January Releases, Part III: Taylor Harris, Cathy Rentzenbrink & Tanya Shadrick
Rounding off my three-part look at some of the month’s new releases with two memoirs plus a memoir-writer’s self-help guide today. (Can you tell I’m a memoir junkie?) Topics range from medical mysteries and covert racism to a reclaiming of life after a near-death experience, but these three nonfiction works by women are linked by the determination to overcome self-doubt.
This Boy We Made: A Memoir of Motherhood, Genetics, and Facing the Unknown by Taylor Harris
One morning, Taylor Harris and her husband (an African American family based in Charlottesville, Virginia) found their 22-month-old son Christopher, nicknamed “Tophs,” awake but unresponsive in his crib. In the years that followed, she and his doctors looked for answers as to why his body couldn’t regulate his blood sugar levels, sometimes leading to seizures, and to why his speech and mental processing remained delayed. All their tests and theories have never amounted to a conclusive diagnosis. This was a book that repeatedly surprised me. I’d assumed it would be exclusively about the medical mystery of Tophs’s physical and intellectual disability. But Harris elegantly weaves in a lot of other themes, too: mental illness, her own physical concerns (a BRCA2 mutation), racism, faith, and advocating for her children’s health and education. (Full review at BookBrowse.)
Write It All Down: How to put your life on the page by Cathy Rentzenbrink
Cathy Rentzenbrink is a lovely human being, and I’ve always appreciated her enthusiastic support of books. I’ve read all of her work even though I’ve been disappointed with her last few releases. There are so many writing guides out there – including several on memoir-writing specifically – that the first question to ask about one is, does it offer anything new? For me, this one doesn’t. In fact, it’s more of a therapy session than a practical writing guide.
The undemanding prose slides right down, but 60 pages in (at the end of Part One, “Preparation”) I realized all we’d had thus far was enumerating and countering the hang-ups of unconfident, procrastinating would-be writers. The rest of the book does then get into the nitty-gritty of producing a first draft (“Excavation”) of a life story and editing it into a more polished form. Rentzenbrink peppers in little tricks to keep oneself at the desk, like setting a timer or micro-goals, writing a section in the form of a letter, and dredging up sensory details. Most of the mini chapters are just a couple of pages. Several end with a series of prompts. I’m notorious for skipping the application questions in self-help books, but I’d be interested to hear if other readers have actually gone through these exercises and found them helpful.
I’m so familiar with the author’s own story from her three autobiographical works that I was less than patient about encountering certain incidents again here – though I was intrigued to learn that she gave up alcohol in the recent past after realizing that she was a problem drinker. I’ve also read most of the material in her Further Reading list; all told, I didn’t feel this book offered me much, as a lay reader or a maybe-some-day memoirist. But it seems to have been enormously popular among critics and readers (its average Goodreads rating is 4.38), so clearly a lot of people have been finding Rentzenbrink’s down-to-earth approach reassuring.
With thanks to Emma Finnigan PR and Bluebird for the proof copy for review.
The Cure for Sleep: Memoir of a Late-Waking Life by Tanya Shadrick
From my Most Anticipated list. Shadrick hangs around the fringes of nature writing cliques on Twitter, so I expected this to have more of a nature/travel element. Instead, it bears a fairy tale ambience, of a little girl lost in the woods and craving freedom; of a sleepwalking woman deciding to live more deliberately. It opens with a near-death experience: Shadrick, new mother to a son conceived after infertility treatment, suffered a severe haemorrhage after the placenta tore an artery and was rushed to hospital for emergency surgery.
From this point she returns to the beginning of her life and proceeds chronologically, pausing at joyful or traumatic moments. Her childhood feels like the key to understanding everything else: her father left when she was a baby; her mother, all too aware of being of lower class, was driven to improve herself. Shadrick wanted her mother all to herself, at the same time as she felt trapped by her. She injured herself jumping off an outhouse roof in protest at her mother’s new boyfriend, who became her stepfather. At university she reacted against her upbringing in predictable ways, failing her first year and having an abortion. Even once happily married, she kept unconsciously searching for surrogate father (older male) figures.
