Three new books with medical themes (no surprise there), including the first Covid wave in the UK; fertility and body issues in a new queer family; and pain management strategies.
Breathtaking: Inside the NHS in a Time of Pandemic by Rachel Clarke
Clarke is a palliative care doctor based in Oxfordshire. She runs the Katharine House hospice but during the coronavirus pandemic has also been on active duty in the Oxford University Hospitals system. If you’re on social media you have likely come across some of her postings as she has been equally vocal in her praise of the NHS and her criticism of Boris Johnson’s faltering policies, which are often of the too little, too late variety. So I was eager to read her insider’s account of hospital treatment of the first wave of Covid in the UK, especially because her previous book, Dear Life, was one of my top two nonfiction releases of last year.
The focus is on the first four full months of 2020, and the book originated in Clarke’s insomniac diaries and notes made when, even after manically busy shifts, she couldn’t rest her thoughts. Her pilot husband was flying to China even as increasingly alarming reports started coming in from Wuhan. She weaves in the latest news from China and Italy as well as what she hears from colleagues and disease experts in London. But the priority is given to stories: of the first doctor to die in China; of a Yorkshire ICU nurse’s father, who comes down with Covid and is on a ventilator in an Oxford hospital; and of her patients there and in the hospice. She is touched that so many are making great sacrifices, such as by deciding not to visit loved ones at the end of their lives so as not to risk spreading infection.
A shortage of PPE remained a major issue, though Dominic Pimenta (whose Duty of Care was my first COVID-19 book) pulled through for her with an emergency shipment for the hospice – without which it would have had to close. Clarke marvels at the NHS’s ability to create an extra 33,000 beds within a month, but knows that this comes at a cost of other services, including cancer care, being stripped back or cancelled, meaning that many are not receiving the necessary treatment or are pushing inescapable problems further down the road.
A comparison with Gavin Francis’s Intensive Care, published earlier in the month, is inevitable. Both doctors bounce between headlines and everyday stories, government advice and the situation on the ground. Both had their own Covid scare – Clarke didn’t meet the criteria to be tested so simply went back to work two weeks later, when she felt well enough – and had connections to regions that foreshadowed what would soon happen in the UK. Both give a sense of the scope of the crisis and both lament that, just when patients need compassion most, full PPE leads to their doctors feeling more detached from them than ever.
However, within the same page count, Francis manages to convey more of the science behind the virus and its transmission, and helpfully explores the range of effects Covid is having for different groups. He also brings the story more up to the minute with a look back from November, whereas Clarke ends in April and follows up with an epilogue set in August. A book has to end somewhere, yes, but with this crisis ongoing, the later and more relevant its contents can be, the better. And in any book that involves a lot of death, mawkishness is a risk; Clarke so carefully avoided this in Dear Life, but sometimes succumbs here, with an insistence on how the pandemic has brought out the best in people (clapping and rainbows and all that). Her writing is as strong as ever, but I would have appreciated a sharper, more sombre look at the situation a few months later. Perhaps there will be a sequel.
With thanks to Little, Brown UK for the free copy for review.
Some Body to Love: A Family Story by Alexandra Heminsley
From Heminsley’s previous book, Leap In, I knew about her getting married and undergoing IVF. It was also a book about outdoor swimming; I appreciated her words on acquiring a new skill as an adult and overcoming body issues. This memoir continues the story: in 2017, after a gruelling journey through infertility treatment, Heminsley finally got the baby she wanted. But not before a couple more heart-wrenching moments: the lab made an error and notified her that she shared no DNA with this last embryo, and while heavily pregnant she was assaulted by a drunk man on a train. Both incidents left her feeling a loss of agency. “Why was I consistently being deemed the least reliable witness of my own reality?” she asks.
As they adjusted to new life with a baby, Heminsley started to notice that she wasn’t connecting with her husband, D, like she used to. She felt emotionally unsupported and, in fact, jealous of D’s relationship with their son, L. And while they’d never been the most conventional couple, D’s changes of appearance and wardrobe seemed like a sign of something bigger. Indeed, when L was six months old, D told Heminsley, “this body doesn’t represent who I am” and announced a decision to begin transitioning.
As D moved towards having a body that fit their identity, Heminsley, too, needed to get back in touch with her body. After books like Running Like a Girl, she was considered an exercise guru, but she didn’t see herself in the new obsession with Instagram-ready images of fitness perfection. This is not, then, primarily a memoir of queer family-making, because D’s transitioning was not Heminsley’s story to tell and mostly occurs in the background. Instead she focuses on what she does know and can control: her relationship to her own body.
