The Language of Kindness: A Nurse’s Story by Christie Watson
After all that Wellcome Book Prize reading, I’ve given myself a break from the medical reads, right? No way! I’m already eagerly looking out for hopefuls for next year’s prize – I’ve amassed quite a nice little pile – and this is a particularly strong candidate, based on the 20 years that Watson spent as a nurse in England’s health system before leaving to write full-time. (Her debut, Tiny Sunbirds Far Away, won the Costa First Novel Award in 2011; she followed it up with Where Women Are Kings in 2013.) It taps into the widespread feeling that medicine is in desperate need of a good dose of compassion, and will ring true for anyone who spends time in hospitals, whether as a patient or a carer.
Watson presents her book as a roughly chronological tour through the stages of nursing – from pediatrics through to elderly care and the tending to dead bodies – but also through her own career, as she grows from a seventeen-year-old trainee who’s squeamish about blood to a broadly experienced nurse who can hardly be fazed by anything. The first chapter is set up like a tour of the hospital, describing everything she sees and hears as she makes her way up to her office, and the final chapter takes place on her very last day as a nurse, when, faced with a laboring mother in a taxi, she has to deliver the baby right there in the carpark.
In between we hear a series of vivid stories that veer between heartwarming and desperately sad. Watson sees children given a second shot at life. Aaron gets a heart–lung transplant to treat his cystic fibrosis and two-year-old Charlotte bounces back from sepsis – though with prosthetic limbs. But she also sees the ones who won’t get better: Tia, a little girl with a brain tumor; Mahesh, who has muscular dystrophy and relies on a breathing tube; and Jasmin, who is brought to the hospital after a house fire but doesn’t survive for long. She dies in the nurses’ arms as they’re washing the smoke smell out of her hair.
Although Watson specialized in children’s intensive care nursing, she trained in all branches of nursing, so we follow her into the delivery room, mental health ward, and operating theatre. As in Maggie O’Farrell’s I Am, I Am, I Am, we learn about her links to hospitals over the years, starting with her memories of being nursed as a child. She met her former partner, a consultant, at the hospital; they had a child together and adopted another before splitting 12 years later. And as her father was dying of lung cancer, she developed a new appreciation for what nurses do as she observed the dedicated care he received from his hospice nurse. She characterizes nursing as a career that requires great energy, skill and emotional intelligence, “that demands a chunk of your soul on a daily basis,” yet is all too often undervalued.
For me the weakest sections of Watson’s book are the snippets of history about hospitals and the development of the theory and philosophy of nursing. These insertions feel a little awkward and break up the flow of personal disclosure. The same applies to the occasional parenthetical phrase that seems to talk down to the reader, such as “women now receive medical help (IVF) to have their babies” and “obstetricians (doctors) run the show.” Footnotes or endnotes connected to a short glossary might have been a less obtrusive way of adding such explanatory information.
I would particularly recommend this memoir to readers of Kathryn Mannix’s With the End in Mind and Henry Marsh’s Admissions. But with its message of empathy for suffering and vulnerable humanity, it’s a book that anyone and everyone should read. I have it on good authority that there has recently been a copy on the desk of Jeremy Hunt, Health Secretary of the UK, which seems like an awfully good start.
A few favorite passages:
“I wanted to live many lives, to experience different ways of living. I didn’t know then that I would find exactly what I searched for: that both nursing and writing are about stepping into other shoes all the time.”
“What I thought nursing involved when I started: chemistry, biology, physics, pharmacology and anatomy. And what I now know to be the truth of nursing: philosophy, psychology, art, ethics and politics.”
“You get used to all sorts of smells, as a nurse. [An amazingly graphic passage!] But for all that I’ve seen and touched and smelled, and as difficult as it is at the time, there is a patient at the centre of it, afraid and embarrassed. … The horror of our bodies – our humanity, our flesh and blood – is something nurses must bear, lest the patient think too deeply, remember the lack of dignity that makes us all vulnerable. It is our vulnerability that unites us. Promoting dignity in the face of illness is one of the best gifts a nurse can give.”
The Language of Kindness was published in the UK on May 3rd by Chatto & Windus. My thanks to the publisher for the free review copy. It is released today, May 8th, by Doubleday Canada and Tim Duggan Books in the States.
The Wellcome Book Prize 2018 Awards Ceremony
Hey, we got it right! Mark O’Connell’s To Be a Machine, our shadow panel’s pick, won the Wellcome Book Prize 2018 last night. Of the three shadow panels I’ve participated in and the many others I’ve observed, this is the only time I remember the shadow winner matching the official one. Clare, Paul and I were there in person for the announcement at the Wellcome Collection in London. When we briefly spoke to the judges’ chair, Edmund de Waal, later in the evening, he said he was “relieved” that their decision matched ours – but I think it was definitely the other way around!
