It’s my stop on the “Not the Wellcome Prize” blog tour. With two dozen reviews of health-themed 2019 books to choose from, I decided to nominate these two for the longlist because they’re under the radar compared to some other medical releases, plus they showcase the breadth of the books that the Prize recognizes: from a heartfelt memoir of a mother welcoming premature babies to a laugh-out-loud graphic novel about a doctor practicing in a small town in Wales. (The Prize website says “picture-led books are not eligible,” so in fact it is likely that graphic novels have never been considered, but we’ve been flexible with the rules for this unofficial blog tour.)
Mother Ship by Francesca Segal
This first work of nonfiction from the author of the exquisite The Innocents is a visceral diary of the first eight weeks in the lives of her twin daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU, “an extremely well-funded prison or perhaps more accurately a high-tech zoo.” In Mother Ship, she strives to come to terms with this unnatural start to motherhood. “Taking my unready daughters from within me felt not like a birth but an evisceration,” she writes. “My children do not appear to require mothering. Instead they need sophisticated medical intervention.”
Segal describes with tender precision the feeling of being torn: between the second novel she’d been in the middle of writing and the all-consuming nature of early parenthood; and between her two girls (known for much of the book as “A-lette” and “B-lette”), who are at one point separated in different hospitals. Her attitude towards the NHS is pure gratitude.
As well as portraying her own state of mind, she crafts twinkly pen portraits of the others she encountered in the NICU, including the staff but especially her fellow preemie mums, who met in a “milking shed” where they pumped breast milk for the babies they were so afraid of losing that they resisted naming. (Though it was touch and go for a while, A-lette and B-lette finally earned the names Raffaella and Celeste and came home safely.) Female friendship is thus a subsidiary theme in this exploration of desperate love and helplessness.
The Lady Doctor by Ian Williams
This sequel to 2014’s The Bad Doctor returns to a medical practice in small-town Wales. This time, though, the focus is on Iwan James’s colleague, Dr. Lois Pritchard, who also puts in two days a week treating embarrassing ailments at the local hospital’s genitourinary medicine clinic. At nearly 40, Lois is a divorcee with no children; just a dog. She enjoys her nights out drinking with her best friend, Geeta, but her carefree life is soon beset by various complications: she has to decide whether she wants to join the health centre as a full partner, a tryst with her new fella goes horribly wrong, and her estranged mother suddenly reappears in her life, hoping that Lois will give her a liver transplant. And that’s not to mention all the drug addicts and VD-ridden lotharios hanging about.
Williams was a GP in North Wales for 20 years, and no doubt his experiences have inspired his comics. His tone is wonderfully balanced: there are plenty of hilarious, somewhat raunchy scenes, but also touching moments where Lois learns that a doctor is never completely off duty and has no idea what medical or personal challenge will crop up next. The drawing style reminded me most of Alison Bechdel’s or Posy Simmonds’, with single shades from rose to olive alternating as the background. I especially loved the pages where each panel depicts a different patient to show the range of people and complaints a doctor might see in a day. Myriad Editions have a whole “Graphic Medicine” series that I’m keen to explore.
See below for details of the blogs where other reviews have appeared or will be appearing soon.
The shadow panel will choose a shortlist of six titles to be announced on 4 May. We will then vote to choose a winner, with the results of a Twitter poll serving as one additional vote. The Not the Wellcome Prize winner will be announced on 11 May.
Three May–June releases: A fish-out-of-water comic novel about teaching English in Prague; and memoirs about acting like an extrovert and giving birth to premature twins.
Goulash by Brian Kimberling
“Look where we are. East meets West. Communism meets capitalism.” In 1998 Elliott Black leaves Indiana behind for a couple of years to teach English in Prague. The opening sequence, in which he discovers that his stolen shoes have been incorporated into an art installation, is an appropriate introduction to a country where bizarre things happen. Elliott doesn’t work for a traditional language school; his students are more likely to be people he meets in the pub or tobacco company executives. Their quirky, deadpan conversations are the highlight of the book.
Elliott starts dating a fellow teacher from England, Amanda (she “looked like azaleas in May and she spoke like the BBC World Service”), who also works as a translator. They live together in an apartment they call Graceland. Much of this short novel is about their low-key, slightly odd adventures, together and separately, while the epilogue sees Elliott looking back at their relationship from many years later.