However, this entails what can feel like irrelevant flashbacks to her teenage years of undergoing rehab at a military clinic in Germany for hypermobility, trips to Trinidad and Italy, and the genesis of her two sporting memoirs. Much as I applaud the sensitivity to trans and body issues, the book ends up feeling scattered. Still, the writing is so candid and the narrative so eventful that you’ll race through this even if you don’t normally pick up nonfiction. (For a bit more information, see my short write-up of the virtual book launch.)
With thanks to Chatto & Windus for the free copy for review.
Pain: The Science of the Feeling Brain by Abdul-Ghaaliq Lalkhen
Originally from South Africa, Dr Lalkhen is an anaesthesiology and pain specialist based in Manchester. In a nutshell, his approach is “biopsychosocial,” meaning that he seeks to understand pain not just as a physical phenomenon resulting from acute injury or damage but as an ongoing process that is affected by emotional and psychological factors. Particularly in the context of chronic syndromes, he acknowledges that pain can continue even when its immediate cause has been repaired. Mental preparation can come into the equation: if a patient assumes they’ll wake up from surgery healed, they may be alarmed if pain persists. Lalkhen talks about managing patient expectations, perhaps with something as simple as the promise, “we’ll aim to get your pain down to a 4 after surgery.” In part, he blames Western society’s Cartesian philosophy for treating mind and body as separate rather than a system.
There are genetic and psychological reasons people might be predisposed to chronic pain. Pain itself can then change the brain chemistry, making the body more alert to pain signals. People can choose one of three paths, Lalkhen observes: “You can spend your time agitating about the alarm going off, you can try to ignore it (but the ignoring of it actually takes up more energy), or the final alternative is to learn to live with this deeply unpleasant situation.” Those who opt for pharmacological solutions can become addicted to opiates, which are less effective over time. Non-drug-related therapies involve the desensitization of nerves, the injection of anaesthetics or steroids, or the implanting of spinal cord stimulators. But all of these strategies have their limitations, and can diminish in efficacy. The patients he sees in his pain clinics may be disappointed that, rather than offering a panacea, he wants to wean them off their current pain relief and help them develop a new way of thinking about pain.
I felt I learned a lot from reading this. Lalkhen is careful to state that he is only referring to non-cancer pain (cancer pain in terminal patients will take all the morphine you can throw at it). Like many physicians, he worries about the modern epidemic of overtreatment and our obsession with wellness. I especially enjoyed the discussion of the understanding of pain and its treatment from the ancient world onward, and in particular the history of opiates. The prose is not literary, but this is an accessible and informational read if the subject matter draws you.
With thanks to Atlantic Books for the free copy for review.
What recent nonfiction releases can you recommend?
A bit of a miscellany today, as a placeholder until I finally have some more reviews to share.
Stuck in the Middle
I’ve been reading up a storm in 2021, of course, but I’m having an unusual problem: I can’t seem to finish anything. Okay, I’ve finished three books so far – Intensive Care, my first read and only proper review so far of the year; In These Days of Prohibition by Caroline Bird, a surprising and funny poetry collection about mental illness and the crutches people turn to, including drugs and sex; and one more poetry book, a recent release I’ll round up later in the month – but compare that to January 2020, when I’d finished 11 books within the first 11 days. Half a month gone and I’m way behind on my Goodreads challenge already.
Most of you know that I take multi-reading to an extreme: I currently have nearly 30 books on the go, plus piles of set-aside and occasional-reading titles that I try to reintroduce a few at a time. All in all, that’s nearly 60 books I’m partway through, whether by a mere 10 pages or over 200. These stacks represent thousands of pages read, but no finished books. By the end of this month, I will at least have finished and reviewed the five more January releases, but it’s still an awfully slow start to the year for me. Maybe I’ve spread myself too thin.
I often stretch the definition of “currently reading” in that most days I don’t sit with every book on my stack; instead, I end up spending time with a changing subset of 10‒15. Some books I have barely touched since Christmas. But there are others that consistently hold my attention and that I look forward to reading 20 or more pages in each day. Here are some of the highlights on the pile:
Spinster by Kate Bolick: Written as she was approaching 40, this is a cross between a memoir, a social history of unmarried women (mostly in the USA), and a group biography of five real-life heroines who convinced her it was alright to not want marriage and motherhood. First was Maeve Brennan; now I’m reading about Neith Boyce. The writing is top-notch.