Simon Chaplin, Director of Culture & Society at the Wellcome Trust, said that each year more and more books are being considered for the prize. De Waal revealed that the judges read 169 books over nine months in what was for him his most frightening book club ever. “To bring the worlds of medicine and health into urgent conversation” requires a “lyrical and disciplined choreography,” he said, and “how we shape stories of science … is crucial.” He characterized the judges’ discussions as both “personal and passionate.” The Wellcome-shortlisted books make a space for public debate, he insisted.
The judges brought each of the five authors present onto the stage one at a time for recognition. De Waal praised Ayobami Adebayo’s “narrative of hope and fear and anxiety” and Meredith Wadman’s “beautifully researched and paced thriller.” Dr Hannah Critchlow of Magdalene College, Cambridge called Lindsey Fitzharris’s The Butchering Art “gruesome yet fascinating.” Oxford English professor Sophie Ratcliffe applauded Kathryn Mannix’s book and its mission. New Scientist editor-in-chief Sumit Paul-Choudhury said Mark O’Connell’s book is about the future “just as much as what it means to be human in the twenty-first century.” Journalist and mental health campaigner Bryony Gordon thanked Sigrid Rausing for her “great honesty and stunning prose.”
But there can only be one winner, and it was Mark O’Connell, who couldn’t be there as his wife is/was giving birth to their second child imminently. The general feeling in the room was that he’d made the right call by deciding to stay with his family. He must be feeling like the luckiest man on earth right now, to have a baby plus £30,000! Max Porter, O’Connell’s editor at Granta and the author of Grief Is the Thing with Feathers, received the award on his behalf and read out the extremely witty speech he’d written in advance.
Afterwards we spoke to three of the shortlisted authors. Kathryn Mannix said she’d so enjoyed following our shadow panel reviews and that it was for the best that O’Connell won, as any other outcome might have spoiled the lovely girls’ club the others had going on during the weekend’s events. I got two signatures and we nabbed a quick photo with Lindsey Fitzharris. It was also great to meet Simon Savidge, the king of U.K. book blogging, and author and vlogger Jen Campbell. Other ‘celebrities’ spotted: Sarah Bakewell and Ben Goldacre.
This time I stayed long enough for pudding canapés to come around – raspberry cake pops and mini meringues with strawberries. What a great idea! On the way out I again acquired a Wellcome goody bag: this year’s tote with a copy of The Butchering Art, which I only had on Kindle before. I’d also treated myself to this brainy necklace from the Wellcome shop and wore it to the ceremony. An all-round great evening. I’m looking forward to next year’s prize season already!
Wellcome Book Prize Shortlist Event
Five of the six shortlisted authors (barring Dublin-based Mark O’Connell) were at the Wellcome Collection in London yesterday to share more about their books in mini-interviews with Lisa O’Kelly, the associate editor of the Observer. She called each author up onto the stage in turn for a five-minute chat about her work, and then brought them all up for a general conversation and audience questions. Clare and I found it a very interesting afternoon. Here’s some context that I gleaned about the five books and their writers.
Ayobami Adebayo says sickle cell anemia is a massive public health problem in Nigeria, as brought home to her when some friends died of complications of sickle cell. She herself was tested for the gene and learned that she is a carrier, so her children would have a 25% chance of having the disease if her partner was also a carrier. Although life expectancy with the disease has improved to 45–50, a cure is still out of reach for most Nigerians because bone marrow/stem cell transplantation and anti-rejection drugs are so expensive. Compared to the 1980s, when her book opens, she believes polygamy is becoming less fashionable in Nigeria and people are becoming more open to other means of becoming parents, whether IVF or adoption. It’s a way of acknowledging, she says, that parenthood is “not just about biology.”
Sigrid Rausing started writing her book soon after her sister-in-law Eva’s body was found: just random paragraphs to make sense of what had happened. From there it became an investigation, a quest to find the nature of addiction. She thinks that as a society we still don’t quite understand what addiction is, and the medical research and public perception are very separate. In addition to nature and nurture, she thinks we should consider the influence of culture – as an anthropologist by training, she’s very interested in drug culture and how that drew in her brother, Hans. Although there have been many memoirs by ex-addicts, she can’t think of another one by a family member. Perhaps, she suggested, this is because the addict is seen as the ultimate victim. She referred to her book as a “collage,” a very apt description.
