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.

Invisible Cities by Italo Calvino

Invisible Cities
by Italo Calvino (trans. William Weaver)
Vintage Classics, 1997 (original Italian published in 1972)
162 pages

I wish I had something beautiful to say to start this entry, but next to Calvino my writing feels pedestrian and my observations mundane. Invisible Cities is breathtaking. I don't think -- though I am not entirely sure -- that this book is genius or perfect, but it was a remarkable reading experience and I'm looking forward to going back in once my own copy arrives. I am looking forward to tracing threads and mulling over ideas and wallowing in the language.

Thanks to Aarti, I went into this book knowing what to expect. I knew I wasn't getting a novel, though there was a hint more of a narrative (though really, it's hard to call it that) than I did expect. But as she said, it was a series of very short pieces, some only a paragraph and at most three or four pages, each about a different fictional city or describing an interaction between Kublai Khan and Marco Polo. The pieces are each related to each other, though sometimes in very tenuous or subtle ways, and the interactions between Kublai Khan and Marco Polo bookend each of nine sections. There is an overall pattern, like a piece of music, and there are other, less obvious patterns at play throughout the book. It feels like the sort of book that I might actually want to read critical interpretations of, but at the same time I want to resist, so I can discover it for myself.

And I loved it. I loved every second of reading this book. I have no idea how to read it, I have no idea if I read it "right," but that doesn't matter at all. At its best, I think Invisible Cities taps into something universal. The rest of the time it is just gorgeous. Very, very rarely it may slip into a cliche or a pedestrian moment that seems a bit too... easy, perhaps. But that didn't happen very often, and maybe it didn't happen at all, and those moments will vanish upon rereads (it's possible, I suppose, that it could go the other way, too, and seem more cliched and pedestrian upon rereads; I hope not.)

Each city is its own entity, but each city is also every city. Some might say -- the blurbs do, Kublai Khan eventually does -- that it is just one city Marco Polo is describing; I have never been there, but I recognize it in the cities I do know. And yet they are strange and wonderful, too, each city described. And perhaps even better is to recognize cities that truly do exist today in the same strange and wonderful terms, a moment of sheer reading perfection when it comes about unexpectedly.

Sometimes I worry that I'm too much Mary Bennet, making my extracts and barely scratching the surface of meanings, living through my books and not enough through my experience. But I've made extracts, and here are a few to share.

The city, however, does not tell its past, but contains it like the lines of a hand, written in the corners of the streets, the gratings of the windows, the banisters of the steps, the antennae of the lightning rods, the poles of the flags, every segment marked in turn with scratches, indentations, scrolls.

and later:

So if I wished to describe Aglaura to you, sticking to what I personally saw and experienced, I should have to tell you that it is a colourless city, without character, planted there at random. But this would not be true, either: at certain hours, in certain places along the street, you see opening before you the hint of something unmistakable, rare, perhaps magnificent; you would like to say what it is, but everything previously said of Aglaura imprisons your words and obliges you to repeat rather than say. 

Therefore the inhabitants still believe they live in an Aglaura which grows only with the name Aglaura and they do not notice the Aglaura that grows on the ground. And even I, who would like to keep the two cities distinct in my memory, can speak only of the one, because the recollection of the other, in the lack of words to fix it, has been lost.

There is a lilt and a lull to the way Calvino writes that I find very pleasant. Maybe it's the original Italian, maybe it's just Calvino (I am not sure I have read anything else translated from Italian, at least not in recent memory.) And the end of the book felt just right to me, which is a rare and lucky and excellent thing. This book isn't for everyone, and at one point might not have been for me, but it was exactly the sort of thing for me right now and I am so very glad I read it. More Calvino in my future, for sure; I don't really care what form it takes as long as he wrote it.

A Short History of Myth by Karen Armstrong

A Short History of Myth
by Karen Armstrong
Alfred A. Knopf Canada, 2005
159 pages

I took a long time to read this book. It occurs to me that maybe this is not a bad thing. While it might have been nice to read it much faster, and I might have been able to absorb more if I'd read it more than two pages at a time, it still worked. That is to say, I didn't have a lot of time for reading this past month, and so it was good that I could put down this book and walk away and then pick it back up either minutes or days later and not really miss too much.