I was tickled by a number of the turns of phrase, but didn’t feel particularly engaged with the plot, which was inspired by Kimberling’s own experiences living in Prague.
With thanks to Tinder Press for a proof copy to review.
“Sorrowful stories like airborne diseases made their way through the windows and under the doorframe, bubbled up like the bathtub drain. It was possible to fill Graceland with light and color and music and the smell of good food, and yet the flat was like a patient with some untreatable condition, and we got tired of palliative care.”
“‘It’s good to be out of Prague,’ he said. ‘Every inch drenched in blood and steeped in alchemy, with a whiff of Soviet body odor.’ ‘You should write for Lonely Planet,’ I said.”
Sorry I’m Late, I Didn’t Want to Come: An Introvert’s Year of Living Dangerously by Jessica Pan
Like Jessica Pan, I’m a shy introvert (a “shintrovert”) as well as an American in the UK, so I was intrigued to see the strategies she employed and the experiences she sought out during a year of behaving like an extrovert. She forced herself to talk to strangers on the tube, give a talk at London’s Union Chapel as part of the Moth, use friendship apps to make new girlfriends, do stand-up comedy and improv, go to networking events, take a holiday to an unknown destination, eat magic mushrooms, and host a big Thanksgiving shindig.
Like Help Me!, which is a fairly similar year challenge book, it’s funny, conversational and compulsive reading that was perfect for me to be picking up and reading in chunks while I was traveling. Although I don’t think I’d copy any of Pan’s experiments – there’s definitely a cathartic element to reading this; if you’re also an introvert, you’ll feel nothing but relief that she’s done these things so you don’t have to – I can at least emulate her in initiating deeper conversations with friends and pushing myself to attend literary and networking events instead of just staying at home.
With thanks to Doubleday UK for a proof copy to review.
Mother Ship by Francesca Segal
I’m a big fan of Segal’s novels, especially The Innocents, one of the loveliest debut novels of the last decade, so I was delighted to hear she was coming out with a health-themed memoir about giving birth to premature twins. Mother Ship is a visceral diary of the first eight weeks in the lives of her daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU, “an extremely well-funded prison or perhaps more accurately a high-tech zoo.”
Segal strives to come to terms with this unnatural start to motherhood. “Taking my unready daughters from within me felt not like a birth but an evisceration,” she writes; “my children do not appear to require mothering. Instead they need sophisticated medical intervention.” She describes with tender precision the feeling of being torn: between the second novel she’d been in the middle of writing and the all-consuming nature of early parenthood; and between her two girls (known for much of the book as “A-lette” and “B-lette”), who are at one point separated in different hospitals.
As well as portraying her own state of mind, Segal crafts twinkly pen portraits of the others she encountered in the NICU, including the staff but especially her fellow preemie mums, who met in a “milking shed” where they pumped breast milk for the babies they were so afraid of losing that they resisted naming. (Though it was touch and go for a while, A-lette and B-lette finally earned the names Raffaella and Celeste and came home safely.) Female friendship is a subsidiary theme in this exploration of desperate love and helplessness. The layman’s look at the inside workings of medicine would have made this one of my current few favorites for next year’s Wellcome Book Prize (which, alas, is on hiatus). After encountering some unpleasant negativity about the NHS in a recent read, I was relieved to find that Segal’s outlook is pure gratitude.
With thanks to Chatto & Windus for the free copy for review.
Would you be interested in reading one or more of these?
After all that Wellcome Book Prize reading, I’ve given myself a break from the medical reads, right? No way! I’m already eagerly looking out for hopefuls for next year’s prize – I’ve amassed quite a nice little pile – and this is a particularly strong candidate, based on the 20 years that Watson spent as a nurse in England’s health system before leaving to write full-time. (Her debut, Tiny Sunbirds Far Away, won the Costa First Novel Award in 2011; she followed it up with Where Women Are Kings in 2013.) It taps into the widespread feeling that medicine is in desperate need of a good dose of compassion, and will ring true for anyone who spends time in hospitals, whether as a patient or a carer.
