Intricate essays about writing in the wake of trauma, a feel-good novel about an odd couple on a trip to France, hilarious festive outtakes from a career in medicine, and a race-themed family memoir: I have four very different books to recommend to you this month. All:
Notes Made while Falling by Jenn Ashworth
(Coming from Goldsmiths Press [UK] on the 15th; already out from MIT Press [USA])
Like Anne Boyer’s The Undying and Sinéad Gleeson’s Constellations, this is an incisive memoir-in-essays about the effects of trauma on a woman’s body. Specifically, Ashworth’s story starts with her son’s birth in 2010, a disaster she keeps returning to over the course of seven sinuous personal essays. A routine C-section was followed by haemorrhaging, blood transfusions and anaphylaxis. The effects lasted for years afterwards: haunted by the sound of her blood dripping and the feeling that her organs could fall out of her abdomen at any time, she suffered from vomiting, insomnia and alcoholism, drinking late into the night as she watched gruesome true crime films.
Ashworth toggles between experience, memory, and the transformation of experience into a written record. She admits she has lost faith in fiction, either reading or writing it (she is a lecturer at Lancaster University and the author of four novels). Her Mormon upbringing in Preston is a major part of her backstory, and along with her childhood indoctrination she remembers brief stays in a children’s home and in the hospital with chicken pox.
The essays experiment with structure and content. For instance, “Ground Zero” counts down from #8, with incomplete final lines in each section, then back up to #8, with each piece from the second set picking up where the first left off. Slashes and cross-outs represent rethinking or alternate interpretations. “Off Topic: On Derailment” encompasses so many topics, from excommunication to Agatha Christie to rollercoasters to Charles Dickens, that you have to read it to believe she can make it all fit together (elsewhere she muses on Chernobyl, magic tricks and hating King Lear).
“How to Begin: The Cut” started as a talk given at Greenbelt 2013, when I was in the audience. I especially loved “A Lecture on Influence,” a coy self-examination through creative writing lessons, and “How to Fall without Landing: Celestial City,” a meditation on the precariousness of the human condition. Her frame of literary reference is wide and surprising. This also reminded me of Sight by Jessie Greengrass, The Empathy Exams by Leslie Jamison, I Am, I Am, I Am by Maggie O’Farrell, and In the Days of Rain by Rebecca Stott; I would recommend it to readers of any of the above.
Some favorite lines:
“My God-hurt head has a hole in it or needs one; to let the world in, or out – I can’t ever decide.”
“how to write about everything? How to take in the things that don’t belong to you without being poisoned by them? How to make use of the things that live inside, those seedlings you never asked for? How to breathe in? How to breathe out? How to keep on doing that?”
“Some days it feels like writing truthfully about her own life is the most subversive thing a woman can do.”
My thanks to the publisher for the free copy for review.
Akin by Emma Donoghue
(Coming from Picador [UK] on the 3rd; already out from Little, Brown and Co. [USA])
I’ve read Donoghue’s six most recent works of fiction. Her books are all so different from each other in setting – a one-room prison in contemporary America, bawdy 1870s San Francisco, rural Ireland in the 1850s – that it’s hard to pin her down to one time period or roster of topics. She never writes the same book twice, and that’s got to be a good thing.
Akin gets off to a slightly slow start but soon had me hooked. Noah Selvaggio, a childless widower and retired chemist in New York City, is looking forward to an imminent trip to Nice, where he was born, to celebrate his 80th birthday. He never guessed that he’d have company on his trip, much less a surly 11-year-old. This is Michael Young, his nephew Victor’s son. Victor died of a drug overdose a year and a half ago; the boy’s mother is in prison; his maternal grandmother has just died. There’s no one else to look after Michael, so with a rush passport he’s added to the itinerary.
In some ways Michael reminded me of my nephews, ages 11 and 14: the monosyllabic replies, the addiction to devices and online gaming, the finicky eating, and the occasional flashes of childlike exuberance. Having never raised a child, Noah has no idea how strict to be with his great-nephew about screen time, unhealthy food and bad language. He has to learn to pick his battles, or every moment of this long-awaited homecoming trip would be a misery. And he soon realizes that Michael’s broken home and troubled area of NYC make him simultaneously tougher and more vulnerable than your average kid.
The odd-couple dynamic works perfectly here and makes for many amusing culture clashes, not so much France vs. the USA as between these Americans of different generations. The dialogue, especially, made me laugh. Donoghue nails it:
[Noah:] “The genre, the style. Is rap the right word for it? Or hip-hop?”
[Michael:] “Don’t even try.” Michael turned his music back on.
(At the cathedral)
[Michael:] “This is some seriously frilly shit.”
[Noah:] “It’s called Baroque style.”
[Michael:] “I call it fugly.”
But there’s another dimension to the novel that keeps it from being pleasant but forgettable. Noah’s grandfather was a famous (fictional) photographer, Père Sonne, and he has recently found a peculiar set of photographs left behind by his late mother, Margot. One is of the hotel where they’re staying in Nice, known to be a holding tank for Jews before they were sent off to concentration camps. The more Noah looks into it, the more he is convinced that his mother was involved in some way – but which side was she on?
This is feel-good fiction in the best possible sense: sharp, true-to-life and never sappy. With its spot-on dialogue and vivid scenes, I can easily see it being made into a movie, too. It’s one of my favorite novels of the year so far.
My thanks to the publisher for the proof copy for review.
Twas the Nightshift before Christmas by Adam Kay
(Coming from Picador on the 17th)
If you’ve read This Is Going to Hurt, the UK’s bestselling nonfiction title of 2018, you’ll know just what to expect from the comedian’s holiday-themed follow-up. It’s raunchy, morbid and laugh-out-loud funny. In the seven years that Kay was a medical doctor, he had to work on Christmas Day six times. He takes us through the holiday seasons of 2004 to 2009, from the sickeningly festive run-up to the letdown of Christmas day and its aftermath. With his Rudolph tie on and his Scrooge spirit intact, he attends to genital oddities, childbirth crises and infertility clients, and feebly tries to keep up his relationships with his family and his partner despite them having about given up on him after so many holiday absences.