Kathryn Mannix spoke of how her grandmother, born in 1900, saw so much more death than we do nowadays: siblings, a child, and so on. Today, though, Mannix has encountered people in their sixties who are facing, with their parents, their very first deaths. Death is fairly “gentle” and “dull” if you’re not directly involved, she insists; she blames Hollywood and Eastenders for showing unusually dramatic deaths. She said once you understand what exactly people are afraid of about dying (e.g. hell, oblivion, pain, leaving their families behind) you can address their specific concerns and thereby “beat out the demon of terror and fear.” Mannix never intended to write a book, but someone heard her on the radio and invited her to do so. Luckily, from her medical school days onward, she’d been writing an A4 page about each of her most mind-boggling cases to get them out of her head and move on. That’s why, as O’Kelly put it, the characters in her 30 stories “leap off the page.”
Lindsey Fitzharris called The Butchering Art “a love story between science and medicine” – it was the first time that the former (antisepsis) was applied to the latter. She initially thought Robert Liston was her man – he was so colorful, larger than life – but eventually found that the real story was with Joseph Lister, the quiet, persistent Quaker. (However, the book does open with Liston performing the first surgery under ether.) Fitzharris is also involved in the Order of the Good Death, author Caitlin Doughty’s initiative, and affirmed Mannix’s efforts to remove the taboo from talking about death. I think I heard correctly that she said there is a film of The Butchering Art in the works?! I’ll need to look into that some more.
Meredith Wadman started with a brief explanation of how immunization works and why the 1960s were ripe for vaccine research. This segment went really science-y, which I thought was a little unfortunate as it may have made listeners tune out and be less interested in her work than the others’. It was perhaps inevitable given her subject matter, but also a matter of the questions O’Kelly asked – with the others she focused more on stories and themes than on scientific facts. It was interesting to hear what Wadman has been working on recently: for the past 6–8 months, she’s been reporting for Science on sexual harassment in science. For her next book, though, she’s pondering the conflict between a congressman and a Centers for Disease Control scientist over funding into research that might lead to gun control.
The question time brought up the issues of medical misinformation online, the distrust people with chronic illnesses have of medical professionals, and euthanasia – Mannix rather dodged that one, stating that her book is about the natural dying process so that’s not really her area. (Though it does come up in a chapter of her book.) We also heard a bit about the projects up next for each author. Rausing’s next book will be a travel memoir about the Capetown drought, taking in apartheid and her husband’s family’s immigration. Adebayo is at work on a very nebulous novel “about people,” and possibly how privilege affects access to healthcare.
Wellcome Book Prize Shortlist: To Be a Machine by Mark O’Connell
The topic of this shortlisted book didn’t particularly appeal to me, so I was pleasantly surprised to enjoy it. Transhumanism is about using technology to help us overcome human limitations and radically extend our lifespan. Many of the strategies O’Connell, a Dublin-based freelance writer with a literature background, profiles are on the verge of science fiction. Are we looking at liberation from the rules of biology, or enslavement to technology? His travels take him to the heart of this very American, and very male, movement.
Cryogenic freezing: The first person was cryogenically frozen in 1966. Max More’s Alcor Life Extension Foundation in Scottsdale, Arizona offers whole-body or head-only (“neuro”) options for $200,000 or $80,000. More argues that the residents of Alcor are somewhere between living and dead. These entities are held in suspension in the belief that technology will one day allow us to upload the contents of the mind into a new vessel.
- This approach seems to conceive of the human mind/consciousness as pure information to be computed.
Cyborgs: Grindhouse Wetware, near Pittsburgh, aims to turn people into literal cyborgs. Tim Cannon had a Circadia device the size of a deck of cards implanted in his arm for three months to take biometric measurements. Other colleagues have implanted RFID chips. He intends to have his arms amputated and replaced by superior prostheses as soon as the technology is available.
- That may seem extreme, but think how bound people already are to machines: O’Connell calls his smartphone a “mnemonic prosthesis” during his research travels.
Mortality as the enemy: Many transhumanists O’Connell meets speak of aging and death as an affront to human dignity. We mustn’t be complacent, they argue, but must oppose these processes with all we’re worth. One of the key people involved in that fight is Aubrey de Grey of SENS (“Strategies for Engineered Negligible Senescence”), and Google has also gotten in on it with their “Calico” project.
- O’Connell recounts explaining aging and death to his three-year-old son; his wife chipped in that – according to “Dada’s book” – perhaps by the time the boy is grown up death will no longer be a problem.
The Singularity: Posited by Ray Kurzweil, the Singularity is the future point at which artificial intelligence will surpass humanity. O’Connell likens it to the Christian idea of the Rapture, itself a moment of transcendence. At a conference on transhumanism and religion in Piedmont, California, he encounters Terasem, a religion founded recently by a transhumanist and transgender person.
