Tag Archives: organ transplantation

“Graphic Medicine”: The Lady Doctor by Ian Williams

This sequel to Ian Williams’s 2014 graphic novel 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 nights out drinking with her best friend, Geeta, but her carefree life is soon beset by complications: she has to decide whether she wants to join the health center as a full partner, a tryst with her new fella goes horribly wrong, and her estranged mother suddenly reappears in her life, hoping 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; no doubt his experiences have inspired his comics. His 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 (and in the cover blurb she says, “Ian Williams is the best thing to happen to medicine since penicillin”), with single colors from pink to olive alternating as the background. I especially loved the pages where each panel depicts a different patient to show the breadth of people and complaints a doctor might see in a day.

This review is on the short side for me, but I don’t want to resort to spoilers, so will just say that if you’re a fan of Bechdel and Posy Simmonds, or if you are unfamiliar with graphic novels and fancy trying one, do seek this out. The medical theme made it a must for me. In fact, Myriad Editions have a whole “Graphic Medicine” series that I’ll be keen to explore.

My rating:

 

The Lady Doctor will be published in the UK by Myriad Editions on January 31st and in the USA by Penn State University Press on February 18th. My thanks to the publisher and publicist Emma Dowson for the free copy for review.

Other 2018 Superlatives and Some Early 2019 Recommendations

 

My Best Discoveries of the Year: Neil Ansell, James Baldwin, Janet Frame, Rohinton Mistry, Blake Morrison, Dani Shapiro, Sarah Vowell; Roald Dahl’s work for adults

 

The Author I Read the Most By: Anne Tyler (four novels)

 

My Proudest Reading Achievement: Getting through a whole Rachel Cusk book (it was my third attempt to read her).

 

The 2018 Books Everybody Else Loved but I Didn’t: Melmoth by Sarah Perry and Normal People by Sally Rooney

 

The Year’s Biggest Disappointments: The Travelling Cat Chronicles by Hiro Arikawa and Sabrina by Nick Drnaso

 

The Funniest Books I Read This Year: Fox 8 by George Saunders and Calypso by David Sedaris

 

Books that Made Me CryLeaving Before the Rains Come by Alexandra Fuller and The Long Goodbye by Meghan O’Rourke

 

The Downright Strangest Books I Read This Year: The Bus on Thursday by Sheila Barrett, The Pisces by Melissa Broder and I Love Dick by Chris Kraus

 

The Debut Authors Whose Next Work I’m Most Looking Forward To: Julie Buntin, Lisa Ko and R.O. Kwon

 

The Best First Line of the Year: “Dust and ashes though I am, I sleep the sleep of angels.” (from The Western Wind by Samantha Harvey)

 

 

Some Early 2019 Recommendations

(in release date order)

Book Love by Debbie Tung: Bookworms will get a real kick out of these cartoons, which capture everyday moments in the life of a book-obsessed young woman (perpetually in hoodie and ponytail). She reads anything, anytime, anywhere. Even though she has piles of books staring her in the face everywhere she looks, she can never resist a trip to the bookstore or library. The very idea of culling her books or finding herself short of reading material makes her panic, and she makes a friend sign a written agreement before he can borrow one of her books. Her partner and friends think she’s batty, but she doesn’t care. I found the content a little bit repetitive and the drawing style not particularly distinguished, but Tung gets the bibliophile’s psyche just right. (Out January 1.)

 

 

When Death Becomes Life: Notes from a Transplant Surgeon by Joshua D. Mezrich: In this debut memoir a surgeon surveys the history of organ transplantation, recalling his own medical education and the special patients he’s met along the way. In the 1940s and 1950s patient after patient was lost to rejection of the transplanted organ, post-surgery infection, or hemorrhaging. Mezrich marvels at how few decades passed between transplantation seeming like something out of a science-fiction future and becoming a commonplace procedure. His aim is to never lose his sense of wonder at the life-saving possibilities of organ donation, and he conveys that awe to readers through his descriptions of a typical procedure. One day I will likely need a donated kidney to save my life. How grateful I am to live at a time when this is a possibility. (Out January 15.)

