It’s my stop on the “Not the Wellcome Prize” blog tour. With two dozen reviews of health-themed 2019 books to choose from, I decided to nominate these two for the longlist because they’re under the radar compared to some other medical releases, plus they showcase the breadth of the books that the Prize recognizes: from a heartfelt memoir of a mother welcoming premature babies to a laugh-out-loud graphic novel about a doctor practicing in a small town in Wales. (The Prize website says “picture-led books are not eligible,” so in fact it is likely that graphic novels have never been considered, but we’ve been flexible with the rules for this unofficial blog tour.)
Mother Ship by Francesca Segal
This first work of nonfiction from the author of the exquisite The Innocents is a visceral diary of the first eight weeks in the lives of her twin daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU, “an extremely well-funded prison or perhaps more accurately a high-tech zoo.” In Mother Ship, she strives to come to terms with this unnatural start to motherhood. “Taking my unready daughters from within me felt not like a birth but an evisceration,” she writes. “My children do not appear to require mothering. Instead they need sophisticated medical intervention.”
Segal describes with tender precision the feeling of being torn: between the second novel she’d been in the middle of writing and the all-consuming nature of early parenthood; and between her two girls (known for much of the book as “A-lette” and “B-lette”), who are at one point separated in different hospitals. Her attitude towards the NHS is pure gratitude.
As well as portraying her own state of mind, she crafts twinkly pen portraits of the others she encountered in the NICU, including the staff but especially her fellow preemie mums, who met in a “milking shed” where they pumped breast milk for the babies they were so afraid of losing that they resisted naming. (Though it was touch and go for a while, A-lette and B-lette finally earned the names Raffaella and Celeste and came home safely.) Female friendship is thus a subsidiary theme in this exploration of desperate love and helplessness.
The Lady Doctor by Ian Williams
This sequel to 2014’s The Bad Doctor returns to a medical practice in small-town Wales. This time, though, the focus is on Iwan James’s colleague, Dr. Lois Pritchard, who also puts in two days a week treating embarrassing ailments at the local hospital’s genitourinary medicine clinic. At nearly 40, Lois is a divorcee with no children; just a dog. She enjoys her nights out drinking with her best friend, Geeta, but her carefree life is soon beset by various complications: she has to decide whether she wants to join the health centre as a full partner, a tryst with her new fella goes horribly wrong, and her estranged mother suddenly reappears in her life, hoping that Lois will give her a liver transplant. And that’s not to mention all the drug addicts and VD-ridden lotharios hanging about.
Williams was a GP in North Wales for 20 years, and no doubt his experiences have inspired his comics. His tone is wonderfully balanced: there are plenty of hilarious, somewhat raunchy scenes, but also touching moments where Lois learns that a doctor is never completely off duty and has no idea what medical or personal challenge will crop up next. The drawing style reminded me most of Alison Bechdel’s or Posy Simmonds’, with single shades from rose to olive alternating as the background. I especially loved the pages where each panel depicts a different patient to show the range of people and complaints a doctor might see in a day. Myriad Editions have a whole “Graphic Medicine” series that I’m keen to explore.
See below for details of the blogs where other reviews have appeared or will be appearing soon.
The shadow panel will choose a shortlist of six titles to be announced on 4 May. We will then vote to choose a winner, with the results of a Twitter poll serving as one additional vote. The Not the Wellcome Prize winner will be announced on 11 May.
Soon after I heard that the Wellcome Book Prize would be on hiatus this year, I had the idea to host a “Not the Wellcome Prize” blog tour to showcase some of the best health-themed literature published in 2019. I was finalizing the participants and schedule just before as well as during the coronavirus crisis, which has reinforced the importance of celebrating books that disseminate crucial information about medicine and/or tell stories about how health affects our daily lives. I got the go-ahead for this unofficial tour from the Wellcome Trust’s Simon Chaplin (Director of Culture & Society) and Jeremy Farrar (overall Director).
Starting on Monday and running for the next two weeks (weekdays only), the tour will be featuring 19 books across 10 blogs. One of the unique things about the Wellcome Prize is that both fiction and nonfiction are eligible, so we’ve tried to represent a real variety here: on the longlist we have everything from autobiographical essays to science fiction, including a graphic novel and a couple of works in translation.
Based on the blog tour reviews and the Prize’s aims*, the shadow panel (Annabel of Annabookbel, Clare of A Little Blog of Books, Laura of Dr. Laura Tisdall, Paul of Halfman, Halfbook and I) will choose a shortlist of six titles, to be announced on the 4th of May. We will then vote to choose a winner, with the results of a Twitter poll serving as one additional vote (be sure to have your say!). The overall winner of the Not the Wellcome Prize will be announced on the 11th of May.