- To my surprise, To Be a Machine makes frequent reference to religious ideas: O’Connell thinks of transhumanism as an attempt to reverse the Fall and become godlike, and he often describes the people he meets as zealots or saints, driven by the extremity of their beliefs. Both religion and transhumanism could be seen as a way of combating nihilism and insisting on the meaning of human life.
O’Connell’s outsider position helped me to engage with the science; he’s at least as interested, if not more so, in the deeper philosophical questions that transhumanism raises. I would caution that a grounding in religion and philosophy could be useful, as the points of reference used here range from the Gnostic gospels and St. Augustine to materialism and Nietzsche. But anyone who’s preoccupied with human nature should find the book intriguing.
You could also enjoy this purely as a zany travelogue along the lines of Elif Batuman’s The Possessed and Donovan Hohn’s Moby-Duck. The slapstick antics of the robots at the DARPA Robotics Challenge and the road trip in Zoltan Istvan’s presidential campaign Immortality Bus are particularly amusing. O’Connell’s Dickensian/Wildean delight in language is evident, and I also appreciated his passing references to William Butler Yeats.
It could be argued, however, that O’Connell was not the ideal author of this book. He is not naturally sympathetic to transhumanism; he’s pessimistic and skeptical, often wondering whether the proponents he meets are literally insane (e.g., to think that they are in imminent danger of being killed by robots). Most of the relevant research, even when conducted by Europeans, is going on in the USA, particularly in the Bay Area. So why would an Irish literary critic choose transhumanism as the subject for his debut? It’s a question I asked myself more than once, though it never stopped me from enjoying the book.
The title (from an Andy Warhol quote) may reference machines, but really this is about what it means to be human. O’Connell even ends with a few pages on his own cancer scare, a reminder that our bodies are flawed machines. I encourage you to give this a try even if you think you have no particular interest in technology or science fiction. It could also give a book club a lot to discuss.
“We exist, we humans, in the wreckage of an imagined splendor. It was not supposed to be this way: we weren’t supposed to be weak, to be ashamed, to suffer, to die. We have always had higher notions of ourselves. … The frailty is the thing, the vulnerability. This infirmity, this doubtful convalescence we refer to, for want of a better term, as the human condition.”
See what the rest of the shadow panel has to say about this book:
Annabel’s review: “I loved this book from the front cover to the back, starting with its title. … He writes with empathy and a good deal of humour which makes the text always readable and entertaining, while provoking his readers to think deeply about their own beliefs.”
Clare’s review: “O’Connell’s prose style is wordy and ironic. He is pleasingly sceptical about many aspects of transhumanism. … It is an entertaining book which provides a lot of food for thought for a layperson like myself.”
Laura’s review: “Often, I found that his description of his own internal questions would mirror mine. This is a really fantastic book, and for me, a clear front runner for the Wellcome Book Prize.”
Paul’s review: “An interesting book that hopefully will provoke further discussion as we embrace technology and it envelops us.”
My gut feeling: Though they highlight opposite approaches to death – transcending it versus accepting it – this and Kathryn Mannix’s With the End in Mind seem to me the two shortlisted books of the most pressing importance. I’d be happy to see either of them win. To Be a Machine is an awful lot of fun to read, and it seems like a current favorite for our panel.
- I’m coming close to the end of my skim of The Vaccine Race by Meredith Wadman.
- I’m still awaiting a review copy of Mayhem by Sigrid Rausing, which I’ll be featuring as part of the official Wellcome Book Prize shortlist blog tour.
Quick Reactions to the Wellcome Book Prize Shortlist
From 12, we are now down to six. The 2018 Wellcome Book Prize shortlist is here!
Some quick thoughts:
I sort-of predicted three out of the six in yesterday’s post: The Butchering Art by Lindsey Fitzharris, With the End in Mind by Kathryn Mannix, and To Be a Machine by Mark O’Connell.
I’m relieved that I’d already gotten to two of the shortlisted titles (Fitzharris and Mannix), so I can focus on reading the other four over the next 5+ weeks, and will briefly revisit those first two on my Kindle when it’s decision time.
I am pretty shocked that Maggie O’Farrell’s I Am, I Am, I Am did not advance to the shortlist. Mayhem will have to be a truly amazing memoir to outdo it; I wanted to read it anyway, but now I’m particularly keen – it would be a good one for me to feature on the official blog tour if that happens to work out.
I’m not feeling very cheerful about having to start Stay with Me again (I DNFed it last year), but I’ll try to approach it with an open mind.