This will be a stocking-stuffer for many this year, and I can see myself returning to it year after year and flicking through for a laugh. However, there’s one story here that Kay regrets omitting from This Is Going to Hurt as being too upsetting, and he also ends on a serious note, urging readers to spare a thought for those who give up their holidays to keep our hospitals staffed.
A favorite passage:
“A lot of the reward for this job comes in the form of a warm glow. It doesn’t make you look any less tired, you can’t pay the rent with it, and it’s worth a lot less than the social life you’ve traded it for, but this comforting aura of goodness and purpose definitely throws light into some dark corners and helps you withstand a lot of the shit.”
My thanks to the publisher for the proof copy for review.
Shame on Me: An Anatomy of Race and Belonging by Tessa McWatt
(Coming from Scribe UK on the 10th)
“What are you?” This question has followed McWatt since she was eight years old. When her third-grade teacher asked the class if they knew what “Negro” meant, one boy pointed to her. “Oh, no, not Tessa,” the teacher replied, following up with a question: “What are you, Tessa?” But it has always been hard to put her mixed-race background into one word. Her family moved from Guyana to Canada and she has since settled in England, where she is a professor of creative writing; her ancestry is somewhat uncertain but may include Chinese, Indian, indigenous South American, Portuguese, French/Jewish, African, and Scottish.
The book opens with the startling scene of her grandmother, a young Chinese woman brought over to work the sugarcane fields of British Guiana, being raped by her own uncle. “To strangers, even friends—on some days also to myself—I am images of violence and oppression. I am the language of shame and destitution, of slavery and indenture, of rape and murder. I am images of power and privilege, of denial and shades of skin, shapes of faces,” McWatt writes.
Her investigation of the meaning of race takes the form of an academic paper, Hypothesis–Experiment–Analysis–Findings, and within the long third section she goes part by part through the bodily features that have most often been used as markers of racial identity, including the nose, eyes, hair and buttocks. She dives into family history but also into wider historical movements, literature and science to understand her hybrid self. It’s an inventive and sensitive work reminiscent of The Color of Water by James McBride. I would recommend it to anyone who enjoys reading (or feels they should try) interrogations of race.
A favorite line:
“as I try to square my politics with my privilege, it seems that my only true inheritance is that I am always running somewhere else.”
I won a signed proof copy in a Twitter giveaway.
Have you read any October releases that you would recommend? Do any of these tempt you?
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]
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.”
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 Argonauts, The Undying will … show you contemporary America as a thing both desperately ill and occasionally, perversely glorious.” (print review copy from publisher)
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.
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?
Where the Road Runs Out by Gaia Holmes (2018)
A gem of a poetry collection. Gaia Holmes is a creative writing tutor in Halifax, Yorkshire. This is her third volume of poetry. A major thread of the book is caring for her father at home and in the hospital as he was dying on the Orkney Islands – a time of both wonder and horror. It felt like she could never get anything right and kept angering him, as she recounts in “Feckless.” Even after his death, she continued to see him. I especially loved the food metaphors in “Kummerspeck” (a German term for emotional overeating; literally, “grief bacon”), where sweets, meat and salt cannot sate the cravings of ravenous grief.
Other themes include pre-smartphone life (“Before All This” – not everything needed to be documented, you could live where you were and not rely on others’ constant approval), the lengths women will go to impress men (“The Audition”), being the only childless person in a room (“Ballast”) and a marriage falling apart (“Your Orange Raincoat”). Also notable are a multi-part tribute to the Chilean miners trapped in 2010 and an imagined outbreak of violence between runners and ramblers. Holmes channels Anne Sexton in “Angel of the Checkout,” with its wonderful repeated line “do you know the price of love?”, and Mary Oliver in the first stanza of “Wild Pigeons.”
There are no rhymes, just alliteration and plays on words, with a lot of seaside imagery. I would highly recommend this to poetry lovers and newbies alike.
A favorite passage:
I have no manual
so I do what I think
you’re supposed to do
in this situation.
I light the stub
of last night’s candle,
utter something holy
at your bedside
with the unfamiliar taste
of the Lord’s Prayer
clinging to my lips.
(from “The Lord’s Prayer”)
My thanks to Comma Press for the free copy for review.
Drive Your Plow over the Bones of the Dead by Olga Tokarczuk (2009; English translation, 2018)
[Translated from the Polish by Antonia Lloyd-Jones]
What a bizarre novel! Janina Dusezjko is a delightfully twisted Miss Marple type who lives in a remote forest cabin in Poland, near the Czech border. She’s determined to learn the truth of what happened to her two beloved dogs, whom she calls her Little Girls. When four different men who were involved in local hunting – her unpleasant neighbor, a deer poacher whom she nicknamed Big Foot; a police commandant; a fox farm owner; and the president of the mushroom pickers’ association – are all found murdered, her theorizing runs wild. She believes the animals are taking revenge, and intends to use her astrology skills to glean more information about these untimely deaths. The police, meanwhile, dismiss her as a hysterical old crone.
The title comes from William Blake, whose writing is an undercurrent to the book: Dizzy, Janina’s former English pupil, is reading and translating Blake, and I reckon Janina’s nutty philosophy and capitalization of random words, especially abstractions, may be an homage to Blake. I probably missed some of the more intricate allusions, and my attention wandered for a while during the middle of the book, but this was an offbeat and mostly enjoyable read. I struggled with Flights, but I’m glad I tried Tokarczuk again.
A representative passage:
“We have this body of ours, a troublesome piece of luggage, we don’t really know anything about it and we need all sorts of Tools to find out about its most natural processes.”