Watson presents her book as a roughly chronological tour through the stages of nursing – from pediatrics through to elderly care and the tending to dead bodies – but also through her own career, as she grows from a seventeen-year-old trainee who’s squeamish about blood to a broadly experienced nurse who can hardly be fazed by anything. The first chapter is set up like a tour of the hospital, describing everything she sees and hears as she makes her way up to her office, and the final chapter takes place on her very last day as a nurse, when, faced with a laboring mother in a taxi, she has to deliver the baby right there in the carpark.
In between we hear a series of vivid stories that veer between heartwarming and desperately sad. Watson sees children given a second shot at life. Aaron gets a heart–lung transplant to treat his cystic fibrosis and two-year-old Charlotte bounces back from sepsis – though with prosthetic limbs. But she also sees the ones who won’t get better: Tia, a little girl with a brain tumor; Mahesh, who has muscular dystrophy and relies on a breathing tube; and Jasmin, who is brought to the hospital after a house fire but doesn’t survive for long. She dies in the nurses’ arms as they’re washing the smoke smell out of her hair.
Although Watson specialized in children’s intensive care nursing, she trained in all branches of nursing, so we follow her into the delivery room, mental health ward, and operating theatre. As in Maggie O’Farrell’s I Am, I Am, I Am, we learn about her links to hospitals over the years, starting with her memories of being nursed as a child. She met her former partner, a consultant, at the hospital; they had a child together and adopted another before splitting 12 years later. And as her father was dying of lung cancer, she developed a new appreciation for what nurses do as she observed the dedicated care he received from his hospice nurse. She characterizes nursing as a career that requires great energy, skill and emotional intelligence, “that demands a chunk of your soul on a daily basis,” yet is all too often undervalued.
For me the weakest sections of Watson’s book are the snippets of history about hospitals and the development of the theory and philosophy of nursing. These insertions feel a little awkward and break up the flow of personal disclosure. The same applies to the occasional parenthetical phrase that seems to talk down to the reader, such as “women now receive medical help (IVF) to have their babies” and “obstetricians (doctors) run the show.” Footnotes or endnotes connected to a short glossary might have been a less obtrusive way of adding such explanatory information.
I would particularly recommend this memoir to readers of Kathryn Mannix’s With the End in Mind and Henry Marsh’s Admissions. But with its message of empathy for suffering and vulnerable humanity, it’s a book that anyone and everyone should read. I have it on good authority that there has recently been a copy on the desk of Jeremy Hunt, Health Secretary of the UK, which seems like an awfully good start.
A few favorite passages:
“I wanted to live many lives, to experience different ways of living. I didn’t know then that I would find exactly what I searched for: that both nursing and writing are about stepping into other shoes all the time.”
“What I thought nursing involved when I started: chemistry, biology, physics, pharmacology and anatomy. And what I now know to be the truth of nursing: philosophy, psychology, art, ethics and politics.”
“You get used to all sorts of smells, as a nurse. [An amazingly graphic passage!] But for all that I’ve seen and touched and smelled, and as difficult as it is at the time, there is a patient at the centre of it, afraid and embarrassed. … The horror of our bodies – our humanity, our flesh and blood – is something nurses must bear, lest the patient think too deeply, remember the lack of dignity that makes us all vulnerable. It is our vulnerability that unites us. Promoting dignity in the face of illness is one of the best gifts a nurse can give.”
The Language of Kindness was published in the UK on May 3rd by Chatto & Windus. My thanks to the publisher for the free review copy. It is released today, May 8th, by Doubleday Canada and Tim Duggan Books in the States.
Ruth Fitzmaurice’s husband, a filmmaker named Simon, was diagnosed with motor neurone disease in 2008. Like Stephen Hawking, he is wheelchair-bound and motionless, communicating only through the mechanical voice of an eye gaze computer.
My husband is a wonder to me but he is hard to find. I search for him in our home. He breathes through a pipe in his throat. He feels everything but cannot move a muscle. I lie on his chest counting mechanical breaths. I hold his hand but he doesn’t hold back. His darting eyes are the only windows left. I won’t stop searching.
Between their five children under the age of 10 (including twins conceived after Simon’s diagnosis), an aggressive basset hound, and Simon’s army of nurses coming and going 24 hours a day, this is one chaotic household. The recurring challenge is to find pockets of stillness – daydreaming, staring at trees outside her window – and to learn what things can bring her back from the brink of despair, again and again.
