The Language of Kindness: A Nurse’s Story by Christie Watson
After all that Wellcome Book Prize reading, I’ve given myself a break from the medical reads, right? No way! I’m already eagerly looking out for hopefuls for next year’s prize – I’ve amassed quite a nice little pile – and this is a particularly strong candidate, based on the 20 years that Watson spent as a nurse in England’s health system before leaving to write full-time. (Her debut, Tiny Sunbirds Far Away, won the Costa First Novel Award in 2011; she followed it up with Where Women Are Kings in 2013.) It taps into the widespread feeling that medicine is in desperate need of a good dose of compassion, and will ring true for anyone who spends time in hospitals, whether as a patient or a carer.
Watson presents her book as a roughly chronological tour through the stages of nursing – from pediatrics through to elderly care and the tending to dead bodies – but also through her own career, as she grows from a seventeen-year-old trainee who’s squeamish about blood to a broadly experienced nurse who can hardly be fazed by anything. The first chapter is set up like a tour of the hospital, describing everything she sees and hears as she makes her way up to her office, and the final chapter takes place on her very last day as a nurse, when, faced with a laboring mother in a taxi, she has to deliver the baby right there in the carpark.
In between we hear a series of vivid stories that veer between heartwarming and desperately sad. Watson sees children given a second shot at life. Aaron gets a heart–lung transplant to treat his cystic fibrosis and two-year-old Charlotte bounces back from sepsis – though with prosthetic limbs. But she also sees the ones who won’t get better: Tia, a little girl with a brain tumor; Mahesh, who has muscular dystrophy and relies on a breathing tube; and Jasmin, who is brought to the hospital after a house fire but doesn’t survive for long. She dies in the nurses’ arms as they’re washing the smoke smell out of her hair.
Although Watson specialized in children’s intensive care nursing, she trained in all branches of nursing, so we follow her into the delivery room, mental health ward, and operating theatre. As in Maggie O’Farrell’s I Am, I Am, I Am, we learn about her links to hospitals over the years, starting with her memories of being nursed as a child. She met her former partner, a consultant, at the hospital; they had a child together and adopted another before splitting 12 years later. And as her father was dying of lung cancer, she developed a new appreciation for what nurses do as she observed the dedicated care he received from his hospice nurse. She characterizes nursing as a career that requires great energy, skill and emotional intelligence, “that demands a chunk of your soul on a daily basis,” yet is all too often undervalued.

(The superior American cover.)
For me the weakest sections of Watson’s book are the snippets of history about hospitals and the development of the theory and philosophy of nursing. These insertions feel a little awkward and break up the flow of personal disclosure. The same applies to the occasional parenthetical phrase that seems to talk down to the reader, such as “women now receive medical help (IVF) to have their babies” and “obstetricians (doctors) run the show.” Footnotes or endnotes connected to a short glossary might have been a less obtrusive way of adding such explanatory information.
I would particularly recommend this memoir to readers of Kathryn Mannix’s With the End in Mind and Henry Marsh’s Admissions. But with its message of empathy for suffering and vulnerable humanity, it’s a book that anyone and everyone should read. I have it on good authority that there has recently been a copy on the desk of Jeremy Hunt, Health Secretary of the UK, which seems like an awfully good start.
A few favorite passages:
“I wanted to live many lives, to experience different ways of living. I didn’t know then that I would find exactly what I searched for: that both nursing and writing are about stepping into other shoes all the time.”
“What I thought nursing involved when I started: chemistry, biology, physics, pharmacology and anatomy. And what I now know to be the truth of nursing: philosophy, psychology, art, ethics and politics.”
“You get used to all sorts of smells, as a nurse. [An amazingly graphic passage!] But for all that I’ve seen and touched and smelled, and as difficult as it is at the time, there is a patient at the centre of it, afraid and embarrassed. … The horror of our bodies – our humanity, our flesh and blood – is something nurses must bear, lest the patient think too deeply, remember the lack of dignity that makes us all vulnerable. It is our vulnerability that unites us. Promoting dignity in the face of illness is one of the best gifts a nurse can give.”
My rating:
The Language of Kindness was published in the UK on May 3rd by Chatto & Windus. My thanks to the publisher for the free review copy. It is released today, May 8th, by Doubleday Canada and Tim Duggan Books in the States.