After the postnatal operation, she felt a need to escape – by suicide if necessary – yet forced herself to stay, make connections in her town and be present for her children. But she remained a free spirit, swimming and writing a mile-long scroll as public performance art. Her work with hospice patients, recording their memories, qualified her to edit Lynne Roper’s wild swimming diaries into a Wainwright Prize-longlisted book.
Awakening versus sleep is the figurative framework for the memoir, with a feminist insistence on freedom and self-fulfilment at the same time as being a mother. This is an unusual book – at times overwritten and too deliberately moulded into tropes as a rebuttal to randomness, even though, looking back, I can’t decipher a coherent plot to the events – that reminded me most of Free Woman by Lara Feigel and I Am, I Am, I Am by Maggie O’Farrell.
With thanks to W&N for the free copy for review.
Does one of these books appeal to you?
20 Books of Summer, #6–8: Aristide, Hood, Lamott
This latest batch of colour-themed summer reads took me from a depleted post-pandemic landscape to the heart of dysfunctional families in Rhode Island and California.
Under the Blue by Oana Aristide (2021)
Fans of Station Eleven, this one’s for you: the best dystopian novel I’ve read since Mandel’s. Aristide started writing this in 2017, and unknowingly predicted a much worse pandemic than Covid-19. In July 2020, Harry, a middle-aged painter inhabiting his late nephew’s apartment in London, finally twigs that something major is going on. He packs his car and heads to his Devon cottage, leaving its address under the door of the cute neighbour he sometimes flirts with. Hot days stack up and his new habits of rationing food and soap are deeply ingrained by the time the gal from #22, Ash – along with her sister, Jessie, a doctor who stocked up on medicine before fleeing her hospital – turn up. They quickly sink into his routines but have a bigger game plan: getting to Uganda, where their mum once worked and where they know they will be out of range of Europe’s at-risk nuclear reactors. An epic road trip ensues.
It gradually becomes clear that Harry, Ash and Jessie are among mere thousands of survivors worldwide, somehow immune to a novel disease that spread like wildfire. There are echoes of Cormac McCarthy’s The Road in the way that they ransack the homes of the dead for supplies, and yet there’s lightness to their journey. Jessie has a sharp sense of humour, provoking much banter, and the places they pass through in France and Italy are gorgeous despite the circumstances. It would be a privilege to wander empty tourist destinations were it not for fear of nuclear winter and not finding sufficient food – and petrol to keep “the Lioness” (the replacement car they steal; it becomes their refuge) going. While the vague sexual tension between Harry and Ash persists, all three bonds are intriguing.
In an alternating storyline starting in 2017, Lisa and Paul, two computer scientists based in a lab at the Arctic Circle, are programming an AI, Talos XI. Based on reams of data on history and human nature, Talos is asked to predict what will happen next. But when it comes to questions like the purpose of art and whether humans are worth saving, the conclusions he comes to aren’t the ones his creators were hoping for. These sections are set out as transcripts of dialogues, and provide a change of pace and perspective. Initially, I was less sure about this strand, worrying that it would resort to that well-worn trope of machines gone bad. Luckily, Aristide avoids sci-fi clichés, and presents a believable vision of life after the collapse of civilization.
The novel is full of memorable lines (“This absurd overkill, this baroque wedding cake of an apocalypse: plague and then nuclear meltdowns”) and scenes, from Harry burying a dead cow to the trio acting out a dinner party – just in case it’s their last. There’s an environmentalist message here, but it’s subtly conveyed via a propulsive cautionary tale that also reminded me of work by Louisa Hall and Maja Lunde. (Public library) 
Ruby by Ann Hood (1998)
Olivia had the perfect life: fulfilling, creative work as a milliner; a place in New York City and a bolthole in Rhode Island; a new husband and plans to try for a baby right away. But then, in a fluke accident, David was hit by a car while jogging near their vacation home less than a year into their marriage. As the novel opens, 37-year-old Olivia is trying to formulate a letter to the college girl who struck and killed her husband. She has returned to Rhode Island to get the house ready to sell but changes her mind when a pregnant 15-year-old, Ruby, wanders in one day.