It is indeed a short history. Armstrong covers human myth from prehistory to contemporary times in less than 200 pages, and this causes some difficulties. Particularly in the early part of the book, Armstrong makes some claims and wild generalizations that I found too broad to be easily swallowed, and sometimes she offers no references or arguments to support her statement. The most egregious example of this would be when Armstrong suggests that the brutal, demanding, bloodthirsty "Great Goddess" persona likely dating back to many paleolithic myths was born of male resentment ("Why should a goddess have become so dominant in an aggressively male society? This may be due to an unconscious resentment of the female." pg39.) Maybe so, and maybe there is lots of data to back this up elsewhere, but a claim like that ought not be offhand and unsupported if you expect me to take it, or anything you're saying, seriously. I'm a lay reader, not particularly versed in human culture in paleolithic times. In a couple of cases, Armstrong's claims about people and cultures in the Paleolithic and Neolithic Ages seemed over simplified and under supported, which made those sections of the book rather frustrating.

That said, she did say it was a short history, so I forged on, thinking perhaps that I should get a more in depth history sometime. Something I would likely have to read more than two pages at a time.

I'm glad I kept reading, because Armstrong does a good job with the ages post-Neolithic, or maybe that's just because I do have a little more background knowledge. And her final, overarching argument, however brief (as befits the book) was convincing enough to be unsettling. She makes a strong case for myth as primitive psychology, for myth as a way humans have made sense of the big questions and the angst of being humans in a big, scary, uncontrollable world. In conjunction with a belief system and ritual, myth becomes the internalized way we deal with our deep fears and insecurities. Myth and its accompanying rituals help humans face death, destruction, change, and our insignificant place in the world.

Finally, Armstrong argues that with the onset of humans privileging science and technology over our collective myths, and refusing to identify anything that cannot be objectively proven "true" as valuable in our understanding of the world, we have lost our connection to the deeper things that make us human. By discounting myth as "just a myth" we have lost an integral part of what allows us as individuals and societies to cope with the unknown and the unknowable. We become disconnected and disillusioned, and Armstrong argues that Western society has sunk into a general malaise due in large part to our inability to understand and to value a collective mythology. She is not necessarily arguing for religion here -- she points out flaws in that structure, though also clearly believes it has value -- but for literatures and arts that get at the deeper, universal truths of being human, that can become transformative experiences for contemporary people and societies.

I don't necessarily think it's quite so simple, but I do think that Armstrong's arguments -- for the purposes of myth, and for the hazards of losing it -- make a great deal of sense. Her suggestion that literature and the arts are part of our deeper psychological sense-making, and therefore hold an incredibly and increasingly important position in contemporary, myth-less lives, is also agreeable to this reader. As an introduction to the Myths Series (including Atwood's The Penelopiad, Jeanette Winterson's Weight, and A.S. Byatt's Ragnarok) A Brief History of Myth does an excellent job of making a case for why the series should exist.

This book is not without its bumps, but it does what it advertises. If you're looking for meat, go elsewhere, but if you're looking for a lighter primer on myth and its functions, this is a good start, mostly well-written and enjoyable.

The Penderwicks by Jeanne Birdsall

The Penderwicks: A Summer Tale of Four Sisters, Two Rabbits, and a Very Interesting Boy
by Jeanne Birdsall
Oakhill Audiobooks, 2008 (originally published in 2005)
6 discs, unabridged

This book feels like an older children's classic -- along the lines of The Railway Children, say -- and yet is relatively recent. It felt like I was listening to a story from my childhood again; only this was brand new, with new characters and new adventures. And I'd say Jeanne Birdsall has taken pains to make sure this book will remain as timeless as possible; there are telephones and cars, but no mention of what sorts of telephones and cars. Technology doesn't really make an appearance, aside from a mention of a computer that one of the girls uses once, and though that itself could make the book feel dated, it doesn't. This is a summer tale, an outdoor tale, a tale of four girls and a cottage and a lovely extended vacation. With, as the book's subtitle mentions, two rabbits and a very interesting boy. And a dog. And another very interesting boy.

