Review: Intensive Care by Gavin Francis
I finally finished a book in 2021! And it’s one with undeniable ongoing relevance. The subtitle is “A GP, a Community & COVID-19.” Francis, a physician who is based at an Edinburgh practice and frequently travels to the Orkney Islands for healthcare work, reflects on what he calls “the most intense months I have known in my twenty-year career.” He draws all of his chapter epigraphs from Daniel Defoe’s A Journal of the Plague Year and journeys back through most of 2020, from the day in January when he and his colleagues received a bulletin about a “novel Wuhan coronavirus” to November, when he was finalizing the book and learned of promising vaccine trials but also a rumored third wave and winter lockdown.
In February, no one knew whether precautions would end up being an overreaction, so Francis continued normal life: attending a conference, traveling to New York City, and going to a concert, pub, and restaurant. By March he was seeing more and more suspected cases, but symptoms were variable and the criteria for getting tested and quarantining changed all the time. The UK at least seemed better off than Italy, where his in-laws were isolating. Initially it was like flu outbreaks he’d dealt with before, with the main differences being a shift to telephone consultations and the “Great Faff” of donning full PPE for home visits and trips to care homes. The new “digital first” model left him feeling detached from his patients. He had his own Covid scare in May, but a test was negative and the 48-hour bug passed.
Through his involvement in the community, Francis saw the many ways in which coronavirus was affecting different groups of people. He laments the return of mental health crises that had been under control until lockdown. Edinburgh’s homeless, many in a perilous immigration situation thanks to Brexit, were housed in vacant luxury hotels. He visited several makeshift hostels, where some residents were going through drug withdrawal, and also met longtime patients whose self-harm and suicidal ideation were worsening.
Children and the elderly were also suffering. In June, he co-authored a letter begging the Scottish education secretary to allow children to return to school. Perhaps the image that will stick with me most, though, is of the confused dementia patients he met at care homes: “there was a crushing atmosphere of sadness among the residents … [they were] not able to understand why their families no longer came to visit. How do you explain social distancing to someone who doesn’t remember where they are, sometimes even who they are?”
Francis incorporates brief histories of vaccination and the discovery of herd immunity, and visits a hospital where a vaccine trial is underway. I learned some things about COVID-19 specifically: it can be called a “viral pneumonia”; it has two phases, virological (the virus makes you unwell) and immunological (the immune system misdirects messages and the lungs get worse); and it affects the blood vessels as well as the lungs, with one in five presenting with a rash and some developing chilblains in the summer. Amazingly, as the year waned, Francis only knew three patients who had died of Covid, with many more recovered. But in August, a city that should have been bustling with festival tourists was nearly empty.
Necessarily, the book ends in the middle of things; Francis has clear eyes but a hopeful heart. While this is not the first COVID-19 book I’ve encountered (that was Duty of Care by Dominic Pimenta) and will be far from the last – next up for me will be Rachel Clarke’s Breathtaking, out at the end of this month – it is an absorbing first-hand account of a medical crisis as well as a valuable memorial of a time like no other in recent history. A favorite line was “One of the few consolations of this pandemic is its grim camaraderie, a new fellowship among the fear.” Another consolation for me is reading books by medical professionals who can compassionately bridge the gap between expert opinion and everyday experience.
Intensive Care was published by the Wellcome Collection/Profile Books on January 7th. My thanks to the publisher for the free copy for review.
Gavin Francis’s other work includes:
Previously reviewed: Shapeshifters
Also owned: Adventures in Human Being
I’m keen to read: Empire Antarctica, about being the medical officer at the British research centre in Antarctica – ironically, this was during the first SARS pandemic. (In July 2020, conducting medical examinations on the next batch of scientists to ship out there, he envied them the chance to escape: “By the time they came home it would be 2022. Surely we’d have the virus under control by then?”)
My Year in Nonfiction (Thus Far)
If your household is anything like mine, stressful days and nights of lost sleep are ceding to relief after the U.S. election result was finally announced. We celebrated with whoopie pies (a Pennsylvania specialty) and Prosecco.
And look: I happened to pass 270 yesterday as well!
I’d taken part in the Six Degrees of Separation meme every month since February, but this time I had no inspiration. I was going to start with these two apple covers…
…but that’s as far as I got. Never mind! I’ll be back next month, when we all start with the YA classic Are You There God? It’s Me, Margaret by Judy Blume.