I hope you’ll follow along with the reviews and voting. I would like to express my deep thanks to all the blog tour participants, especially the shadow panel for helping with ideas and planning – plus Annabel designed the graphics.
*Here is how the website describes the Prize’s purpose: “At some point, medicine touches all our lives. Books that find stories in those brushes with medicine are ones that add new meaning to what it means to be human. The subjects these books grapple with might include birth and beginnings, illness and loss, pain, memory, and identity. In keeping with its vision and goals, the Wellcome Book Prize aims to excite public interest and encourage debate around these topics.”
Below I’ve appended our preliminary list of eligible books that were considered but didn’t quite make the cut to be featured on the tour, noting major themes and positive blog review coverage I’ve come across. (The official Prize excludes poetry entries, but we were more flexible.)
- When Death Takes Something from You Give It Back by Naja Marie Aidt (memoir of child’s sudden death)
- The Man in the Red Coat by Julian Barnes (biography of 19th-century gynecologist)
- Let Me Not Be Mad by A.K. Benjamin (neuropsychologist’s memoir)
- The Story of Sex: From Apes to Robots by Philippe Brenot (medical history/graphic novel, in translation)
- The Prison Doctor by Amanda Brown (doctor’s memoir)
- The Undying by Anne Boyer (essays – cancer)
- Breaking & Mending by Joanna Cannon (doctor’s memoir)
- How to Treat People by Molly Case (nurse’s memoir)
- Will My Cat Eat My Eyeballs? by Caitlin Doughty (popular science – death)
- Happening by Annie Ernaux (memoir, in translation – abortion)
- I Remain in Darkness by Annie Ernaux (memoir, in translation – mother’s dementia)
- Out of Our Minds by Felipe Fernández-Armesto (popular science – evolutionary biology)
- The Heartland by Nathan Filer (medical history/memoir – schizophrenia)
- Childless Voices by Lorna Gibb (cultural history – infertility, etc.)
- Maybe You Should Talk to Someone by Lori Gottlieb (memoir/self-help – therapy)
- Once More We Saw Stars by Jayson Greene (memoir – child’s sudden death)
- A Short History of Falling by Joe Hammond (memoir – disability, dying)
- All Things Consoled by Elizabeth Hay (memoir – geriatrics, dementia)
- Hard Pushed by Leah Hazard (midwife’s memoir)
- Life Lessons from a Brain Surgeon by Rahul Jandial (memoir/self-help)
- Twas the Nightshift before Christmas by Adam Kay (doctor’s memoir)
- Why Can’t We Sleep? by Darian Leader (popular science – insomnia)
- Incandescent: We Need to Talk about Light by Anna Levin (light’s effects on health and body rhythms)
- A Puff of Smoke by Sarah Lippett (memoir – growing up with rare disease)
- Hormonal by Eleanor Morgan (popular science – women’s health)
- Critical by Matt Morgan (ICU doctor’s memoir)
- A Short History of Medicine by Steve Parker (medical history, illustrated)
- Notes to Self by Emilie Pine (essays – infertility, rape, etc.)
- That Good Night by Sunita Puri (doctor’s memoir – palliative care)
- An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives by Matt Richtel (popular science)
- The Gendered Brain by Gina Ripon (popular science – neuroscience, gender)
- The Five by Hallie Rubenhold (alcoholism, sex work)
- When I Had a Little Sister by Catherine Simpson (memoir – mental health, suicide)
- Flash Count Diary: Menopause and the Vindication of Natural Life by Darcey Steinke (memoir, female anatomy)
- Skeleton Keys: The Secret Life of Bone by Brian Switek (popular science – anatomy)
- Out of the Woods by Luke Turner (memoir – masculinity, bisexuality)
- The Making of You by Katharina Vestre (popular science, in translation – embryology)
- Transcendence: How Humans Evolved through Fire, Language, Beauty, and Time by Gaia Vince (popular science – human evolution)
- The Knife’s Edge by Stephen Westaby (surgeon’s memoir)
- Starling Days by Rowan Hisayo Buchanan (literary fiction – mental illness, bisexuality)
- Recursion by Blake Crouch (science fiction – memory)
- Expectation by Anna Hope (women’s fiction – infertility, cancer)
- Stillicide by Cynan Jones (speculative fiction – water crisis)
- Things in Jars by Jess Kidd (historical fiction – Victorian medicine)
- Patience by Toby Litt (disability)
- The Migration by Helen Marshall (speculative fiction – immune disorder)
- The Warlow Experiment by Alix Nathan (historical fiction – medical experimentation)
- Night Theatre by Vikram Paralkar (magic realism – surgeon to the dead)
- The Art of Dying by Ambrose Parry (historical mystery – Victorian medicine)
- The Dutch House by Ann Patchett (doctor narrator, diabetes)
- Body Tourists by Jane Rogers (science fiction – body rental technology)
- Children of Ruin by Adrian Tchaikovsky (science fiction – evolutionary biology)
- Oligarchy by Scarlett Thomas (eating disorders)
- Wanderers by Chuck Wendig (science fiction – sleepwalking disorder)
- O Positive by Joe Dunthorne (death, therapy)
- The Carrying by Ada Limon (ageing parents, infertility)
Back in January I had the idea to catch up as much as I can on previous Wellcome Book Prize long- and shortlists while the Prize is on hiatus. I decided to start with a pair of novels about polio from my public library system: The Golden Age by Joan London and Nemesis by Philip Roth. The latter, especially, has taken on new significance due to its evocation of a time of panic over a public health crisis (see this article, but beware spoilers). On a fellow book reviewer’s recommendation, I also took Year of Wonders by Geraldine Brooks off the shelf and read it at the same time as the Roth.
