Tag Archives: assisted dying
Hard to believe we’ve already crossed the midpoint of the year. My top 20 releases of 2021 thus far, in alphabetical order within genre (fiction is dominating this year!), are below. I link to those I’ve already reviewed in full here or on Goodreads:
Under the Blue by Oana Aristide: Fans of Station Eleven, this one’s for you: the best dystopian novel I’ve read since Mandel’s. Aristide started writing in 2017, and unknowingly predicted a much worse pandemic than Covid-19. In July 2020, Harry and sisters Ash and Jessie are among mere thousands of survivors worldwide. Their plan is to flee England for Uganda, out of range of Europe’s at-risk nuclear reactors. An epic road trip ensues. A propulsive cautionary tale that also reminded me of work by Louisa Hall and Maja Lunde.
The Push by Ashley Audrain: Blythe Connor, living alone with her memories, ponders what went wrong with her seemingly perfect family: a handsome architect husband, Fox, and their daughter Violet and baby son Sam. How much of what happened was because of Violet’s nature, and how much was Blythe’s fault for failing to be the mother the girl needed? The fact that her experience with Sam was completely different makes her feel ambivalent about motherhood. A cracking psychological thriller with an unreliable narrator.
A Lie Someone Told You About Yourself by Peter Ho Davies: Davies’ minimalist approach – short sections skating over the months and years, wryly pulling out representative moment – crystallizes fatherhood, illuminating its daily heartaches and joys. The tone is just right in this novella, showing both sides of parenthood and voicing things you aren’t allowed to think, or at least not to admit to, starting with abortion, which would-be fathers aren’t expected to have strong feelings about. I loved the rumination on the role that chance plays in a life.
The Living Sea of Waking Dreams by Richard Flanagan: Extinction, personal and global, is at the heart of this timely and enchanting story. It starts off as a family drama. Francie, the 86-year-old matriarch, is in a Tasmanian hospital after a brain bleed. Her three middle-aged children can’t bear to let her go. In an Australia blighted by bushfires, species loss mirrors Francie’s physical and mental crumbling. Smartphone addiction threatens meaningful connection. And then characters start to literally disappear, part by part…
Mrs Death Misses Death by Salena Godden: Grief Is the Thing with Feathers meets Girl, Woman, Other would be my marketing shorthand for this one. Poet Salena Godden’s debut novel is a fresh and fizzing work, passionate about exposing injustice but also about celebrating simple joys, and in the end it’s wholly life-affirming despite a narrative stuffed full of deaths real and imagined. The novel balances the cosmic and the personal through Wolf’s family story. Unusual, musical, and a real pleasure to read.
Early Morning Riser by Katherine Heiny: This tickled my funny bone. A cross between Kitchens of the Great Midwest and Olive Kitteridge, it’s built of five extended episodes, crossing nearly two decades in the lives of Jane and Duncan and lovingly portraying the hangers-on who compose their unusual family constellation in Boyne City, Michigan. All the characters are incorrigible but wonderful. Bad things happen, but there’s a core of love as Heiny explores marriage and parenting. A good-natured book that feels wise and bittersweet.
No One Is Talking About This by Patricia Lockwood: This starts as a flippant skewering of modern life. A woman who became a social media star by tweeting quips like “Can a dog be twins?” reflects on life on “the portal” and under “the dictator.” Midway through the book, she gets a wake-up call when her mother summons her back to the Midwest for a family emergency. It’s the about-face that makes this novel, forcing readers to question the value of a digital existence based on glib pretence. Funny, but with an ache behind it.
In by Will McPhail: Alternately laugh-out-loud funny and gentle. This debut graphic novel is a spot-on picture of modern life in a generic city. Nick never knows the right thing to say. The bachelor artist’s well-intentioned thoughts remain unvoiced; all he can manage is small talk. That starts to change when he meets Wren, a Black doctor who sees past his pretence. If only he can find the magic words that elicit honesty, he might make real connections with other human beings. A good old-fashioned story, with a wide emotional range.