Instead, I’m catching up with this past week’s Nonfiction November prompt: Your Year in Nonfiction. It was hosted by Leann of Shelf Aware.
What topics have been prominent in your year’s nonfiction reading?
I’ve read a lot of nature and popular science, probably more than in an average year. Greenery by Tim Dee has been an overall highlight. I managed to read 12 books from the Wainwright Prize longlists, and I’m currently reading four books of nature-themed essays or journals. Thoughtful as well as consoling.
The popular science material has focused on environmentalism and current events, which has inevitably involved politics and long-term planning (Annabel called this category “The State We’re In”): e.g. Losing Eden, Footprints, The Good Ancestor, and Notes from an Apocalypse.
Thanks to the food and drink theme I set for my 20 Books of Summer, I read a number of foodie memoirs. The best one was Heat by Bill Buford, but I also really enjoyed Kitchen Confidential by Anthony Bourdain and My Berlin Kitchen by Luisa Weiss.
Since the Wellcome Book Prize didn’t run this year, I’ve read fewer health-related books, although I did specially read Not the Wellcome Prize shortlistee The Remarkable Life of the Skin by Monty Lyman, and Dear Life by Rachel Clarke, a palliative care doctor, has been one of my overall best nonfiction reads of the year.
Not very well represented in my nonfiction reading this year were biographies and travel books. I can struggle with the depth and dryness of some books from these genres, but I’d like to find some readable options to get stuck into next year.
What are your favorite nonfiction books you’ve read so far?
I’m a huge memoir junkie. Some of the most memorable ones this year have been Winter Journal by Paul Auster, Traveling Mercies by Anne Lamott (a reread), and A Three Dog Life by Abigail Thomas (another reread).
An incidental theme in the life writing I’ve read in 2020 is childhood (Childhood by Tove Ditlevsen, Cider with Rosie by Laurie Lee, Oleander, Jacaranda by Penelope Lively, Period Piece by Gwen Raverat); I hope to continue reading around this topic next year.
What books have you recommended the most to others?
I’ve mentioned the Clarke (above) in any discussions of books about illness and death.
I recommended the memoir Are You Somebody? by Nuala O’Faolain more than once following Reading Ireland Month.
Entangled Life, Merlin Sheldrake’s enthusiastic book about fungi, is one I can imagine suggesting to readers who don’t often pick up nonfiction.
And Signs of Life by Dr. Stephen Fabes has generated a fair bit of interest among my Goodreads friends.
Besides Annabel, Kate and Liz also wrote about their 2020 nonfiction reading habits.
How has your nonfiction reading been going this year?
Nonfiction Catch-Up: Long-Term Thinking, Finding a Home in Wales, Eels
Not long now until Nonfiction November. I’m highlighting three nonfiction books I’ve read over the last few months; any of them would be well worth your time if you’re still looking for some new books to add to the pile. I’ve got a practical introduction to the philosophy and politics of long-term/intergenerational planning, a group biography about the two gay couples who inhabited a house in the Welsh hills in turn, and a wide-ranging work on eels.
The Good Ancestor: How to Think Long Term in a Short-Term World by Roman Krznaric
I saw Krznaric introduce this via a digital Hay Festival session back in May. He is an excellent speaker and did an admirable job of conveying all the major ideas from his recent work within a half-hour presentation. Unfortunately, this meant that reading the book itself didn’t add much for me, although it goes deeper into his propositions and is illustrated with unique, helpful figures.
Without repeating from my write-up of the Festival talk, then, I’ll add in points and quotes that struck me:
- “some of the fundamental ways we organise society, from nation states and representative democracy to consumer culture and capitalism itself, are no longer appropriate for the age we live in.”
- 100 years as the minimum timeframe to think about (i.e., a long human life) – “taking us beyond the ego boundary of our own mortality so we begin to imagine futures that we can influence yet not participate in ourselves.”
- “The phones in our pockets have become the new factory clocks, capturing time that was once our own and offering in exchange a continuous electronic now full of infotainment, advertising and fake news. The distraction industry works by cleverly tapping into our ancient mammalian brains: our ears prick up at the ping of an arriving message … Facebook is Pavlov, and we’re the dogs.”