Thoughts on the Wellcome Book Prize Longlist
The 2018 Wellcome Book Prize longlist is here! From the prize’s website, you can click on any of these 12 books’ covers, titles or authors to get more information about them.
Some initial thoughts:
I correctly predicted three of the entries (or 25%) in yesterday’s post: In Pursuit of Memory by Joseph Jebelli, With the End in Mind by Kathryn Mannix, and I Am, I Am, I Am by Maggie O’Farrell. I’m pretty shocked to not see Fragile Lives or Admissions on the list.
Of the remainder, I’ve already read one (Midwinter Break) and DNFed another (Stay with Me). Midwinter Break didn’t immediately suggest itself to me for this prize because its themes of ageing and alcoholism are the background to a story about the disintegration of a long marriage. Nonetheless, it’s a lovely book that hasn’t gotten as much attention as it deserves – it was on my runners-up list from last year – so I’m delighted to see it nominated. Stay with Me was also on the Women’s Prize shortlist; it appears here for its infertility theme, but I wouldn’t attempt it again unless it made the Wellcome shortlist.
As to the rest:
- I’m annoyed with myself for not remembering The Butchering Art, which I have on my Kindle. Sometimes I assume that books I’ve gotten from NetGalley are USA-only and don’t check for a UK publisher. I plan to read this and With the End in Mind (also on my Kindle) soon.
- I already knew about and was interested in Mayhem and The White Book.
- Of the ones I didn’t know about, Plot 29 appeals to me the most. I’m off to get it from the library this very afternoon, in fact. Its health theme seems quite subtle: it’s about a devoted gardener ‘digging’ into his past in an abusive family and foster care. The Guardian review describes it thus: “Like Helen Macdonald’s H Is for Hawk, this is a profoundly moving account of mental trauma told through the author’s encounters with nature. Jenkins sees his garden as a place where a person can try to escape from, and atone for, the darkness of human existence.” This is the great thing about prize lists: they can introduce you to fascinating books you might never have heard of otherwise. Even if it’s just one book that takes your fancy, who knows? It might end up being a favorite.
- While I’m not immediately drawn to the books on the history of vaccines, the evolution of human behavior, and transhumanism, I will certainly be glad to read them if they make the shortlist.
Some statistics on this year’s longlist, courtesy of the press release I was sent by e-mail:
- Three novels, three memoirs, and six nonfiction titles
- Five debut authors
- Three titles from independent publishers (Canongate and Granta/Portobello Books)
- The authors are from the UK, Ireland, USA, Nigeria, Canada, and – making their first appearance – Sweden (Sigrid Rausing) and South Korea (Han Kang)
Chair of judges Edmund de Waal writes: “The Wellcome Book Prize is unique in its reach across genres, and so the range of books that we have considered has been exhilarating in its extent and ambition. This is a remarkable time for readers, with a great flourishing of writing on ideas around science, medicine and health, lives and deaths, histories and futures. After passionate discussions we have arrived at our longlist for the Wellcome Book Prize 2018 and are proud to be part of this process of bringing to a wider public these 12 tremendous books that have moved, intrigued and inspired us. All of them bring something new to our understanding of what it is to be human.”
The shortlist is announced on Tuesday, March 20th, and the winner will be revealed on Monday, April 30th.
Are there any books on here that you’d like to read?
Brain vs. Heart Surgery: Admissions and Fragile Lives
It’s never too early to start thinking about which books might make it onto next year’s Wellcome Book Prize nominees list, open to any medical-themed books published in the UK in calendar year 2017. I’ve already read some cracking contenders, including these two memoirs from British surgeons.
Brain surgeon Henry Marsh’s first book, Do No Harm, was one of my favorite reads of 2015. In short, enthrallingly detailed chapters named after conditions he had treated or observed, he reflected on life as a surgeon, expressing sorrow over botched operations and marveling at the God-like power he wields over people’s quality of life. That first memoir saw him approaching retirement age and nearing the end of his tether with NHS bureaucracy.
