I’ve done a couple of other dual review posts this year (and I have another planned for Friday) where the books’ titles are so similar that I couldn’t resist discussing them together, even if the books themselves were extremely different. First I featured two books called Ex Libris; later I reviewed The Still Point with The Still Point of the Turning World. This time I have two 2021 releases: How Not to Be Afraid, Gareth Higgins’s self-help/theology book about resisting despair and living in faith; and Chinese American poet Jane Wong’s collection How to Not Be Afraid of Everything, which draws on her family history. Together the titles seemed like a perfect antidote to R.I.P. (more coming up for that on Halloween!).
How Not to Be Afraid: Seven Ways to Live When Everything Seems Terrifying by Gareth Higgins
I saw Higgins at the online Church Times Festival of Faith and Literature in April, after which I promptly ordered all the speakers’ books; I’m still reading the other three. He grew up in Northern Ireland in the waning days of the Troubles and has been involved in peacemaking projects as well as in artistic expressions of progressive Christianity such as Wild Goose Festival, which he co-founded, and The Porch, an online magazine he edits. Fear was ingrained in him from his upbringing and reinforced by the bullying he experienced over his sexuality. He writes that it took him decades to learn that fear is a story, one often based on false assumptions about our powerlessness, and that we can change the story.
There’s a psychological/self-help bent to the book as Higgins invites readers, through the exercises at the end of each chapter, to ponder what myths about the true self and its possibilities are limiting their lives. The “seven” of the subtitle actually refers to seven main types of fear, each addressed in turn, such as “fear of having done something that can’t be fixed,” “fear of not having enough,” and “fear of a meaningless life.” There’s a good mix of memoir, theory, anecdotes and therapy speak (though it’s never jargon-y), and while the perspective is Christian, the content is not so religious as to turn off anyone – unless they’re dead set against faith. Many passages hit me right in the solar plexus and made me long to work out how my life can be bigger and part of telling a better story. Particularly recommended to fans of Barbara Brown Taylor, Brian McLaren and Richard Rohr. (New purchase)
How to Not Be Afraid of Everything by Jane Wong
Wong is an assistant professor of creative writing at Western Washington University. The centerpiece of her second collection is “When You Died,” a 20-page epic about her grandparents’ experience during China’s “Great Leap Forward,” a 1950s–60s Maoist campaign of agricultural reform that led to severe famine. Her grandfather survived it and her mother was born at the tail end of it. Wong was born to immigrant parents in New Jersey and the atmosphere and imagery she uses to describe her living situation there reminded me of Qian Julie Wang’s in her memoir Beautiful Country.
Foodstuffs provide the figurative palette, with decay never far behind. I most enjoyed the multi-part poem “The Frontier” (“The frontier arranges itself / around me like a moat. / The frontier drops fruit / upon my head. I break open, / hot cantaloupe in winter. / I wobble around, spilling fruit / everywhere. All day, fruit flies / pay their respects.”) and “The Cactus,” about her spiky self-preservation instincts. This is the theme of the title poem as well:
How to not punch everyone in the face.
How to not protect everyone’s eyes from
my own punch. I have been practicing
my punch for years, loosening my limbs.
My jaw unhinged creates a felony I refuse
to go to court for.
There are many unusual metaphors and word choices, and a lot of the alliteration I love. Opening poem “Mad” is playfully set up like a Mad Libs game with all the key words as blanks. But at the same time, there are loads of prose poems – never my favourite thing to come across in a collection – and some long ones that I kept getting lost in.
Released by Alice James Books on the 12th. With thanks to Nectar Literary for the free e-copy for review.
Ella Berthoud is one of the bibliotherapists at the School of Life in London and co-author of The Novel Cure. (I wrote about my bibliotherapy session with her in this post.) For her contribution to a Leaping Hare Press series on mindfulness – whose titles range from The Mindful Art of Wild Swimming to Mindfulness and the Journey of Bereavement – she’s thought deeply about how reading can be an active, deliberate practice rather than a time of passive receiving or entertainment. Through handy exercises and quirky tips she encourages readers to take stock of how they read and to become more aware of each word on the page.
