Saturday, September 14, 2013

Deja Dead by Kathy Reichs

Déjà Dead (Tempe Brennan 1)
by Kathy Reichs (read by Amy Irving)
Simon and Schuster Audio, 1998 (as part of the "A Deadly Audio Collection" compilation)
5 discs, abridged

Another case of me kind of cheating on the "Canadian" designation, as Kathy Reichs is pretty firmly American, but she also works in Canada (Quebec, specifically) and the entirety of this novel is set in Montreal. So there. I claim this as a Canadian crime novel.

And I liked it. I really did. It was also another case of me discovering after the fact that it was an abridgment, but in this case, with a few caveats, I didn't actually mind. I think the things that were missing were okay to be missing, with a couple of exceptions that I will get into in the following paragraphs. The production on the audiobook was excellent; Amy Irving as the reader was just great. She had the perfect voice, the perfect intonation, and the perfect pacing for Tempe's first person narration. I was hooked pretty much immediately and I fully intend to listen to the next book in the series at some point. Whether or not I listen to it abridged or unabridged remains to be seen. Abridged is much more accessible to me at this time, so I'll probably go that way.

This is the first of the Dr. Temperance Brennan books, made somewhat more popular than they already were by the advent of the television series Bones. The thought of reading this appealed to my book club because it's a forensic mystery -- a genre we had yet to read from -- plus it has a Canadian connection. Dr. Brennan, or Tempe, is a professor of anthropology in North Carolina, and a forensic anthropologist on the staff at the Laboratoire des Sciences Judiciaires et de Médecine Légale in Montreal, Quebec. Tempe is called to go ensure that some bones found near an old burial site are in fact old human bones, but it doesn't take long for her to realize that they're not that old at all -- and the person the bones belonged to didn't die from any natural cause, nor did she end up in pieces by accident. Further, Tempe notices some alarming similarities between this body and another she examined not long ago. What started as a simple call leads to an increasingly tense murder investigation. Tempe can't seem to convince the powers that be that a serial killer might be at work; and even when she does, it turns out she might be his next target, putting those closest to her at risk.

This is not a book for the faint of heart. The murders are grisly, over-the-top, sadistic serial killer murders, and the conditions the bodies are found in are very well-described. And this book employs my absolute least favourite murder mystery trope: This Time It's Personal. Further, the tension is ramped up heavily as we get towards the end of the story. So one would think that this book wouldn't be my cup of tea, with the least-favourite-trope plus heart-pounding-occasionally-gory-suspense-thriller. In the hands of a lesser storyteller, with a less fabulous central character, with less fascinating science, in a different setting, with a different reader, I'm pretty sure I would have put this one aside. But by the time it became clear to me where we were headed -- and when the foreshadowing got a little heavy-handed for me -- I was so interested in the whole thing I couldn't stop.

In addition to This Time It's Personal, Tempe also suffers from a bit of Horror Movie Heroine Syndrome, in that she makes some really dumb decisions for reasons that are not explained in full but appear to be entirely driven by plot. I get that Tempe is a bit brash and hasty, and I get that she's fighting for acceptance in a man's world, but heading out to a possible body-dump location by yourself in the dark in a storm is stupid. Especially if the killer knows that you know where to go. A killer who has already indicated that he's targeting you. There are a couple of incidents along the same lines, which really stretches believability, or perhaps just patience, with Tempe's character. But she was also incredibly likable, and smart, and abrasive in that somewhat endearing way. She is close to her daughter, she is leaving a shaky marriage reluctantly, she loves living alone with her cat.

Small issues with the fleshing out of Tempe's character are what makes me think I was missing stuff with the abridgement. Particularly towards the end of the novel, when I wanted to see Tempe reacting a bit more realistically to some of the awful things that have happened, I am wondering if there were things cut for abridging purposes that would have made Tempe a more well-rounded, psychologically interesting character; as it was, I liked her, but she didn't seem to even really think about certain things except perfunctorily, and they didn't seem to carry much traumatic weight. I can't discuss much further for fear of spoiling. I can fill in some of the gaps with my own imagination, but I'm not sure I should have to, given how well-written the book seems to be in places, and how rounded Tempe is in other matters. This bothered me as being lazy, an author wanting to have a sensational climax without having to give her main character suitable baggage for the rest of the series. Or possibly it's just abridged.

So there you go -- a book I probably shouldn't have liked given some of the issues with it, but in the end I really did like it, and I'm looking forward to the next. Recommended for crime/thriller fans who like their science, but can suspend disbelief fairly handily when it comes to certain plot points.

Friday, September 6, 2013

Cheating Death by Dr. Sanjay Gupta

Cheating Death
by Dr. Sanjay Gupta
Wellness Central, 2009
202 pages

I do so love my adult book club. I was pretty scared of it at first, when I started running it around three years ago. I didn't know anything about book clubs. I didn't really want to read books that I thought book clubs read. Luckily, I had stumbled upon leading a book club that didn't want to read those books either. Now we read everything we can agree might be somewhat interesting.

This was certainly interesting, and those of us who are science wonks (there are thankfully a couple of us now!) really enjoyed the experience. Others were rather meh on the book, but we have come to accept that there are very few books in the world that the entire group is going to like, no matter how excellent those books may be (one recent exception: To Say Nothing of the Dog by Connie Willis.) We did have some great discussion mostly tangential to the book, regarding medical ethics.

