Three new books with medical themes (no surprise there), including the first Covid wave in the UK; fertility and body issues in a new queer family; and pain management strategies.
Breathtaking: Inside the NHS in a Time of Pandemic by Rachel Clarke
Clarke is a palliative care doctor based in Oxfordshire. She runs the Katharine House hospice but during the coronavirus pandemic has also been on active duty in the Oxford University Hospitals system. If you’re on social media you have likely come across some of her postings as she has been equally vocal in her praise of the NHS and her criticism of Boris Johnson’s faltering policies, which are often of the too little, too late variety. So I was eager to read her insider’s account of hospital treatment of the first wave of Covid in the UK, especially because her previous book, Dear Life, was one of my top two nonfiction releases of last year.
The focus is on the first four full months of 2020, and the book originated in Clarke’s insomniac diaries and notes made when, even after manically busy shifts, she couldn’t rest her thoughts. Her pilot husband was flying to China even as increasingly alarming reports started coming in from Wuhan. She weaves in the latest news from China and Italy as well as what she hears from colleagues and disease experts in London. But the priority is given to stories: of the first doctor to die in China; of a Yorkshire ICU nurse’s father, who comes down with Covid and is on a ventilator in an Oxford hospital; and of her patients there and in the hospice. She is touched that so many are making great sacrifices, such as by deciding not to visit loved ones at the end of their lives so as not to risk spreading infection.
A shortage of PPE remained a major issue, though Dominic Pimenta (whose Duty of Care was my first COVID-19 book) pulled through for her with an emergency shipment for the hospice – without which it would have had to close. Clarke marvels at the NHS’s ability to create an extra 33,000 beds within a month, but knows that this comes at a cost of other services, including cancer care, being stripped back or cancelled, meaning that many are not receiving the necessary treatment or are pushing inescapable problems further down the road.
A comparison with Gavin Francis’s Intensive Care, published earlier in the month, is inevitable. Both doctors bounce between headlines and everyday stories, government advice and the situation on the ground. Both had their own Covid scare – Clarke didn’t meet the criteria to be tested so simply went back to work two weeks later, when she felt well enough – and had connections to regions that foreshadowed what would soon happen in the UK. Both give a sense of the scope of the crisis and both lament that, just when patients need compassion most, full PPE leads to their doctors feeling more detached from them than ever.
However, within the same page count, Francis manages to convey more of the science behind the virus and its transmission, and helpfully explores the range of effects Covid is having for different groups. He also brings the story more up to the minute with a look back from November, whereas Clarke ends in April and follows up with an epilogue set in August. A book has to end somewhere, yes, but with this crisis ongoing, the later and more relevant its contents can be, the better. And in any book that involves a lot of death, mawkishness is a risk; Clarke so carefully avoided this in Dear Life, but sometimes succumbs here, with an insistence on how the pandemic has brought out the best in people (clapping and rainbows and all that). Her writing is as strong as ever, but I would have appreciated a sharper, more sombre look at the situation a few months later. Perhaps there will be a sequel.
With thanks to Little, Brown UK for the free copy for review.
Some Body to Love: A Family Story by Alexandra Heminsley
From Heminsley’s previous book, Leap In, I knew about her getting married and undergoing IVF. It was also a book about outdoor swimming; I appreciated her words on acquiring a new skill as an adult and overcoming body issues. This memoir continues the story: in 2017, after a gruelling journey through infertility treatment, Heminsley finally got the baby she wanted. But not before a couple more heart-wrenching moments: the lab made an error and notified her that she shared no DNA with this last embryo, and while heavily pregnant she was assaulted by a drunk man on a train. Both incidents left her feeling a loss of agency. “Why was I consistently being deemed the least reliable witness of my own reality?” she asks.
As they adjusted to new life with a baby, Heminsley started to notice that she wasn’t connecting with her husband, D, like she used to. She felt emotionally unsupported and, in fact, jealous of D’s relationship with their son, L. And while they’d never been the most conventional couple, D’s changes of appearance and wardrobe seemed like a sign of something bigger. Indeed, when L was six months old, D told Heminsley, “this body doesn’t represent who I am” and announced a decision to begin transitioning.