To Be a Machine is currently on shelf at my local library (fingers crossed that it’s still there when I go on Friday) and I’ve reserved The Vaccine Race from another branch. I’ll start with one of those.
I’ve also been promised two review copies at random in the post – let’s hope it’s not the two I’ve already read!
(See also Laura’s initial thoughts.)
Feel like joining the shadow panel in reading one or more of these six books?
One More Wellcome Longlist Review & Shortlist Predictions
Tomorrow the six titles on the Wellcome Book Prize shortlist will be revealed. I’ve managed to read one more from the longlist since my last batch.
The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine by Lindsey Fitzharris
Surgery was a gory business with a notably high fatality rate well into the nineteenth century. Surgeons had the fastest hands in the West, but their victims were still guaranteed at least a few minutes of utter agony as they had a limb amputated or a tumor removed, and the danger wasn’t over after they were sewn up either: most patients soon died from hospital infections. The development of anesthetics and antiseptic techniques helped to change all that.
Fitzharris opens with the vivid and rather gruesome scene of a mid-thigh amputation performed by Robert Liston at University College Hospital in London in 1846. This surgery was different, though: it only took 28 seconds, but the patient felt nothing thanks to the ether he had been administered. He woke up a few minutes later asking when the procedure would begin. In the audience that day was Joseph Lister, who would become one of Britain’s most admired surgeons.
Lister came from a Quaker family and, after being educated at University College London, started his career in Edinburgh. Different to many medical professionals of the time, he was fascinated by microscopy and determined to find out what caused deadly infections. Carbolic acid and catgut ligatures were two of Lister’s main innovations that helped to fight infection. In fact, whether we realize it or not, his legacy is forever associated with antiseptics: Listerine mouthwash (invented in 1879) is named after him, and the Johnson brothers of Johnson & Johnson fame started their business mass-producing sterile surgical dressings after attending one of Lister’s lectures.
My interest tailed off a bit after the first third, as the book starts going into more depth about Lister’s work and personal life: he married his boss’s daughter and moved from Edinburgh to Glasgow and then back to London. However, the best is yet to come: the accounts of the surgeries he performed on his sister (a mastectomy that bought her three more years of life) and Queen Victoria (removing an orange-sized abscess from under her arm) are terrific. The chapter on treating the queen in secret at Balmoral Castle in 1871 was my overall favorite.
I was that kid who loved going to Civil War battlefields and medical museums and looking at all the different surgical saws and bullet fragments in museum cases, so I reveled in the gory details here but was not as interested in the biographical material. Do be sure you have a strong stomach before you try reading the prologue over a meal. This is a comparable read to The Remedy, about the search for a cure to tuberculosis.
Now, I’ve still only read half of the longlisted titles so far, so it’s hard to make any solid guesses. However, the below fall somewhere between wishes and informed predictions:
- In Pursuit of Memory by Joseph Jebelli: A definitive treatment of an epidemic of our time, Alzheimer’s disease. The neuroscientist author achieves the right balance between history and research on the one hand and personal stories readers can relate to on the other.
- The White Book by Han Kang: The only fiction title from the longlist that I haven’t read at least part of. This is also on this year’s Man Booker International Prize longlist and has been well received. From what I can tell, the health theme seems stronger than that of Stay with Me or Midwinter Break, and it would also be nice for one title in translation to make the shortlist.
- With the End in Mind by Kathryn Mannix: As I said in my review last week, this is an excellent all-round guide to preparation for death, based around touching patient stories plus the author’s experience in palliative care and CBT. Practical, compassionate and helpful.
- I Am, I Am, I Am by Maggie O’Farrell: For me, this book stands out as the one that most clearly illuminates the effects of illness, medical treatment, and other threats to life and limb in the course of an ordinary existence. I’d be very happy to see it win the whole thing.
- EITHER The Butchering Art by Lindsey Fitzharris OR The Vaccine Race by Meredith Wadman: I reckon one history of science title deserves to be on there; I think Wadman might have the slight edge.
- EITHER To Be a Machine by Mark O’Connell OR Behave by Robert Sapolsky: The Wellcome Prize loves big books investigating human tendencies and possibilities. I find the thought of either of these daunting, but I know they would also be illuminating. I’d prefer to read the O’Connell, but I’d give the edge to Sapolsky.
Any predictions of your own to make?
Wellcome Book Prize Shadow Panel & Two Longlist Reviews
I’m delighted to announce the other book bloggers on my Wellcome Book Prize 2018 shadow panel: Paul Cheney of Halfman, Halfbook, Annabel Gaskell of Annabookbel, Clare Rowland of A Little Blog of Books, and Dr. Laura Tisdall. Once the shortlist is announced on Tuesday the 20th, we’ll be reading through the six nominees and sharing our thoughts. Before the official winner is announced at the end of April we will choose our own shadow winner.