Admissions: A Life in Brain Surgery serves as a sort of sequel, recording Marsh’s last few weeks at his London hospital and the projects that have driven him during his first years of retirement: woodworking, renovating a derelict lock-keeper’s cottage by the canal in Oxford, and yet more neurosurgery on medical missions to Nepal and the Ukraine. But he also ranges widely over his past, recalling cases from his early years in medicine as well as from recent memory, and describing his schooling and his parents. If I were being unkind, I might say that this feels like a collection of leftover incidents from the previous book project.
However, the life of a brain surgeon is so undeniably exciting that, even if these stories are the scraps, they are delicious ones. The title has a double meaning, of course, referring not only to the patients who are admitted to the hospital but also to a surgeon’s confessions. And there are certainly many cases Marsh regrets, including operating on the wrong side in a trapped nerve patient, failing to spot that a patient was on the verge of a diabetic coma before surgery, and a young woman going blind after an operation in the Ukraine. Often there is no clear right decision, though; operating or not operating could lead to equal damage.
Once again I was struck by Marsh’s trenchant humor: he recognizes the absurdities as well as the injustices of life. In Houston he taught on a neurosurgery workshop in which students created and then treated aneurysms in live pigs. When asked “Professor, can you give us some surgical pearls?” he “thought a little apologetically of the swine in the nearby bay undergoing surgery.” A year or so later, discussing the case of a twenty-two-year-old with a fractured spine, he bitterly says, “Christopher Reeve was a millionaire and lived in America and he eventually died from complications, so what chance a poor peasant in Nepal?”
Although some slightly odd structural decisions have gone into this book – the narrative keeps jumping back to Nepal and the Ukraine, and a late chapter called “Memory” is particularly scattered in focus – I still thoroughly enjoyed reading more of Marsh’s anecdotes. The final chapter is suitably melancholy, with its sense of winding down capturing not just the somewhat slower pace of his retired life but also his awareness of the inevitable approach of death. Recalling two particularly hideous deaths he observed in his first years as a doctor, he lends theoretical approval for euthanasia as a way of maintaining dignity until the end.
What I most admire about Marsh’s writing is how he blends realism and wonder. “When my brain dies, ‘I’ will die. ‘I’ am a transient electrochemical dance, made of myriad bits of information,” he recognizes. But that doesn’t deter him from producing lyrical passages like this one: “The white corpus callosum came into view at the floor of the chasm, like a white beach between two cliffs. Running along it, like two rivers, were the anterior cerebral arteries, one on other side, bright red, pulsing gently with the heartbeat.” I highly recommend his work to readers of Atul Gawande and Paul Kalanithi.
My rating:
Admissions: A Life in Brain Surgery was published in the UK by Weidenfeld & Nicolson on May 4th. My thanks to the publisher for sending a free copy for review. It will be published in the USA by Thomas Dunne Books on October 3rd.
What Marsh does for brain surgery in his pair of memoirs, Professor Stephen Westaby does for heart surgery in Fragile Lives, a vivid, compassionate set of stories culled from his long career. A working class lad from Scunthorpe who watched his grandfather die of heart failure, he made his way up from hospital porter to world-leading surgeon after training at Charing Cross Hospital Medical School.
Each of these case studies, from a young African mother and her sick child whom he met while working in Saudi Arabia in the 1980s to a university student who collapses not far from his hospital in Oxford, is told in impressive depth. Although the surgery details are not for the squeamish, I found them riveting. Westaby conveys a keen sense of the adrenaline rush a surgeon gets while operating with the Grim Reaper looking on. I am not a little envious of all that he has achieved: not just saving the occasional life despite his high-mortality field – as if that weren’t enough – but also pioneering various artificial heart solutions and a tracheal bypass tube that’s named after him.
Like Marsh, he tries not to get emotionally attached to his patients, but often fails in this respect. “Surgeons are meant to be objective, not human,” he shrugs. But, also like Marsh, at his retirement he feels that NHS bureaucracy has tied his hands, denying necessary funds and equipment. Both authors come across as mavericks who don’t play by the rules, but save lives anyway. This is a fascinating read for anyone who enjoys books on a medical theme.
A few favorite lines:
“We stop life and start it again, making things better, taking calculated risks.”
“We were adrenaline junkies living on a continuous high, craving action. From bleeding patients to cardiac arrests. From theatre to intensive care. From pub to party.”