As D moved towards having a body that fit their identity, Heminsley, too, needed to get back in touch with her body. After books like Running Like a Girl, she was considered an exercise guru, but she didn’t see herself in the new obsession with Instagram-ready images of fitness perfection. This is not, then, primarily a memoir of queer family-making, because D’s transitioning was not Heminsley’s story to tell and mostly occurs in the background. Instead she focuses on what she does know and can control: her relationship to her own body.
However, this entails what can feel like irrelevant flashbacks to her teenage years of undergoing rehab at a military clinic in Germany for hypermobility, trips to Trinidad and Italy, and the genesis of her two sporting memoirs. Much as I applaud the sensitivity to trans and body issues, the book ends up feeling scattered. Still, the writing is so candid and the narrative so eventful that you’ll race through this even if you don’t normally pick up nonfiction. (For a bit more information, see my short write-up of the virtual book launch.)
With thanks to Chatto & Windus for the free copy for review.
Pain: The Science of the Feeling Brain by Abdul-Ghaaliq Lalkhen
Originally from South Africa, Dr Lalkhen is an anaesthesiology and pain specialist based in Manchester. In a nutshell, his approach is “biopsychosocial,” meaning that he seeks to understand pain not just as a physical phenomenon resulting from acute injury or damage but as an ongoing process that is affected by emotional and psychological factors. Particularly in the context of chronic syndromes, he acknowledges that pain can continue even when its immediate cause has been repaired. Mental preparation can come into the equation: if a patient assumes they’ll wake up from surgery healed, they may be alarmed if pain persists. Lalkhen talks about managing patient expectations, perhaps with something as simple as the promise, “we’ll aim to get your pain down to a 4 after surgery.” In part, he blames Western society’s Cartesian philosophy for treating mind and body as separate rather than a system.
There are genetic and psychological reasons people might be predisposed to chronic pain. Pain itself can then change the brain chemistry, making the body more alert to pain signals. People can choose one of three paths, Lalkhen observes: “You can spend your time agitating about the alarm going off, you can try to ignore it (but the ignoring of it actually takes up more energy), or the final alternative is to learn to live with this deeply unpleasant situation.” Those who opt for pharmacological solutions can become addicted to opiates, which are less effective over time. Non-drug-related therapies involve the desensitization of nerves, the injection of anaesthetics or steroids, or the implanting of spinal cord stimulators. But all of these strategies have their limitations, and can diminish in efficacy. The patients he sees in his pain clinics may be disappointed that, rather than offering a panacea, he wants to wean them off their current pain relief and help them develop a new way of thinking about pain.
I felt I learned a lot from reading this. Lalkhen is careful to state that he is only referring to non-cancer pain (cancer pain in terminal patients will take all the morphine you can throw at it). Like many physicians, he worries about the modern epidemic of overtreatment and our obsession with wellness. I especially enjoyed the discussion of the understanding of pain and its treatment from the ancient world onward, and in particular the history of opiates. The prose is not literary, but this is an accessible and informational read if the subject matter draws you.
With thanks to Atlantic Books for the free copy for review.
What recent nonfiction releases can you recommend?
Constellations: Reflections from Life by Sinéad Gleeson
This book best met the criteria of the Wellcome Book Prize: “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.”
Jackie says (in her blog tour review): “Constellations is a collection of fourteen essays written by an eloquent storyteller. Each celebrates the imperfect body – its workings and failings. … The stories told are incisive and highly personal. They cover a variety of the author’s lived experiences including: bone disease, cancer treatment, pregnancy, motherhood, and death. … The writing throughout is percipient and exquisitely rendered, arguments expressed with clarity and compassion.”
