Tag: infertility

Reading Ireland Month 2019: Nonfiction – Lynn Enright and Emilie Pine

It’s my second time participating in Reading Ireland Month, run each March by Cathy of 746 Books and Niall of Raging Fluff. For this week’s nonfiction theme, I’ve put together reviews of two hard-hitting feminist books I happen to have read recently.

 

Vagina: A Re-education by Lynn Enright (2019)

Sex education is poor and lacking in many parts of the world, Enright argues, including the Ireland she grew up in in the 1980s. We need better knowledge about gender, anatomy (including the range of what’s ‘normal’) and issues of consent, she insists. To that end, she sets out to bust myths about the hymen, clitoris, female orgasm, menstruation, gynecological problems, infertility, pregnancy and menopause. Her just-the-facts approach is especially helpful in her rundown of the female anatomy. She also encourages women not to take no for an answer from doctors who try to deny or minimize their pain.

This is a confident book sometimes marred by TMI (all in the name of openness and honesty, but still…) and repetitive writing. For me, there was too much overlap with other books I’ve read over the last five years or so: Vagina: A New Biography by Naomi Wolf, The Wonder Down Under: A user’s guide to the vagina by two female Norwegian medical students, Gross Anatomy by Mara Altman (waxing), Notes to Self by Emilie Pine (see below! rape, menstruation and infertility) and the upcoming Constellations by Sinéad Gleeson (women’s pain). Thus, after about page 50 I just skimmed this one. If you haven’t read anything like Vagina before, though, it would serve as a wonderfully comprehensive introduction.

Some favorite lines:

“With vaginas, it seems, we doubt what we know. With vaginas, we listen to the lies, more than we listen to the truth. … We perpetuate the unsureness with our silences – and with our acceptance of lies.”

“Pregnancy, abortion, miscarriage and birth are common but extraordinary – each story is unique. Women benefit when those stories are told – and listened to.”

My rating:


With thanks to Allen & Unwin for the free copy for review.

 

Notes to Self: Essays by Emilie Pine (2018)

Originally released by Ireland’s Tramp Press, this won the An Post Irish Book Award and has now been re-released by Penguin and other major publishers. You expect the average essay collection to contain 10 or 12 pieces, so the fact that there are only six here accounts for why they drag at a certain point. While I think most could be made snappier, they remain bold, accessible feminist takes on the body and expectations for women’s lives.

I especially liked “Notes on Intemperance,” the first essay, about her alcoholic father’s health crisis and the poor chances of him getting adequate treatment on Corfu, where he lived. She had to beg his nurses to wear gloves. When she learned that staff had to buy such disposables out of their own salaries, she understood – but was still appalled. Just being there was a miracle given there was no love lost between father and daughter.

Other essays are about infertility, the early breakdown of their parents’ marriage, menstruation and body hair, her wild teenage years and being raped, and the working woman’s constant struggle to be ambitious yet vulnerable without coming across as bitchy or oversensitive. The writing style is not flashy, but it doesn’t need to be. This is relatable straight talk, like you might get if you were to sit down with girlfriends of various backgrounds and experiences and actually discuss things that matter.

 A favorite passage:

 “It is hard to love an addict. Not only practically difficult, in the picking up after them and the handling of those aspects of life they’re not able [to] for themselves, but metaphysically hard. It feels like bashing yourself against a wall, not just your head, but your whole self. It makes your heart hard. … It took years of refusing him empathy before I realised that the only person I was hurting was myself.”

 My rating:


I read an e-copy via NetGalley.

 

I’ve also started a travel classic by Dervla Murphy, Full Tilt: Ireland to India with a Bicycle (1965), but travel books are such slow reads for me that I’ll likely be working on this one for months. Where I’ve got to now, she’s between Tehran and Afghanistan and nursing a bad sunburn. Already she’s eternally grateful that she brought a gun with her: she’s used it once to fend off wolves, once to deter a would-be rapist, and once to prevent bike thieves. Exciting stuff!

Advertisements

Childless Voices by Lorna Gibb

People end up not having children for any number of reasons: medical issues, bereavement, a lack of finances, not having a partner at the right time, or the simple decision not to become a parent. The subtitle of Lorna Gibb’s Childless Voices acknowledges these various routes: “Stories of Longing, Loss, Resistance and Choice.”

For Gibb, a university lecturer, biographer and novelist, the childless state was involuntary, a result of severe endometriosis that led to infertility and early menopause. Although this has been a source of sadness for her and her husband, she knows that she has it easy compared to women in other parts of the world. Through her research and Skype interviews, she hears horrific stories about infertile women who meet with domestic violence and social ostracism and are sometimes driven to suicide. In Ghana childless women can be branded as witches and exiled. Meanwhile, some are never given the chance to have the children they might long for: Gibb cites China’s one-child policy, female genital mutilation, and enforced sterilization programs like those of the Roma in Yugoslavia and the Quechua in Peru.

Gibb is admirably comprehensive here, considering every possible aspect of childlessness. Particularly interesting are the different cultural adaptations childless women make. Certain countries allow polygamy, giving a second wife a chance to bear children on behalf of an infertile one; Kenya and other parts of sub-Saharan Africa recognize ‘marriages’ between childless women so they can create a family and support system. In Albania being a “sworn virgin” is an old and venerable custom. And, of course, there are any number of support groups and online communities. The situation of those who were once parents but are no longer is especially wrenching. Stillbirth only started to be talked about in the 1980s, Gibb notes, but even today is seen as a lesser loss than that of a child who dies later in life.