To start with, a close reading exercise using a passage from Alice in Wonderland invites you to find out whether you’re an auditory, visual or kinesthetic reader. I learned that I’m a cross between auditory and visual: I hear every word aloud in my head, but I also picture the scenes, usually unfolding in black and white in settings that are familiar to me (my childhood best friend’s home used to be a common backdrop, for instance). The book then discusses ways to incorporate reading into daily life, from breakfast to bedtime and from a favorite chair to the crook of a tree, and how to combine it with other activities. I will certainly be trying out the reading yoga poses!
As I discovered at my bibliotherapy appointment, Ella is passionate about getting people reading in as many different ways as possible. That can include listening to audiobooks, reading aloud with a partner, or reading silently but in company with other people. She also surveys the many ways there are of sharing an enthusiasm for books nowadays, such as Book Crossing, book clubs and Little Free Libraries.
Although she acknowledges the place of e-readers and smartphones, Ella generally describes reading as a tactile experience, and insists on the importance of keeping a print reading journal as well as a ‘Golden Treasury’ of favorite passages, two strategies that will combat the tendency to forget a book as soon as you’ve finished it.
Some of her suggestions of what to do with physical books are beyond the pale for me – such as using a knife to slice a daunting doorstopper into more manageable chunks, or beating up a much-hyped book to “rob [it] of its glamour and gloss, and bring it down from its pedestal to a more humble state, a place where you can read it in comfort” – but there are ideas here to suit every kind of reader. Take a quick break between novels and use this book to think about how you read and in what ways you could improve or intensify the experience.
“As a bibliotherapist, I believe that every novel you read shapes the person that you are, speaking to you on a deep, unconscious level, and altering your very nature with the ideas that it shows you.”
“I often find that people imagine reading fiction is a self-indulgent thing to do, and that they ought to be doing something else. Much research has been conducted into the benefits of reading fiction, which deepens your empathy and emotional intelligence, helps with making important life decisions and allows your brain to rest. Research has shown that reading provides as much relaxation as meditation”
With thanks to Leaping Hare Press for the free copy for review.
Two nonfiction books: a frank account of an abortion; clutter-busting techniques.
Two novels: amusing intellectual fare featuring a big dog or the Parisian Surrealists.
Happening by Annie Ernaux (2000; English translation, 2019)
[Translated from the French by Tanya Leslie]
“I believe that any experience, whatever its nature, has the inalienable right to be chronicled,” Ernaux writes. In 1963, when she was 23 and living in a student residence in Rouen, she realized she was pregnant. An appointment with a gynecologist set out the facts starkly: “Pregnancy certificate of: Mademoiselle Annie Duchesne. Date of delivery: 8 July, 1964. I saw summer, sunshine. I tore up the certificate.” Abortion was illegal in France at that time. Ernaux tried to take things into her own hands – “plunging a knitting needle into a womb weighed little next to ruining one’s career” – but couldn’t go through with it. Instead she went to the home of a middle-aged nurse she’d heard about…
This very short book (just 60-some pages) is told in a matter-of-fact style – apart from the climactic moment when her pregnancy ends: “It burst forth like a grenade, in a spray of water that splashed the door. I saw a baby doll dangling from my loins at the end of a reddish cord.” It’s such a garish image, almost cartoonish, that I didn’t know whether to laugh or be horrified. Mostly, Ernaux reflects on memory and the reconstruction of events. I haven’t read many nonfiction accounts of abortion/miscarriage and for that reason found this interesting, but it was perhaps too brief and detached for me to be fully engaged.
With thanks to Fitzcarraldo Editions for the free copy for review.
The Friend by Sigrid Nunez (2018)
“Does something bad happen to the dog?” We animal lovers are wary when approaching a book about a pet. Nunez playfully anticipates that question as she has her unnamed female narrator reflect on her duty of care to her dead friend’s dog. The narrator is a writer and academic – like her late friend, a Bellovian womanizer who recently committed suicide, leaving behind two ex-wives, a widow, and Apollo the aging Great Dane. She addresses the friend directly as “you” for almost the whole book, which unfolds – in a similar style to Jenny Offill’s Department of Speculation – via quotations, aphorisms, and stories from literary history as well as mini-incidents from a life.
This won the 2018 National Book Award in the USA and is an unashamedly high-brow work whose intertextuality comes through in direct allusions to many classic works of autofiction (Coetzee, Knausgaard and Lessing) and/or doggy lit (Ackerley; Coetzee again – Disgrace). As Apollo starts to take up more physical, mental and emotional space in the narrator’s life, she waits for a miracle that will allow her to keep him despite an eviction notice and muses on lots of questions: Is all writing autobiographical? Why does animal suffering pain us so much (especially compared to human suffering)? I was impressed: it feels like Nunez has encapsulated everything she’s ever known or thought about, all in just over 200 pages, and alongside a heart-warming little plot. (Animal lovers need not fear.)