Annabel says: “Gleeson’s beautifully written essays on her life, her health, pain and illness, motherhood, and being a woman in Ireland are deeply personal, yet speak volumes. Richly varied in style and closing with a poem written to her daughter, the collection explores her themes in elegant prose with not a word wasted. She questions, explains, understands, writing through pain, but also shows her joie de vivre. Superb!” (See more in her 5-star review.)
From my review (December 2018): “Gleeson turns pain into art. … She marvels at all that the body can withstand, but realizes that medical interventions leave permanent marks, physical or emotional. She also remarks on the essential loneliness of illness, and the likelihood of women’s pain not being believed in or acknowledged. This book feels timely and is inventive in how it brings together disparate topics to explore the possibilities and limitations of women’s bodies.”
Some favourite quotes from Constellations:
“Our bodies are sacred, certainly, but they are often not ours alone. Our hospital body, all rivers of scars; the day-to-day form that we present to the world … we create our own matryoshka bodies, and try to keep one that is just for us.”
“Joints can be replaced, organs transplanted, blood transfused, but the story of our lives is still the story of one body. From ill health to heartbreak, we live inside the same skin, aware of its fragility, grappling with our mortality.”
“Illness is an outpost: lunar, Arctic, difficult to reach.”
(Honorable mention goes to The Remarkable Life of the Skin by Monty Lyman for winning the popular vote on Twitter. I was so pleased that we got 354 votes! We arrived at a winner, as we have in the past few years, through each member of the shadow panel doling out 21 points, assigning each book a point value from 1 to 6. The Twitter scores were assigned in the same way and added in, and the winner was the book with the most points in total.)
Thank you to the rest of the shadow panel (Annabel of Annabookbel, Clare of A Little Blog of Books, Laura of Dr. Laura Tisdall and Paul of Halfman, Halfbook) and to all the bloggers who took part in the blog tour for helping to showcase some of the best health-themed literature published in 2019.
Here’s hoping that this time next year some of us can be meeting up in person to celebrate the awarding of the 2021 Wellcome Book Prize.
After deliberation and two rounds of voting, we as a shadow panel (Annabel of Annabookbel, Clare of A Little Blog of Books, Laura of Dr. Laura Tisdall, Paul of Halfman, Halfbook and I) have reduced the 19 longlisted titles to a shortlist of six books. A few of these were clear standouts on which we all agreed, while the others required more difficult decisions.
Exhalation by Ted Chiang
Invisible Women by Caroline Criado Perez
Constellations by Sinéad Gleeson
The Nocturnal Brain by Guy Leschziner
The Remarkable Life of the Skin by Monty Lyman
War Doctor by David Nott
We’re pleased with the quality and variety we’ve come up with here. While nonfiction dominates, we have included science fiction stories that raise questions about artificial intelligence and human development. The other books address gender inequality; cancer, chronic pain, and disability; circadian rhythms and sleep; anatomy; and surgery in war zones.
The shadow panel members will vote this coming weekend to choose a winner. In the meantime, I have set up a Twitter poll to run through Saturday, the results of which will serve as one additional weighted vote. Our winner will be announced one week from today, on the morning of Monday the 11th. Go forth and vote!
Which book(s) are you rooting for?
I haven’t done much dipping into 2020 releases yet, but I do have two that I would highly recommend to pretty much anyone, plus some more that are also worth highlighting.
My top recommendations (so far) for 2020:
American Dirt by Jeanine Cummins
[Coming on January 21st from Tinder Press (UK) / Flatiron Books (USA)]
You’ve most likely already heard of this novel about the plight of migrants crossing the U.S. border in search of a better life. What’s interesting is that the main characters are not your typical border crossers: Lydia was a middle-class Acapulco bookshop owner whose journalist husband was murdered for his pieces exposing the local drug cartel. She and her eight-year-old son, Luca, know that the cartel is after them, too, and its informers are everywhere. They join Central American migrants in hopping onto La Bestia, a dangerous freight train network running the length of Mexico. Their fellow travelers’ histories reveal the traumatic situations migrants leave and the hazards they face along the way. Cummins alternates between the compelling perspectives of Lydia and Luca, and the suspense is unrelenting. It feels current and crucial. (My full review will be in Issue 491 of Stylist magazine, so if you are in London or another city that hands it out and can pick up a copy, keep an eye out!)
