Review: Intensive Care by Gavin Francis
I finally finished a book in 2021! And it’s one with undeniable ongoing relevance. The subtitle is “A GP, a Community & COVID-19.” Francis, a physician who is based at an Edinburgh practice and frequently travels to the Orkney Islands for healthcare work, reflects on what he calls “the most intense months I have known in my twenty-year career.” He draws all of his chapter epigraphs from Daniel Defoe’s A Journal of the Plague Year and journeys back through most of 2020, from the day in January when he and his colleagues received a bulletin about a “novel Wuhan coronavirus” to November, when he was finalizing the book and learned of promising vaccine trials but also a rumored third wave and winter lockdown.
In February, no one knew whether precautions would end up being an overreaction, so Francis continued normal life: attending a conference, traveling to New York City, and going to a concert, pub, and restaurant. By March he was seeing more and more suspected cases, but symptoms were variable and the criteria for getting tested and quarantining changed all the time. The UK at least seemed better off than Italy, where his in-laws were isolating. Initially it was like flu outbreaks he’d dealt with before, with the main differences being a shift to telephone consultations and the “Great Faff” of donning full PPE for home visits and trips to care homes. The new “digital first” model left him feeling detached from his patients. He had his own Covid scare in May, but a test was negative and the 48-hour bug passed.
Through his involvement in the community, Francis saw the many ways in which coronavirus was affecting different groups of people. He laments the return of mental health crises that had been under control until lockdown. Edinburgh’s homeless, many in a perilous immigration situation thanks to Brexit, were housed in vacant luxury hotels. He visited several makeshift hostels, where some residents were going through drug withdrawal, and also met longtime patients whose self-harm and suicidal ideation were worsening.
Children and the elderly were also suffering. In June, he co-authored a letter begging the Scottish education secretary to allow children to return to school. Perhaps the image that will stick with me most, though, is of the confused dementia patients he met at care homes: “there was a crushing atmosphere of sadness among the residents … [they were] not able to understand why their families no longer came to visit. How do you explain social distancing to someone who doesn’t remember where they are, sometimes even who they are?”
Francis incorporates brief histories of vaccination and the discovery of herd immunity, and visits a hospital where a vaccine trial is underway. I learned some things about COVID-19 specifically: it can be called a “viral pneumonia”; it has two phases, virological (the virus makes you unwell) and immunological (the immune system misdirects messages and the lungs get worse); and it affects the blood vessels as well as the lungs, with one in five presenting with a rash and some developing chilblains in the summer. Amazingly, as the year waned, Francis only knew three patients who had died of Covid, with many more recovered. But in August, a city that should have been bustling with festival tourists was nearly empty.
Necessarily, the book ends in the middle of things; Francis has clear eyes but a hopeful heart. While this is not the first COVID-19 book I’ve encountered (that was Duty of Care by Dominic Pimenta) and will be far from the last – next up for me will be Rachel Clarke’s Breathtaking, out at the end of this month – it is an absorbing first-hand account of a medical crisis as well as a valuable memorial of a time like no other in recent history. A favorite line was “One of the few consolations of this pandemic is its grim camaraderie, a new fellowship among the fear.” Another consolation for me is reading books by medical professionals who can compassionately bridge the gap between expert opinion and everyday experience.
Intensive Care was published by the Wellcome Collection/Profile Books on January 7th. My thanks to the publisher for the free copy for review.
Gavin Francis’s other work includes:
Previously reviewed: Shapeshifters
Also owned: Adventures in Human Being
I’m keen to read: Empire Antarctica, about being the medical officer at the British research centre in Antarctica – ironically, this was during the first SARS pandemic. (In July 2020, conducting medical examinations on the next batch of scientists to ship out there, he envied them the chance to escape: “By the time they came home it would be 2022. Surely we’d have the virus under control by then?”)
Best of 2020: Nonfiction
Complementing yesterday’s list of my top fiction and poetry reads of 2020, I have chosen my six favorite nonfiction works of the year. Last year’s major themes were bodies, archaeology, and the environmental crisis; this year’s are adjacent: anatomy, nature, deep time, death, and questions of inheritance, both within families and more broadly. What will we leave behind? As usual, these topics reflect my own interests but also, I think, something of the zeitgeist.
Let the countdown begin!
Kay’s Anatomy: A Complete (and Completely Disgusting) Guide to the Human Body by Adam Kay: Think of this as a juvenile, graphic novel version of Bill Bryson’s The Body; that’s exactly how thorough, accessible, and entertaining it is. Kay ditches his usual raunchiness and plumps for innocuous forms of humor: puns, dad jokes, toilet humor, running gags and so on. But where it counts – delivering vital information about not smoking, mental health, puberty, and facing the death of someone you love – Kay is completely serious, and always lets young readers know when it’s essential to tell an adult or ask a doctor. Henry Paker’s silly, grotesque illustrations are the perfect accompaniment.