With thanks to Virago for the free copy for review.
Outer Order, Inner Calm: Declutter and Organize to Make More Room for Happiness by Gretchen Rubin (2019)
What with all the debate over Marie Kondo’s clutter-reducing tactics, the timing is perfect for this practical guide to culling and organizing all the stuff that piles up around us at home and at work. Unlike the rest of Rubin’s self-help books, this is not a narrative but a set of tips – 150 of them! It’s not so much a book to read straight through as one to keep at your bedside and read a few pages to summon up motivation for the next tidying challenge.
Famously, Kondo advises one to ask whether an item sparks joy. Rubin’s central questions are more down-to-earth: Do I need it? Do I love it? Do I use it? With no index, the book is a bit difficult to navigate; you just have to flip through until you find what you want. The advice seems in something of a random order and can be slightly repetitive. But since this is really meant as a book of inspiration, I think it will be a useful jumping-off point for anyone trying to get on top of clutter. I plan to work through the closet checklist before I pass the book to my sister – who’s dealing with a basement full of stuff after she and her second husband merged their households. If I could add one page, it would be a flowchart of what to do with unwanted stuff that corresponds to the latest green recommendations.
With thanks to Two Roads for the free copy for review.
The Age of Light by Whitney Scharer (2019)
This novel about Lee Miller’s relationship with Man Ray is in the same vein as The Paris Wife, Z, Loving Frank and Frieda: all of these have sought to rescue a historical woman from the shadow of a celebrated, charismatic male and tell her own fascinating life story. Scharer captures the bohemian atmosphere of 1929–30 Paris in elegant but accessible prose. Along with the central pair we meet others from the Dada group plus Jean Cocteau, and get a glimpse of Josephine Baker. The novel is nearly 100 pages too long, I think, such that my interest in the politics of the central relationship – Man becomes too possessive and Lee starts to act out, longing for freedom again – started to wane.
Miller was a photographer as well as a model and journalist, and this is an appropriately visual novel that’s interested in appearances, lighting and what gets preserved for posterity. It’s also fairly sexually explicit for literary fiction, sometimes unnecessarily so, so keep that in mind if it’s likely to bother you. I especially enjoyed the brief flashes of Lee at other points in her life: in London during the Blitz, photographing the aftermath of the war in Germany (there’s a famous image of her in Hitler’s bathtub), and hoping she’s more than just a washed-up alcoholic in the 1960s. It would be a boon to have a prior interest in or some knowledge of the Surrealists.
With thanks to Picador for the free copy for review.
Would you be interested in reading one or more of these?
Today is apparently what’s known as “Blue Monday,” the saddest day of the year. It can be hard to find reasons to be cheerful in mid-January, especially given the state of Anglo-American politics. All too often I give in to melancholy on these dark mornings. However, I aim to do better. Gretchen Rubin’s The Happiness Project was one of the most memorable books I read in the second half of last year. What I appreciated most about it was that her approach is not about undertaking extreme actions to try to achieve happiness, but about finding contentment with the life you already have by adding or tweaking small habits.
I was keen to see what additional tips I could glean from Live Happy: 100 Simple Ways to Fill Your Life with Joy by positive psychologists Bridget Grenville-Cleave and Ilona Boniwell. They explain that about 50% of the capacity for happiness is genetic, while 10% is related to your current situation. That means that individuals are able to boost their happiness by up to 40% through their attitude and choices.
The key is to focus on what you can influence for the better. The book includes in this category things like luck, health and confidence. I found it difficult to accept the idea that I could choose to have good luck and high energy. It’s just such a foreign concept to me. But according to Grenville-Cleave and Boniwell, perceived control of one’s life course is extremely important.
Live Happy contains good generic advice on diet, use of time, relationships and forming positive habits, though the 100-item format leads to some repetition. In a few cases examples of practical application are necessary; otherwise what we have is just sound bites. For instance, “Try adopting extrovert behaviours such as assertiveness and engaging with others” and “you can also try to face problems head on, rather than simply giving up; you’ll find it easier to bounce back after misfortune.”
