Category Archives: Non fiction

Life by Keith Richards #book review

I lead a gentleman’s life. Listen to Mozart, read many, many books. I’m a voracious reader. History, in  particular the British Navy, is my subject. The Nelson era and World War II are top of my list, but I do the ancient Romans too. I have a fine library furnished with these works, with dark wooden shelves reaching to the ceiling. This is where I hole up.

lifeThis is not perhaps how most people would picture the leisure days of one of rock and roll’s most famously debauched characters. Yet in his 2010 autobiography Life (there were surely more compelling title options than that!), Keith Richards comes across as a surprisingly erudite, intelligent and articulate individual. And yes, in his own way, he seems to be a gentleman – and a gentle man.

‘Surprisingly’ sounds condescending and perhaps a little naive – swallowing the druggie, dissolute showman image whole and not giving too much thought to the fact that that there is a person underneath this facade.

And this autobiography reveals a person who is thoughtful, perceptive, caring and seemingly completely without prejudices and the baggage of judgement. Naturally his background means that he is not a great respecter of ‘suits’ – the Establishment. The 75-year-old (67 when the book came out) has always been ready to ‘stick it to the man’ both in song, gesture, verbal exchange and – in previous years – in deed (he’s had a few punch-ups along the way and admits to habitually carrying a knife).

The writing style here is engaging. How much credit is due to the co-author James Fox is difficult to judge. The former Sunday Times journalist has been a friend of the rock star since the early 1970s and would certainly be able to bring an authentic authorial tone to the writing. But to me the voice (and certainly the view of life) belongs largely to the man himself. Fox is perhaps not so much ghosting and tidying up the prose – putting apostrophes where they should be and reworking sentences which lost their way.

First meeting with Jagger

We begin in 1940s Dartford, Kent, birthplace of Richards and a certain Mick Jagger. The family history background, often rather tedious in works such as these, is illuminating and entertaining. By sticking to the salient, Richards keeps the reader engaged. 

From a boyhood love of the guitar and hours of finger-bleeding practice, his story leads us through the famous railway station meeting with Jagger – where a profound affinity in musical taste is established – to the early days of playing for beer (or for nothing) in seedy clubs and grimy pubs. Band members come and go; Brian Jones appears and stays; Jagger and Richards really want a drummer called Charlie Watts and they manage to snare him; a bassist called Bill Perks completes the line-up under the name of Wyman.

Years of poverty (getting the deposit back on stolen beer bottles) in squalid houses and flats precede a sudden propulsion – under the management of Andrew Oldham – to modest fame, notoriety (urinating at the roadside) and ultimately world-dominating rock deity.

Keith Richards

The career-span of The Rolling Stones is unprecedented in the world of showbiz. In the 1989 documentary 25×5, Richards (then a mere 46 years old) said the band was travelling ‘without maps’. No other group had lasted that long; there was no model, no template to follow. Amazingly the Stones continue to tour to this day filling gigantic stadia the world over. They’ve gone from ‘Lock up your daughters’ through ‘Lock up your mums’ to ‘Lock up your grannies’ and still (replacing a guitarist or two) they rock on.

The rise-to-fame part of the story Richards tells without pretensions of grandeur. He knows the band is unique and very good at what they do. He doesn’t have to work the message. His engaging, chat-over-a-pint style is never affected. He is proud of his achievements but not boastful.

An unreliable narrator?

There is, however, a point in the book where Richards becomes less engaging and develops the feels of an unreliable narrator. For most of the 1970s he was catastrophically involved with drugs. Heroin, in particular, created turmoil in his life. Though he somehow managed to make the gigs and turn up in the recording studio, his life was formed around drugs and the necessity to have them available. It took several years, in and out of cold turkey, to free himself from smack. When he came round, it was the 80s.

It is in this passage of Life that Richards loses my good will. He complains about Jagger’s insistence on controlling the band and making the decisions – conveniently forgetting that for a decade he was more or less out of his wits and his band mate had stepped up to the mark to keep the show on the road. Until then Richards had always been the glue, keeping the best interests of the group at heart and pushing forward.

Though there had been some disagreements between the two before (an unavoidable clash of two massive egos) this was the start of a rift between the boyhood friends which endures to this day. Richards complains that Jagger became ‘a control freak’ but doesn’t acknowledge that there was probably good reason for Mick taking the reins – doubting, as he must have done, the mental capabilities of his junkie partner.

Earlier in the book Richards complains that Brian Jones had become unpredictable and unreliable because of his drug habit. Regarded as an embarrassment and dead weight, he wanted Jones gone. Jagger can’t be blamed for feeling Richards had become a similar encumbrance, though the loss of this gifted songwriting partner would probably have dealt a lethal blow to the band.

But Richards pulled out of his nosedive and the band played on. The group’s legendary globe-trotting tours continue to this day with all four frontmen well into their 70s, travelling without maps and, seemingly – bar the odd accident with a coconut tree – without care. As they once observed: it’s only rock n roll.