The Golden Age by Joan London (2014)
[First published in the UK in 2016; on the Wellcome Book Prize 2017 longlist]
The Golden Age was a real children’s polio hospital in Western Australia, but London has peopled it with her own fictional cast. In 1953–4, Frank Gold and Elsa Briggs, polio patients aged 12 going on 13, fall in love in the most improbable of circumstances: “The backs of their hands brushed as they walked side by side on their crutches. Their bloodstreams recharged by exercise and fresh air, they experienced a fiery burst of pleasure.”
Frank is much the more vibrant character thanks to his family’s wartime past in Hungary and his budding vocation as a poet, which was spurred on by his friendship with Sullivan, a fellow inmate at his previous rehabilitation center. The narrative spends time with the nurses, parents and other patients but keeps coming back to Frank and Elsa. However, Chapter 7, with Frank and his mother Ida still back in Budapest, was my favorite.
I was reminded of Tracy Farr’s work (The Life and Loves of Lena Gaunt), especially the look back from decades later. This has a strong premise and some great lines, but for me there was something slightly lacking in the execution.
There was beauty everywhere, strange beauty, even—especially?—in a children’s polio hospital.
Polio is like love, Frank says … Years later, when you think you have recovered, it comes back.
Nemesis by Philip Roth (2010)
[On the Wellcome Book Prize 2011 shortlist]
In the summer of 1944 Newark, New Jersey is hit hard by polio. As a local playground director, 23-year-old Bucky Cantor is distressed when several of his charges become ill; a couple of them even die within a matter of days.
At first Bucky, whose poor eyesight kept him out of the War, sees his job as his own field of duty, but gradually fear and helplessness drive him away. He escapes to the Pocono Mountains to join his fiancée, Marcia, as a summer camp counselor, but soon realizes the futility of trying to outrun a virus. Unable to accept the randomness of bad luck, he blames God – and himself – for the epidemic’s spread.
Despite our better general understanding of epidemiology today, there were still many passages in this novel that rang true for me as they picture life proceeding as normal until paranoia starts to take hold:
Despite polio’s striking in the neighborhood, the store-lined main street was full of people out doing their Saturday grocery shopping…
(Bucky) Look, you mustn’t be eaten up with worry … What’s important is not to infect the children with the germ of fear. We’ll come through this, believe me. We’ll all do our bit and stay calm and do everything we can to protect the children, and we’ll all come through this together.
The important thing, he said, was always to wash your hands after you handled paper money or coins. What about the mail, someone else said … What are you going to do, somebody retorted, suspend delivering the mail? The whole city would come to a halt. Six or seven weeks ago they would have been talking about the war news.
Roth really captures the atmosphere of alarm and confusion, but doesn’t always convey historical and medical information naturally, sometimes resorting to paragraphs of context and representative conversations like in the last quote above. I also wasn’t sure about the use of a minor character (revealed on page 108 to be one of Bucky’s playground kids and a polio patient) as the narrator. This seemed to me to make Bucky more of a symbolic hero than a genuine character. Still, this was a timely and riveting read.