My thanks to Fitzcarraldo Editions for the free copy for review.
Chicken Unga Fever: Stories from the Medical Frontline by Dr. Phil Whitaker (2018)
This is a selection of Whitaker’s “Health Matters” columns from the New Statesman magazine. In his time as a GP he’s seen his fair share of common and unusual illnesses, and has so honed his diagnosing skills that he can start to figure out what’s wrong based on how someone stands up and walks towards his office from the waiting room. That’s why he’s a “meeter” (calling names in person and escorting patients down the hallway) rather than a “buzzer” (waiting for them to come to him, having being called via a digital screen).
In digestible essays of 2.5 pages each, Whitaker discusses mental health sectioning, home visiting, the rise of technology and antibiotic resistance, the culture of complaint, zealous overscreening and overtreatment (he’d have an ally there in Barbara Ehrenreich: see her Natural Causes) and the tricky issue of getting consent from teenagers. He also recreates individual cases that have left an impression on him. When it comes to diagnoses, he recognizes that sometimes it’s a matter of luck – like when he landed on Cushing’s disease based on a rare combination of common symptoms – and that sometimes you have to admit you don’t know and turn to the Internet. That’s where the title comes from – an out-of-hours caller’s approximation of suspected chikungunya fever.
This is an enjoyable book for medically minded laymen to read a few pieces at a time, though I suspect its take on various issues could soon be outdated.
My thanks to Salt Publishing for the free copy for review.
This was the book I wanted Places I Stopped on the Way Home to be: a wry, bittersweet look at the unpredictability of life as an idealistic young woman in the world’s major cities. Edelstein’s memoir also fits into several of my favorite subgenres: it’s a family memoir, a medical memoir and a bereavement memoir all at once. The story opens in Brooklyn in February 2014 as Edelstein, age 32, is trying to build an adult life back in America after 14 years in London and Berlin. Two years earlier her father had told her via Skype from Baltimore that he had lung cancer, and she returned to the States to be closer to help. But when the moment came, she was still unprepared: “if someone had said to me: What would you like to be doing when your father dies? I would not have said, I would like to be looking for love on OKCupid. But I did not have the luxury to make that decision. Who does?”
Her father never smoked yet died of lung cancer; his mother had colon cancer and died at 42. Both had Lynch syndrome, a genetic disease that predisposes people to various cancers. Six months after her father’s death, Edelstein took a genetic test, as he had wanted her to, and learned that she was positive for the Lynch syndrome mutation. The book’s structure (“Between” – “Before” – “After”) plunges readers right into the middle of the family mess, then pulls back to survey her earlier life, everything from childhood holidays in her mother’s native Scotland to being a secretary to a London literary agent who hated her, before returning to the turning point of that diagnosis. How is she going to live with this knowledge hanging over her? Doctors want her to have a prophylactic hysterectomy, but how can she rule out children when she doesn’t yet have a partner in her life?
So many aspects of this book resonated for me, especially moving between countries and having a genetic disease in the family. Beyond those major themes, there were tiny moments that felt uncannily familiar to me, like when she’s helping her mother prepare for an online auction of the contents of the family home in Maryland, or comparing the average cleanliness and comfort of rental properties in England and the States. There are so many little memorable scenes in this memoir: having an allergic reaction to shellfish two days after her arrival in the States, getting locked out of her sublet and having to call an Uzbek/Israeli locksmith at 3 a.m., and subsisting on oatmeal three times a day in London versus going on all-expenses-paid trips to Estonia and Mauritius for a conference travel magazine.
This is a clear-eyed look at life in all its irony (such as the fact that she’s claustrophobic and dreads getting MRI tests when it was her own father, a nuclear physicist, who built the world’s first full-body MRI scanner at Aberdeen) and disappointment. I’m prizing this as a prime example of life writing that’s not comprehensive or strictly chronological yet gives a clear sense of the self in the context of a family and in the face of an uncertain future.
The Family Gene by Joselin Linder
My Salinger Year by Joanna Rakoff
Mrs Gaskell & Me by Nell Stevens
“when I was in London, … I wondered if the problem of having my whole life ahead of me, free and clear and open for anything, was that having an unlimited number of options made the chance of choosing the wrong thing so high.”
“I was not yet old enough to realize that I’d never really know, that there would never be a time when I could think: I am here. This is me, without becoming uncertain again a moment later.”
“When I lived in England I drank a lot of tea, many cups a day, even though I didn’t like it. I learned quite fast after I arrived in London that drinking tea was an important way to connect with people: when I went over to their homes, or if we worked together in an office. Being offered a cup of tea meant that you were being offered an entry to something, and accepting it was important.”
This Really Isn’t About You was published by Picador on August 23rd. My thanks to the publisher for the free copy for review.
Tomorrow the longlist for the 2018 Wellcome Book Prize will be announced. This year’s judging panel is chaired by Edmund de Waal, author of The Hare with Amber Eyes. I hope to once again shadow the shortlist along with a few fellow book bloggers. I don’t feel like I’ve read all that many books that are eligible (i.e., released in the UK in 2017, and on a medical theme), but here are some that I would love to see make the list. I link to all those I’ve already featured here, and give review extracts for the books I haven’t already mentioned.
- I Found My Tribe by Ruth Fitzmaurice
- In Pursuit of Memory: The Fight against Alzheimer’s by Joseph Jebelli
- Goodbye, Vitamin by Rachel Khong
- In Every Moment We Are Still Alive by Tom Malmquist
- Admissions: A Life in Brain Surgery by Henry Marsh
- I Am, I Am, I Am: Seventeen Brushes with Death by Maggie O’Farrell: O’Farrell captures fragments of her life through essays on life-threatening illnesses and other narrow escapes she’s experienced. The pieces aren’t in chronological order and aren’t intended to be comprehensive. Instead, they crystallize the fear and pain of particular moments in time, and are rendered with the detail you’d expect from her novels. She’s been mugged at machete point, nearly drowned several times, had a risky first labor, and was almost the victim of a serial killer. (My life feels awfully uneventful by comparison!) But the best section of the book is its final quarter: an essay about her childhood encephalitis and its lasting effects, followed by another about her daughter’s extreme allergies.