-
Sign Here If You Exist and Other Essays by Jill Sisson Quinn: The naturalist’s second essay collection considers themes of connection and change. Quinn regrets the afterlife prospect she lost along with her childhood Christian faith, while adopting a baby leads her to question notions of belonging and inheritance. Whether she’s studying wasps and reptiles or musing on family and faith, she knits her subjects together with meticulous attention. Putting self and nature under the microscope, she illuminates both. (Reviewed for Foreword.)
Footprints: In Search of Future Fossils by David Farrier: Blending human and planetary history, environmental realism and literary echoes, Farrier, a lecturer in English literature, tells the story of the human impact on the Earth. Each chapter is an intricate blend of fact, experience, and story. We’ll leave behind massive road networks, remnants of coastal megacities, plastics, carbon and methane in the permafrost, the fossilized Great Barrier Reef, nuclear waste, and jellyfish-dominated oceans. An invaluable window onto the deep future.
-
Greenery: Journeys in Springtime by Tim Dee: From the Cape of Good Hope to the Arctic Circle, Dee tracks the spring as it travels north. From first glimpse to last gasp, moving between his homes in two hemispheres, he makes the season last nearly half the year. His main harbingers are migrating birds, starting with swallows. The book is steeped in allusions and profound thinking about deep time and what it means to be alive in an era when nature’s rhythms are becoming distorted. A fresh, masterful model of how to write about nature.
-
Dear Life: A Doctor’s Story of Love and Loss by Rachel Clarke: I’ve read so many doctors’ memoirs and books about death that it takes a truly special one to stand out. Clarke specializes in palliative medicine and alternates her patients’ stories with her own in a natural way. A major theme is her relationship with her doctor father and his lessons of empathy and dedication. She wrote in the wake of his death from cancer – an experience that forced her to practice what she preaches as a hospice doctor: focus on quality of life rather than number of days. This passionate and practical book encourages readers to be sure they and their relatives have formalized their wishes for end-of-life care and what will happen after their death.
Vesper Flights by Helen Macdonald: Any doubt that Macdonald could write a worthy follow-up to H Is for Hawk evaporates instantly. Though these essays were written for various periodicals and anthologies and range in topic from mushroom-hunting to deer–vehicle collisions and in scope from deeply researched travel pieces to one-page reminiscences, they form a coherent whole. Equally reliant on argument and epiphany, the book has more to say about human–animal interactions in one of its essays than some whole volumes manage. As you might expect, birds are a recurring theme. Her final lines are always breath-taking. I’d rather read her writing on any subject than almost any other author’s.
(Books not pictured were read digitally, or have already gone back to the library.)
What were some of your top nonfiction reads of the year?
Upcoming posts:
28th: Library Checkout
29th: Runners-up from 2020 (all genres)
30th: Best backlist reads
31st: Random superlatives and some statistics
Recent Reviews for Shiny New Books: Poetry, Fiction and Nature Writing
First up was a rundown of my five favorite poetry releases of the year, starting with…
Dearly by Margaret Atwood
Dearly is a treasure trove, twice the length of the average poetry collection and rich with themes of memory, women’s rights, environmental crisis, and bereavement. It is reflective and playful, melancholy and hopeful. I can highly recommend it, even to non-poetry readers, because it is led by its themes; although there are layers to explore, these poems are generally about what they say they’re about, and more material than abstract. Alliteration, repetition, internal and slant rhymes, and neologisms will delight language lovers and make the book one to experience aloud as well as on paper. Atwood’s imagery ranges from the Dutch masters to The Wizard of Oz. Her frame of reference is as wide as the array of fields she’s written in over the course of over half a century.
I’ll let you read the whole article to discover my four runners-up. (They’ll also be appearing in my fiction & poetry best-of post next week.)
Next was one of my most anticipated reads of the second half of 2020. (I was drawn to it by Susan’s review.)
Artifact by Arlene Heyman
Lottie’s story is a case study of the feminist project to reconcile motherhood and career (in this case, scientific research). In the generic more than the scientific meaning of the word, the novel is indeed about artifacts – as in works by Doris Lessing, Penelope Lively and Carol Shields, the goal is to unearth the traces of a woman’s life. The long chapters are almost like discrete short stories. Heyman follows Lottie through years of schooling and menial jobs, through a broken marriage and a period of single parenthood, and into a new relationship. There were aspects of the writing that didn’t work for me and I found the book as a whole more intellectually noteworthy than engaging as a story. A piercing – if not notably subtle – story of women’s choices and limitations in the latter half of the twentieth century. I’d recommend it to fans of Forty Rooms and The Female Persuasion.
