Extreme Measures: Finding a Better Path to the End of Life by Jessica Nutik Zitter

32311672In medical school, no one teaches you how to let a patient die.

Zitter started her career as an ICU doctor, one of the more intense specialties in medicine.  It’s your job to do stuff to turn around patient problems – put them on breathing machines and kidney machines when organs stop functioning, place a tube so they can be fed, use medications to stabilize blood pressure or prevent a clot.  It’s your job save a patient’s life, so why would you stop when there’s another procedure or a different medication you’ve yet to try?

This, she says, is why doctors are so awful at helping their patients have a good death.  A patient dying is akin to failure and no one, especially highly trained professionals with a wealth of options and technology at their disposal, wants to fail.  Add in a family that wants you to “do everything”, and it’s a recipe for more and more machines and care that will make it impossible for the patient to die peacefully at home.  Zitter calls it the “end-of-life conveyor belt” and she got certified in palliative care to help people navigate and possibly avoid it.

This book is an extension of that work.  She details how and why we got to this point and what we – both patients and health care professionals – can do to guide people towards the death they want.  Patient stories are woven through to illustrate what things look like when they go right, go wrong, or just… go.  End of life care is a minefield of pitfalls and potential missteps and she doesn’t shy away from any of it.

It’s a bit of a side note, but I want to give Zitter a great big hug for discussing my profession of medical interpreting in a chapter about cultural values.  She includes the interpreter as part of the care team, asking about cultural differences and how to approach a thorny topic.  In my experience interpreters can be treated like walking dictionaries, more a thing than a person, and it means a lot to me that Zitter accurately depicts and advocates for the important work we do.

The author reads the audiobook and I really liked it, though I did have to crank up the speed a little bit more than usual.  I liked it so much that I went back and relistened to sections so I could add them to my notebook word for word.  Here’s some of the wisdom she drops:

The human being is unknowable.  Unless, maybe, you ask.

While I may be the expert on the patient’s disease I am not the expert on the patient.

Sometimes it isn’t that the doctor needs to work harder to elicit the patient’s values, but that those values are simply different from the doctor’s.  Yet another lesson in listening.

An amazing must read for anyone with anything do to in medicine, and highly recommended to everyone else.

…and because I have an inkling it will come up in the comments – no, I haven’t read Atul Gawande’s Being Mortal yet. 🙂  I hope to get to it sooner rather than later.  I’m curious to see how a surgeon approaches these same issues and where the two doctors’ views converge and divide.

Advertisements

Nonfiction November – New to My TBR

NonfictionNovember-e1506979820517I can’t believe the month is almost over!  Nonfiction November has been my first blogging event of this scale and I’m having a wonderful time.  I’ve met a ton of wonderful people, and heaven knows they’ve recommended some wonderful books.  Here are a few that have made it onto my To Be Read list:

32311672Extreme Measures: Finding a Better Path to the End of Life by Jessica Nutik Zitter, MD
Recommended by Running ‘n’ Reading (her review is thisaway)

A look at end of life care from the perspective of an ICU doctor who also became certified in palliative care.  She describes a “End-of-Life Conveyor Belt” and how receiving more care (ventilator, surgically placed feeding tube, etc.) makes it harder to die outside of a hospital, on your own terms. This book is so perfect for me I’ve already read it and loved it!  Review forthcoming.

34127677The Solace of Open Spaces by Gretel Ehrlich
Recommended by What’s Nonfiction? (her review is thataway)

Ehrlich went to Wyoming on assignment and ended up staying once her work was done.  She writes about how the  myth of the American West stands up to the reality, working on a ranch and the people you’ll find there, and what makes it the perfect place for her.  I’ve already read this one, too, and in fact I’ll be giving it as a Christmas gift!  I don’t want to tip off the recipient so the review will be a little delayed.  Until then know that it’s awesome and worth your time.

