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Six degrees from catastrophe

Another month when I have been wrestling to make any headway with #6Degrees. It never seems to get any easier!

This month’s starter book is Chloe Hooper’s The Arsonist published in 2018,  which I’ve not heard about let alone read. Some basic research tells me it’s about a horrendous episode of bush fires in Western Australia in 2009. They were among the country’s worst fires and caused the deaths of more than 100 people.

Five_Days_at_Memorial

Four years earlier, a natural disaster caused the loss of some 1800 people in Florida and Louisiana. They were victims of Hurricane Katrina, the deadliest hurricane since 1928. Five Days at Memorial by Sheri Fink is an investigative account of how some of those people died – they were all patients at the Memorial Hospital in New Orleans. Suspicion fell on a few of the medical staff who were accused of unlawfully hastening the deaths of some of those patients.

mosquito coast

Harrison Ford as Allie Fox in the film adaptation of Mosquito Coast

In Mosquito Coast by Paul Theroux, it is to avoid catastrophe that Allie Fox takes link his family away from their comfortable home in Massachusetts to a new settlement in Honduras. He has  become increasingly critical of American consumerism, education and culture and is convinced that a world war is imminent,

While in Honduras he builds a huge ice-making machine called ‘Fat Boy’ powered by hydrogen and ammonia, and transports the ice it produces farther up the river to isolated tribesmen, only to find to his disgust that missionaries have already reached them and ‘corrupted’ them to the ways of the West.

Poisonwood bible.jpg

Barbara Kingsolver’s best selling novel The Poisonwood Bible features one of those missionary families: the Prices of Georgia. They move to the Belgian Congo where each of the four daughters develop differently as they adapt to African village life and the political turmoil that overtakes the Belgian Congo in the 1960s.

Heart of darkness

The setting of the Congo gives me the link to my next book: Joseph Conrad’s best known novella: The Heart of Darkness.  It’s a tale within a tale of a steamboat journey to trading posts alongside the Congo river and one man’s obsession with an ivory trader called Kurtz whose methods and interactions with native inhabitants are morally ambiguous.

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Heart of Darkness raises questions about imperialism and racism and sees little difference between so-called civilised people and those described as savages. Similar questions appear in the next book in my chain: R. L Stevenson’s Treasure Island. Although this was essentially an adventure story written for young boys, it poses some interesting questions about moral integrity. Some of the characters who are  meant to be upstanding figures of authority – the Squire and the Doctor – are shown to be just as avaricious as the recognisably evil pirates.

It’s a good reminder that fiction written for an audience of young readers can seem simple but is often quite complex when examined more closely. Which takes me to the next and final book in my chain this month. Well actually its just the first book in a very large series.

Harry-Potter

You might just have heard of Harry Potter…. J K Rowling’s tales of a boy wizard are  considered to have done more to encourage young people (especially boys) to read than any number worthy government inspired initiatives. They can be viewed as little more than a spiced up version of the tried and tested boarding school yarn, albeit  with a bit of magic sprinkled about.  But look more closely and you’ll find a lot more going on: questions about loyalty, dishonesty and the nature of true friendship, for example. Of course, being aimed at children, the presiding morality is that evil (in the form of Voldemort) must be destroyed whatever the cost and good must triumph. The question however is whether the way evil is destroyed is appropriate. Does Harry always come out of his encounters with Voldermort with his integrity intact?

And on that question I will bring the chain to an end. We’ve moved from a book about fire and a deliberate act of damage, to clashes between cultures and good and evil. I had no idea when I started this chain that I would end up talking about Harry Potter!

Snapshot August 2016

 

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July came and went in a blink of the eye. August will likely go just as quickly and then all we’ll hear about for the next few months is that dreaded word Christmas. I’ve already seen promotions from a hotel and a local restaurant even though some people have only just headed off for their summer holiday. I know retailers in the UK have been moaning about low sales because of the crap summer weather so far but it’s depressing how the commercial world seems intent on pushing the Christmas season earlier and earlier. I’m going to turn a blind eye to it all and just focus on the month ahead.

So as a new month begins this is a bit of a  wrap up of what’s I’ve been reading recently and what I’m planning or the month ahead.

Just Finished

July readingJuly was a good month during which I managed to read 4 books for the #20booksofsummer challenge and make a little space in the TBR pile.