Finally, I contributed a dual review of two works of nature writing that would make perfect last-minute Christmas gifts for outdoorsy types and/or would be perfect bedside books for reading along with the English seasons into a new year.
The Stubborn Light of Things by Melissa Harrison
This collects five and a half years’ worth of Harrison’s monthly Nature Notebook columns for The Times. The book falls into two rough halves, “City” and “Country”: initially based in South London, Harrison moved to the Suffolk countryside in late 2017. In the grand tradition of Gilbert White, she records when she sees her firsts of a year. Often, she need look no further than her own home and garden. I appreciated how hands-on and practical she is: She’s always picking up dead animals to clean up and display the skeletons, and she never misses an opportunity to tell readers about ways they can create habitat for wildlife (e.g. bat and bird nest boxes that can be incorporated into buildings) and get involved in citizen science projects like moth recording.
The book’s final two entries were set during the UK’s first COVID-19 lockdown in spring 2020 – a notably fine season. This inspired me to review it alongside…
The Consolation of Nature by Michael McCarthy, Jeremy Mynott and Peter Marren
A tripartite diary of the coronavirus spring kept by three veteran nature writers based in southern England (all of them familiar to me through their involvement with New Networks for Nature and its annual Nature Matters conferences). The entries, of a similar length to Harrison’s, are grouped into chronological chapters from 21 March to 31 May. While the authors focus in these 10 weeks on their wildlife sightings – red kites, kestrels, bluebells, fungal fairy rings and much more – they also log government advice and death tolls. They achieve an ideal balance between current events and the timelessness of nature, enjoyed all the more in 2020’s unprecedented spring because of a dearth of traffic noise.
Review Book Catch-Up: Gange, Mann, O’Donoghue
The end of the year is fast approaching, and one of my main reading goals is to follow through on all the rest of the review books I’ve received from publishers. I have another handful on the go, including a few holiday- and snow-themed ones I’ll review together.
Today, I have a history-rich travelogue that explores the Atlantic coast of Britain and Ireland, a memoir by an Anglican priest who has transitioned and experienced chronic illness, and a humorous, offbeat novel about finding the real Ireland.
The Frayed Atlantic Edge: A Historian’s Journey from Shetland to the Channel by David Gange (2019)
This was one of the 2020 Wainwright Prize finalists. Having now experienced the entire nature writing shortlist, I stick with my early September pronouncement that it should have won. I was consistently impressed with the intricacy of the interdisciplinary approach. While kayaking down the western coast of the British Isles and Ireland, Gange delved into the folklore, geology, history, local language and wildlife of each region and island group. From the extreme north of Scotland at Muckle Flugga to the southwest tip of Cornwall, he devoted a month to each Atlantic-facing area, often squeezing in expeditions between commitments as a history lecturer at Birmingham.
Gange’s thesis is that the sea has done more to shape Britain and Ireland than we generally recognize, and that to be truly representative history books must ascribe the same importance to coastal communities that they do to major inland cities. Everywhere he goes he meets locals, trawls regional archives and museums, and surveys the art and literature (especially poetry) that a place has produced. Though dense with information, the book is a rollicking travelogue that – in words no less than in the two sections of stunning colour photographs – captures the elation and fear of an intrepid solo journey. He hunkers on snowy cliffs in his sleeping bag and comes face to face with otters, seals and seabirds in his kayak; at the mercy of the weather, he has deep respect for the Atlantic waves’ power.
I enjoyed revisiting places I’ve seen in person (Shetland, the Orkney Islands, Skomer) and getting a taste of others I’ve not been to but would like to go (like the Western Isles and the west coast of Ireland). Gange’s allusive writing reminds me of Tim Dee’s and Adam Nicolson’s, and Madeleine Bunting’s Love of Country is a similar read I also loved.
With thanks to William Collins for the free copy for review.
Dazzling Darkness: Gender, sexuality, illness and God by Rachel Mann (2012; 2020)
I’ve so enjoyed discovering Rev. Rachel Mann’s work: poetry collection A Kingdom of Love, Advent devotional In the Bleak Midwinter, and novel The Gospel of Eve. This is a revised edition of her memoir, which is less an autobiographical blow-by-blow of becoming a trans priest in the Church of England than it is a vibrant theological meditation based around keywords like loneliness, reconciliation and vocation. She reflects on the apparent contradictions of her life: she was a typical boy who loved nothing more than toy guns, and then a young man obsessed with drugs and guitars; as ‘Nick’, she was married to a woman at the time of coming out, but continued to have relationships with women after transitioning and undergoing reassignment surgery, so considers herself a lesbian.
