The Not the Wellcome Prize Blog Tour: Francesca Segal and Ian Williams
It’s my stop on the “Not the Wellcome Prize” blog tour. With two dozen reviews of health-themed 2019 books to choose from, I decided to nominate these two for the longlist because they’re under the radar compared to some other medical releases, plus they showcase the breadth of the books that the Prize recognizes: from a heartfelt memoir of a mother welcoming premature babies to a laugh-out-loud graphic novel about a doctor practicing in a small town in Wales. (The Prize website says “picture-led books are not eligible,” so in fact it is likely that graphic novels have never been considered, but we’ve been flexible with the rules for this unofficial blog tour.)

Mother Ship by Francesca Segal
This first work of nonfiction from the author of the exquisite The Innocents is a visceral diary of the first eight weeks in the lives of her twin 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.” In Mother Ship, she 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.”
Segal 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. Her attitude towards the NHS is pure gratitude.
As well as portraying her own state of mind, she 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 thus a subsidiary theme in this exploration of desperate love and helplessness.
The Lady Doctor by Ian Williams
This sequel to 2014’s The Bad Doctor returns to a medical practice in small-town Wales. This time, though, the focus is on Iwan James’s colleague, Dr. Lois Pritchard, who also puts in two days a week treating embarrassing ailments at the local hospital’s genitourinary medicine clinic. At nearly 40, Lois is a divorcee with no children; just a dog. She enjoys her nights out drinking with her best friend, Geeta, but her carefree life is soon beset by various complications: she has to decide whether she wants to join the health centre as a full partner, a tryst with her new fella goes horribly wrong, and her estranged mother suddenly reappears in her life, hoping that Lois will give her a liver transplant. And that’s not to mention all the drug addicts and VD-ridden lotharios hanging about.
Williams was a GP in North Wales for 20 years, and no doubt his experiences have inspired his comics. His tone is wonderfully balanced: there are plenty of hilarious, somewhat raunchy scenes, but also touching moments where Lois learns that a doctor is never completely off duty and has no idea what medical or personal challenge will crop up next. The drawing style reminded me most of Alison Bechdel’s or Posy Simmonds’, with single shades from rose to olive alternating as the background. I especially loved the pages where each panel depicts a different patient to show the range of people and complaints a doctor might see in a day. Myriad Editions have a whole “Graphic Medicine” series that I’m keen to explore.
See below for details of the blogs where other reviews have appeared or will be appearing soon.
The shadow panel will choose a shortlist of six titles to be announced on 4 May. We will then vote to choose a winner, with the results of a Twitter poll serving as one additional vote. The Not the Wellcome Prize winner will be announced on 11 May.

Review Books Roundup: Blackburn, Bryson, Pocock, Setterwall, Wilson
I’m attempting to get through all my 2019 review books before the end of the year, so expect another couple of these roundups. Today I’m featuring a work of poetry about one of Picasso’s mistresses, a thorough yet accessible introduction to how the human body works, a memoir of personal and environmental change in the American West, Scandinavian autofiction about the sudden loss of a partner, and a novel about kids who catch on fire. You can’t say I don’t read a variety! See if one or more of these tempts you.
The Woman Who Always Loved Picasso by Julia Blackburn
Something different from Blackburn: biographical snippets in verse about Marie-Thérèse Walter, one of Pablo Picasso’s many mistress-muses. When they met she was 17 and he was 46. She gave birth to a daughter, Maya – to his wife Olga’s fury. Marie-Thérèse’s existence was an open secret: he rented a Paris apartment for her to live in, and left his home in the South of France to her (where she committed suicide three years after his death), but unless their visits happened to overlap she was never introduced to his friends. “I lived in the time I was born into / and I kept silent, / acquiescing / to everything.”
In Marie-Thérèse’s voice, Blackburn depicts Picasso as a fragile demagogue: in one of the poems that was a highlight for me, “Bird,” she describes how others would replace his caged birds when they died, hoping he wouldn’t notice – so great was his horror of death. I liked getting glimpses into a forgotten female’s life, and appreciated the whimsical illustrations by Jeffrey Fisher, but as poems these pieces don’t particularly stand out. (Plus, there are no page numbers! which doesn’t seem like it should make a big difference but ends up being annoying when you want to refer back to something. Instead, the poems are numbered.)