 

Inheritance: A Memoir of Genealogy, Paternity, and Love by Dani Shapiro: Shapiro was used to strangers’ comments about her blond hair and blue eyes. How could it be that she was an Orthodox Jew? people wondered. It never occurred to her that there was any truth to these hurtful jokes. On a whim, in her fifties, she joined her husband in sending off a DNA test kit. It came back with alarming results. Within 36 hours of starting research into her origins, Shapiro had found her biological father, a sperm donor whom she calls Dr. Ben Walden, and in the year that followed, their families carefully built up a relationship. The whole experience was memoirist’s gold, for sure. This is a moving account of her emotional state as she pondered her identity and what her sense of family would be in the future. (Out January 15.)

 

constellationsConstellations: Reflections from Life 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. As a child Gleeson had arthritis that weakened her hip bones, and eventually she had to have a total hip replacement. She 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. In the tradition of Virginia Woolf, Frida Kahlo and Susan Sontag, Gleeson turns pain into art, particularly in a set of 20 poems based on the McGill Pain Index. The book feels timely and is inventive in how it brings together disparate topics to explore the possibilities and limitations of women’s bodies. (Out April 4.)

 

The Hot Young Widows Club: Lessons on Survival from the Front Lines of Grief by Nora McInerny: In June 2016 I read It’s Okay to Laugh (Crying Is Cool Too), McInerny’s memoir about losing her father and her husband to cancer and her second child to a miscarriage – all within a few weeks – when she was 31. In this short book, an expansion of her TED talk, she argues that we are all incompetent when it comes to grief. There’s no rule book for how to do it well or how to help other people who are experiencing a bereavement, and comparing one loss to another doesn’t help anyone. I especially appreciated her rundown of the difference between pity and true empathy. “Pity keeps our hearts closed up, locked away. Empathy opens our heart up to the possibility that the pain of others could one day be our own pain.” (Out April 30.)

 

Coming tomorrow: Library Checkout & Final statistics for the year

 

Have you read any 2019 releases you can recommend?

Wellcome Prize Shortlist, Part 1: de Kerangal and Kalanithi

I’m delighted to announce the final members of our Wellcome Book Prize 2017 shadow panel:

Ruby blogs at My Booking Great Blog.

GrrlScientist is an ornithologist and science journalist who was on the judging panel for the 2016 Royal Society Insight Investment Science Book Prize.

Along with Paul and Amy, this brings us up to five people – the same number as the official judging panel.


Luckily, I’ve already read two of the shortlisted titles, one quite recently and one nearly a year and a half ago. Here are the reviews I published on Goodreads at the time. I’ll be getting both books back out of the library soon to have another look before we choose our winner.


Mend the Living by Maylis de Kerangal

(translated from the French by Jessica Moore; published in the USA as The Heart)

[This is the French author’s second novel to be translated into English. It has been made into a film and won the Prix Orange du Livre and the Grand prix RTL du livre. It was also recently shortlisted for the Albertine Prize, an American readers’ choice award for contemporary French fiction. If you’re based in the States, feel free to vote by April 30th!]


Nineteen-year-old Simon Limbeau is declared brain dead in a French hospital after a car accident, but his heart lives on: metaphorically through the love of his parents, sister, friends, and girlfriend; but also literally, in the recipient of his organ donation. Again and again de Kerangal makes a distinction between the physical reality of organs and what they represent: “Simon’s eyes are not just his nervous retina, his taffeta iris, his pupil of pure black in front of the crystalline – they are also his gaze; his skin isn’t just the threaded mesh of his epidermis, his porous cavities – it’s his light and his touch, the living sensors of his body.”