Maybe I am just a sucker for this sort of thing, but if that's so, I'm in good company: The Penderwicks won a National Book Award the year it was released. It has played very well with the adults who give out awards and starred reviews. It first came to my attention through the discerning Aarti. I am curious to know if it will play as well with kids. My child-parent book club is going to be reading it next spring, to get them set for summer, and I'm very curious to know if they will enjoy it as much as I have.

The Penderwicks, four girls, their loving but somewhat distracted father, and their dog Hound, are on summer vacation. Seeking a last minute cottage rental, they've chanced upon a place called Arundel -- a grand estate in the mountains, a mansion with beautifully manicured gardens. Their cottage is a humble, but lovely, little place behind the mansion, hidden from the main grounds by a tall hedge. And while that would be fun enough for four girls with big imaginations and lively curiosity, there happens to be a handsome young gardener (handsome enough and young enough to turn eldest Penderwick Rosalind's 12-year-old head for a first crush), a friendly and comforting housekeeper, a nasty, shrill, very rich lady who owns the place, her sneering suitor, and her mysterious son, who happens to be just the right age to make an ideal playmate for the girls.

And the girls play. They get into all sorts of scrapes and wild adventures over their three week vacation, some of them inadvertent and some of them deliberate, some of them dangerous and some of them harmless. They are good-hearted, imperfect, and impulsive, which makes for excellent stories. You're always rooting for whichever Penderwick is featured, even when you know she's squarely responsible for her own tricky situation. What makes this book are the characters, not necessarily the storylines; and not necessarily the secondary characters, either. Mr. Penderwick is charming, but hardly there (not in a bad way, mind you, and when he needs to be he is there) and Churchie the housekeeper, Harry the Tomato Man, and even Cagney the gardener are all pretty one-note, though very alive and each quite likable. Mrs. Tifton and her suitor are pretty much caricatures and extremely dislikable. It's the four girls -- motherly, responsible Rosalind, difficult and brilliant Skye, dreamy Jane, and shy little Batty -- and Jeffrey Tifton who make the story worth reading. They are gently handled by Birdsall, even Skye, who I'll admit was a challenging character for me at first though she did grow on me. Their dreams and fears and feelings are all considered fairly and without judgement, and they felt like very, very authentic people. I'm not so far away from Jane or Rosalind (though Skye is pretty foreign to me) that I don't remember what that was like. Birdsall has it pretty much dead on.

Which lead to a couple of very uncomfortably squirmy moments for me, listening in the car. At one point I actually stopped the audiobook cold without even realizing I'd planned to do it, just before Skye did something she should not have done, but that I couldn't blame her for, that I kind of wanted her to do, but that I was painfully aware was going to be mortifying for her and therefore by extension for me. Except when I realized what I'd done and turned the audio back on, it wasn't as bad as I'd feared. Birdsall once again treated Skye with dignity and didn't play up the full mortifying horror of the situation for amusement or tension as a different author might have done.

The reader of the audiobook, Laurence Bouvard, is a voice actor and veteran audiobook reader, and that comes through. Overall the narration was good. I occasionally had some trouble -- Jeffrey and Cagney sounded pretty much the same to me, and Mr. Penderwick just sounded silly and dopier than I think he was, text-wise. However, her voices for the four girls were brilliant and I never had any trouble telling any of them apart. I do find children's audiobooks can be really hit or miss for me; I don't like being talked down to and can't stand it for an entire story. I wouldn't say this was an entire hit, as it occasionally skirted that very subjective line, but it certainly wasn't a miss.

A warm, engaging, fun, gently-told story that appeals to me for any number of reasons. I think this would be a perfect family read-aloud, especially for the summer... or maybe for the cold spring, when summer seems too far away and a little warmth is needed.

Books by Larry McMurtry

Books
by Larry McMurtry
Tantor, 2008
5 discs

I would have done better with this if I'd written the review right after finishing the book, but so it goes. The difficulty here is that I don't have a lot of strong feelings either way. I picked this up because I very much like books about books, and I got some of that. I also got a bit of other stuff, and a lot of names that didn't really mean very much to me at all.