- The Smell of Fresh Rain: A Journey into the Sense of Smell by Barney Shaw
- Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table by Stephen Westaby
It’s also possible that we could see these make the longlist:
- History of Wolves by Emily Fridlund: Fridlund’s Minnesota-set debut novel is haunted by a dead child. From the second page readers know four-year-old Paul is dead; a trial is also mentioned early on, but not until halfway does Madeline Furston divulge how her charge died. This becomes a familiar narrative pattern: careful withholding followed by tossed-off revelations that muddy the question of complicity. The novel’s simplicity is deceptive; it’s not merely a slow-building coming-of-age story with Paul’s untimely death at its climax. For after a first part entitled “Science”, there’s still half the book to go – a second section of equal length, somewhat ironically labeled “Health”. (Reviewed for the TLS.)
- Hair Everywhere by Tea Tulić
- Modern Death: How Medicine Changed the End of Life by Haider Warraich: A learned but engaging book that intersperses science, history, medicine and personal stories. The first half is about death as a medical reality, while the second focuses on social aspects of death: religious beliefs, the burden on families and other caregivers, the debate over euthanasia and physician-assisted suicide, and the pros and cons of using social media to share one’s journey towards death. (See my full Nudge review.)
Of 2017’s medical titles that I haven’t read, I would have especially liked to have gotten to:
- Sound: A Story of Hearing Lost and Found by Bella Bathurst
- This Is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay
- With the End in Mind: Dying, Death, and Wisdom in an Age of Denial by Kathryn Mannix [I have this one on my Kindle from NetGalley]
- Into the Grey Zone: A Neuroscientist Explores the Border between Life and Death by Adrian Owen
- Patient H69: The Story of My Second Sight by Vanessa Potter
We are also likely to see a repeat appearance from the winner of the 2017 Royal Society Science Book Prize, Testosterone Rex: Myths of Sex, Science, and Society by Cordelia Fine.
Other relevant books I read last year that have not (yet?) been released in the UK:
- The Education of a Coroner: Lessons in Investigating Death by John Bateson
- The Family Gene: A Mission to Turn My Deadly Inheritance into a Hopeful Future by Joselin Linder
- Last Things: A Graphic Memoir of Loss and Love by Marissa Moss
- Love and Laughter in the Time of Chemotherapy by Manjusha Pawagi
- No Apparent Distress: A Doctor’s Coming-of-Age on the Front Lines of American Medicine by Rachel Pearson: Pearson describes her Texas upbringing and the many different hands-on stages involved in her training: a prison hospital, gynecology, general surgery, rural family medicine, neurology, dermatology. Each comes with memorable stories, but it’s her experience at St. Vincent’s Student-Run Free Clinic on Galveston Island that stands out most. Pearson speaks out boldly about the divide between rich and poor Americans (often mirrored by the racial gap) in terms of what medical care they can get. A clear-eyed insider’s glimpse into American health care.
- The Bright Hour: A Memoir of Living and Dying by Nina Riggs
- The Tincture of Time: A Memoir of (Medical) Uncertainty by Elizabeth L. Silver: At the age of six weeks, Silver’s daughter suffered a massive brain bleed for no reason that doctors could ever determine. Thanks to the brain’s plasticity, especially in infants, the bleed was reabsorbed and Abby has developed normally, although the worry never goes away. Alongside the narrative of Abby’s baffling medical crisis, Silver tells of other health experiences in her family. An interesting exploration of the things we can’t control and how we get beyond notions of guilt and blame to accept that time may be the only healer.
Do you follow the Wellcome Book Prize? Have you read any books that might be eligible?
Julia Buckley can pinpoint the very moment when her battle with chronic pain began: it was a Tuesday morning in May 2012, and she was reaching across her desk for a cold cup of coffee. Although she had some underlying health issues, the “fire ants” down her arm and “carving knife” in her armpit? These were new. From there it just got worse: neck and back pain, swollen legs, and agonizing periods. Heal Me is a record of four years of chronic pain and the search for something, anything to take the pain away. “I couldn’t say no – that was a forbidden word on my journey. You never know who’s going to be your saviour.”
Having exhausted the conventional therapies available privately and via the NHS, most of which focus on cognitive behavioral therapy and coping strategies, Buckley quit work and registered as disabled. Ultimately she had to acknowledge that forces beyond the physiological might be at work. Despite her skepticism, she began to seek out alternative practitioners in her worldwide quest for a cure. Potential saviors included a guru in Vienna, traditional healers in Bali and South Africa, a witch doctor in Haiti, an herbalist in China, and a miracle worker in Brazil. She went everywhere from Colorado Springs (for medical marijuana) to Lourdes (to be baptized in the famous grotto). You know she was truly desperate when you read about her bathing in the blood and viscera of a sacrificial chicken.
Now the travel editor of the Independent and Evening Standard, Buckley captures all these destinations and encounters in vivid detail, taking readers along on her rollercoaster ride of new treatment ideas and periodically dashed hopes. She is especially incisive in her accounting of doctors’ interactions with her. All too often she felt like a statistic or a diagnosis instead of a person, and sensed that her (usually male) doctors dismissed her as a stereotypically hysterical woman. Fat shaming came into the equation, too. Brief bursts of compassion, wherever they came from, made all the difference.
I was morbidly fascinated with this story, which is so bizarre and eventful that it reads like a great novel. I’ll be cheering it on in next year’s Wellcome Book Prize race.
