#NonFicNov: Being the Expert on Covid Diaries
This year the Be/Ask/Become the Expert week of the month-long Nonfiction November challenge is hosted by Veronica of The Thousand Book Project. (In previous years I’ve contributed lists of women’s religious memoirs (twice), accounts of postpartum depression, and books on “care”.)
I’ve been devouring nonfiction responses to COVID-19 for over a year now. Even memoirs that are not specifically structured as diaries take pains to give a sense of what life was like from day to day during the early months of the pandemic, including the fear of infection and the experience of lockdown. Covid is mentioned in lots of new releases these days, fiction or nonfiction, even if just via an introduction or epilogue, but I’ve focused on books where it’s a major element. At the end of the post I list others I’ve read on the theme, but first I feature four recent releases that I was sent for review.
Year of Plagues: A Memoir of 2020 by Fred D’Aguiar
The plague for D’Aguiar was dual: not just Covid, but cancer. Specifically, stage 4 prostate cancer. A hospital was the last place he wanted to spend time during a pandemic, yet his treatment required frequent visits. Current events, including a curfew in his adopted home of Los Angeles and the protests following George Floyd’s murder, form a distant background to an allegorized medical struggle. D’Aguiar personifies his illness as a force intent on harming him; his hope is that he can be like Anansi and outwit the Brer Rabbit of cancer. He imagines dialogues between himself and his illness as they spar through a turbulent year.
Cancer needs a song: tambourine and cymbals and a choir, not to raise it from the dead but [to] lay it to rest finally.
Tracing the effects of his cancer on his wife and children as well as on his own body, he wonders if the treatment will disrupt his sense of his own masculinity. I thought the narrative would hit home given that I have a family member going through the same thing, but it struck me as a jumble, full of repetition and TMI moments. Expecting concision from a poet, I wanted the highlights reel instead of 323 rambling pages.
(Carcanet Press, August 26.) With thanks to the publisher for the free copy for review.
100 Days by Gabriel Josipovici
Beginning in March 2020, Josipovici challenged himself to write a diary entry and mini-essay each day for 100 days – which happened to correspond almost exactly to the length of the UK’s first lockdown. Approaching age 80, he felt the virus had offered “the unexpected gift of a bracket round life” that he “mustn’t fritter away.” He chose an alphabetical framework, stretching from Aachen to Zoos and covering everything from his upbringing in Egypt to his love of walking in the Sussex Downs. I had the feeling that I should have read some of his fiction first so that I could spot how his ideas and experiences had infiltrated it; I’m now rectifying this by reading his novella The Cemetery in Barnes, in which I recognize a late-life remarriage and London versus countryside settings.
Still, I appreciated Josipovici’s thoughts on literature and his own aims for his work (more so than the rehashing of Covid statistics and official briefings from Boris Johnson et al., almost unbearable to encounter again):
In my writing I have always eschewed visual descriptions, perhaps because I don’t have a strong visual memory myself, but actually it is because reading such descriptions in other people’s novels I am instantly bored and feel it is so much dead wood.
nearly all my books and stories try to force the reader (and, I suppose, as I wrote, to force me) to face the strange phenomenon that everything does indeed pass, and that one day, perhaps sooner than most people think, humanity will pass and, eventually, the universe, but that most of the time we live as though all was permanent, including ourselves. What rich soil for the artist!
Why have I always had such an aversion to first person narratives? I think precisely because of their dishonesty – they start from a falsehood and can never recover. The falsehood that ‘I’ can talk in such detail and so smoothly about what has ‘happened’ to ‘me’, or even, sometimes, what is actually happening as ‘I’ write.