The Lost Family: How DNA Testing Is Upending Who We Are by Libby Copeland
[Coming on March 3rd from Abrams Press (USA)]
A terrific follow-up to one of my runners-up from last year, Inheritance by Dani Shapiro. I learned that “non-paternity events” such as Shapiro experienced are not as uncommon as you might think. Copeland spoke to scientists, DNA testing companies, and some 400 ordinary people who sent off saliva samples to get their DNA profile and, in many cases, received results they were never expecting. There are stories of secret second families, of people who didn’t find out they were adopted until midlife, and of babies switched at birth. We’ve come a long way since the days when people interested in family history had to trawl through reams of microfilm and wait months or years to learn anything new; nowadays a DNA test can turn up missing relatives within a matter of days. But there are a lot of troubling aspects to this new industry, including privacy concerns, notions of racial identity, and criminal databases. It’s a timely and thought-provoking book, written with all the verve and suspense of fiction.
Also of note (in release date order):
Half Broke: A Memoir by Ginger Gaffney: Horse trainer Gaffney has volunteered at the Delancey Street Foundation’s New Mexico ranch, an alternative prison for drug offenders, for six years. She chronicles how feral horses and humans can help each other heal. Great for fans of Cheryl Strayed. (February 4, W.W. Norton)
Survival Is a Style: Poems by Christian Wiman: Wiman examines Christian faith in the shadow of cancer. This is the third of his books that I’ve read; I’m consistently impressed by how he makes room for doubt, bitterness and irony, yet a flame of faith remains. Really interesting phrasing and vocabulary here. (February 4, Farrar, Straus and Giroux)
Pain Studies by Lisa Olstein: Another in a growing number of hard-hitting books about female pain. Specifically, Olstein has chronic migraines. In these essays she ranges from ancient philosophy to recent television in her references, and from lists of symptoms to poetic descriptions in her format. A little rambly, but stylish nonetheless. (March 4, Bellevue Literary Press)
My Wild Garden: Notes from a Writer’s Eden by Meir Shalev: The Israeli novelist tells of how he took a derelict garden in the Jezreel Valley and made it thrive. He blends botanical knowledge with Jewish folklore. I particularly enjoyed his good-natured feud against his local mole rats. Gentle and charming. (March 31, Shocken)
The Alekizou and His Terrible Library Plot! by Nancy Turgeon: The Alekizou can’t read! Jealous of the fun he sees children having at the library, he breaks in and steals all the vowels. Without them, books and speech don’t make sense. Luckily, the children know sign language and use it to create replacement letters. A fun picture book with rhymes reminiscent of Dr. Seuss, this also teaches children vowels and basic signing. (April 6, CrissCross AppleSauce)
With thanks to the publisher for the free PDF copy for review.
Why We Swim by Bonnie Tsui: A personal history with swimming, but also a wide-ranging study of humans’ relationship with the water – as a source of food, exercise, healing, competition and enjoyment. Tsui meets scientists, coaches, Olympians and record holders, and recounts some hard-to-believe survival tales. (April 14, Algonquin Books)
Will you look out for one or more of these?
Any other 2020 reads you can recommend?
For me, 2019 has been a more memorable year for nonfiction than for fiction. Like I did last year, I’ve happened to choose 12 favorite nonfiction books – though after some thematic grouping this has ended up as a top 10 list. Bodies, archaeology, and the environmental crisis are recurring topics, reflecting my own interests but also, I think, something of the zeitgeist.
Let the countdown begin!
- Because Internet: Understanding how language is changing by Gretchen McCulloch: Surprisingly fascinating stuff, even for a late adopter of technology. The Internet popularized informal writing and quickly incorporates changes in slang and cultural references. The book addresses things you may never have considered, like how we convey tone of voice through what we type and how emoji function as the gestures of the written word. Bursting with geeky enthusiasm.