On the other hand, I did find specific suggestions that I plan to put into practice. A tip for being more optimistic is to wear a rubber band around your wrist and snap yourself every time you experience an Automatic Negative Thought. I also appreciated these words about making choices: “For unimportant decisions try to be satisfied with an option that is merely good enough, rather than trying to make absolutely the best choice. Lower your expectations – do not expect perfection.”
This is an attractive book, with each page containing pull quotes or whimsical drawings that tie into the blue-yellow-green palette. I would recommend it to readers of The Artist’s Way by Julia Cameron, A Manual for Heartache by Cathy Rentzenbrink and Option B by Sheryl Sandberg. It could also make an ideal bedside book for people who aren’t big readers but are interested in injecting a little more happiness into their everyday life.
Live Happy was published by Modern Books on January 17th. My thanks to Alison Menzies for arranging my free copy for review.
If you would be interested in winning a copy of Live Happy, please comment to that effect below and I will choose one winner at random on Monday the 28th (UK only, sorry!).
We arrived in the UK on January 1, after an overnight flight from Baltimore. There was no midnight announcement, no complimentary champagne; nothing. Clearly I had my hopes too high. So we’re feeling a bit cheated out of our New Year’s Eve experience and will be doing a recreated countdown and toast when we have houseguests over for this Epiphany weekend.
It was a low-key, relaxing couple of weeks back in the States, the majority of it spent seeing family and friends. We also made it into D.C. to see the new Obama portraits. Mostly I enjoyed doing not a lick of work. And I acquired books, of course: a secondhand and remainder stack that, after my trade-in of some cast-off books, cost just $4; and a few ARCs I’m excited about.
I’m feeling restless in my career, like if someone gave me permission to quit all my gigs I would do it tomorrow. But, of course, only a fool would do so with no plan to replace them with other remunerative work. The year is likely to involve a lot of rethinking for me as I evaluate which of my proofreading and writing jobs feel worthwhile, and what’s taking me in the direction I want to go (not that I currently know what that is).
Life is awfully hard to plan out. Reading is much easier! So here are my fairly modest reading goals for the year, some of them overlapping:
- I plan to reinstate the Classic and Doorstopper of the month features I ran in 2017, since otherwise I hardly ever read them. I’m starting with Annabel’s readalong of The Name of the Rose by Umberto Eco, which is just over 500 pages but also conveniently falls into one of the below categories.
- I’ll make a second attempt at getting through some of the travel books and biographies I own, though I won’t hold myself to any particular target. At least five of each would be nice.
- I’m determined to up my literature in translation ratio. These are all the books I own that were originally published in other languages – pitiful! – but I will get hold of more through the library and publishers.
- Re-reading is something I undertake very reluctantly. I have friends who swear by it, but to me it can feel like a waste of time. Last year I re-read just four books: Little Women, Give Me Everything You Have, Crossing the Moon, and Diary of a Bookseller. In each case, on the second reading I rated the book a star lower. That suggests that, far from appreciating books more on a second reading, I have less patience with them and find more flaws! All the same, I’ve chosen four books to re-read in 2019. The Collins is a longtime favorite about moving to Hay-on-Wye; the Thomas is one of the books that first got me into reading memoirs. I’ve been let down by Lamott’s latest three books so wanted to go back to one of her spiritual classics; I’ve gotten into L’Engle’s writing for adults and want to revisit her most famous children’s book (which I don’t think I comprehended at age nine or whatever I was).
- I have a bad habit of racing through self-help and theology books rather than taking my time mulling over them and fully exploring how I might apply them in my life. This was especially true of The Artist’s Way, one of my bibliotherapy prescriptions. I started out with the aim of completing the daily “morning pages” of free writing (though for me they were ‘evening pages’; I’m not a morning person) and each chapter’s self-knowledge exercises. But soon I’d given up on the writing and contemplation and begun just reading the book straight through, which is not the point of it at all. So this year I mean to go back through the Cameron and Rubin books more mindfully, and use the McLaren devotional as it is intended, reading the recommended Bible passages alongside the weekly reflections.
What are some of your goals (reading-related or otherwise) for 2019?
