Tag: cancer

Best Nonfiction Books of 2018

Below I’ve chosen my 12 favorite nonfiction books published in 2018. You’ll be unsurprised to learn that half of them have a medical theme. Many have already featured on my blog in some way over the course of the year. To keep things simple, as I’ve done in previous years, I’m limiting myself to two sentences per title: a potted summary plus why you should read it. Let the countdown begin!

12. The Line Becomes a River by Francisco Cantú: Francisco Cantú was a U.S. Border Patrol agent for four years in Arizona and Texas. Impressionistic rather than journalistic, his book is a loosely thematic scrapbook that, in giving faces to an abstract struggle, argues passionately that people should not be divided by walls but united in common humanity.

11. Bookworm by Lucy Mangan: Mangan takes us along on a nostalgic chronological tour through the books she loved most as a child and adolescent. No matter how much or how little of your early reading overlaps with hers, you’ll appreciate her picture of the intensity of children’s relationship with books – they can completely shut out the world and devour their favorite stories over and over, almost living inside them, they love and believe in them so much – and her tongue-in-cheek responses to them upon rereading them decades later.

10. Everything Happens for a Reason: And Other Lies I’ve Loved by Kate Bowler: An assistant professor at Duke Divinity School, Bowler was fascinated by the idea that you can claim God’s blessings, financial and otherwise, as a reward for righteous behavior and generosity to the church (“the prosperity gospel”), but if she’d been tempted to set store by this notion, that certainty was permanently fractured when she was diagnosed with stage IV colon cancer in her mid-thirties. Bowler writes tenderly about suffering and surrender, about living in the moment with her husband and son while being uncertain of the future.

9. Gross Anatomy by Mara Altman: Through a snappy blend of personal anecdotes and intensive research, Altman exposes the cultural expectations that make us dislike our bodies, suggesting that a better knowledge of anatomy might help us feel normal. It’s funny, it’s feminist, and it’s a cracking good read.

8. The Unmapped Mind by Christian Donlan: Donlan, a Brighton-area video games journalist, was diagnosed with (relapsing, remitting) multiple sclerosis in 2014; he approaches his disease with good humor and curiosity, using metaphors of maps to depict himself as an explorer into uncharted territory. This is some of the best medical writing from a layman’s perspective I’ve ever read.

7. Skybound by Rebecca Loncraine: For Rebecca Loncraine, after treatment for breast cancer in her early thirties, taking flying lessons in an unpowered glider (everywhere from Wales to Nepal) was a way of rediscovering joy and experiencing freedom by facing her fears in the sky. Each year seems to bring one exquisite posthumous memoir about facing death with dignity; this is a worthwhile successor to When Breath Becomes Air et al.

6. Face to Face by Jim McCaul: Eighty percent of a facial surgeon’s work is the removal of face, mouth and neck tumors in surgeries lasting eight hours or more; McCaul also restores patients’ appearance as much as possible after disfiguring accidents. This is a book that inspires wonder at all that modern medicine can achieve.

5. That Was When People Started to Worry by Nancy Tucker: Tucker interviewed 70 women aged 16 to 25 for a total of more than 100 hours and chose to anonymize their stories by creating seven composite characters who represent various mental illnesses: depression, bipolar disorder, self-harm, anxiety, eating disorders, PTSD and borderline personality disorder. Reading this has helped me to understand friends’ and acquaintances’ behavior; I’ll keep it on the shelf as an invaluable reference book in the years to come.

4. Free Woman by Lara Feigel: A familiarity with the works of Doris Lessing is not a prerequisite to enjoying this richly satisfying hybrid of biography, literary criticism and memoir. Lessing’s The Golden Notebook is about the ways in which women compartmentalize their lives and the struggle to bring various strands into harmony; that’s what Free Woman is all about as well.

3. Implosion by Elizabeth W. Garber: The author endured sexual and psychological abuse while growing up in a glass house designed by her father, Modernist architect Woodie Garber – a fascinating, flawed figure – outside Cincinnati in the 1960s to 1970s. This is definitely not a boring tome just for architecture buffs; it’s a masterful memoir for everyone.

2. Educated by Tara Westover: Westover writes with calm authority, channeling the style of the scriptures and history books that were formative in her upbringing and education as she tells of a young woman’s off-grid upbringing in Idaho and the hard work that took her from almost complete ignorance to a Cambridge PhD. This is one of the most powerful and well-written memoirs I’ve ever read.

It was a real toss-up between Westover and this one, but since Educated has already gotten a ton of attention this year, I’ve awarded the title of nonfiction book of the year to:

1. Under the Rock by Benjamin Myers: A spell-bindingly lyrical book that ranges from literature and geology to true crime but has an underlying autobiographical vein. Its every sentence is well-crafted and memorable; this isn’t old-style nature writing in search of unspoiled places, but part of a growing interest in the ‘edgelands’ where human impact is undeniable but nature is creeping back in.

My 2018 nonfiction books of the year (the ones I own in print, anyway).

