Tag Archives: midwife

First Four in a Row: Márai, Maupin, McEwan, McKay

I announced a few new TBR reading projects back in May 2020, including a Four in a Row Challenge (see the ‘rules’, such as they are, in my opening post). It only took me, um, nearly 11 months to complete a first set! The problem was that I kept changing my mind on which four to include and acquiring more that technically should go into the sequence, e.g. McCracken, McGregor; also, I stalled on the Maupin for ages. But here we are at last. Debbie, meanwhile, took up the challenge and ran with it, completing a set of four novels – also by M authors, clearly a numerous and tempting bunch – back in October. Here’s hers.

I’m on my way to completing a few more sets: I’ve read one G, one and a bit H, and I selected a group of four L. I’ve not chosen a nonfiction quartet yet, but that could be an interesting exercise: I file by author surname even within categories like science/nature and travel, so this could throw up interesting combinations of topics. Do feel free to join in this challenge if, like me, you could use a push to get through more of the books on your shelves.

 

Embers by Sándor Márai (1942)

[Translated from the Hungarian by Carol Brown Janeway]

My first work of Hungarian literature.* This was a random charity shop purchase, simply because I’m always trying to read more international literature and had enjoyed translations by Carol Brown Janeway before. In 1940, two old men are reunited for the first time in 41 years at a gloomy castle, where they will dine by candlelight and, over the course of a long conversation, face up to the secret that nearly destroyed their friendship. This is the residence of 75-year-old Henrik, usually referred to as “the General,” who lives alone apart from Nini, his 91-year-old wet nurse. His wife, Krisztina, died 33 years ago.

Henrik was 10 when he met Konrad at an academy school. They were soon the best of friends, but two things came between them: first was the difference in their backgrounds (“each forgave the other’s original sin: wealth on the one hand and poverty on the other”); second was their love for the same woman.

I appreciated the different setup to this one – a male friendship, just a few very old characters, the probing of the past through memory and dialogue – but it was so languid that I struggled to stay engaged with the plot.

*My next will be Journey by Moonlight by Antal Szerb, another charity shop find.

Favourite lines:

“My homeland was a feeling, and that feeling was mortally wounded.”

“Life becomes bearable only when one has come to terms with who one is, both in one’s own eyes and in the eyes of the world.”

 

Tales of the City by Armistead Maupin (1978)

I’d picked this up from the free bookshop we used to have in the local mall (the source of my next two as well) and started it during Lockdown #1 because in The Novel Cure it is given as a prescription for Loneliness. Berthoud and Elderkin suggest it can make you feel like part of a gang of old friends, and it’s “as close to watching television as literature gets” due to the episodic format – the first four Tales books were serialized in the San Francisco Chronicle.

How I love a perfect book and bookmark combination!

The titled chapters are each about three pages long, which made it an ideal bedside book – I would read a chapter per night before sleep. The issue with this piecemeal reading strategy, though, was that I never got to know any of the characters; because I’d often only pick up the book once a week or so, I forgot who people were and what was going on. That didn’t stop individual vignettes from being entertaining, but meant it didn’t all come together for me.

Maupin opens on Mary Ann Singleton, a 25-year-old secretary who goes to San Francisco on vacation and impulsively decides to stay. She rooms at Anna Madrigal’s place on Barbary Lane and meets a kooky assortment of folks, many of them gay – including her new best friend, Michael Tolliver, aka “Mouse.” There are parties and affairs, a pregnancy and a death, all told with a light touch and a clear love for the characters; dialogue predominates. While it’s very much of its time, it manages not to feel too dated overall. I can see why many have taken the series to heart, but don’t think I’ll go further with Maupin’s work.

Note: Long before I tried the book, I knew about it through one of my favourite Bookshop Band songs, “Cleveland,” which picks up on Mary Ann’s sense of displacement as she ponders whether she’d be better off back in Ohio after all. Selected lyrics:

Quaaludes and cocktails

A story book lane

A girl with three names

A place, post-Watergate

Freed from its bird cage

Where the unafraid parade

[…]

Perhaps, we should all

Go back to Cleveland

Where we know what’s around the bend

[…]

Citizens of Atlantis

The Madrigal Enchantress cries

And we decide, to stay and bide our time

On this far-out, far-flung peninsula.