Detransition, Baby by Torrey Peters: A sparkling, sexy comedy with a tender heart beneath the zingers. Peters has set herself up as the Jane Austen of the trans community, tracing the ins and outs of relationships with verve and nuance. For me this was a valuable book simply for normalizing trans sexuality. The themes are universal, after all: figuring out who you are and what the shape of your life will be. I admire when authors don’t pander to readers by making things easy for those who are unfamiliar with a culture. Great lines abound.
Brood by Jackie Polzin: Polzin’s debut is a quietly touching story of a woman in the Midwest raising chickens and coming to terms with the shape of her life. The unnamed narrator is Everywoman and no one at the same time. At one point she reveals, with no fanfare, that she miscarried four months into pregnancy in the bathroom of one of the houses she cleans. There is a bittersweet tone to this short work. It’s a low-key, genuine portrait of life in the in-between stages and how it can be affected by fate or by other people’s decisions.
The Circling Sky by Neil Ansell: Hoping to reclaim an ancestral connection, Ansell visited the New Forest some 30 times between January 2019 and January 2020, observing the unfolding seasons and the many uncommon and endemic species its miles house. He weaves together his personal story, the shocking history of forced Gypsy relocation into forest compounds starting in the 1920s, and the unfairness of land ownership in Britain. The New Forest is a model of both wildlife-friendly land management and freedom of human access.
The Inevitable by Katie Engelhart: Engelhart spends time with doctors and patients who are caught up in the assisted dying argument, chiefly in Western Europe and the United States. Each case is given its own long chapter, like an extended magazine profile. The stories are wrenching, but compassionately told. The author explores the nuances of each situation, crafting expert portraits of suffering people and the medical professionals who seek to help them, and adding much in the way of valuable context. A voice of reason and empathy.
The Screaming Sky by Charles Foster: A Renaissance man as well versed in law and theology as he is in natural history, Foster is obsessed with swifts and ashamed of his own species: for looking down at their feet when they could be watching the skies; for the “pathological tidiness” that leaves birds and other creatures no place to live. He delivers heaps of information on the birds but refuses to stick to a just-the-facts approach. The book quotes frequently from poetry and the prose is full of sharp turns of phrase and whimsy.
Intensive Care by Gavin Francis: Francis, an Edinburgh physician, reflects on “the most intense months I have known in my twenty-year career.” He journeys back through 2020, from the January day when he received a bulletin about a “novel Wuhan coronavirus” to November, when he learned of promising vaccine trials but also a rumored third wave and winter lockdown. An absorbing first-hand account of a medical crisis, it compassionately bridges the gap between experts and laymen. The best Covid chronicle so far.
A Still Life by Josie George: Over a year of lockdowns, many of us became accustomed to spending most of the time at home. But for Josie George, social isolation is nothing new. Chronic illness long ago reduced her territory to her home and garden. The magic of A Still Life is in how she finds joy and purpose despite extreme limitations. Opening on New Year’s Day and travelling from one winter to the next, the book is a window onto George’s quiet existence as well as the turning of the seasons. (Reviewed for TLS.)
Dusk, Night, Dawn by Anne Lamott: Lamott’s best new essays in nearly a decade. The central theme is how to have hope in God and in other people even when the news – Trump, Covid, and climate breakdown – only heralds the worst. One key thing that has changed for her is getting married for the first time, in her mid-sixties, to a Buddhist. In thinking of marriage, she writes about friendship, constancy, and forgiveness, none of which comes easy. Opportunities for maintaining quiet faith in spite of the circumstances arise all the time.
A Braided Heart by Brenda Miller: Miller, a professor of creative writing, delivers a master class on the composition and appreciation of autobiographical essays. In 18 concise pieces, she tracks her development as a writer and discusses the “lyric essay”—a form as old as Seneca that prioritizes imagery over narrative. These innovative and introspective essays, ideal for fans of Anne Fadiman, showcase the interplay of structure and content. (Coming out on July 13th from the University of Michigan Press. My first review for Shelf Awareness.)
