Month: June 2016

Being Mortal by Atul Gawande

beingmortalBeing Mortal, by surgeon and New Yorker staff writer Atul Gawande, confronts aging and the life well-lived — two of my personal fascinations. I received this book as a gift from one of my coworkers at the start of my sabbatical. (Thank you, as-yet-unguessed friend!)

For all its technical advancements, Gawande posits that medical science struggles to achieve what should be its most important goal: focusing on well-being for the frail, the aging, and the terminally ill, as opposed to attempting to cure often incurable diseases and conditions. (You can’t cure old age, but you can do things to reduce pain, and improve comfort, mobility, and overall quality of life.)

We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive.

As you age and become unable to manage the tasks of daily existence (cooking food, shopping, using the toilet independently, cleaning, and personal grooming) there are few options for a well-lived life. Assisted living offers some autonomy — but not nearly enough when you’re forced to rise, dress, shower, and eat on a pre-determined schedule meant to create institutional efficiency, not happy, fulfilled, human beings. Gawande’s book challenges the institutional default setting by profiling small-scale, successful assisted living communities that allow elderly and frail people to do the things that bring them happiness on a schedule they choose.

For the terminally ill, the treatments are often much worse than the illness itself, although science’s default setting is try everything, to exhaust all options — even when death is an eventuality. Gawande suggests doctors should seek to understand what’s most important to patients, their fears, and the trade-offs they’re willing to make when considering treatments that can never cure, only extend life.

Well-being is about being able to live the life you want to live and do the activities you want to do, on your terms. It’s about ice-cream in front of the hockey game at home, as opposed to wasting away in a hospital as disease takes over. It’s about maximizing comfort and the quality of the time remaining, as opposed to focusing on mostly useless treatment.

This is a book I’ve seen advertised though I’d bypassed it several times. I’m so glad that I read it. Reading it, I reflected on how difficult it was for Mike’s family when his mom was diagnosed with pancreatic cancer. Although we really could have benefited from reading this book over 20 years ago, we did what we could to help Joan enjoy the time she had left. There were trips to the lake, lots of chocolate milkshakes, and most importantly, time with friends and loved ones.

Reading this book has also made me think of what I want for myself and my loved ones was we all age and eventually become frail. Being Mortal has equipped me with a set of questions to consider when time is running short, to help reveal fears and hopes and help choose which to live and make decisions by. Not only has it helped me to think about the (hopefully!) long-term future, it’s helped me to re-evaluate how I spend my time in the present.

Each day of my sabbatical is a gift. I get the exquisite luxury of being able to choose precisely how I want to spend my time each day. I’m fortunate to be in good health and the fact that I can run, bike, read, and sit on the deck and listen to bird radio has been a tremendous joy. I’ve been able to think about my life, what I’ve done so far, what’s most important to me, and how I want to spend my time going forward.

Being Mortal is an excellent read and it couldn’t have come at a better time. Highly recommended!

June, 2016

Galore by Michael Crummey

galoremichaelcrummeyThe word galore means “in abundance.” In Michael Crummey’s Galore, the only things in abundance are misery, desire, greed, and a compellingly tenacious will to survive.

Galore roams the lives of the families in Paradise Deep, Newfoundland, in the late 19th and early 20th centuries. The landscape offers little respite. It’s bitterly cold, windy, and wet. It’s a fickle mistress given to cycles of plenty and want, imperilling those who try to eke out an existence by fishing, logging, and sealing. Death by starvation and exposure is ever-present. In living each day, we’re all that much closer to our own deaths — especially the hardscrabble residents of Paradise Deep.

…death wasn’t sudden and complete but took a man out of the world piecemeal, a little at a time.

The characters and the beautiful prose carry Galore through what I feel is an uneven narrative. The book follows mostly several generations of the Devine family. You can’t help but love them for the sheer effort they put into survival and the sacrifices they make to help one another along though a harsh world.

Judah Devine (a variation on Jonah) is adopted into the fold after being rescued from the belly of a beached whale by a woman known only as Devine’s Widow. He’s known for his bright white hair, skin, and a pervasive foul odor that he passes on to his offspring. Judah’s origin and past is a mystery — he never utters a word. He becomes a Devine only after Devine’s Widow arranges a hasty marriage to her granddaughter Mary Tryphena Devine, to save “The Great White” from a mob. The Devines are resourceful and stubborn, two qualities that sustain them over the decades.

Galore and its characters are imaginative — Crummey does a great job chronicling everyone’s longings, desires, conflicts, and losses and you become invested as you follow the burgeoning families. This book has a deep and conflicted soul of its own and I loved it for that. The characters are resolute in their beautiful, pervasive, stoic catechism.

They came finally to the consensus that life was a mystery and a wonder beyond human understanding, a conclusion they were comfortable with though there was little comfort in the thought.

My primary quibbles with Galore are narrative threads raised and dropped and seemingly random time hopping that accelerates the plot. You care about the characters and it’s irritating when they’re suddenly elderly and you’re not privy as a reader to those missing years. Critical characters like Bride Newman simply die offstage and the revelation feels rushed — an afterthought. I would have loved a longer book that followed fewer characters more closely.

Despite these irritations, Crummey is a writer I plan to explore further. In the words of Callum Devine, “what is it you wants?”

I wants me s’more Newfoundland, b’y.

June, 2016

Uprooted by Naomi Novik

uprootedNaomi Novrik’s Uprooted is a fantasy novel that, sadly, feels a bit more like a too-familiar fairy tale.

Agnieszka is the surprise pick of the wizard called “Dragon.” Every ten years, he whisks a village girl away to his tower to teach her to manage her magic skills. She’s bubbly and positive and easily outraged — everything you’d expect of a precocious witch. The Dragon (150-year-old Sarkan) is Oscar the Grouch in wizard form, quick with rebukes and ridicule, short on kind words and depth as a character. His pervasive negativity and sourpuss outlook is unwavering, which makes him thin and tedious.

I felt like Uprooted had great potential, but it was the lack of depth — in the characters, mostly but also in the plot — that put me off this battle-heavy epic. Uprooted’s scenes post-climactic battle left me confused. Agnieszka and Sarkan venture into the evil Wood to stop its omnipresent malevolence from devouring the surrounding small towns, yet these scenes feel muzzy, somehow like the dream the wood people seek to find peace. This part of the plot feels like it comes out of left field. I understand the idea and theme that wanton violence solves nothing and only creates more problems, though there is nothing to alert the reader earlier in the book that taking the path of nonviolence with the Wood is what will eventually bring peace.

Some of the most compelling scenes in the book take place when Agnieszka and Sarkan make magic together and I happily lost myself in the telling of that part of the story, only to find the battle scenes overdone and exceptionally longwinded in telling description. This, along with the puzzling dénouement, and I’d have to say that Uprooted was not for me.

May and June, 2016