At first, I worried that the setup would be too neat: Olivia wants a baby but didn’t get a chance to have one with David before he died; Ruby didn’t intend to get pregnant and looks forward to getting back her figure and her life of soft drugs and petty crime. And indeed, Olivia suggests an adoption arrangement early on. But the outworkings of the plot are not straightforward, and the characters, both main and secondary (including Olivia’s magazine writer friend, Winnie; David’s friend, Rex; Olivia’s mother and sister; a local lawyer who becomes a love interest), are charming.
It’s a low-key, small-town affair reminiscent of the work of Anne Tyler, and I appreciated how it sensitively explores grief, its effects on the protagonist’s decision-making, and how daunting it is to start over (“The idea of that, of beginning again from nothing, made Olivia feel tired.”). It was also a neat touch that Olivia is the same age as me, so in some ways I could easily imagine myself into her position.
This was the ninth book I’ve read by Hood, an author little known outside of the USA – everything from grief memoirs to a novel about knitting. Ironically, its main themes of adoption and bereavement were to become hallmarks of her later work: she lost her daughter in 2002 and then adopted a little girl from China. (Secondhand purchase, June 2021) 
[I’ve read another novel titled Ruby – Cynthia Bond’s from 2014.]
Blue Shoe by Anne Lamott (2002)
I’m a devoted reader of Lamott’s autobiographical essays about faith against the odds (see here), but have been wary of trying her fiction, suspecting I wouldn’t enjoy it as much. Well, it’s true that I prefer her nonfiction on the whole, but this was an enjoyably offbeat novel featuring the kind of frazzled antiheroine who wouldn’t be out of place in Anne Tyler’s work.
Mattie Ryder has left her husband and returned to her Bay Area family home with her young son and daughter. She promptly falls for Daniel, the handyman she hires to exterminate the rats, but he’s married, so she keeps falling into bed with her ex, Nicky, even after he acquires a new wife and baby. Her mother, Isa, is drifting ever further into dementia. A blue rubber shoe that Mattie finds serves as a totem of her late father – and his secret life. She takes a gamble that telling the truth, no matter what the circumstances, will see her right.
As in Ruby, I found the protagonist relatable and the ensemble cast of supporting characters amusing. Lamott crafts some memorable potted descriptions: “She was Jewish, expansive and yeasty and uncontained, as if she had a birthright for outrageousness” and “He seemed so constrained, so neatly trimmed, someone who’d been doing topiary with his soul all his life.” She turns a good phrase, and adopts the same self-deprecating attitude towards Mattie that she has towards herself in her memoirs: “She usually hoped to look more like Myrna Loy than an organ grinder’s monkey when a man finally proclaimed his adoration.”
At a certain point – maybe two-thirds of the way through – my inward reply to a lot of the novel’s threads was “okay, I get it; can we move on?” Yes, the situation with Isa is awful; yes, something’s gotta give with Daniel and his wife; yes, the revelations about her father seem unbearable. But with a four-year time span, it felt like Mattie was stuck in the middle for far too long. It’s also curious that she doesn’t apply her zany faith (a replica of Lamott’s) to questions of sexual morality – though that’s true of more liberal Christian approaches. All in all, I had some trouble valuing this as a novel because of how much I know about Lamott’s life and how closely I saw the storyline replicating her family dynamic. (Secondhand purchase, c. 2006 – I found a signed hardback in a library book sale back in my U.S. hometown for $1.) 
Hmm, altogether too much blue in my selections thus far (4 out of 8!). I’ll have to try to come up with some more interesting colours for my upcoming choices.
Next books in progress: The Other’s Gold by Elizabeth Ames and God Is Not a White Man by Chine McDonald.
Read any of these? Interested?
Recommended May Releases: Adichie, Pavey and Unsworth
Three very different works of women’s life writing: heartfelt remarks on bereavement, a seasonal diary of stewarding four wooded acres in Somerset, and a look back at postnatal depression.
Notes on Grief by Chimamanda Ngozi Adichie
This slim hardback is an expanded version of an essay Adichie published in the New Yorker in the wake of her father’s death in June 2020. With her large family split across three continents and coronavirus lockdown precluding in-person get-togethers, they had a habit of frequent video calls. She had seen her father the day before on Zoom and knew he was feeling unwell and in need of rest, but the news of his death still came as a complete shock.