Year of Wonders by Geraldine Brooks (2001)
In 1665, with the Derbyshire village of Eyam in the grip of the Plague, the drastic decision was made to quarantine it. A benevolent landowner arranged for regular deliveries of food and other supplies to just outside the parish boundaries. The villagers made an oath that no one would leave until the pestilence was eradicated. One year later, two-thirds of its residents were dead. Brooks imagines that the “plague seeds” came to the village in a bolt of cloth that was delivered from London to the tailor George Viccars, who lodged with widow Anna Frith. Viccars is the first victim and the disease quickly spreads outward from Anna’s home.
Anna barely has time to grieve her own losses before she’s called into service: along with the minister’s wife, Elinor Mompellion, she steps in as a midwife, herbal healer and even a miner. The village succumbs to several sobering trajectories. Suspicion of women’s traditional wisdom leads some to take vigilante action against presumed witches. Unscrupulous characters like Anna’s father, who sets up as a gravedigger, try to make a profit out of others’ suffering. Frustration with the minister’s apparent ineffectuality attracts others to forms of religious extremism. Like Bucky, people cannot help but see the hand of God here.
Perhaps what I was most missing in the London and Roth novels (and in Hamnet, which bears such striking thematic similarities to Year of Wonders) was intimate first-person narration, which is just what you get here from Anna. The voice and the historical recreation are flawless, and again there were so many passages that felt apt:
Stay here, in the place that you know, and in the place where you are known. … Stay here, and here we will be for one another.
the current times did seem to ask us all for every kind of sacrifice
(once they start meeting for church in a meadow) We placed ourselves so that some three yards separated each family group, believing this to be sufficient distance to avoid the passing of infection.
Yet it is a good day, for the simple fact that no one died upon it. We are brought to a sorry state, that we measure what is good by such a shortened yardstick.
I’ve docked a half-star only because of a far-fetched ending that reminded me of that to The Wonder by Emma Donoghue. Apart from that, this is just what I want from my historical fiction.
Are you doing any reading about epidemics?
My top 10 releases of 2019 thus far, in no particular order, are:
General / Historical Fiction
Stubborn Archivist by Yara Rodrigues Fowler: What a hip, fresh approach to fiction. Broadly speaking, this is autofiction: like the author, the protagonist was born in London to a Brazilian mother and an English father. The book opens with fragmentary, titled pieces that look almost like poems in stanzas. The text feel artless, like a pure stream of memory and experience. Navigating two cultures (and languages), being young and adrift, and sometimes seeing her mother in herself: there’s a lot to sympathize with in the main character.
The Flight Portfolio by Julie Orringer: Every day the Emergency Rescue Committee in Marseille interviews 60 refugees and chooses 10 to recommend to the command center in New York City. Varian and his staff arrange bribes, fake passports, and exit visas to get celebrated Jewish artists and writers out of the country via the Pyrenees or various sea routes. The story of an accidental hero torn between impossible choices is utterly compelling. This is richly detailed historical fiction at its best. My top book of 2019 so far.
Daisy Jones and The Six by Taylor Jenkins Reid: This story of the rise and fall of a Fleetwood Mac-esque band is full of verve and heart, and it’s so clever how Reid delivers it all as an oral history of pieced-together interview fragments, creating authentic voices and requiring almost no footnotes or authorial interventions. It’s pure California sex, drugs, and rock ’n roll, but there’s nothing clichéd about it. Instead, you get timeless rivalry, resentment, and unrequited or forbidden love; the clash of personalities and the fleeting nature of fame.
Things in Jars by Jess Kidd: In the autumn of 1863 Bridie Devine, female detective extraordinaire, is tasked with finding the six-year-old daughter of a baronet. Kidd paints a convincingly stark picture of Dickensian London, focusing on an underworld of criminals and circus freaks. Surgery before and after anesthesia and mythology (mermaids and selkies) are intriguing subplots woven through. Kidd’s prose is spry and amusing, particularly in her compact descriptions of people but also in more expansive musings on the dirty, bustling city.
The Doll Factory by Elizabeth Macneal: Iris Whittle dreams of escaping Mrs Salter’s Doll Emporium and becoming a real painter. Set in the early 1850s and focusing on the Great Exhibition and Pre-Raphaelite Brotherhood, this also reveals the everyday world of poor Londoners. It’s a sumptuous and believable fictional world, with touches of gritty realism. If some characters seem to fit neatly into stereotypes (fallen woman, rake, etc.), be assured that Macneal is interested in nuances. A terrific debut full of panache and promise.