Sanctuary by Emily Rapp Black: A continuation of The Still Point of the Turning World, about the author’s son Ronan, who died of Tay-Sachs disease at age three. In the months surrounding his death, she split from her husband and raced into another relationship that led to her daughter, Charlie. Rapp Black questions the sorts of words she got branded with: “brave,” “resilient.” Sanctuary is full of allusions and flashbacks, threading life’s disparate parts into a chaotic tapestry. It’s measured and wrought, taming fire into light and warmth.
Pilgrim Bell by Kaveh Akbar: An Iranian American poet imparts the experience of being torn between cultures and languages, as well as between religion and doubt, in this gorgeous collection of confessional verse. Food, plants, animals, and the body supply the book’s imagery. Wordplay and startling juxtapositions lend lightness to a wistful, intimate collection that seeks belonging and belief. (Coming out on August 3rd from Graywolf Press. Reviewed for Shelf Awareness.)
Eat or We Both Starve by Victoria Kennefick: In this audacious debut collection, the body is presented as a battleground: for the brain cancer that takes the poet’s father; for disordered eating that entwines with mummy issues; for the restructuring of pregnancy. Families break apart and fuse into new formations. Cannibalism and famine metaphors dredge up emotional states and religious doctrines. There’s a pleasingly morbid cast to the book, but it also has its lighter moments. Rich with imagery and alliteration, this is just my kind of poetry.
What are some of the best books you’ve read so far this year?
What 2021 releases do I need to catch up on right away?
Why, she wanted to know, was I so interested in the subject?
“Why isn’t everyone?” I asked.
The fact that I read a lot more books about death than the average person is something I attribute not to some morbid curiosity, but to pragmatism. As the title of Canadian reporter and documentary filmmaker Katie Engelhart’s book makes clear, this is the one subject none of us can avoid indefinitely, so why not learn about and understand it as much as possible? The Inevitable focuses on the controversial matter of assisted dying, also known as assisted suicide, euthanasia, or physician-assisted death. It’s a topic that’s already come up in my reading a couple of times this year: in the Dutch context of That One Patient by Ellen de Visser, and as a key part of the narrative in Darke Matter by Rick Gekoski.
Engelhart spends time with doctors and patients who are caught up in the assisted dying argument, chiefly in Western Europe and the United States. Ten states plus Washington, D.C. have assisted dying laws, sparked by Oregon’s Death with Dignity Act in 1994. In California, the author follows Dr. Lonny Shavelson for a month, observing all the meticulous regulations surrounded a physician-assisted death: patients with a terminal diagnosis and less than six months to live have to complete multiple forms, give many signatures, deliver oral testimony, and be able to drink the fatal concoction by themselves (whereas in other countries doctors can administer lethal injections). And if, when the time comes, a patient is too far gone to give spoken consent, the procedure is cancelled.
Other chapters consider specific cases that are not generally covered by current legislation but can drive people to seek assisted suicide: the ravages of old age, chronic degenerative illnesses, dementia, and severe mental illness. Each of these is given its own long chapter, like an extended magazine profile.
- Meet Avril Henry, a former Exeter University professor in her eighties, now living alone with a failing body but no specific diagnosis that would qualify her for AD. Pain has long since outweighed pleasure in her life, so she illegally imports Nembutal from a veterinary supplier in Mexico and makes a careful plan for what will happen with her body, home, and possessions after she takes the drug in the bathtub.
- Meet Maia Calloway, a 39-year-old former filmmaker confined to a wheelchair by multiple sclerosis. Her medicines cost $65,000 a year, not all covered by Medicare, and she can no longer rely on the patience of her boyfriend, who acts as her carer. She decides to raise the money to travel from Taos to a Swiss assisted dying clinic.
- Meet Debra, a 65-year-old widow so rapidly declining with dementia that she knows she has to make her arrangements at once. She contacts the Final Exit Network, which gives advice and equipment (e.g. a nitrogen tank) that can make a death look unexplained or like a standard suicide.
