Tag: Atul Gawande

Best of 2019: Nonfiction

For me, 2019 has been a more memorable year for nonfiction than for fiction. Like I did last year, I’ve happened to choose 12 favorite nonfiction books – though after some thematic grouping this has ended up as a top 10 list. Bodies, archaeology, and the environmental crisis are recurring topics, reflecting my own interests but also, I think, something of the zeitgeist.

Let the countdown begin!

 

  1. Because Internet: Understanding how language is changing by Gretchen McCulloch: Surprisingly fascinating stuff, even for a late adopter of technology. The Internet popularized informal writing and quickly incorporates changes in slang and cultural references. The book addresses things you may never have considered, like how we convey tone of voice through what we type and how emoji function as the gestures of the written word. Bursting with geeky enthusiasm.

 

  1. Surfacing by Kathleen Jamie: A fusion of autobiography with nature and travel writing – two genres that are too often dominated by men. Jamie has a particular interest in birds, islands, archaeology and the oddities of the human body, all subjects that intrigue me. There is beautiful nature writing to be found in this volume, as you might expect, but also relatable words on the human condition.

 

  1. Mother Ship by Francesca Segal: A visceral diary of the first eight weeks in the lives of the author’s daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU. Segal describes with tender precision the feeling of being torn between writing and motherhood, and crafts twinkly pen portraits of others she encountered in the NICU, including the staff but especially her fellow preemie mums.

 

  1. Surrender: Mid-Life in the American West by Joanna Pocock: Prompted by two years spent in Missoula, Montana and the disorientation felt upon a return to London, this memoir-in-essays varies in scale from the big skies of the American West to the smallness of one human life and the experience of loss and change. This is an elegantly introspective work that should engage anyone interested in women’s life writing and the environmental crisis.

 

  1. (A tie) Constellations by Sinéad Gleeson / The Undying by Anne Boyer / Notes Made while Falling by Jenn Ashworth: Trenchant autobiographical essays about female pain. All three feel timely and inventive in how they bring together disparate topics to explore the possibilities and limitations of women’s bodies. A huge theme in life writing in the last couple of years and a great step toward trauma and chronic pain being taken seriously. (See also Notes to Self by Emilie Pine and the forthcoming Pain Studies by Lisa Olstein.)

 

  1. Time Song: Searching for Doggerland by Julia Blackburn: Deep time is another key topic this year. Blackburn follows her curiosity wherever it leads as she does research into millions of years of history, including the much shorter story of human occupation. The writing is splendid, and the dashes of autobiographical information are just right, making her timely/timeless story personal. This would have been my Wainwright Prize winner.

 

  1. The Seafarers: A Journey among Birds by Stephen Rutt: The young naturalist travelled the length and breadth of the British Isles – from Skomer to Shetland – courting encounters with seabirds. Discussion of the environmental threats that hit these species hardest, such as plastic pollution, makes for a timely tie-in to wider issues. The prose is elegantly evocative, and especially enjoyable because I’ve been to a lot of the island locations.

 

  1. Once More We Saw Stars by Jayson Greene: In 2015 the author’s two-year-old daughter, Greta, was fatally struck in the head by a brick that crumbled off an eighth-story Manhattan windowsill. Music journalist Greene explores all the ramifications of grief. I’ve read many a bereavement memoir and can’t remember a more searing account of the emotions and thoughts experienced moment to moment. The whole book has an aw(e)ful clarity to it.

 

  1. The Body: A Guide for Occupants by Bill Bryson: Bryson is back on form indulging his layman’s curiosity. Without ever being superficial or patronizing, he gives a comprehensive introduction to every organ and body system. He delights in our physical oddities, and his sense of wonder is contagious. Shelve this next to Being Mortal by Atul Gawande in a collection of books everyone should read – even if you don’t normally choose nonfiction.

 

  1. Irreplaceable: The Fight to Save Our Wild Places by Julian Hoffman: Species and habitat loss are hard to comprehend even when we know the facts. This exquisitely written book is about taking stock, taking responsibility, and going beyond the numbers to tell the stories of front-line conservation work. Irreplaceable is an elegy of sorts, but, more importantly, it’s a call to arms. It places environmentalism in the hands of laypeople and offers hope that in working together in the spirit of defiance we can achieve great things. So, if you read one 2019 release, make it this one.