America Is Not the Heart by Elaine Castillo: Set in the 1990s in the Philippines and in the Filipino immigrant neighborhoods of California, this novel throws you into an unfamiliar culture and history right at the deep end. The characters shine and the story is complex and confident – I’m reminded especially of Chimamanda Ngozi Adichie’s work.
Some Body to Love by Alexandra Heminsley: Finally pregnant after a grueling IVF process, Heminsley thought her family was perfect. But then her husband began transitioning. This is not just a memoir of queer family-making, but, as the title hints, a story of getting back in touch with her body after an assault and Instagram’s obsession with exercise perfection.
The Light Years by Elizabeth Jane Howard: We’re reading the first volume of The Cazalet Chronicles for a supplementary book club meeting. I can hardly believe it was published in 1990; it’s such a detailed, convincing picture of 1937‒8 for a large, wealthy family in London and Sussex as war approaches. It’s so Downton Abbey; I love it and will continue the series.
Outlawed by Anna North: After Reese Witherspoon chose it for her book club, there’s no chance you haven’t heard about this one. I requested it because I’m a huge fan of North’s previous novel, The Life and Death of Sophie Stark, but I’m also enjoying this alternative history/speculative take on the Western. It’s very Handmaid’s, with a fun medical slant.
Love After Love by Ingrid Persaud: It was already on my TBR after the Faber Live Fiction Showcase in November, but my interest was redoubled by this recently winning the Costa First Novel Award. Set in Trinidad, it’s narrated, delightfully, in turn by Betty, a young widow; Solo, her teenage son; and Mr. Chetan, their lodger. Perfect for fans of Mr Loverman.
Last week I ordered 21 books in one day. (In my defense, only 18 of them were for me.) It started like this: “Ah, must find a clearance 2021 calendar. Waterstones had a good selection last year…” And indeed, I found the perfect calendar, for half price. But then I continued browsing the online sale items and before I knew it there were also seven books in my basket. While I was at it, I went onto Awesomebooks.com and put together an order of secondhand books by authors I’ve been wanting to try or read more by. Add to that a couple more review books coming through the door and a couple of giveaways from neighbors (the Nicolson in the first photo, and Stoner for me to reread) and it’s been a big week for book acquisitions.
Attending a Book Launch
My fifth book launch since March 2020; my first to take place on Instagram. Hosted by Damian Barr, who runs a literary salon, it was for one I’ve already mentioned, Some Body to Love by Alexandra Heminsley, which came out on the 14th. (Barr and his husband are the book’s dedicatees.) “I am not ashamed of what happened,” she said about how her family has changed, adding that writing about such recent events has been a way of solidifying how she felt about them. Her ex has not read the book but wrote to Chatto & Windus saying she completely trusted Heminsley and consented to the publication. Some of her offers were for a more mass-market memoir about the marriage, whereas the book ended up being more diffuse, including other medical experiences and challenges to self-belief. It was amusing to hear that after the BLM movement her manuscript went through a “Karen edit” to make sure she hadn’t taken her privilege for granted.
A New TBR Challenge
“Hands. Face. Space.” is a current UK public health campaign slogan. It inspired me to trawl through my TBR shelves for appropriate covers and titles. I don’t know if I’m actually serious about reading these particular books I selected (I could have chosen any of dozens for the Face covers), but it was fun to put together the photo shoot. I had two replies from people on Twitter who came up with their own trio of titles.
And to cap off this miscellany, something non-book-related…
Top 5 albums from 2020
I originally wrote this little note for Facebook.
Banana Skin Shoes, Badly Drawn Boy – His best since his annus mirabilis of 2002. Funky pop gems we’ve been caught dancing to by people walking past the living room window … oops! A track to try: “Is This a Dream?” (psychedelic music video)!
Where the World Is Thin, Kris Drever – You may know him from Lau. Top musicianship and the most distinctive voice in folk. Nine folk-pop winners, including a lockdown anthem. A track to try: “I’ll Always Leave the Light On.”
Henry Martin, Edgelarks – Mention traditional folk and I’ll usually run a mile. But the musical skill and new arrangements, along with Hannah Martin’s rich alto, hit the spot. A track to try: “Bird in a Cage.”