The Clever Guts Diet by Michael Mosely #book review

What happens in our bodies when we eat a meal or swallow a drink?

clever gutsMany people would rather not know the answer and yet the last few years have seen more and more evidence about the importance of our digestive system to overall health and well-being. Three separate specialists from different branches of medicine  and health have all told me in the last year that the gut is now considered as a second brain: a highly integrated system that manages a set of processes as complex as all those neural pathways. When a surgeon, a physiotherapist and a mindfullness teacher all sang the same song  I began to sit up and pay attention.

Which is how I came to be reading Michael Mosely’s book: The Clever Guts Diet: How to Revolutionise Your Body From The Inside Out.

I’ve seen Michael Mosely multiple times on British television through his Trust Me I’m A Doctor series and he always struck me as the kind of man who isn’t swayed by fads or pseudo science of the kind  trotted by many a clean eating celebrity.  He has a deeply inquiring mind  that often leads him to take extreme actions in a search for answers. In this case, his desire to know how the digestive system really works, what foods might trigger problems like allergies or IBS (irritable bowel syndrome) and cancer, led him to an experiment with a live audience at the British Museum.

After a meal of steak, chips and kale washed down with apple juice he then swallowed a microscopic camera called a “pillcam”, which captured digital images of  his gastrointestinal tract . The idea was to watch in real-time what happened to his meal.

Your gut is astonishingly clever. It contains millions of neurons – as many as you would find in the head of a cat. It is also home to the microbiome, trillions of microbes that influence our mood, weight and immune system.

Mosely loves those microbes.  He can name the different species of the 50 million microbes (mainly bacteria)  that live in the gut and make up the microbiome.

The bad news? A diet limited in variety and heavy in processed food – along with antibiotic overuse – has ravaged the modern microbiome. This helps explain dramatic increases in health conditions including obesity, type 2 diabetes, inflammatory bowel diseases, allergies, food intolerances, asthma and eczema.

But there is good news in the book too. It’s possible, says Mosely, to halt the damage and reboot the system back to health with a gut-friendly eating regime. Avoiding fruit juice is an early piece of advice. It moves through the body so quickly there’s little time for its nutrients to be absorbed. Worse still: it creates a spike in blood sugar levels.  Sugar encourages the growth of the microbes that love sugar,. They crave even more of it – telling your brain (and you) to eat more … and more….  In the meantime, the good microbes get destroyed.

So message number one: cut down (or even better, out) uncessary sugar.

Message number two:  encourage the growth and variety of “good” gut microbes, by eating probiotics (fermented foods that contain live bacteria and yeast) and prebiotics (certain vegetables and pulses containing indigestible plant fibre).

The Good Gut Diet is based on research Mosely conducted for more than a year during which he interviewed multiple experts and read scores of research papers. The result is a  treasure house of insights and factual information.   It’s often amusing. Often provokes a reaction of Yuck when you read it. But it’s also thought provoking. This is not a book for anyone who feels in the slightest bit queasy when confronted by information about bodily functions but it is definitely a book for anyone who wants to take back control of their health.

 

About the author

Michael Mosely  was an investment banker who retrained as a doctor. After studying medicine at the Royal Free Hospital in London and qualifying as a doctor…he decided that he was better suited to the world of television. He has made numerous science and history documentaries for the BBC, first behind the camera and more recently as a presenter.

He has won numerous awards, including being named Medical Journalist of the Year by the British Medical Association in 1995. 

I Am, I Am, I Am: Seventeen Brushes with Death by Maggie O’Farrell

i am i amI Am, I Am, I Am: Seventeen Brushes with Death is an astonishing memoir, a celebration of the tenacity for which we cling to life while on the edge of death.

It chronicles 17 occasions when Maggie O’Farrell came close to death and how those experiences have shaped her outlook on life and her attitude towards her children.

Her close encounters with death began with the sudden onset of viral encephalitis at eight years old. It rendered her incapable of speech and robbed her of the ability to walk. Medical experts put her chances of full recovery at next to nothing. But they had not reckoned with this girl’s determination to beat the odds.

O’Farrell reflects that “a near-death experience changes you for ever: you come back from the brink altered, wiser, sadder”. And yet the evidence of this book speaks to the contrary. In the middle of a crisis, she often berates herself for having not thought more carefully about her actions. Was it wise, she wonders in hindsight,  to have taken that evening walk around a remote late in Chile (she was seized from behind by a thief who presses a machete against her throat)? Why had she trusted the holiday maker and tried to wade out to a diving platform in the Indian Ocean with her young son ( a non swimmer)? Why had she been the one to leap off a harbour wall into the sea as a teenager?

What drives her actions is often her intense desire for freedom: to break free from all bonds.

It is an urge so strong, so all-encompassing that it overwhelms everything else. I cannot stand my life as it is. I cannot stand to be here, in this town, in this school. I have to get away.

In her quest for that freedom, O’Farrell becomes a risk taker. It’s as if, having survived once, she is determined forever after to stick two fingers up to death. To face it down.