The novel spends time with Simon’s family, especially his mother, but also with the transplant coordinator, the surgeons, the nurse, and so on. I was reminded of ER as well as the French TV show The Returned – this would work really well on screen, and would be a way of avoiding the more off-putting aspects of the author’s style. She writes long, run-on sentences: sometimes half a page, sometimes even stretching to two pages, and stuffs her prose with abstruse vocabulary (or at least that’s how the translator has rendered it), a lot of it medical but some of it simply inaccessible: “emollient conjugality” plus at least a dozen English words I’d never encountered (e.g. abulic, tumid, atony, claudicant, auscultation, precellence, torticollis, naevi, scialytic).

The worst example of the unnecessary opacity is “the digitigrade gait of the sardana dancer when he’s nearing a quintal, the corpulence of an ex-obese man calibrating him in thickness, in fullness, but without visible excrescence” – in plain English, the guy is stocky.


Read in November 2016.

My rating:

My gut feeling: The novel gives a vivid sense of the fragility of life and imbues parts of the body with metaphorical meaning. However, I think the style makes it too inaccessible and I can’t see its appeal ever being more than niche.


More reviews:

Annabel’s at Shiny New Books

Carolyn’s at Rosemary and Reading Glasses

 

When Breath Becomes Air by Paul Kalanithi

[The first posthumous nominee for the Wellcome Book Prize. I’ll be interested to see what I make of this one when I revisit it.]


Paul Kalanithi was 36 and just completing his neurosurgery residency in Stanford, California when he was diagnosed with advanced lung cancer that did not respond well to treatment. It came as a complete surprise to this non-smoker, and set his life on a new course. He and his coterie of doctors managed his symptoms so he could operate for as long as possible, but when the time came he knew he wanted to devote his last year to writing this memoir. In addition, he would get a brief, sweet taste of fatherhood: he and his wife Lucy, also in the medical field, decided to have a child, a daughter named Cady.

Kalanithi grew up the son of Indian immigrants in Arizona. “I was driven less by achievement than by trying to understand, in earnest: What makes human life meaningful?” he recalls. Degrees in English literature and human biology were disparate attempts to find an answer. Like Henry Marsh (Do No Harm), he has a surgeon’s knowledge of the anatomy of reasoning, but realizes that does not provide the full picture. He recognizes the responsibility of holding others’ lives in the balance, and regrets occasional failures of empathy.

Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.

It’s intriguing to see religious language in that statement – indeed, Kalanithi saw his work as a calling, and one with moral connotations. Christian imagery shows up repeatedly:

Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused.

Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can.

When’s the last time you encountered the word “narthex”?! The vocabulary is striking throughout, as in another favorite passage: “A tureen of tragedy was best allotted by the spoonful. Only a few patients demanded the whole at once; most needed time to digest.”

Kalanithi died in March 2015. In addition to the foreword by Abraham Verghese, there’s a lovely epilogue from his widow, who’s more than competent to carry on his legacy.

I appreciate stories lived on the knife edge of life and death, but I would recommend this to those who don’t normally choose to read illness narratives, simply for the beauty of its prose – a fine blend of literature and medicine – and the wholehearted picture of a life cut short.


Read in October 2015 (Random House were looking for early readers via NetGalley).

My rating:

My gut feeling: I suspect this is by far the most popular and best-selling title on this year’s shortlist. So many people have taken it to their hearts. It will take a truly special book to knock it from the top spot.


More reviews:

Shadow panelist Paul’s at Nudge

Shadow panelist Ruby’s at My Booking Great Blog

Susan’s at A life in books


Shortlist strategy:

Currently reading: The Tidal Zone by Sarah Moss – about halfway through.

Up next: Whichever of the remaining nonfiction titles turns up to the library for me first!

I’ve also sent off an emergency e-mail to Bodley Head asking for a copy of Ed Yong’s I Contain Multitudes; it’s on loan through my library system until April 19th, which gives me no time to read it even if it comes back on time.

