a year,” said Ms. Allen. “They’ll stop you before getting onto the freeway and be like, ‘Hi, we’re doing a sobriety check, have you had anything to drink tonight?’

“Of course you say no,” she added sagely.

The Alternate Side of Paradise

For all the comforts that car life allegedly provides, few can deny that it also demands a heavy fee from its adherents. These fees range from the annoying to the enraging—from the cold, hard cash demanded by meter maids, busted windows, and your car’s shocks after you make a single sortie down the BQE; to the less tangible but no less Gordian hell of traffic snarls and parking.w

And yet, ask any sad sop waiting out the alternate-side morning ritual, and most of them will say they wouldn’t give up their cars for all the MetroCards in America: the convenience, the familiarity, the freedom—thank you, George W. Bush!—make the sacrifice worthwhile.

“Yeah, it’s a pain,” said a 29-year-old school teacher named Barbara as she sat in the driver’s seat of her keg-colored Jeep Grand Cherokee Laredo one morning, waiting out a 90-minute alternate-side-of-the-street-parking sentence on West 71st Street. To help pass the time, she had brought along a copy of Inside magazine, a cellphone, and a pack of Marlboro Lights—one of which was dangling between her fingers. “But it’s worth it, basically, to have it. Otherwise, you have to take a train or go to that God-forsaken Port Authority to get out of the city.”

Remarkably, Michelle Barlak, another young auto-fiend and owner of the aforementioned Digger, also finds it worth it, despite enduring some serious vehicular nuttiness during her brief time in the city.

Ms. Barlak, 23, purchased Digger last fall, just a year or so after she moved to New York from her home in the upper reaches of the state. The car, a 1993 Buick Century, was used, but it was, in Ms. Barlak’s own words, “in great condition.” Then came its urban baptism—the bangs, bashes, scrapes and dings that relieved it of one of its tail lights and turned it into the kind of creature that “definitely wouldn’t be entered into the car show,” she said.

Ms. Barlak herself was almost banged up and bashed because of her car. It happened late one autumn evening after she arrived home from a dog-training class—she has three dogs, all champions—only to find that there were no parking spaces in her Queens neighborhood. For two hours she drove around looking for a spot. She finally found one, but as she was parallel-parking—another dread reality of New York car life—a guy in a flashy sports car sped past and bumped her Buick. Ms. Barlak maintains it was his fault, but before she knew it, the man had gotten out of his car, begun screaming, and tried to punch her through her window. (Fortunately, he missed most of her face, but he did manage to mangle her glasses.)

Ms. Barlak is the first to admit this was an unpleasant incident, the kind of New York moment that most transplants fear. But, she said, the mere fact that a man tried to punch her and then muscle his way into her car never made her question her commitment to Digger—just as the fact that she spends 10 to 30 minutes parking the vehicle several times a week never made her want to ditch the machine in the middle of the street.

The Al Gore Effect

For all this, there is a limit to all the crazy auto-love—or at least a potential limit, known to some people as guilt and to others as Al Gore’s disappointed face jowling down at them from the screen of the local multiplex.

All over the city, from Park Slope to Washington Heights, car junkies acknowledged a small tingle of shame over their gas-gulping ways. Some of them announced that their next car would be a hybrid (because there would be a next car). Others insisted they were trying to limit their car time—like the earthy lass who declared that, despite driving her giant Jimmy GMC from Fort Greene to the Park Slope Food Coop that morning, she hated having a car, had been forced to get it by her husband, and was boycotting most long-distance driving.

And then there is Jessica Peterson, a perky-eyed Michigan native, who announced that she was getting rid of her car altogether.

Ms. Peterson, 30, came to New York some five years ago with her clunky Subaru station wagon in tow. At the time, the car was already 10 years old, and somewhat the worse for wear, but she lugged it to Queens because—well, she’s not all that sure why. “I guess because I came from sort of a suburban place, I kind of felt like I needed a car,” she said with a shrug that erupted into a laugh. “I didn’t really question it.”

But now, what with all the enviro-consciousness going around—to say nothing of the endless parking-space wars—she is starting to rethink things.