23214337Forensics: What Bugs, Burns, Prints, DNA and More Tell Us About Crime
by Val McDermid
Recommended by Words and Peace

I think I’ll like this because I liked Working Stiff – how forensic types figure out how someone died or who committed a crime.  It looks like the author has written a bunch of crime novels and did a lot of research, so it’s sure to be an engrossing read.

How is everyone faring?  Sick of nonfiction yet?  😉

Kokoro Button (Love Button) #1 by Maki Usami

9533185I finally stopped in a used bookstore I pass on my commute and, oh my.  Every hardcover is less than four dollars US, some paperbacks are less than a buck, and the manga.  My goodness, the manga – full sets impeccably shelved, calling to me.  And it was 10% off day.

~ded~

I browsed for an hour and settled on a nonfiction book by a 911-esque dispatcher (old habits die hard) and the first volume of Kokoro Button (ココロボタン).  In it a guy (Koga) and a girl (Kasuga) meet at high school orientation – she is smitten, but he is not looking for a relationship with anyone.  She says how about a trial period to see if we could like each other?  His reply:

You don’t know much about me yet… are you sure?

It turns out Koga-kun is a “little bit S”, or a little bit sadistic, so she doesn’t realize how loaded the question is.  She says she’s sure, and the series is off and running.

Fear not, there is no BDSM in this high school manga; in fact, it’s purely PG.  This “little bit S” is the reason I picked up the book – what does that look like?

Well, it’s basically teasing in the form of misdirection.  He’d tell her one thing, she’d get worried or upset, and he’d enjoy that reaction (there’s the S).  Then he’d say no, actually it’s this other thing, and turn into a sweet boyfriend until it was time to tease her again.  It’s hurt/comfort, but with both parts from the same person.

I can see this working if Kasuga-san a) realizes what’s going on or b) gives as good as she gets, but she worries and laments about every little thing.  For example, one night Koga-kun doesn’t call and she’s reduced to a sobbing catatonic mess.  I’m okay with not-strong heroines (huzzah variety!) but this is a little much for me.

20171124_080951.jpgEven so it was a quick read.  The style is typical shojo with lots of white space and wispy lines, and while the art is average some frames stick out as particularly well framed or comical.  I love Kasuga’s reaction when Koga sees a beetle in her hair:

When I freak out I shout in squiggles, too.

All in all I’m not a fan, and can only recommend Kokoro Button if a “little bit S” is your sort of thing.


This is my first manga review on Always Doing, yea!  If you’d like to see more reviews like this let me know in the comments, and if you’d rather I didn’t review books I read in Japanese let me know that, too.  I feel bad that this series isn’t available in English (at least officially…) but my thoughts were overflowing and I couldn’t resist.

 

Jackaby by William Ritter (Jackaby #1)

23003390Newly arrived in New Fiddleham, New England, 1892, and in need of a job, Abigail Rook meets R. F. Jackaby, an investigator of the unexplained with a keen eye for the extraordinary–including the ability to see supernatural beings. Abigail has a gift for noticing ordinary but important details, which makes her perfect for the position of Jackaby’s assistant. On her first day, Abigail finds herself in the midst of a thrilling case: A serial killer is on the loose. The police are convinced it’s an ordinary villain, but Jackaby is certain it’s a nonhuman creature, whose existence the police–with the exception of a handsome young detective named Charlie Cane–deny.

Review:

I mostly enjoyed my time with Jackaby, but after coming highly recommended I was hoping for more.

The good:

  • I enjoy the time and setting, 1890s New England not being one of my usual literary destinations.
  • The story is Sherlock Holmes inspired with a paranormal element.
  • The characters were interesting and have room to grow as the series continues.
  • Even though the story is about Jackaby and his assistant there is no wiff of romance between them, huzzah!  The titular-guy-falls-for-the-new-gal trope has been way, way over done.
  • In its place there’s the hint of a romance with another character and I like where it may head.