Four Books for World Kidney Day

Today, March 9th, is World Kidney Day. “The kidneys are like the Rodney Dangerfield of vital organs—they get no popular respect,” Vanessa Grubbs (whose memoir I discuss below) wryly comments. Chances are you rarely have occasion to think about your kidneys. But I’m honoring them with a reading list because several years ago I was diagnosed with polycystic kidney disease, a degenerative condition that runs in my family. My maternal grandmother had it – we’ve never definitively traced it further back than her – and four of her six children have it, too. (If you took a high school genetics class, you might remember that with an autosomal dominant condition offspring have a 50% chance of inheriting the gene for the disease.) A few cousins of my generation also have PKD, and starting with my mom we’ve had a few successful kidney transplants in the family so far.

I must mention the excellent work done by the PKD Foundation in the States and the PKD Charity here in the UK. Both are a great support and source of information for me and my wider family.


The Plimsoll Line by Juan Gracia Armendáriz

As soon as I read Melissa’s review at The Book Binder’s Daughter, I knew I had to get this one. “The Plimsoll line” is a maritime term indicating how low a cargo-laden ship can sit in the water without sinking; here it’s used metaphorically to ask just how much one man can take. Gabriel Ariz is a 52-year-old art professor who lives not far from the city yet surrounded by oak woods. He’s divorced from Ana, who’s pressuring him to sell the house, and their young adult daughter Laura died a few years ago in a car accident. Now this pack-a-day smoker who gets drunk with his brother, traveling photographer Óscar, learns that he has end-stage renal disease and his life will have to change. On indefinite leave from work, he attends a dialysis clinic several times a week and joins the organ transplant list.

At times this was a bit overwritten for my tastes – some paragraphs stretch to several pages, and I’ve had to look up words, including “lentitude” and “logomachy” – but I did love the author’s trick of jumping into different perspectives. On multiple occasions he employs an “anonymous observer,” and in various chapters the point-of-view shifts to a member of the animal kingdom: Polanski the cat, a black kite flying overhead, a mole popping up in the garden, or a beetle winging across the detritus of Gabriel’s untidy household. We also get an extended section from Laura’s journals that reveals a disturbing family secret.

This is not one for the squeamish as it gives an unflinching account of dialysis: “His forearm throbbed, lacerated by needle marks. Sara had taken a while to find the fistula, and now the pain spread under the surgical tape like a jellyfish sting.” But for every passage that makes you cringe there’s a beautiful one that captures things perfectly: “he is living in constant deferment, between parentheses” and “If the succubus of his bad dreams were to say to him, ‘Make a wish,’ he would ask to be able to mold himself to the geological quietude of stones.”

The Plimsoll Line won Spain’s Premio Tiflos de Novela in 2008 and first appeared in English translation in 2015. It is part of a “Trilogy of Illness”; I presume the other volumes are not yet available in English, though I’ve enquired of the translator, Jonathan Dunne, via a Facebook message just in case. Forget Ferrante and Knausgaard; this is the semi-autobiographical series I’ll be awaiting the next installment of with bated breath.

My rating:

 

Hundreds of Interlaced Fingers by Vanessa Grubbs

Grubbs is a nephrologist and assistant professor of medicine at San Francisco General Hospital. Well before she made the kidneys her clinical area of expertise, a personal encounter made them special to her. In 2003 she met Robert Phillips when she was an attending trying to get support for her Office of Diversity Affairs; he was a hospital trustee. She only later learned, after they started dating, that due to FSGS his kidneys had failed in his twenties and he’d been on dialysis for years. In 2005 she donated him one of her kidneys. Robert’s health was touch-and-go for a little while there, but he proposed to her soon afterwards. I read about a third of this and then skimmed the rest because I wasn’t all that interested in their separate histories. However, I did like the context Grubbs gives, such as a brief history of dialysis, nephrology case studies, and a great set of FAQs. She also notes that minorities are less likely to get organ transplants, a disparity she is working to rectify.