The author believes there is societal injustice in terms of who has access to fertility treatment and how the state deals with childless people. In the UK, she characterizes IVF as a “postcode lottery”: where you live often determines how many free cycles you’re entitled to on the NHS. In the USA, meanwhile, fertility treatment is so expensive that only those with a certain level of wealth can consider it. The childless may also feel ‘punished’ by tax breaks that favor parents and workplaces that expect non-parents to work unsociable hours. In a sense, then, the childless contribute more but benefit less.

Chosen childlessness is perhaps given short shrift at just 32 pages out of 239. However, it’s still a very thorough treatment of the reasons why couples decide not to become parents, including cultural norms, career goals, self-knowledge and environmental concerns. No surprise that this was the chapter that resonated with me the most. I also especially enjoyed the personal interludes (all titled “A Short Note on…”) in which Gibb celebrates her feminist, childless heroes like Frida Kahlo and Anaïs Nin and writes about how much becoming a godmother meant to her but also of the sadness of seeing a good friend’s teenage son die of a brain tumor.

By coincidence, I’ve recently read another book on the same topic: Do You Have Kids? Life when the Answer Is No, by Kate Kaufmann (coming out in America next month). Gibb primarily traces the many different reasons for childlessness; Kaufmann mostly addresses the question of “now what?” – how women without children approach careers, wider family life, housing options, spirituality and the notion of leaving a legacy. Gibb’s approach is international and comparative, while Kaufmann’s is largely specific to the USA. Though the two authors are childless due to endometriosis and infertility, they feel sisterhood with women who never became mothers for whatever reason. I’d say these two books are complementary rather than rivals, and reveal valuable perspectives that can sometimes be overlooked.

My rating:

 

Childless Voices was published by Granta on February 7th. My thanks to the publisher for the free copy for review.

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 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: Stay with Me by Ayobami Adebayo

“Women manufacture children and if you can’t you are just a man. Nobody should call you a woman.”

On balance, I’m glad that the Wellcome Book Prize shortlist reading forced me to go back and give Stay with Me another try. Last year I read the first 15% of this debut novel for a potential BookBrowse review but got bored with the voice and the story, rather unfairly dismissing it as a rip-off of Chimamanda Ngozi Adichie. I also doubted that the health theme was strong enough for it to make the Wellcome shortlist, but that’s because I hadn’t read far enough to realize just how many medical conditions come up for consideration: it’s not just infertility, but also false pregnancy, cot death (or SIDS), sickle cell disease, and impotence.

This time around I found Yejide a more sympathetic character. The words that open this review are cruel ones spoken by her mother-in-law. Her desperation to become and stay a mother drives her to extreme measures that also give a window onto indigenous religion in Nigeria: ‘breastfeeding’ a goat on the Mountain of Jaw-Dropping Miracles, and allowing an act of ritual scarification to prevent the return of an abiku, or spirit child (I’ve heard that one narrates Ben Okri’s Booker Prize-winning 1991 novel, The Famished Road).

Polygamy is another Nigerian custom addressed in the novel. Yejide’s husband, Akinyele Ajayi, allows himself to be talked into taking another wife, Funmilayo, when Yejide hasn’t produced a child after four years. There’s irony in the fact that polygyny is considered a valid route to pregnancy while polyandry is not, and traditional versus Western values are contrasted in the different generations’ reactions to polygamy: does it equate to adultery?

There are some welcome flashes of humor in the novel, such as when Yejide deliberately serves a soup made with three-day-old beans and Funmi gets explosive diarrhea. I also enjoyed the ladies’ gossip at Yejide’s hair salon. However, the story line tends towards the soap operatic, and well before halfway it starts to feel like just one thing after another: A lot happens, but to no apparent purpose. I was unconvinced by the choices the author made in terms of narration (split between Yejide and Akin, both in first person but with some second person address to each other) and structure (divided between 2008 and the main action starting in the 1980s). We see certain scenes from both spouses’ perspective, but that doubling doesn’t add anything to the overall picture. The writing is by turns maudlin (“each minute pregnant with hope, each second tremulous with tragedy”) and uncolloquial (“afraid that my touch might … careen him into the unknown”).

Things that at first seemed insignificant to me – the 1993 election results, what happens to Funmi, the one major scene set in 2008 – do eventually take on more meaning, and there is a nice twist partway through as well as a lovely surprise at the end. I did feel the ache of the title phrase as it applies to this couple’s children and marriage, so threatened by “all the mess of love and life that only shows up as you go along.” It all makes for truly effortless reading that I gobbled up in chunks of 50 or 100 pages – which indicates authorial skill, of course – yet this seems to me a novel more interesting for the issues it addresses than for its story and writing.

My rating:

 

See also:

Clare’s review

 

My gut feeling: I would be very surprised if a novel won two years in a row. While the medical situations examined here are fairly wrenching, Stay with Me isn’t strong enough to win. Its appearance on the shortlist (for the Women’s Prize, too) is honor enough, I think.

 

Shortlist strategy:

  • I’m one-third through The Vaccine Race by Meredith Wadman but have started skimming because it’s dense and not quite as laymen-friendly as The Immortal Life of Henrietta Lacks and The Emperor of All Maladies, the two books its subject matter is most reminiscent of for me.
  • On Friday I started To Be a Machine by Mark O’Connell, which I’m also one-third through and have taken away on our mini-holiday. This is the shortlisted book whose topic appealed to me the least, so I’m pleasantly surprised to be enjoying it so much. It helps that O’Connell comes at the science as an outsider – he’s a freelance writer with a literature background, and he’s interested in the deeper philosophical questions that transhumanism raises.
  • I’m awaiting a review copy of Mayhem by Sigrid Rausing, which I’ll be featuring as part of the official Wellcome Book Prize shortlist blog tour.