Outwardly Marianne Power’s life was fine, but deep down she felt unhappy and unfulfilled. An Irish freelance journalist living in London, she was 36 and single. “There has to be more than just working and paying bills and buying crap we don’t need,” she felt. She’d been an obsessive reader of self-help books for years – Feel the Fear and Do It Anyway inspired her to leave her temp job at age 24 – but she realized that she’d never implemented most of the books’ lessons. So instead of just reading self-help, she set out to do self-help, one book per month, for a year (though it ended up being longer) to see if she could truly change her life.
January was a baptism of fire. Jumping in with that old favorite, Jeffers’s Feel the Fear, Power listed things she was afraid of and then did one per day: an outdoor swim on New Year’s Day, nude modeling for an art class, parallel parking, standup comedy, and skydiving. In subsequent months she tackled her disastrous finances (Money, A Love Story), tested out the law of attraction (The Secret), practiced lots of rejection therapy, worked on relinquishing control (F**k It), attended a Tony Robbins “Unleash the Power Within” seminar, and imagined what she’d want said at her funeral (The Seven Habits of Highly Effective People).
There came a point in the year when Power had to admit she was physically rundown and emotionally shattered. Months spent focusing on herself had alienated her from friends and family – even her mum, a wonderfully matter-of-fact character who believes in just getting on with life instead of moaning about it. A trio of truly useful books (The Power of Now by Eckhart Tolle, Daring Greatly by Brené Brown and You Can Heal Your Life by Louise Hay) started to turn the tide, helping Power counter negative thoughts with positive affirmations and reminding her that self-help is futile because you can never go it alone. Being with other people who understand you, volunteering and exercise: these are the things that really help.
I have a particular weakness for year-challenge books, and Power’s is written in an easy, chatty style, as if Bridget Jones had given over her diary to testing self-help books for 16 months (“Do a budget, make a plan. Two phrases that made me break into a cold sweat”). If I have one tiny complaint, it’s that I might have liked a little more context on the books she chose. Help Me! is self-deprecating and relatable, with some sweary Irish swagger thrown in. I can recommend it to self-help junkies and skeptics alike.
“The dangerous expectation that can be created by self-help books is that if you’re not walking around like a cross between Mary Poppins, Buddha and Jesus every day you’re doing it wrong. You must try harder. … The higher I was setting my standards the more I was feeling like a failure.”
(I also loved the pep talk from a taxi driver who got depressed when doing a PhD on Thomas Hardy!)
Full disclosure: Marianne and I are Facebook friends and she arranged for me to be sent a proof copy of Help Me! The finished book was released by Picador on September 6th.
Can’t believe I let the summer slip away again
Like watermelon juice dripping down my chin
It might be light enough for one last swim
If we hurry on down to the shore
A fool would ask for more
A fool would ask for more
~from “August” by Mark Erelli
Summer is winding down here in southern England. The chilly nights and mornings and the huge ripe blackberries tell us autumn will be here soon. Did I make enough of the summer? Or did I so ardently escape the heat, here and in America, that I didn’t let myself enjoy it?
We didn’t end up making a summer pudding this year. It’s an old-fashioned, grown-up dessert made of almost nothing but white bread and fresh berries, but if you want to taste July in a bowl this is it. Sweetness from strawberries and raspberries; only just palatable sharpness from currants; smoothness from a generous pouring of cream. As my husband says each year, who knows how many more annual summer puddings we’ll get? Food traditions are as important a way of marking the passing of time and the seasons’ gifts as anything else.
I’ve had “August” by Mark Erelli, a New England folk singer/songwriter we discovered through The Darwin Song Project, in my head for weeks and weeks. It presents scenes from a languid summer evening that appeal to my nostalgia for my American childhood. More than that, though, its recurring line – “A fool would ask for more” – encourages me to be grateful for what I have and to appreciate these ordinary, fleeting moments.
“You’re one of those people who wants everything but what they have.” So Ruth, dying of breast cancer, skewers her best friend Ann, the narrator of Talk before Sleep by Elizabeth Berg. That line stung a little, because I fear it’s true of me. When I’m in America I’m silently contemptuous of the lavish lifestyle and the can-do attitude; as soon as I’m back in England I stew in my cluttered house and my shabby little life. I envy friends with design magazine-worthy homes (but I don’t want the hassle of owning a house), sweet kids (but I don’t want to have children), stable careers (but I don’t want a regular job), and comfortable habits not needled by environmental and ethical dilemmas (but once you know you can’t go back).