You never know till you’ve plunged in just what it is you really want to write. When I started writing The Inventory I had no idea repetition would play such an important role in it. And so it has been all through, right up to The Cemetery in Barnes. If I was a poet I would no doubt use refrains – I love the way the same thing becomes different the second time round
To write a novel in which nothing happens and yet everything happens: a secret dream of mine ever since I began to write
I did sense some misogyny, though, as it’s generally female writers he singles out for criticism: Iris Murdoch is his prime example of the overuse of adjectives and adverbs, he mentions a “dreadful novel” he’s reading by Elizabeth Bowen, and he describes Jean Rhys and Dorothy Whipple as women “who, raised on a diet of the classic English novel, howled with anguish when life did not, for them, turn out as they felt it should.”
While this was enjoyable to flip through, it’s probably more for existing fans than for readers new to the author’s work, and the Covid connection isn’t integral to the writing experiment.
(Carcanet Press, October 28.) With thanks to the publisher for the free copy for review.
A stanza from the below collection to link the first two books to this next one:
Have they found him yet, I wonder,
whoever it is strolling
about as a plague doctor, outlandish
beak and all?
The Crash Wake and Other Poems by Owen Lowery
Lowery was a tetraplegic poet – wheelchair-bound and on a ventilator – who also survived a serious car crash in February 2020 before his death in May 2021. It’s astonishing how much his body withstood, leaving his mind not just intact but capable of generating dozens of seemingly effortless poems. Most of the first half of this posthumous collection, his third overall, is taken up by a long, multipart poem entitled “The Crash Wake” (it’s composed of 104 12-line poems, to be precise), in which his complicated recovery gets bound up with wider anxiety about the pandemic: “It will take time and / more to find our way / back to who we were before the shimmer / and promise of our snapped day.”
As the seventh anniversary of his wedding to Jayne nears, Lowery reflects on how love has kept him going despite flashbacks to the accident and feeling written off by his doctors. In the second section of the book, the subjects vary from the arts (Paula Rego’s photographs, Stanley Spencer’s paintings, R.S. Thomas’s theology) to sport. There is also a lovely “Remembrance Day Sequence” imagining what various soldiers, including Edward Thomas and his own grandfather, lived through. The final piece is a prose horror story about a magpie. Like a magpie, I found many sparkly gems in this wide-ranging collection.
(Carcanet Press, October 28.) With thanks to the publisher for the free e-copy for review.
Behind the Mask: Living Alone in the Epicenter by Kate Walter
[135 pages, so I’m counting this one towards #NovNov, too]
For Walter, a freelance journalist and longtime Manhattan resident, coronavirus turned life upside down. Retired from college teaching and living in Westbeth Artists Housing, she’d relied on activities outside the home for socializing. To a single extrovert, lockdown offered no benefits; she spent holidays alone instead of with her large Irish Catholic family. Even one of the world’s great cities could be a site of boredom and isolation. Still, she gamely moved her hobbies onto Zoom as much as possible, and welcomed an escape to Jersey Shore.
In short essays, she proceeds month by month through the pandemic: what changed, what kept her sane, and what she was missing. Walter considers herself a “gay elder” and was particularly sad the Pride March didn’t go ahead in 2020. She also found herself ‘coming out again’, at age 71, when she was asked by her alma mater to encapsulate the 50 years since graduation in 100 words.
There’s a lot here to relate to – being glued to the news, anxiety over Trump’s possible re-election, looking forward to vaccination appointments – and the book is also revealing on the special challenges for older people and those who don’t live with family. However, I found the whole fairly repetitive (perhaps as a result of some pieces originally appearing in The Village Sun and then being tweaked and inserted here).
Before an appendix of four short pre-Covid essays, there’s a section of pandemic writing prompts: 12 sets of questions to use to think through the last year and a half and what it’s meant. E.g. “Did living through this extraordinary experience change your outlook on life?” If you’ve been meaning to leave a written record of this time for posterity, this list would be a great place to start.
(Heliotrope Books, November 16.) With thanks to the publicist for the free e-copy for review.