I’ve been working my way through some of the longlisted titles I was able to access via the public library and NetGalley. Here’s my latest two (both ):
Plot 29: A Memoir by Allan Jenkins
This is an unusual hybrid memoir: it’s a meditative tour through the gardening year, on a plot in London and at his second home in his wife’s native Denmark. But it’s also the story of how Jenkins, editor of the Observer Food Monthly, investigated his early life. Handed over to a Barnardo’s home at a few months of age, he was passed between various family members and a stepfather (with some degree of neglect: his notes show scabies, rickets and TB) and then raised by strict foster parents in Devon with his beloved older half-brother, Christopher. It’s interesting to read that initially Jenkins intended to write a simple gardening diary, with a bit of personal stuff thrown in. But as he got further into the project, it started to morph.
The book has a complicated chronology: though arranged by month, within chapters its fragments jump around in time, a year or a date at the start helping the reader to orient herself between flashbacks and the contemporary story line. Sections are often just a paragraph long; sometimes up to a page or two. I suspect some will find the structure difficult and distancing. It certainly made me read the book slowly, which I think was the right way. You take your time adjusting to the gradual personal unveiling just as you do to the slow turn of the seasons. When major things do happen – meeting his mother in his 30s; learning who his father was in his 60s – they’re almost anticlimactic, perhaps because of the rather flat style. It’s the process that has mattered, and gardening has granted solace along the way.
I’m grateful to the longlist for making me aware of a book I otherwise might never have heard about. I don’t think the book’s mental health theme is strong enough for it to make the shortlist, but I enjoyed reading it and I’ll also take a look at Jenkins’s upcoming book, Morning, about the joys of being an early riser. (Ironic after my recent revelations about my own sleep patterns!)
“Solitude plus community, the constant I search for, the same as the allotment”
“The last element to be released from Pandora’s box, they say, was hope. So I will mourn the children we once were and I will sow chicory for bitterness. I will plant spring beans and alliums. I’ll look after them.”
“As a journalist, I have learned the five Ws – who, what, where, when, why. They are all needed to tell a story, we are taught, but too many are missing in my tale.”
With the End in Mind: Dying, Death and Wisdom in an Age of Denial by Kathryn Mannix
This is an excellent all-round guide to preparation for death. It’s based around relatable stories of the patients Mannix met in her decades working in the fields of cancer treatment and hospice care. She has a particular interest in combining CBT with palliative care to help the dying approach their remaining time with realism rather than pessimism. In many cases this involves talking patients and their loved ones through the steps of dying and explaining the patterns – decreased energy, increased time spent asleep, a change in breathing just before the end – as well as being clear about how suffering can be eased.
I read the first 20% on my Kindle and then skimmed the rest in a library copy. This was not because I wasn’t enjoying it, but because it was a two-week loan and I was conscious of needing to move on to other longlist books. It may also be because I have read quite a number of books with similar themes and scope – including Caitlin Doughty’s two books on death, Caring for the Dying by Henry Fersko-Weiss, Being Mortal by Atul Gawande, and Waiting for the Last Bus by Richard Holloway. Really this is the kind of book I would like to own a copy of and read steadily, just a chapter a week. Mannix’s introductions to each section and chapter, and the Pause for Thought pages at the end of each chapter, mean the book lends itself to being read as a handbook, perhaps in tandem with an ill relative.
The book is unique in giving a doctor’s perspective but telling the stories of patients and their families, so we see a whole range of emotions and attitudes: denial, anger, regret, fear and so on. Tears were never far from my eyes as I read about a head teacher with motor neurone disease; a pair of women with metastatic breast cancer who broke their hips and ended up as hospice roommates; a beautiful young woman who didn’t want to stop wearing her skinny jeans even though they were exacerbating her nerve pain, as then she’d feel like she’d given up; and a husband and wife who each thought the other didn’t know she was dying of cancer.
Mannix believes there’s something special about people who are approaching the end of their life. There’s wisdom, dignity, even holiness surrounding them. It’s clear she feels she’s been honored to work with the dying, and she’s helped to propagate a healthy approach to death. As her children told her when they visited her dying godmother, “you and Dad [a pathologist] have spent a lifetime preparing us for this. No one else at school ever talked about death. It was just a Thing in our house. And now look – it’s OK. We know what to expect. We don’t feel frightened. We can do it. This is what you wanted for us, not to be afraid.”
I would be happy to see this advance to the shortlist.