Ah, but how did I do with it, you ask? This is indeed my blog about me, so here we go.

I quite enjoyed it for the most part, in that it was a series of interesting facts and stories well-told. Gupta knows how to tell a story, and he knows how to make statistics (which are few and far between in this book) and medical jargon accessible. His chapter about fetal surgery had me literally on the edge of my seat, my heart pounding and my mouth dry. I suspect this is more than just Gupta's ability to tell the story, though he's certainly extremely adept. But two years out from my own very medical experience with a baby that should have stayed a fetus for longer than she did, I think that I still have a lot of emotional baggage when it comes to anything involving infants and/or their parents in less-than-ideal situations. (My own is now a very speedy toddler, and doing just fine.)

I was also captivated particularly by two of the first chapters, a chapter about therapeutic hypothermia and another about CPR without the artificial respiration. I've been trying to figure out why these chapters were so much more interesting to me than the rest of the book, and I think it's because they were particularly strong at outlining the practical treatment, the case for using it, the people involved in researching it, the hurdles the treatments face to becoming accepted and then standard practice, and then people who have benefited from the treatments. Not necessarily in that order, but wound around each other in such a way as to make a good story and still deliver the facts. Many of the other chapters I found a little less captivating, though still very interesting; I think this was because of the fact that they were either about treatments or phenomena still in the very early stages of testing, or because of something that triggered the medical ethics discussion at my book club.

There are two chapters specifically -- one about a patient who was seemingly headed straight for brain death, and another about a couple of patients with cancers that should have been lethal -- that seemed... good, but not perfect. They were good, because in all fairness to Dr. Gupta, he makes sure to state that we don't quite understand what happened and that these are vanishingly rare cases (though he perhaps doesn't make either point quite strongly enough.) He makes sure they are cases that are rigorously documented, and he also seems to argue that patients and their families must fight for the best care possible. I think this is all good. The part where I got a little uncomfortable was the feeling that... well, a) most people don't have $2 million lying around or even have the hopes of raising it, to get their loved ones the best, most cutting edge treatment available; b) there is so little information on why these particular few, out of the thousands of people in similar situations or with the same conditions, were able to survive; and c) there are lots of good reasons, physically and emotionally, for not trying absolutely everything to survive when the odds are so drastically bad, and for compassionate doctors to let people know the truth rather than fidgeting around the difficult answers.

People in situations with loved ones in comas or with inoperable brain tumours are extremely vulnerable. I can't even imagine what would happen to me in one of those situations. I honestly try not to think about it too much because I am perfectly capable of making myself weep just by imagining it. I want doctors in that situation to be totally up front and honest. I don't want them to give up because their case load is so heavy, or because they don't feel up to the challenge -- one gets the impression that Dr. Gupta feels this is a problem, and if so that's worrisome -- but if they honestly and truly tell me they don't believe there is anything that can be done and also offer a good chance of a high quality of life post-treatment -- I want to know that. I want to know I can trust that information, and I want to know that I'm not prolonging pain or suffering, or going to end up with a loved one who can't swallow their own food due to brain damage that may or may not be reversible. What I'm saying is that I think there is a tendency in human nature to grasp at any straws, and I don't want to be given false hope.

This is where the ethics comes in: is it in a patient's best interest for a doctor to tell him about the one-in-a-million case who survived an extremely aggressive cancer for twelve years when given three months, with help from a treatment that he/she may not be able to get, much less benefit from? What about if that treatment is available, but might make your last three months -- maybe four or five with the treatment, maybe longer if you're really lucky -- complete hell because of side effects? Is it fair to tell the wife of the terminal coma patient that once someone did come out of it, and walks around with a normal life treating his own patients at a rehab centre today, and no one knows why or exactly what happened? (What wife in their right mind would pull the plug after that? Not me.) Could you live with the what-if?

Which is not to say that Sanjay Gupta shouldn't write about those things. These are cases we should be studying. I just wish that in his effort to popularize the information, and to gently suggest that people advocate better for their own health care, he had also made it more clear that these are such rare outliers, that there isn't some sort of treatment plan that your loved one just isn't getting because of physician stubbornness or laziness, or government red tape. I think that having the information -- knowing, for example, that the brain is an amazingly plastic organ that can totally reorganize itself, given the chance and lots of time to heal -- is crucial, because it contributes to a patient being able to have a full and complete discussion with health professionals. On the other hand, I think suggesting that the problem is that doctors give up too easily, as one of his subjects seems to, is going a bit too far.

I'm not even going to get into some of my other thoughts related to the chapter on near death experiences (aside from the thought that I wasn't quite sure what it was doing in the book, other than it had to do with death) wherein I wish to discuss, as related to Karen Armstrong's A Short History of Myth, whether or not there are places science can't always provide all the answers. Pretty conflicted on this question, too, frankly. I was a bit surprised to find myself on the "I am not sure I want to know the mechanics of this" side of the line.

So if nothing else, this book gave me an awful lot to think about. The reading experience was easy and mostly pleasant, fascinating and a bit like brain candy for a science junkie like me. It's very clear to see why Sanjay Gupta is considered one of the best popularizers of medical science in the English language. Recommended, but maybe don't swallow Gupta's enthusiasm without a grain or two of salt.