Her life is one crammed to the brim with accidents, illness and frighteningly close calls. They include a haemorrhage during a too-long delayed cesarean section, amoebic dysentery picked up on holiday in China, a close encounter with a blindfolded circus knife-thrower, and a narrow escape from a murderer .

I Am, I Am, I Am: Seventeen Brushes with Death is consequently built upon drama, piling one hair-raising moment on another. On a walk up a mountain she escapes from a murderer by prattling on about ducks; on a flight to Hong Kong the plane plummets; on holiday in France she fumbles desperately for the door lock when two strange men approach the car in which she is feeding her new born baby.

This book could easily have become little more than a litany of episodes but O’Farrell has this knack of balancing the drama with reflection as she looks to make sense of her extraordinary life.

It’s one in which she has had cause to be thankful for the vast array of medical practitioners she has encountered over the years. Mostly she recalls their kindnesses: the unknown man who held her hand while surgeons battled to save her life in a theatre awash with her blood. She never saw him again but recalls even now the touch of his hand. Or the nurse who refused to leave the consulting room where the young Maggie O’Farrell was seeing a pediatric specialist. Decades later she hears he has been revealed as a paedophile.

Her life continues to involve “a fair amount of sprinting along hospital corridors” but now it’s her daughter that requires emergency medical treatment. Born with a severe immune disorder this child can have between 12 and 15 severe anaphylactic shocks a year.  It means O’Farrell and her husband are constantly on the alert for any encounter that could trigger a reaction.

It’s this final section of the book that I found the most powerfull and compelling. It’s brim full of the anxiety she felt as a young mum faced with a small child who is covered head to toe in burning, itching, bleeding eczema. She shares her feelings of desolation and helplessness and how the desire to protect her daughter is overwhelming.

Ulimately this isn’t a book about death or danger. It’s about life and love. Though O’Farrell concedes that our life on life is fragile:

We are, all of us, wandering about in a state of oblivion, borrowing our time, seizing our days, escaping our fates, slipping through loopholes, unaware of when the axe may fall.

her book is really a message to her daughter that the human spirit is a resilient one. It can  meet with danger and endure trauma. And can still bounce back.

I Am, I Am, I Am: Seventeen Brushes with Death is an intense reading experience. But it’s one that is the highlight of my year so far.

 

 

 

 

 

 

 

 

Non-Fiction November: perfect couples

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For Nonfiction November this week we’re looking at pairing up a work of fiction with a work of non fiction.

I’m feeling generous this week (it’s probably all those endorphins floating around after my session in the gym this morning) so am going to offer you not one, but two pairings. In a week that we will mark the end of one of the worst conflicts in history, I thought it was fitting that both are on the theme of war.

Couple #1: World War 1

Birdsong by Sebastian Faulks follows two characters who live at different times. One is Stephen Wraysford, a British soldier on the front line in Amiens during the First World War.  The other is his granddaughter, Elizabeth Benson, who more than fifty years later discovers his journals from World War I and seeks to learns about his experiences at Marne, Verdun and the Somme.

Faulks said that he wrote the novel partly because he felt that the First World War had not been discussed enough in both literary and historical contexts.

I’m not sure whether he thinks that has now changed. We’ve certainly seen “The Great War” feature more prominently in the UK school curriculum in the last few years and the 100th anniversary of the Armistice this weekend is appropriately being marked around the country.

Unfortunately so many of the people who returned from that conflict are no longer with us to share their memories and experiences. We do however have the archives of the Imperial War Museum who recorded thousands of soldiers, the families they left behind and people who survived the war. The results are available in The Forgotten Voices series of books. The one I read, the Forgotten Voices of the Great War contained some tremendously moving testimonies that helped me appreciate what my great grandfather experienced ( he was one of the lucky ones who returned home to his family). Highly recommended reading if you have anyone in your family who served in the war or even if you didn’t but want to understand more about the war that was meant to end all wars.

 Couple #2: World War 2 

 

Oskar Schindler saved the lives of more than 1,000 Jewish people during World War 2. His actions were brought to public attention through the book Schindler’s List (sold as Schindler’s Ark outside the United States) by Keneally. The book, which Keneally labelled a novel, won him the Booker Prize in 1982. The film version directed by Steven Spielberg, won seven Academy Awards.

But none of this would have happened it it had not been for chance encounter in Beverley Hills, Los Angeles between Keneally and Poldek Pfefferberg, a Holocaust survivor. Pfefferberg had tried for years to interest writers and film makers about the story of Schindler but it was only when Thomas Keneally walked into his shop that he got the response he wanted.

The story of that meeting and the visits the two men made to Poland, to talk to people whose lives Schindler saved, are recorded in Searching for Schindler.  It’s worth reading this to understand some of the challenges Keneally encountered when he came to write his novel and the even bigger challenge of creating the film script. Here’s my review.

 

 

Non-Fiction November: favourite reads

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I’ve taken the plunge and joined Nonfiction November which is an annual challenge to read, critique and discuss non-fiction books for a month. There are five hosts who will take turns to post a topic for discussion each week.