Ambiguities like this make us uncomfortable, Mann notes, but change and loss, and making the best of impossible situations, are all a part of the human condition. I appreciated how she characterizes herself as a perennial beginner: having to face the world anew after the second adolescence of becoming a woman as well as after the end of a long-term relationship and the last in a series of hospitalizations for severe Crohn’s disease.
While I’ve read other trans memoirs (Amateur by Thomas Page McBee and Conundrum by Jan Morris), this is my first from a Christian perspective, apart from the essays in The Book of Queer Prophets. Mann describes her early faith as intense but shallow, like falling in love; later it became deeper but darker as she followed Jesus’s path of suffering. Ministry has been a gift but is not without challenges: At synod meetings she is unsure whether to speak out or remain silent, but at least she bears witness to the presence of trans people in the Church.
With thanks to Wild Goose Publications for the free copy for review.
Scenes of a Graphic Nature by Caroline O’Donoghue (2020)
Charlotte “Charlie” Regan is a 29-year-old filmmaker based in London. Her father has had cancer on and off for four years, but he got his ‘survivor’ label in a different way: when he was a child on an island off the western coast of Ireland, his teacher and 18 classmates died of carbon monoxide poisoning from the faulty secondhand oil burner in the schoolhouse; he was the only one left alive. Although her film commemorates this story, Charlie has never actually been to Ireland, so an invitation to Cork Film Festival is the perfect opportunity to see the place before her father dies. Travelling with her is her former best friend and roommate, Laura Shingle. There’s sexual tension between these two: Charlie is a lesbian, but Laura is determined to think of herself as straight even though she and Charlie would occasionally share a bed. To prove herself, Laura goes too far the other way, making homophobic comments about strangers.
If initially Charlie thinks this trip to Ireland will be about shamrock-green nostalgia, she soon snaps out of her idealism as she has to face some tough truths about the film and her family’s history. Charlie is a companionable narrator, but, while I enjoyed the pub scenes and found some of the one-liners very funny (“Everything in our room is a faint brown, as though it were daubed very gently by a child with a teabag” and “He had an X-ray and there’s legumes all over it.” / “Legumes? Do you mean lesions?”), I was underwhelmed overall. My interest peaked at the halfway point and waned thereafter. This is one I might recommend to fans of Caoilinn Hughes.
With thanks to Virago for the free copy for review.
Would you be interested in reading one or more of these?
Miscellaneous Novellas: Murdoch, Read & Spark; Comics; Art Books
Novellas in November will be coming to a close on Monday and has been a great success in terms of blogger engagement. I’ve been adding review links to the master post nearly every day of the month, and I’m sure there are some I have missed. Although I still have a couple of novellas on the go, I don’t see myself finishing them this month, so I’m going to end with this set: three short classics to continue the week’s theme, two graphic novels, and a pair of nature/art/music/poetry books.
Classics:
Something Special by Iris Murdoch (1957)
[51 pages]
A Murdoch rarity, this appeared in a 1950s anthology and in an English-language textbook in Japan, but was not otherwise published in the author’s lifetime. I think it’s her only short story. I’m counting it as a novella because it was published as a stand-alone volume by Vintage Classics in 2000. Twenty-four-year-old Yvonne Geary doesn’t know precisely what she wants from life, but hopes there might be more for her than a conventional marriage to Sam, her beau. “Can’t I live my life as I please since it’s the only thing I have?” she asks her hen-pecking mother. “I can’t see him as something special and I won’t marry him if I can’t.” Maybe she’ll escape to England. But for now she’s off for a night on the town in Dublin with Sam, going from a rowdy pub to the quiet of a locked-up park. Sam may be dull, but he seems sensitive, solicitous and well-meaning. Yvonne’s feelings for him flip-flop over the course of the evening. I’ve noticed before that Murdoch is a bit funny about Jewishness, but this is still a brisk, bittersweet story in the direct lineage of Sally Rooney’s Normal People. (With striking black-and-white woodcut-style illustrations by Michael McCurdy.)
The Fairacre Festival by ‘Miss Read’ (1968)
[80 pages]
I’m not sure why I’d never tried anything by ‘Miss Read’ (the pseudonym of Dora Jessie Saint, a teacher turned author who was based not far from me in Berkshire) until now. She wrote two series of quaint novels set in the fictional villages of Fairacre and Thrush Green; this is #7 in the Fairacre series. Miss Read, her narrator, is a schoolteacher who records her wry observations of all the local happenings. After an autumn storm damages the church roof, the parishioners are dismayed to learn the renovations could cost £2000. No amount of jumble sales, concerts and tea dances will raise that much. So they set their sights higher, to an Edinburgh-style festival with a light show and an appearance from a famous opera singer. But it’s not going to be smooth sailing now, is it? This was cozy, quaint fun, and if I wished it had been a full-length book, that means I’ll just have to begin at the beginning with 1955’s Village School.
