An Embarrassment of Riches at the (Digital) Hay Festival 2021
There was a phenomenal program for this year’s digital Hay Festival. I signed up to a whopping eight events and enjoyed them all. If you missed watching live, it’s not too late to donate and catch up on the archived talks. For three of these, the host-cum-interviewer appeared in person on a studio stage, with the guest(s) joining, perhaps from thousands of miles away, on a large screen mounted on the wall behind them. I thought this was a neat hybrid approach. The rest of my sessions had interviewer and interviewee appearing remotely on a split screen. Let me know which, if any, events you attended and how you found them.
Richard Flanagan
Flanagan’s The Living Sea of Waking Dreams is my novel of 2021 so far (my review), so it was a delight to hear him say more (and in that fantastic accent) about it in the course of a conversation with Stephanie Merritt. Tasmania, where he lives, had always seemed like an ark for species, but now they are vanishing. Ninety percent of the kelp forest has disappeared within the last 20 years because of warming oceans; there are only 300 swift parrots remaining; and the bushfires of 2018–19 were unprecedented in severity. Although he had already roughed out the novel by the time of the fires, Flanagan said he rewrote it in response to the sense of accelerating environmental collapse.
The novel’s twin themes are species extinction and personal extinction, with an elderly family matriarch being kept alive at all costs. Flanagan spoke of the “evasions of the soul” that make us ignore the environmental losses around us and refuse to die – “the final avoidance of life.” He thinks the pandemic has forced people to rethink these ideas and ponder the meaning of life. At age 21, he nearly drowned while kayaking, and ever since he has been frightened not of death, but of the pain of dying. He is not optimistic per se, but hopeful because the world is still so beautiful – on the island he goes to for writing, he is surrounded by wild creatures.
Merritt asked about the novel’s magic realist element and how stylistically different his novels have been from each other. He was glad she found the book funny, as “life is tragicomic.” In an effort not to get stuck in a rut, he deliberately ‘breaks the mould’ after each book and starts over. This has not made him popular with his publisher!
Three take-aways:
- The one obligation of a writer? “Not to be boring.”
- Novels are not about messages; “that’s what Twitter is for.”
- “To despair is rational, but to hope is the very essence of what it means to be human.”
Rachel Clarke interviewing Jim Down and Michael Rosen
All three authors have written books about the coronavirus pandemic (I have reviewed Clarke’s Breathtaking and Rosen’s Many Different Kinds of Love). Clarke said that the belief foundational to the NHS is that all lives have equal value, but as an ICU doctor Down found that the question of who would benefit most from the use of ventilation was creeping in as there was a risk that there would be more patients than there was equipment to treat them with. With decisions needing to be made very quickly, his hospital adopted the “three wise people” collaborative method. The element that often felt lost, however, was the patient’s wishes, since they might be unresponsive and no family or other visitors were around.
Rosen, who contracted Covid-19 in March 2020 and was in an induced coma for six weeks, included letters from his medical team in his book to give a 360° view of NHS treatment. He thinks of the NHS as being almost in the role of parents, giving altruistic care and support. “Tell the truth about herd immunity” was his pithy message to the government. He read the poem “These Are the Hands,” which he wrote for the 60th anniversary of the NHS, to close.
Bryan Washington and Raven Leilani
Last year’s Dylan Thomas Prize winner interviewed this year’s winner, and it was clear that the mutual admiration was strong. Though I had mixed feelings about Luster (my review), I was blown away by this high-level intellectual discussion. Both authors are invested in the debate around what it means to be a Black artist. Leilani said she did not want to make concessions in the form of Edie comporting herself better; this character is open about her wants, giving the novel a libidinal flavour. She said she almost envies her protagonist her autonomy, and thinks of the novel as a letter to her old self, granting permission and reassuring herself that “the mess has merit.”
Three take-aways:
- Writing offers Leilani a sanctuary or sense of control.
- While Washington sees works full of strife, grief, and malice as most likely to be considered the pinnacle of American literary fiction, he admires Luster for its theme of communion (especially via the character Akila).
- Leilani sees her novel as being in conversation with Queenie, Sula, The New Me, and Detransition, Baby.
Maggie Shipstead
Shipstead (also a Dylan Thomas Prize winner) echoed something Leilani had said: that she starts a novel with questions, not answers. Such humility is refreshing, and a sure way to avoid being preachy in fiction. Her new novel, Great Circle, is among my most anticipated books of the year and tells the stories of a fictional female pilot from the golden age of aviation and the actress playing her in a biopic. The book was long in the gestation: In 2012 Shipstead saw a sculpture commemorating a female pilot in Auckland, and in 2014 she started researching. She came to appreciate the miracle of flight and read many books by and about female pilots. The book is dedicated to her brother, recently retired from 20 years in the Air Force. She told Sameer Rahim that, although she used to say this is not a love story, she has since changed her mind.
Three take-aways:
- Shipstead was a competitive show jumper and applied to a creative writing program on a whim.
- She has made a name for herself as a travel writer, too, often combining magazine assignments with her research for the novel (e.g., various trips to Antarctica).
- While she has appreciated the year off from Covid, she is looking forward to getting back to travelling; her first booking is a women’s wilderness experience in Alaska.
Patricia Lockwood
Lockwood is the only novelist to be included on the Atlantic’s roster of best tweets. She and Nina Stibbe, who interviewed her, agreed that 1) things aren’t funny when they try too hard and 2) the Internet used to be a taboo subject for fiction – producing time-stamped references that editors used to remove. “I had so many observations and I didn’t know where to put them,” Lockwood said, and it seems to her perverse to not write about something that is such a major part of our daily lives. The title of her Women’s Prize-shortlisted novel, No One Is Talking About This (my review), refers to many things, including this reticence to grant the Internet a place in our discourse.
Lockwood said she has been delighted by the high-quality literary pieces coming out about her book, often in comparison with Lauren Oyler’s Fake Accounts. The timing of the publication meant that her initial (U.S.) media interviews ended up being more about Trump than she would have liked. “I think I’m not a natural fiction writer,” she said; it’s true that the novel is so autobiographical it can only be described as autofiction – the second half is all true and all sincere, she was careful to point out – but it’s a gem.