Heal Me: In Search of a Cure is published today, January 25th, by Weidenfeld & Nicolson. My thanks to the publisher for a free copy for review.
Julia graciously agreed to take part in a Q&A over e-mail. We talked about invisible disabilities, the gendered treatment of pain, and whether she believes in miracles.
“I spent a day at the Paralympic stadium with tens of thousands cheering on equality, but when it was time to go home, nobody wanted to give me a seat on the Central Line. I was, I swiftly realised, the wrong kind of disabled.”
Yours was largely an invisible disability. How can the general public be made more aware of these?
I feel like things are very, very gradually moving forward – speaking as a journalist, I know that stories about invisible disabilities do very well, and I think as we all try to be more “on” things and “woke” awareness is growing. But people are still cynical – Heathrow and Gatwick now have invisible disability lanyards for travellers and someone I was interviewing about it said “How do I know the person isn’t inventing it?” I think the media has a huge part to play in raising awareness, as do things like books (cough cough). And when trains have signs saying things like “be aware that not all disabilities are visible” on their priority seats, I think that’s a step forward. Openness helps, too, if people are comfortable about it – I’m a huge believer in oversharing.
“I wondered whether it was a peculiarly female trait to blame oneself when a treatment fails.”
You make a strong case for the treatment of chronic pain being gendered, and your chapter epigraphs, many from women writers who were chronic pain or mental health patients, back this up. There’s even a name for this phenomenon: Yentl Syndrome. Can you tell us a little more about that? What did you do to push back against it?
Yentl Syndrome is the studied phenomenon that male doctors are un/consciously sexist in their dealings with female patients – with regards to pain, they’re twice as likely to ascribe female pain to psychological reasons and half as likely to give them adequate painkillers. In the US, women have to cycle through 12 doctors, on average, before they find the one to treat their pain adequately. There are equally shocking stats if you look at race and class, too.
I did absolutely nothing to push back against it when I was being treated, to be honest, because I didn’t recognise what was going on, had never heard of Yentl Syndrome and thought it was my problem, not theirs. It was really only when I met Thabiso, my sangoma in South Africa, that I felt the scales lift from my eyes about what had been going on. I make up for it now, though – I recently explained to a GP what it was, and suggested he be tested for it (long story, but we were on the phone and he was being incredibly patronising and not letting me speak). He hung up on me.
“In my head I added, I don’t care what they do to me, as long as it helps the pain.”
Meatloaf sang, “I would do anything for love, but I won’t do that.” Can you think of anything you wouldn’t have done in the search for a cure?
Well, I refused a spiritual surgery from John of God – I would have had the medical clamp up my nose or happily been cut into, but I was phobic about having my eyeball scraped – I had visions of Un Chien Andalou. So I had said repeatedly I was up for the other stuff but wouldn’t do the eye-scraping, and was told that probably meant I’d get the eye-scraping so I should go for the “invisible” surgery instead. But I can’t think of anything else I wouldn’t have done. The whole point, for me, was that if I didn’t throw myself into something completely, if I didn’t get better I’d never know if that was the treatment not working or my fault. Equally, my life was worthless to me – I knew I would probably be dead if I didn’t find an answer, so I didn’t have anything to lose.
Having said that, I know I would have had major difficulties slaughtering a goat if I’d gone back to Thabiso – I’m not sure if I could even have asked anyone else to do that for me.
Looking back, do you see your life in terms of a clear before and after? Are you the same person as you were before you went through this chronic pain experience?
There’s definitely a clear before and after in terms of how I think of my life – before the accident and after it. The date is in my head and I measure everything in my life around that, whether that’s a work event, a holiday, anything else – it’s always XX months/years before or after the accident. I don’t have the same thing with the day I got better because I try not to think about what happened and why, so I still calculate everything around the accident even though I should probably try and move my life to revolve around that happier day.
Largely I’m the same person. I still have the same interests and the same job, so I haven’t changed in that way. But I’d say I’m more focused – I lost so much of my life that I’m trying to make up for it now. So I don’t watch TV, I don’t go out to anything I’m not really interested in, I didn’t go to the work Christmas party because I could think of better things to do than stand around sober shouting over music … so I’m more ruthless about how I spend my time.
I also think invisible illness – or people’s reaction to it – hardens you. You have to grow a shell, otherwise you wouldn’t get through it. So I’m probably more brusque. I’m also really fucking angry about how I was treated and how I see other people – especially other women – being treated and I know that low-level anger shows through a lot. But as I said to a friend (male, obviously) recently, when he read my book and was upset at my anger: once you start noticing what’s going on, when you see people’s lives ruined because of pain, when in extreme cases you see women dying because of their gender, how can you not be angry? I think we should all be more angry. Maybe we could get more done.
You got a book contract before you’d completed all the travel. At that point you didn’t know what the conclusion of your quest would be: a cure, or acceptance of chronic pain as your new normal. Given that uncertainty, how did you go about shaping this narrative?
For the proposal for the book I did a country-by-country, treatment-by-treatment chapter plan (it was wildly ambitious, but pain and finances put the dampeners on it) and suggested the last chapter would be at a meditation retreat in Dorset, learning acceptance. I put in some waggish comment like “assuming I don’t get cured first hahaha”, but secretly I knew there was no way I could write the book if I wasn’t cured, partly on a very literal level – I physically wouldn’t be able to do it – but more because I didn’t see how I would ever be able to accept it. I actually postponed the deadline twice for the same reasons, and when I realised deadline 3 was looming and I wasn’t better and I was going to have to suck it up and write it I was distraught. I genuinely thought that putting all that I had been through onto the page and having to admit that I had failed – and failed my fellow pain people I was doing it for – would kill me. So I don’t know what I would have done if it had come to the crunch; luckily I got my pot of white chrysanthemums and didn’t have to see what happened.
You are leery of words like “miracle” and “cure,” so what terms might you use to describe what ended your pain after four years?