“‘So, how long has she got?’ I hate this question. It’s almost impossible to answer, yet people ask as though it’s a calculation of change from a pound. It’s not a number – it’s a direction of travel, a movement over time, a tiptoe journey towards a tipping point. I give my most honest, most direct answer: I don’t know exactly. But I can tell you how I estimate, and then we can guesstimate together.”
“we are privileged to accompany people through moments of enormous meaning and power; moments to be remembered and retold as family legends and, if we get the care right, to reassure and encourage future generations as they face these great events themselves.”
Currently reading: The Butchering Art by Lindsey Fitzharris: a history of early surgery and the fight against hospital infection, with a focus on the life and work of Joseph Lister.
Up next: I’ve requested review copies of The White Book by Han Kang and Mayhem by Sigrid Rausing, but if they don’t make it to the shortlist they’ll slip down the list of priorities.
Thoughts on the Wellcome Book Prize Longlist
The 2018 Wellcome Book Prize longlist is here! From the prize’s website, you can click on any of these 12 books’ covers, titles or authors to get more information about them.
Some initial thoughts:
I correctly predicted three of the entries (or 25%) in yesterday’s post: In Pursuit of Memory by Joseph Jebelli, With the End in Mind by Kathryn Mannix, and I Am, I Am, I Am by Maggie O’Farrell. I’m pretty shocked to not see Fragile Lives or Admissions on the list.
Of the remainder, I’ve already read one (Midwinter Break) and DNFed another (Stay with Me). Midwinter Break didn’t immediately suggest itself to me for this prize because its themes of ageing and alcoholism are the background to a story about the disintegration of a long marriage. Nonetheless, it’s a lovely book that hasn’t gotten as much attention as it deserves – it was on my runners-up list from last year – so I’m delighted to see it nominated. Stay with Me was also on the Women’s Prize shortlist; it appears here for its infertility theme, but I wouldn’t attempt it again unless it made the Wellcome shortlist.
As to the rest:
- I’m annoyed with myself for not remembering The Butchering Art, which I have on my Kindle. Sometimes I assume that books I’ve gotten from NetGalley are USA-only and don’t check for a UK publisher. I plan to read this and With the End in Mind (also on my Kindle) soon.
- I already knew about and was interested in Mayhem and The White Book.
- Of the ones I didn’t know about, Plot 29 appeals to me the most. I’m off to get it from the library this very afternoon, in fact. Its health theme seems quite subtle: it’s about a devoted gardener ‘digging’ into his past in an abusive family and foster care. The Guardian review describes it thus: “Like Helen Macdonald’s H Is for Hawk, this is a profoundly moving account of mental trauma told through the author’s encounters with nature. Jenkins sees his garden as a place where a person can try to escape from, and atone for, the darkness of human existence.” This is the great thing about prize lists: they can introduce you to fascinating books you might never have heard of otherwise. Even if it’s just one book that takes your fancy, who knows? It might end up being a favorite.
- While I’m not immediately drawn to the books on the history of vaccines, the evolution of human behavior, and transhumanism, I will certainly be glad to read them if they make the shortlist.
Some statistics on this year’s longlist, courtesy of the press release I was sent by e-mail:
- Three novels, three memoirs, and six nonfiction titles
- Five debut authors
- Three titles from independent publishers (Canongate and Granta/Portobello Books)
- The authors are from the UK, Ireland, USA, Nigeria, Canada, and – making their first appearance – Sweden (Sigrid Rausing) and South Korea (Han Kang)
Chair of judges Edmund de Waal writes: “The Wellcome Book Prize is unique in its reach across genres, and so the range of books that we have considered has been exhilarating in its extent and ambition. This is a remarkable time for readers, with a great flourishing of writing on ideas around science, medicine and health, lives and deaths, histories and futures. After passionate discussions we have arrived at our longlist for the Wellcome Book Prize 2018 and are proud to be part of this process of bringing to a wider public these 12 tremendous books that have moved, intrigued and inspired us. All of them bring something new to our understanding of what it is to be human.”
The shortlist is announced on Tuesday, March 20th, and the winner will be revealed on Monday, April 30th.
Are there any books on here that you’d like to read?
My 2018 Wellcome Book Prize Wish List
Tomorrow the longlist for the 2018 Wellcome Book Prize will be announced. This year’s judging panel is chaired by Edmund de Waal, author of The Hare with Amber Eyes. I hope to once again shadow the shortlist along with a few fellow book bloggers. I don’t feel like I’ve read all that many books that are eligible (i.e., released in the UK in 2017, and on a medical theme), but here are some that I would love to see make the list. I link to all those I’ve already featured here, and give review extracts for the books I haven’t already mentioned.