The not-so-good:

  • While I like the setting it wasn’t evoked very well.  I could picture the inside of houses well enough but once the action headed outside I felt lost.
  • The mystery wasn’t all that mysterious.
  • There are tons of paranormal creatures but the lack of world building makes each feel like a one off.  I don’t need a taxonomy of creepy crawlies but a hint at some structure would be nice.
  • Overall the writing and characterization were thin and obvious.  It’s a common complaint I have with YA books, but there you go. ~shrug~

While I might recommend Jackaby to my niece I don’t see myself continuing the series.

Nonfiction November – Nonfiction Favorites

Here’s our prompt for this week:

NonfictionNovember-e1506979820517Let us know what qualities make you add a nonfiction book to your list of favorites. Is the topic pretty much all that matters? Are there particular ways a story can be told or particular writing styles that you love? Do you look for a light, humorous approach or do you prefer a more serious tone?

To suss out my proclivities I’m going over my favorite nonfiction reads over the past few years.  I haven’t found a magic bullet but there are some factors that will propel a book up my list of favorites.

Amazing Writing

22253729A nonfiction book doesn’t need to leave literary style behind!  It can be as elevated David Foster Wallace’s Consider the Lobster or as grounded as Nina MacLaughlin’s Hammer Head, but great sentence level writing will get me every time.

Getting My Study On

605663I love reading to learn and some books have blown my mind wide open.  There’s Whipping Girl, an own voices take on transwomen and femininity, Smoke Gets in Your Eyes about the business of death in the United States, and Tears We Cannot Stop, an African American minister’s sermon to white America.

Primary Source Documents

27507970That may not sound exciting, but stick with me!  Documents from their time, often with analysis or historical background, can be transporting.  Charleston Syllabus pulls together everything from slave’s first person accounts to Constitution of the Confederate States to give an overview of the history of black people in America and how we arrived at our current state of affairs.  War Diaries is the personal journal of Astrid Lindgren, the author of Pippi Longstocking, which she wrote during World War II.

…and Fire

351219It doesn’t make sense considering how terrified I am of flames, but I am drawn to books about fire.  It can be a well-known historical fire (Triangle: The Fire that Changed America), a fire lost to time (The Circus Fire), about what it’s like to watch for fires (Fire Season: Field Notes from a Wilderness Lookout) or fight them (The Fire Inside).

Do we match up on any of these likes?  What makes a nonfiction read a favorite for you?

Do No Harm: Stories of Life, Death, and Brain Surgery by Henry Marsh

24510511In neurosurgery, more than in any other branch of medicine, the doctor’s oath to “do no harm” holds a bitter irony. Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.

If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon’s life.

Review:

You know you’ve read a lot of medical nonfiction when you think, “This is an alright book by a neurosurgeon discussing the intricacies of brain surgery, but I’ve read better.”  (For the record I like When the Air Hits Your Brain by Frank T. Vertosick Jr. more.)

Marsh hits all the expected beats and themes – surgery that goes well despite all odds, surgery that doesn’t go well despite all efforts, kids you don’t want to see die, adults who face death with dignity. The cases are engaging and the writing solid.

But I’m not sure I get along with Marsh as a person.  He’s nearing the end of his career, which is good in that we can see how hospital conditions and doctor training have changed over time.  These changes, though, are often framed in terms of the good ol’ days and how they compare with the bad ol’ now.  For example, an anesthetist refused to do a big surgery at 4 pm because she didn’t have childcare for the evening.

“But we can’t cancel it,” I protested.  “She was cancelled once already!”

“Well I’m not doing it.” …

For a few moments I was struck dumb. I thought of how until a few years ago a problem like this would never have arisen… I envy the way in which the generation who trained me could relieve the intense stress of their work by losing their temper, at times quite outrageously, without fear of being had up for bullying and harassment.