- Surfacing by Kathleen Jamie: A fusion of autobiography with nature and travel writing – two genres that are too often dominated by men. Jamie has a particular interest in birds, islands, archaeology and the oddities of the human body, all subjects that intrigue me. There is beautiful nature writing to be found in this volume, as you might expect, but also relatable words on the human condition.
- Mother Ship by Francesca Segal: A visceral diary of the first eight weeks in the lives of the author’s daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU. Segal describes with tender precision the feeling of being torn between writing and motherhood, and crafts twinkly pen portraits of others she encountered in the NICU, including the staff but especially her fellow preemie mums.
- Surrender: Mid-Life in the American West by Joanna Pocock: Prompted by two years spent in Missoula, Montana and the disorientation felt upon a return to London, this memoir-in-essays varies in scale from the big skies of the American West to the smallness of one human life and the experience of loss and change. This is an elegantly introspective work that should engage anyone interested in women’s life writing and the environmental crisis.
- (A tie) Constellations by Sinéad Gleeson / The Undying by Anne Boyer / Notes Made while Falling by Jenn Ashworth: Trenchant autobiographical essays about female pain. All three feel timely and inventive in how they bring together disparate topics to explore the possibilities and limitations of women’s bodies. A huge theme in life writing in the last couple of years and a great step toward trauma and chronic pain being taken seriously. (See also Notes to Self by Emilie Pine and the forthcoming Pain Studies by Lisa Olstein.)
- Time Song: Searching for Doggerland by Julia Blackburn: Deep time is another key topic this year. Blackburn follows her curiosity wherever it leads as she does research into millions of years of history, including the much shorter story of human occupation. The writing is splendid, and the dashes of autobiographical information are just right, making her timely/timeless story personal. This would have been my Wainwright Prize winner.
- The Seafarers: A Journey among Birds by Stephen Rutt: The young naturalist travelled the length and breadth of the British Isles – from Skomer to Shetland – courting encounters with seabirds. Discussion of the environmental threats that hit these species hardest, such as plastic pollution, makes for a timely tie-in to wider issues. The prose is elegantly evocative, and especially enjoyable because I’ve been to a lot of the island locations.
- Once More We Saw Stars by Jayson Greene: In 2015 the author’s two-year-old daughter, Greta, was fatally struck in the head by a brick that crumbled off an eighth-story Manhattan windowsill. Music journalist Greene explores all the ramifications of grief. I’ve read many a bereavement memoir and can’t remember a more searing account of the emotions and thoughts experienced moment to moment. The whole book has an aw(e)ful clarity to it.
- The Body: A Guide for Occupants by Bill Bryson: Bryson is back on form indulging his layman’s curiosity. Without ever being superficial or patronizing, he gives a comprehensive introduction to every organ and body system. He delights in our physical oddities, and his sense of wonder is contagious. Shelve this next to Being Mortal by Atul Gawande in a collection of books everyone should read – even if you don’t normally choose nonfiction.
- Irreplaceable: The Fight to Save Our Wild Places by Julian Hoffman: Species and habitat loss are hard to comprehend even when we know the facts. This exquisitely written book is about taking stock, taking responsibility, and going beyond the numbers to tell the stories of front-line conservation work. Irreplaceable is an elegy of sorts, but, more importantly, it’s a call to arms. It places environmentalism in the hands of laypeople and offers hope that in working together in the spirit of defiance we can achieve great things. So, if you read one 2019 release, make it this one.
What were some of your top nonfiction reads of the year?
29th: Other superlatives and some statistics
30th: Best backlist reads
31st: The final figures on my 2019 reading
“Launched in 2009, the Wellcome Book Prize, worth £30,000, celebrates the best new books that engage with an aspect of medicine, health or illness, showcasing the breadth and depth of our encounters with medicine through exceptional works of fiction and non-fiction.” I was delighted to be asked to participate in the official Wellcome Book Prize 10th anniversary blog tour. For this stop on the tour I’m highlighting a shortlisted title from 2010, a very strong year. The winning book, Rebecca Skloot’s The Immortal Life of Henrietta Lacks, along with Siddhartha Mukherjee’s The Emperor of All Maladies, turned me on to health-themed reading and remains one of my most memorable reads of the past decade.
