Tag: death

Recent Nonfiction Reads, in 200 Words Each: Black, Fee, Gaw

I’ve let months pass between receiving these books from the kindly publishers and following through with a review, so in an attempt to clear the decks I’m putting up just a short response to each, along with some favorite quotes.

All that Remains: A Life in Death by Sue Black

Black, a world-leading forensic anthropologist, was part of the war crimes investigation in Kosovo and the recovery effort in Thailand after the 2004 tsunami. She is frequently called into trials to give evidence, has advised the U.K. government on disaster preparedness, and is a co-author of the textbook Developmental Juvenile Osteology (2000). Whether working in a butcher’s shop as a teenager or exploring a cadaver for an anatomy class at the University of Aberdeen, she’s always been comfortable with death. “I never had any desire to work with the living,” she confesses; “The dead are much more predictable and co-operative.”

The book considers death in its clinical and personal aspects: the seven stages of postmortem alteration and the challenges of identifying the sex and age of remains; versus her own experiences with losing her grandmother, uncle and parents. Black wants her skeleton to go to Dundee University’s teaching collection. It doesn’t creep her out to think of that, no more than it did to meet her future cadaver, a matter-of-fact, curious elderly gentleman named Arthur. My favorite chapter was on Kosovo; elsewhere I found the mixture of science and memoir slightly off, and the voice never fully drew me in.

Favorite line: “Perhaps forensic anthropologists are the sin-eaters of our day, addressing the unpleasant and unimaginable so that others don’t have to.”

My rating:

All that Remains was published by Doubleday on April 19th. My thanks to the publisher for the free copy for review.

Places I Stopped on the Way Home: A Memoir of Chaos and Grace by Meg Fee

Fee came to New York City to study drama at Julliard. Her short essays, most of them titled after New York locations (plus a few set further afield), are about the uncertainty of her twenties: falling in and out of love, having an eating disorder, and searching for her purpose. She calls herself “a mess of disparate wants, a small universe in bloom.” New York is where she has an awful job she hates, can’t get the man she’s in love with to really notice her, and hops between terrible apartments – including one with bedbugs, the subject of my favorite essay – and yet the City continues to lure her with its endless opportunities.

I think this book could mean a lot to women who are younger than me or have had experiences similar to the author’s. I found the essays slightly repetitive, and rather unkindly wondered what this privileged young woman had to whine about. It’s got the same American, generically spiritual self-help vibe that you get from authors like Brené Brown and Elizabeth Gilbert. Despite her loneliness, Fee retains a romantic view of things, and the way she writes about her crushes and boyfriends never truly connected with me.

Some favorite lines:

“Writing felt like wrangling storm clouds, which is to say, impossible. But so did life. Writing became a way to make peace with that which was flawed.”

“I have let go of the idea of permanency and roots and What Comes Next.”

My rating:

Places I Stopped on the Way Home was published by Icon Books on May 3rd. My thanks to the publisher for the free copy for review.

The Pull of the River: A journey into the wild and watery heart of Britain by Matt Gaw**

A watery travelogue in the same vein as works by Roger Deakin and Alys Fowler, this jolly yet reflective book traces Gaw’s canoe trips down Britain’s rivers. His vessel was “the Pipe,” a red canoe built by his friend James Treadaway, who also served as his companion for many of the jaunts. Starting with his local river, the Waveney in East Anglia, and finishing with Scotland’s Great Glen Way, the quest was a way of (re)discovering his country by sensing the currents of history and escaping to the edge of danger.

Access issues, outdoor toileting, getting stuck on mudflats, and going under in the winter – it wasn’t always a comfortable method of travel. But Gaw’s expressive writing renders even rubbish- and sewage-strewn landscapes beautiful in their own way: “grim bunting made from discarded bags of dog poo,” “a savannah of quivering, moussey mud” and “cormorants hunched together like sinister penguins, some holding ragged wings to the wind in taxidermic poses.”

My favorite chapters were about pollution and invasive species, as seen at the Lark, and about the beaver reintroduction project in Devon (we have friends who live near it). I’m rooting for this to make next year’s Wainwright Prize longlist.