It’s taken me a few years to get around to reading Sheri Fink’s Five Days at Memorial.(reviewed here)The subject matter made it challenging but it was worth the effort – the issues raised by Fink about medical ethics during times of disaster have made for some heated discussions among friends and relatives. I also read the wonderful Bel Canto by Ann Patchett -my first experience of her writing but I know it will not the be the last. July saw the completion of two Booker prize winners – Last Orders by Graham Swift and The Life & Times of Michael K by J. M Coetzee.  I had planned to read to short story collections but so far have managed just one of them – The Thing Around My Neck by Chimamanda Adichie with the help of advice in response to my question on how to approach a collection of short stories. Most people recommended I read them in bite size pieces  which helped hugely.

Reading Currently 

I have two books on the go at the moment. Tree of Life: A Novel of the Caribbean is a 1992 novel by the Guadeloupean writer, Maryse Condé. It’s the story of three generations of  one family and their rise from poverty against a backdrop of racial tension and world events like the construction of the Panama Canal and World War 1. It’s my choice for #womeninliterature month. I’m about a third of the way through and finding it OK but not that engaging. Certainly not as riveting as my other read which is Moskva by Jack Grimwood. Set in the 1980s it features  a British intelligence officer sent to Moscow to avoid an investigation over his actions in Northern Ireland. Shortly after his arrival he gets roped in to help find the Ambassador’s daughter who has gone missing. This is a page turner that was highlighted by the Daily Telegraph as one of the best crime novels of 2016. 

On the Horizon  

If it’s August then it has to be AllAugust/AllVirago of which I’ll be reading A Favourite of the Gods by Sybille Bedford and posting a few reviews for Viragos I read earlier in the summer but haven’t got around to reviewing yet.  I have a  few NetGalley review copies requiring my attention including  The Sleeping World by Gabrielle Lucille Fuentes which is set in 1970s post-Franco Spain and The Explosion Chronicles by Yan Lianke. What comes after that I haven’t yet decided since I don’t like making detailed plans which feel constraining. There’ll certainly be a Booker title in the mix but I know I’m not going to get around to making much of an impression on the 2016 longlist other than reading some samples of each title.

Five Days at Memorial by Sheri Fink: A Storm of Ethical Questions

Through the power of 24-hour international news coverage, the world saw the devastation and human tragedy caused when Hurricane Katrina moved ashore over southeast Louisiana and southern Mississippi early on August 29, 2005. It was one of the deadliest hurricanes ever to hit the United States, causing an estimated 1,833 deaths and leaving hundreds of thousands of people homelessHurricane_Katrina.

What the world didn’t know was that at New Orleans’ Memorial Hospital, right in the centre of the maelstrom, life and death decisions were taken that would become the focus of a legal battle. At the heart of the battle lay challenging questions on whether medical practitioners have a duty to protect lives at all costs or whether – in exceptional circumstances – it is acceptable to ease the path of patients to death.

I would have been ignorant of that battle but for an article in The Sunday Times magazine in 2012 (based on Sheri Fink’s award-winning book Five Days at Memorial) which revealed the horrendous conditions at the Medical Centre where thousands of people were trapped for five days without power. Doctors and nurses worked tirelessly in humid, fetid conditions to care for their patients and to get them out as soon as rescue looked possible. But then those very medical staff were arrested and charged with murder when suspicious amounts of morphine were found in the bloodstream of 20 of the 45 patients who died.

Five Days at Memorial grew from a Pulitzer Prize-winning article written by Fink and published in The New York Times Magazine in 2009. She was drawn to the subject because of her experience as a doctor working in areas of conflict and as a journalist reporting on hospitals in war zones. It’s a deeply impressive piece of journalism which draws on more than 2 years of research and interviews with some 500 plus people, from patients to their family members and from hospital staff to legal representatives.

The story she pieces together from emails, phone logs, witness testimonies and floor plans, traces the events from shortly before the hurricane hit land. All her research points to how hopelessly inadequate were the plans of both the hospital, its owners, federal agencies and the city government. Lack of investment in flood water protection and drainage coupled with bad design decisions taken decades earlier meant the hospital quickly lost power for lighting, air conditioning, sewer systems and essential medical equipment. Day after day those trapped in the building waited for rescue by helicopter or boat. Controversially, staff adopted a triage system which saw those with “do not resuscitate” orders placed last in the list for evacuation. What happened on the fifth and final day is clouded with ambiguity. According to prosecutors some medical staff decided to hasten the death of the most critical patients with lethal injections of morphine. Those arrested protested their innocence but for more than two years multiple murder charges were pursued against one doctor and two nurses.