“I’m a science teacher, and there’s people in the office where I teach who, they don’t even have air-conditioners, and they’re teasing me about the car,” she said. “So it’s time to get rid of the car.”

Still, Ms. Peterson remains more of an oddity at this point than a sign of the times. Even in this age of organo-insanity—of new-mom hysterics, eco-opportunistic marketers and annoyingly self-righteous reporters—most people find it hard to say no to the sweet purr of the automobile.

“It just seems to me, if I stop driving my car, I don’t think that’s doing anything about the real issue,” said Hans, a 31-year-old Williamsburg media guy (and musician, of course) with a receding, Jack Nicholson hairline and Chattanooga drawl, as he eyed his silver Elantra. “I know I’m contributing to it, but the end of the day, I obviously don’t feel bad enough about it to not drive my car.”

He was speaking to an audience made up mostly of women—middle-aged types with wide waists, heaving hearts, and the look of worship on their faces. Many of them had seen him on The Oprah Winfrey Show, the dashing doctor in the sky-blue scrubs, and like latter-day pilgrims they had driven from New Jersey, Rochester, even Chicago just to attend his workshop, “It’s All About You: Be the World Expert on Your Body.”

They weren’t disappointed. As he launched into a parable about the ravages of heart disease—a horror scenario that he narrated with the help of two JumboTrons and an animation of a giant, atherosclerotic artery—it was clear that he had achieved an extraordinary feat, even by medical standards: he had managed to wrap Deepak Chopra, Dr. McDreamy and C. Everett Koop into a single, well-tailored suit.

“BOOM!” he shouted into his microphone as the JumboTrons turned red, and an angry mass of platelets and fibrinogen—a Clot—fully and fatally blocked off the artery.

“You just saw the leading cause of death in the Western world. That’s what a heart attack looks like!” said Dr. Oz, whose official title is director of the Cardiovascular Institute at New York-Presbyterian Hospital/Columbia. “And you know what? It doesn’t take years to happen. The actual closure of the artery takes place in minutes to hours.”

The audience sat in silent, panicked attention. A few women scribbled notes, but mostly they just stared, wide-eyed and intent, as Dr. Oz continued his lesson, warning and expounding until finally he was ready for the moment of redemption—the moment when he declared that for all the damage that people might have done to their bodies, they can still be saved.

“Yes!” he declared, his voice boyish and excited. “We dig the foundation for bad health over decades, but we actually influence our health much more short term. The things we’re going to talk to you about today, the action steps, if you act on them, within three months, three months, we can measure a difference in your life expectancy.

“It’s a profoundly important power that you have,” he said.

Hallelujah!

DR. OZ HAS BEEN PREACHING this gospel of health and self-help for several years now, injecting it into books, crowds and television shows like some gooey, life-promising vaccine. Leaning on his many, well-polished laurels, he’s moved beyond his area of specialty—the heart—to explain the ins and outs, ups and downs, of the entire body. His message is a seductively simple one—eat a little less, exercise a little more, get a second opinion—though at times it seems like two or three parts common sense to one part medical expertise (with a dose of spiritual alterna-speak thrown in for good measure).

His ambition is huge, his bank account is bulging; increasingly, he seems like the TV doctor who also plays one in real life instead of the other way around. Yet his ultimate message isn’t about him, it’s about you: He wants nothing more, he says, than to create a “movement” of Americans who recognize that only they are the masters of their health.

“For the American public,” he told The Observer during an interview in his office, “I hope the epiphany is that, yes, we’ve made huge advances in science, but it’s not the Holy Grail. It’s not by itself going to take you to the Promised Land. Only you can do that.”

The Promised Land. It’s an enticing concept, no matter how you get there, and thus far, the good doctor has been doing a fine job of winning converts to his cause. He hasn’t quite created a movement just yet, but thanks to an uncanny ability to combine medical skill with marketing savvy (he has an M.B.A. as well as an M.D.), he has done what few members of his inward-looking medical profession have managed to do—he has turned himself into an industry.