- Meet Adam, a 27-year-old in daily distress from OCD, anxiety, and depersonalization disorder. Though he’s lobbied for the inclusion of mental illness, he doesn’t qualify for AD under Canada’s laws. In 2017 he starts a Facebook livestream from a hotel room, intending to take poison off-screen. He loses his nerve this time, but is determined to try again.
These stories are so wrenching, but so compassionately told. Engelhart explores the nuances of each situation, crafting expert portraits of suffering people and the medical professionals who seek to help them, and adding much in the way of valuable context. Hers is a voice of reason and empathy. She mostly stays in the background, as befits a journalist, but occasionally emotional responses or skepticism come through – Exit International’s Philip Nitschke, vilified as a “Dr. Death” like Jack Kevorkian, is too much of a maverick for her.
And while her sympathy for the AD cause is evident, she also presents opposing arguments: from hospice doctors, from those afraid that the disabled will be pushed into assisted suicide to free up resources, from the family members of her subjects, and from those who have witnessed abuses of the system. There are those who frame this as a question of rights, and others who recognize a rare privilege; some who scorn the notion of escape, and others who speak of dignity and the kindness one would show a dying pet. The book is a vital contribution to an ongoing debate, with human stories at its heart.
With thanks to Atlantic Books for the free copy for review. The Inevitable was published in the UK on March 11th and is available from St. Martin’s Press in the USA.
Back in 2017, I enjoyed Rick Gekoski’s debut novel, Darke, in which curmudgeonly Dr. James Darke, a retired English teacher, literally seals himself off from the world after his wife Suzy’s death from cancer. I was pleasantly surprised to learn that a sequel was released last year – how appropriate to revisit themes of grief and isolation in 2020! – and right away was reminded of the delights of his grumpy, pompous first-person narration. As the second book opens, Darke is preparing to host his daughter Lucy with her partner Sam and son Rudy for Christmas and is in a Scrooge-like mood: “In my own home, I am blessedly safe from the canvassers, beggars and importuners spreading bubonically from house to house at Yuletide.”
Soon two things happen to shatter his peace: one is an invitation to join a poetry reading club hosted by a literary associate of his late wife – but he soon realizes it’s more of a support group for bereaved spouses. The second and much more serious interruption is a knock on the door from the police, who require more information about Suzy’s death. You see, early on in this book, Darke tells us himself that he gave Suzy a “soothing drink to carry her away,” and even in the face of others’ horror he maintains two seemingly contradictory facts: that he did not want for her to die, but that he did give her a fatal concoction to ease her terrible pain.
By coincidence, I was reading a nonfiction study of assisted dying, The Inevitable by Katie Engelhart, at the same time, and I’d also read That One Patient, a collection of interviews with Dutch medical professionals, some of whom have helped terminally ill patients to commit suicide, earlier this year. It was amusing, but also touching, to see Darke becoming an unwitting spokesman for this movement. He writes a manifesto headed “Easeful Death – Do you love your dog more than your wife?” and gets help disseminating it from a journalist acquaintance. Media attention follows and a scandal erupts.
One of the joys of this pair of novels is Darke’s fondness for literary allusions. In the previous book, these were mostly to Dante and Dickens. Here, the greatest debt is to Jonathan Swift: Darke has been reading Gulliver’s Travels to his grandson at bedtime, and decides to write a pastiche sequel to entertain the boy. Gradually, this turns into a coded story by which he can explain to Rudy what might happen to his grandfather. Will Captain Gulliver be found guilty of heresy? Will he have to flee to avoid jail?
Because we only ever experience Darke’s point of view, he is something of an unreliable narrator, and because he delivers the novel’s finale via his italicized Swiftian narrative, there is some uncertainty about what actually happens to our antihero. I didn’t enjoy this quite as much as the first book, but together they form a striking and witty character study. I especially appreciated how the sequel adds in a gentle note of controversy without allowing it to overtake the pleasures of the voice.
Darke Matter was first published in the UK by Constable in May 2020. The paperback edition came out on April 1st. My thanks to the publisher for the free copy for review.
I was happy to take part in the blog tour for Darke Matter. See below for details of where other reviews and features have appeared or will be appearing.