This week’s topic comes from Kim at Sophisticated Dorkiness is all about reflecting on the year so far via four questions.

What was your favourite nonfiction read of the year?

Do No Harm

This is a toss up between two books with vastly different styles and topics.  Do No Harm by Henry Marsh is the no-holds-barred memoir of a neurological surgeon in which he discusses some of the challenges of working with one of the most complex systems in the body. The Wicked Boyby Kate Summerscale is a hybrid of biography/real life crime that focuses on the case in 1895 of a young boy who killed his mother and was sentenced to spend an indefinite period in Broadmoor high security psychiatric hospital.  On balance I’m going to settle for Do No Harm, largely because it was so different from anything I have read previously.

Do you have a particular topic you’ve been attracted to more this year?

poppy

This year marks the 100th anniversary of the Armistice, the end of World War 1. The Royal British Legion in the UK has been marking that event by asking people to remember people who were killed while serving in the conflict. I’m trying to do my bit by researching the 22 men from the Commonwealth who share my maiden name and posting information about them on line. It’s meant I’ve spent a fair amount of time reading the war diaries; a day by day account; completed by commanding officers of battalions in the field. They can be uncomfortable reading at times – today for example I discovered one battalion lost more than 400 men in one attack in the final year of the war. I’ve also been dipping into a number of books which deal with different aspects of the war..

What nonfiction book have you recommended the most?

Do No Harm is the book I’ve talked most about this year. But my recommendation always comes with a caveat that this book does go into a lot of detail about surgical procedures. So if you are at all squeamish then this book is not for you.

What are you hoping to get out of participating in Nonfiction November?

The number of books of fiction I read each year far outweighs the number for non fiction. So I’m hoping that Nonfiction November will give me a bit of a nudge to get reading with the many books I have on the shelves. A lot of them are history related but I also have some about literature and culture.

The Wicked Boy by Kate Summerscale [book review]

The Wicked BoyIn the summer of 1895, readers of British newspapers were both shocked and gripped by the case of two boys accused of killing their mother in her London home.

The decomposing body of Emily Coombes had lain in bed for ten days while her sons, aged 12 and 13 had a jolly time. They played cards, went to cricket matches and to the seaside and ate their favourites foods. They fobbed off relatives’ inquiries about their mother with a variety of reasons for her absence. Only when neighbours noticed a sickening smell coming from the terraced house was the crime revealed. One local newspaper described the murder as ‘the most horrible, the most awful and revolting crime that we have ever been called upon to record.”

The true-life story of Robert Coombes and his younger brother Nathaniel (known as Nattie) is revealed in Kate Summerscale’s The Wicked Boy. 

This book is a forensic examination of the events before and after the day in July when Robert stabbed his mother with a knife he had bought specifically for that purpose.  Robert admitted immediately that he had killed his mother, explaining that it was because Nattie had been beaten for stealing food and he thought he would be next. Nattie was let off the murder charge so he could testify against his brother,

When Robert appeared for trial at the Old Bailey, the key question for the jurors was whether he was mad or just bad.

Contemporary opinion was that criminals and lunatics had certain physical characteristics that distinguished them from normal people. Robert’s demeanour contradicted that theory however. While his brother sobbed and shook with fear, Robert was cool and calm, a picture of a young gentleman dressed smartly and neatly in a boater and blazer.

Some of the Coombes’ neighbours testified that he was a clever and musically talented child, well-spoken and well-dressed. His teachers described him as obedient and unusually bright.

If he wasn’t mad or bad had he killed his mother in the interests of self preservation? Was it true, as both children claimed, that Mrs Coombes was prone to sudden outbreaks of violence against her children, particularly when her husband was away at sea?

Summerscale posits another idea: that Robert was influenced by the Penny Dreadfuls —sensational comics which chronicled the adventures of pirates and highwaymen — a collection of which were found in his bedroom.

In the end the jury brought in a verdict of guilty but insane and he was sent to  the Broadmoor high-security psychiatric hospital for an indefinite period.

At this point in the narrative other authors may have brought the book to an end with a short summary of what happened to Robert subsequent to his conviction. But Summerscale is nothing if not a completist and also a meticulous researcher. The Wicked Boy  is packed with social, historical and political details but Summerscale never allows the factual content to detract from the story itself.

She visited Broadmoor, discovering the lad was a model prisoner who learned to sew and to to grow veg and became a skilled chess player. By chance she found a picture of his gravestone in Australia and discovered he had emigrated after 17 years incarceration, had won a medal while serving in World War 1 and was a well respected leader of a military band. The very model of an upright citizen about whose previous troubles no-one in Australia was aware.

