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.

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Tears We Cannot Stop: A Sermon to White America by Michael Eric Dyson

33395053As the country grapples with racist division at a level not seen since the 1960s, one man’s voice soars above the rest with conviction and compassion. In his 2016 New York Times op-ed piece “Death in Black and White,” Michael Eric Dyson moved a nation. Now he continues to speak out in Tears We Cannot Stop—a provocative and deeply personal call for change. Dyson argues that if we are to make real racial progress we must face difficult truths, including being honest about how black grievance has been ignored, dismissed, or discounted.

“The time is at hand for reckoning with the past, recognizing the truth of the present, and moving together to redeem the nation for our future. If we don’t act now, if you don’t address race immediately, there very well may be no future.”

Review:

A must-read primer to race in America, especially for people who are new to racial justice.  Aimed specifically at white people but readable by anyone, Dyson explains why history, police brutality, and white fragility matter.

Don’t be put off by the fact that the author is a minister – he’s not pushing a god on anyone, much appreciated by this agnostic.  Using the framework of a sermon Dyson goes through the stages of white guilt, the construction of whiteness, the specter of slavery, and more.  As a primer he avoids going overly deep, which is perfect for what he’s doing.  Other authors have covered the specifics elsewhere and he lists dozens of them if you’d like to read more.

What gets to me is that the people who need to read this most – whites with no grounding in racial justice – are the least likely to pick it up.  So read it yourself and put it in other people’s hands.  We need to get the message out.

Clouds of Witness by Dorothy L. Sayers (Lord Peter Wimsey #2)

192888Rustic old Riddlesdale Lodge was a Wimsey family retreat filled with country pleasures and the thrill of the hunt – until the game turned up human and quite dead. He lay among the chrysanthemums, wore slippers and a dinner jacket and was Lord Peter’s brother-in-law-to-be. His accused murderer was Wimsey’s own brother, and if murder set all in the family wasn’t enough to boggle the unflappable Lord Wimsey, perhaps a few twists of fate would be – a mysterious vanishing midnight letter from Egypt … a grieving fiancée with suitcase in hand … and a bullet destined for one very special Wimsey.

Review:

I loved the first Peter Wimsey book, Whose Body?, and have been doing my best not to blast through the entire series.  I’m saving them for when I need a fun, thinking, comfort read and Clouds of Witness delivers.

This time I went with the audiobook and I have a much better grasp of the characters now that I’ve heard them.  It must be hard to do British narration, having to take into account geographical accents as well as those of class, and Ian Carmichael does a great job.   The scene with a drunk Wimsey is pure gold that left me giggling.

The mystery itself kept me interested and guessing… the latter isn’t a high bar considering this is me, but hey.  I enjoyed the twists as well as the meta comments Sayers puts in here and there.

Here’s the thing, though – I don’t know if I want to continue the series in print, which shows off the writing, or on audiobook, where the characters come to life.  Have you read the Peter Wimsey series?  Do you prefer audio or print?

Sunshine by Robin McKinley

23384972Although it had been mostly deserted since the Voodoo Wars, there hadn’t been any trouble out at the lake for years. Rae Seddon, nicknamed Sunshine, head baker at her family’s busy and popular café in downtown New Arcadia, needed a place to get away from all the noise and confusion—of the clientele and her family. Just for a few hours. Just to be able to hear herself think.

She knew about the Others, of course. Everyone did. And several of her family’s best regular customers were from SOF—Special Other Forces—which had been created to deal with the threat and the danger of the Others.

She drove out to her family’s old lakeside cabin and sat on the porch, swinging her feet and enjoying the silence and the silver moonlight on the water.

She never heard them coming. Of course, you don’t when they’re vampires.

Review:

I love this book so. much.

The good:

  • As much as I love vampires they have been done (and overdone) poorly in the years since Twilight. McKinley builds a believable, gritty world that includes them.  They don’t sparkle or do anything weird.  In fact humans don’t know too much about them because anyone who interacts with a vampire ends up dead.
  • The first person perspective is used to perfection.  Our narrator Sunshine has a defined voice that rambles, but is exact in that rambleyness. She makes me smile and she fleshes out the story in a way that should feel like an info dump but is anything but.