A favorite passage:

“I feel like I’ve shed the rust gathered from being landlocked and lazy. The habits and responsibilities of modern life can be hard to shake off, the white noise difficult to muffle. But the water has returned me to my senses. I’ve been reborn in a baptism of the Waveney [et al.]”

My rating:

The Pull of the River was published by Elliott & Thompson on April 5th. My thanks to the publisher for the free copy for review.

Have you read any stand-out nonfiction recently?

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 Shortlist Event

Five of the six shortlisted authors (barring Dublin-based Mark O’Connell) were at the Wellcome Collection in London yesterday to share more about their books in mini-interviews with Lisa O’Kelly, the associate editor of the Observer. She called each author up onto the stage in turn for a five-minute chat about her work, and then brought them all up for a general conversation and audience questions. Clare and I found it a very interesting afternoon. Here’s some context that I gleaned about the five books and their writers.

Ayobami Adebayo says sickle cell anemia is a massive public health problem in Nigeria, as brought home to her when some friends died of complications of sickle cell. She herself was tested for the gene and learned that she is a carrier, so her children would have a 25% chance of having the disease if her partner was also a carrier. Although life expectancy with the disease has improved to 45–50, a cure is still out of reach for most Nigerians because bone marrow/stem cell transplantation and anti-rejection drugs are so expensive. Compared to the 1980s, when her book opens, she believes polygamy is becoming less fashionable in Nigeria and people are becoming more open to other means of becoming parents, whether IVF or adoption. It’s a way of acknowledging, she says, that parenthood is “not just about biology.”

Sigrid Rausing started writing her book soon after her sister-in-law Eva’s body was found: just random paragraphs to make sense of what had happened. From there it became an investigation, a quest to find the nature of addiction. She thinks that as a society we still don’t quite understand what addiction is, and the medical research and public perception are very separate. In addition to nature and nurture, she thinks we should consider the influence of culture – as an anthropologist by training, she’s very interested in drug culture and how that drew in her brother, Hans. Although there have been many memoirs by ex-addicts, she can’t think of another one by a family member. Perhaps, she suggested, this is because the addict is seen as the ultimate victim. She referred to her book as a “collage,” a very apt description.

Kathryn Mannix spoke of how her grandmother, born in 1900, saw so much more death than we do nowadays: siblings, a child, and so on. Today, though, Mannix has encountered people in their sixties who are facing, with their parents, their very first deaths. Death is fairly “gentle” and “dull” if you’re not directly involved, she insists; she blames Hollywood and Eastenders for showing unusually dramatic deaths. She said once you understand what exactly people are afraid of about dying (e.g. hell, oblivion, pain, leaving their families behind) you can address their specific concerns and thereby “beat out the demon of terror and fear.” Mannix never intended to write a book, but someone heard her on the radio and invited her to do so. Luckily, from her medical school days onward, she’d been writing an A4 page about each of her most mind-boggling cases to get them out of her head and move on. That’s why, as O’Kelly put it, the characters in her 30 stories “leap off the page.”

Mannix, Adebayo, O’Kelly, Rausing, Wadman & Fitzharris

Lindsey Fitzharris called The Butchering Art “a love story between science and medicine” – it was the first time that the former (antisepsis) was applied to the latter. She initially thought Robert Liston was her man – he was so colorful, larger than life – but eventually found that the real story was with Joseph Lister, the quiet, persistent Quaker. (However, the book does open with Liston performing the first surgery under ether.) Fitzharris is also involved in the Order of the Good Death, author Caitlin Doughty’s initiative, and affirmed Mannix’s efforts to remove the taboo from talking about death. I think I heard correctly that she said there is a film of The Butchering Art in the works?! I’ll need to look into that some more.