Often these are outdoor experiences: a last hurrah of a six-month holiday in Australia, running, and especially plunging into the Irish Sea with her “Tragic Wives’ Swimming Club” – a group that includes her friend Michelle, whose husband is also in a wheelchair after a motorbike crash, and her favorite of Simon’s nurses, Marian, who has a serious car accident.
Rather than a straight chronological narrative, this is a set of brief thematic essays with titles like “Dancing,” “Fear,” “Twins” and “Holidays.” Fitzmaurice’s story is one you piece together through vivid vignettes from her home life. Her prose is generally composed of short, simple phrases; as with Cathy Rentzenbrink’s The Last Act of Love, you can tell there is deep emotion pulsing under the measured sentences. With such huge questions in play – How much can one person take? What would losing one’s mind look like? – there’s no need for added drama, after all. Instead, the author turns to whimsy, toying with the superhero cliché for caregivers and wondering what magic might be at work in her situation.
I was particularly impressed by how Fitzmaurice holds the past and present in her mind, and by how she uses an outsider’s perspective to imagine herself out of her circumstances. At times she uses the third person for these visions of herself as a younger woman newly in love:
The young wife at her kitchen table knows about deep magic. But I know her future. Life is going to push and pull her like a wave. She doesn’t have a choice and neither do I. Come with me, dear girl, sit at my tablecloth. The journey is upon us and to survive it, you can’t just ride the wave, you have to become one. Can we do this? Let’s go. Becoming a wave just might be the deepest magic of them all.
There are so many poignant moments in this book: memories of their determinedly vegetarian wedding; pulling out all the stops for Simon’s fortieth birthday with customized art installations to brighten his view; leaving the marital bed – now a “hospital contraption” – after six years of MND being a part of their lives; a full moon swim with the Tragic Wives on her and Simon’s anniversary. But all the quiet, everyday stuff has power too, especially her interactions with her precocious children, who are confused about why Dadda is like this.
If I had one tiny complaint, it’s that Simon feels like something of a shadowy figure. In flashbacks we get a real sense of his forceful personality, but this new, silent Simon in the wheelchair is a mystery. Only once or twice does she record words he ‘says’ to her via his computer. Perhaps this is inevitable given how locked into himself he’s become. However, he was still capable of becoming the first person with MND to direct a feature film, on location in County Wicklow (My Name Is Emily). He has told his own story elsewhere; in his wife’s telling, their ventures now seem so separate that they rarely appear as equal partners.
It’s my tenth wedding anniversary tomorrow; as I was reading this I kept thinking that, for as much as I complain (to myself) about how hard marriage is, I’ve had it so easy. The stresses a couple face when caregiving of one partner is involved are immense. Fitzmaurice has found herself part of a tribe she probably never wanted to join: the walking wounded, with pain behind their eyes and worry never far from their minds. But in the midst of it she’s also found the band of family and friends who help her pull through each time. Her lovely book – wry, wise, and realistic – will strike a chord with anyone who has faced illness and family tragedy.
I Found My Tribe is published in the UK today, July 6th, by Chatto & Windus. My thanks to the publisher for the review copy.
Note: Fitzmaurice got her book deal on the strength of a series of pieces she wrote for the Irish Times. You can read an extract from the book here. Film rights to her story have been sold to Element Pictures; more details are here. A documentary about Simon’s life, It’s Not Yet Dark, based on his memoir of the same title, has recently been released. For more information see here (this article also showcases multiple family photos).
Update: Simon Fitzmaurice died on October 26, 2017, aged 43.
I’ve long meant to read Sarah Bakewell’s How to Live, a biography of Montaigne that also promises to be a deep examination of philosophical and ethical issues. When I heard she had a new book out, I jumped at the chance to learn more about existentialism. I’ve come away from At the Existentialist Café with only a nebulous sense of what existentialism actually means (though Bakewell’s bullet-pointed list of points towards a definition on page 34 is helpful), but certainly with more knowledge about and appreciation for Jean-Paul Sartre and Simone de Beauvoir, two of her main subjects. This is appropriate given the shift in Bakewell’s thinking: “When I first read Sartre and Heidegger, I didn’t think the details of a philosopher’s personality or biography were important. … Thirty years later, I have come to the opposite conclusion. Ideas are interesting, but people are vastly more so.”