Other Covid-themed nonfiction I have read:
- Breathtaking by Rachel Clarke
- Intensive Care by Gavin Francis
- Every Minute Is a Day by Robert Meyer and Dan Koeppel (reviewed for Shelf Awareness)
- Duty of Care by Dominic Pimenta
- Many Different Kinds of Love by Michael Rosen
+ I have a proof copy of Everything Is True: A Junior Doctor’s Story of Life, Death and Grief in a Time of Pandemic by Roopa Farooki, coming out in January.
- Goshawk Summer by James Aldred
- The Heeding by Rob Cowen (in poetry form)
- Birdsong in a Time of Silence by Steven Lovatt
- The Consolation of Nature by Michael McCarthy, Jeremy Mynott and Peter Marren
- Skylarks with Rosie by Stephen Moss
- Hold Still (a National Portrait Gallery commission of 100 photographs taken in the UK in 2020)
- The Rome Plague Diaries by Matthew Kneale
- Quarantine Comix by Rachael Smith (in graphic novel form; reviewed for Foreword Reviews)
- UnPresidented by Jon Sopel
+ on my Kindle: Alone Together, an anthology of personal essays
+ on my TBR: What Just Happened: Notes on a Long Year by Charles Finch
If you read just one… Make it Intensive Care by Gavin Francis. (And, if you love nature books, follow that up with The Consolation of Nature.)
Can you see yourself reading any of these?
January’s Nonfiction Releases: Clarke, Heminsley and Lalkhen
Three new books with medical themes (no surprise there), including the first Covid wave in the UK; fertility and body issues in a new queer family; and pain management strategies.
Breathtaking: Inside the NHS in a Time of Pandemic by Rachel Clarke
Clarke is a palliative care doctor based in Oxfordshire. She runs the Katharine House hospice but during the coronavirus pandemic has also been on active duty in the Oxford University Hospitals system. If you’re on social media you have likely come across some of her postings as she has been equally vocal in her praise of the NHS and her criticism of Boris Johnson’s faltering policies, which are often of the too little, too late variety. So I was eager to read her insider’s account of hospital treatment of the first wave of Covid in the UK, especially because her previous book, Dear Life, was one of my top two nonfiction releases of last year.
The focus is on the first four full months of 2020, and the book originated in Clarke’s insomniac diaries and notes made when, even after manically busy shifts, she couldn’t rest her thoughts. Her pilot husband was flying to China even as increasingly alarming reports started coming in from Wuhan. She weaves in the latest news from China and Italy as well as what she hears from colleagues and disease experts in London. But the priority is given to stories: of the first doctor to die in China; of a Yorkshire ICU nurse’s father, who comes down with Covid and is on a ventilator in an Oxford hospital; and of her patients there and in the hospice. She is touched that so many are making great sacrifices, such as by deciding not to visit loved ones at the end of their lives so as not to risk spreading infection.
A shortage of PPE remained a major issue, though Dominic Pimenta (whose Duty of Care was my first COVID-19 book) pulled through for her with an emergency shipment for the hospice – without which it would have had to close. Clarke marvels at the NHS’s ability to create an extra 33,000 beds within a month, but knows that this comes at a cost of other services, including cancer care, being stripped back or cancelled, meaning that many are not receiving the necessary treatment or are pushing inescapable problems further down the road.
A comparison with Gavin Francis’s Intensive Care, published earlier in the month, is inevitable. Both doctors bounce between headlines and everyday stories, government advice and the situation on the ground. Both had their own Covid scare – Clarke didn’t meet the criteria to be tested so simply went back to work two weeks later, when she felt well enough – and had connections to regions that foreshadowed what would soon happen in the UK. Both give a sense of the scope of the crisis and both lament that, just when patients need compassion most, full PPE leads to their doctors feeling more detached from them than ever.
However, within the same page count, Francis manages to convey more of the science behind the virus and its transmission, and helpfully explores the range of effects Covid is having for different groups. He also brings the story more up to the minute with a look back from November, whereas Clarke ends in April and follows up with an epilogue set in August. A book has to end somewhere, yes, but with this crisis ongoing, the later and more relevant its contents can be, the better. And in any book that involves a lot of death, mawkishness is a risk; Clarke so carefully avoided this in Dear Life, but sometimes succumbs here, with an insistence on how the pandemic has brought out the best in people (clapping and rainbows and all that). Her writing is as strong as ever, but I would have appreciated a sharper, more sombre look at the situation a few months later. Perhaps there will be a sequel.