My rating: 
With thanks to Carcanet Press for the free copy for review. Published today.
The Body: A Guide for Occupants by Bill Bryson
Shelve this next to Being Mortal by Atul Gawande in a collection of books everyone should read – even if you don’t normally choose nonfiction. Bryson is back on form here, indulging his layman’s curiosity. As you know, I read a LOT of medical memoirs and popular science. I’ve read entire books on organ transplantation, sleep, dementia, the blood, the heart, evolutionary defects, surgery and so on, but in many cases these go into more detail than I need and I can find my interest waning. That never happens here. Without ever being superficial or patronizing, the author gives a comprehensive introduction to every organ and body system, moving briskly between engaging anecdotes from medical history and encapsulated research on everything from gut microbes to cancer treatment.
Bryson delights in our physical oddities, and his sense of wonder is infectious. He loves a good statistic, and while this book is full of numbers and percentages, they are accessible rather than obfuscating, and will make you shake your head in amazement. It’s a persistently cheerful book, even when discussing illness, scientists whose work was overlooked, and the inevitability of death. Yet what I found most sobering was the observation that, having conquered many diseases and extended our life expectancy, we are now overwhelmingly killed by lifestyle, mostly a poor diet of processed and sugary foods and lack of exercise.
My rating: 
With thanks to Doubleday for the free copy for review.
Surrender: Mid-Life in the American West by Joanna Pocock
Prompted by two years spent in Missoula, Montana and the disorientation felt upon a return to London, this memoir-in-essays varies in scale from the big skies of the American West to the smallness of one human life and the experience of loss and change. Then in her late forties, Pocock had started menopause and recently been through the final illnesses and deaths of her parents, but was also mother to a fairly young daughter. She explores personal endings and contradictions as a kind of microcosm of the paradoxes of the Western USA.
It’s a place of fierce independence and conservatism, but also mystical back-to-the-land sentiment. For an outsider, so much of the lifestyle is bewildering. The author attends a wolf-trapping course, observes a Native American buffalo hunt, meets a transsexual rewilding activist, attends an ecosexuality conference, and goes foraging. All are attempts to reassess our connection with nature and ask what role humans can play in a diminished planet.
This is an elegantly introspective work that should engage anyone interested in women’s life writing and the environmental crisis. There are also dozens of black-and-white photographs interspersed in the text. In 2018 Pocock won the Fitzcarraldo Editions Essay Prize for this work-in-progress. It came to me as an unsolicited review copy and hung around on my shelves for six months before I picked it up; I’m glad I finally did.
My rating: 
With thanks to Fitzcarraldo Editions for the free copy for review.
Let’s Hope for the Best by Carolina Setterwall
[Trans. from the Swedish by Elizabeth Clark Wessel]
Although this is fiction, it very closely resembles the author’s own life. She wrote this debut novel to reflect on the sudden loss of her partner and how she started to rebuild her life in the years that followed. It quickly splits into two parallel story lines: one begins in April 2009, when Carolina first met Aksel at a friend’s big summer bash; the other picks up in October 2014, after Aksel’s death from cardiac arrest. The latter proceeds slowly, painstakingly, to portray the aftermath of bereavement. In the alternating timeline, we see Carolina and Aksel making their life together, with her always being the one to push the relationship forward.
Setterwall addresses the whole book in the second person to Aksel. When the two story lines meet at about the two-thirds point, it carries on into 2016 as she moves house, returns to work and resumes a tentative social life, even falling in love. This is a wrenching story reminiscent of In Every Moment We Are Still Alive by Tom Malmquist, and much of it resonated with my sister’s experience of widowhood. There are many painful moments that stick in the memory. Overall, though, I think it was too long by 100+ pages; in aiming for comprehensiveness, it lost some of its power. Page 273, for instance (the first anniversary of Aksel’s death, rather than the second, where the book actually ends), would have made a fine ending.