If the details about Robert’s childhood are interesting, it was the sections about his time at Broadmoor and then his military service that fascinated me the most.  I had imagined Broadmoor at the end of the 19th century to operate an austere regime but it was actually rather enlightened. Robert was allowed access to books, could walk in flower gardens and encouraged to take part in activities like chess and billiards. He was taught to play the violin and the cornet to almost a professional standard.

australian stretcher bearers

Australian stretcher bearers on the Western Front, World War 1

At the start of World War 1 when the Australian government pledged its full support for the allied cause, Robert enlisted for the army. He was despatched to Egypt for training and then to Gallipoli where he served with great distinction, being mentioned for his bravery under sustained attacks. He also led the troops to and from the trenches in France, playing stirring tunes on his cornet.

robert coombes headstoneIn due course he returned to Australia, living in a quiet shack in a remote valley where he grew and sold vegetables. When one of his neighbours was arrested for a vicious assault on his son, Robert stepped in and became the boy’s ward. Kate Summerscale tracked the boy — now a man in his nineties — to his home in Australia and learned how Robert had been a force for good in his life.  That man, Harry Mulville, gave thanks to his de facto father by arranging a headstone for Robert.

By the end of The Wicked Boy it was impossible not to feel that whatever wrong Robert had committed in his early life, his rescue of another unhappy child, had in the end been his redemption.

Footnotes

The Wicked Boy by Kate Summerscale was published by Bloomsbury in 2016. It was shortlisted in the non fiction category of  the Crime Writers’ Association Gold Dagger Award in 2017. It went on to win the 2017 Mystery Writers of America Edgar Award for Best Fact Crime.  There’s an interesting interview with The Telegraph newspaper in which Summerscale explains what drew her to the story of  the Coombes family.

 

 

 

 

Searching for Schindler by Thomas Keneally

Searching for SchindlerBut for serendipity, the world may never have heard the remarkable true-life story of Oskar Schindler, the man who saved the lives of more than 1,000 Jewish people during World War 2.

It would never have become a novel that went on to win the Booker Prize for Thomas Keneally in 1982.

It would never have become an Oscar-winning film directed by Steven Spielberg in 1993.

The fates however determined that one evening in 1980, the Australian author Thomas Keneally would walk into the leather goods shop in Beverley Hills in search of a replacement briefcase. Discovering that his customer was an author, the elderly, very talkative and inquisitive Polish proprietor pitched him a story he said the world needed to hear.

In Searching for Oskar, Keneally looks back at the unusual genesis for his award-winning novel and his many subsequent meetings with Leopold Poldek. Poldek owed his life and that of his wife to Schindler. In gratitude he wanted the world to know how Schindler had risked his own life to protect many Jews from concentration camps and certain death.

In essence this is a memoir of how Schindler’s Ark came to be written, the battle with the publishers over their preferred title for the American edition (it came out as Schindler’s List in America only), Keneally’s struggle to write the screen play (Spielberg eventually gave the job to someone else) and the long gap before the film version got into production.

For much of the early section of the book he traces the steps he and Leopold took together to track down some of those survivors and capture their stories. There were times when this threatened to become a dull list of names and places but fortunately Poldek is such a remarkable individual that whenever he is present, the book comes alive. Keneally is more than once mortified by the behaviour of his travelling companion but is also charmed by him. On one trip to Warsaw (still part of a Soviet state) Keneally is terrified that Poldek’s insistence he change his currency on the black market will land him behind bars. Another time he waits in acute embarrassment when Poldek remonstrates with a hotel clerk that had the temerity to charge them for photocopying (the bill seemed to be less than $5).

The Independent newspaper in the UK was less than flattering about Searching for Oskar, implying that it was written because Keneally wanted to cash in on the success of Schindler’s Ark. The reviewer calls it ‘tedious’, ‘banal’, ‘cliched’ and ‘clumsy’, a book in fact that should never have been published.

I think that’s too harsh a critique. Searching for Oskar does have its faults – for example, Keneally dwells far too much on some famine relief trips he made to Ethiopia while waiting for Speilberg to begin filming, These sections felt as if he was just padding out of the book. But I did find some other insights interesting – like the issue of whether in writing Schindler’s Ark he was producing a work of fiction or a biography – and some of the insights into Schindler’s character that were not captured in the novel or film. I finished reading Keneally’s memoir with a huge admiration for the determination shown by Poldek in ensuring the story came to public attention and Schindler got the credit he deserved.

 

Do No Harm by Henry Marsh

Do No HarmPeople who tend to be squeamish or prefer not to know about the internal workings of the human body, wouldn’t enjoy reading Do No Harm by Henry Marsh. It’s also probably best to avoid this book if you have a friend or relative who has been diagnosed with a neurological condition or is about to have surgery.

Marsh is a neurological surgeon with more than 30 years experience. In Do No Harm he offers insight into the joy and despair of a career dedicated to one of the most complex systems in the body. This is a candid account of how it feels to drill into someone’s skull, navigate through a myriad of nerves that control memory, reason, speech and imagination and suck out abnormal growths. If successful he can save someone’s life or extend their projected life span. But often he is millimetres away from catastrophe. One false move and the result could be death or paralysis.

Marsh frankly admits that in his career he has made mistakes. A few years ago, he prepared a lecture called “All My Worst Mistakes.” For months, he lay awake in the mornings, remembering the patients he had failed. “The more I thought about the past,” he recalls , “the more mistakes rose to the surface, like poisonous methane stirred up from a stagnant pond.”