Something happened, and it happened in Brazil. But I would never tell anyone to hop on a plane to Brazil. What happened to me happened after four years of soul-searching and introspection as well as all those treatments. If I’d gone to Brazil first, I don’t know what would have happened.
Who do you see being among the audience for your book?
I’d love people who need it to read it and take what they need from it, but I’d also love doctors to read it – as an insight into patient psychology if nothing else – and I’d love it to be seen as a continuation of the whole #MeToo debate. That sounds holier than thou, and obviously it’d be great for people to read it as a Jon-Ronson-meets-Elizabeth-Gilbert-style romp because I’d feel like I’d succeeded from a writing point of view, but to be honest the only reason I wanted to write it in the first place was to show what’s happening to people in pain, and once I got better, the only thing that mattered to me was getting it into the hands of people who need it. I know how much I needed something like this.
Here are 30 books that are on my radar for the months of January through June. This is by no means a full inventory of what’s coming out (or even of what I have available through NetGalley and Edelweiss); instead, think of it as a preview of the books I actually intend to read. This time my list seems strangely skewed towards plants (the covers too), with a couple of bird- and medical-themed reads in there too. Also: two feminist group biographies, plenty of historical fiction, some short stories, a bit of true crime, and a fair few memoirs. I hope you’ll find a book or two here to tempt you.
(The descriptions below are generally adapted from the publisher blurbs on Goodreads, NetGalley or Edelweiss. Some of these I already have access to in print or galley form; others I’m still on the look-out for. The list is in chronological order by first publication date; if multiple books release on the same day they are in alphabetical order by author surname.)
On the Bright Side: The New Secret Diary of Hendrik Groen [Jan. 11, Michael Joseph (Penguin UK)]: I loved the first Hendrik Groen novel back in 2016 (reviewed here); this promises more of the same witty, bittersweet stories about elderly Dutch eccentrics. “Chaos will ensue as 85-year-old Hendrik Groen is determined to grow old with dignity … He dreams of escaping the confines of his care home and practising hairpin turns on his mobility scooter.” (NetGalley download)
Writer’s Luck: A Memoir: 1976–1991 by David Lodge [Jan. 11, Harvill Secker]: I reviewed the first volume of Lodge’s memoirs, Quite a Good Time to Be Born, for Nudge back in 2015, so I’m eager to continue his life story in this second installment. “Readers of Lodge’s novels will be fascinated by the insights this book gives—not only into his professional career but also more personal experience. The main focus, however, is on writing as a vocation.”
Brass: A Novel by Xhenet Aliu (for BookBrowse review) [Jan. 23, Random House]: “A waitress at the Betsy Ross Diner, Elsie hopes her nickel-and-dime tips will add up to a new life. Then she meets Bashkim, … who left Albania to chase his dreams. … Told in equally gripping parallel narratives with biting wit and grace, Brass announces a fearless new voice with a timely, tender, and quintessentially American story.” (NetGalley download)
Heal Me: In Search of a Cure by Julia Buckley [Jan. 25, Weidenfeld & Nicolson]: The “search for a cure [for chronic pain] takes her on a global quest, exploring the boundaries between science, psychology and faith with practitioners on the fringes of conventional, traditional and alternative medicine. Rais[es] vital questions about the modern medical system … and the struggle to retain a sense of self.” (print review copy)
The Mermaid and Mrs. Hancock by Imogen Hermes Gowar [Jan. 25, Harvill Secker]: “A spellbinding story of curiosity, love and obsession from an astonishing new talent. One September evening in 1785, the merchant Jonah Hancock hears urgent knocking on his front door. One of his captains is waiting eagerly on the step. He has sold Jonah’s ship for what appears to be a mermaid.” Comes recommended by Elle. (NetGalley download)
Owl Sense by Miriam Darlington [Feb. 6, Guardian Faber]: Darlington’s previous nature book, Otter Country, was stunning. Here, “Darlington sets out to tell a new story. Her fieldwork begins with wild encounters in the British Isles and takes her to the frosted borders of the Arctic. In her watching and deep listening to the natural world, she cleaves myth from reality and will change the way you think of this magnificent creature.”
The Grave’s a Fine and Private Place by Alan Bradley [Feb. 8, Orion]: I’ve read all eight Flavia de Luce novels so far, which is worth remarking on because I don’t otherwise read mysteries and I usually find child narrators annoying. There’s just something delicious about this series set in 1950s England. This one will be particularly interesting because a life-changing blow came at the end of the previous book.
A Black Fox Running by Brian Carter [Feb. 8, Bloomsbury UK]: “A beautiful lost classic of nature writing” from 1981 that “sits alongside Tarka the Otter, Watership Down,” et al. “This is the story of Wulfgar, the dark-furred fox of Dartmoor, and of his nemesis, Scoble the trapper, in the seasons leading up to the pitiless winter of 1947. As breathtaking in its descriptions of the natural world as it is perceptive in its portrayal of damaged humanity.” Championed by Melissa Harrison.
White Houses by Amy Bloom [Feb. 13, Random House]: The story of Lorena Hickock’s friendship/affair with Eleanor Roosevelt. “From Washington, D.C. to Hyde Park, from a little white house on Long Island to an apartment on Manhattan’s Washington Square, Amy Bloom’s new novel moves elegantly through fascinating places and times, written in compelling prose and with emotional depth, wit, and acuity.” (Edelweiss download)
The Italian Teacher by Tom Rachman [Feb. 20, Riverrun/Viking]: I’m a huge fan of Rachman’s, especially his previous novel, The Rise & Fall of Great Powers. “1955: The artists are gathering together for a photograph. In one of Rome’s historic villas, a party is bright with near-genius, shaded by the socialite patrons of their art. … Rachman displays a nuanced understanding of twentieth-century art and its demons, vultures and chimeras.” (Edelweiss download)
The Sea Beast Takes a Lover: Stories by Michael Andreasen [Feb. 27, Dutton (Penguin Group)]: “Romping through the fantastic with big-hearted ease, these stories cut to the core of what it means to navigate family, faith, and longing, whether in the form of a lovesick kraken slowly dragging a ship of sailors into the sea [or] a small town euthanizing its grandfathers in a time-honored ritual.” (NetGalley download)
The Cadaver King and the Country Dentist: A True Story of Injustice in the American South by Radley Balko and Tucker Carrington [Feb. 27, PublicAffairs]: “After two three-year-old girls were raped and murdered in rural Mississippi, law enforcement pursued and convicted two innocent men, [who] spent a combined thirty years in prison before finally being exonerated in 2008. Meanwhile, the real killer remained free.”