The Lady Doctor by Ian Williams: Dr. Lois Pritchard works at a medical practice in small-town Wales and puts in two days a week treating embarrassing ailments at the local hospital’s genitourinary medicine clinic. The tone is wonderfully balanced: there are plenty of hilarious, somewhat raunchy scenes, but also a lot of heartfelt moments as Lois learns that a doctor is never completely off duty and you have no idea what medical or personal challenge will crop up next. The drawing style reminds me of Alison Bechdel’s.
Constellations by Sinéad Gleeson: Perfect for fans of I Am, I Am, I Am by Maggie O’Farrell, this is a set of trenchant autobiographical essays about being in a female body, especially one wracked by pain. Gleeson ranges from the seemingly trivial to life-and-death matters as she writes about hairstyles, blood types, pregnancy, the abortion debate in Ireland and having a rare type of leukemia. The book feels timely and is inventive in how it brings together disparate topics to explore the possibilities and limitations of women’s bodies.
Hard Pushed: A Midwife’s Story by Leah Hazard: An empathetic picture of patients’ plights and medical professionals’ burnout. Visceral details of sights, smells and feelings put you right there in the delivery room. Excerpts from a midwife’s official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of the work. This is a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it.
Mother Ship by Francesca Segal: A visceral diary of the first eight weeks in the lives of her daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU. As well as portraying her own state of mind, Segal crafts twinkly pen portraits of the others she encountered in the NICU, including the staff but especially her fellow preemie mums. Female friendship is thus a subsidiary theme in this exploration of desperate love and helplessness.
Thousandfold by Nina Bogin: This is a lovely collection whose poems devote equal time to interactions with nature and encounters with friends and family. Birds – along with their eggs and feathers – are a frequent presence. Often a particular object will serve as a totem as the poet remembers the most important people in her life. Elsewhere Bogin greets a new granddaughter and gives thanks for the comforting presence of her cat. Gentle rhymes and half-rhymes lend a playful or incantatory nature. I recommend it to fans of Linda Pastan.
The three 4.5- or 5-star books that I read this year (and haven’t yet written about on here) that were not published in 2019 are:
Girls Are Coming Out of the Woods by Tishani Doshi [poetry]
Faces in the Water by Janet Frame
Priestdaddy: A Memoir by Patricia Lockwood
What are some of the best books you’ve read so far this year?
What 2019 releases do I need to catch up on right away?
Here are excerpts from (and links to, where available) some of my recent reviews for other places. A few of these books will undoubtedly be showing up on my end-of-year best lists in a couple weeks’ time.
I was pleased to have three of the books I reviewed show up on BookBrowse’s list of the top 20 books of the year, as voted for by the site’s readers. What’s more, Educated was voted their top nonfiction book of the year and Where the Crawdads Sing (below) their #1 debut novel. (The third on the list was Unsheltered.)
Beauty in the Broken Places by Allison Pataki: Ernest Hemingway wrote that we are strong at the broken places, and Allison Pataki found that to be true when her husband, David Levy, a third-year orthopedic surgery resident in Chicago, had a near-fatal stroke at age 30. On June 9, 2015, Dave and five-months-pregnant Allison were on a flight from Chicago to Hawaii for their babymoon, planning to stop in Seattle to visit Dave’s brothers. But they never made it there. On the plane Dave told her he couldn’t see out of his right eye.The plane made an emergency landing in Fargo, North Dakota and Dave was rushed to a hospital for testing. Doctors found he had suffered a bithalamic midbrain ischemic stroke, even though he’d had no risk factors and this stroke type was virtually unknown in patients of his age. Pataki goes back and forth between the details of this health crisis and her past with Dave. Hers is a relatable story of surviving the worst life can throw at you and finding the beauty in it.
Sick by Porochista Khakpour: Khakpour can’t remember a time when she didn’t feel unwell and like she wanted to escape. “I had no idea what normal was. I never felt good,” she writes in her bracing memoir. Related to this sense of not being at home in her body was the feeling of not having a place where she fit in. Throughout Sick, she gives excellent descriptions of physical and mental symptoms. Her story is a powerful one of being mired in sickness and not getting the necessary help from medical professionals. Lyme disease has cost her $140,000 so far, and a lack of money and health insurance likely delayed her diagnosis by years. There is, unfortunately, some inherent repetition in a book of this nature. At times it feels like an endless cycle of doctors, appointments, and treatment strategies. However, the overall arc of struggling with one’s body and coming to terms with limitations will resonate widely.