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

Upcoming posts:

27th: Best fiction of the year

28th: Runners-up

29th: Best backlist reads

30th: Other superlatives and some early 2019 recommendations

31st: Library Checkout & Final statistics on my 2018 reading

Natural Causes by Barbara Ehrenreich & Human Errors by Nathan Lents

Two recent books about our flawed bodies and the ultimate pointlessness of trying to control them…

Natural Causes: Life, Death and the Illusion of Control by Barbara Ehrenreich

A decade ago, Barbara Ehrenreich discovered a startling paradox through a Scientific American article: the immune system assists the growth and spread of tumors, including in breast cancer, which she had in 2000. It was an epiphany for her, confirming that no matter how hard we try with diet, exercise and early diagnosis, there’s only so much we can do to preserve our health; “not everything is potentially within our control, not even our own bodies and minds.” I love Ehrenreich’s Smile or Die (alternate title: Bright-Sided), which is what I call an anti-self-help book refuting the supposed health benefits of positive thinking. In that book I felt like her skeptical approach was fully warranted, and I could sympathize with her frustration – nay, outrage – when people tried to suggest she’d attracted her cancer and limited her chances of survival through her pessimism.

However, Natural Causes is so relentlessly negative and so selective in the evidence it provides that, even though it’s sure to be considered for next year’s Wellcome Book Prize longlist, I would be unlikely to recommend it. In the first chapter, “Midlife Revolt,” which has been excerpted at Literary Hub and is worth reading, Ehrenreich writes of her decision to give up routine medical screening after a false positive mammogram caused undue stress. She decided once she passed 70 she was old enough to die without accepting a “medicalized life.” Moreover, she believes there’s an epidemic of “overdiagnosis,” especially in the USA, where there can be a profit motive behind testing. (This is certainly not the case in the UK, where the NHS doesn’t pester me about getting cervical smear tests to line any pockets; no, it’s about saving taxpayers money by catching cancer early and thus minimizing treatment costs.)

I love the U.S. cover. (Note the different subtitle.)

Ehrenreich goes on to argue that many medical procedures are simply rituals to establish patient trust, that cancer screening is invasive and ineffective, that there is little evidence that meditation does any good, and that fitness has become a collective obsession that probably doesn’t help us live any longer. It’s uncomfortable to hear her dismiss early detection techniques as worthless; no one whose doctor found cancer in the early stages would agree. The author also seems unwilling to confront her own personal prejudices (e.g. against yoga).

Although she uses plenty of statistics to back up her points, these usually come from newspapers and websites rather than peer-reviewed journals; only in two chapters about how macrophages ‘betray’ the body by abetting cancer does she consult the scientific literature, in keeping with her PhD in cellular immunology. Her most bizarre example of how our bodies aren’t evolutionarily fit for purpose is copious menstruation. Overall, the book is a strange mixture of hard science, social science, and, in later chapters, philosophy, as Ehrenreich asks about the nature of the self and the soul and what survives of us after death. As usual, her work is very readable, but this doesn’t match up to many other mind/body books I’ve read.

Favorite lines:

“The only cure for bad science is more science, which has to include both statistical analysis and some recognition that the patient is not ‘just a statistic,’ but a conscious, intelligent agent, just as the doctor is.”

“The objection raised over and over to any proposed expansion of health insurance was, in so many words: Why should I contribute to the care of those degenerates who choose to smoke and eat cheeseburgers? … we persist in subjecting anyone who dies at a seemingly untimely age to a kind of bio-moral autopsy: Did she smoke? Drink excessively? Eat too much fat and not enough fiber? Can she, in other words, be blamed for her own death?”

My rating:

Natural Causes was published in the UK by Granta on April 12th. My thanks to the publisher for the free copy for review.

Human Errors: A Panorama of Our Glitches, from Pointless Bones to Broken Genes by Nathan H. Lents

Lents is a biology professor at John Jay College, City University of New York, and in this, his second book, he explores the ways in which the human body is flawed. These errors come in three categories: adaptations to the way the world was for early humans (to take advantage of once-scarce nutrients, we gain weight quickly – but lose it only with difficulty); incomplete adaptations (our knees are still not fit for upright walking); and the basic limitations of our evolution (inefficient systems such as the throat handling both breath and food, and the recurrent laryngeal nerve being three times longer than necessary because it loops around the aorta). Consider that myopia rates are 30% or higher, the retina faces backward, sinuses drain upwards, there are 100+ autoimmune diseases, we have redundant bones in our wrist and ankle, and we can’t produce most of the vitamins we need. Put simply, we’re not a designer’s ideal. And yet this all makes a lot of sense for an evolved species.

My favorite chapter was on the inefficiencies of human reproduction compared to that of other mammals. Infertility and miscarriage rates are notably high, and gestation is shorter than it really needs to be: because otherwise their heads would get too big to pass through the birth canal, all babies are effectively born premature, so are helpless for much longer than other newborn mammals. I also especially liked the short section on cancer, which would eventually get us all if we only lived long enough. As it is, “evolution has struck an uneasy balance with cancer. Mutations cause cancer, which kills individuals, but it also brings diversity and innovation, which is good for the population.”

Lents writes in a good conversational style and usually avoids oversimplifying the science. In places his book reminded me of Kathryn Schulz’s Being Wrong and Mark O’Connell’s To Be a Machine. It’s a wry and gentle treatment of human weakness; the content never turns depressing or bitter. Recommended for all curious readers of popular science.

Favorite lines:

“While lithopedions [“stone babies”] and abdominal pregnancies are quite rare, they are also 100 percent the result of poor design. Any reasonable plumber would have attached the fallopian tube to the ovary, thereby preventing tragic and often fatal mishaps like these.”

“to call our immune system perfectly designed would be equally inaccurate. There are millions of people who once happily walked this planet only to meet their demise because their bodies simply self-sabotaged. When bodies fight themselves, there can be no winner.”

My rating:

Human Errors was published in the UK by Weidenfeld & Nicolson on May 3rd. My thanks to the publisher for the free copy for review.

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.