 

The Children Act by Ian McEwan (2014)

Although it’s good to see McEwan take on a female perspective – a rarer choice for him, though it has shown up in Atonement and On Chesil Beach – this is a lesser novel from him, only interesting insomuch as it combines elements from two of his previous works, The Child in Time (legislation around child welfare) and Enduring Love (a religious stalker). Fiona Maye, a High Court judge, has to decide whether 17-year-old Adam, a bright and musical young man with acute leukaemia, should be treated with blood transfusions despite his Jehovah’s Witness parents’ objection.


[SPOILERS FOLLOW]

She rules that the doctors should go ahead with the treatment. “He must be protected from his religion and from himself.” Adam, now better but adrift from the religion he was raised in, starts stalking Fiona and sending her letters and poems. Estranged from her husband, who wants her to condone his affair with a young colleague, and fond of Adam, Fiona spontaneously kisses the young man while traveling for work near Newcastle. But thereafter she ignores his communications, and when he doesn’t seek treatment for his recurring cancer and dies, she blames herself.

[END OF SPOILERS]


It’s worth noting that the AI in McEwan’s most recent full-length novel, Machines Like Me, is also named Adam, and in both books there’s uncertainty about whether the Adam character is supposed to be a child substitute.

 

The Birth House by Ami McKay (2006)

Dora is the only daughter to be born into the Rare family of Nova Scotia’s Scots Bay in five generations. At age 17, she becomes an apprentice to Marie Babineau, a Cajun midwife and healer who relies on ancient wisdom and appeals to the Virgin Mary to keep women safe and grant them what they want, whether that’s a baby or a miscarriage. As the 1910s advance and the men of the village start leaving for the war, the old ways represented by Miss B. and Dora come to be seen as a threat. Dr. Thomas wants women to take out motherhood insurance and commit to delivering their babies at the new Canning Maternity Home with the help of chloroform and forceps. “Why should you ladies continue to suffer, most notably the trials of childbirth, when there are safe, modern alternatives available to you?” he asks.

Encouraged into marriage at an early age, Dora has to put her vocation on hold to be a wife to Archer Bigelow, a drunkard with big plans for how he’s going to transform the area with windmills that generate electricity. Dora’s narration is interspersed with journal entries, letters, faux newspaper articles, what look like genuine period advertisements, and a glossary of herbal remedies – creating what McKay, in her Author’s Note, calls a “literary scrapbook.” I love epistolary formats, and there are so many interesting themes and appealing secondary characters here. Early obstetrics is not the only aspect of medicine included; there is also an exploration of “hysteria” and its treatment, and the Spanish flu makes a late appearance. Dora, away in Boston at the time, urges her friends from the Occasional Knitters’ Society to block the road to the Bay, make gauze masks, and wash their hands with hot water and soap.

There are a few places where the narrative is almost overwhelmed by all the (admittedly, fascinating) facts McKay, a debut author, turned up in her research, and where the science versus superstition dichotomy seems too simplistic, but for the most part this was just the sort of absorbing, atmospheric historical fiction that I like best. McKay took inspiration from her own home, an old birthing house in the Bay of Fundy.

Hard Pushed: A Midwife’s Story by Leah Hazard

“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.

Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.

Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.

A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.

I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.

Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.

Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s 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. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.

 

A few favorite passages:

“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”

“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”

“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”

My rating:

 


Hard Pushed was published in the UK on May 2nd (just a few days before International Midwives’ Day) by Hutchinson. My thanks to the publisher for the free proof copy for review.