Julianne Pachico
Like Lockwood, Pachico was part of the “10 @ 10” series featuring debut novelists (though her first book, the linked story collection The Lucky Ones, was marketed as a novel in the USA). Her new book, The Anthill, another of my most anticipated books of the year, is about a young woman returning to Medellín, Colombia, where Pachico spent her formative years. Although she is not a citizen and only goes back on a tourist visa, it feels like going home each time. For her, writing fiction has been a way of sorting out her feelings about the place. She wrote 50,000 words of the novel at her sister’s apartment in Medellín. Pachico told Rosie Goldsmith that, though she considers herself part of the Latin American literary tradition, she is conscious of presenting the country to English-speaking readers: a politically divided place that has gentrified in pockets, but is still plagued by extreme poverty and hardship. She described The Anthill as “a ghost story without ghosts.” I can’t wait to dive into my copy.
Brit Bennett
Speaking to Arifa Akbar about The Vanishing Half, Bennett admitted that she was worried a historical setting was a cop-out, but reassured herself that she was not writing out of nostalgia and that she did not allow readers a sense of distance – the characters are so ordinary that we know we’d do the same sorts of things. She thinks of passing as a distinctly American project of self-reinvention but acknowledged that we have no definitive statistics on it because, if someone succeeds, they disappear. Some of Stella’s psychology – a very interior character who makes decisions that are difficult to understand – came from her reading of Playing Dead by Elizabeth Greenwood. She loves writing about small towns because they force people to interact with each other. Akbar noted that passing is a double-edged sword, involving subterfuge but also offering liberation (e.g. for a trans character later in the book).
Three take-aways:
- “That’s the most exciting place to be, writing into a mystery.”
- “Race is a fiction, but racism is a reality.”
- An HBO adaptation is in the works, but Bennett doesn’t know if it will cast real twins, two actors, or meld separate people using CGI.
Rachel Cusk and Sheila Heti
I’ve read more of and gotten on better with Heti’s work than Cusk’s, so this was a rare case of being perhaps more interested in interviewer than interviewee. Heti said that, compared with the Outline trilogy, Cusk’s new novel Second Place feels wilder and more instinctual. Cusk, speaking from the Greek island of Tinos, where she is researching marble quarrying, described her book in often vague yet overall intriguing terms: it’s about exile and the illicit, she said; about femininity and entitlement to speak; about the domestic space and how things are legitimized; about the adoption of male values and the “rightness of the artist.”
Ironically, given that Cusk initially hesitated over revealing her debt to Mabel Dodge Luhan’s memoir Lorenzo in Taos, much of the discussion ended up revolving around Luhan and D.H. Lawrence, about whom Cusk now considers herself an amateur scholar. In his personal writings he reserved special scorn for Luhan, with whom he stayed in New Mexico in the 1920s. This was something Cusk wanted to explore: misogyny and Luhan’s “voice of obscurity.” She hopes that her book will contribute to a better understanding of Luhan’s; not vice versa.
Three take-aways:
- A reviewer noted the use of exclamation points, counting 189 of them in the novel. Cusk equates an exclamation point to a laying down of arms – proof that someone (especially her protagonist, M) means to be nonthreatening.
- Cusk thinks of this book as being like a play: staged and in the moment.
- A woman observing but not being noticed is, like in the Outline trilogy, Cusk’s basic framework.
Review Book Catch-Up: Ante, Evans, Foster and White
Today I have a book of poems about the Filipinx experience in the UK, a collection of short stories reflecting on racial injustice, a monograph on a bird that spells summer for many of us, and a biographical investigation into a little-understood medical condition.
Antiemetic for Homesickness by Romalyn Ante
I was drawn to this debut collection by the terrific title and cover, but also by the accolades it received: it was on the Dylan Thomas Prize longlist and the Jhalak Prize shortlist. I hope we’ll see it on the Sunday Times Young Writer of the Year Award shortlist, too. Ante grew up in the Philippines but at age 16 joined her mother in the UK, where she had moved years before to work as a nurse in the NHS. She has since followed in her mother’s footsteps as a nurse – indeed, overseas Filipinx workers (Jamaicans, too) are a mainstay of the NHS.
Ante remembers the years when her mother was absent but promised to send for the rest of the family soon: “You said all I needed to do was to sleep and before I knew it, / you’d be back. But I woke to the rice that needed rinsing, / my siblings’ school uniforms that needed ironing.” The medical profession as a family legacy and noble calling is a strong element of these poems, especially in “Invisible Women,” an ode to the “goddesses of caring and tending” who walk the halls of any hospital. Hard work is a matter of survival, and family – whether physically present or not – bolsters weary souls. A series of short, untitled poems are presented as tape recordings made for her mother.
Food is inextricably entwined with memory (reminding me of Nina Mingya Powles’s approach in Tiny Moons) and provides some of the standout metaphors, especially in “Patis” and “Ode to a Pot Noodle.” Ante uses a lot of alliteration and adapts various forms. I especially liked “Tagay!”, a traditional drinking song, and “Mateo,” printed in the shape of a pound sign. The nuanced look at the immigrant experience reminded me of Jenny Xie’s Eye Level. Movement entails losses as well as benefits. The focus on the Filipinx experience also made me think of America Is Not the Heart. My favourite single poem was “The Making of a Smuggler,” which opens “Wherever we travel, we carry / the whole country with us – // our rice terraces are folded garments, / we have pillars of trees, a rainforest // on a hairbrush.”
Favourite lines:
“Gone are the nights he steals / the moon with a mango picker / and swaps it for her pocket mirror”
“The yellow admission papers in my hands escaped / flustering at my face into a flight of orioles.”
“I am halved in order to be whole – / I rebuild by leaving / everything I love.”
With thanks to Chatto & Windus for the free copy for review.