 

(Books not pictured were read from the library or on Kindle.)

What were some of your top nonfiction reads of the year?

 

Upcoming posts:

28th: Runners-up

29th: Other superlatives and some statistics

30th: Best backlist reads

31st: The final figures on my 2019 reading

Review Books Roundup: Blackburn, Bryson, Pocock, Setterwall, Wilson

I’m attempting to get through all my 2019 review books before the end of the year, so expect another couple of these roundups. Today I’m featuring a work of poetry about one of Picasso’s mistresses, a thorough yet accessible introduction to how the human body works, a memoir of personal and environmental change in the American West, Scandinavian autofiction about the sudden loss of a partner, and a novel about kids who catch on fire. You can’t say I don’t read a variety! See if one or more of these tempts you.

 

The Woman Who Always Loved Picasso by Julia Blackburn

Something different from Blackburn: biographical snippets in verse about Marie-Thérèse Walter, one of Pablo Picasso’s many mistress-muses. When they met she was 17 and he was 46. She gave birth to a daughter, Maya – to his wife Olga’s fury. Marie-Thérèse’s existence was an open secret: he rented a Paris apartment for her to live in, and left his home in the South of France to her (where she committed suicide three years after his death), but unless their visits happened to overlap she was never introduced to his friends. “I lived in the time I was born into / and I kept silent, / acquiescing / to everything.”

In Marie-Thérèse’s voice, Blackburn depicts Picasso as a fragile demagogue: in one of the poems that was a highlight for me, “Bird,” she describes how others would replace his caged birds when they died, hoping he wouldn’t notice – so great was his horror of death. I liked getting glimpses into a forgotten female’s life, and appreciated the whimsical illustrations by Jeffrey Fisher, but as poems these pieces don’t particularly stand out. (Plus, there are no page numbers! which doesn’t seem like it should make a big difference but ends up being annoying when you want to refer back to something. Instead, the poems are numbered.)

My rating:


With thanks to Carcanet Press for the free copy for review. Published today.

 

The Body: A Guide for Occupants by Bill Bryson

Shelve this next to Being Mortal by Atul Gawande in a collection of books everyone should read – even if you don’t normally choose nonfiction. Bryson is back on form here, indulging his layman’s curiosity. As you know, I read a LOT of medical memoirs and popular science. I’ve read entire books on organ transplantation, sleep, dementia, the blood, the heart, evolutionary defects, surgery and so on, but in many cases these go into more detail than I need and I can find my interest waning. That never happens here. Without ever being superficial or patronizing, the author gives a comprehensive introduction to every organ and body system, moving briskly between engaging anecdotes from medical history and encapsulated research on everything from gut microbes to cancer treatment.

Bryson delights in our physical oddities, and his sense of wonder is infectious. He loves a good statistic, and while this book is full of numbers and percentages, they are accessible rather than obfuscating, and will make you shake your head in amazement. It’s a persistently cheerful book, even when discussing illness, scientists whose work was overlooked, and the inevitability of death. Yet what I found most sobering was the observation that, having conquered many diseases and extended our life expectancy, we are now overwhelmingly killed by lifestyle, mostly a poor diet of processed and sugary foods and lack of exercise.

(The Wellcome Book Prize isn’t running in 2020, but if it were this would win hands down.)

My rating:


With thanks to Doubleday for the free copy for review.

 

Surrender: Mid-Life in the American West by Joanna Pocock

Prompted by two years spent in Missoula, Montana and the disorientation felt upon a return to London, this memoir-in-essays varies in scale from the big skies of the American West to the smallness of one human life and the experience of loss and change. Then in her late forties, Pocock had started menopause and recently been through the final illnesses and deaths of her parents, but was also mother to a fairly young daughter. She explores personal endings and contradictions as a kind of microcosm of the paradoxes of the Western USA.