Some of the interesting characters herein, apart from Sartre and de Beauvoir (always referred to in these pages as “Beauvoir,” which irked me unduly), are Edmund Husserl, Martin Heidegger, Karl Jaspers, Hannah Arendt, Maurice Merleau-Ponty and Albert Camus. It’s a large cast; you may well find yourself flipping back and forth to the helpful who’s who list in the back of the book. I was amused to see that Freiburg, Germany is the seat of phenomenology (which gave rise to existentialism) – I’m heading there in June to stay with friends at the start of a mini European tour. Husserl was the chair of philosophy at Freiburg, and Heidegger his colleague.
The best I can make out, Heidegger’s philosophy was about describing experience to get to the heart of things. Disregard peripherals and focus on the self’s knowledge of the world, he advised. His best known work, Being and Time, contrasted individual beings with Being itself (i.e. ontology). Think of him as an experimental, modernist novelist, Bakewell advises; understanding what he’s doing with his philosophy is difficult otherwise. Existentialism built on this framework but emphasized freedom and how it is exercised in particular situations.
World War II, especially the year 1945, was a turning point for many of the philosophers discussed. Sartre was held in a POW camp but his eye troubles gave him a way out. Many left Europe for America due to anti-Semitism, including Hannah Arendt and Bruno Bettelheim. Although Heidegger contrasted “the they” (das Man – more similar, perhaps, to the English phrase “the Man”) with the voice of conscience in such a way that suggested one should resist totalitarianism, he would later be exposed as a Nazi. In the following years, the United States became very popular culturally: jazz music, film noir, Hemingway. At the same time, the French were shocked at America’s racial inequality. Sartre believed that one should always take the opinion of the “least favored” or most oppressed party in any situation, which would lead him to speak out for minorities and the colonized, as in the Algerian liberation movement of the 1950s–60s. In the meantime, the rise of the Soviet Union and the development of the atom bomb would emerge as imminent societal threats.
Sartre and de Beauvoir had an open relationship but clearly relied on and felt deeply about each other, especially when it came to their writing. Bakewell convinced me of Sartre’s surprising sex appeal, despite his unprepossessing appearance: “down-turned grouper lips, a dented complexion, prominent ears, and eyes that pointed in different directions.” Apparently he had a silly side and would even do Donald Duck impressions. At the same time, he had rock-solid convictions, as evidenced by his refusal of the Légion d’Honneur and the Nobel Prize. I also learned that he was a biographer of Jean Genet and Gustave Flaubert; his biography of the latter, in three volumes, stretched to 2800 pages! Bakewell waxes anti-lyrical in her account of the disheartening experience of reading it: “Occasional lightning flashes strike the primordial soup, although they never quite spark it into life, and there is no way to find them except by dredging through the bog for as long as you can stand it.”
From the title and subtitle (“Freedom, Being and Apricot Cocktails”), I expected this book to be a bit more of a jolly narrative than it was. The frequent Left Bank Paris setting is atmospheric, but the tone is never as blithe as promised. I would also have liked some additional autobiographical material from Bakewell, who grew up in Reading, England (where I currently live) and met the existentialists through Sartre’s Nausea at age 16.
In the end the fault may not be her book’s but mine: I wasn’t up for fully engaging with a multi-subject biography packed with history and hard-to-grasp philosophical ideas. I’d recommend this to readers who long for bohemian Paris and have enjoyed either an existentialist work or a philosophical novel like Sophie’s World (Jostein Gaarder) or 36 Arguments for the Existence of God (Rebecca Goldstein).
With thanks to Chatto & Windus for the review copy.
Further reading: If anything, I think I’m likely to try de Beauvoir’s autobiographical works – the descriptive language Bakewell quotes from them sounds appealing, and of course she was fundamental in paving the way for modern feminism.
You can read an excerpt from At the Existentialist Café, about de Beauvoir’s composition of The Second Sex, at Flavorwire. See also Bakewell’s Guardian list of 10 reasons why we should still be reading the existentialists.
Have you read anything by the existentialists? What would you recommend?