The Office of Historical Corrections by Danielle Evans
To boil these six stories and a novella down to the topic of race in America risks painting them as solemn or strident – more concerned with meaning than with art – when the truth is that they are playful and propulsive even though they keep cycling back to bereavement and injustice. Several of the protagonists are young Black women coming to terms with a loss.
In “Happily Ever After,” Lyssa works in the gift shop of a Titanic replica and is cast as an extra in a pop star’s music video. Mythical sea monsters are contrasted with the real dangers of her life, like cancer and racism. “Anything Could Disappear” was a favourite of mine, though it begins with that unlikely scenario of a single woman acquiring a baby as if by magic. What starts off as a burden becomes a bond she can’t bear to let go. A family is determined to clear the name of their falsely imprisoned ancestor in “Alcatraz.” In “Richard of York Gave Battle in Vain” (a mnemonic for the colours of the rainbow), photojournalist Rena is wary about attending the wedding of a friend she met when their plane was detained in Africa some years ago. The only wedding she’s been in is her sister’s, which ended badly.
Mistakes and deceit seem to follow these characters. In the title novella that closes the book, Cassie and her colleagues combat fake news, going around putting correction labels on plaques that whitewash history. When she and her former colleague meet up in Wisconsin to find the truth behind a complex correction case, a clash with a white supremacist group quickly turns pedantry into a matter of life and death. The story I’d heard the most about beforehand was “Boys Go to Jupiter,” about a college girl who dons a Confederate flag bikini, not caring what message it sends to others in her dorm. It turns out she has history with a Black family, but has chosen to airbrush this experience out of her life.
There was only one story I didn’t care for, “Why Won’t Women Just Say What They Want,” about a celebrity who turns apologizing into performance art. Overall, this is a very strong collection I would recommend to readers of Brit Bennett and Raven Leilani, with some stories also reminding me of recent work by Curtis Sittenfeld and Mary South. I’ll be sure to seek out Evans’s previous book (also short stories), too.
With thanks to Picador for the proof copy for review.
The Screaming Sky by Charles Foster
The other week I was volunteering at our local community garden and looked up to see a dozen common swifts wheeling over the Kennet & Avon canal and picking off insects among the treetops. I hope this fellow Foster (for whom my husband was once confused on a nature conference attendee list) would be proud of me for pausing to gaze at the birds for a while. My impression of the author is as a misanthropic eccentric. A Renaissance man as well versed in law and theology as he is in natural history, he’s obsessed with swifts and ashamed of his own species: for looking down at their feet when they could be watching the skies; for the “pathological tidiness” that leaves swifts and so many other creatures no place to live.
The obsession began when he was eight years old and someone brought him a dead swift fledgling for his taxidermy hobby. Ever since, he’s dated the summer by their arrival. “It is always summer for them,” though, as his opening line has it. This monograph is structured chronologically. Much like Tim Dee does in Greenery, Foster follows the birds for a year: from their winter territory in Africa to the edges of Europe in spring and then to his very own Oxford street in high summer. When they leave, he’s bereft and ready to book a flight back to Africa.
Along the way, Foster delivers heaps of information: the fossil evidence of swifts, how they know where to migrate (we have various theories but don’t really know), their nesting habits and lifespan, and the typical fates of those individuals that don’t survive. But, thumbing his nose at his “ex-friend” (a closed-minded biologist he repeatedly, and delightfully, rails against), he refuses to stick to a just-the-facts approach. Acknowledging the risks of anthropomorphizing, he speaks of swifts as symbols of aspiration, of life lived with intensity. He believes that we can understand animal emotions analogously through our own, so that, inappropriate as such words might seem, we can talk about what birds hope and plan for. He scorns reductive ecosystem services lingo that defines creatures by what we get out of them.
Also like Dee, Foster quotes frequently from poetry. His prose is full of sharp turns of phrase and moments of whimsy and made me eager to try more of his work (I know the most about but have not yet read Being a Beast).
Swifts know the roar of lions better than the roar of the M25, the piping of hornbills better than the Nunc Dimittis of parish Evensong … Are memories of our eaves spiralling high above the Gulf of Guinea? … They don’t seem to prevaricate. One moment they’re there, the next they’re off, diving straight into the journey. It’s the way we should run into cold water.
As I’ve found with a number of Little Toller releases now (On Silbury Hill, Snow, Landfill), knowledge meets passion to create a book that could make an aficionado of the most casual of readers. Towards the close I was also reminded of Richard Smyth’s An Indifference of Birds: “When Homo sapiens has gone there will be lots of ideal swift holes in the decaying buildings we’ll leave behind.” It’s comforting to think of natural cycles continuing after we’re gone … but let’s start making the space for them now. Jonathan Pomroy’s black-and-white illustrations of swift behaviour only add to this short book’s charms.
With thanks to Little Toller Books for the free copy for review.
Waiting for Superman: One Family’s Struggle to Survive – and Cure – Chronic Fatigue Syndrome by Tracie White
Like Suzanne O’Sullivan’s books (most recently, The Sleeping Beauties), this is presented as an investigation into a medical mystery. White, a Stanford Medicine journalist, focuses on one family that has been indelibly changed by chronic fatigue syndrome – now linked with myalgic encephalomyelitis and termed ME/CFS for short. Whitney Dafoe was a world traveller and promising photographer before, in 2010, a diagnosis of ME/CFS explained his exhaustion and gastrointestinal problems. By the time White first met the family in 2016, the thirtysomething was bedbound in his parents’ home with a feeding tube, only able to communicate via gestures and rearranging Scrabble tiles. He couldn’t bear loud noises, or to be touched. At times he was nearly comatose.
Whitney’s father, Ron Davis, is a Stanford geneticist whose research has contributed to the Human Genome Project. He has devoted himself to studying ME/CFS, which affects 20 million people worldwide yet receives little research funding; he calls it “the last major disease we know nothing about.” Testing his son’s blood, he found a problem with the citric acid cycle that produces ATP, essential fuel for the body’s cells – proof that there was a physiological reason for Whitney’s condition. Frustratingly, though, a Stanford colleague who examined Whitney prescribed a psychological intervention. This is in line with the current standard of care for ME/CFS: a graded exercise regime (nigh on impossible for someone who can’t get out of bed) and cognitive behavioural therapy.