The Gospel of Trees: A Memoir by Apricot Irving [March 6, Simon & Schuster]: “Apricot Irving grew up as a missionary’s daughter in Haiti—a country easy to sensationalize but difficult to understand. Her father was an agronomist, a man who hiked alone into the hills … to preach the gospel of trees in a deforested but resilient country. Her mother and sisters, meanwhile, spent most of their days in the confines of the hospital compound they called home. As a child, this felt like paradise; as a teenager, the same setting felt like a prison.”
The Little Book of Feminist Saints by Julia Pierpont (illus. by Manjitt Thapp) [March 6, Random House]: This project reminds me a lot of A Glorious Freedom with its focus on women’s achievements and the full-color portraits of the subjects. I’ve just opened the file and the first two pieces give you a sense of the range that will be covered: Artemisia Gentileschi and Michelle Obama! (Edelweiss download)
Orchid Summer: In Search of the Wildest Flowers of the British Isles by Jon Dunn [March 8, Bloomsbury UK]: Dunn’s were my favorite contributions to the Wildlife Trusts’ Seasons anthologies (e.g. Winter). I’ve also enjoyed following his botanical travels on Twitter. “From the chalk downs of the south coast of England to the heathery moorland of the Shetland Isles, and from the holy island of Lindisfarne in the east to the Atlantic frontier of western Ireland, Orchid Summer is a journey into Britain and Ireland’s most beautiful corners.”
Anatomy of a Miracle by Jonathan Miles [March 13, Hogarth]: Miles’s previous novel, Want Not, is one of the books I most wish I’d written. “Rendered paraplegic after a traumatic event, Cameron Harris has been living his new existence alongside his sister, Tanya, in their battered Biloxi, Mississippi neighborhood where only half the houses made it through Katrina. … [A] stunning exploration of faith, science, mystery, and the meaning of life.”
Happiness by Aminatta Forna [March 16, Grove Atlantic]: “London. A fox makes its way across Waterloo Bridge. The distraction causes two pedestrians to collide—Jean, an American studying the habits of urban foxes, and Attila, a Ghanaian psychiatrist there to deliver a keynote speech. … Forna’s unerring powers of observation show how in the midst of the rush of a great city lie numerous moments of connection.” (NetGalley download)
The Long Forgotten by David Whitehouse [March 22, Pan Macmillan/Picador]: “When the black box flight recorder of a plane that went missing 30 years ago is found at the bottom of the sea, a young man named Dove begins to remember a past that isn’t his. The memories belong to a rare flower hunter in 1980s New York, whose search led him around the world and ended in tragedy.” (NetGalley download)
The Parentations by Kate Mayfield (to review for Shiny New Books?) [March 29, Oneworld]: From editor Jenny Parrott: “a stunning speculative historical novel … The story spans 200 years across Iceland and London, as a strange boy who can never die is surrounded by a motley collection of individuals, each with vested interests in his welfare. … [S]ome of the most extraordinary literary prose I’ve read during a thirty-year career.”
Things Bright and Beautiful by Anbara Salam [April 5, Fig Tree]: “1954, the South Pacific islands. When Beatriz Hanlon agreed to accompany her missionary husband Max to a remote island, she knew there would be challenges. But it isn’t just the heat and the damp and the dirt. There are more insects than she could ever have imagined, and the islanders are strangely hostile. [Then] an unexpected … guest arrives, and the couple’s claustrophobic existence is stretched to breaking point.” Sounds like Euphoria by Lily King. (NetGalley download)
Sharp: The Women Who Made an Art of Having an Opinion by Michelle Dean [April 10, Grove Press]: “Dorothy Parker, Rebecca West, Hannah Arendt, Mary McCarthy, Susan Sontag, Pauline Kael, Joan Didion, Nora Ephron, Renata Adler, and Janet Malcolm—these brilliant women’s lives intertwine as they cut through the cultural and intellectual history of America in the twentieth century, arguing as fervently with each other as they did with the sexist attitudes of the men who often undervalued their work as critics and essayists.”
The Plant Messiah: Adventures in Search of the World’s Rarest Species by Carlos Magdalena [April 10, Doubleday]: “Carlos Magdalena is not your average horticulturist. He’s a man on a mission to save the world’s most endangered plants. … [He] takes readers from the Amazon to the jungles of Mauritius. … Back in the lab, we watch as he develops groundbreaking, left-field techniques for rescuing species from extinction, encouraging them to propagate and thrive once again.” (NetGalley download)
The Man on the Middle Floor by Elizabeth S. Moore (for blog tour) [April 12, RedDoor Publishing]: “Despite living in the same three-flat house in the suburbs of London, the residents are strangers to one another. … They have lived their lives separately, until now, when an unsolved murder and the man on the middle floor connect them. … It questions whether society is meeting the needs of the fast growing autistic section of society.” (print ARC)
Bookworm: A Memoir of Childhood Reading by Lucy Mangan [April 24, Random House UK]: “This is a love letter to the joys of childhood reading, full of enthusiasm and wit, telling the colorful story of our best-loved children’s books, the extraordinary people who created them, and the thousand subtle ways they shape our lives.” (NetGalley download)
You Think It, I’ll Say It: Stories by Curtis Sittenfeld [April 24, Random House]: I would read anything Curtis Sittenfeld wrote; American Wife is still one of my absolute favorites. “The theme that unites these stories … is how even the cleverest people tend to misread others, and how much we all deceive ourselves. Sharp and tender, funny and wise, this collection shows [her] knack for creating real, believable characters that spring off the page.”