Adichie anticipates all the unhelpful platitudes people could and did send her way: he lived to a ripe old age (he was 88), he had a full life and was well respected (he was Nigeria’s first statistics professor), he had a mercifully swift end (kidney failure). Her logical mind knows all of these facts, and her writer’s imagination has depicted grief many times. Still, this loss blindsided her.
She’d always been a daddy’s girl, but the anecdotes she tells confirm how special he was: wise and unassuming; a liberal Catholic suspicious of materialism and with a dry humour. I marvelled at one such story: in 2015 he was kidnapped and held in the boot of a car for three days, his captors demanding a ransom from his famous daughter. What did he do? Correct their pronunciation of her name, and contradict them when they said that clearly his children didn’t love him. “Grief has, as one of its many egregious components, the onset of doubt. No, I am not imagining it. Yes, my father truly was lovely.” With her love of fashion, one way she dealt with her grief was by designing T-shirts with her father’s initials and the Igbo words for “her father’s daughter” on them.
I’ve read many a full-length bereavement memoir, and one might think there’s nothing new to say, but Adichie writes with a novelist’s eye for telling details and individual personalities. She has rapidly become one of my favourite authors: I binged on most of her oeuvre last year and now have just one more to read, Purple Hibiscus, which will be one of my 20 Books of Summer. I love her richly evocative prose and compassionate outlook, no matter the subject. At £10, this 85-pager is pricey, but I was lucky to get it free with Waterstones loyalty points.
Favourite lines:
“In the face of this inferno that is sorrow, I am callow and unformed.”
“How is it that the world keeps going, breathing in and out unchanged, while in my soul there is a permanent scattering?”
Deeper Into the Wood by Ruth Pavey
In 1999 Ruth Pavey bought four acres of scrubland at auction, happy to be returning to her family’s roots in the Somerset Levels and hoping to work alongside nature to restore some of her land to orchard and maintain the rest in good health. Her account of the first two decades of this ongoing project, A Wood of One’s Own, was published in 2017.
In this sequel, she gives peaceful snapshots of the wood throughout 2019, from first snowdrops to final apple pressing, but also faces up to the environmental degradation that is visible even in this pocket of the countryside. “I am sure there has been a falling off in numbers of insects, smaller birds and rabbits on my patch,” she insists. Without baseline data, it is hard to support this intuition, but she has botanical and bird surveys done, and invites an expert in to do a moth-trapping evening. The resulting species lists are included as appendices. In addition, Pavey weaves a backstory for her land. She meets a daffodil breeder, investigates the source of her groundwater, and visits the head gardener at the Bishop’s Palace in Wells, where her American black walnut sapling came from. She also researches the Sugg family, associated with the land (“Sugg’s Orchard” on the deed) from the 1720s.
Pavey aims to treat this landscape holistically: using sheep to retain open areas instead of mowing the grass, and weighing up the benefits of the non-native species she has planted. She knows her efforts can only achieve so much; the pesticides standard to industrial-scale farming may still be reaching her trees on the wind, though she doesn’t apply them herself. “One sad aspect of worrying about the state of the natural world is that everything starts to look wrong,” she admits. Starting in that year’s abnormally warm January, it was easy for her to assume that the seasons can no longer be relied on.
Compared with her first memoir, this one is marked by its intellectual engagement with the principles and practicalities of rewilding. Clearly, her inner struggle is motivated less by the sense of ownership than by the call of stewardship. While this book is likely be of most interest to those with a local connection or a similar project underway, it offers a universal model of how to mitigate our environmental impact. Pavey’s black-and-white sketches of the flora and fauna on her patch, reminiscent of Quentin Blake, are a highlight.
With thanks to Duckworth for the proof copy for review. The book will be published tomorrow, the 27th of May.
After the Storm: Postnatal Depression and the Utter Weirdness of New Motherhood by Emma Jane Unsworth
The author’s son was born on the day Donald Trump won the U.S. presidential election. Six months later, she realized that she was deep into postnatal depression and finally agreed to get help. The breaking point came when, with her husband* away at a conference, she got frustrated with her son’s constant fussing and pushed him over on the bed. He was absolutely fine, but the guilty what-ifs proliferated, making this a wake-up call for her.