White delves into Whitney’s past, looking for clues to what could have triggered his illness (having mono in high school? a parasite he picked up in India?). She also goes back to the mid-1980s to consider the Lake Tahoe outbreak of ME/CFS, whose victims “looked too healthy to be sick and were repeatedly disbelieved.” The media called it “yuppie flu,” downplaying the extreme fatigue involved. White also meets Laura Hillenbrand, author of Seabiscuit, who suffers from ME/CFS and managed to write her bestselling books from bed. Like Whitney, she only has a certain allotment of energy and mustn’t use it up too fast.
- A neat connection: Stephanie Land, author of Maid, was Whitney’s ex-girlfriend when he was 19 and living in Alaska; she wrote a Longreads article about their relationship.
- The title is from a Flaming Lips lyric and expresses Whitney’s trust in his dad’s ability to cure him; the U.S. title is The Puzzle Solver and the working title was The Invisible Patient.
With thanks to Atlantic Books for the free copy for review.
Would you be interested in reading one or more of these?
January’s Nonfiction Releases: Clarke, Heminsley and Lalkhen
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.
From January 26, 2021
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.
From January 6, 2021
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?
Being the Expert for #NonficNov / Three on a Theme: “Care”
The Being/Becoming/Asking the Expert week of the month-long Nonfiction November challenge is hosted by Rennie of What’s Nonfiction. This is my second entry for the week after Monday’s post on postpartum depression, as well as the second installment in my new “Three on a Theme” series, where I review three books that have something significant in common and tell you which one to pick up if you want to read into the topic for yourself.
It will be no surprise to regular readers that both of my ‘expert’ posts have been on a health theme: I have an amateur’s love of medical memoirs and works of medical history, and I’ve followed the Wellcome Book Prize closely for a number of years – participating in official blog tours, creating a shadow panel, and running this past year’s Not the Wellcome Prize.
The three books below are linked by the word “Care” in the title or subtitle; all reflect, in the wake of COVID-19, on the ongoing crisis in UK healthcare and the vital role of nurses.
Labours of Love: The Crisis of Care by Madeleine Bunting
Bunting’s previous nonfiction work could hardly be more different: Love of Country was a travel memoir about the Scottish Hebrides. It was the first book I finished reading in 2017, and there could have been no better start to a year’s reading. With a background in history, journalism and politics, the author is well placed to comment on current events. Labours of Love arose from five years of travel to healthcare settings across the UK: care homes for the elderly and disabled, hospitals, local doctors’ surgeries, and palliative care units. Forget the Thursday-night clapping and rainbows in the windows: the NHS is perennially underfunded and its staff undervalued, by conservative governments as well as by people who rely on it.
We first experience bodily care as infants, Bunting notes, and many of the questions that run through her book originated in her early days of motherhood. Despite all the advances of feminism, parental duties follow the female-dominated pattern evident in the caring careers:
By the age of fifty-nine, women will have a fifty-fifty chance of being, or having been, a carer for a sick or elderly person. At the same time, many are still raising their teenage children and almost half of those over fifty-five are providing regular care for grandchildren.
Women dominate caring professions such as nursing (89 per cent), social work (75 per cent) and childcare (98 per cent). They now form the majority of GPs (54 per cent) and three out of four teachers are female. And they provide the vast bulk of the army of healthcare workers in the NHS (80 per cent) and social-care workers (82 per cent) for the long-term sick, disabled and frail elderly.
These are things we know intuitively, but seeing the numbers laid out so plainly is shocking. I most valued the general information in Bunting’s introduction and in between her interviews, while I found that the bulk of the book alternated between dry statistics and page after page of interview transcripts. However, I did love hearing more from Marion Coutts, the author of the 2015 Wellcome Book Prize winner, The Iceberg, about her husband’s death from brain cancer. (Labours of Love was longlisted for the Baillie Gifford Prize for Non-Fiction 2020.) 
My thanks to Granta for the free copy for review.
Duty of Care: One NHS Doctor’s Story of Courage and Compassion on the COVID-19 Frontline by Dr Dominic Pimenta
We’re going to see a flood of such books; I’m most looking forward to Dr Rachel Clarke’s Breathtaking (coming in January). Given how long it takes to get a book from manuscript to published product, I was impressed to find this on my library’s Bestsellers shelf in October. Pimenta’s was an early voice warning of the scale of the crisis and the government’s lack of preparation. He focuses on a narrow window of time, from February – when he encountered his first apparent case of coronavirus – to May, when, in protest at a government official flouting lockdown (readers outside the UK might not be familiar with the Cummings affair), he resigned his cardiology job at a London hospital to focus on his new charity, HEROES, which supports healthcare workers via PPE, childcare grants, mental health help and so on.
It felt uncanny to be watching events from earlier in the year unfold again: so clearly on a trajectory to disaster, but still gripping in the telling. Pimenta’s recreated dialogue and scenes are excellent. He gives a real sense of the challenges in his personal and professional lives. But I think I’d like a little more distance before I read this in entirety. Just from my skim, I know that it’s a very fluid book that reads almost like a thriller, and it ends with a sober but sensible statement of the situation we face. (All royalties from the book go to HEROES.) 
The Courage to Care: A Call for Compassion by Christie Watson
I worried this would be a dull work of polemic; perhaps the title, though stirring, is inapt, as the book is actually a straightforward sequel to Watson’s 2018 memoir about being a nurse, The Language of Kindness. Although, like Bunting, Watson traveled widely to research the state of care in the country, she mostly relies on her own experience of various nursing settings over two decades: a pediatric intensive care unit, home healthcare for the elderly, a children’s oncology day center, a residential home for those with severe physical and learning disabilities, a community mental-health visiting team, and the emergency room. She also shadows military nurses and prison doctors.