- The Intergenerational Solidarity Index as a way of assessing governments’ future preparation: long-term democracies tend to perform better, though they aren’t perfect; Iceland scores the highest of all, followed by Sweden.
- Further discussion of Doughnut Economics (a model developed by Krznaric’s wife, Kate Raworth), which pictures the sweet spot humans need to live in between a social foundation and the ecological ceiling; failures lead to overshoot or shortfall.
- Four fundamental barriers to change: outdated institutional designs (our basic political systems), the power of vested interests (fossil fuel companies, Amazon, et al.), current insecurity (refugees), and “insufficient sense of crisis” – we’re like frogs in a gradually boiling pot, he says, and need to be jolted out of our complacency.
This is geared more towards economics and politics than much of what I usually read, yet fits in well with other radical visions of the future I’ve engaged with this year (some of them more environmentalist in approach), including Footprints by David Farrier, The Future Earth by Eric Holthaus, and Notes from an Apocalypse by Mark O’Connell.
With thanks to WH Allen for the free copy for review.
On the Red Hill: Where Four Lives Fell into Place by Mike Parker (2019)
I ordered a copy from Blackwell’s after this made it through to the Wainwright Prize shortlist – it went on to be named the runner-up in the UK nature writing category. It’s primarily a memoir/group biography about Parker, his partner Peredur, and George and Reg, the couple who previously inhabited their home of Rhiw Goch in the Welsh Hills and left it to the younger pair in their wills. In structuring the book into four parts, each associated with an element, a season, a direction of the compass and a main character, Parker focuses on the rhythms of the natural year. The subtitle emphasizes the role Rhiw Goch played, providing all four with a sense of belonging in a rural setting not traditionally welcoming to homosexuals.
Were George and Reg the ‘only gays in the village,’ as the Little Britain sketch has it? Impossible to say, but when they had Powys’ first same-sex civil partnership ceremony in February 2006, they’d been together nearly 60 years. By the time Parker and his partner took over the former guesthouse, gay partnerships were more accepted. In delving back into his friends’ past, then, he conjures up another time: George fought in the Second World War, and for the first 18 years he was with Reg their relationship was technically illegal. But they never rubbed it in any faces, preferring to live quietly, traveling on the Continent and hosting guests at their series of Welsh B&Bs; their politics was conservative, and they were admired locally for their cooking and hospitality (Reg) and endurance cycling (George).
There are lots of in-text black-and-white photographs of Reg and George over the years and of Rhiw Goch through the seasons. Using captioned photos, journal entries, letters and other documents, Parker gives a clear impression of his late friends’ characters. There is something pitiable about both: George resisting ageing with nude weightlifting well into his sixties; Reg still essentially ashamed of his sexuality as well as his dyslexia. I felt I got to know the younger protagonists less well, but that may simply be because their stories are ongoing. It’s remarkable how Welsh Parker now seems: though he grew up in the English Midlands, he now speaks decent Welsh and has even stood for election for the Plaid Cymru party.
It’s rare to come across something in the life writing field that feels genuinely sui generis. There were moments when my attention waned (e.g., George’s feuds with the neighbors), but so strong is the overall sense of time, place and personality that this is a book to prize.
The Gospel of the Eels: A Father, a Son and the World’s Most Enigmatic Fish by Patrik Svensson
[Translated from the Swedish by Agnes Broomé]
“When it comes to eels, an otherwise knowledgeable humanity has always been forced to rely on faith to some extent.”
We know the basic facts of the European eel’s life cycle: born in the Sargasso Sea, it starts off as a larva and then passes through three stages that are almost like separate identities: glass eel, yellow eel, silver eel. After decades underwater, it makes its way back to the Sargasso to spawn and die. Yet so much about the eel remains a mystery: why the Sargasso? What do the creatures do for all the time in between? Eel reproduction still has not been observed, despite scientists’ best efforts. Among the famous names who have researched eels are Aristotle, Sigmund Freud and Rachel Carson, all of whom Svensson discusses at some length. He even suggests that, for Freud, the eel was a suitable early metaphor for the unconscious – “an initial insight into how deeply some truths are hidden.”
But there is a more personal reason for Svensson’s fascination with eels. As a boy he joined his father in eel fishing on Swedish summer nights. It was their only shared hobby; the only thing they ever talked about. His father was as much a mystery to him as eels are to science. And it was only as his father was dying of a cancer caused by his long road-paving career that Svensson came to understand secrets he’d kept hidden for decades.