With thanks to Little, Brown UK for the free copy for review.
Some Body to Love: A Family Story by Alexandra Heminsley
From Heminsley’s previous book, Leap In, I knew about her getting married and undergoing IVF. It was also a book about outdoor swimming; I appreciated her words on acquiring a new skill as an adult and overcoming body issues. This memoir continues the story: in 2017, after a gruelling journey through infertility treatment, Heminsley finally got the baby she wanted. But not before a couple more heart-wrenching moments: the lab made an error and notified her that she shared no DNA with this last embryo, and while heavily pregnant she was assaulted by a drunk man on a train. Both incidents left her feeling a loss of agency. “Why was I consistently being deemed the least reliable witness of my own reality?” she asks.
As they adjusted to new life with a baby, Heminsley started to notice that she wasn’t connecting with her husband, D, like she used to. She felt emotionally unsupported and, in fact, jealous of D’s relationship with their son, L. And while they’d never been the most conventional couple, D’s changes of appearance and wardrobe seemed like a sign of something bigger. Indeed, when L was six months old, D told Heminsley, “this body doesn’t represent who I am” and announced a decision to begin transitioning.
As D moved towards having a body that fit their identity, Heminsley, too, needed to get back in touch with her body. After books like Running Like a Girl, she was considered an exercise guru, but she didn’t see herself in the new obsession with Instagram-ready images of fitness perfection. This is not, then, primarily a memoir of queer family-making, because D’s transitioning was not Heminsley’s story to tell and mostly occurs in the background. Instead she focuses on what she does know and can control: her relationship to her own body.
However, this entails what can feel like irrelevant flashbacks to her teenage years of undergoing rehab at a military clinic in Germany for hypermobility, trips to Trinidad and Italy, and the genesis of her two sporting memoirs. Much as I applaud the sensitivity to trans and body issues, the book ends up feeling scattered. Still, the writing is so candid and the narrative so eventful that you’ll race through this even if you don’t normally pick up nonfiction. (For a bit more information, see my short write-up of the virtual book launch.)
With thanks to Chatto & Windus for the free copy for review.
Pain: The Science of the Feeling Brain by Abdul-Ghaaliq Lalkhen
Originally from South Africa, Dr Lalkhen is an anaesthesiology and pain specialist based in Manchester. In a nutshell, his approach is “biopsychosocial,” meaning that he seeks to understand pain not just as a physical phenomenon resulting from acute injury or damage but as an ongoing process that is affected by emotional and psychological factors. Particularly in the context of chronic syndromes, he acknowledges that pain can continue even when its immediate cause has been repaired. Mental preparation can come into the equation: if a patient assumes they’ll wake up from surgery healed, they may be alarmed if pain persists. Lalkhen talks about managing patient expectations, perhaps with something as simple as the promise, “we’ll aim to get your pain down to a 4 after surgery.” In part, he blames Western society’s Cartesian philosophy for treating mind and body as separate rather than a system.
There are genetic and psychological reasons people might be predisposed to chronic pain. Pain itself can then change the brain chemistry, making the body more alert to pain signals. People can choose one of three paths, Lalkhen observes: “You can spend your time agitating about the alarm going off, you can try to ignore it (but the ignoring of it actually takes up more energy), or the final alternative is to learn to live with this deeply unpleasant situation.” Those who opt for pharmacological solutions can become addicted to opiates, which are less effective over time. Non-drug-related therapies involve the desensitization of nerves, the injection of anaesthetics or steroids, or the implanting of spinal cord stimulators. But all of these strategies have their limitations, and can diminish in efficacy. The patients he sees in his pain clinics may be disappointed that, rather than offering a panacea, he wants to wean them off their current pain relief and help them develop a new way of thinking about pain.