With a novelist’s talent for scene-setting and characterization, Watson weaves each patient and incident into a vibrant story. Another strand is about parenthood: giving birth to her daughter and the process of adopting her son – both are now teenagers she raises as a single mother. She affirms the value of everyday care delivered by parents and nurses alike. I was especially struck by the account of a teenage girl who contracted measles (then pneumonia, meningitis and encephalitis) and was left blind and profoundly disabled, all because her parents were antivaxxers. In general, I’ve wearied of doctors’ memoirs composed of obviously anonymized case studies, but I’ll always make an exception for Clarke and Watson because of their gorgeous writing. 
Note: Watson had left nursing to write full-time, but explains in an afterword that she returned to critical care in a London hospital during COVID-19.
What I learned:
Empathy is a key term for all three authors. They emphasize that the skills of compassion and listening are just as important as the ability to perform the required medical procedures.
A chilling specific fact I learned: 43,000 people died in the Blitz* in the UK. Pimenta cited that figure and warned that COVID-19 could be worse. And indeed, as of now, over 63,000 people have died of COVID-19 in the UK. The American death toll is even more alarming.
Here are some passages that stood out for me from each book:
Bunting: “Good care is as much an art as a skill, as much competence as tact. … Care is where we make profound collective decisions about the worth of an individual life. … There is no tradition of ageing wisely in the West, unlike in many Asian and African cultures where age has prestige, status and is associated with wisdom … We need to speak about care in a different language, instead of the relentless macho repetition of words such as ‘efficiency’, ‘quality’, ‘driving’, ‘choice’, ‘delivery’ and productivity.’”
Pimenta: “this will be akin to the Blitz*, and … we need to start thinking of it like that. A marathon, not a sprint. … The challenges to come – a second or even third wave, a global recession, climate change, mass misinformation … and political and societal upheaval … – will all require more from all of us if we hope to meet them. The challenge of our generation is not behind us, it is only just beginning. I plan to continue doing something about it, and perhaps now you do as well. So stay informed, stay safe and be kind.”
Watson: “So much of nursing, I think to myself, seems obvious, and yet seeing that need in the first place is difficult and takes experience, training and something extra. … The mundanity of human existence is where I find the most beauty … It takes my breath away: how fragile, extraordinary and vulnerable, how full of hatred and love and obsession and complexity we all are – every single one of us.”
*I highly recommend all of folk artist Kris Drever’s latest album, Where the World Is Thin, but especially the song “Hunker Down / That Old Blitz Spirit,” which has become my lockdown anthem.
If you read just one, though… Make it The Courage to Care by Christie Watson.
Can you see yourself reading any of these books?
Recommended July Releases: Donoghue, Maizes, Miller, Parikian, Trethewey
My five new releases for July include historical pandemic fiction, a fun contemporary story about a father-and-daughter burglar team, a new poetry collection from Carcanet Press, a lighthearted nature/travel book, and a poetic bereavement memoir about a violent death.
The Pull of the Stars by Emma Donoghue
Donoghue’s last two novels, The Wonder and Akin, were big hits with me. Less than a year after the contemporary-set Akin, she’s back to a historical setting – and an uncannily pertinent pandemic theme – with her latest. In 1918, Julia Power is a nurse on a Dublin maternity ward. It’s Halloween and she is about to turn 30, making her a spinster for her day; she lives with her mute, shell-shocked veteran brother, Tim, and his pet magpie.
Because she’s already had “the grip” (influenza), she is considered immune and is one of a few staff members dealing with the flu-ridden expectant mothers in quarantine in her overcrowded hospital. Each patient serves as a type, and Donoghue whirls through all the possible complications of historical childbirth: stillbirth, obstructed labor, catheterization, forceps, blood loss, transfusion, maternal death, and so on.
It’s not for the squeamish, and despite my usual love of medical reads, I felt it was something of a box-ticking exercise, with too much telling about medical procedures and recent Irish history. Because of the limited time frame – just three days – the book is far too rushed. We simply don’t have enough time to get to know Julia through and through, despite her first-person narration; the final 20 pages, in particular, are so far-fetched and melodramatic it’s hard to believe in a romance you’d miss if you blinked. And the omission of speech marks just doesn’t work – it’s downright confusing with so many dialogue-driven scenes.
Donoghue must have been writing this well before Covid-19, but I wouldn’t be surprised if the publication was hurried forward to take advantage of the story’s newfound relevance. It shows: what I read in May and June felt like an unpolished draft, with threads prematurely tied up to meet a deadline. This was an extremely promising project that, for me, was let down by the execution, but it’s still a gripping read that I wouldn’t steer you away from if you find the synopsis appealing. (Some more spoiler-y thoughts here.)
Prescient words about pandemics:
“All over the globe … some flu patients are dropping like flies while others recover, and we can’t solve the puzzle, nor do a blasted thing about it. … There’s no rhyme or reason to who’s struck down.”
“Doctor Lynn went on, As for the authorities, I believe the epidemic will have run its course before they’ve agreed to any but the most feeble action. Recommending onions and eucalyptus oil! Like sending beetles to stop a steamroller.”
Why the title?
Flu comes from the phrase “influenza delle stelle” – medieval Italians thought that illness was fated by the stars. There’s also one baby born a “stargazer” (facing up) and some literal looking up at the stars in the book.
My rating:
My thanks to Picador for the proof copy for review.
Other People’s Pets by R.L. Maizes
This is Maizes’ debut novel, after her 2019 short story collection We Love Anderson Cooper. Louise “La La” Fine and her father, Zev, share an unusual profession: While outwardly they are a veterinary student and a locksmith, respectively, for many years they broke into homes and sold the stolen goods. Despite close shaves, they’ve always gotten away with it – until now. When Zev is arrested, La La decides to return to her criminal ways just long enough to raise the money to post bail for him. But she doesn’t reckon on a few complications, like her father getting fed up with house arrest, her fiancé finding out about her side hustle, and her animal empathy becoming so strong that when she goes into a house she not only pilfers valuables but also cares for the needs of ailing pets inside.