It’s a place of fierce independence and conservatism, but also mystical back-to-the-land sentiment. For an outsider, so much of the lifestyle is bewildering. The author attends a wolf-trapping course, observes a Native American buffalo hunt, meets a transsexual rewilding activist, attends an ecosexuality conference, and goes foraging. All are attempts to reassess our connection with nature and ask what role humans can play in a diminished planet.

This is an elegantly introspective work that should engage anyone interested in women’s life writing and the environmental crisis. There are also dozens of black-and-white photographs interspersed in the text. In 2018 Pocock won the Fitzcarraldo Editions Essay Prize for this work-in-progress. It came to me as an unsolicited review copy and hung around on my shelves for six months before I picked it up; I’m glad I finally did.

My rating:


With thanks to Fitzcarraldo Editions for the free copy for review.

 

Let’s Hope for the Best by Carolina Setterwall

[Trans. from the Swedish by Elizabeth Clark Wessel]

Although this is fiction, it very closely resembles the author’s own life. She wrote this debut novel to reflect on the sudden loss of her partner and how she started to rebuild her life in the years that followed. It quickly splits into two parallel story lines: one begins in April 2009, when Carolina first met Aksel at a friend’s big summer bash; the other picks up in October 2014, after Aksel’s death from cardiac arrest. The latter proceeds slowly, painstakingly, to portray the aftermath of bereavement. In the alternating timeline, we see Carolina and Aksel making their life together, with her always being the one to push the relationship forward.

Setterwall addresses the whole book in the second person to Aksel. When the two story lines meet at about the two-thirds point, it carries on into 2016 as she moves house, returns to work and resumes a tentative social life, even falling in love. This is a wrenching story reminiscent of In Every Moment We Are Still Alive by Tom Malmquist, and much of it resonated with my sister’s experience of widowhood. There are many painful moments that stick in the memory. Overall, though, I think it was too long by 100+ pages; in aiming for comprehensiveness, it lost some of its power. Page 273, for instance (the first anniversary of Aksel’s death, rather than the second, where the book actually ends), would have made a fine ending.

My rating:


With thanks to Bloomsbury UK for the proof copy for review.

 

Nothing to See Here by Kevin Wilson

I’d read a lot about this novel while writing a synopsis and summary of critical opinion for Bookmarks magazine – perhaps too much, as it felt familiar and offered no surprises. Lillian, a drifting twentysomething, is offered a job as a governess for her boarding school roommate Madison’s stepchildren. Madison’s husband is a Tennessee senator in the running for the Secretary of State position, so it’s imperative that they keep a lid on the situation with his 10-year-old twins, Bessie and Roland.

You see, when they’re upset these children catch on fire; flames destroy their clothes and damage nearby soft furnishings, but leave the kids themselves unharmed. Temporary, generally innocuous spontaneous combustion? Okay. That’s the setup. Wilson writes so well that it’s easy to suspend your disbelief about this, but harder to see a larger point, except perhaps creating a general allegory for the challenges of parenting. This was entertaining enough, mostly thanks to Lillian’s no-nonsense narration, but for me it didn’t soar.

My rating:


With thanks to Text Publishing UK for the PDF for review. This came out in the States in October and will be released in the UK on January 30th.

  

Would you be interested in reading one or more of these?

Wellcome Book Prize Shadow Panel & Two Longlist Reviews

I’m delighted to announce the other book bloggers on my Wellcome Book Prize 2018 shadow panel: Paul Cheney of Halfman, Halfbook, Annabel Gaskell of Annabookbel, Clare Rowland of A Little Blog of Books, and Dr. Laura Tisdall. Once the shortlist is announced on Tuesday the 20th, we’ll be reading through the six nominees and sharing our thoughts. Before the official winner is announced at the end of April we will choose our own shadow winner.