Meredith Wadman started with a brief explanation of how immunization works and why the 1960s were ripe for vaccine research. This segment went really science-y, which I thought was a little unfortunate as it may have made listeners tune out and be less interested in her work than the others’. It was perhaps inevitable given her subject matter, but also a matter of the questions O’Kelly asked – with the others she focused more on stories and themes than on scientific facts. It was interesting to hear what Wadman has been working on recently: for the past 6–8 months, she’s been reporting for Science on sexual harassment in science. For her next book, though, she’s pondering the conflict between a congressman and a Centers for Disease Control scientist over funding into research that might lead to gun control.

The question time brought up the issues of medical misinformation online, the distrust people with chronic illnesses have of medical professionals, and euthanasia – Mannix rather dodged that one, stating that her book is about the natural dying process so that’s not really her area. (Though it does come up in a chapter of her book.) We also heard a bit about the projects up next for each author. Rausing’s next book will be a travel memoir about the Capetown drought, taking in apartheid and her husband’s family’s immigration. Adebayo is at work on a very nebulous novel “about people,” and possibly how privilege affects access to healthcare.

Wellcome Book Prize Shadow Panel Decision

Addiction, death, infertility, surgery, transhumanism and vaccines: It’s been quite the varied reading list for the five of us this spring! Lots of science, lots of medicine, but also a lot of stories and imagination.

After some conferring and voting, we have arrived at our shadow panel winner for the Wellcome Book Prize 2018: To Be a Machine by Mark O’Connell.

Rarely have I been so surprised to love a book. It’s a delight to read, and no matter what your background or beliefs are, it will give you plenty to think about. It goes deep down, beneath our health and ultimately our mortality, to ask what the essence of being human is.

Here’s what the rest of the shadow panel has to say about our pick:

Annabel: “O’Connell, as a journalist and outsider in the surprisingly diverse field of transhumanism, treats everyone with respect: asking the questions, but not judging, to get to the heart of the transhumanists’ beliefs. For a subject based in technology, To Be a Machine is a profoundly human story.”

Clare: “The concept of transhumanism may not be widely known or understood yet, but O’Connell’s engaging and fascinating book explains the significance of the movement and its possible implications both in the distant future and how we live now.”

Laura: “My brain feels like it’s been wired slightly differently since reading To Be a Machine. It’s not just about weird science and weird scientists, but how we come to terms with the fact that even the luckiest of us live lives that are so brief.”

Paul: “An interesting book that hopefully will provoke further discussion as we embrace technology and it envelops us.”

On Monday we’ll find out which book the official judges have chosen. I could see three or four of these as potential winners, so it’s very hard to say who will take home the £30,000.

Who are you rooting for?

Wellcome Book Prize: Shortlist Recap

Tomorrow morning we will announce our Wellcome Book Prize 2018 shadow panel winner. Beforehand I wanted to do a quick recap of my reviews, especially for the two books that I read before the shortlist announcement. My full reviews are here:

Stay with Me by Ayobami Adebayo

To Be a Machine by Mark O’Connell

Mayhem by Sigrid Rausing

The Vaccine Race by Meredith Wadman

I give some extra thoughts on and favorite quotes from the other two below:

The Butchering Art by Lindsey Fitzharris

This is a great blend of medical history and popular science that should draw in readers who wouldn’t normally gravitate to either topic – provided they aren’t too squeamish. Fitzharris has recently returned to Oxford as a visiting academic, and this has also been nominated for the Wolfson History Prize. Follow her on Instagram (@drlindseyfitzharris) for a steady stream of gruesomely fascinating photos (I wish The Butchering Art had been illustrated!). Her next book will be much of a muchness, it seems, documenting the early years of plastic surgery after World War I through the story of pioneering surgeon Harold Gillies.

In the days before Joseph Lister…

“Operating theaters were gateways to death. It was safer to have an operation at home than in a hospital, where mortality rates were three to five times higher than they were in domestic settings.”

“The surgeon was very much viewed as a manual labourer who used his hands to make his living, much like a key cutter or plumber today.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[A]n extremely readable account of a ground-breaking career which led to real advances in hospital medicine. I enjoyed the whole, but particularly the grisly bits!”

Laura’s review: “It’s easy for me to feel a bit impatient with popular histories of periods or subjects that I know well, but Fitzharris strikes exactly the right note, writing clearly and accessibly with no dumbing down.”