My rating: 
With thanks to Bloomsbury UK for the proof copy for review.
Nothing to See Here by Kevin Wilson
I’d read a lot about this novel while writing a synopsis and summary of critical opinion for Bookmarks magazine – perhaps too much, as it felt familiar and offered no surprises. Lillian, a drifting twentysomething, is offered a job as a governess for her boarding school roommate Madison’s stepchildren. Madison’s husband is a Tennessee senator in the running for the Secretary of State position, so it’s imperative that they keep a lid on the situation with his 10-year-old twins, Bessie and Roland.
You see, when they’re upset these children catch on fire; flames destroy their clothes and damage nearby soft furnishings, but leave the kids themselves unharmed. Temporary, generally innocuous spontaneous combustion? Okay. That’s the setup. Wilson writes so well that it’s easy to suspend your disbelief about this, but harder to see a larger point, except perhaps creating a general allegory for the challenges of parenting. This was entertaining enough, mostly thanks to Lillian’s no-nonsense narration, but for me it didn’t soar.
My rating: 
With thanks to Text Publishing UK for the PDF for review. This came out in the States in October and will be released in the UK on January 30th.
Would you be interested in reading one or more of these?
How Not to Decide: Motherhood by Sheila Heti
Should one have children? No matter who’s asking the question or in what context, you’re going to get the whole gamut of replies, as proven by this recent Literary Hub survey of authors. Should I have children? Turn the question personal and, even if it’s actually rhetorical, you’ll still get an opinion from every quarter. As The Decision looms over her, the narrator of Sheila Heti’s new novel, a 37-year-old writer from Toronto, isn’t sure who to listen to. Her neurotic inner voice makes her second-guess her life. “The question of a child is a bug in the brain—it’s a bug that crawls across everything, every memory, and every sense of my own future.” Meanwhile, acquaintances and strangers alike all have their two cents to chip in. Everywhere she goes on her book tour, for instance, she hears other people’s stories and has to sift through them. She’s something like the protagonist of Rachel Cusk’s Outline trilogy, though with a stronger personality and internal commentary.
Having a child is an act of creation, and Heti’s narrator worries that she only has sufficient creative energy for one or the other: writing or breeding. Her identity as an artist is so precious to her that she is terrified of giving it up, or watering it down, to risk being a (not very good?) mother. Yet she has the sense that to remain childless she had better come up with a really good excuse. People will want to know what she is going to do with her life instead, and they’re unlikely to be satisfied by the notion that her books are like her babies.

The novel is in short, aphoristic paragraphs and is dominated by cogitation rather than scenes, though there are some concrete events and secondary characters, such as the narrator’s mother; her friend Libby, a new mother; and her partner, Miles, who has a 12-year-old daughter from a previous relationship. The sections are given headings like “PMS,” “Bleeding,” “Follicular,” and “Ovulating,” which suggest the cyclical nature of life: whether she likes it or not, this character is part of a physical process geared towards reproduction.
The cyclical workings of the female body mirror the circularity of her thoughts: she keeps revolving around the same questions, never seeming to get any closer to a decision – though by the end she does decide. The temptation is always to offload the choice onto an external, fate-like force. The narrator wants the oracular voice of the universe to answer everything for her via coin tosses. (Heti writes in a prefatory note that these were based on actual coin tosses.) She asks series of yes/no questions and reports what the coins have to say. It’s a way of avoiding responsibility for her own decision, and produces some truly hilarious passages. Oh, the absurdity of having a dialogue with an impersonal force!
Our heroine does ultimately realize how random and meaningless the coins’ yes/no answers are, but she continues to look outside herself for wisdom: to a fortune teller, psychics, dreams, and even a crazy woman in New York City who hits her up for money. Anything to bypass the wringer of her own mind. She also latches onto the biblical story of Jacob wrestling with the angel, and contrasts this with the symbol of a kitchen knife, which represents a demon that robs her of hope.