Five_Days_at_MemorialIn part 2 of the book, Fink focuses on the investigation against those staff members (a Special Grand Jury refused to indict the three so the charges were dropped) and then examines the ethical issues surrounding euthanasia and health care in disaster scenarios.

Fink doesn’t pull any punches in her assessment of what went wrong at Memorial, seeing it as a microcosm of the larger failures that assailed New Orleans during Katrina, “with compromised physical structure, compromised operating systems, compromised individuals. And also instances of heroism.” She also points to a broader issue in America at that time with emergency preparations skewed, in the light of post-9/11 fears, towards acts of terrorism, not natural disasters.

By 2005, more than a billion dollars had been made available to the nation’s roughly 5,000 hospitals to promote bioterrorism preparedness. Memorial’s most detailed and by far its longest emergency planning scenario was written shortly after the 2001 attacks. This bioterrorism plan ran to 101 pages, as opposed to the 11 pages devoted to hurricanes.

Nor does she let the owners of Memorial off the hook, showing from email traffic how responded with indifference until the acute nature of the problem was staring them in the face. Staff felt their employer had abandoned them despite the extraordinary dedication they had shown in those five days. They received no thank you letter for their efforts and only partial pay when the hospital was closed for a six month clean up.

What lessons can be learned from the events at Memorial, Fink asks in the final sections of her book. She is in no doubt that some kind of crime took place at the hospital though she tempers this with respect and sympathy for the exhausted medical team and the conditions they endured.  They took action for the best of intentions but in the absence of any agreed protocols to decide how to ration medical aid, how could they be sure those were the right decisions?  “Moral clarity,” she writes, describing the moment the patients were injected with a powerful cocktail of drugs, “was easier to maintain in concept than in execution.”  And therein lies Fink’s key point, ethical questions of this magnitude cannot be resolved in the heat of the moment, under what are effectively war time conditions when judgements can be clouded.

To the extent that protections and plans have been put in place since Katrina, recent events have shown them to be inadequate or misguided. Life and death in the immediate aftermath of a crisis most often depends on the preparedness, performance and decision making of the individuals on the scene.

It is hard for any of us to know how we would act under such terrible pressure.

But we have the luxury to prepare and resolve how we would want to make the decision

Five Days at Memorial is a masterful and compelling piece of journalism though not a comfortable reading experience given its subject matter. It was tough going at times because of the sheer weight of information – I became quickly lost in a fog of names of doctors and patients and the finer points of the responsibilities of each federal agency – but the desire to want to know what happened and why kept me reading.  The reviewer for the Star Tribune in Minnesota exactly captured my reaction when he described it as “an important book that will make your blood boil no matter which side of the issue you support”

End Notes

Five Days at Memorial by Sheri Fink was published in the UK by Atlantic Books in 2013

Snapshot July 2016

Wales-football-FansI was far too excited by the phenomenal success of the Welsh national football team to post my July snapshot on the first of the month. Against all the odds they soundly beat off the favourites Belgium last night (ranked number two in the world) to get through to the Euro 2016 semi finals, the first time we’ve qualified for a major tournament since 1958.

We’re a nation whose passion is normally devoted to a different shaped ball but last night everyone seemed to be glued to the tv screens. Even me whose knowledge of the finer rules of soccer can be written on the back of a beer mat.

Don’t worry I am not about to abandon Booker Talk’s normal fare of literary postings in favour of sports topics but I hope you’ll allow me a little indulgence on this historic occasion.

So what else was I doing on the first of this month??

Just Finished

After months in which my world literature reading project seemed to have stalled, I added one more country to the list – Belgium.  That makes 31 countries completed from a goal of 50 by January 2018. Fear and Trembling by Amélie Nothomb was a delight and thanks to sylvie heroux I have recommendations for three more books by her: The Character of Rain, 
Tokyo Fiancee and  The Stranger Next Door. My review is posted here.

Reading Currently 

I have two books on the go at the moment. Having made good progress so far with the 20booksofsummer challenge run by Cathy at 746 books, I’ve taken a pause to dip into my TBR.