My rating:
Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table was published in the UK by HarperCollins on February 9th. I read a public library copy. It will be published in the USA, by Basic Books, under the title Open Heart on June 20th.
Wellcome Prize Shortlist, Part 1: de Kerangal and Kalanithi
I’m delighted to announce the final members of our Wellcome Book Prize 2017 shadow panel:
Ruby blogs at My Booking Great Blog.
GrrlScientist is an ornithologist and science journalist who was on the judging panel for the 2016 Royal Society Insight Investment Science Book Prize.
Along with Paul and Amy, this brings us up to five people – the same number as the official judging panel.
Luckily, I’ve already read two of the shortlisted titles, one quite recently and one nearly a year and a half ago. Here are the reviews I published on Goodreads at the time. I’ll be getting both books back out of the library soon to have another look before we choose our winner.
Mend the Living by Maylis de Kerangal
(translated from the French by Jessica Moore; published in the USA as The Heart)
[This is the French author’s second novel to be translated into English. It has been made into a film and won the Prix Orange du Livre and the Grand prix RTL du livre. It was also recently shortlisted for the Albertine Prize, an American readers’ choice award for contemporary French fiction. If you’re based in the States, feel free to vote by April 30th!]
Nineteen-year-old Simon Limbeau is declared brain dead in a French hospital after a car accident, but his heart lives on: metaphorically through the love of his parents, sister, friends, and girlfriend; but also literally, in the recipient of his organ donation. Again and again de Kerangal makes a distinction between the physical reality of organs and what they represent: “Simon’s eyes are not just his nervous retina, his taffeta iris, his pupil of pure black in front of the crystalline – they are also his gaze; his skin isn’t just the threaded mesh of his epidermis, his porous cavities – it’s his light and his touch, the living sensors of his body.”
The novel spends time with Simon’s family, especially his mother, but also with the transplant coordinator, the surgeons, the nurse, and so on. I was reminded of ER as well as the French TV show The Returned – this would work really well on screen, and would be a way of avoiding the more off-putting aspects of the author’s style. She writes long, run-on sentences: sometimes half a page, sometimes even stretching to two pages, and stuffs her prose with abstruse vocabulary (or at least that’s how the translator has rendered it), a lot of it medical but some of it simply inaccessible: “emollient conjugality” plus at least a dozen English words I’d never encountered (e.g. abulic, tumid, atony, claudicant, auscultation, precellence, torticollis, naevi, scialytic).
The worst example of the unnecessary opacity is “the digitigrade gait of the sardana dancer when he’s nearing a quintal, the corpulence of an ex-obese man calibrating him in thickness, in fullness, but without visible excrescence” – in plain English, the guy is stocky.
Read in November 2016.
My rating:
My gut feeling: The novel gives a vivid sense of the fragility of life and imbues parts of the body with metaphorical meaning. However, I think the style makes it too inaccessible and I can’t see its appeal ever being more than niche.
More reviews:
Annabel’s at Shiny New Books
Carolyn’s at Rosemary and Reading Glasses
When Breath Becomes Air by Paul Kalanithi
[The first posthumous nominee for the Wellcome Book Prize. I’ll be interested to see what I make of this one when I revisit it.]
Paul Kalanithi was 36 and just completing his neurosurgery residency in Stanford, California when he was diagnosed with advanced lung cancer that did not respond well to treatment. It came as a complete surprise to this non-smoker, and set his life on a new course. He and his coterie of doctors managed his symptoms so he could operate for as long as possible, but when the time came he knew he wanted to devote his last year to writing this memoir. In addition, he would get a brief, sweet taste of fatherhood: he and his wife Lucy, also in the medical field, decided to have a child, a daughter named Cady.
Kalanithi grew up the son of Indian immigrants in Arizona. “I was driven less by achievement than by trying to understand, in earnest: What makes human life meaningful?” he recalls. Degrees in English literature and human biology were disparate attempts to find an answer. Like Henry Marsh (Do No Harm), he has a surgeon’s knowledge of the anatomy of reasoning, but realizes that does not provide the full picture. He recognizes the responsibility of holding others’ lives in the balance, and regrets occasional failures of empathy.
Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.