Every woman is a daughter as well as a potential mother, and a particularly moving strand of Motherhood is the narrator’s relationship with her female ancestors. Her Hungarian grandmother, Magda, survived Auschwitz only to die of cancer at 53; her mother, a doctor, devoted herself to her career and left the traditional household and childrearing tasks to her husband. This dual legacy of suffering and professional pride helps explain the narrator’s feelings. Deep down, she believes her family line was meant to end in a concentration camp; how dare she continue it now? She also emulates her mother’s commitment to a cerebral vocation – “So I also wanted to be the brains: to be nothing but words on a page.”
Chance, inheritance, and choice vie for pride of place in this relentless, audacious inquiry into the purpose of a woman’s life. I marked out dozens of quotes that could have been downloaded directly from my head or copied from my e-mails and journal pages. The book encapsulates nearly every thought that has gone through my mind over the last decade as I’ve faced the intractable question of whether to have children. I suspect it will mean the most to people who are still unsure or have already decided against children; parents may interpret Heti’s arguments as personal barbs, even though the narrator insists her own decision is not an inherent comment on anyone else’s. It’s a book I could have written, but now don’t have to; Heti has captured brilliantly what it’s like to be in this situation in this moment in time.
Here are a few of my favorite passages. They should give you an idea of whether this book might resonate with you, or at least interest you academically:
“On the one hand, the joy of children. On the other hand, the misery of them. On the one hand, the freedom of not having children. On the other hand, the loss of never having had them—but what is there to lose?”
“for a woman of curiosity, no decision will ever feel like the right one. In both, too much is missing. What can I say, except: I forgive myself for every time I neglected to take a risk, for all the narrowings and winnowings of my life. I understand that fear beckons to a person as much as possibility does, and even more strongly.”
“I don’t have to live every possible life, or to experience that particular love. I know I cannot hide from life; that life will give me experiences no matter what I choose. Not having a child is no escape from life, for life will always put me in situations, and show me new things, and take me to darknesses I wouldn’t choose to see, and all sorts of treasures of knowledge I cannot comprehend.”
My rating: 
Motherhood was published in the UK by Harvill Secker on May 24th. My thanks to the publisher for the free copy for review. It came out in North America on May 1st (Knopf Canada / Henry Holt and Co.).

Dark, Salt, Clear: Life in a Cornish Fishing Town by Lamorna Ash: In her early 20s, Ash made multiple trips from London to stay in Newlyn: walking to the cove that bears her name, going out on fishing trawlers, and getting accepted into the small community. Gruelling and lonely, the fishermen’s way of life is fading away. The book goes deeper into Cornish history than non-locals need, but I enjoyed the literary allusions – the title is from Elizabeth Bishop. I liked the writing, but this was requested after me at the library, so I could only skim it. 


Bird Therapy by Joe Harkness: In 2013, Harkness was in such a bad place that he attempted suicide. Although he’s continued to struggle with OCD and depression in the years since then, birdwatching has given him a new lease on life. Avoiding the hobby’s more obsessive, competitive aspects (like listing and twitching), he focuses on the benefits of outdoor exercise and mindfulness. He can be lyrical when describing his Norfolk patch and some of his most magical sightings, but the writing is weak. (My husband helped crowdfund the book via Unbound.) 
Dancing with Bees: A Journey Back to Nature by Brigit Strawbridge Howard: Bees were the author’s gateway into a general appreciation of nature, something she lost for a time in midlife because of the rat race and family complications. Allotment gardening gives her opportunities to observe bee behaviour and marvel at their various lookalikes (like hoverflies), identify plants, work on herbal remedies, and photograph her finds. She delights in discovery and is devoted to lifelong learning in a book characterized by curiosity and warmth. (On my runners-up of 2019 list) 




I think this year’s is an especially appealing longlist. It’s great to see small presses and debut authors getting recognition. I’ve now read 8 out of 13 (and skimmed one), and am interested in the rest, too, especially The Frayed Atlantic Edge by David Gange. The final three, all combining nature and (auto)biographical writing, are On the Red Hill by Mike Parker, The Well-Gardened Mind by Sue Stuart-Smith, and Rootbound: Rewilding a Life by Alice Vincent.