I’ve been working my way through some of the longlisted titles I was able to access via the public library and NetGalley. Here’s my latest two (both ):

Plot 29: A Memoir by Allan Jenkins

This is an unusual hybrid memoir: it’s a meditative tour through the gardening year, on a plot in London and at his second home in his wife’s native Denmark. But it’s also the story of how Jenkins, editor of the Observer Food Monthly, investigated his early life. Handed over to a Barnardo’s home at a few months of age, he was passed between various family members and a stepfather (with some degree of neglect: his notes show scabies, rickets and TB) and then raised by strict foster parents in Devon with his beloved older half-brother, Christopher. It’s interesting to read that initially Jenkins intended to write a simple gardening diary, with a bit of personal stuff thrown in. But as he got further into the project, it started to morph.

This cover image is so sweet. It’s a photograph from Summer 1959 of Christopher and Allan (on the right, aged five), just after they were taken in by their foster parents in Devon.

The book has a complicated chronology: though arranged by month, within chapters its fragments jump around in time, a year or a date at the start helping the reader to orient herself between flashbacks and the contemporary story line. Sections are often just a paragraph long; sometimes up to a page or two. I suspect some will find the structure difficult and distancing. It certainly made me read the book slowly, which I think was the right way. You take your time adjusting to the gradual personal unveiling just as you do to the slow turn of the seasons. When major things do happen – meeting his mother in his 30s; learning who his father was in his 60s – they’re almost anticlimactic, perhaps because of the rather flat style. It’s the process that has mattered, and gardening has granted solace along the way.

I’m grateful to the longlist for making me aware of a book I otherwise might never have heard about. I don’t think the book’s mental health theme is strong enough for it to make the shortlist, but I enjoyed reading it and I’ll also take a look at Jenkins’s upcoming book, Morning, about the joys of being an early riser. (Ironic after my recent revelations about my own sleep patterns!)

 

Favorite lines:

“Solitude plus community, the constant I search for, the same as the allotment”

“The last element to be released from Pandora’s box, they say, was hope. So I will mourn the children we once were and I will sow chicory for bitterness. I will plant spring beans and alliums. I’ll look after them.”

“As a journalist, I have learned the five Ws – who, what, where, when, why. They are all needed to tell a story, we are taught, but too many are missing in my tale.”

 


With the End in Mind: Dying, Death and Wisdom in an Age of Denial by Kathryn Mannix

This is an excellent all-round guide to preparation for death. It’s based around relatable stories of the patients Mannix met in her decades working in the fields of cancer treatment and hospice care. She has a particular interest in combining CBT with palliative care to help the dying approach their remaining time with realism rather than pessimism. In many cases this involves talking patients and their loved ones through the steps of dying and explaining the patterns – decreased energy, increased time spent asleep, a change in breathing just before the end – as well as being clear about how suffering can be eased.

I read the first 20% on my Kindle and then skimmed the rest in a library copy. This was not because I wasn’t enjoying it, but because it was a two-week loan and I was conscious of needing to move on to other longlist books. It may also be because I have read quite a number of books with similar themes and scope – including Caitlin Doughty’s two books on death, Caring for the Dying by Henry Fersko-Weiss, Being Mortal by Atul Gawande, and Waiting for the Last Bus by Richard Holloway. Really this is the kind of book I would like to own a copy of and read steadily, just a chapter a week. Mannix’s introductions to each section and chapter, and the Pause for Thought pages at the end of each chapter, mean the book lends itself to being read as a handbook, perhaps in tandem with an ill relative.

The book is unique in giving a doctor’s perspective but telling the stories of patients and their families, so we see a whole range of emotions and attitudes: denial, anger, regret, fear and so on. Tears were never far from my eyes as I read about a head teacher with motor neurone disease; a pair of women with metastatic breast cancer who broke their hips and ended up as hospice roommates; a beautiful young woman who didn’t want to stop wearing her skinny jeans even though they were exacerbating her nerve pain, as then she’d feel like she’d given up; and a husband and wife who each thought the other didn’t know she was dying of cancer.

Mannix believes there’s something special about people who are approaching the end of their life. There’s wisdom, dignity, even holiness surrounding them. It’s clear she feels she’s been honored to work with the dying, and she’s helped to propagate a healthy approach to death. As her children told her when they visited her dying godmother, “you and Dad [a pathologist] have spent a lifetime preparing us for this. No one else at school ever talked about death. It was just a Thing in our house. And now look – it’s OK. We know what to expect. We don’t feel frightened. We can do it. This is what you wanted for us, not to be afraid.”