Chapters alternate between this family story and the story of the eels. The book explores eels’ place in culture (e.g., Günter Grass’ The Tin Drum) and their critically endangered status due to factors such as a herpes virus, nematode infection, pollution, overfishing and climate change. A prior curiosity about marine life would be helpful to keep you going through this, but the prose is lovely enough to draw in even those with a milder interest in nature writing.
With thanks to Picador for the free copy for review.
One of my recent borrows from the public library’s children’s section was the picture book Think of an Eel by Karen Wallace. Her unrhymed, alliterative poetry and the paintings by Mike Bostock beautifully illustrate the eel’s life cycle and journey.
You simply must hear folk singer Kitty Macfarlane’s gorgeous song “Glass Eel” – literally about eels, it’s also concerned with migration, borders and mystery.
Would you be interested in reading one or more of these?
The 1956 Club: The Lonely Londoners and Night
It’s my second time participating in one of Simon and Karen’s reading weeks (after the 1920 Club earlier this year). It was a boon that the two books I chose and borrowed from the library were of novella length. As in April, I managed one very enjoyable read and one slightly less successful skim.
The Lonely Londoners by Sam Selvon
This title was familiar to me because it was one of the texts the London secondary school students could choose to review for a special supplement of Wasafiri literary magazine when I did a few in-school sessions mentoring them in the basics of book reviewing in early 2014. (An experience that was totally outside my comfort zone and now feels like a lifetime away.)
Selvon, a Trinidadian journalist who settled in London in 1950, became known as the “father of black writing” in Britain. Moses Aloetta, an expert in London life after a few years here, lends a hand to his West Indian brethren who are fresh off the boat. As the book opens, he’s off to meet Henry Oliver, whom he soon dubs “Sir Galahad” for his naïve idealism. Moses warns Galahad that, although racism isn’t as blatant as in America, the British certainly aren’t thrilled about black people coming over and taking their jobs. Galahad reassures him that he’s a “born hustler.” We meet a series of other immigrants, like Cap and Bart, who move flats and change jobs frequently, drink and carouse, and “love woman too bad.”
I read and enjoyed the first 52 pages but skimmed from that point on because the patois, while initially captivating, got to be a bit much – I have a limited tolerance for dialect, and for episodic storytelling. I did love the sequences about Galahad catching pigeons for food and Cap following up with seagulls. There is a strong voice and sense of place here: if you want to experience London in the 1950s and see a rarer immigrant perspective, it would be a great choice. (Also recently reviewed by Liz and Annabel.)
Representative passages:
“It have people living in London who don’t know what happening in the room next to them, far more the street, or how other people living. London is a place like that. It divide up in little worlds, and you stay in the world you belong to and you don’t know anything about what happening in the other ones except what you read in the papers.”
the nine-page stream-of-consciousness paragraph that starts “Oh what a time it is when summer come to the city and all them girls throw away heavy winter coat and wearing light summer frocks so you could see the legs and shapes that was hiding away from the cold blasts”
My rating:
Night by Elie Wiesel
[Translated from the French by Marion Wiesel]
A short, harrowing memoir of concentration camp life. Eliezer Wiesel was a young teenager obsessed with the Kabbalah when his family was moved into a Romanian ghetto for Jews and then herded onto a transport train. Uniquely in my reading of Holocaust memoirs, Wiesel was not alone but had his father by his side for much of the time as they were shuttled between various concentration camps including Auschwitz and Buchenwald, from which he was liberated in April 1945. But if the presence of family started as a blessing in a life of privation and despair, it became more of a liability as his father fell ill with dysentery.
Like Viktor Frankl, Wiesel puts his survival down to luck: not once but several times, he and his father were sent to the left (towards the crematoria), but spared at the last minute. They endured infection, a stampede, a snowstorm and near-starvation. But their faith did not survive intact. “For God’s sake, where is God?” someone watching the hanging of a child burst out. “And from within me, I heard a voice answer: ‘Where He is? This is where—hanging here from this gallows.’” I’d heard that story before, twisted by Christian commentators into a “Hey, that’s like Jesus on the cross! God is right here suffering with us” message when actually it’s more “God is dead. God has abandoned us.”