Notes from an Apocalypse: A Personal Journey to the End of the World and Back by Mark O’Connell: The same satirical outlook that made
Like some lost mid-career gem from Toni Morrison, this novel is meaty with questions of racial and sexual identity and seems sure to follow in the footsteps of Ruby and
The unnamed narrator of Gabrielsen’s fifth novel is a 36-year-old researcher working towards a PhD on the climate’s effects on populations of seabirds, especially guillemots. During this seven-week winter spell in the far north of Norway, she’s left her three-year-old daughter behind with her ex, S, and hopes to receive a visit from her lover, Jo, even if it involves him leaving his daughter temporarily. In the meantime, they connect via Skype when signal allows. Apart from that and a sea captain bringing her supplies, she has no human contact.
This is the first collection of the Chinese Singaporean poet’s work to be published in the UK. Infused with Asian history, his elegant verse ranges from elegiac to romantic in tone. Many of the poems are inspired by historical figures and real headlines. There are tributes to soldiers killed in peacetime training and accounts of high-profile car accidents; “The Passenger” is about the ghosts left behind after a tsunami. But there are also poems about the language and experience of love. I also enjoyed the touches of art and legend: “Monologues for Noh Masks” is about the Pitt-Rivers Museum collection, while “Notes on a Landscape” is about Iceland’s geology and folk tales. In most places alliteration and enjambment produce the sonic effects, but there are also a handful of rhymes and half-rhymes, some internal.
I noted the recurring comparison of natural and manmade spaces; outdoors (flowers, blackbirds, birds of prey, the sea) versus indoors (corridors, office life, even Emily Dickinson’s house in Massachusetts). The style shifts from page to page, ranging from prose paragraphs to fragments strewn across the layout. Most of the poems are in recognizable stanzas, though these vary in terms of length and punctuation. Alliteration and repetition (see, as an example of the latter, her poem “The Studio” on the
There isn’t, or needn’t be, a contradiction between faith and queerness, as the authors included in this anthology would agree. Many of them are stalwarts at Greenbelt, a progressive Christian summer festival – Church of Scotland minister John L. Bell even came out there, in his late sixties, in 2017. I’m a lapsed regular attendee, so a lot of the names were familiar to me, including those of poets Rachel Mann and Padraig O’Tuama.
Mike Barnes, a Toronto poet and novelist, has been a primary caregiver for his mother, Mary, in the nine years since her Alzheimer’s diagnosis disease. She grew up on a Saskatchewan farm and is now in her nineties; he’s in his sixties. A bipolar sufferer, Barnes has spent his own fair share of time in hospitals and on disability. He’s moved Mary between care homes four times as her condition has deteriorated. Though he laments her gradual loss of words and awareness of her family, he can still discern instances of her bravery and the beauty of life.
Journalist Nick Duerden always appreciated how his maternal grandparents, Nonna and Nonno, seemed so ordinary and unchanging. Every trip to see them in the Milan suburbs was, comfortingly, the same. He’d muddle along with his meager Italian, and they’d look after him in their usual clucking way. It was only as he reached middle age and realized that his grandparents were undeniably very old – his grandmother is 99 and in a care home at the time of writing – that he realized how lucky he was to still have them in his life and how unlikely it was that they’d be around for much longer.
This offbeat novella was a bestseller and a successful film. You surely know its most famous line: “Love means not ever having to say you’re sorry.” Oliver Barrett IV is a golden boy: his banker father and previous generations of the eminent Barrett family funded various buildings at Harvard, where Oliver is a hockey player in the late 1960s. Jenny Cavilleri, on the other hand, comes from a single-parent Italian-American family in New Jersey. She’s made it to Radcliffe as a harpsichordist, but her father is just a baker; she’d never be considered good enough for the likes of Oliver. But they meet at the Radcliffe library and, sure enough, fall for each other. She calls him “Preppie”; he calls her a bitch. They’re only partially joking. It may be true love against the odds, but it has an expiration date, as we know from the first line: “What can you say about a twenty-five-year old girl who died?”