Indeed, the 47-year-old surgeon, who was once named People Magazine’s “Sexiest Doctor,” is everywhere these days: beaming from the flaps of his best-selling books, YOU: The Owner’s Manual and YOU: On a Diet; lecturing his less-successful Harvard comrades at their 25th college reunion; praising his employer, New York-Presbyterian Hospital, in local radio spots; writing a men’s health column in Esquire; and, of course, touring the country with his co-guru, Dr. Michael Roizen, a Cleveland Clinic anesthesiologist who earned his motivational-speaker stripes by coming up with a way to test people’s RealAge®, and who advises people to “get control” of their genes by walking 30 minutes a day and learning to manage stress (which, he notes, adds 32 years to your age). Dr. Oz’s Reiki-master wife, Lisa, is also part of the act, discussing “energy, spirit, and relationships.”

Call it Oz-Fest II.

All this in addition to the hefty amount of time he spends instructing his good pal Oprah Winfrey about how to “get younger and healthier,” warning against the dangers of belly fat and deliniating the proper shape of poop. (You have to know? It should be S-shaped.) It’s a service that has earned him both a place among that circle of helpfulness known as “Oprah and Friends” and even a special title: Ms. Winfrey has dubbed him “America’s doctor.”

“Dr. Oz recognizes that the spiritual is connected with the medical,” Ms. Winfrey told The Observer, via her publicist. “I love him because he likes to combine Eastern and Western medicine like acupuncture and massage. He has a true passion for the human body and has helped me understand things about the way it works.”

Dr. Oz is quick to return the favor. During our interview and his lecture, he dropped Ms. Winfrey’s name reverently into conversation, like a communion wafer or a slot-machine coin, calling her a “wonderful teacher” and the “best.” He used her purple “Oprah-patented” surgical gloves to cradle enlarged hearts and “light, fluffy” lungs during the show-and-tell section of Oz-Fest. And in one of the more creative acts of co-branding perhaps ever concocted, he used her heart—quite literally—to educate his audience about, well, Oprah’s heart.

“This is the inside of someone’s chest,” Dr. Oz told his Javits Center audience as he pointed to a pulsing, three-dimensional image on the JumboTrons. “See the little ribs coming out of the side, and the heart? You may not recognize this person, but her name is Oprah Winfrey. That’s what Oprah’s heart looks like.” (From what we could tell, Oprah looked pretty good!)

Ms. Winfrey’s heart has done wonders for Dr. Oz’s cause, winning him converts and credibility among the vast, Oprah-mom demographic. “We’ve seen him on Oprah, and he’s very informative,” said Theresa Bosco, a 58-year-old grandma who took a seven-and-a-half-hour train ride all the way from Rochester, New York, just to hear her favorite TV doctor speak. “Being a cardiologist, I think he tells you how it really is.”

But some of his cardio-jock colleagues aren’t so sure about all of this Oz mania. They respect his technical skill, appreciate his way with a scalpel, but they sniff and cluck at his Doc America image.

For some, perhaps, it’s simply a case of good old-fashioned competitive envy. But for others it’s philosophical, a legacy of Arrowsmith—Sinclair Lewis’ tortured medical hero, not the hair-metal band—who stands as a kind of modern-day Hippocrates against the commercialization of medicine.

“I think there’s probably some sense in the cardiac surgical community that publicity-mongering is not consistent with our behavior,” said one prominent cardiothoracic surgeon who asked to remain anonymous. “We don’t think that a serious cardiac surgeon would hop on an airplane, fly to Chicago and take questions on commercial television about the treatment of urinary tract infections or other topics that are not pertinent to our profession.”

Then again, who else is urging middle-aged America to gut-bust its belly fat?

ON A HARRIED FRIDAY AFTERNOON two days before the Javits Center mega-conference, Dr. Oz sat behind his desk in the Milstein Hospital building, sharing his thoughts on life and medicine before rushing off to do the day’s surgery—a combined bypass-and-valve replacement job on a 60-year-old woman. He was dressed in his signature blue scrubs, the ones that Oprah audiences have come to know so well, but he looked different than the man people are used to seeing on TV. There was still the same angled chin, the same broad face that evokes Dick York on Bewitched. But his hair was tousled, his eyes gleaming green, and it was suddenly possible to see why a woman might actually want to have her chest cracked open by him.