This memoir grew out of an essay for Health Affairs, “Good for Harvest, Bad for Planting.” Releases June 13th.

My rating:

 

The A to Z of You and Me by James Hannah

(First reviewed in November 2015; here’s a shortened version.) Lying in a hospice bed, 40-year-old Ivo looks back on his life. Even after just four short decades and a modest career at a garden center, he has plenty to regret. Hard partying and drug use exacerbated his diabetes and prompted kidney failure. His lifestyle also led indirectly to his girlfriend, nursing student Mia (the “you” he often addresses directly), leaving him. He’s estranged from his sister and his friends from school days, especially Mal. How did he mess up so badly and cut himself off so completely that he’s now dying alone? And how much can he put right before he goes?

There’s plenty of affecting writing in Hannah’s debut novel. I liked how he captures the routines of institutional life. Nurse Sheila’s A to Z game, encouraging Ivo to think of a memory attached to body parts starting with each letter of the alphabet, provides a hokey but effective structure. Keeping in mind that in British English Z is pronounced ‘zed’, the title doesn’t rhyme, but this is still somewhat sappy. I’d recommend it to fans of Mark Haddon and David Nicholls. I’ll follow Hannah’s career and hope he avoids melodrama and a contrived setup – the two near-pitfalls of this one – in the future.

My rating:

 

The Reluctant Donor by Suzanne F. Ruff

A sepia-toned photograph at the centerfold tells a solemn tale: six of these eight members of Ruff’s Irish-Catholic Chicago family died, directly or indirectly, as a result of PKD. I’ve always known there’s a long waiting list for transplant kidneys, but I was surprised to learn that dialysis machines used to be rare; demand far exceeded supply, and the procedure was not covered by Medicare until 1973. Ruff’s aunt, Sister Mike, decided the lives of people with children were more important than her own, so didn’t press for dialysis; when her kidneys failed in her forties, death followed just a few months later.

Things had greatly improved by the time Ruff’s mother needed a transplant. Joan sounds like a feisty, lovable character, with plenty of good advice on being a patient: fight for your rights (the meek ones often end up being carried out feet first), get up and walk as soon after surgery as you possibly can, and appreciate the joy of an entirely ordinary day. Ruff’s parents had her and her sisters tested for PKD when they were teenagers. Having gone to the trouble, they then lied about the results! They said no one had PKD, but in the end two out of three did; only Ruff was spared. This is how she ended up donating a kidney to her younger sister, JoAnn. The more interesting sections of the book are about Ruff’s family history; her internal struggle to convince herself to commit to organ donation makes for pretty repetitive moaning.

In general, the writing isn’t great. Skimming through, I found a page with 16 of my proofreading marks; on most pages it’s more like 2–3. There’s also a tendency to over-write when portraying emotion: “Genetic disease. Those two words made my spine shiver, my ears ring, my throat close, and my heart pound; I became lightheaded and faint. Terror crept into my core and gripped me in its vice [sic].” While I’m not sure I could recommend this to someone who doesn’t have a personal stake in organ donation, for those who are interested in an autobiographical account of genetic disease/transplant surgery, it’s a quick, pleasant read.

My rating:


Plus two more kidney-themed novels I’m on the look-out for:

  • Useful, Debra Oswald, about a man who decides to donate a kidney to a stranger
  • The Kidney Hypothetical: Or How to Ruin Your Life in Seven Days, Lisa Yee, a YA comedy in which a girl asks her boyfriend if he’d give her a kidney. Hypothetically, right?

I’m on the fence about:

  • Larry’s Kidney: Being the True Story of How I Found Myself in China with My Black Sheep Cousin and His Mail-Order Bride, Skirting the Law to Get Him a Transplant—and Save His Life, Daniel Asa Rose (I think the subtitle says it all!)
  • I, Kidney, Chris Six: a self-published, semi-autobiographical novel