Teach Us to Sit Still: A Sceptic’s Search for Health and Healing by Tim Parks
Tim Parks, an Englishman, has lived and worked in Italy for over 30 years. He teaches translation at the university in Milan, and is also a novelist and a frequent newspaper columnist on literary topics. Starting in his forties, Parks was plagued by urinary problems and abdominal pain. Each night he had to get up five or six times to urinate, and when he didn’t have fiery pangs shooting through his pelvic area he had a dull ache. Doctors assessed his prostate and bladder in tests that seemed more like torture sessions, but ultimately found nothing wrong. While he was relieved that his worst fears of cancer were allayed, he was left with a dilemma: constant, unexplained discomfort and no medical strategy for treating it.
When conventional medicine failed him, Parks asked himself probing questions: Had he in some way brought this pain on himself through his restless, uptight and pessimistic ways? Had he ever made peace with his minister father’s evangelical Christianity after leaving it for a life based on reason? Was his obsession with transmuting experience into words keeping him from living authentically? During a translation conference in Delhi, he consulted an ayurvedic doctor on a whim and heard words that haunted him: “This is a problem you will never get over, Mr Parks, until you confront the profound contradiction in your character.”
The good news is: some things helped. One was the book A Headache in the Pelvis, which teaches a paradoxical relaxation technique that Parks used for up to an hour a day, lying on a yoga mat in his study. Another was exercise, especially running and kayaking – a way of challenging himself and seeking thrills in a controlled manner. He also started shiatsu therapy. And finally, Vipassana meditation retreats helped him shift his focus off the mind’s experience of pain and onto bodily wholeness. Vipassana is all about “seeing things as they really are,” so the retreats were for him a “showdown with this tangled self” and a chance to face the inevitability of death. Considering he couldn’t take notes at the time, I was impressed by the level of detail with which Parks describes his breakthroughs during meditation.
Though I was uneasy reading about a middle-aged man’s plumbing issues and didn’t always follow the author on his digressions into literary history (Coleridge et al.), I found this to be an absorbing and surprising quest narrative. If not with the particulars, I could sympathize with the broader strokes of Parks’s self-interrogation. He wonders whether sitting at a desk, tense and with poor posture, and wandering around with eyes on the ground and mind on knots of words for years contributed to his medical crisis. Borrowing the title phrase from T.S. Eliot, he’s charted an unlikely journey towards mindfulness in a thorough, bracingly honest, and diverting book that won’t put off those suspicious of New Age woo-woo.
With thanks to Midas PR for the free copy for review.
Wellcome Book Prize 2010
Winner: The Immortal Life of Henrietta Lacks by Rebecca Skloot
Shortlist: Angel of Death by Gareth Williams; Grace Williams Says It Loud by Emma Henderson; So Much for That by Lionel Shriver; Medic by John Nicols and Tony Rennell; Teach Us to Sit Still by Tim Parks
Judges: Comedy writer and television presenter Clive Anderson (chair); novelist and academic Maggie Gee; academic and writer Michael Neve; television presenter and author Alice Roberts; academic and writer A.C. Grayling
The 2019 Wellcome Book Prize longlist will be announced in February. I’m already looking forward to it, of course, and I’m planning to run a shadow panel once again.
Elif Shafak, award-winning author, is the chair of this year’s judges and is joined on the panel by Kevin Fong, consultant anaesthetist at University College London Hospitals; Viv Groskop, writer, broadcaster and stand-up comedian; Jon Day, writer, critic, and academic; and Rick Edwards, broadcaster and author.
See below for details of where other reviews have appeared or will be appearing soon as part of the Wellcome Book Prize 10th anniversary blog tour.