I would be happy to see this advance to the shortlist.

 

Favorite lines:

“‘So, how long has she got?’ I hate this question. It’s almost impossible to answer, yet people ask as though it’s a calculation of change from a pound. It’s not a number – it’s a direction of travel, a movement over time, a tiptoe journey towards a tipping point. I give my most honest, most direct answer: I don’t know exactly. But I can tell you how I estimate, and then we can guesstimate together.”

“we are privileged to accompany people through moments of enormous meaning and power; moments to be remembered and retold as family legends and, if we get the care right, to reassure and encourage future generations as they face these great events themselves.”

 


Longlist strategy:

Currently reading: The Butchering Art by Lindsey Fitzharris: a history of early surgery and the fight against hospital infection, with a focus on the life and work of Joseph Lister.

Up next: I’ve requested review copies of The White Book by Han Kang and Mayhem by Sigrid Rausing, but if they don’t make it to the shortlist they’ll slip down the list of priorities.

Brain vs. Heart Surgery: Admissions and Fragile Lives

It’s never too early to start thinking about which books might make it onto next year’s Wellcome Book Prize nominees list, open to any medical-themed books published in the UK in calendar year 2017. I’ve already read some cracking contenders, including these two memoirs from British surgeons.


Brain surgeon Henry Marsh’s first book, Do No Harm, was one of my favorite reads of 2015. In short, enthrallingly detailed chapters named after conditions he had treated or observed, he reflected on life as a surgeon, expressing sorrow over botched operations and marveling at the God-like power he wields over people’s quality of life. That first memoir saw him approaching retirement age and nearing the end of his tether with NHS bureaucracy.

Admissions: A Life in Brain Surgery serves as a sort of sequel, recording Marsh’s last few weeks at his London hospital and the projects that have driven him during his first years of retirement: woodworking, renovating a derelict lock-keeper’s cottage by the canal in Oxford, and yet more neurosurgery on medical missions to Nepal and the Ukraine. But he also ranges widely over his past, recalling cases from his early years in medicine as well as from recent memory, and describing his schooling and his parents. If I were being unkind, I might say that this feels like a collection of leftover incidents from the previous book project.

However, the life of a brain surgeon is so undeniably exciting that, even if these stories are the scraps, they are delicious ones. The title has a double meaning, of course, referring not only to the patients who are admitted to the hospital but also to a surgeon’s confessions. And there are certainly many cases Marsh regrets, including operating on the wrong side in a trapped nerve patient, failing to spot that a patient was on the verge of a diabetic coma before surgery, and a young woman going blind after an operation in the Ukraine. Often there is no clear right decision, though; operating or not operating could lead to equal damage.

Once again I was struck by Marsh’s trenchant humor: he recognizes the absurdities as well as the injustices of life. In Houston he taught on a neurosurgery workshop in which students created and then treated aneurysms in live pigs. When asked “Professor, can you give us some surgical pearls?” he “thought a little apologetically of the swine in the nearby bay undergoing surgery.” A year or so later, discussing the case of a twenty-two-year-old with a fractured spine, he bitterly says, “Christopher Reeve was a millionaire and lived in America and he eventually died from complications, so what chance a poor peasant in Nepal?”

Although some slightly odd structural decisions have gone into this book – the narrative keeps jumping back to Nepal and the Ukraine, and a late chapter called “Memory” is particularly scattered in focus – I still thoroughly enjoyed reading more of Marsh’s anecdotes. The final chapter is suitably melancholy, with its sense of winding down capturing not just the somewhat slower pace of his retired life but also his awareness of the inevitable approach of death. Recalling two particularly hideous deaths he observed in his first years as a doctor, he lends theoretical approval for euthanasia as a way of maintaining dignity until the end.