Flashbacks to La La’s growing-up years, especially her hurt over her mother leaving, take this deeper than your average humorous crime caper. The way the plot branches means that for quite a while Zev and La La are separated, and I grew a bit weary of extended time in Zev’s company, but this was a great summer read – especially for animal lovers – that never lost my attention. The magic realism of the human‒pet connection is believable and mild enough not to turn off readers who avoid fantasy. Think The Twelve Lives of Samuel Hawley meets Hollow Kingdom.
My rating: 
My thanks to the author and Celadon Books for the free e-copy for review.
The Long Beds by Kate Miller
Here and there; now and then: the poems in Miller’s second collection enlarge such dichotomies by showcasing the interplay of the familiar and the foreign. A scientist struggles to transcribe birdsong, and a poppy opens in slow motion. “Flag” evokes the electric blue air and water of a Greek island, while “The Quarters” is set in the middle of the night in a French village. A few commissions, including “Waterloo Sunrise,” stick close to home in London or other southern England locales.
Various poems, including the multi-part “Album Without Photographs,” are about ancestor Muriel Miller’s experiences in India and Britain in the 1910s-20s. “Keepers of the States of Sleep and Wakefulness, fragment from A Masque,” patterned after “The Second Masque” by Ben Jonson, is an up-to-the-minute one written in April that names eight nurses from the night staff at King’s College Hospital (and the short YouTube film based on it is dedicated to all NHS nurses).
My two favorites were “Outside the Mind Shop,” in which urban foxes tear into bags of donations outside a charity shop one night while the speaker lies awake, and “Knapsack of Parting Gifts” a lovely elegy to a lost loved one. I spotted a lot of alliteration and assonance in the former, especially. Thematically, the collection is a bit scattered, but there are a lot of individual high points.
My rating:
My thanks to Carcanet Press for the free e-copy for review.
Into the Tangled Bank: In Which Our Author Ventures Outdoors to Consider the British in Nature by Lev Parikian
In the same way that kids sometimes write their address by going from the specific to the cosmic (street, city, country, continent, hemisphere, planet, galaxy), this book, a delightfully Bryson-esque tour, moves ever outwards, starting with the author’s own home and garden and proceeding to take in his South London patch and his journeys around the British Isles before closing with the wonders of the night sky. By slowing down to appreciate what is all around us, he proposes, we might enthuse others to engage with nature.
With the zeal of a recent convert, he guides readers through momentous sightings and everyday moments of connection. As they were his gateway, many of these memories involve birds: looking for the year’s first swifts, trying to sketch a heron and realizing he’s never looked at one properly before, avoiding angry terns on the Farne Islands, ringing a storm petrel on Skokholm, and seeing white-tailed eagles on the Isle of Skye. He brings unique places to life, and pays tribute to British naturalists who paved the way for today’s nature-lovers by visiting the homes of Charles Darwin, Gilbert White, Peter Scott, and more.
I was on the blog tour for Parikian’s previous book, Why Do Birds Suddenly Disappear?, in 2018. While the books are alike in levity (pun intended!), being full of self-deprecation and witty asides along with the astute observations, I think I enjoyed this one that little bit more for its all-encompassing approach to the experience of nature. I fully expect to see it on next year’s Wainwright Prize longlist (speaking of the Wainwright Prize, in yesterday’s post I correctly predicted four on the UK nature shortlist and two on the global conservation list!).
Readalikes (that happen to be from the same publisher): Under the Stars by Matt Gaw and The Seafarers by Stephen Rutt
My rating: 
My thanks to Elliott & Thompson for the free copy for review.
Memorial Drive: A Daughter’s Memoir by Natasha Trethewey
Trethewey grew up in 1960s Mississippi with a Black mother and a white Canadian father, at a time when interracial marriage remained illegal in parts of the South. After her parents’ divorce, she and her mother, Gwen, moved to Georgia to start a new life, but her stepfather Joel was physically and psychologically abusive. Gwen’s murder opens and closes the book. Trethewey only returned to that Atlanta apartment on Memorial Drive after 30 years had passed. The blend of the objective (official testimonies and transcripts) and the subjective (interpreting photographs, and rendering dream sequences in poetic language) makes this a striking memoir, as delicate as it is painful. I recommend it highly to readers of Elizabeth Alexander and Dani Shapiro. (Full review forthcoming at Shiny New Books.)
My rating: 
My thanks to Bloomsbury for the proof copy for review.
I’m reading two more July releases, Mostly Dead Things by Kristen Arnett (Corsair, 2 July; for Shiny New Books review), about a family taxidermy business in Florida, and The Liar’s Dictionary by Eley Williams (William Heinemann, 2 July), about an unusual dictionary being compiled in the Victorian period and digitized in the present day.
What July releases can you recommend?
Too Male! (A Few Recent Reviews for Shiny New Books and TLS)
I tend to wear my feminism lightly; you won’t ever hear me railing about the patriarchy or the male gaze. But there have been five reads so far this year that had me shaking my head and muttering, “too male!” While aspects of these books were interesting, the macho attitude or near-complete dearth of women irked me. Two of them I’ve already written about here: Ernest Hemingway’s The Garden of Eden was a previous month’s classic and book club selection, while Chip Cheek’s Cape May was part of my reading in America. The other three I reviewed for Shiny New Books or the Times Literary Supplement; I give excerpts below, with links to visit the full reviews in two cases, plus ideas for a book or two by a woman that should help neutralize the bad taste these might leave.
Shiny New Books
The Way Home: Tales from a Life without Technology by Mark Boyle
Boyle lives without electricity in a wooden cabin on a smallholding in County Galway, Ireland. He speaks of technology as an addiction and letting go of it as a detoxification process. For him it was a gradual shift that took place at the same time as he was moving away from modern conveniences. The Way Home is split into seasonal sections in which the author’s past and present intermingle. The writing consciously echoes Henry David Thoreau’s. Without even considering the privilege that got Boyle to the point where he could undertake this experiment, though, there are a couple of problems with this particular back-to-nature model. One is that it is a very male enterprise. Another is that Boyle doesn’t really have the literary chops to add much to the canon. Few of us could do what he has done, whether because of medical challenges, a lack of hands-on skills or family commitments. Still, the book is worth engaging with. It forces you to question your reliance on technology and ask whether making life easier is really a valuable goal.