The Driver’s Seat by Muriel Spark (1970)
[107 pages]
Lise has her “glad rags” on – bright new clothes in clashing patterns that strangers can’t help commenting on. The 34-year-old single woman has worked in an accounting office for the last 16 years and is now off to the South (Italy?) for a long-awaited vacation. This will be no blissful holiday, though. Just 11 pages in, we get our first hint that things are going to go wrong, and in the opening line of Chapter 3 Spark gives the game away. Clearly, her intention is to subordinate what happens to why it happens, so the foreshadowing of the early chapters is twisted to ironic effect later on. Lise is an unappealing character, haughty and deceitful, and the strangers she meets on the flight and at the hotel, including a man obsessed with the macrobiotic diet, are little better. I felt I didn’t have enough time to change my mind about Lise before we’re asked to have pity. Of course, this is meant to be a black comedy, but it was a little abrasive for my taste. This was my third and probably last from Spark, as I haven’t particularly enjoyed any of her work; I do love this pithy description of The Ballad of Peckham Rye, though: “An entertaining tale of satanism in South London.”
Graphic Novels:
Why Don’t You Write My Eulogy Now So I Can Correct It? A Mother’s Suggestions by Patricia Marx, illus. Roz Chast (2019)
[81 pages]
I loved Chast’s graphic memoir Can’t We Talk about Something More Pleasant? and figured this would have the same witty approach to an elderly parent’s decline. Apart from a brief introduction to her mother (from Philadelphia, outspoken, worked as a guidance counselor and for her husband’s office supplies company), there is hardly any text; the rest is just illustrated one-liners, sayings her mother had or opinions she espoused. Many of these have to do with fashion no-nos, dinner party etiquette, grammar pedantry, avoiding the outdoors and exercise, and childrearing. “My mother never hesitates to say what other mothers would not even think to think. She calls it constructive criticism.” She reminds me of Bess Kalb’s grandmother in Nobody Will Tell You This but Me, an overall much funnier and more complete picture of an entertaining figure.
The Exciting World of Churchgoing by Dave Walker (2010)
[90 pages]
A third set of Church Times comics, not as memorable as the original Dave Walker Guide to the Church. Once again, Walker pokes fun at bureaucracy, silly traditions, closed-mindedness, and the oddities of church buildings and parishioners’ habits. You really need to be familiar with the UK churchgoing scene, and specifically with Anglican churches, to get much out of the cartoons. I loved “According to legend, there is a lady who changes the teatowels in the church kitchen from time to time” and the “Infestations” spread that starts with bats and wasps and moves on to Charismatics. Most striking are two pages on church proceedings during swine flu – what was meant to be a joke doesn’t seem so funny now that it literally describes in-person services during COVID-19: “Shaking hands during the peace should be replaced by a friendly wave,” “Administration of anti-bacterial gel should take place,” etc.
Art Books:
The Lost Words: A Spell Book by Robert Macfarlane, illus. Jackie Morris (2017)
[112 pages]
Macfarlane’s work has been hit or miss for me and I was suspicious of this project in general, thinking it would be twee or juvenile, but the beauty of the artwork and playful energy of the poems won me over. It’s common knowledge that this book arose as a response to news that many words to do with nature had been removed from the latest version of a junior dictionary published in the UK, to be replaced by technology vocabulary. Macfarlane spotlights these omitted words through acrostic poems alive with alliteration (“Fern’s first form is furled, / Each frond fast as a fiddle-head”), wordplay and internal rhymes. He peppers in questions, both rhetorical and literal-minded, and exclamations. Conker, Dandelion, Lark and Otter are highlights. Morris’s wildlife paintings are superb, with a Giotto-like gilt portrait facing each poem and two-page in situ tableaux in between.
The Lost Words Spell Songs (2019)
[112 pages]
I followed up immediately with this companion book to the 14-track album a group of eight folk musicians made in response to The Lost Words. We were already fans of Kris Drever (mostly via Lau), Karine Polwart and Beth Porter (via the Bookshop Band), and became familiar with a few more of the artists (Kerry Andrew, Julie Fowlis and Rachel Newton) earlier this year through the online Folk on Foot festivals. This volume includes six additional poems, four of which directly inspired songs on the album, plus brief bios and words on the project from each artist (each portrayed by Morris as a relevant bird, with the musician serving as the “spirit human” for the bird) the complete lyrics with notes from whoever took the lead on a particular song, and short essays by Macfarlane, Morris (also an interview) and Polwart.