In this succinct, wry and hard-hitting memoir, Unsworth exposes the conspiracies of silence that lead new mothers to lie and pretend that everything is fine. Since her son’s traumatic birth (which I first read about in Dodo Ink’s Trauma anthology), she hadn’t been able to write and was losing her sense of self. To add insult to injury, her baby had teeth at 16 weeks and bit her as he breastfed. She couldn’t even admit her struggles to her fellow mum friends. But “if a woman is in pain for long enough, and denied sleep for long enough, and at the same time feels as though she has to keep going and put a ‘brave’ face on, she’s going to crack.”
The book’s titled mini-essays give snapshots into the before and after, but particularly the agonizing middle of things. I especially liked the chapter “The Weirdest Thing I’ve Ever Done in a Hotel Room,” in which she writes about borrowing her American editor’s room to pump breastmilk. Therapy, antidepressants and hiring a baby nurse helped her to ease back into her old life and regain some part of the party girl persona she once exuded – enough so that she was willing to give it all another go (her daughter was born late last year).
While Unsworth mostly writes from experience, she also incorporates recent research and makes bold statements of how cultural norms need to change. “You are not monsters,” she writes to depressed mums. “You need more support. … Motherhood is seismic. It cracks open your life, your relationship, your identity, your body. It features the loss, grief and hardship of any big life change.” I can imagine this being hugely helpful to anyone going through PND (see also my Three on a Theme post on the topic), but I’m not a mother and still found plenty to appreciate (especially “We have to smash the dichotomy of mums/non-mums … being maternal has nothing to do with actually physically being a mother”).
I’m attending a Wellcome Collection online event with Unsworth and midwife Leah Hazard (author of Hard Pushed) this evening and look forward to hearing more from both authors.
*It took me no time at all to identify him from the bare facts: Brighton + doctor + graphic novelist = Ian Williams (author of The Lady Doctor)! I had no idea. What a fun connection.
With thanks to Profile Books/Wellcome Collection for the free copy for review.
What recent releases can you recommend?
Two Novels of Ambivalent Parenthood: The Push & A Lie Someone Told You About Yourself
These 2021 releases I read from the library stood out to me for daring to suggest that sometimes children aren’t little angels and parenthood isn’t all it’s cracked up to be.
The Push by Ashley Audrain
“Do you wish you weren’t a mother?”
“Sometimes I wish I were a different kind of person.”
A cracking psychological thriller with an unreliable narrator, this is in the same vein as The Woman in the Window, Gone Girl, and A Good Enough Mother. I hardly ever pick up novels that fit into this genre, but these were all well worth making an exception for. The Push feels closer to literary fiction than to crime. Blythe Connor, living alone with her memories, ponders what went wrong with her seemingly perfect family: a handsome architect husband, Fox, and their daughter Violet and baby son Sam. Now reduced to being a stalker and an impersonator, Blythe vows to write everything down as evidence, taking care to note when she first had cause to question whether Violet was normal. A daddy’s girl from the start, Violet never bonded with Blythe and admitted to deliberately hurting other children in her preschool. But how much of what happened next was because of Violet’s nature, and how much was Blythe’s fault for failing to be the mother the girl needed?
The inkblot design of the cover cleverly evokes classical psychological concepts and experiments. A key topic the novel explores is how trauma is passed down through the generations: Blythe had worried that she wasn’t cut out for motherhood, chiefly because her mother and her grandmother both abandoned their daughters. “Blythe, the women in this family, we’re different. You’ll see,” her mother had warned. The exchange between Blythe and her mother that opens my review reiterates her suspicion: some people just aren’t cut out for parenting. Blythe can’t dismiss her daughter as evil because she knows how much guilt rests on her own shoulders, and because she doubts that she saw what she thought she saw. Moreover, the fact that her experience with Sam was completely different makes her feel ambivalent about motherhood: she’s seen how wonderful it can be, but also how it can turn bad. The nuance sets the book apart from run-of-the-mill thrillers. Yet it’s in short, page-turning chapters, so it reads very quickly and would make a great book club selection.