Wellcome Book Prize: Shortlist Recap

Tomorrow morning we will announce our Wellcome Book Prize 2018 shadow panel winner. Beforehand I wanted to do a quick recap of my reviews, especially for the two books that I read before the shortlist announcement. My full reviews are here:

Stay with Me by Ayobami Adebayo 

To Be a Machine by Mark O’Connell 

Mayhem by Sigrid Rausing  

The Vaccine Race by Meredith Wadman 

 

I give some extra thoughts on and favorite quotes from the other two below:

 

The Butchering Art by Lindsey Fitzharris

This is a great blend of medical history and popular science that should draw in readers who wouldn’t normally gravitate to either topic – provided they aren’t too squeamish. Fitzharris has recently returned to Oxford as a visiting academic, and this has also been nominated for the Wolfson History Prize. Follow her on Instagram (@drlindseyfitzharris) for a steady stream of gruesomely fascinating photos (I wish The Butchering Art had been illustrated!). Her next book will be much of a muchness, it seems, documenting the early years of plastic surgery after World War I through the story of pioneering surgeon Harold Gillies. 


In the days before Joseph Lister…

“Operating theaters were gateways to death. It was safer to have an operation at  home than in a hospital, where mortality rates were three to five times higher than they were in domestic settings.”

“The surgeon was very much viewed as a manual labourer who used his hands to make his living, much like a key cutter or plumber today.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[A]n extremely readable account of a ground-breaking career which led to real advances in hospital medicine. I enjoyed the whole, but particularly the grisly bits!”

Laura’s review: “It’s easy for me to feel a bit impatient with popular histories of periods or subjects that I know well, but Fitzharris strikes exactly the right note, writing clearly and accessibly with no dumbing down.”

Paul’s review: “It is one of the better books that I have read on medical history[;] Fitzharris writes in an engaging way on a subject that is not going to appeal to everyone, but in amongst all the blood is the fascinating story of Joseph Lister.”

 

With the End in Mind by Kathryn Mannix

“It’s time to talk about dying. This is my way of promoting the conversation,” Mannix writes in her introduction to this accessible and reassuring book about death. She believes we are afraid of death because of our misconception that it is inevitably painful and undignified. In her decades of working in hospice care, this has rarely been the case. (Thank goodness that, compared to the earlier nineteenth-century situation Fitzharris surveys, we have reliable pain control options.) Mannix sees the role of the hospice worker as being like a midwife for the dying, a helpful idea I first encountered in Henry Fersko-Weiss’s Caring for the Dying: The Doula Approach to a Meaningful Death


Many of the stories in this book are of peaceful deaths the patient and family had time to prepare for. Others are sad stories of denial. One, though, is quite gruesome, yet magnificently described. Alex, a young man with testicular teratoma, has a massive GI bleed:

“Alex’s head is thrown back, almost as though it is a voluntary movement. A huge, dark-red python slithers rapidly out of his mouth, pushing his head backwards as it coils itself onto the pillow beside him; the python is wet and gleaming and begins to stain the pillowcase and sheets with its red essence as Alex takes one snoring breath, and then stops breathing. His mother screams as he realises that the python is Alex’s blood. Probably all of his blood.”

See what the rest of the shadow panel has to say about this book:

Annabel’s review: “[I]t is helping patients, and their families and loved ones, to understand the process of dying, and dispelling the taboos around it that make this book such a valuable and compelling read. I wish I’d read something like this book before my mum died.”

Clare’s review: “For me, this enlightening book is a strong potential winner for the Wellcome Book Prize and I hope it brings comfort and guidance for those who need it.”

Laura’s review: “[The book is] written from her own experiences as a specialist in palliative care, and this proved, for me, both its strength and its downfall. … Mannix writes particularly well on the characteristic patterns of somebody who is entering a gradual decline.”

Paul’s review: “Can highly recommend this moving book and I think it should be essential reading for anyone who has any concerns about death.”

 


I wouldn’t be at all surprised to see either of these win the Wellcome Book Prize on Monday. Stay tuned for tomorrow’s shadow panel winner announcement, and Sunday’s write-up of a shortlist event I’m attending in London.