It was interesting to compare the different approaches to the project: five songs directly set Macfarlane’s poetry to music, two of them primarily in spoken word form; five are based on Macfarlane “extras,” like the new spells and the “charm against harm” he wrote during anti-tree felling campaigns like the one in Sheffield; a few are essentially pop songs based around major lines from Dandelion, Goldfinch and Lark (these plus “Selkie-Boy,” based on Grey Seal, ended up being my favorites); one is a traditional song from Seckou Keita’s native Senegal that also incorporates the bilingual Fowlis’s Gaelic to mourn the words that are lost with the past; and one is a final blessing song that weaves in bits from multiple spells. The artists all bring their individual styles, but the collaborations are strong, too.
Are you squeezing in any more novellas this month?
Do you like the sound of any of the ones I’ve read?
Being the Expert for #NonficNov / Three on a Theme: “Care”
The Being/Becoming/Asking the Expert week of the month-long Nonfiction November challenge is hosted by Rennie of What’s Nonfiction. This is my second entry for the week after Monday’s post on postpartum depression, as well as the second installment in my new “Three on a Theme” series, where I review three books that have something significant in common and tell you which one to pick up if you want to read into the topic for yourself.
It will be no surprise to regular readers that both of my ‘expert’ posts have been on a health theme: I have an amateur’s love of medical memoirs and works of medical history, and I’ve followed the Wellcome Book Prize closely for a number of years – participating in official blog tours, creating a shadow panel, and running this past year’s Not the Wellcome Prize.
The three books below are linked by the word “Care” in the title or subtitle; all reflect, in the wake of COVID-19, on the ongoing crisis in UK healthcare and the vital role of nurses.
Labours of Love: The Crisis of Care by Madeleine Bunting
Bunting’s previous nonfiction work could hardly be more different: Love of Country was a travel memoir about the Scottish Hebrides. It was the first book I finished reading in 2017, and there could have been no better start to a year’s reading. With a background in history, journalism and politics, the author is well placed to comment on current events. Labours of Love arose from five years of travel to healthcare settings across the UK: care homes for the elderly and disabled, hospitals, local doctors’ surgeries, and palliative care units. Forget the Thursday-night clapping and rainbows in the windows: the NHS is perennially underfunded and its staff undervalued, by conservative governments as well as by people who rely on it.
We first experience bodily care as infants, Bunting notes, and many of the questions that run through her book originated in her early days of motherhood. Despite all the advances of feminism, parental duties follow the female-dominated pattern evident in the caring careers:
By the age of fifty-nine, women will have a fifty-fifty chance of being, or having been, a carer for a sick or elderly person. At the same time, many are still raising their teenage children and almost half of those over fifty-five are providing regular care for grandchildren.
Women dominate caring professions such as nursing (89 per cent), social work (75 per cent) and childcare (98 per cent). They now form the majority of GPs (54 per cent) and three out of four teachers are female. And they provide the vast bulk of the army of healthcare workers in the NHS (80 per cent) and social-care workers (82 per cent) for the long-term sick, disabled and frail elderly.
These are things we know intuitively, but seeing the numbers laid out so plainly is shocking. I most valued the general information in Bunting’s introduction and in between her interviews, while I found that the bulk of the book alternated between dry statistics and page after page of interview transcripts. However, I did love hearing more from Marion Coutts, the author of the 2015 Wellcome Book Prize winner, The Iceberg, about her husband’s death from brain cancer. (Labours of Love was longlisted for the Baillie Gifford Prize for Non-Fiction 2020.)
My thanks to Granta for the free copy for review.
Duty of Care: One NHS Doctor’s Story of Courage and Compassion on the COVID-19 Frontline by Dr Dominic Pimenta
We’re going to see a flood of such books; I’m most looking forward to Dr Rachel Clarke’s Breathtaking (coming in January). Given how long it takes to get a book from manuscript to published product, I was impressed to find this on my library’s Bestsellers shelf in October. Pimenta’s was an early voice warning of the scale of the crisis and the government’s lack of preparation. He focuses on a narrow window of time, from February – when he encountered his first apparent case of coronavirus – to May, when, in protest at a government official flouting lockdown (readers outside the UK might not be familiar with the Cummings affair), he resigned his cardiology job at a London hospital to focus on his new charity, HEROES, which supports healthcare workers via PPE, childcare grants, mental health help and so on.