My rating: 
A Lie Someone Told You About Yourself by Peter Ho Davies
At its best, autofiction is an intriguing blend of memoir and fiction, all of it true and universal in appeal. Davies’ minimalist approach – short sections skating over the months and years, wryly pulling out representative moments here and there, all in a mere 180 pages – could hardly be more different from Karl Ove Knausgaard’s, but both are equally dedicated to the unique alchemy of crystallizing fatherhood by illuminating its daily heartaches and joys.
Years ago, “the writer” and his wife were presented with a choice. When genetic tests indicated mosaicism, they terminated their first pregnancy. Instead of a little girl, they later had a baby boy who presented his own challenges, including delayed development and possible ASD. Years later, the abortion still haunts “the father.” He attempts to exorcise his shame (the title = how Anaïs Nin defined it) by volunteering at an abortion clinic. Escorting patients to and from their cars, ignoring the taunts of protestors, he lives out his conviction that you can never fully know what others are going through and why they make the decisions they do.
Davies gets the tone just right in this novella, showing both sides of parenthood and voicing the things you aren’t allowed to think, or at least not to admit to – starting with abortion, which would-be fathers aren’t expected to have strong feelings about. Soon after the writer’s son is born: “He feels about himself for love, the way he might pat his pockets for his wallet and keys. Do I love him yet? Is this love?” As the boy grows into a figure of pathos: “All the things they’ve imagined him growing up to be: A basketball player, a fireman, a chef. [vs. what he actually seems to be] Allergic, friendless, autistic.” Davies also has a gift for zinging phrases, like “the deification of babies” and “the baby-industrial complex” of Babies R Us.
But what I most loved was the rumination on the role that chance plays in a life. “All the coin flips. All the what ifs. Like the litany of prompts he uses in writing class. Heads and tales.” The writer has a background in physics (as Davies himself does), so often brings up Schrödinger’s cat as a metaphor – in any situation, things might have gone either way. Now that the possibilities have narrowed to one and the path has been started, what will you do? The treatment of luck, in particular, led me to think of this as a cross between Larry’s Party by Carol Shields and What Are You Going Through by Sigrid Nunez. The style is similar to Jenny Offill’s; another similar and nearly contemporaneous release is Brood by Jackie Polzin.
I know I read The Fortunes back in 2016 but I retain virtually no memory of it. Davies’s prose, themes, and voice stood out much more for me here. I’ll try his novel The Welsh Girl, too, maybe even for book club later this year. This is an early entry on my Best of 2021 list.
Favorite lines:
“this is also what the internet is for, he thinks. If online porn universalizes shame, social media universalizes judgment. Both exercises in self-gratification.”
“An older colleague told him once cats were baby substitutes. ‘They weigh the same, they sleep on you, they roll around on their backs kicking their legs in the air. They mewl.’”
For more on abortion from a male perspective: The Cider House Rules by John Irving and Ars Botanica by Tim Taranto.
My rating: 
Born Digital by Robert Wigley (Blog Tour)
Robert Wigley spent a career in finance and is a father to three teenage sons. For two years, he learned more about their generation by meeting with 200 young entrepreneurs, one per business day. That combination of research and personal experience fuels his first book, Born Digital, which is about the unique challenges faced by Generation Z.
He found that, with young people spending an average of seven hours a day online, technology can exacerbate mental health issues, especially with the doom and gloom and lack of authenticity found on social media. Rather than making people feel more connected, technology tends to increase loneliness and reduce face-to-face interactions. Popularity and hook-ups are sought over meaningful, long-term relationships, while multi-tasking leads to an overall lack of focus.
This book brings up so many issues, including the potential for online surveillance and manipulation, and the problem of anonymity plus a failure to effectively verify users’ age. I’m still a smartphone refusenik because I want to carefully guard my time and attention, so I was particularly interested in the statistics and stories Wigley conveys about what it’s like for young people who have grown up with smartphones. This is a book I’ll be keeping on the shelf for future reference. It would of course be very relevant to parents and teachers, but I found it enlightening as well. Here’s a few-page excerpt to whet your appetite.
Chapter 6
LET’S TALK ABOUT THE JUGGLER’S BRAIN
My youngest son is at home with my wife and me; my older two are in London. We are all glued to Chelsea (who they all avidly support) playing Manchester United in the semi-final of the FA Cup. Chelsea scores, and my son screams with excitement and then starts his hilarious victory dance in front of the TV. The family WhatsApp channel bursts into life. Ping, ping. My wife has sent a picture of my youngest in front of the TV. My eldest has replied saying ‘doing exactly the same’. Everyone is high on a cocktail of Chelsea scoring, WhatsApp pinging and the humorous pictures and messages that it conveys.