Southernmost by Silas House: In Silas House’s sixth novel, a Tennessee preacher’s family life falls apart when he accepts a gay couple into his church. We go on a long journey in Southernmost: not just a literal road trip from Tennessee to Florida, but also a spiritual passage from judgment to grace. Reconciliation is a major theme, but so is facing up to the consequences of poor decisions. I found the plotting decisions rewarding but also realistic. The pattern of a narrow religious worldview ebbing away to no faith at all and eventually surging back as a broader and more universal spirituality truly resonates. I loved House’s characters and setups, as well as his gentle evocation of the South. His striking metaphors draw on the natural world, like “She had the coloring of a whip-poor-will” and “The sky is the pink of grapefruit meat.” It’s a beautiful, quietly moving novel of redemption and openness to what life might teach us.
Unsheltered by Barbara Kingsolver: Kingsolver’s bold eighth novel has a dual timeline that compares the America of the 1870s and the recent past, revealing how they are linked by distrust and displacement. The book’s themes and structure emphasize similarities between two time periods that might initially appear very different. Chapters alternate between the story lines, and the last words of one chapter form the title of the next. It’s a clever and elegant connecting strategy, as is the habit of using variations on the title word as frequently as possible – something Jonathan Franzen also does in his novels. (I counted 22 instances of “shelter” and its variants in the text; how many can you spot?) Kingsolver can be heavy-handed with her messages about science, American politics and healthcare, etc. All the same, Unsheltered is a rich, rewarding novel and an important one for our time, with many issues worth pondering and discussing.
Where the Crawdads Sing by Delia Owens: It’s easy to see why so many have taken this debut novel into their hearts: it’s a gripping mystery but also a tender coming-of-age story about one woman’s desperately lonely upbringing and her rocky route to finding love and a vocation. Not only that, but its North Carolina marsh setting is described in lyrical language that evinces Delia Owens’s background in nature writing, tempered with folksy Southern dialect. The title refers to places where wild creatures do what comes naturally, and throughout the book we are invited to ponder how instinct and altruism interact and what impact human actions can have in the grand scheme of things. In Kya, Owens has created a truly outstanding character. The extremity of her situation makes her a sympathetic figure in spite of her oddities. Crawdads is a real treat.
Shiny New Books
Under the Rock by Benjamin Myers: When Myers moved to the Calder Valley of West Yorkshire from London over a decade ago, he approached his new patch with admirable curiosity, and supplemented the observations he made from his study window with frequent long walks with his dog (“Walking is writing with your feet”) and research into the history of the area. The result is a divagating, lyrical book that ranges from literature and geology to true crime but has an underlying autobiographical vein. This isn’t old-style nature writing in search of unspoiled places. Instead, it’s part of a growing interest in the ‘edgelands’ where human impact is undeniable but nature is creeping back in. Interludes transcribe his field notes, which are stunning impromptu poems. I came away from this feeling that Myers could write anything – a thank-you note, a shopping list – and make it profound literature. Every sentence is well-crafted and memorable. “Writing is a form of alchemy,” he declares. “It’s a spell, and the writer is the magician.” I certainly fell under his spell here.
Nine Pints by Rose George: Nine Pints dives deep into the science and cultural history of blood. George’s journalistic tenacity keeps her pushing through the statistics to find the human stories that animate the book. In the first chapter we track the journey of a pint of blood that she donates in her hometown of Leeds. I was particularly interested, if morbidly so, in the chapter on leeches and bloodletting. Other sections journey further afield, chiefly to South Africa and India, to explore AIDS and menstruation taboos. The style can be choppy and repetitive, given to short sentences and identical paragraph openers, and there are a couple of places where the nine-chapter structure shows its weaknesses. While Nine Pints is quite uneven, it does convey a lot of important information about the past, present and future of our relationship to blood.
Times Literary Supplement
Face to Face: True stories of life, death and transformation from my career as a facial surgeon by Jim McCaul: Eighty percent of a facial surgeon’s work is the removal of face, mouth and neck tumors in surgeries lasting eight hours or more. McCaul also restores patients’ appearance as much as possible after disfiguring accidents. Here he pulls back the curtain on the everyday details of his work life: everything from his footwear (white Crocs that soon become stained with blood and other fluids) to his musical choices (pop for the early phases; classical for the more challenging microsurgery stage). Like neurosurgeon Henry Marsh, he describes the awe of the first incision – “an almost overwhelming sense of entering into a sanctuary.” There’s a vicarious thrill to being let into this insider zone, and the book’s prose is perfectly clear and conversational, with unexpectedly apt metaphors such as “Sometimes the blood vessels can be of such poor quality that it is like trying to sew together two damp cornflakes.” This is a book that inspires wonder at all that modern medicine can achieve.