It felt uncanny to be watching events from earlier in the year unfold again: so clearly on a trajectory to disaster, but still gripping in the telling. Pimenta’s recreated dialogue and scenes are excellent. He gives a real sense of the challenges in his personal and professional lives. But I think I’d like a little more distance before I read this in entirety. Just from my skim, I know that it’s a very fluid book that reads almost like a thriller, and it ends with a sober but sensible statement of the situation we face. (All royalties from the book go to HEROES.)
The Courage to Care: A Call for Compassion by Christie Watson
I worried this would be a dull work of polemic; perhaps the title, though stirring, is inapt, as the book is actually a straightforward sequel to Watson’s 2018 memoir about being a nurse, The Language of Kindness. Although, like Bunting, Watson traveled widely to research the state of care in the country, she mostly relies on her own experience of various nursing settings over two decades: a pediatric intensive care unit, home healthcare for the elderly, a children’s oncology day center, a residential home for those with severe physical and learning disabilities, a community mental-health visiting team, and the emergency room. She also shadows military nurses and prison doctors.
With a novelist’s talent for scene-setting and characterization, Watson weaves each patient and incident into a vibrant story. Another strand is about parenthood: giving birth to her daughter and the process of adopting her son – both are now teenagers she raises as a single mother. She affirms the value of everyday care delivered by parents and nurses alike. I was especially struck by the account of a teenage girl who contracted measles (then pneumonia, meningitis and encephalitis) and was left blind and profoundly disabled, all because her parents were antivaxxers. In general, I’ve wearied of doctors’ memoirs composed of obviously anonymized case studies, but I’ll always make an exception for Clarke and Watson because of their gorgeous writing.
Note: Watson had left nursing to write full-time, but explains in an afterword that she returned to critical care in a London hospital during COVID-19.
What I learned:
Empathy is a key term for all three authors. They emphasize that the skills of compassion and listening are just as important as the ability to perform the required medical procedures.
A chilling specific fact I learned: 43,000 people died in the Blitz* in the UK. Pimenta cited that figure and warned that COVID-19 could be worse. And indeed, as of now, over 63,000 people have died of COVID-19 in the UK. The American death toll is even more alarming.
Here are some passages that stood out for me from each book:
Bunting: “Good care is as much an art as a skill, as much competence as tact. … Care is where we make profound collective decisions about the worth of an individual life. … There is no tradition of ageing wisely in the West, unlike in many Asian and African cultures where age has prestige, status and is associated with wisdom … We need to speak about care in a different language, instead of the relentless macho repetition of words such as ‘efficiency’, ‘quality’, ‘driving’, ‘choice’, ‘delivery’ and productivity.’”
Pimenta: “this will be akin to the Blitz*, and … we need to start thinking of it like that. A marathon, not a sprint. … The challenges to come – a second or even third wave, a global recession, climate change, mass misinformation … and political and societal upheaval … – will all require more from all of us if we hope to meet them. The challenge of our generation is not behind us, it is only just beginning. I plan to continue doing something about it, and perhaps now you do as well. So stay informed, stay safe and be kind.”
Watson: “So much of nursing, I think to myself, seems obvious, and yet seeing that need in the first place is difficult and takes experience, training and something extra. … The mundanity of human existence is where I find the most beauty … It takes my breath away: how fragile, extraordinary and vulnerable, how full of hatred and love and obsession and complexity we all are – every single one of us.”
*I highly recommend all of folk artist Kris Drever’s latest album, Where the World Is Thin, but especially the song “Hunker Down / That Old Blitz Spirit,” which has become my lockdown anthem.
If you read just one, though… Make it The Courage to Care by Christie Watson.
Can you see yourself reading any of these books?
Be(com)ing an ‘Expert’ on Postpartum Depression for #NonficNov
This Being/Becoming/Asking the Expert week of the month-long Nonfiction November challenge is hosted by Rennie of What’s Nonfiction.
I’m also counting this as the first entry in my new “Three on a Theme” series, where I’ll review three books that have something significant in common and tell you which one to pick up if you want to read into the topic for yourself. I have another medical-themed one lined up for this Friday as a second ‘Being the Expert’ entry.
I never set out to read several memoirs of women’s experience of postpartum depression this year; it sort of happened by accident. I started with the graphic memoir and then chanced upon a recent pair of traditional memoirs published in the UK – in fact, I initially pitched them as a dual review to the TLS, but they’d already secured a reviewer for one of the books.