“If I could be known as a teacher, I’d be happy,” he said, his voice earnest, his hands clasped on the desk in front of him. “I love teaching, I always have.

“The big epiphany for me,” he continued, “was that most of what I really need to do as a doctor—remember, the word “doctor” means “teacher”—most of what I need to do is to teach you to take better care of yourself. I mean, more than 50 percent of your ability to recover and live a long time after heart surgery is things you do, not me.

“So people have to take that mantle of responsibility on their shoulders. But”—and here he suddenly leaned forward—“in America, we have moved to a belief that the magic bullet of modern medicine will always cure us of our ills; that we can sprinkle a little bit of a statin drug on a kielbasa and we’ll still be okay. And we have to change that.”

Dr. Oz shifted in his chair. He had reached the heart of his philosophy—the part from which the Oz-tours, TV spots, and YOU books sprang—and he wanted to drive the point home.

Dr. Oz’s philosophy emerged, he said, over years of treating patients who could have avoided the knife if only they had grasped their own essential power sooner—if only they had realized that “we don’t have the free lunch, that there is no easy way of getting through this, that you have to be part of the equation,” Dr. Oz said. As a theory, it sits comfortably alongside the self-help and medical empowerment manuals that have sprung up in health food stores, in alternative medicine Meccas and from the occasional Ayn Rand sympathizer. But it is also essentially Oz-ian, a product of his own specific DNA.

Dr. Oz was born in Cleveland, Ohio, and grew up in Wilmington, Delaware, the son of two Turkish immigrants. (His father, the first Dr. Oz, was also a cardiothoracic surgeon.) From the start, he seems to have had a knack for success, an eerie ability to collect achievements the way other people collected one-night stands or baseball cards.

At Harvard, which he finished in three-and-a-half years, he was both a pre-med biology major and a member of the water polo and football teams (he played safety). During his graduate school years, he attended both the University of Pennsylvania’s medical school—where he was voted class chairman and school president—as well as its business school, Wharton. As a surgeon at Columbia, he quickly gained a reputation as a talented researcher and as fleet-fingered surgeon—even as he held down a marriage, spawned four kids, and ran marathons. (To this day his blood pressure is 110 over 70, while his cholesterol is 160.)

It’s no wonder he believes that people can master their fate.

“HE'S A PHENOMENAL SURGEON. Technically he’s got excellent hands,” said Dr. Mathew Williams, surgical director of cardiovascular transcatheter therapies at New York-Presbyterian Hospital/Columbia. “You hear the term “thinking outside the box” a lot, but he really epitomizes that. He’s come up with a lot of innovative ways to tackle problems.”

In fact, the only area that Dr. Oz has not yet conquered seems to be the grotty gladiators’ ring of politics—though that area, too, might someday be Oz-ified. A self-described “moderate Republican” concerned with “fiscal and leadership issues,” Dr. Oz has been active in his local Republican Party (in New Jersey) for several years, donated handsomely to G.O.P. candidates like Senators John McCain and Bill Frist and, when asked, readily acknowledged that the idea of elected office has crossed his mind. “I get asked all the time about it,” he said. “I’ve always enjoyed leading people.”

Should he choose to enter the electoral fray, Dr. Oz already has two icons whose political path he said he would like to follow: California bodybuilder-turned-actor-turned governor, Arnold Schwarzenegger, whom he calls a “wonderful” guy and a “good chess player too” (and whose picture sits proudly in Dr. Oz’s office alongside a bottle of wine the Governator gave him for moderating his health summit in July 2006); and Teddy Roosevelt, the original boot-strapping individualist.

“Teddy Roosevelt to me was the ideal Republican,” he said. “He was someone who felt strongly about the need for individuals to make the place work better without having someone tell them how to do it. But they had an obligation to do that as well. It wasn’t a favor for the country; it was an obligation as Americans.”

Has somebody been practicing his stump speech?

Still, obligations to Americans aside, it looks like the rise of Candidate Oz may still be a few years in the future. “Maybe down the road, if I learn my lessons well and people still think that I might be able to do it, I’d consider it,” he said. For now, his duty lies elsewhere—in supersizing the message of “wellness” and “vitality” that he teaches his patients every day in his office.

It lies, in other words, with YOU.