Tag: death

September Recommendations: Boyer, Doughty, Englehardt, Jamie, Patchett

For this second half of the year I chose just 15 of the new releases I was most excited about. Limiting myself in that way has been helpful for focusing the mind: I’ve already read six of my most anticipated books, I’m currently reading another, and I have several more awaiting me. Had I chosen 30 or more titles, I would likely be feeling overwhelmed by now, but as it is I have a good chance of actually getting to all these books before the end of the year. These five September releases, while very different – their topics range from cancer and dead bodies to archaeological digs and family inheritance – all lived up to my expectations:

 

The Undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care by Anne Boyer

(Coming from Farrar, Straus and Giroux [USA] on the 17th and Allen Lane [UK] on October 3rd)

In 2014, Boyer, then a 41-year-old poet and professor at the Kansas City Art Institute (and a single mother) was diagnosed with triple-negative breast cancer. The book’s subtitle gives you clues to the sort of practical and emotional territory that’s covered here. Although she survived this highly aggressive cancer, she was not unscathed: the chemotherapy she had is so toxic it leads to lasting nerve damage and a brain fog that hasn’t completely lifted.

All the more impressive, then, that Boyer has been able to put together this ferociously intellectual response to American cancer culture. Her frame of reference ranges from ancient Greece – Aelius Aristides, who lived in a temple, hoping the gods would reveal the cure to his wasting illness via dreams, becomes an offbeat hero for her – to recent breast cancer vloggers. She is scathing on vapid pink-ribbon cheerleading that doesn’t substantially improve breast cancer patients’ lives, and on profit-making healthcare schemes that inevitably discriminate against poor women of color and send people home from the hospital within a day or two of a double mastectomy. Through her own experience, she reflects on the pressure women are under to be brave, to be optimistic, to go to work as normal, and to look as beautiful as ever when they are in excruciating pain and beyond exhaustion.

Impossible to avoid comparisons to Susan Sontag’s Illness as Metaphor, but this book has a personal power I don’t remember finding in Sontag’s more detached, academic-level work. Boyer sees herself as one in a long lineage of women writing about their cancer – from Fanny Burney to Audre Lorde – and probes the limits of language when describing pain. I was reminded of another terrific, adjacent book from this year, Constellations by Sinéad Gleeson, especially where Boyer describes her imagined 10-part pain scale (Gleeson has a set of 20 poems based on the McGill Pain Index).

I could quote excellent passages all day, but here are a few that stood out to me:

“People with breast cancer are supposed to be ourselves as we were before, but also better and stronger and at the same time heart-wrenchingly worse. We are supposed to keep our unhappiness to ourselves but donate our courage to everyone.”

“The moral failure of breast cancer is not in the people who die: it is in the world that makes them sick, bankrupts them for a cure that also makes them sick, then blames them for their own deaths.”

“If suffering is like a poem, I want mine to be lurid, righteous, and goth.”

My thanks to FSG for the proof copy for review.

 

Will My Cat Eat My Eyeballs?: Big Questions from Tiny Mortals about Death by Caitlin Doughty

(Coming from W.W. Norton [USA] on the 10th and W&N [UK] on the 19th)

This is the third book by the millennial mortician, and I’ve taken perverse glee in reading them all. Smoke Gets in Your Eyes explains cremation and combats misconceptions about death; From Here to Eternity surveys death rituals from around the world. This new book seems to be aimed at (morbid) children, but for me it was more like one of those New Scientist books (Why Don’t Penguins’ Feet Freeze?) or Why Do Men Have Nipples?

Some of the questions are more serious than others, but with her usual punning wit and pop culture references Doughty gives biologically sound answers to them all. For instance, she explains what might happen to a corpse in space, why the hair and fingernails of a cadaver appear to keep growing, and why the quantity of ashes from a cremation is about the same no matter the dead person’s girth (all the fat burns away; what would make your ashes weigh more is being taller and thus having longer bones). I was most interested in the chapter on why conjoined twins generally die at roughly the same time.