From the preface to a new translation by his wife, I learned that the original Yiddish manuscript was even bleaker in outlook, with opening and closing passages that voice a cynical loss of trust in God and fellow man. “I am not so naïve as to believe that this slim volume will change the course of history or shake the conscience of the world. Books no longer have the power they once did. Those who kept silent yesterday will remain silent tomorrow” was the chilling final line of his first version. And yet Night has been taught in many high schools, and if it opens even a few students’ eyes – given the recent astonishing statistics about American ignorance of the scope of the Holocaust – it has been of value.
Wiesel won the Nobel Peace Prize in 1986. His acceptance speech is appended to the text of my 2008 Penguin paperback. In it he declares: “I swore never to be silent whenever and wherever human beings endure suffering and humiliation. We must take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Sometimes we must interfere. When human lives are endangered, when human dignity is in jeopardy, national borders and sensitivities become irrelevant. Wherever men and women are persecuted because of their race, religion, or political views, that place must—at that moment—become the center of the universe.” Wise words with perennial relevance.
My rating:
20 Books of Summer, #13–14: Ruth Reichl and Alice Steinbach
Just three weeks remain in this challenge. I’m reading another four books towards it, and have two more to pick up during our mini-break to Devon and Dorset this coming weekend. A few of my choices are long and/or slow-moving reads, though, so I have a feeling I’ll be reading right down to the wire…
Today I have another two memoirs linked by France and its cuisine.
Tender at the Bone: Growing Up at the Table by Ruth Reichl (1998)
(20 Books of Summer, #13) I’ve read Reichl’s memoirs out of order, starting with Garlic and Sapphires (2005), about her time as a New York Times food critic, and moving on to Comfort Me with Apples (2001), about her involvement in California foodie culture in the 1970s–80s. Whether because I’d been primed by the disclaimer in the author’s note (“I have occasionally embroidered. I learned early that the most important thing in life is a good story”) or not, I sensed that certain characters and scenes were exaggerated here. Although I didn’t enjoy her memoir of her first 30 years as much as either of the other two I’d read, it was still worth reading.
The cover image is a genuine photograph taken by Reichl’s German immigrant father, book designer Ernst Reichl, in 1955. Early on, Reichl had to fend for herself in the kitchen: her bipolar mother hoarded discount food even it was moldy, so the family quickly learned to avoid her dishes made with ingredients that were well past their best. Like Eric Asimov and Anthony Bourdain, whose memoirs I’ve also reviewed this summer, Reichl got turned on to food by a top-notch meal in France. Food was a form of self-expression as well as an emotional crutch in many situations to come: during boarding school in Montreal, her rebellious high school years, and while living off of trendy grains and Dumpster finds at a co-op in Berkeley.
Reichl worked with food in many ways during her twenties. She was a waitress during college in Michigan, and a restaurant collective co-owner in California; she gave cooking lessons; she catered parties; and she finally embarked on a career as a restaurant critic. Her travels took her to France (summer camp counselor; later, wine aficionado), Morocco (with her college roommate), and Crete (a honeymoon visit to her favorite professor). Raised in New York City, she makes her way back there frequently, too. Overall, the book felt a bit scattered to me, with few if any recipes that I would choose to make, and the relationship with a mentally ill mother was so fraught that I will probably avoid Reichl’s two later books focusing on her mother.
Source: Awesomebooks.com
My rating:
Educating Alice: Adventures of a Curious Woman by Alice Steinbach (2004)
(20 Books of Summer, #14) Steinbach makes a repeat appearance in my summer reading docket: her 2000 travel book Without Reservations was one of my 2018 selections. In that book, she took a sabbatical during her 50s to explore Paris, England, and Italy. Here she continues her efforts at lifelong learning by taking up some sort of lessons everywhere she goes. The long first section sees her back in Paris, enrolling at the Hotel Ritz’s Escoffier École de Gastronomie Française. She’s self-conscious about having joined late, being older than the other students and having to rely on the translator rather than the chef’s instructions, but she’s determined to keep up as the class makes omelettes, roast quail and desserts.
Full disclosure: I’ve only read the first chapter for now as it’s the only one directly relevant to food – in others she takes dance lessons in Japan, studies art in Cuba, trains Border collies in Scotland, etc. – but I was enjoying it and will go back to it before the end of the year.
Source: Free bookshop