Pleasurable human experiences result in the release of dopamine in the brain. The dopamine attaching itself to receptors in the brain causes the feeling of pleasure we experience. Most pleasurable experiences cause the release of a small amount of dopamine. Broadly speaking, to start with, the more dopamine, the more pleasure.
Normally, this release of dopamine is a good thing. It encourages us to seek out what is healthy or beneficial in our environment. It’s so important, in fact, that neuroscientists have given it a central role in a type of fundamental human learning called reinforcement learning. I will explain how technology companies abuse reinforcement learning to modify human behaviour so that we maximise time on their platforms and apps. What scientists have found is that dopamine is related to the prediction of rewards. If a reward is received but not anticipated, an increase in dopamine is seen. And if a reward is anticipated and not seen, a decrease in dopamine is seen. Since our brains are wired to optimise rewards, this means that humans will be motivated to seek out new rewards in any given situation, do anything they know delivers a reward repeatedly and avoid anything which gives them negative effects. Technology companies design their platforms and apps to make them addictive using this science. Receiving a notification, a like on Facebook or Instagram, a match on Tinder or a win in Fortnite all trigger dopamine releases. Being blocked by a friend or killed in the game causes a decrease in dopamine.
The problem starts when you seek out dopamine regularly and repeatedly as most people could be tempted to, given the pleasurable effect. The brain starts to develop a tolerance for dopamine. So more dopamine is needed to generate the same degree of pleasure. In the natural world, the availability of rewards is largely out of humans’ hands. On technology platforms, it is designed in and can be made almost infinitely abundant. Addictions develop because two things happen. The brain produces less dopamine per stimulus, and the brain feels less stimulated by each new release. So more, larger stimuli are needed, requiring the addict to seek them.
Sean Parker, Facebook’s Founding President, said in 2017, ‘We need to give you a little dopamine hit every once in a while … exploiting a vulnerability in human psychology … the inventors, creators … understood it consciously. And we did it anyway. God only knows what it’s doing to our children’s brains.’
Mirror neurons fire in the brain when an animal acts and observes the same action in another. You smile, I smile back. This may explain why some people unwittingly imitate their companions, sitting similarly in terms of leg positions or with their heads cocked at a similar angle. Some neuroscientists believe that mirror neurons form the basis of emotions such as empathy. If true, to develop and display empathy requires the physical observation of a counterparty during the intercourse – something, of course, that social media chat doesn’t deliver.
While neuroscientists debate precise mechanisms, it seems reasonably well accepted that bonding situations – a mother feeding or hugging a child – result in the release of oxytocin, which itself triggers the release of dopamine and serotonin. This leads to pleasurable feelings of comfort and security and builds the bond between the baby and the parent or carer. We have seen that dopamine leads to pleasure, and serotonin boosts feelings of wellbeing and collegiality. Paul Zak, one of the original researchers into the effects of oxytocin, described this as Human Oxytocin Medicated Empathy (‘HOME’). Bonding and empathy require at least physical proximity or engaged face-to-face engagement to occur. This is one of the reasons why it is so important that babies are not distracted with iPads fixed inches in front of their faces in their recliners before they are two, and equally important that parents must not be distracted from fixing their baby’s gaze, eye to eye, by combining feeding or bonding time with use of their own devices.
Eye-to-eye contact seems to be critical not just as a baby, but throughout life. ‘Whether it’s affection, amusement, arrogance or annoyance, our eyes convey how we feel. And the ability to read another person’s eyes, face to face, is one of the best predictors of a person’s social intelligence,’ says King. Referring to the conclusions of Simon Baron-Cohen’s ‘reading the mind in the eye test’, she says. ‘The better you are at inferring someone else’s mental state by looking at their eyes, the more likely you are to be prosocial, perform well in groups and respond empathetically.’
My thanks to Midas PR for the proof copy. I was glad to take part in the blog tour. See below for details of where other reviews and features have appeared.

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.
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