What I most admire about Marsh’s writing is how he blends realism and wonder. “When my brain dies, ‘I’ will die. ‘I’ am a transient electrochemical dance, made of myriad bits of information,” he recognizes. But that doesn’t deter him from producing lyrical passages like this one: “The white corpus callosum came into view at the floor of the chasm, like a white beach between two cliffs. Running along it, like two rivers, were the anterior cerebral arteries, one on other side, bright red, pulsing gently with the heartbeat.” I highly recommend his work to readers of Atul Gawande and Paul Kalanithi.

My rating:

Admissions: A Life in Brain Surgery was published in the UK by Weidenfeld & Nicolson on May 4th. My thanks to the publisher for sending a free copy for review. It will be published in the USA by Thomas Dunne Books on October 3rd.

 

 

What Marsh does for brain surgery in his pair of memoirs, Professor Stephen Westaby does for heart surgery in Fragile Lives, a vivid, compassionate set of stories culled from his long career. A working class lad from Scunthorpe who watched his grandfather die of heart failure, he made his way up from hospital porter to world-leading surgeon after training at Charing Cross Hospital Medical School.

Each of these case studies, from a young African mother and her sick child whom he met while working in Saudi Arabia in the 1980s to a university student who collapses not far from his hospital in Oxford, is told in impressive depth. Although the surgery details are not for the squeamish, I found them riveting. Westaby conveys a keen sense of the adrenaline rush a surgeon gets while operating with the Grim Reaper looking on. I am not a little envious of all that he has achieved: not just saving the occasional life despite his high-mortality field – as if that weren’t enough – but also pioneering various artificial heart solutions and a tracheal bypass tube that’s named after him.

Like Marsh, he tries not to get emotionally attached to his patients, but often fails in this respect. “Surgeons are meant to be objective, not human,” he shrugs. But, also like Marsh, at his retirement he feels that NHS bureaucracy has tied his hands, denying necessary funds and equipment. Both authors come across as mavericks who don’t play by the rules, but save lives anyway. This is a fascinating read for anyone who enjoys books on a medical theme.

A few favorite lines:

 “We stop life and start it again, making things better, taking calculated risks.”

“We were adrenaline junkies living on a continuous high, craving action. From bleeding patients to cardiac arrests. From theatre to intensive care. From pub to party.”

My rating:


Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table was published in the UK by HarperCollins on February 9th. I read a public library copy. It will be published in the USA, by Basic Books, under the title Open Heart on June 20th.

Two Books about Mind–Body Medicine

Two of my library reads from this month were about different aspects of mind–body medicine. I expected them to overlap more than they did, actually, and hoped that the second might serve as a sort of well-written rebuttal to the first, but in the end they stayed in different camps: the first is about psychosomatic illness and psychiatric treatment, while the second is about the placebo effect and how alternative and holistic treatment strategies might be complementary to orthodox medical approaches. Both gave me a lot to think about.

It’s All in Your Head: Stories from the Frontline of Psychosomatic Illness

By Suzanne O’Sullivan

all-in-your-headO’Sullivan is a UK-based neurology consultant. I picked this up on a whim because I knew it had won the Wellcome Book Prize, as well as the Royal Society of Biology General Book Prize. The conditions she writes about go by many names: psychosomatic illnesses, conversion disorders, or functional conditions. In every case the patients have normal neurological test results – they do not have epilepsy or nerve damage, for instance – but still suffer from seizures or lose the use of limb(s). Their symptoms have an emotional origin instead. Many of her patients are outraged by referral to a psychiatrist, as if they’re being told they’re making it all up, but it’s actually a holistic approach: acknowledging the influence the mind has on how we feel.

Along with cases from her own career, the author writes about early doctors who developed the science of conversion disorders, including Jean-Martin Charcot and Sigmund Freud. I read the book very quickly, almost compulsively; these are fascinating stories for anyone who’s interested in medical mysteries. That’s in spite of the fact that O’Sullivan does not strike me as a natural storyteller: her accounts of patients’ cases are often no more than just one thing after another, and in reports of her own conversations with patients she comes across as robotic and not always very compassionate. Ultimately I believe she does empathize with those with psychosomatic illnesses – otherwise she wouldn’t have written a whole book to illuminate their plight – but it would have taken the writing skill of someone like Atul Gawande for this to be a better book. I’m somewhat surprised it won a major prize.