Doughty also discusses laws relating to the dead, such as “abuse of corpse” regulations and whether or not deaths at a property have to be reported to potential buyers (it depends on what state or country you live in); and what happens in countries that are literally running out of space for burials. In highly population-dense places like Singapore, but also in countries such as Germany, one is considered to ‘rent’ grave space, which is then recycled after 15 years and the previous set of remains cremated. Or graves might get stacked vertically.

This is good fun, and features lots of cartoonishly gruesome black-and-white illustrations by Dianné Ruz. If you’ve got a particularly curious niece or nephew who might appreciate a dark sense of humor, this would make a good Christmas gift for one who is an older child or young teen.

My thanks to W&N for the free copy for review.

 

Bloomland by John Englehardt

(Coming from Dzanc Books [USA only] on the 10th)

“you wonder if the scariest thing about all this is not that life can’t return to normal, but that it already has”

Especially after Gilroy and El Paso, I wasn’t sure I’d have the heart to pick up Bloomland, a novel about a mass shooting at (fictional) Ozarka University, Arkansas. But I’m very glad I did. Crucially, Englehardt’s debut doesn’t a) make easy assignments of guilt, b) resort to lurid scenes for shock value, or c) employ the cut-and-dried language of cause and effect. It’s a subtle and finely crafted piece of literary fiction. The second-person narration is an effective means of drawing the reader into the action, and inviting ‘you’ to extend sympathy to three very different characters: Rose, an Ozarka student who becomes romantically involved with one of the injured; Eddie, a professor whose wife dies in the massacre; and Eli, the shooter.

Both Rose and Eli lost their mothers when they were 11 years old. Six years before starting a poultry science course at Ozarka, Rose was caught up in a tornado that killed her grandmother and fractured her skull. The fact that her upbringing was even more traumatic than Eli’s is, I think, meant to discredit the lazy argument that dysfunctional families produce killers. In his early days at university we see Eli befriending a drug dealer named Gordon, whose hunting rifle he soups up to use in the shooting at the campus library in finals week. Englehardt also tests out another couple of predictors of violence: cruelty towards animals (au contraire, Eli can’t stand more than one day of debeaking chickens at a poultry factory and even takes one home as a pet) and violent, video-game-fueled fantasies (the story he writes for creative writing class is average for a teenage male so doesn’t raise any alarm bells).

Gradually we learn that there is an “I” behind this triple-stranded narrative: Dr. Steven Bressinger, an Ozarka creative writing professor. Although Rose, Eddie and Eli are all fully realized characters, we are also left to wonder how this Bressinger is able to access their memories and emotions. To what extent can he really put himself into their situations? And how much of the rest is made up? But then, that’s what the novelist does anyway: imagine what it’s like to be inside a character’s experience, especially when they’ve made unimaginable decisions.

So this novel within a novel thoroughly convinced me, especially as it moves into the future to examine how the campus and the wider community address issues of guilt and vengeance. Its timeliness is obvious, and Englehardt writes a gorgeous sentence, even when it’s about the homogeneity of the American suburb: e.g., “You start driving down MLK, past the mass grave of dollar stores, under the even clouds converging like one stoic slab of ice.”

My thanks to the publisher for the proof copy for review.

 

Surfacing by Kathleen Jamie

(Coming from Sort Of Books [UK] on the 19th and Penguin Books [USA] on the 24th)

I’m a big fan of Kathleen Jamie’s work, prose and poetry. Like her two previous essay collections, Sightlines and Findings, both of which I read in 2012, this fuses autobiography with nature and travel writing – two genres that are too often dominated by males. Jamie has a particular interest in birds, islands, archaeology and the oddities of the human body, all subjects that intrigue me, too.

