Tag Archives: assisted suicide

Recommended April Releases by Amy Bloom, Sarah Manguso & Sara Rauch

Just two weeks until moving day – we’ve got a long weekend ahead of us of sanding, painting, packing and gardening. As busy as I am with house stuff, I’m endeavouring to keep up with the new releases publishers have been so good as to send me. Today I review three short works: the story of accompanying a beloved husband to Switzerland for an assisted suicide, a coolly perceptive novella of American girlhood, and a vivid memoir of two momentous relationships. (April was a big month for new books: I have another 6–8 on the go that I’ll be catching up on in the future.) All:

 

In Love: A Memoir of Love and Loss by Amy Bloom

“We’re not here for a long time, we’re here for a good time.”

(Ameche family saying)

Given the psychological astuteness of her fiction, it’s no surprise that Bloom is a practicing psychotherapist. She treats her own life with the same compassionate understanding, and even though the main events covered in this brilliantly understated memoir only occurred two and a bit years ago, she has remarkable perspective and avoids self-pity and mawkishness. Her husband, Brian Ameche, was diagnosed with early-onset Alzheimer’s in his mid-60s, having exhibited mild cognitive impairment for several years. Brian quickly resolved to make a dignified exit while he still, mostly, had his faculties. But he needed Bloom’s help.

“I worry, sometimes, that a better wife, certainly a different wife, would have said no, would have insisted on keeping her husband in this world until his body gave out. It seems to me that I’m doing the right thing, in supporting Brian in his decision, but it would feel better and easier if he could make all the arrangements himself and I could just be a dutiful duckling, following in his wake. Of course, if he could make all the arrangements himself, he wouldn’t have Alzheimer’s”

U.S. cover

She achieves the perfect tone, mixing black humour with teeth-gritted practicality. Research into acquiring sodium pentobarbital via doctor friends soon hit a dead end and they settled instead on flying to Switzerland for an assisted suicide through Dignitas – a proven but bureaucracy-ridden and expensive method. The first quarter of the book is a day-by-day diary of their January 2020 trip to Zurich as they perform the farce of a couple on vacation. A long central section surveys their relationship – a second chance for both of them in midlife – and how Brian, a strapping Yale sportsman and accomplished architect, gradually descended into confusion and dependence. The assisted suicide itself, and the aftermath as she returns to the USA and organizes a memorial service, fill a matter-of-fact 20 pages towards the close.

Hard as parts of this are to read, there are so many lovely moments of kindness (the letter her psychotherapist writes about Brian’s condition to clinch their place at Dignitas!) and laughter, despite it all (Brian’s endless fishing stories!). While Bloom doesn’t spare herself here, diligently documenting times when she was impatient and petty, she doesn’t come across as impossibly brave or stoic. She was just doing what she felt she had to, to show her love for Brian, and weeping all the way. An essential, compelling read.

With thanks to Granta for the free copy for review.

 

Very Cold People by Sarah Manguso

I’ve read Manguso’s four nonfiction works and especially love her Wellcome Book Prize-shortlisted medical memoir The Two Kinds of Decay. The aphoristic style she developed in her two previous books continues here as discrete paragraphs and brief vignettes build to a gloomy portrait of Ruthie’s archetypical affection-starved childhood in the fictional Massachusetts town of Waitsfield in the 1980s and 90s. She’s an only child whose parents no doubt were doing their best after emotionally stunted upbringings but never managed to make her feel unconditionally loved. Praise is always qualified and stingily administered. Ruthie feels like a burden and escapes into her imaginings of how local Brahmins – Cabots and Emersons and Lowells – lived. Her family is cash-poor compared to their neighbours and loves nothing more than a trip to the dump: “My parents weren’t after shiny things or even beautiful things; they simply liked getting things that stupid people threw away.”

The depiction of Ruthie’s narcissistic mother is especially acute. She has to make everything about her; any minor success of her daughter’s is a blow to her own ego. I marked out an excruciating passage that made me feel so sorry for this character. A European friend of the family visits and Ruthie’s mother serves corn muffins that he seems to appreciate.

My mother brought up her triumph for years. … She’d believed his praise was genuine. She hadn’t noticed that he’d pegged her as a person who would snatch up any compliment into the maw of her unloved, throbbing little heart.

U.S. cover

At school, as in her home life, Ruthie dissociates herself from every potentially traumatic situation. “My life felt unreal and I felt half-invested. I felt indistinct, like someone else’s dream.” Her friend circle is an abbreviated A–Z of girlhood: Amber, Bee, Charlie and Colleen. “Odd” men – meaning sexual predators – seem to be everywhere and these adolescent girls are horribly vulnerable. Molestation is such an open secret in the world of the novel that Ruthie assumes this is why her mother is the way she is.

While the #MeToo theme didn’t resonate with me personally, so much else did. Chemistry class, sleepovers, getting one’s first period, falling off a bike: this is the stuff of girlhood – if not universally, then certainly for the (largely pre-tech) American 1990s as I experienced them. I found myself inhabiting memories I hadn’t revisited for years, and a thought came that had perhaps never occurred to me before: for our time and area, my family was poor, too. I’m grateful for my ignorance: what scarred Ruthie passed me by; I was a purely happy child. But I think my sister, born seven years earlier, suffered more, in ways that she’d recognize here. This has something of the flavour of Eileen and My Name Is Lucy Barton and reads like autofiction even though it’s not presented as such. The style and contents may well be divisive. I’ll be curious to hear if other readers see themselves in its sketches of childhood.