I felt I learned a lot from reading this. Lalkhen is careful to state that he is only referring to non-cancer pain (cancer pain in terminal patients will take all the morphine you can throw at it). Like many physicians, he worries about the modern epidemic of overtreatment and our obsession with wellness. I especially enjoyed the discussion of the understanding of pain and its treatment from the ancient world onward, and in particular the history of opiates. The prose is not literary, but this is an accessible and informational read if the subject matter draws you.
With thanks to Atlantic Books for the free copy for review.
What recent nonfiction releases can you recommend?
Being the Expert for #NonficNov / Three on a Theme: “Care”
The Being/Becoming/Asking the Expert week of the month-long Nonfiction November challenge is hosted by Rennie of What’s Nonfiction. This is my second entry for the week after Monday’s post on postpartum depression, as well as the second installment in my new “Three on a Theme” series, where I review three books that have something significant in common and tell you which one to pick up if you want to read into the topic for yourself.
It will be no surprise to regular readers that both of my ‘expert’ posts have been on a health theme: I have an amateur’s love of medical memoirs and works of medical history, and I’ve followed the Wellcome Book Prize closely for a number of years – participating in official blog tours, creating a shadow panel, and running this past year’s Not the Wellcome Prize.
The three books below are linked by the word “Care” in the title or subtitle; all reflect, in the wake of COVID-19, on the ongoing crisis in UK healthcare and the vital role of nurses.
Labours of Love: The Crisis of Care by Madeleine Bunting
Bunting’s previous nonfiction work could hardly be more different: Love of Country was a travel memoir about the Scottish Hebrides. It was the first book I finished reading in 2017, and there could have been no better start to a year’s reading. With a background in history, journalism and politics, the author is well placed to comment on current events. Labours of Love arose from five years of travel to healthcare settings across the UK: care homes for the elderly and disabled, hospitals, local doctors’ surgeries, and palliative care units. Forget the Thursday-night clapping and rainbows in the windows: the NHS is perennially underfunded and its staff undervalued, by conservative governments as well as by people who rely on it.
We first experience bodily care as infants, Bunting notes, and many of the questions that run through her book originated in her early days of motherhood. Despite all the advances of feminism, parental duties follow the female-dominated pattern evident in the caring careers:
By the age of fifty-nine, women will have a fifty-fifty chance of being, or having been, a carer for a sick or elderly person. At the same time, many are still raising their teenage children and almost half of those over fifty-five are providing regular care for grandchildren.
Women dominate caring professions such as nursing (89 per cent), social work (75 per cent) and childcare (98 per cent). They now form the majority of GPs (54 per cent) and three out of four teachers are female. And they provide the vast bulk of the army of healthcare workers in the NHS (80 per cent) and social-care workers (82 per cent) for the long-term sick, disabled and frail elderly.
These are things we know intuitively, but seeing the numbers laid out so plainly is shocking. I most valued the general information in Bunting’s introduction and in between her interviews, while I found that the bulk of the book alternated between dry statistics and page after page of interview transcripts. However, I did love hearing more from Marion Coutts, the author of the 2015 Wellcome Book Prize winner, The Iceberg, about her husband’s death from brain cancer. (Labours of Love was longlisted for the Baillie Gifford Prize for Non-Fiction 2020.)
My thanks to Granta for the free copy for review.
Duty of Care: One NHS Doctor’s Story of Courage and Compassion on the COVID-19 Frontline by Dr Dominic Pimenta
We’re going to see a flood of such books; I’m most looking forward to Dr Rachel Clarke’s Breathtaking (coming in January). Given how long it takes to get a book from manuscript to published product, I was impressed to find this on my library’s Bestsellers shelf in October. Pimenta’s was an early voice warning of the scale of the crisis and the government’s lack of preparation. He focuses on a narrow window of time, from February – when he encountered his first apparent case of coronavirus – to May, when, in protest at a government official flouting lockdown (readers outside the UK might not be familiar with the Cummings affair), he resigned his cardiology job at a London hospital to focus on his new charity, HEROES, which supports healthcare workers via PPE, childcare grants, mental health help and so on.