On Sheep: Diary of a Swedish Shepherd by Axel Lindén: Lindén left city life behind to take on his parents’ rural collective in southeast Sweden. This documents two years in his life as a shepherd aspiring to self-sufficiency and a small-scale model of food production. Published diaries can devolve into tedium, but the brevity and selectiveness of this one prevent its accounts of everyday tasks from becoming tiresome. Instead, the rural routines are comforting, even humbling, as the shepherd practices being present with these “quiet and unpretentious and stoical” creatures. The attention paid to slaughtering and sustainability issues – especially as the business starts scaling up and streamlining activities – lends the book a wider significance. It is thus more realistic and less twee than its stocking-stuffer dimensions and jolly title font seem to suggest.
Though I’m often wary of war fiction – can anything new still be written about World War I? – I was drawn to The Winter Soldier by the enthusiastic American reviews and the medical theme. The protagonist of psychiatrist Daniel Mason’s third novel, Lucius Krzelewski, comes from southern Polish nobility. In the 1910s medicine was a path for those seeking social mobility, but for Lucius neurology study is a way out of his stifling aristocratic household. Under Herr Doktor Zimmer’s tutelage in Vienna, he experiments on ways to make blood vessels visible. Dismayed to learn that Zimmer believes the “mermaid” in the medical school’s anatomical museum is real, he hurries to enlist when war begins in 1914.
As a 22-year-old medical lieutenant he’s stationed at a church turned into a regimental hospital at Lemnowice. Here Sister Margarete has been making do without a doctor in charge for two months. She’s been performing amputations and setting fractures in a lice-ridden building where hunger and typhoid are never far away. Lucius is ashamed of his ignorance compared to this skilled nurse; though he has textbook knowledge, he has no practical experience and has to learn on the job.
The following winter a Hungarian soldier suffering from “nervous shock” but no visible wounds is brought in, a sheaf of accomplished drawings padding his coat. For Lucius and Margarete, Sergeant József Horváth poses a particular challenge, which makes his recovery seem more like a resurrection: “they were both falling a little bit in love with their silent visitor or, more, with the cure that they had wrought.” Even as Lucius and Margarete fall in love and steal moments alone, they regret they couldn’t do more for Horváth. When Lucius and Margarete are separated, he vows to find her again – and make things right with Horváth.
I loved the novel’s first half, with its gallows humor, memorable scenes of gruesome medical procedures, and bleak conditions so convincing you’ll find yourself itching right along with the lice-plagued patients. But at about the halfway point the pace changes dramatically. Years pass and Lucius has various deployments and hospital positions. Curiously, although so much is happening to him outwardly, he’s stalled internally – haunted by thoughts of Margarete and Horváth. Perhaps this is why I felt the narrative slowed to a crawl. I could barely force myself to read more than five or 10 pages in a sitting, and the novel as a whole took me much longer to read than normal. Or maybe I was just missing Margarete, the most vibrant character.
Early on I was reminded of Julie Orringer’s The Invisible Bridge and Hubert Mingarelli’s A Meal in Winter, lesser-known war novels in which the stark beauty of the writing tempers the somber subject matter. Partway through I started thinking of Ambrose Parry’s The Way of All Flesh, in which an unqualified female outshines a male in medical knowledge. By the end I was recalling epic separation-filled romances like The English Patient and Birdsong.
Though the novel’s second half never matched the strength of the first, I was at least pleased that Mason avoided a clichéd, Hollywood-ready ending in favor of a more fitting one that, while still somewhat far-fetched, makes sense of the title’s emphasis. This is a moving story of the physical and psychological effects of war, and I would certainly read more by Mason.
The Winter Soldier was published in the UK by Mantle on October 18th. With 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?
My classic for September was one of those books that are so ingrained in the canon you most likely know the basic story line even if you’ve never read a word Gustave Flaubert wrote. I’d happened to read a fair bit about Madame Bovary (1857), mostly via Julian Barnes, and had also encountered some modern novels that might be said to be updates (Hausfrau by Jill Alexander Essbaum and perhaps even George and Lizzie by Nancy Pearl), but never picked up the book itself until earlier this month. While the essential turns of the plot were indeed familiar to me, there was also plenty that surprised me in terms of the details and the mechanics. I’ve set this out in nine points below; if you’re determined to avoid anything that seems like spoilers, I’d suggest skipping over #6–8.
#1. We open with Charles Bovary.
And in the first-person plural: “We were studying when the headmaster came in, followed by a new boy”. I suppose I assumed the book would open immediately on Emma Bovary, already married to Charles. Instead, we get a quick tour through Charles’s adolescent schooling and independent medical studies.