It’s intriguing to see religious language in that statement – indeed, Kalanithi saw his work as a calling, and one with moral connotations. Christian imagery shows up repeatedly:
Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused.
Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can.
When’s the last time you encountered the word “narthex”?! The vocabulary is striking throughout, as in another favorite passage: “A tureen of tragedy was best allotted by the spoonful. Only a few patients demanded the whole at once; most needed time to digest.”
Kalanithi died in March 2015. In addition to the foreword by Abraham Verghese, there’s a lovely epilogue from his widow, who’s more than competent to carry on his legacy.
I appreciate stories lived on the knife edge of life and death, but I would recommend this to those who don’t normally choose to read illness narratives, simply for the beauty of its prose – a fine blend of literature and medicine – and the wholehearted picture of a life cut short.
Read in October 2015 (Random House were looking for early readers via NetGalley).
My rating:
My gut feeling: I suspect this is by far the most popular and best-selling title on this year’s shortlist. So many people have taken it to their hearts. It will take a truly special book to knock it from the top spot.
More reviews:
Shadow panelist Paul’s at Nudge
Shadow panelist Ruby’s at My Booking Great Blog
Susan’s at A life in books
Shortlist strategy:
Currently reading: The Tidal Zone by Sarah Moss – about halfway through.
Up next: Whichever of the remaining nonfiction titles turns up to the library for me first!
I’ve also sent off an emergency e-mail to Bodley Head asking for a copy of Ed Yong’s I Contain Multitudes; it’s on loan through my library system until April 19th, which gives me no time to read it even if it comes back on time.
My Favorite Nonfiction Reads of 2015
Without further ado, I present to you my 15 favorite non-fiction books read in 2015. I’m a memoir junkie so many of these fit under that broad heading, but I’ve dipped into other areas too. I give two favorites for each category, then count down my top 7 memoirs read this year.
Note: Only four of these were actually published in 2015; for the rest I’ve given the publication year. Many of them I’ve already previewed through the year, so – like I did yesterday for fiction – I’m limiting myself to two sentences per title: the first is a potted summary; the second tells you why you should read this book. (Links given to full reviews.)
Foodie Lit
A Homemade Life: Stories and Recipes from My Kitchen Table by Molly Wizenberg (2009): Wizenberg reflects on the death of her father Burg from cancer, time spent living in Paris, building a new life in Seattle, starting her food blog, and meeting her husband through it. Each brief autobiographical essay is perfectly formed and followed by a relevant recipe, capturing precisely how food is tied up with memories.
Comfort Me with Apples: More Adventures at the Table by Ruth Reichl (2001): Reichl traces the rise of American foodie culture in the 1970s–80s (Alice Waters and Wolfgang Puck) through her time as a food critic for the Los Angeles Times, also weaving in personal history – from a Berkeley co-op with her first husband to a home in the California hills with her second after affairs and a sticky divorce. Throughout she describes meals in mouth-watering detail, like this Thai dish: “The hot-pink soup was dotted with lacy green leaves of cilantro, like little bursts of breeze behind the heat. … I took another spoonful of soup and tasted citrus, as if lemons had once gone gliding through and left their ghosts behind.”
Nature Books
Meadowland: The Private Life of an English Field by John Lewis-Stempel (2014): Lewis-Stempel is a proper third-generation Herefordshire farmer, but also a naturalist with a poet’s eye. Magical moments and lovely prose, as in “The dew, trapped in the webs of countless money spiders, has skeined the entire field in tiny silken pocket squares, gnomes’ handkerchiefs dropped in the sward.”
Landmarks by Robert Macfarlane: This new classic of nature writing zeroes in on the language we use to talk about our environment, both individual words – which Macfarlane celebrates in nine mini-glossaries alternating with the prose chapters – and the narratives we build around places, via discussions of the work of nature writers he admires. Whether poetic (“heavengravel,” Gerard Manley Hopkins’s term for hailstones), local and folksy (“wonty-tump,” a Herefordshire word for a molehill), or onomatopoeic (on Exmoor, “zwer” is the sound of partridges taking off), his vocabulary words are a treasure trove.