The bulk of Surfacing is given over to three long pieces set in Alaska, Orkney and Tibet. She was drawn to Quinhagak, Alaska, a village that’s about the farthest you can go before crossing the Bering Sea into Russia, by her fascination with the whaling artifacts found along the UK’s east coast. Here she helped out on a summer archaeological dig and learned about the language and culture of the Yup’ik people. Alarmingly, the ground here should have been frozen most of the way to the surface, forcing the crew to wear thermals; instead, the ice was a half-meter down, and Jamie found that she never needed her cold-weather gear.

On Westray, Orkney (hey, I’ve been there!), there was also evidence of environmental degradation in the form of rapid erosion. This Neolithic site, comparable to the better-known Skara Brae, leads Jamie to think about deep time and whether we’re actually much better off than people in the Bronze Age were. Prehistory fits the zeitgeist, as seen in two entries from the recent Wainwright Prize shortlist: Time Song by Julia Blackburn and Underland by Robert Macfarlane. It’s a necessary corrective to the kind of short-term thinking that has gotten us into environmental crisis.

A cancer biopsy coincides with a dream memory of being bitten by a Tibetan dog, prompting Jamie to get out her notebook from a trip to China/Tibet some 30 years ago. Xiahe was technically in China but ethnically and culturally Tibetan, and so the best they could manage at that time since Tibet was closed to foreigners. There’s an amazing amount of detail in this essay given how much time has passed, but her photos as well as her notebook must have helped with the reconstruction.

The depth and engagement of the long essays are admirable, yet I often connected more with the few-page pieces on experiencing a cave, spotting an eagle or getting lost in a forest. Jamie has made the interesting choice of delivering a lot of the memoir fragments in the second person. My favorite piece of all is “Elders,” which in just five pages charts her father’s decline and death and marks her own passage into unknown territory: grown children and no parents; what might her life look like now?

There is beautiful nature writing to be found in this volume, as you might expect, but also relatable words on the human condition:

What are you doing here anyway, in the woods? … You wanted to think about all the horror. The everyday news … No, not to think about it exactly but consider what to do with the weight of it all, the knowing … You are not lost, just melodramatic. The path is at your feet, see? Now carry on.

My thanks to Sort Of Books for the free copy for review.

 

The Dutch House by Ann Patchett

(Coming from Bloomsbury [UK] and Harper [USA] on the 24th)

Maeve and Danny Conroy are an inseparable brother-and-sister pair. Their mother left when Danny was little, so his older sister played a maternal role, too. And when their father dies, they become like Hansel and Gretel (or Cinderella and her little brother): cast out into the wilds by an evil stepmother who takes possession of the only home they’ve ever known, a suburban Philadelphia mansion built on the proceeds of the VanHoebeeks’ cigarette empire.

It’s interesting to see Patchett take on a male perspective in this novel; she does it utterly convincingly. I also loved the medical threads running through: Maeve is diagnosed with diabetes as a teenager, and Danny spends many years in medical training even though his only ambition is to follow in his father’s footsteps as a property developer. There was a stretch in the middle of the book – something like 46% to 58% – when I was really bored with Danny’s dithering (‘but I don’t want to be a doctor … but I don’t want to marry Celeste’), and the chronology is unnecessarily complicated by flashbacks, though this is, I think, meant to convey Danny’s desultory composition of his memoirs.

In the end I didn’t like this quite as much as Commonwealth, but it’s a memorable exploration of family secrets and memories. As the decades pass you see how what happened to Maeve and Danny has been turned into myth: a story they repeat to themselves about how they were usurped, until this narrative has more power than the reality. Readers, meanwhile, are invited to question the people and places we base our security on, and to imagine what it would mean to forgive and forget and start living in a different way.

Patchett is always so good on the psychology of complicated families, and her sharp prose never fails to hit the nail on the head. The Goldfinch comes to mind as a readalike – not least because of the significance of a piece of art: the cover depicts a painting made of Maeve when she was 10 – as well as Nick Hornby’s How to Be Good.