Oh, I’m sorry that asshole-ry is no longer tolerated.  Geesh.  This doesn’t take away from the amazing work Marsh has done in his life, including humanitarian work in rural Ukraine, but neurosurgeon as god thing turns me off.

In sum the book is good but there’s better out there – check out Vertosick’s first.

Slave to Sensation by Nalini Singh (Psy-Changeling #1)

25578803In a world that denies emotions, where the ruling Psy punish any sign of desire, Sascha Duncan must conceal the feelings that brand her as flawed. To reveal them would be to sentence herself to the horror of “rehabilitation” – the complete psychic erasure of everything she ever was…

Both human and animal, Lucas Hunter is a changeling hungry for the very sensations the Psy disdain. After centuries of uneasy coexistence, these two races are now on the verge of war over the brutal murders of several changeling women. Lucas is determined to find the Psy killer who butchered his packmate, and Sascha is his ticket into their closely guarded society. But he soon discovers that this ice-cold Psy is very capable of passion – and that the animal in him is fascinated by her. Caught between their conflicting worlds, Lucas and Sascha must remain bound to their identities – or sacrifice everything for a taste of darkest temptation.

Review:

Singh is one of the big names in paranormal romance and while I have read from her Guild Hunter series this was my first foray into the world of Psy-Changelings. While I had no idea what I was in for I like what I found.

The Psy are Borg-like, shunning emotion and sharing a hive mind of sorts.  Uniformity and logic rule.  Changelings are were creatures that burst with emotion and sensual energy.  I see why this series is at sixteen books and counting – a romance between such opposites is a gold mine of internal conflict, and the mechanics of the world provide all the external oomph you could need.

A series opener like Slave to Sensation could be overloaded with info dumps but the romance balances out the world building nicely.  While part of me would love some more back story I’m more than willing to let it play out in the many books ahead.

As for the romance itself… it’s okay.  Lucas is sexy as all get out and respects Sascha’s professional abilities from day one, which is much appreciated.  Once the action plot kicks in, though, I got annoyed.  Any time the heroine is offered up as bad guy bait my mental alarm bells go off.  Luckily she’s not too stupid to live, and the way things went down stayed just this side of forgivable, but I’d rather it not happen in the first place.

A negative note, to be sure, but I’m excited to continue the series.  The world Singh is building holds a lot of promise and fans clamoring for volume eleven-zillion of a series can’t steer me too wrong.

Nonfiction November – Be the Expert

This week’s Nonfiction November topic gives us lots of choice!

NonfictionNovember-e1506979820517Three ways to join in this week! You can either share three or more books on a single topic that you have read and can recommend (be the expert), you can put the call out for good nonfiction on a specific topic that you have been dying to read (ask the expert), or you can create your own list of books on a topic that you’d like to read (become the expert).

I have decided to Be the Expert in medicine, more specifically “books by doctors doing their thing awesomely”.  I’m a medical interpreter and work in hospitals, so it’s a topic that’s close to my heart.  After I made the list I realized all the authors are women – extra bonus!  The titles link to my full reviews.

15998346 What Doctors Feel: How Emotions Affect the Practice of Medicine by Danielle Ofri, MD

Each chapter covers an emotion doctors deal with on a near-daily basis, from empathy and fear to sadness and shame.  Good practices are shared and less than ideal situations analyzed in solid, assured prose that is still honest about the author’s misgivings and failings. The feelings behind what your doctor is thinking.

29955558Committed: The Battle Over Involuntary Psychiatric Care by Dinah Miller, MD and Annette Hanson, MD

Involuntary care is a a minefield of ethical conundrums and this book covers as many points of view as possible, from pro-involuntary treatment groups to anti-anything-psychiatry groups like Scientology. Thorough, well-considered, and fascinating.