Blindsided, Mark Erelli – We saw him perform the whole of his new folk-Americana album live in lockdown. Love the Motown and Elvis influences; his voice is at a peak. A track to try: “Rose-Colored Rearview.”
American Foursquare, Denison Witmer – A gorgeous ode to family life in small-town Pennsylvania from a singer-songwriter whose career we’ve been following for upwards of 15 years. A track to try: “Birds of Virginia.”
How is your 2021 reading going?
Lev Parikian was a keen birdwatcher when he was 11, but as an adult he barely remembered most of what he used to know about birds. He’d confidently declare that he’d seen a nightingale and then be too embarrassed to later admit it was actually a skylark. Also, he had to acknowledge that he hadn’t been completely honest as a preteen birder: No way had he seen a black redstart, for instance. Probably about 30% of his childhood sightings could be dismissed as cheats or downright lies. As the birdwatching bug bit again at the start of 2016, he decided it was time to set the record straight. His aim? To see 200 birds in a year, with no twitching (driving many miles to see a reported rarity) and no cheating.
Most of the book is a chronological tour through 2016, with each month’s new sightings totaled up at the end of the chapter. Being based in London isn’t the handicap one might expect – there’s a huge population of parakeets there nowadays, and the London Wetland Centre in Barnes is great for water birds – but Parikian also fills in his list through various trips around the country. He picks up red kites while in Windsor for a family wedding, and his list balloons in April thanks to trips to Minsmere and Rainham Marshes, where he finds additions like bittern and marsh harrier. The Isle of Wight, Scotland, Lindsifarne, North Norfolk… The months pass and the numbers mount until it’s the middle of December and his total is hovering at 196. Will he make it? I wouldn’t dare spoil the result for you!
I’ve always enjoyed ‘year-challenge’ books, everything from Julie Powell’s Julie and Julia to Nina Sankovitch’s Tolstoy and the Purple Chair, so I liked this memoir’s air of self-imposed competition, and its sense of humor. Having accompanied my husband on plenty of birdwatching trips, I could relate to the alternating feelings of elation and frustration. I also enjoyed the mentions of Parikian’s family history and career as a freelance conductor – I’d like to read more about this in his first book, Waving, Not Drowning (2013). This is one for fans of Alexandra Heminsley’s Leap In and Kyo Maclear’s Birds Art Life, or for anyone who needs reassurance that it’s never too late to pick up a new skill or return to a beloved hobby.
Lastly, I must mention what a beautiful physical object this book is. The good folk of Unbound have done it again. The cover image and endpapers reproduce Alan Harris’s lovely sketch of a gradually disappearing goldcrest, and if you lift the dustjacket you’re rewarded with the sight of some cheeky bird footprints traipsing across the cover.
Some favorite passages:
“Birders love a list. Day lists, week lists, month lists, year lists, life lists, garden lists, county lists, walk-to-work lists, seen-from-the-train lists, glimpsed-out-of-the-bathroom-window-while-doing-a-poo lists.”
“It’s one thing sitting in your favourite armchair, musing on the plumage differences between first- and second-winter black-headed gulls, but that doesn’t help identify the scrubby little blighter that’s just jigged into that bush, never to be seen again. And it’s no use asking them politely to damn well sit still blast you while I jot down the distinguishing features of your plumage in this notebook dammit which pocket is it in now where did I put the pencil ah here it is oh bugger it’s gone. They just won’t. Most disobliging.”
“There is a word in Swedish, gökotta, for the act of getting up early to listen to birdsong, but the knowledge that this word exists, while heartwarming, doesn’t make it any easier. It’s a bitter pill, this early rising, but my enthusiasm propels me to acts of previously unimagined heroism, and I set the alarm for an optimistic 5 a.m., before reality prompts me to change it to 5.15, no 5.30, OK then 5.45.”
Why Do Birds Suddenly Disappear? was published by Unbound on May 17th. My thanks to the publisher for the free copy for review.
I was delighted to be invited to participate in the blog tour for Why Do Birds Suddenly Disappear? See below for details of where other reviews and features have appeared or will be appearing soon (including on my hubby’s blog on Thursday!).