My five-year freelancing anniversary passed quietly at the end of July. Being a freelancer has all the perks you’d expect – no boss or co-workers, at least not in the traditional sense; no commute; flexibility; variety – but also some downsides you might not realize. In my case, it means I virtually never leave my house, and I’m sedentary and sitting most of the time. I don’t get vacation time or sick pay, I have to muddle through my taxes in two countries, and I put hours and hours of work into assignments that pay insultingly little.
When asked recently for advice about freelance writing, I warned that it is extremely difficult to make money from writing about books – so if you want to do it, be sure you’re just doing it for the love of books, and secure another source of income. For me that’s proofreading science journal articles. It’s something I’m good at and find just challenging enough to keep me stimulated, but if I’m honest I don’t really care about this work. It’s just a paycheck.
To put it simply, I’m bored. Some of my writing gigs have spanned the full five years, and I’m still doing exactly the same things. I’ve had a couple small pay rises, but I’m not earning significantly more than I was in 2013, even though I was recently named an associate editor at one of the magazines (an honorary title, alas). I feel restless and like I’m just waiting for the smallest signal to tell me I can drop everything. It would be a relief to let it all go. Julia Cameron captures this feeling in The Artist’s Way: “Restive in our lives, we yearn for more, we wish, we chafe. … We want to do something but we think it needs to be the right something, by which we mean something important.”
So really what I should be doing is aiming higher. I’m now a member of the National Book Critics Circle and have access to a document listing the pay rates for big-name venues, places that pay hundreds of dollars for book reviews and $1+/word for literary articles. But it often takes me months to get up the courage to pitch to a new publication, if I ever do it at all.
In Help Me! (out on September 6th), freelance journalist Marianne Power took on a different self-help book each month for a year to see if she could change her life for the better. One particularly rough month was all about Rejection Therapy. “I should have been constantly sending ideas to different publications but I didn’t. … I didn’t want to get rejected because I would take that as a confirmation of all the insecurities I had in my head – that I was a rubbish writer, that I had been lucky to get even this far, that I would never work again.”
That passage certainly resonated for me. No matter how many hundreds of reviews I write, I still barely trust myself to write another successful one. Temporary triumphs fade fast. Getting a pitch accepted at Literary Hub had been one of the highlights of my year, but pretty much as soon as the article was published on the website I felt deflated. It was a flash in the pan; a few comments and retweets and then it was forgotten before you know it.
I didn’t think I was a flighty person who needed a lot of novelty in my life. But Beryl Markham – lion hunter, horse trainer, aviatrix – has been reminding me that even if you have a good life that many would admire, even if you’d be a fool to ask for more, sometimes you still need a change. Here’s a passage from the formidable adventurer’s West with the Night: “I wonder if I should have a change – a year in Europe this time – something new, something better, perhaps. A life has to move or it stagnates. Even this life, I think. … it is no good anticipating regrets. Every tomorrow ought not to resemble every yesterday.”
My 35th birthday is coming up this autumn. It feels like time for a rethink. What do I want every tomorrow to look like? It’s all too easy to stick with what feels like a sure thing instead of launching into something new.
How do you ensure you’re appreciating your life but also challenging yourself with new things?
Two recent books about our flawed bodies and the ultimate pointlessness of trying to control them…
Natural Causes: Life, Death and the Illusion of Control by Barbara Ehrenreich
A decade ago, Barbara Ehrenreich discovered a startling paradox through a Scientific American article: the immune system assists the growth and spread of tumors, including in breast cancer, which she had in 2000. It was an epiphany for her, confirming that no matter how hard we try with diet, exercise and early diagnosis, there’s only so much we can do to preserve our health; “not everything is potentially within our control, not even our own bodies and minds.” I love Ehrenreich’s Smile or Die (alternate title: Bright-Sided), which is what I call an anti-self-help book refuting the supposed health benefits of positive thinking. In that book I felt like her skeptical approach was fully warranted, and I could sympathize with her frustration – nay, outrage – when people tried to suggest she’d attracted her cancer and limited her chances of survival through her pessimism.
However, Natural Causes is so relentlessly negative and so selective in the evidence it provides that, even though it’s sure to be considered for next year’s Wellcome Book Prize longlist, I would be unlikely to recommend it. In the first chapter, “Midlife Revolt,” which has been excerpted at Literary Hub and is worth reading, Ehrenreich writes of her decision to give up routine medical screening after a false positive mammogram caused undue stress. She decided once she passed 70 she was old enough to die without accepting a “medicalized life.” Moreover, she believes there’s an epidemic of “overdiagnosis,” especially in the USA, where there can be a profit motive behind testing. (This is certainly not the case in the UK, where the NHS doesn’t pester me about getting cervical smear tests to line any pockets; no, it’s about saving taxpayers money by catching cancer early and thus minimizing treatment costs.)