19967171Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner by Judy Melinek, MD and T.J. Mitchell

The training and most memorable cases of a medical examiner.  While the jacket copy teases the stories around terrorist attacks my favorites were more commonplace – injuries that only show up after a day has passed, how to figure out which stab wound came first, pinning down someone’s age thanks to a single rib bone. Riveting and perfect for anyone who perks up when Law and Order heads to the morgue.

I’m always on the lookout for more medical nonfiction – what’s your favorite?

The Austen Escape by Katherine Reay

34460584Mary Davies lives and works in Austin, Texas, as an industrial engineer. She has an orderly and productive life, a job and colleagues that she enjoys—particularly a certain adorable, intelligent, and hilarious consultant. But something is missing for Mary. When her estranged and emotionally fragile childhood friend Isabel Dwyer offers Mary a two-week stay in a gorgeous manor house in Bath, Mary reluctantly agrees to come along, in hopes that the holiday will shake up her quiet life in just the right ways. But Mary gets more than she bargained for when Isabel loses her memory and fully believes that she lives in Regency England.

Outings are undertaken, misunderstandings play out, and dancing ensues as this triangle works out their lives and hearts among a company of clever, well-informed people who have a great deal of conversation.

Review:

I love and respect Jane Austen as a literary figure but I have a confession to make – I haven’t read any of her books.  Don’t get me wrong, I’ve tried! I’ve started Pride and Prejudice many times but haven’t gotten past page 30. Sigh.

That being said I love the Regency period so the idea of a “real” manor vacation is exactly my thing.  I like the way it was handled, too – technology is put into the background but not shunned all together.  A vacation spot that confiscates cell phones probably wouldn’t be popular, you know?  The days are filled with as many Regency activities as the guests can handle with chances to tap out when needed.  The pragmatism kept any nitpicking part of my brain at bay.

Even with the interesting setting the characters take center stage. People grow and change and everyone is fleshed out from the leads down to the manor maid.  While Austen is discussed a lot over the course of the story I felt like I was able to keep up.  Some references went over my head but it didn’t get in the way of the story.  Needless to say, Austen fans will have more to dig into. The writing is solid but not stylistically notable, and the plot pulled me through no problem.

The more you love (and know) Austen the more you’ll get out of The Austen Escape, but even if you’re a relative know-nothing like me you can enjoy the ride.

Thanks to Thomas Nelson and NetGalley for providing a review copy.

Curry: Eating, Reading, and Race by Naben Ruthnum

34144408By grappling with novels, recipes, travelogues, pop culture, and his own upbringing, Naben Ruthnum depicts how the distinctive taste of curry has often become maladroit shorthand for brown identity. With the sardonic wit of Gita Mehta’s Karma Cola and the refined, obsessive palette of Bill Buford’s Heat, Ruthnum sinks his teeth into the story of how the beloved flavor calcified into an aesthetic genre that limits the imaginations of writers, readers, and eaters. Following in the footsteps of Salman Rushdie’s Imaginary Homelands, Curry cracks open anew the staid narrative of an authentically Indian diasporic experience.

Review:

A deep and thoughtful look at what Ruthnum calls “currybooks”, or books of the South Asian diaspora.  Curry has adapted to the many parts of the world it has been brought to, with spices and cream added and subtracted to cater to the tastes of a particular people.  Likewise, currybooks charge form based on different factors but have nostalgia, authenticity, and the idea of getting back to one’s roots as overarching themes.

Is there a problem with these expectations in the genre?  Only that they constrain and limit the potential methods of expression for brown writers.

Ruthnum examines novels, cookbooks, movies, and touches on his own experience as the son of Mauritian immigrants.  The writing is well-done and interesting, falling more on the educational side of things than entertaining.  There’s nothing wrong with that,  but go in knowing that Curry will require (and reward) your mental effort.  My e-copy is full of highlights that I suspect I’ll be returning to as I read more books set in and by authors from this part of the world.

Great for those interested in representation, the immigrant experience, race, and how they’re expressed in literature.

Thanks to Coach House Books and Edelweiss for providing a review copy.