In the first four months of this year, I got my hands on no fewer than four swimming memoirs. For the upcoming July/August issue of Foreword Reviews magazine I’ve reviewed Floating: A Life Regained by Joe Minihane, in which the author recreates the late nature writer Roger Deakin’s wild swimming journeys from Waterlog (1999) in an attempt to overcome anxiety; I have Leap In by Alexandra Heminsley on my Kindle; and I read roughly the first 60 pages of a library copy of Al Álvarez’s 2013 Pondlife: A Swimmer’s Journal.
For now, I’m featuring Turning by Jessica J. Lee, which has strong similarities to these other memoirs – especially Minihane’s – but is its own beautifully reflective personal story. The book arose from Lee’s resolution, when she was 28 and in Berlin on a research placement for her dissertation in environmental history, to swim in 52 local lakes – a year’s worth – no matter the weather. At the time she blogged about her “52 Lakes Project” for Slow Travel Berlin, and kept friends and family up to date through social media as well. Her focus would be on the former East German region of Brandenburg, which has Berlin at its center and was first popularized by Theodor Fontane’s 1862 travel book.
Lee traveled to the lakes under her own steam, using trains and her bicycle; occasionally she took friends with her, but most often she was alone, which became a chance to cultivate solitude – not the same as loneliness. The challenge entailed all kinds of practical difficulties like bike trouble, getting lost, and a dead phone battery, but gradually it became routine and held less fear for her. On summer days she could manage multiple lakes in a day, and even small encounters with Germans gave her a newfound sense of belonging.
Within chapters, the memoir gracefully alternates pieces of the author’s past with her lake travels. With a father from Wales and a mother from Taiwan, Lee grew up in Ontario and spent summers in Florida. She remembers taking YMCA swimming lessons alongside her mother, and swimming in Canadian lakes. Back then the water usually intimidated her, but over the years her feelings have changed:
Water feels different in each place. The water I grew up with was hard, cutting, and when I go back to visit it now, I feel it in my ears when I dive in. something different, more like rock. The lake a whetted blade. The water in Berlin has a softness to it. Maybe it’s the sand, buffing the edges off the water like splinters from a beam. It slips over you like a blanket. There’s a safety in this feeling. In the lakes here, there is a feeling of enclosure and security that Canada can’t replicate. And it shouldn’t – the pelagic vastness there is entirely its own, and I’ve learned to love that too.
Swimming fulfills many functions for Lee. It served variously as necessary discipline after going mildly off the rails in young adulthood (drinking, smoking pot and having an abortion during college; a short-lived marriage in her early twenties); as a way of bouncing back from depression when her planned life in London didn’t pan out and a budding relationship failed; and as a way of being in touch with the turning seasons and coming to know the German landscape intimately. Symbolically, of course, it’s also a baptism into a new life.
Yet I had to wonder if there was also something masochistic about this pursuit, especially in the winter months. On the back cover there’s a photograph of Lee using a hammer to chip out a path through the ice so she can do her minimum of 45 strokes. (No wetsuit!) As spring came, ironically, the water felt almost too warm to her. She had learned to master the timing of a winter swim: “Between pain and numbness there’s a brightness, a crisp, heightened sensation in the cold: that’s the place to swim through. When it ends, when numbness arrives, it’s time to get out.”
The end of Lee’s year-long project is bittersweet, but she’s consoled by the fact that she didn’t have to leave her ordinary life in order to complete it. It was a companion alongside the frantic last-minute work on her dissertation and it never got in the way of her relationships; on the contrary, it strengthened certain friendships. And with Berlin looking like her home for the foreseeable future, she’s committed to seeking out more lakes, too.
There are a lot of year quest books out there, but this one never feels formulaic because there’s such a fluid intermingling of past and present. As memoirs go, it is somewhat like Amy Liptrot’s The Outrun – but much better. It’s also comparable to Angela Palm’s Riverine, with a watery metaphor at the heart to reflect the author’s conception of life as a meandering route. Unlike the other swimming memoirs I’ve sampled, I can recommend this one to a general reader with no particular interest in wild swimming or any other sport. It’s for you if you enjoy reading about the ebb and flow of women’s lives.
In the stillness of the lakes, the border between nature and culture is thinned. Swimming takes place at this border, as if constantly searching for home. Water is a place in which I don’t belong, but where I find myself nonetheless. Out of my culture, out of my depth.
There is more space inside than I can imagine, more hope and possibility than I’d known. Feeling as clear as the day, as deep as the lake.
Turning: A Swimming Memoir was published in the UK by Virago on May 4th. My thanks to the publisher for sending a free copy for review.