    There are always cats around Charlie’s, but they are usually refugees seeking asylum from the local rat population, and rather desperately friendly.

  • Sunshine goes through a lot of traumatic experiences and her psychological experience feels right on.  I never questioned or doubted her inner life.

    It was easier, saying I didn’t remember.  I walled it all out, including everybody’s insistent, well-meaning concern.  And it turned out to be easy – a little too easy – to burst into tears if anyone tried to go on asking me questions.  Some people are mean drunks: I’m a mean weeper.

  • The plot kept me riveted and pages flew by.  Instead of many small chapters the book is split into only four parts… so I devoured it in four gulps. Yum.
  • Sunshine has a healthy sex life and a grounded view of what she wants from relationships.  There’s no guilt tied up with sex, no apologizing for banging people in college, none of it.  Hey world – more of this, please!
  • The ending is slightly ambiguous, and the lack of a neat-as-a-bow resolution means I can think about Sunshine and Con like they’re still “alive”. What will they do now that this part of their story is over?  What does the future hold for them?  I like thinking about the possibilities.

The not-so-good:

  • In one or two places the awesome rambleyness becomes only so-so rambleyness.
  • That’s pretty much it.

One of my requirements for a five star read is thinking “I can’t wait to reread that” as soon as I close the book.  Sunshine barely misses on that point so I’m giving it an enthusiastic four stars.  Vampire and urban fantasy fans, you’ve found a home.

The Red by Tiffany Reisz

30755704Mona Lisa St. James made a deathbed promise that she would do anything to save her mother’s art gallery. Unfortunately, not only is The Red painted red, but it’s in the red. She soon realizes she has no choice but to sell it.

Just as she realizes she has no choice but to sell it, a mysterious man comes in after closing time and makes her an offer: He will save The Red if she agrees to submit to him for the period of one year.

The man is handsome, English, and terribly tempting…but surely her mother didn’t mean for Mona to sell herself to a stranger. Then again, she did promise to do anything to save The Red…

Review:

Reisz has been in mainstream mode lately (The Night Mark, Her Halloween Treat) so I’m thrilled to see she’s come back to hot, kinky erotica.  Huzzah!

The good:

  • This is porn with a plot.  Mona agrees to have sex with a mysterious man over the course of a year in order to save her art gallery.  Each encounter is based on a painting and could easily become episodic but the thread of the story carries through wonderfully.
  • Ooo boy, the sex is hot.  The kink is thick and there’s guaranteed to be something that challenges you… which is just way I like it.
  • There’s a twist at the end that I didn’t see that brings everything full circle.  Well done.

The not-so-good:

  • The ending is a bit rushed, and while it didn’t bother me too much it could have used a little more development.
  • The characters are rounded but lack some depth.

All in all I’m sooo happy to see Reisz stretch her kinky wings again.  On Twitter she teased an upcoming title, calling it a “sexy sex cult”… so it looks like I have more to look forward to!

Thanks to 8th Circle Press and NetGalley for providing a review copy.

Things Fall Apart by Chinua Achebe

37781Things Fall Apart tells two overlapping, intertwining stories, both of which center around Okonkwo, a “strong man” of an Ibo village in Nigeria. The first of these stories traces Okonkwo’s fall from grace with the tribal world in which he lives, and in its classical purity of line and economical beauty it provides us with a powerful fable about the immemorial conflict between the individual and society.

The second story, which is as modern as the first is ancient, and which elevates the book to a tragic plane, concerns the clash of cultures and the destruction of Okonkwo’s world through the arrival of aggressive, proselytizing European missionaries. These twin dramas are perfectly harmonized, and they are modulated by an awareness capable of encompassing at once the life of nature, human history, and the mysterious compulsions of the soul. Things Fall Apart is the most illuminating and permanent monument we have to the modern African experience as seen from within.

Review:

Things Fall Apart has been on my gotta-someday list, and recently someone pushed me to read it.  I’m glad he did –  this book a classic for a reason and makes for great discussion.

The story isn’t happy but it’s beautifully told.  In short: Okonkwo is a strong man with a nasty streak fueled by fear.  He’s become a powerful figure in his own village but a series of events, both of his own doing and not, lead to…. things falling apart.  (I couldn’t resist.)