Inferno: A Memoir by Catherine Cho
I was delighted to see this prediction of mine make the Sunday Times Young Writer of the Year Award shortlist. Coincidentally, I was already halfway through the book on my Kindle (via NetGalley) at that point, but its nomination gave me the push to finish in a timely manner. Cho, a Korean American literary agent based in London, experienced stress-induced postpartum psychosis after the birth of her son, Cato. She and her husband James had gone back to the USA when Cato was two months old to introduce him to friends and family, ending with a big Korean 100-day celebration for him at her in-laws’ home in New Jersey. Almost as soon as they got to her in-laws’, though, she started acting strangely: she was convinced there were cameras watching their every move, and Cato’s eyes were replaced with “devil’s eyes.” She insisted they leave for a hotel, but soon she would be in an emergency room, followed by a mental health ward.
Cho alternates between her time on the New Bridge ward – writing in a notebook, trying to act normal whenever James visited, expressing milk from painfully swollen breasts, and interacting with her fellow patients with all their quirks – and a rundown of the rest of her life before the breakdown. Her Kentucky childhood was marked by her mathematician father’s detachment and the sense that she and her brother were together “in the trenches,” pitted against the world. In her twenties she worked in a New York City corporate law firm and got caught up in an abusive relationship with a man she moved to Hong Kong to be with. All along she weaves in her family’s history and Korean sayings and legends that explain their values.
Twelve days. That was the length of her hospitalization in early 2018, but Cho so painstakingly depicts her mindset that readers are fully immersed in an open-ended purgatory – a terrifying time when she questioned her sanity and whether she was cut out for motherhood. “Koreans believe that happiness can only tempt the fates and that any happiness must be bought with sorrow,” she writes. She captures both extremes, of suffering and joy, in this vivid account.
My rating:
What Have I Done? An honest memoir about surviving postnatal mental illness by Laura Dockrill
Dockrill is a British children’s author. Her style reminded me of others of her contemporaries who do a good line in light, witty, warts-and-all, here’s-what-it’s-really-like-to-be-a-woman books: Dolly Alderton, Caitlin Moran and the like. From a labor that quickly deviated from her birth plan due to an emergency Caesarean to the usual post-baby blues to full-blown psychosis, Dockrill recreates her experience with fluid dialogue and italicized passages of her paranoid imaginings. Her memoir resembles Cho’s in its broad strokes but also in certain particulars, like imagining surveillance cameras and hearing a voice in her head telling her she is a bad mum. I skimmed this one because of a library deadline and because of an overload on similar content. I had a greater affinity for Cho’s literary style compared to the more between-girlfriends, self-help bent of this memoir. With the glossary and resources at the end, though, I’d say this one would be more useful for someone going through the same thing.
My rating:
Dear Scarlet: The Story of My Postpartum Depression by Teresa Wong (2019)
Memoir as letter and as graphic novel. Wong narrates the traumatic birth of her first child and her subsequent postpartum depression in black-and-white sketches that manage to feel breezy and fun despite the heavy subject matter. “I felt lost. I had no maternal instincts and no clue how I was supposed to take care of a baby,” she writes to Scarlet. “Your first two months in the world were the hardest two months of my life.”
For Wong, a combination of antidepressants, therapy, a postnatal doula, an exercise class, her mother’s help, and her husband’s constant support got her through, and she knows she’s lucky to have had a fairly mild case and to have gotten assistance early on. I loved the “Not for the Faint of Heart” anatomical spreads and the reflections on her mother’s tough early years after arriving in Canada from China.
The drawing and storytelling style is similar to that of Sarah Laing and Debbie Tung. The writing is more striking than the art, though, so I hope that with future work the author will challenge herself to use more color and more advanced designs (from her Instagram page it looks like she is heading that way).
My rating:
My thanks to publicist Beth Parker for the free e-copy for review.
What I learned:
All three authors emphasize that motherhood does not always come naturally; “You might not instantly love your baby,” as Dockrill puts it. There might be a feeling of detachment –from the baby and/or from one’s new body. They all note that postpartum depression is common and that new mothers should not be ashamed of seeking help from medical professionals, baby nurses, family members and any other sources of support.
These two passages were representative for me:
Cho: “I don’t feel a rush of love or an overwhelming weight of responsibility, emotions that I’d been expecting. Instead, I felt curious, like I’d just been introduced to a stranger. He was a creature, an idea, not even human yet, just a being, a life. … I’d thought I would reclaim my body after birth, but instead, it was now a tool, something to sustain life.”
Dockrill: “If childbirth and motherhood are the most natural, universal, common things in the world, the things that women have been doing since the beginning of time, then why does nobody tell us that there’s a good chance that you might not feel like yourself after you have a baby? That you might even lose your head? That you might not ever come back?”
On this topic, I have also read: Birth of a New Brain by Dyane Harwood. There are more book ideas here and here.
Nobody Told Me by Hollie McNish, one of my current bedside books, also deals with complicated pregnancy emotions and the chaotic early months of motherhood.
If you read just one, though… Make it Inferno by Catherine Cho.