On a visit to a nursing home for people with extensive brain damage he sees the result of some of those mistakes in the motionless forms of patients in their beds “To my dismay I recognised at least five of the names.” One of them is a schoolteacher in his fifties whose life he ‘wrecked’ (Marsh’s word) during a fifteen hour operation to remove a large tumour. In the final stages he tore part of the artery that keeps the brainstem, and thus the rest of the brain alive. The patient remained in a coma for the rest of his life. The experience haunted Marsh for years.

Yet without mistakes, he says, there would be no progress. And without the willingness of doctors to take risks, many of the greatest advances in his field would never have happened.

It’s one of the painful truths about neurosurgery that you only get good at doing the really difficult cases if you get lots of practice but act means making lots of mistakes at first and leaving a trail of injured patients behind you. I suspect that you’ve got to be a bit of a psychopath to carry on…

Henry MarshDoes that mean surgery is always the best course? This is a question discussed regularly in the daily case conferences Marsh holds with the junior doctors and radiographers who form his hospital team. Is it kinder to let someone die gradually than to undertake invasive surgery from which they may never recover or if they do, face life changing side effects? The team reach a clinical, unemotional conclusion but its down to Marsh to face the patient and explain the decision. It’s an encounter that requires a delicate balance of compassion and detachment.

Marsh suffers anxiety before such meetings, trying to resist the temptation to be overly optimistic about the likely outcome of any procedure. Often before surgery he is oppressed by “almost a feeling of doom’ and panic which only dissipates at the last moment when he sits in his operating chair and takes up his scalpel.

… full of surgical self-confidence, I press it precisely through the patients scalp. As the blood rises from the wound the thrill of the chase takes over and I feel in control of what is happening.

Marsh never set out to become a neurosurgeon. After completing his medical degree he caught a glimpse through a porthole of a patient “anaesthetized, her head completely shaven, sitting bolt upright on a special operating table.” The surgeon stood behind her, with a light fixed to his head, patting her bare scalp with dark brown iodine antiseptic. The image stayed in his mind, and struck him as “a scene from a horror film.”

But his second visit to a neurological theatre fascinated him. Unlike all the other operations he had witnessed which involved the handling of ‘warm and slippery body parts’, this was done with an operating microscope through a small opening in the side of the head using only a few microscopic instruments.

The brain continues to fascinate Marsh. He is awed by what he sees through his surgical microscope, which “leans out over the patient’s head like an inquisitive, thoughtful crane ” as the infra-red cameras in his GPS system shows he position of his instruments. The internal cerebral veins are like “the great arches of a cathedral roof” and beyond the Great Vein of Galen can be seen “dark blue and glittering in the light of the microscope.”

In Do No Harm he does a grand job of sharing that wonder with his readers and also the drama of the operating theatre. You don’t need extensive biological or medical knowledge to appreciate the level of difficulty involved in these procedures though a schematic showing what bits of the brain lie where would have been a useful addition to the book.

Every chapter is headed with the name of a type of tumour (who knew there were so many?) in which Marsh talks about some of the cases that involved those conditions. In between he shares his many battles with the bureaucracies and inefficiencies he encounters in the British National Health Service (NHS).

Surgeons kept waiting because of a decree that doctors can’t begin a new operation while another is in the final stages in an adjoining theatre. Or theatre staff forced to kick their heels because their next patient wasn’t allowed to change into their hospital gown while there were members of another gender in the same waiting room. The working hours of junior doctors changed without any consultation with the surgical leads. Computer systems that won’t co-operate when a bed is needed quickly. The causes of Marsh’s frustration range far and wide.

In one episode, which would be farcical in any other sector, he describes having to leave his clinic to repeatedly go up two flights of stairs to get a password so he can discuss an X-Ray result with his patient. “Try Mr Johnston’s,” he’s told. “That usually works. He hates computers. The password is ‘Fuck Off 45’.” It marks the forty-five months since the introduction of a highly-expensive computer system.

Back in his office, Marsh tries every possible combination of upper and lower case letters, adding spaces, taking them out, all without success. He runs up the two flights again. One staff member realises there’s been a miscalculation. The system has been in place two months longer than they recalled. So it turns out the password is now “Fuck Off 47.” All of this while the poor patient waits to hear if Marsh can save his life by operating to remove the cause of his elliptic fits.

His railings stem from a deep concern for his patients and a desire to want to do right by them (he even washes and dries the hair of his female patients before they leave the theatre). He tries not to let his feelings show but his mask slips regularly. Leaving the hospital one evening having told one man that an operation was not possible, he rails against the traffic as if it were the drivers’ fault

“ … that this good and noble man should die and leave his wife a widow and his young children fatherless. I shouted and cried and stupidly hit the steering wheel with my fists. And I felt shame, not at my failure to save his life — his treatment had been as good as it could be — but at my loss of professional detachment and what felt like the vulgarity of my distress compared to his composure and his family’s suffering, to which I could only bear impotent witness.