I read an electronic proof copy via Edelweiss.

 

Have you read any September releases that you would recommend? Which of these tempt you?

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My Most Anticipated Releases of the Second Half of 2019

Although over 90 books from the second half of the year are already on my radar, I’ve managed to narrow it down to the 15 July to November releases that I’m most excited about. I have access to a few of these already, and most of the rest I will try requesting as soon as I’m back from Milan. (These are given in release date order within thematic sections; the quoted descriptions are from the publisher blurbs on Goodreads.)

[By the way, here’s how I did with my most anticipated releases of the first half of the year:

  • 16 out of 30 read; of those 9 were somewhat disappointing (i.e., 3 stars or below) – This is such a poor showing! Is it a matter of my expectations being too high?
  • 10 I still haven’t managed to find
  • 1 print review copy arrived recently
  • 1 I have on my Kindle to read
  • 1 I skimmed
  • 1 I lost interest in]

 

Fiction

The Lager Queen of Minnesota by J. Ryan Stradal [July 23, Pamela Dorman Books] Stradal’s Kitchens of the Great Midwest (2015) is one of my recent favorites. This one has a foodie theme again, and sounds a lot like Louise Miller’s latest – two sisters: a baker of pies and a founder of a small brewery. “Here we meet a cast of lovable, funny, quintessentially American characters eager to make their mark in a world that’s often stacked against them.”

 

Hollow Kingdom by Kira Jane Buxton [August 6, Grand Central Publishing / Headline Review] As soon as I heard that this was narrated by a crow, I knew I was going to have to read it. (And the Seattle setting also ties in with Lyanda Lynn Haupt’s book.) “Humanity’s extinction has seemingly arrived, and the only one determined to save it is a foul-mouthed crow whose knowledge of the world around him comes from his TV-watching education.”

 

Inland by Téa Obreht [August 13, Random House / Weidenfeld & Nicolson] However has it been eight years since her terrific debut novel?! “In the lawless, drought-ridden lands of the Arizona Territory in 1893, two extraordinary lives collide. … [L]yrical, and sweeping in scope, Inland subverts and reimagines the myths of the American West.” The synopsis reminds me of Eowyn Ivey’s latest.

 

A Door in the Earth by Amy Waldman [August 27, Little, Brown and Company] I loved The Submission, Waldman’s 2011 novel about a controversial (imagined) 9/11 memorial. “Parveen Shamsa, a college senior in search of a calling, feels pulled between her charismatic and mercurial anthropology professor and the comfortable but predictable Afghan-American community in her Northern California hometown [and] travels to a remote village in the land of her birth to join the work of his charitable foundation.” (NetGalley download)

 

Bloomland by John Englehardt [September 10, Dzanc Books] “Bloomland opens during finals week at a fictional southern university, when a student walks into the library with his roommate’s semi-automatic rifle and opens fire. In this richly textured debut, Englehardt explores how the origin and aftermath of the shooting impacts the lives of three characters.” (print review copy from publisher)

 

The Dutch House by Ann Patchett [September 25, Harper / Bloomsbury UK] I’m more a fan of Patchett’s nonfiction, but will keep reading her novels thanks to Commonwealth. “At the end of the Second World War, Cyril Conroy combines luck and a single canny investment to begin an enormous [Philadelphia] real estate empire … Set over … five decades, The Dutch House is a dark fairy tale about two smart people who cannot overcome their past.”

 

Medical themes

Will My Cat Eat My Eyeballs?: Big Questions from Tiny Mortals about Death by Caitlin Doughty [September 10, W.W. Norton / September 19, Weidenfeld & Nicolson] I’ve read Doughty’s previous books about our modern attitude towards mortality and death customs around the world. She’s wonderfully funny and iconoclastic. Plus, how can you resist this title?! Although it sounds like it’s geared towards children, I’ll still read the book. “Doughty blends her mortician’s knowledge of the body and the intriguing history behind common misconceptions … to offer factual, hilarious, and candid answers to thirty-five … questions.”