- I Found My Tribe by Ruth Fitzmaurice
- In Pursuit of Memory: The Fight against Alzheimer’s by Joseph Jebelli
- Goodbye, Vitamin by Rachel Khong
- In Every Moment We Are Still Alive by Tom Malmquist
- Admissions: A Life in Brain Surgery by Henry Marsh
- I Am, I Am, I Am: Seventeen Brushes with Death by Maggie O’Farrell: O’Farrell captures fragments of her life through essays on life-threatening illnesses and other narrow escapes she’s experienced. The pieces aren’t in chronological order and aren’t intended to be comprehensive. Instead, they crystallize the fear and pain of particular moments in time, and are rendered with the detail you’d expect from her novels. She’s been mugged at machete point, nearly drowned several times, had a risky first labor, and was almost the victim of a serial killer. (My life feels awfully uneventful by comparison!) But the best section of the book is its final quarter: an essay about her childhood encephalitis and its lasting effects, followed by another about her daughter’s extreme allergies.
- The Smell of Fresh Rain: A Journey into the Sense of Smell by Barney Shaw
- Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table by Stephen Westaby
It’s also possible that we could see these make the longlist:
- History of Wolves by Emily Fridlund: Fridlund’s Minnesota-set debut novel is haunted by a dead child. From the second page readers know four-year-old Paul is dead; a trial is also mentioned early on, but not until halfway does Madeline Furston divulge how her charge died. This becomes a familiar narrative pattern: careful withholding followed by tossed-off revelations that muddy the question of complicity. The novel’s simplicity is deceptive; it’s not merely a slow-building coming-of-age story with Paul’s untimely death at its climax. For after a first part entitled “Science”, there’s still half the book to go – a second section of equal length, somewhat ironically labeled “Health”. (Reviewed for the TLS.)
- Hair Everywhere by Tea Tulić
- Modern Death: How Medicine Changed the End of Life by Haider Warraich: A learned but engaging book that intersperses science, history, medicine and personal stories. The first half is about death as a medical reality, while the second focuses on social aspects of death: religious beliefs, the burden on families and other caregivers, the debate over euthanasia and physician-assisted suicide, and the pros and cons of using social media to share one’s journey towards death. (See my full Nudge review.)
Of 2017’s medical titles that I haven’t read, I would have especially liked to have gotten to:
- Sound: A Story of Hearing Lost and Found by Bella Bathurst
- This Is Going to Hurt: Secret Diaries of a Junior Doctor by Adam Kay
- With the End in Mind: Dying, Death, and Wisdom in an Age of Denial by Kathryn Mannix [I have this one on my Kindle from NetGalley]
- Into the Grey Zone: A Neuroscientist Explores the Border between Life and Death by Adrian Owen
- Patient H69: The Story of My Second Sight by Vanessa Potter
We are also likely to see a repeat appearance from the winner of the 2017 Royal Society Science Book Prize, Testosterone Rex: Myths of Sex, Science, and Society by Cordelia Fine.
Other relevant books I read last year that have not (yet?) been released in the UK:
- The Education of a Coroner: Lessons in Investigating Death by John Bateson
- The Family Gene: A Mission to Turn My Deadly Inheritance into a Hopeful Future by Joselin Linder
- Last Things: A Graphic Memoir of Loss and Love by Marissa Moss
- Love and Laughter in the Time of Chemotherapy by Manjusha Pawagi
- No Apparent Distress: A Doctor’s Coming-of-Age on the Front Lines of American Medicine by Rachel Pearson: Pearson describes her Texas upbringing and the many different hands-on stages involved in her training: a prison hospital, gynecology, general surgery, rural family medicine, neurology, dermatology. Each comes with memorable stories, but it’s her experience at St. Vincent’s Student-Run Free Clinic on Galveston Island that stands out most. Pearson speaks out boldly about the divide between rich and poor Americans (often mirrored by the racial gap) in terms of what medical care they can get. A clear-eyed insider’s glimpse into American health care.
- The Bright Hour: A Memoir of Living and Dying by Nina Riggs
- The Tincture of Time: A Memoir of (Medical) Uncertainty by Elizabeth L. Silver: At the age of six weeks, Silver’s daughter suffered a massive brain bleed for no reason that doctors could ever determine. Thanks to the brain’s plasticity, especially in infants, the bleed was reabsorbed and Abby has developed normally, although the worry never goes away. Alongside the narrative of Abby’s baffling medical crisis, Silver tells of other health experiences in her family. An interesting exploration of the things we can’t control and how we get beyond notions of guilt and blame to accept that time may be the only healer.