With thanks to Picador for the proof copy for review.

XO by Sara Rauch

Sara Rauch won the Electric Book Award for her short story collection What Shines from It. This compact autobiographical parcel focuses on a point in her early thirties when she lived with a long-time female partner, “Piper”, and had an intense affair with “Liam”, a fellow writer she met at a residency.

“no one sets out in search of buried treasure when they’re content with life as it is”

“Longing isn’t cheating (of this I was certain), even when it brushes its whiskers against your cheek.”

Adultery is among the most ancient human stories we have, a fact Rauch acknowledges by braiding through the narrative her musings on religion and storytelling by way of her Catholic upbringing and interest in myths and fairy tales. She’s looking for the patterns of her own experience and how endings make way for new life. The title has multiple meanings: embraces, crossroads and coming full circle. Like a spider’s web, her narrative pulls in many threads to make an ordered whole. All through, bisexuality is a baseline, not something that needs to be interrogated.

This reminded me of a number of books I’ve read about short-lived affairs – Tides, The Instant – and about renegotiating relationships in a queer life – The Fixed Stars, In the Dream House – but felt most like reading a May Sarton journal for how intimately it recreates daily routines of writing, cooking, caring for cats, and weighing up past, present and future. Lovely stuff.

With thanks to publicist Lori Hettler and Autofocus Books for the e-copy for review.

Will you seek out one or more of these books?

What other April releases can you recommend?

Six Degrees of Separation: What Are You Going Through to No Saints Around Here

I’ve become an occasional Six Degrees of Separation post-er, when the mood strikes me and/or I get a flash of inspiration. This month we began with What Are You Going Through, which I reviewed back in October 2020. (See Kate’s opening post.)

Between that, The Friend and A Feather on the Breath of God, Sigrid Nunez has quickly become one of my favourite contemporary authors. I have two more of her novels on the shelf to read soon, one from my birthday haul.

In What Are You Going Through, the narrator is called upon to help a terminally ill friend commit suicide. However, I summed up the message as “Curiosity about other lives fuels empathy,” and noted “a sort of slapstick joy early in this morbid adventure.”

 

#1 One of the stand-out books from my 2021 reading so far has been The Inevitable, which is about assisted dying. The case studies are wrenching but compassionately told. Katie Engelhart explores the nuances of situations, crafting expert portraits of suffering people and the medical professionals who seek to help them, and adding much in the way of valuable context.

 

#2 As the saying goes, if there’s one thing inevitable besides death, it’s taxes. And if you’re a U.S. citizen, you will remain accountable to the IRS until the day you die, no matter where you live. (Eritrea is the only other country that requires expatriates to fill in tax returns.) I’ve now gotten my U.S. tax forms down to a science, keeping a list of pointers and previous years’ forms as scanned files so that I just have to plug in the year’s numbers, put zeroes in all the important boxes (since I’ve already paid income tax in the UK), and send it off. A matter of an hour or two’s work, rewarded by a G&T.

But I distinctly remember the Junes when I would spend days muddling through byzantine IRS forms, so I am very grateful that an offer for this e-book arrived in my inbox via my blog contact form in 2017: U.S. Taxes for Worldly Americans by Olivier Wagner. It goes through each form, often line by line. Three cheers for actually helpful self-help guides!

 

#3 Another expat tip that I found extremely useful, small as it might seem, is that “quite” means something different in American vs. British English. To an American it’s a synonym for “very”; to the guarded Brits, it’s more like “rather.” I have the Julian Barnes essay collection Letters from London to thank for this vital scrap of etymological knowledge.

 

#4 Unsurprisingly, I have built up a small library of books about understanding the English and their ways. In the How to Be a Brit omnibus, collecting three short volumes from the 1940s–70s, George Mikes (a Hungarian immigrant) makes humorous observations that have, in general, aged well. His mini-essays on tea, weather and queuing struck me as particularly apt. I would draw a straight line from this through Bill Bryson’s Notes from a Small Island to the Very British Problems phenomenon.

 

#5 As I was preparing to fly to England for the first time for my study abroad year, one of the authors who most whetted my appetite for British travel was Susan Allen Toth, whose trilogy of UK-themed memoirs-with-recommendations began with My Love Affair with England – included in one of my Landmark Books in My Life posts. I’m rereading one of the other three now.

 

#6 Toth is a very underrated author, I feel. I’ve read most of her memoirs and have a short nonfiction work of hers on my pile for #NovNov. Her most recent book is No Saints Around Here: A Caregiver’s Days (2014), in which she chronicled the last 18 months of her husband James’s life, as she and an army of caregivers coped with his decline from Parkinson’s disease. Toth gets the tone just right: although she is honest, she is never melodramatic; although she often feels sorry for herself, she also recognizes how lucky she has been, not just to have done a good job of looking after James, but to have had him in her life at all.

 

I’ve gone full circle from one story of caregiving to another, via death, taxes and Englishness. The starting and ending books are reminders that you never fully know what another person is going through; all we can do is our best while cutting others some slack.

 


Where will your chain take you? Join us for #6Degrees of Separation! (Hosted on the first Saturday of each month by Kate W. of Books Are My Favourite and Best.) Next month’s starting point is our buddy read for week 4 of #NovNov, Ethan Frome by Edith Wharton.

Have you read any of my selections? Are you tempted by any you didn’t know before?

The Inevitable: Dispatches on the Right to Die by Katie Engelhart

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.

Darke Matter by Rick Gekoski (Blog Tour Review)

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.