So, Larry McMurtry: he wrote Lonesome Dove. And Terms of Endearment. And, as he might put it, a number of other novels that have translated rather well to the screen. Though, contrary to what he seems to think, I actually do think of Lonesome Dove the novel first, not the television miniseries. This might be because I am a librarian, but I also think it's because that is indeed considered in some circles one of the best Western novels written. I haven't read it. I think I might, someday.

McMurtry has also written a number of memoirs, or nonfiction books that are rather wrapped up in his interests. Books is one of them, detailing the love of his life: buying, reading, and selling rare books. It starts with his first books, a gift from a cousin, a box of 19 boys adventure books to keep him company while he was sick in bed. By the time he had blazed through those books, some of them multiple times, he had started a lifelong habit he cannot stop: reading. McMurtry is a voracious reader, and originally started buying books just so he could read them, and then sold them only so he could buy new ones to read. But eventually he became a book scout, finding rare or desirable books, buying them from willing sellers, and then selling them to willing dealers. Eventually he became a dealer himself.

There are a couple of challenges here, and interestingly, none of them really ruined the book for me, though I'll admit I didn't love it. I did find it interesting; I don't feel like I wasted my time. But it wasn't as good as I hoped, and here are a couple of reasons why. First, and perhaps the fatal flaw here, was that I did listen to this as an audiobook. And I wasn't wild about the reader. Though there was a bit of a laconic southern twang in reader William Dufris' voice that I liked given that McMurtry is a Texan, he also read the book in a self-satisfied way that may in fact be the way McMurtry intended to come across -- but I hope not, and I rather think the whole tone of the reading missed the mark. It grated, sometimes; because of the reader, the author sounded more full of himself than I think he is based on the text. Occasionally I was able to separate the text from the tone, and I think the text was more intimate and chatty and less self-congratulatory than it sounded.

Also annoying was the tendency McMurtry had to kind of jump everywhere, and often not actually delve into a thought, or, more annoying, a story that he started. There were little snippets here and there, some picked up and many more not. Statements were made and then never taken anywhere. It is a short book, so there's some excuse there; it is the author's prerogative to finish or not finish his thoughts, but too much of that leaves a reader feeling unsatisfied. Further, we were promised discussions of interesting personalities in the rare and antique books trade, and we got some of that -- but not enough. McMurtry is almost careful to avoid talking about his fellow bookmen too much. Again, though, not sure how much of that lack was felt because I was listening. This is not a book that is meant to be listened to. (Actually, at one point McMurtry mentions his dislike of audiobooks. Point to you, sir.)

Particularly because of the audio format, the name-dropping was really noticeable. Because so much of it was name-dropping without context (though not all, and the parts that weren't were thoroughly enjoyable and interesting) this became a problem. I can't remember most of the names, although again, where McMurtry put flesh on his stories I do and would remember the stories if I came across the names again.

That said, the good parts are good. McMurtry provides a peek into a world sort of similar to the one I inhabit as a librarian, and yet totally different as well. I would love, if I had another life to live, to be an antiquarian bookseller. Hell, I'd love to be a rare books librarian, but I'm not looking for another specialty right now, particularly one with extremely limited job prospects. I love rare and old books, but not enough to make it my life, and listening to McMurtry it's clear that books, rare and old, are his. It's an interesting window into a fascinating world, and the little glimpses I got made me anxious to know more, made me wish to have the patience to comb through used book stores and junk yards and garage sales for those once-in-a-lifetime finds of first editions inscribed to mothers or lovers or even just well-wishers.

I generally like books by authors about books, reading, and writing. This one was a little light on substance for me to be entirely pleased, and though I got a few things out of it, I'm afraid I had dearly hoped for more. This won't stop me from reading McMurtry -- I'd like to try his fiction, particularly Lonesome Dove -- but I may steer clear of his nonfiction, at least in audio format. I feel kind of badly about that, because I think McMurtry is likely a lovely person, or at least, this book leads me to think so. Perhaps I would have better luck with a physical book, and I will keep that in mind.