Note: Chapter 7 tackles CFS/ME/fibromyalgia. These are controversial fatigue disorders, and O’Sullivan is aware that even mentioning them in a book about psychosomatic illnesses is “foolhardy to say the least.” I don’t think what she actually has to say about these conditions is offensive, though (and I say that as someone whose mother struggled with fibromyalgia for years). She allows that there may be physical triggers, but that emotional wellbeing and traumatic experiences or regular stress cannot be overlooked.

Chew on this: “More than seventy per cent of patients with dissociative seizures and chronic fatigue syndrome are women.” The author’s best guess as to why this is? “On the face of it, women turn their distress inward and men turn it outward.”

My rating: 3-star-rating

 

Cure: A Journey into the Science of Mind over Body

By Jo Marchant

cureIn this absorbing and well-written work of popular science, Marchant, a journalist with a PhD in genetics and medical microbiology, investigates instances where the mind seems to contribute to medical improvement: the use of placebos in transplant recipients, hypnosis for IBS patients, virtual reality to help burn victims manage pain, and the remarkable differences that social connection, a sense of purpose, meditation and empathic conversation all make. On the other hand, she shows how stress and trauma in early life can set (usually poor) people up for ill health in later years. She also travels everywhere from Boston to Lourdes to meet patients and medical practitioners, and even occasionally proffers herself as a guinea pig.

A relentless scientist, Marchant is skeptical of any claims for which there is no hard evidence, so when she acknowledges that there’s something to these unusual treatments, you know you can believe her. As Jeremy Howick of the Centre for Evidence-Based Medicine, Oxford puts it, “I think it’s more important to know that something works, than how it works.” I finished the book feeling intrigued and hopeful about what this might all mean for the future of medicine. The problem, though, is that most medical trials are funded by big pharmaceutical companies, which won’t be supportive of non-traditional methods or holistic approaches.

My rating: 4-star-rating


Do these books appeal to you? Do you have any experience of psychosomatic illness or mind–body medicine?

Hope for a Cool Pillow by Margaret Overton

“There must be better and worse ways to die. It seems both rational and possible to minimize the likelihood of an unpleasant end.”

~William T. Vollmann, “A Good Death”

hope for a cool pillowIf pressed to say which books Margaret Overton’s wry, out-of-the-ordinary new memoir most reminded me of, I’d describe it as a cross between Atul Gawande’s Being Mortal and Roz Chast’s Can’t We Talk about Something More Pleasant? The Chicago-area anesthesiologist is the author of a previous memoir, Good in a Crisis (2012), about the aftermath of a divorce and a brain aneurysm. Her latest book, which released on March 1st, started off as a manifesto on the need for an overhaul of American end-of-life care, with a strong drive towards creating an advanced directive and otherwise being meticulously prepared for one’s own death.

From there, I gather, the book took on a life of its own. It’s delightfully digressive, incorporating cases Overton observed in the hospital where she worked and lessons gleaned from a Harvard Business School course on healthcare delivery but also her personal experience of guiding her parents through their last days – her father died of lung cancer in 1998 and her mother, who suffered from dementia, finally followed in 2010.

Years surrounded by infirmity and the possibility of death have convinced her of the benefits of hospice and physician-assisted suicide, still only legal in a few states. We need to know (as we already do for our pets) when suffering is too much and stop extending life at any cost, Overton insists – rather than allowing hospitals to profit from death, as currently happens, with many elderly patients undergoing expensive and ultimately ineffectual procedures in their final weeks. “The last six months of life accounted for roughly twenty-five percent of our Medicare spending.”

For as universal as suffering and death are, we sure are wont to refuse them space in our lives. Again and again Overton uses the striking metaphor of “lemon juice,” drawn from a news story about a hapless would-be bank robber who thought spraying himself with lemon juice would make him invisible to onlookers and police. In our daily lives, she opines, we keep wearing that lemon juice, denying that there is a problem with our healthcare system and our thinking about death.