#2. There are two “Madame Bovarys” before the one we’re interested in.
The original Madame Bovary, and the only one to survive the book, is Charles’s mother. Charles also has a brief first marriage to Heloise, an older widow. Conveniently, she dies by the end of the second chapter, in which Charles met Emma when he went to set her farmer father’s broken leg.
#3. There’s a lovely Hardyesque flavor to the novel.
Flaubert’s original subtitle was “Provincial Morals,” and the scenes set among country folk – especially Emma and Charles’s wedding procession and reception and the later agricultural fair – reminded me of Far from the Madding Crowd.
#4. Emma has a child.
Despite all I’d absorbed about the book, I never knew Emma had a baby girl, Berthe. They lodge the infant with a wet nurse and servants do most of the hard work of raising her, so Berthe has only a tiny role. The scene in which Emma violently pushes the little girl away from her is meant, I think, to reflect her fundamental unfitness for motherhood.
#5. In the world of the novel, literature is a danger and religion is no balm.
On the advice of Charles’s mother, he cancels Emma’s lending library subscription lest novels exacerbate her discontent. Manual labor is what Emma needs, Old Madame Bovary proclaims. When Emma goes to the parish priest for advice about her angst, he tells her she must be ill if she benefits from all the physical comforts she could need yet cannot be happy. (An excellent and wrenching scene.)
#6. There’s a strong medical theme.
Charles is a doctor, of course, but I didn’t know his profession would enter into the plot. There’s a crucial sequence in which he performs a groundbreaking operation on a stable boy with a clubfoot, but gangrene sets in and the leg has to be amputated. (Emma guiltily buys the boy a false leg.) Emma’s somewhat prolonged death by poisoning, and the appearance of her corpse, are also described in recognizable medical detail.
#7. Emma’s death isn’t the end.
There’s still two more chapters to go, and things only get worse. It’s as if Emma is still a negative influence after her death: pushing Charles on to extravagances he can’t afford, and sending him deeper into despair when he finds undeniable evidence of her two affairs.
#8. Homais, the arrogant pharmacist, is triumphant.
Monsieur Homais is one of the key secondary characters in Yonville, this small town near Rouen. He’s a middling community member who’s gotten above himself, yet he succeeds whereas Emma is crushed. The very last line of the novel goes to him: “He has just received the Legion of Honor.” In the introduction to my Signet Classic edition, Mary McCarthy suggests that Homais is “not just Emma’s foil; he is her alter ego.”
#9. Madame Bovary went on trial.
Appended to my copy is a 78-page transcript of the novel’s trial. As I skimmed it, I was reminded of the Lady Chatterley’s Lover obscenity case, which took place just over 100 years later (1959–60). Flaubert and his publisher were accused of “offenses against public morality and religion,” specifically of portraying Emma as lascivious and making adultery appealing compared to the banality of marriage. The defense countered that Charles receives all the reader’s sympathy and Emma all the reader’s revulsion. Flaubert was acquitted (as was Lady Chatterley), but the judge’s ruling was essentially “Naughty boy, don’t you know literature has a mission to exalt the spirit, not to hold up vice as an object of horror?”
Now for what doesn’t surprise me about Madame Bovary: the beautiful writing and the enduring power of what is ultimately a rather commonplace story line. The percentage of novels with an adultery subplot must be very high nowadays, but Madame Bovary and Anna Karenina were two of the first to consider the female experience.
Flaubert famously declared “Madame Bovary, c’est moi” (“Madame Bovary is me”), and I think every reader must see something of him-/herself in this character: the lure of a romantic and luxurious life, the boredom of the day to day, the longing to make something more out of existence, and an increasing desperation to cover up one’s mistakes. A book that has had meaning for generations, Madame Bovary is a true classic.
Some favorite lines:
“But her life was as cold as an attic with northern exposure, and boredom, that silent spider, was spinning its web in all the dark corners of her heart.”
“Mealtime was the worst of all in that tiny room on the ground floor, with the smoking oven, the creaking door, the damp walls, and the moist flagstones; all the bitterness of her existence seemed to be served up to her on her plate, and the steam from the boiled beef brought up waves of nausea from the depths of her soul.”
“No one can ever express the exact measure of his needs, or conceptions, or sorrows. The human language is like a cracked kettle on which we beat out a tune for a dancing bear, when we hope with our music to move the stars.”
(Isn’t that last sentence incredible?!)
I read a Signet Classic edition of Mildred Marmur’s 1964 translation.
See also Susan’s review of Sophie Divry’s recent update, Madame Bovary of the Suburbs, at A life in books.