Ehrenreich goes on to argue that many medical procedures are simply rituals to establish patient trust, that cancer screening is invasive and ineffective, that there is little evidence that meditation does any good, and that fitness has become a collective obsession that probably doesn’t help us live any longer. It’s uncomfortable to hear her dismiss early detection techniques as worthless; no one whose doctor found cancer in the early stages would agree. The author also seems unwilling to confront her own personal prejudices (e.g. against yoga).
Although she uses plenty of statistics to back up her points, these usually come from newspapers and websites rather than peer-reviewed journals; only in two chapters about how macrophages ‘betray’ the body by abetting cancer does she consult the scientific literature, in keeping with her PhD in cellular immunology. Her most bizarre example of how our bodies aren’t evolutionarily fit for purpose is copious menstruation. Overall, the book is a strange mixture of hard science, social science, and, in later chapters, philosophy, as Ehrenreich asks about the nature of the self and the soul and what survives of us after death. As usual, her work is very readable, but this doesn’t match up to many other mind/body books I’ve read.
“The only cure for bad science is more science, which has to include both statistical analysis and some recognition that the patient is not ‘just a statistic,’ but a conscious, intelligent agent, just as the doctor is.”
“The objection raised over and over to any proposed expansion of health insurance was, in so many words: Why should I contribute to the care of those degenerates who choose to smoke and eat cheeseburgers? … we persist in subjecting anyone who dies at a seemingly untimely age to a kind of bio-moral autopsy: Did she smoke? Drink excessively? Eat too much fat and not enough fiber? Can she, in other words, be blamed for her own death?”
Natural Causes was published in the UK by Granta on April 12th. My thanks to the publisher for the free copy for review.
Human Errors: A Panorama of Our Glitches, from Pointless Bones to Broken Genes by Nathan H. Lents
Lents is a biology professor at John Jay College, City University of New York, and in this, his second book, he explores the ways in which the human body is flawed. These errors come in three categories: adaptations to the way the world was for early humans (to take advantage of once-scarce nutrients, we gain weight quickly – but lose it only with difficulty); incomplete adaptations (our knees are still not fit for upright walking); and the basic limitations of our evolution (inefficient systems such as the throat handling both breath and food, and the recurrent laryngeal nerve being three times longer than necessary because it loops around the aorta). Consider that myopia rates are 30% or higher, the retina faces backward, sinuses drain upwards, there are 100+ autoimmune diseases, we have redundant bones in our wrist and ankle, and we can’t produce most of the vitamins we need. Put simply, we’re not a designer’s ideal. And yet this all makes a lot of sense for an evolved species.
My favorite chapter was on the inefficiencies of human reproduction compared to that of other mammals. Infertility and miscarriage rates are notably high, and gestation is shorter than it really needs to be: because otherwise their heads would get too big to pass through the birth canal, all babies are effectively born premature, so are helpless for much longer than other newborn mammals. I also especially liked the short section on cancer, which would eventually get us all if we only lived long enough. As it is, “evolution has struck an uneasy balance with cancer. Mutations cause cancer, which kills individuals, but it also brings diversity and innovation, which is good for the population.”
Lents writes in a good conversational style and usually avoids oversimplifying the science. In places his book reminded me of Kathryn Schulz’s Being Wrong and Mark O’Connell’s To Be a Machine. It’s a wry and gentle treatment of human weakness; the content never turns depressing or bitter. Recommended for all curious readers of popular science.
“While lithopedions [“stone babies”] and abdominal pregnancies are quite rare, they are also 100 percent the result of poor design. Any reasonable plumber would have attached the fallopian tube to the ovary, thereby preventing tragic and often fatal mishaps like these.”
“to call our immune system perfectly designed would be equally inaccurate. There are millions of people who once happily walked this planet only to meet their demise because their bodies simply self-sabotaged. When bodies fight themselves, there can be no winner.”
Human Errors was published in the UK by Weidenfeld & Nicolson on May 3rd. My thanks to the publisher for the free copy for review.