My thoughts kept coming back to care at the end of life. How do we change the end game? How do we make it better for the elderly, for those of us who will some day become elderly, and how do we save our country some money in the process so that when it is our turn, there will be money left in the system to provide us with the care we want? It seemed to me that if we could just tinker with this one aspect of healthcare, a number of other issues would fall into place.

Margaret Overton (from her website)
Margaret Overton (from her website)

What’s so special about this book is seeing the problem from several angles and perspectives: that of a physician, that of a healthcare researcher, and that of a dutiful daughter. Overton keeps her narrative interesting by avoiding chronological rundowns; instead she intercuts, sometimes paragraph by paragraph, multiple anecdotes – alternating a hospital case with her mother’s last days, say, or jumping between her experience at the Harvard course and her father’s treatment. I can see how some might find the non-consecutive structure off-putting, but I loved every bit of this short, powerful book, from the evocative title through to the excellent final chapter. Anyone who has enjoyed the aforementioned Gawande and Chast books should not hesitate to make this their next read.

See also this Chicago Tribune article on Margaret Overton.

With thanks to publicist Beth Parker for the e-copy for review.

My rating: 4 star rating

Review: The Birth of the Pill by Jonathan Eig

The development of the birth control pill: this seems like an odd topic for my first book review on the new blog, but I’ll go with it. I have a special love for nonfiction that incorporates many different genres: history, biography, popular science, sociology, and so on. (See my next-to-last paragraph for some other examples of books that do this well.)

the birth of the pillThis is an epic adventure starring four unlikely heroes: two middle-aged doctors, Gregory Pincus, fired by Harvard, and John Rock, a Catholic; and two older ladies, Margaret Sanger, who left her first husband and family and grew increasingly addicted to alcohol and prescription pills, and Katharine McCormick, whose mentally ill husband died and left her with a huge fortune she dug into the birth control movement.

Dr. Gregory Pincus is on the left (date unknown).  Copyright Mrs. F. Hammond.
Dr. Gregory Pincus is on the left (date unknown). Copyright Mrs. F. Hammond.

From testing progesterone on rabbits to the desperate hunt for human test subjects in Puerto Rico and in a Massachusetts mental hospital, it is a tale full of surprises. When first presented to American doctors and the FDA, the contraceptive pill – then known as Enovid – was billed as an infertility drug: It regulated periods to make it more likely that women would then get pregnant after going off it. Pincus et al. conveniently failed to mention that it also prevented ovulation. I never would have expected a Trojan horse story.

Margaret Sanger was given a hero’s welcome on every trip to Japan, but she also had an unfortunate association with the eugenics movement – an inevitable offshoot of concerns about overpopulation? She once said that parents should have to apply for the right to have children just like immigrants have to apply for visas. The best random piece of trivia I came across here was that Prescott S. Bush, father of George and grandfather of Dubya, was the treasurer for Planned Parenthood’s first nationwide fundraising campaign in 1947. You can bet the Bush family has tried to cover that one up!

MargaretSanger-Underwood.LOC
Margaret Sanger in 1922.

“Religion is a very poor scientist,” John Rock was known to say. The fight to have the Catholic Church change its position on birth control is an important background narrative in this book. The sexual revolution and the personal decision to contravene Catholic doctrine regarding contraception is also a major component of Quite a Good Time to Be Born, David Lodge’s recent memoir. It’s always fun when similar ideas come up in multiple books at the same time.

Jonathan Eig was previously known for his sports biographies, and there’s plenty of action and narrative here. Like the best science writers (Rebecca Skloot in The Immortal Life of Henrietta Lacks, David Quammen in Spillover, Atul Gawande in Being Mortal, or Siddhartha Mukherjee in The Emperor of All Maladies), he tells a story rich with three-dimensional characters.

We have a family legend about a Swiss ancestor who admitted herself to a mental asylum (then euphemistically called a sanatorium) in upstate New York in 1922 rather than have more children. She already had nine kids (one more died in infancy); she was tired and overworked. If this was what it took to keep her husband from making her pregnant again, so be it. She and thousands of housewives like her never could have guessed that one day (in 1960, to be precise) a simple pill could limit their family size. This is what this book is all about: the quest to give women control over their lives.

My rating: 4 star rating