The Valley at the Centre of the World by Malachy Tallack [May 3, Canongate]: I’ve reviewed and enjoyed both of Tallack’s previous nonfiction works, including The Un-Discovered Islands. “Set against the rugged west coast of Shetland, in a community faced with extinction, [this] is a novel about love and grief, family and inheritance, rapid change and an age-old way of life. … [T]hese islanders must decide: what is left of us when the day’s work is done, the children grown, and all our choices have been made?”
Shapeshifters: A Journey through the Changing Human Body by Gavin Francis [May 8, Basic Books]: “Francis considers the inevitable changes all of our bodies undergo—such as birth, puberty, and death, but also … those that only some of our bodies will: like getting a tattoo, experiencing psychosis, suffering anorexia, being pregnant, or undergoing a gender transition. … [E]ach event becomes an opportunity to explore the meaning of identity.”
The Ensemble by Aja Gabel [May 15, Riverhead]: An “addictive debut novel about four young friends navigating the cutthroat world of music and their complex relationships with each other, as ambition, passion, and love intertwine over the course of their lives.”
Why Do Birds Suddenly Disappear? by Lev Parikian (for blog tour) [May 17, Unbound]: “A lapsed and hopeless birdwatcher’s attempt to see 200 birds in a year. But it’s not just about birds. It’s about family, music, nostalgia; hearing the stories of strangers; the nature of obsession and obsession with nature.”
The Great Believers by Rebecca Makkai [June 19, Viking]: I loved both of Makkai’s previous novels and have her short story collection on my Kindle. “Fiona is in Paris tracking down her estranged daughter, who disappeared into a cult. While staying with an old friend, a famous photographer …, she finds herself finally grappling with the devastating ways the AIDS crisis affected her life and her relationship with her daughter.” (Edelweiss download)
Other lists of enticing 2018 releases that might give you some ideas:
Guardian (UK, nonfiction)
Halfman, Halfbook (UK, mostly science/nature and history)
Parchment Girl (mostly nonfiction)
Which 2018 books are you most looking forward to? Do any of my choices interest you?
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.
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.”
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.
Yes, another memoir on a medical theme! I really do read a lot of them. My eye was drawn to The Family Gene: A Mission to Turn My Deadly Inheritance into a Hopeful Future by Joselin Linder because of the medical mystery aspect: 14 members of Linder’s Ashkenazi Jewish family are the only known exemplars of their particular genetic disease, so rare it doesn’t have a name or surefire treatment protocol, but now at least has a location on a chromosome.
Linder’s awareness of her family’s peculiar medical problems began when her father, William, himself a doctor near their home in Columbus, Ohio, started having a persistent build-up of lymph (also known as chyle) in his abdomen – usually a sign of heart or liver failure. At one point doctors tapped four liters of the stuff from his lungs. Her father’s illness threw Linder, then a junior in college, for a loop; drugs and music started to replace academics. After he died, aged 49, in September 1996, she became a nomad, moving from Prague to San Francisco to Brooklyn and dabbling in different careers.
Only gradually did they all realize that the same thing had happened to William’s uncle, Nathan, in the 1960s and his grandmother, Mae, before that. While Mae lived to age 54, Nathan died at 34, even after treatment at NIH. Along with the lymphedema, a heart murmur was a common factor. William’s brother, Norman; Linder and her older sister, Hilary; and various cousins of their generation were diagnosed in this way. The author’s own symptoms were initially easily to ignore – swollen ankles and a low platelet count – but escalated in her thirties: a blocked vein in her liver meant she was in danger of bleeding out if she vomited.
It’s rare to be able to trace a genetic disease from its founder through to the present. In Linder’s case, her great-great-grandmother, Ester Bloom, is the first known sufferer. Researchers eventually isolated their family’s gene on the X chromosome, near the location for asthma. This explained why, historically, female family members had a better prognosis than males – they have one normal X chromosome and one diseased one; men only get the defective X chromosome – and why asthma medication helped to an extent.
There are a couple of chapters here on the basics of genetics that felt a little condescending to me; for anyone with a high school or A level biology qualification, the simplistic metaphors explaining the workings of DNA may seem superfluous. I also had trouble relating to Linder’s immediate reaction to her father’s death. Although he’d been severely ill for years by then, her attitude still seems a little heartless. Of the decision to take him off dialysis, she writes, “I was on board. It was time to call it a day.” When the family went around expressing opinions, she said, “I think it’s time, Dad. You’ve been through so much,” to which he replied “F— you”! An ex-boyfriend’s suicide a couple years later affected her much more than her own father’s death. Grief affects people in strange and unpredictable ways, I guess.
What I most appreciated was how the book sensitively reveals the ways a genetic condition complicates life, especially in America: Linder had to do without health insurance for 10 years, having been denied it in Ohio on the grounds of a pre-existing condition. In addition, she and her sister faced a quandary common to those who carry genetic diseases: should they have children? While Hilary underwent pre-implantation genetic diagnosis, a form of IVF, to bear healthy twins, Linder ultimately decided against having children.
I enjoyed the earlier part of this genetic quest narrative a bit more than the later material about Linder’s symptoms. Still, I can recommend this to viewers of House and readers of Susannah Cahalan’s Brain on Fire and the like.
The Family Gene is released by Ecco today. With thanks to Beth Parker and James Faccinto for the electronic review copy via Edelweiss.