The Remedy: Homesick: Why I Live in a Shed by Catrina Davies, which I’m currently reading for a TLS review. Davies crosses Boyle’s Thoreauvian language about solitude and a place in nature with a Woolfian search for a room of her own. Penniless during the ongoing housing crisis, she moves into the shed near Land’s End that once served as her father’s architecture office and embarks on turning it into a home.
Doggerland by Ben Smith
This debut novel has just two main characters: ‘the old man’ and ‘the boy’ (who’s not really a boy anymore), who are stationed on an enormous offshore wind farm. The distance from the present day is indicated in slyly throwaway comments like “The boy didn’t know what potatoes were.” Smith poses questions about responsibility and sacrifice, and comments on modern addictions and a culture of disposability. He has certainly captured something of the British literary zeitgeist. From page to page, though, Doggerland grew tiresome for me. There is a lot of maritime vocabulary and technical detail about supplies and maintenance. The location is vague and claustrophobic, the pace is usually slow, and there are repetitive scenes and few conversations. To an extent, this comes with the territory. But it cannot be ignored that this is an entirely male world. Fans of the themes and style of The Old Man and the Sea and The Road will get on best with Smith’s writing. I most appreciated the moments of Beckettian humor in the dialogue and the poetic interludes that represent human history as a blip in the grand scheme of things.
The Remedy: I’m not a big fan of dystopian or post-apocalyptic fiction in general, but a couple of the best such novels that I’ve read by women are Station Eleven by Emily St. John Mandel and Gold Fame Citrus by Claire Vaye Watkins.
Times Literary Supplement
The Knife’s Edge: The Heart and Mind of a Cardiac Surgeon by Stephen Westaby
In this somewhat tepid follow-up to Fragile Lives, Westaby’s bravado leaves a bad taste and dilutes the work’s ostensibly confessional nature. He has a good excuse, he argues: a head injury incurred while playing rugby in medical school transformed him into a risk taker. It’s widely accepted that such boldness may be a boon in a discipline that requires quick thinking and decisive action. So perhaps it’s no great problem to have a psychopath as your surgeon. But how about a sexist? Westaby’s persistent references to women staff as “lady GP” and “registrar lady” don’t mitigate surgeons’ macho reputation. It’s a shame to observe such casual sexism, because it’s clear Westaby felt deeply for his patients of any gender. And yet any talk of empathy earns his derision. It seems the specific language of compassion is a roadblock for him. The book is strongest when the author recreates dramatic sequences based on several risky surgeries. Alas, at its close he sounds bitter, and the NHS bears the brunt of his anger. Compared to Fragile Lives, one of my favorite books of 2017, this gives the superhero surgeon feet of clay. But it’s a lot less pleasing to read. (Forthcoming in TLS.) 
The Remedy: I’m keen to read Direct Red by Gabriel Weston, a memoir by a female surgeon.
(Crikey! This was my 600th blog post.)
Three Review Books: Brian Kimberling, Jessica Pan & Francesca Segal
Three May–June releases: A fish-out-of-water comic novel about teaching English in Prague; and memoirs about acting like an extrovert and giving birth to premature twins.
Goulash by Brian Kimberling
“Look where we are. East meets West. Communism meets capitalism.” In 1998 Elliott Black leaves Indiana behind for a couple of years to teach English in Prague. The opening sequence, in which he discovers that his stolen shoes have been incorporated into an art installation, is an appropriate introduction to a country where bizarre things happen. Elliott doesn’t work for a traditional language school; his students are more likely to be people he meets in the pub or tobacco company executives. Their quirky, deadpan conversations are the highlight of the book.
Elliott starts dating a fellow teacher from England, Amanda (she “looked like azaleas in May and she spoke like the BBC World Service”), who also works as a translator. They live together in an apartment they call Graceland. Much of this short novel is about their low-key, slightly odd adventures, together and separately, while the epilogue sees Elliott looking back at their relationship from many years later.
I was tickled by a number of the turns of phrase, but didn’t feel particularly engaged with the plot, which was inspired by Kimberling’s own experiences living in Prague.
With thanks to Tinder Press for a proof copy to review.
Favorite passages:
“Sorrowful stories like airborne diseases made their way through the windows and under the doorframe, bubbled up like the bathtub drain. It was possible to fill Graceland with light and color and music and the smell of good food, and yet the flat was like a patient with some untreatable condition, and we got tired of palliative care.”
“‘It’s good to be out of Prague,’ he said. ‘Every inch drenched in blood and steeped in alchemy, with a whiff of Soviet body odor.’ ‘You should write for Lonely Planet,’ I said.”
Sorry I’m Late, I Didn’t Want to Come: An Introvert’s Year of Living Dangerously by Jessica Pan
Like Jessica Pan, I’m a shy introvert (a “shintrovert”) as well as an American in the UK, so I was intrigued to see the strategies she employed and the experiences she sought out during a year of behaving like an extrovert. She forced herself to talk to strangers on the tube, give a talk at London’s Union Chapel as part of the Moth, use friendship apps to make new girlfriends, do stand-up comedy and improv, go to networking events, take a holiday to an unknown destination, eat magic mushrooms, and host a big Thanksgiving shindig.
Like Help Me!, which is a fairly similar year challenge book, it’s funny, conversational and compulsive reading that was perfect for me to be picking up and reading in chunks while I was traveling. Although I don’t think I’d copy any of Pan’s experiments – there’s definitely a cathartic element to reading this; if you’re also an introvert, you’ll feel nothing but relief that she’s done these things so you don’t have to – I can at least emulate her in initiating deeper conversations with friends and pushing myself to attend literary and networking events instead of just staying at home.
With thanks to Doubleday UK for a proof copy to review.
Mother Ship by Francesca Segal
I’m a big fan of Segal’s novels, especially The Innocents, one of the loveliest debut novels of the last decade, so I was delighted to hear she was coming out with a health-themed memoir about giving birth to premature twins. Mother Ship is a visceral diary of the first eight weeks in the lives of her daughters, who were born by Caesarean section at 29 weeks in October 2015 and spent the next two months in the NICU, “an extremely well-funded prison or perhaps more accurately a high-tech zoo.”