Bel CantoBel Canto by Ann Patchett is a novel I first heard of in 2013 when I was trying to think of books which had a musical theme (other titles are in this post). It got added to my TBR later that year when I found a bargain copy in a library sale.  It’s set in a South American country which is desperate to attract international investment. The president hits on the idea of inviting the head of a powerful electronics  corporation in Japan celebrate his birthday in the country with a lavish party at which a world-renowned soprano will perform.  The President decides at the last minute he has far more important things to do (namely to watch the latest episode of his favourite tv soap opera). Which proves a problem for the insurgents who surround the birthday venue planning to take the president hostage. There follows a stand off between the terrorists and their hostages.  This isn’t an action novel however, but one that looks at the way people react to danger and entrapment and how leaders become impotent while ordinary individuals find new sources of strength. So far it’s wonderful to read.

Five_Days_at_MemorialMy other book is also a story of courage in the face of adversity but this is a true story. In August 2005, Hurricane Katrina caused devastation in New Orleans. The Memorial Medical Center – the city’s premier hospital – endured five days trapped by floodwater.  Its back-up generators failed, leaving it without lights, air conditioning, sewer systems and essential medical equipment.  Medical staff had to prioritise which patients should be evacuated, and – controversially – which patients to euthanise because their conditions were so poor.

Five Days at Memorial by Sheri Fink originated as an article which appeared in the New York Times Magazine in 2009 and went on to win  a Pulitzer Prize. Fink details the events of those five days and the investigation that followed into the actions of a few members of the medical team. She then goes on to examine the legal and political consequences of the decision to euthanize patients and the ethical issues surrounding euthanasia and health care in disaster scenarios. I’m only a little way into the book but it’s riveting. There is a chilling prologue which sets the scene. In a reception area, patients lie awaiting rescue amid the miasma of the receding floodwaters. Rescue has started but it is painfully slow. A few members of the medical staff begin to prepare a lethal concoction of drugs for the most critically ill. This is not a book you can read quickly but more one that needs to be read in small chunks to allow for reflection on the key issues.

When do I get the sound of silence?

This seems to happen to me every Christmas. In the run up to the festivities I contemplate all those hours when, sans work pressures,  I’ll be able to indulge in nothing more demanding than picking up a book.  I even list in my head the books that will be my companions during this time.

Seven days into the holiday now and my bookish idyll has yet to materialise. I forget just how much preparation the two days of Christmas seem to require so instead of reading I found myself in a seemingly endless cycle of gift shopping, food shopping, gift wrapping and cooking. Followed by a few days when it felt as if I was either preparing a meal, eating it, or clearing away. The closest I got to a moment of silence was an hour on Boxing Day but even that was a bit of a guilty moment since when you’re staying with members of the family it seems rude to shut yourself off from the conversations.

I’m keeping my fingers crossed that now the big day is over and the visitors have gone, I can get some more relaxation time. And particularly some time to get acquainted with the new additions to my book collection courtesy of generous relatives.

books2014The newcomers to my bookshelves are a mix of genres from authors originating from three continents.

From Europe comes Elizabeth Gaskell’s Mary Barton. This was recommended by a number of bloggers who read my recent review of Wives and Daughters so I shall look forward to this. I’m told its more akin to North and South which I preferred to Wives and Daughters.  A review by Stu of Winstondad’s blog   led me to request The Search Warrant by the Nobel Literature prize winner Patrick Modiano  which traces the author’s attempts to discover the fate of a young girl who vanished from a convent school during the Occupation of France in 1941. Thanks to a review by Guy at SwiftlyTiltingPlanet I became the owner of The Four Corners of Palermo by Giuseppe di Piazza which will take me to Sicily in the 1980s, an island plagued by drugs, death and – of course – the Mafia. My fourth book from the European continent is by the Icelandic author Yrsa Sigurdardottir whose novel The Silence of the Sea by which has been described as ‘a corker of a locked room mystery with one of the most dramatic twists in recent crime fiction.

The two remaining gifts are both going to be emotional reads I suspect because of their subject matter. From Australia I am welcoming Richard Flanagan and his 2014 Man Booker prize winning novel,  The Narrow Road to the Deep North which the publishers describe as ‘a savagely beautiful novel’ partly set in a Japanese POW camp on the Burma Death Railway. Death is also prevalent in my last acquisition, Five Days at Memorial by Sheri Fink. This is a true life account of the five days  at a New Orleans hospital during Hurricane Katrina. I remember reading an extract in a Sunday newspaper supplement and being moved to tears by her depiction of the ethical dilemmas encountered by the hospital staff who knew that they could not save all of those patients in their care.

Now my only dilemma is which of these tremendous books to read first. What would you choose?

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