Theology Books
Amazing Grace: A Vocabulary of Faith by Kathleen Norris (1998): In few-page essays, Norris gives theological words and phrases a rich, jargon-free backstory through anecdote, scripture and lived philosophy. This makes the shortlist of books I would hand to skeptics to show them there might be something to this Christianity nonsense after all.
My Bright Abyss: Meditation of a Modern Believer by Christian Wiman (2013): Seven years into a cancer journey, Wiman, a poet, gives an intimate picture of faith and doubt as he has lived with them in the shadow of death. Nearly every page has a passage that cuts right to the quick of what it means to be human and in interaction with other people and the divine.
General Nonfiction
Penelope Fitzgerald: A Life by Hermione Lee (2013): Although Penelope Fitzgerald always guarded literary ambitions, she was not able to pursue her writing wholeheartedly until she had reared three children and nursed her hapless husband through his last illness. This is a thorough and sympathetic appreciation of an underrated author, and another marvellously detailed biography from Lee.
Being Mortal: Medicine and What Matters in the End by Atul Gawande (2014): A surgeon’s essential guide to decision-making about end-of-life care, but also a more philosophical treatment of the question of what makes life worth living: When should we extend life, and when should we concentrate more on the quality of our remaining days than their quantity? The title condition applies to all, so this is a book everyone should read.
Memoirs
The Year My Mother Came Back by Alice Eve Cohen: Wry and heartfelt, this is a wonderful memoir about motherhood in all its variations and complexities; the magic realism (Cohen’s dead mother keeps showing up) is an added delight. I recommend this no matter what sort of relationship, past or present, you have with your mother, especially if you’re also a fan of Anne Lamott and Abigail Thomas.
- The Art of Memoir
by Mary Karr: There is a wealth of practical advice here, on topics such as choosing the right carnal details (not sexual – or not only sexual – but physicality generally), correcting facts and misconceptions, figuring out a structure, and settling on your voice. Karr has been teaching (and writing) memoirs at Syracuse University for years now, so she’s thought deeply about what makes them work, and sets her theories out clearly for readers at any level of familiarity.
A Circle of Quiet by Madeleine L’Engle (1971): In this account of a summer spent at her family’s Connecticut farmhouse, L’Engle muses on theology, purpose, children’s education, the writing life, the difference between creating stories for children and adults, neighbors and fitting into a community, and much besides. If, like me, you only knew L’Engle through her Wrinkle in Time children’s series, this journal should come as a revelation.
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Do No Harm: Stories of Life, Death and Brain Surgery by Henry Marsh (2014): “Terrible job, neurosurgery. Don’t do it.” – luckily for us, Henry Marsh reports back from the frontlines of brain surgery so we don’t have to. In my favorite passages, Marsh reflects on the mind-blowing fact that the few pounds of tissue stored in our heads could be the site of our consciousness, our creativity, our personhood – everything we traditionally count as the soul.
I Hate to Leave This Beautiful Place by Howard Norman (2013): Norman has quickly become one of my favorite writers. You wouldn’t think these disparate autobiographical essays would fit together as a whole, given that they range in subject from Inuit folktales and birdwatching to a murder–suicide committed in Norman’s Washington, D.C. home and a girlfriend’s death in a plane crash, but somehow they do; after all, “A whole world of impudent detours, unbridled perplexities, degrading sorrow, and exacting joys can befall a person in a single season, not to mention a lifetime.”
Portrait of an Addict as a Young Man by Bill Clegg (2010): Through this book I followed literary agent Bill Clegg on dozens of taxi rides between generic hotel rooms and bar toilets and New York City offices and apartments; together we smoked innumerable crack pipes and guzzled dozens of bottles of vodka while letting partners and family members down and spiraling further down into paranoia and squalor. He achieves a perfect balance between his feelings at the time – being out of control and utterly enslaved to his next hit – and the hindsight that allows him to see what a pathetic figure he was becoming.
And my overall favorite nonfiction book of the year:
1. The Light of the World by Elizabeth Alexander: In short vignettes, beginning afresh with every chapter, Alexander conjures up the life she lived with – and after the sudden death of – her husband Ficre Ghebreyesus, an Eritrean chef and painter. This book is the most wonderful love letter you could imagine, and no less beautiful for its bittersweet nature.
What were some of your best nonfiction reads of the year?