Paul’s review: “It is one of the better books that I have read on medical history[;] Fitzharris writes in an engaging way on a subject that is not going to appeal to everyone, but in amongst all the blood is the fascinating story of Joseph Lister.”

With the End in Mind by Kathryn Mannix

“It’s time to talk about dying. This is my way of promoting the conversation,” Mannix writes in her introduction to this accessible and reassuring book about death. She believes we are afraid of death because of our misconception that it is inevitably painful and undignified. In her decades of working in hospice care, this has rarely been the case. (Thank goodness that, compared to the earlier nineteenth-century situation Fitzharris surveys, we have reliable pain control options.) Mannix sees the role of the hospice worker as being like a midwife for the dying, a helpful idea I first encountered in Henry Fersko-Weiss’s Caring for the Dying: The Doula Approach to a Meaningful Death.

Many of the stories in this book are of peaceful deaths the patient and family had time to prepare for. Others are sad stories of denial. One, though, is quite gruesome, yet magnificently described. Alex, a young man with testicular teratoma, has a massive GI bleed:

“Alex’s head is thrown back, almost as though it is a voluntary movement. A huge, dark-red python slithers rapidly out of his mouth, pushing his head backwards as it coils itself onto the pillow beside him; the python is wet and gleaming and begins to stain the pillowcase and sheets with its red essence as Alex takes one snoring breath, and then stops breathing. His mother screams as he realises that the python is Alex’s blood. Probably all of his blood.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[I]t is helping patients, and their families and loved ones, to understand the process of dying, and dispelling the taboos around it that make this book such a valuable and compelling read. I wish I’d read something like this book before my mum died.”

Clare’s review: “For me, this enlightening book is a strong potential winner for the Wellcome Book Prize and I hope it brings comfort and guidance for those who need it.”

Laura’s review: “[The book is] written from her own experiences as a specialist in palliative care, and this proved, for me, both its strength and its downfall. … Mannix writes particularly well on the characteristic patterns of somebody who is entering a gradual decline.”

Paul’s review: “Can highly recommend this moving book and I think it should be essential reading for anyone who has any concerns about death.”

I wouldn’t be at all surprised to see either of these win the Wellcome Book Prize on Monday. Stay tuned for tomorrow’s shadow panel winner announcement, and Sunday’s write-up of a shortlist event I’m attending in London.

Wellcome Book Prize Shortlist: To Be a Machine by Mark O’Connell

The topic of this shortlisted book didn’t particularly appeal to me, so I was pleasantly surprised to enjoy it. Transhumanism is about using technology to help us overcome human limitations and radically extend our lifespan. Many of the strategies O’Connell, a Dublin-based freelance writer with a literature background, profiles are on the verge of science fiction. Are we looking at liberation from the rules of biology, or enslavement to technology? His travels take him to the heart of this very American, and very male, movement.

Cryogenic freezing: The first person was cryogenically frozen in 1966. Max More’s Alcor Life Extension Foundation in Scottsdale, Arizona offers whole-body or head-only (“neuro”) options for $200,000 or $80,000. More argues that the residents of Alcor are somewhere between living and dead. These entities are held in suspension in the belief that technology will one day allow us to upload the contents of the mind into a new vessel.

This approach seems to conceive of the human mind/consciousness as pure information to be computed.

Cyborgs: Grindhouse Wetware, near Pittsburgh, aims to turn people into literal cyborgs. Tim Cannon had a Circadia device the size of a deck of cards implanted in his arm for three months to take biometric measurements. Other colleagues have implanted RFID chips. He intends to have his arms amputated and replaced by superior prostheses as soon as the technology is available.

That may seem extreme, but think how bound people already are to machines: O’Connell calls his smartphone a “mnemonic prosthesis” during his research travels.

Mortality as the enemy: Many transhumanists O’Connell meets speak of aging and death as an affront to human dignity. We mustn’t be complacent, they argue, but must oppose these processes with all we’re worth. One of the key people involved in that fight is Aubrey de Grey of SENS (“Strategies for Engineered Negligible Senescence”), and Google has also gotten in on it with their “Calico” project.