Segal strives to come to terms with this unnatural start to motherhood. “Taking my unready daughters from within me felt not like a birth but an evisceration,” she writes; “my children do not appear to require mothering. Instead they need sophisticated medical intervention.” She describes with tender precision the feeling of being torn: between the second novel she’d been in the middle of writing and the all-consuming nature of early parenthood; and between her two girls (known for much of the book as “A-lette” and “B-lette”), who are at one point separated in different hospitals.
Spotted at Philadelphia airport.
As well as portraying her own state of mind, Segal crafts twinkly pen portraits of the others she encountered in the NICU, including the staff but especially her fellow preemie mums, who met in a “milking shed” where they pumped breast milk for the babies they were so afraid of losing that they resisted naming. (Though it was touch and go for a while, A-lette and B-lette finally earned the names Raffaella and Celeste and came home safely.) Female friendship is a subsidiary theme in this exploration of desperate love and helplessness. The layman’s look at the inside workings of medicine would have made this one of my current few favorites for next year’s Wellcome Book Prize (which, alas, is on hiatus). After encountering some unpleasant negativity about the NHS in a recent read, I was relieved to find that Segal’s outlook is pure gratitude.
With thanks to Chatto & Windus for the free copy for review.
Would you be interested in reading one or more of these?
Hard Pushed: A Midwife’s Story by Leah Hazard
“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.
Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.
Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.
A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.
I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.
Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.
Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.
A few favorite passages:
“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”
“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”
“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”
My rating:
Hard Pushed was published in the UK on May 2nd (just a few days before International Midwives’ Day) by Hutchinson. My thanks to the publisher for the free proof copy for review.
Review: The Dark Circle by Linda Grant
Linda Grant’s seventh novel, The Dark Circle, stars Lenny and Miriam Lynskey, nineteen-year-old twins and representatives of London’s small Jewish population. It is 1949; Miriam works in a flower shop and Lenny has just been rejected by the army at his National Service medical appointment. He has tuberculosis and there are worries about Miriam’s lungs, too, so it’s off to the Gwendo (the Gwendolyn Downie Memorial Hospital for the Care of Chronic Cases of Tuberculosis, that is) for both of them. We briefly see them through the eyes of the cab driver who takes them down to Kent: “The pair in the back were common as muck.”
It’s clear this is no ordinary sanatorium; it has a “reputation for being a modern, iconoclastic facility for the very best people,” like Lady Anne and Miriam’s Oxford-educated roommate, Valerie. The Lynskeys, as NHS rather than private patients, may be looked down on as a different class of people, but they bring fresh life into the place. That’s doubly true of new arrival Arthur Persky, a twenty-six-year-old Navy man from Brooklyn. He enlivens the bleak, clinical surroundings with rock ’n roll music and a certain sex act. The Gwendo, once a place of boredom and conformity, now seems like a site of quiet rebellion.
One of Grant’s key skills is characterization, and short chapters from different characters’ perspectives give us access to their backstories. I especially liked getting to know German refugee Hannah Spiegel. Kafka, oddly enough, forms a link between her and the Lynskeys: Valerie has been reading The Metamorphosis aloud to Miriam to try to educate her; Miriam, absolutely captivated, gets Lenny in on the listening sessions, and he asks Hannah to interpret the book for them since she’s read the original German. “No, no-one can explain, it’s not possible to do so,” she replies. “You experience it in your way, it’s a labyrinth you must pass through but the labyrinth is yourself.”
The same might be said of tuberculosis. Each of these patients has the same disease, so Dr. Limb and his nurses sometimes treat them as interchangeable, yet each medical journey is individual and unpredictable. The typical approach was a pneumothorax injection to temporarily collapse one lung so it could ‘rest’, but in extreme cases some patients would have ribs removed. Great hopes were pinned on streptomycin treatment, and on Rosh Hashanah, the Jewish day of reckoning in 1950, Dr. Limb takes on the role of God, weighing up who live and who will die in the coming year. He has seven courses of streptomycin to distribute, but who will get them? The weakest? The woman he’s in love with? Or the ones with the most chance of improving? Meanwhile, Miriam’s condition is worsening, and Lenny and Persky decide they’ll do whatever it takes to make sure she gets one of those injections.
I was impressed by how Grant evokes her period setting through dialogue, slang and music. The novel’s tone is wry yet melancholy, almost nostalgic. The terrific opening paragraph gives you a taste of the no-nonsense style:
London. Big black old place, falling down, hardly any colour apart from a woman’s red hat going into the chemist with her string bag, and if you looked carefully, bottle green leather shoes on that girl, but mostly grey and beige and black and mud-coloured people with dirty hair and unwashed shirt collars, because everything is short, soap is short, joy is short, sex is short, and no one on the street was laughing so jokes must be short too. Four years after the war and still everything is up shit creek.
The final 60 pages are set in the future and reveal what happens to Lenny, Miriam and key others in the decades after they leave the sanatorium. These former patients are bound together in the title’s “dark circle” of suffering, but because TB has been eradicated no one remembers their pain. “From a death sentence to a course of antibiotics in a decade,” Lenny marvels. The novel loses momentum a bit in this short final section. I felt it would have been more powerful if Parts II and III were cut and the book simply ended with the plot coming full circle and Lenny and Miriam leaving the Gwendo in a taxi. But this is a minor quibble. The Dark Circle does what the best fiction does: drops you right into a situation you’ve never thought about and can’t begin to imagine—until a first-class novelist does so for you.
The Dark Circle was published by Virago on November 3rd. My thanks to Poppy Stimpson of Little, Brown for the free review copy.
My rating: 
It was a delight to participate in my first blog tour. See below for details of where other reviews have appeared and will be appearing soon.
Bookish Beck = Rebecca Foster. American transplant to England. Freelance proofreader and book reviewer.
Bookish Beck 