This is a book that I never expected to enjoy but it proved far more readable than I expected. I’m glad however that I didn’t read it before my friend had her own surgery to remove a brain tumour (from which she thankfully recovered). I appreciated there were risks involved, but never realised just how narrow the margin of error would be. Sometimes ignorance is a blessing.

Footnotes

About the Book: Do No Harm by Henry Marsh was published by Weidenfeld and Nicholson in 2014.  It was shortlisted for the Costa Biography Award, the Wellcome Book Prize and the Guardian First Book Prize. Marsh wrote a follow up in 2017. Admissions  was written as he prepared for his retirement.

About the Author: Henry Marsh worked as consultant neurosurgeon in London for about thirty years. In addition he travelled regularly to the Ukraine, donating his time to treat patients in extremely difficult situations and in the face of political opposition. H retired from full time work in the NHS in 2015 but continued to work in private practice until 2017.

Why I read this book: This was a book club choice. I probably wouldn’t have read the book otherwise. But I am so glad I did.

Howard’s End is on the Landing by Susan Hill

Howards EndUnlike author Susan Hill I don’t live in an old rambling farmhouse with aged beams and cosy nooks from which I can look upon “gently rising hills and graceful trees”. Nor sadly do I have an elmwood staircase that could take me up to a landing with overflowing bookcases. But I do know the sensation of coming face to face with a mountain of unread books.

Climbing the stairs one day in search of a book she knew was there, Hill discovers “at least a dozen, perhaps two dozen, perhaps two hundred” that she had never read. Among them are recommendations from the Richard and Judy book club, Booker prize winners, classics, childhood annuals (charmingly she still gets The Beano every year) and an old alphabet book.  She resolves to spend a year reading only those books already on her shelves, forgoing the purchase of new ones, which, she admits, is a strange decision for someone who is both author and publisher.

I wanted to repossess my books, to explore what I had accumulated over a lifetime of reading and to map this house of many volumes. There are enough here to divert, instruct, entertain, amaze, amuse, edify, improve, enrich me for far longer than a year and every one of them deserves to be taken down and dusted off, opened and read.

We get some delightful and often surprising titbits: about the time when as an English student at King’s College London, she  devoured detective stories as light relief from Beowulf (one can understand why!). Or the unexpected encounter with EM Forster in the London Library. Having bent down to pick up the book an elderly man had dropped on his foot she looks up to find herself looking into the watery eyes of one of the grandest of the grand old men of literature. But here he was “slightly stooping and wholly unmemorable.” and yet “the wonder of the encounter has never faded.”

 

I warmed to her after reading the chapter where she recollects the magic of receiving the gift of books as a child. It was impossible to disagree with her that today, with such easy access to books, we have forgotten how special they were in our past. For Hill growing up in the 1940s they were rare treats.  Every Christmas brought annuals that she read so often she could memorise the stories but the most precious gift she remembers is her first pop up book. Some of these she still has and one of the pleasures of her year of reading from her bookshelves is going through the collection.

Over the year, Hill draws up a list of 40 titles that she thinks she “could manage with alone, for the rest of my life”. It’s absolutely not a ‘best books ever written’ type of list but ones she considers has special meaning for her. The list tells you a lot about her taste and her foibles. Trollope gets two places, as does P G Wodehouse; Dickens is there with Our Mutual Friend, Virginia Woolf with To the Lighthouse and E. M Forster (not Howard’s End surprisingly but A Passage to India).

The list is significant for its omissions. There is little in the way of European authors unless you count Dostoevsky as ‘European’ – no Zola or Camus however. The Americans are represented by Edith Wharton (the House of Mirth) and Henry James (Washington Square). Her rationale for the poetry choices tell you that she is in essence a conservative reader.  “I do not read much poetry now, and rarely anything new,” she admits. “I know I should. Should. Ought. But I don’t and that’s that. Perhaps I don’t need to. I can recite the whole of ‘The Lady of Shalott’, after all.”

She is without question a woman of firm opinions. Some I found it hard not to agree with, such as her love of the physical feel of a book (she loathes e-readers) and her aversion to the fashion for reading the “very latest book everyone is talking about.” She has little patience with people who pretend to have read certain classics or who boast about the number of books they read each week (“Why has reading turned into a form of speed dating?” she asks). Jane Austen she finds boring but considers Penelope Fitzgerald’s The Blue Flower to be a masterpiece and Elizabeth Jane Howard’s work is long overdue for a re-issue.

The interjections spice up what could easily have become a pleasant but otherwise inconsequential journey through one woman’s reading preferences and habits. Hill has an edge that nicely counterbalances the sometimes whimsical tone and in her final selection of 40 has made certain to stir up debate.

A Room of One’s Own by Virginia Woolf [book review]

room of ones own-1Virginia Woolf’s essay  A Room of One’s Own is a landmark text of feminist literary criticism and, as such, is required reading for students of literature around the world. But I was a student at a time when feminist criticism was not even in its infancy so though we studied Woolf’s fiction, no lecturer ever thought to direct us to her seminal non-fiction output. My experience of this essay has been fragmented as a consequence; I’ve mostly encountered it as references in other works such as Elizabeth Showalter’s A Literature of Their Own.