O’Connell recounts explaining aging and death to his three-year-old son; his wife chipped in that – according to “Dada’s book” – perhaps by the time the boy is grown up death will no longer be a problem.

The Singularity: Posited by Ray Kurzweil, the Singularity is the future point at which artificial intelligence will surpass humanity. O’Connell likens it to the Christian idea of the Rapture, itself a moment of transcendence. At a conference on transhumanism and religion in Piedmont, California, he encounters Terasem, a religion founded recently by a transhumanist and transgender person.

To my surprise, To Be a Machine makes frequent reference to religious ideas: O’Connell thinks of transhumanism as an attempt to reverse the Fall and become godlike, and he often describes the people he meets as zealots or saints, driven by the extremity of their beliefs. Both religion and transhumanism could be seen as a way of combating nihilism and insisting on the meaning of human life.

O’Connell’s outsider position helped me to engage with the science; he’s at least as interested, if not more so, in the deeper philosophical questions that transhumanism raises. I would caution that a grounding in religion and philosophy could be useful, as the points of reference used here range from the Gnostic gospels and St. Augustine to materialism and Nietzsche. But anyone who’s preoccupied with human nature should find the book intriguing.

You could also enjoy this purely as a zany travelogue along the lines of Elif Batuman’s The Possessed and Donovan Hohn’s Moby-Duck. The slapstick antics of the robots at the DARPA Robotics Challenge and the road trip in Zoltan Istvan’s presidential campaign Immortality Bus are particularly amusing. O’Connell’s Dickensian/Wildean delight in language is evident, and I also appreciated his passing references to William Butler Yeats.

It could be argued, however, that O’Connell was not the ideal author of this book. He is not naturally sympathetic to transhumanism; he’s pessimistic and skeptical, often wondering whether the proponents he meets are literally insane (e.g., to think that they are in imminent danger of being killed by robots). Most of the relevant research, even when conducted by Europeans, is going on in the USA, particularly in the Bay Area. So why would an Irish literary critic choose transhumanism as the subject for his debut? It’s a question I asked myself more than once, though it never stopped me from enjoying the book.

The title (from an Andy Warhol quote) may reference machines, but really this is about what it means to be human. O’Connell even ends with a few pages on his own cancer scare, a reminder that our bodies are flawed machines. I encourage you to give this a try even if you think you have no particular interest in technology or science fiction. It could also give a book club a lot to discuss.

Favorite lines:

“We exist, we humans, in the wreckage of an imagined splendor. It was not supposed to be this way: we weren’t supposed to be weak, to be ashamed, to suffer, to die. We have always had higher notions of ourselves. … The frailty is the thing, the vulnerability. This infirmity, this doubtful convalescence we refer to, for want of a better term, as the human condition.”

My rating:

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “I loved this book from the front cover to the back, starting with its title. … He writes with empathy and a good deal of humour which makes the text always readable and entertaining, while provoking his readers to think deeply about their own beliefs.”

Clare’s review: “O’Connell’s prose style is wordy and ironic. He is pleasingly sceptical about many aspects of transhumanism. … It is an entertaining book which provides a lot of food for thought for a layperson like myself.”

Laura’s review: “Often, I found that his description of his own internal questions would mirror mine. This is a really fantastic book, and for me, a clear front runner for the Wellcome Book Prize.”

Paul’s review: “An interesting book that hopefully will provoke further discussion as we embrace technology and it envelops us.”

My gut feeling: Though they highlight opposite approaches to death – transcending it versus accepting it – this and Kathryn Mannix’s With the End in Mind seem to me the two shortlisted books of the most pressing importance. I’d be happy to see either of them win. To Be a Machine is an awful lot of fun to read, and it seems like a current favorite for our panel.

Shortlist strategy:

I’m coming close to the end of my skim of The Vaccine Race by Meredith Wadman.
I’m still awaiting a review copy of Mayhem by Sigrid Rausing, which I’ll be featuring as part of the official Wellcome Book Prize shortlist blog tour.

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.