It felt uncanny to be watching events from earlier in the year unfold again: so clearly on a trajectory to disaster, but still gripping in the telling. Pimenta’s recreated dialogue and scenes are excellent. He gives a real sense of the challenges in his personal and professional lives. But I think I’d like a little more distance before I read this in entirety. Just from my skim, I know that it’s a very fluid book that reads almost like a thriller, and it ends with a sober but sensible statement of the situation we face. (All royalties from the book go to HEROES.)
The Courage to Care: A Call for Compassion by Christie Watson
I worried this would be a dull work of polemic; perhaps the title, though stirring, is inapt, as the book is actually a straightforward sequel to Watson’s 2018 memoir about being a nurse, The Language of Kindness. Although, like Bunting, Watson traveled widely to research the state of care in the country, she mostly relies on her own experience of various nursing settings over two decades: a pediatric intensive care unit, home healthcare for the elderly, a children’s oncology day center, a residential home for those with severe physical and learning disabilities, a community mental-health visiting team, and the emergency room. She also shadows military nurses and prison doctors.
With a novelist’s talent for scene-setting and characterization, Watson weaves each patient and incident into a vibrant story. Another strand is about parenthood: giving birth to her daughter and the process of adopting her son – both are now teenagers she raises as a single mother. She affirms the value of everyday care delivered by parents and nurses alike. I was especially struck by the account of a teenage girl who contracted measles (then pneumonia, meningitis and encephalitis) and was left blind and profoundly disabled, all because her parents were antivaxxers. In general, I’ve wearied of doctors’ memoirs composed of obviously anonymized case studies, but I’ll always make an exception for Clarke and Watson because of their gorgeous writing.
Note: Watson had left nursing to write full-time, but explains in an afterword that she returned to critical care in a London hospital during COVID-19.
What I learned:
Empathy is a key term for all three authors. They emphasize that the skills of compassion and listening are just as important as the ability to perform the required medical procedures.
A chilling specific fact I learned: 43,000 people died in the Blitz* in the UK. Pimenta cited that figure and warned that COVID-19 could be worse. And indeed, as of now, over 63,000 people have died of COVID-19 in the UK. The American death toll is even more alarming.
Here are some passages that stood out for me from each book:
Bunting: “Good care is as much an art as a skill, as much competence as tact. … Care is where we make profound collective decisions about the worth of an individual life. … There is no tradition of ageing wisely in the West, unlike in many Asian and African cultures where age has prestige, status and is associated with wisdom … We need to speak about care in a different language, instead of the relentless macho repetition of words such as ‘efficiency’, ‘quality’, ‘driving’, ‘choice’, ‘delivery’ and productivity.’”
Pimenta: “this will be akin to the Blitz*, and … we need to start thinking of it like that. A marathon, not a sprint. … The challenges to come – a second or even third wave, a global recession, climate change, mass misinformation … and political and societal upheaval … – will all require more from all of us if we hope to meet them. The challenge of our generation is not behind us, it is only just beginning. I plan to continue doing something about it, and perhaps now you do as well. So stay informed, stay safe and be kind.”
Watson: “So much of nursing, I think to myself, seems obvious, and yet seeing that need in the first place is difficult and takes experience, training and something extra. … The mundanity of human existence is where I find the most beauty … It takes my breath away: how fragile, extraordinary and vulnerable, how full of hatred and love and obsession and complexity we all are – every single one of us.”
*I highly recommend all of folk artist Kris Drever’s latest album, Where the World Is Thin, but especially the song “Hunker Down / That Old Blitz Spirit,” which has become my lockdown anthem.
If you read just one, though… Make it The Courage to Care by Christie Watson.