Now I’ve read the essay in its entirety I could better appreciate the full impact of Woolf’s assessment of the difficulties and obstacles facing women writers and how they have risen above those challenges.

The first challenge Woolf identifies is one of attitude. Woolf dramatises this through her narrator’s experience of undertaking research at one of the Oxford colleges. First she is told in no uncertain terms that it is forbidden to walk on their grass (is there a fear she might contaminate them?) and then that as a woman she has no right of entry to the college – such hallowed halls of education are reserved for male students only.  After a day at the British Library perusing the scholarship on women, she discovers that little has been documented about the everyday lives of women; what does exist has come from men who seemed to have been writing in anger.

What I find deplorable … is that nothing is known about women before the eighteenth century. I have no model in my mind to turn about this way and that. … I am not sure how they were educated; whether they were taught to write; whether they had sitting rooms to themselves; … what in short they did from eight in the morning till eight at night.

The second issue is one of practicality. Reflecting on the different educational experiences available to men and women as well as on more material differences in their lives, she concludes that women were kept from writing because they had no money of their own. Significantly Woolf is writing at a time when the law had only recently been changed to allow married women to own any money they earned.   Without money of their own, and without any space of their own (out of the question, unless her parents were exceptionally rich or very noble), their creativity is stifled she argues. And she points to the Romantic poets and those of the nineteenth century for evidence – all but three of them were university men and of those three it was only Keats who was not well to do. Poverty and poetry were impossible bed fellows.

“Intellectual freedom depends upon material things. Poetry depends upon intellectual freedom. And women have always been poor, not for two hundred years merely, but from what the beginning of time . . Women have had less intellectual freedom than the sons of Athenian slaves.”

In Woolf’s view the lack of money and lack of privacy influence also what women wrote. Women turned to the novel form ( considered  a very poor second to the art of poetry) because it was easier to put down and pick up again without loss of imagination. If you had to do your writing in a public space like a drawing room rather than in the private male space of a study or library, then you would have to contend with frequent interruptions. And learn, as did Jane Austen, to hide her manuscripts and cover them with blotting paper when anyone approached her corner of the communal sitting room.

Woolf seemed to then suggest that the quality of what women writers produced was somehow inferior to that of male writers. Having highlighted people like Austen, George Eliot and the Bronte sisters ( Woolf rated Emily as superior to Charlotte) she ponders how much better their work could have been if their experience of life had not confined to house and hearth. How enormously their genius would have benefited if only they could have travelled or gone to a war as did Tolstoy. In Woolf’s mind, War and Peace could not have materialised if Tolstoy had spent his life in domestic seclusion. Well clearly not – it would have been nigh on impossible to write so vividly of battles if he hadn’t witnessed them at first hand during the Crimea war.

There were a few points in Woolf’s argument I found myself challenging. One was the premise that these leading female writers seldom moved beyond the house yet Charlotte’s portrayal of the plight of Victorian governesses is all the more real because it came from her own experience. I doubt Tolstoy could have written so astutely about the position of a woman who was on close intimate terms with a family yet not regarded as one of them or as a servant. Nor does it allow for the role of the imagination – Wuthering Heights owes much of its power to the evocation of the wild moorland Emily Bronte knew well but the portrait of evil and malice in Heathcliff came from her imagination, not knowledge.

Then there is the idea that the challenging conditions under which such novels were created gave rise to a style of sentence alien to women’s nature..

“To begin with, there is a technical difficulty -so simple, apparently; in reality, so baffling- that the very form of the sentence does not fit her [the woman]. It is a sentence made by men; it is too loose, too heavy, too pompous for a woman’s use.”

Instead of trying to ape male writers, Woolf encouraged her sisters to turn their exclusion from the opportunities afforded men to their benefit – by learning to write what she calls “a woman’s sentence.”

It’s a point which I found hard to grasp because Woolf never really gives any examples of what she means. Jane Austen’s work as a guideline (but which one of Austen’s sentences we want to ask!) What is more clear for Woolf is what a woman’s sentence is not: it is not the same as a man’s sentence.

Im confident that I have merely scratched the surface in trying to understand Woolf’s essay and to fully do so I would need to spend many hours taking it apart point by point ( it gets convoluted many times as she wrestles with her own thoughts). But she ends strongly by positioning fiction by women as on the verge of something unprecedented and exciting, and exhortating ther audience of women to take up the baton bequeathed to them and to pass to their own daughters.

Footnotes

About the Book: A Room of One’s Own is an extended essay by Virginia Woolf. First published in 1929, the essay was based on lectures she delivered at Newnham College and Girton College,  Cambridge the previous year. The title of the essay comes from Woolf’s conception that, “a woman must have money and a room of her own if she is to write fiction”.

Why I read this book: Partly from a sense of guilt that I claim to be keenly interested in literature yet have not read this essay. Hence why I added it to my #20boksofsummer reading project.

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