 

The Undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care by Anne Boyer [September 17, Farrar, Straus and Giroux] “A week after her forty-first birthday, the acclaimed poet Anne Boyer was diagnosed with highly aggressive triple-negative breast cancer. … A genre-bending memoir in the tradition of The ArgonautsThe Undying will … show you contemporary America as a thing both desperately ill and occasionally, perversely glorious.” (print review copy from publisher)

 

From the author’s Twitter page.

Breaking and Mending: A doctor’s story of burnout and recovery by Joanna Cannon [September 26, Wellcome Collection] I haven’t gotten on with Cannon’s fiction, but a memoir should hit the spot. “A frank account of mental health from both sides of the doctor-patient divide, from the bestselling author of The Trouble with Goats and Sheep and Three Things About Elsie, based on her own experience as a doctor working on a psychiatric ward.”

 

The Body: A Guide for Occupants by Bill Bryson [October 3, Doubleday / Transworld] His last few books have been somewhat underwhelming, but I’d read Bryson on any topic. He’s earned a reputation for making history, science and medicine understandable to laymen. “Full of extraordinary facts and astonishing stories, The Body: A Guide for Occupants is a brilliant, often very funny attempt to understand the miracle of our physical and neurological makeup.”

 

The Depositions: New and Selected Essays on Being and Ceasing to Be by Thomas Lynch [November 26, W.W. Norton] Lynch is such an underrated writer. A Michigan undertaker, he crafts essays and short stories about small-town life, the Irish-American experience and working with the dead. I discovered him through Greenbelt Festival some years back and have read three of his books. Some of what I’ve already read will likely be repeated here, but will be worth a second look anyway.

 

Other Nonfiction

Confessions of a Bookseller by Shaun Bythell [August 29, Profile Books] The Diary of a Bookseller was a treat in 2017. I’ve read the first two-thirds of this already while in Milan, and I wish I was in Wigtown instead! This sequel picks up in 2015 and is very much more of the same – the daily routines of buying and selling books and being out and about in a small town – so it’s up to you whether that sounds boring or comforting. I’m finding it strangely addictive. (NetGalley download)

 

We Are the Weather: Saving the Planet Begins at Breakfast by Jonathan Safran Foer [September 17, Farrar, Straus and Giroux / October 10, Hamish Hamilton] Foer’s Eating Animals (2009) was a hard-hitting argument against eating meat. In this follow-up he posits that meat-eating is the single greatest contributor to climate change. “With his distinctive wit, insight and humanity, Jonathan Safran Foer presents this essential debate as no one else could, bringing it to vivid and urgent life, and offering us all a much-needed way out.”

 

Surfacing by Kathleen Jamie [September 19, Sort of Books] Jamie is a Scottish poet who writes exquisite essays about the natural world. I’ve read her two previous essay collections, Findings and Sightlines, as well as a couple of volumes of her poetry. “From the thawing tundra linking a Yup’ik village in Alaska to its hunter-gatherer past to the shifting sand dunes revealing the impressively preserved homes of neolithic farmers in Scotland, Jamie explores how the changing natural world can alter our sense of time.”

 

Unfollow by Megan Phelps-Roper [October 8, Farrar, Straus and Giroux / riverrun] Ties in with my special interest in women’s religious memoirs. “In November 2012, at the age of twenty-six, [Phelps-Roper] left [Westboro Baptist Church], her family, and her life behind. Unfollow is a story about the rarest thing of all: a person changing their mind. It is a fascinating insight into a closed world of extreme belief, a biography of a complex family, and a hope-inspiring memoir of a young woman finding the courage to find compassion.”

 

Which of these do you want to read, too?

What other upcoming 2019 titles are you looking forward to?

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.