There are all kinds of themes that can be examined endlessly but here are some that resonated with me:

  • the friction between African and Western cultures meeting, not only in the story but in the form of the novel.  For example, the title is taken from a Yeats poem, and Igbo proverbs and storytelling feature throughout.
  • sons who are determined not to become their father and take it too far
  • how women are treated and viewed in society
  • justice – how it is meted out and by whom

Just as good as I hoped it would be, with lots to think about.

Like One of the Family: Conversations from a Domestic’s Life by Alice Childress

28186071First published in Paul Robeson’s newspaper, Freedom, and composed of a series of conversations between Mildred, a black domestic, and her friend Marge, Like One of the Family is a wry, incisive portrait of working women in Harlem in the 1950’s. Rippling with satire and humor, Mildred’s outspoken accounts vividly capture her white employers’ complacency and condescension—and their startled reactions to a maid who speaks her mind and refuses to exchange dignity for pay.

Upon publication the book sparked a critique of working conditions, laying the groundwork for the contemporary domestic worker movement. Although she was critically praised, Childress’s uncompromising politics and unflinching depictions of racism, classism, and sexism relegated her to the fringe of American literature. Like One of the Family has been long overlooked, but this new edition, featuring a foreword by best-selling author Roxane Gay, will introduce Childress to a new generation.

Review:

This collection of vignettes is a joy.

Marge, I sure am glad that you are my friend… No, I do  not want to borrow anything or ask any favors and I wish you’d stop bein’ suspicious everytime somebody pays you a compliment.  It’s a sure sign of a distrustful nature.

Even more than the joy, though, I love the look at what it’s like to be a black domestic worker in 1950’s New York.  While the way of life is different there are other parts that are eerily familiar.  When Mildred riffs one Christmas about what peace would look like she dispenses with “no war” quickly – peace would be not being turned away from an apartment because of her race.  Peace would be not seeing signs on the subway asking for “tolerance” “regardless” of what other people are.  And,

…if nobody wanted to kill nobody else and I could pick up a newspaper and not read ’bout my folks gettin’ the short end of every stick… that would mean more peace.

How little has changed.

As Roxanne Gay says in the foreword, it’s “political without trying to manipulate the readers’ sensibilites, without ever forgetting that a novel, political or not, must first and foremost entertain.”  The short chapters go down easy and are perfect for reading on the train or at the doctor’s office.  I’m thankful that Childress wrote down the experience of this overlooked slice of society.  I’m so glad I read it.

The Bear and the Nightingale by Katherine Arden

25489134At the edge of the Russian wilderness Vasilisa spends the winter nights huddled around the embers of a fire with her beloved siblings, listening to her nurse’s fairy tales. Above all, she loves the chilling story of Frost, the blue-eyed winter demon, who appears in the frigid night to claim unwary souls. Wise Russians fear him, her nurse says, and honor the spirits of house and yard and forest that protect their homes from evil.

After Vasilisa’s mother dies, her father goes to Moscow and brings home a new wife. Fiercely devout, city-bred, Vasilisa’s new stepmother forbids her family from honoring the household spirits. The family acquiesces, but Vasilisa is frightened, sensing that more hinges upon their rituals than anyone knows.

And indeed, crops begin to fail, evil creatures of the forest creep nearer, and misfortune stalks the village. All the while, Vasilisa’s stepmother grows ever harsher in her determination to groom her rebellious stepdaughter for either marriage or confinement in a convent.

As danger circles, Vasilisa must defy even the people she loves and call on dangerous gifts she has long concealed—this, in order to protect her family from a threat that seems to have stepped from her nurse’s most frightening tales.

Review:

I haven’t read much straight up adult fantasy lately and this books reminds me – why the hell not?! Reading like a grown-up fairy tale, The Bear and the Nightingale wove its spell around me just when I wanted to get away from the world.

So much is satisfying – the prose is weighty in the right places and beautiful throughout. The story could feel segmented but holds together well, having a cohesive instead of episodic feel. And perhaps above all, Arden trusts the reader. There is no semantic break down of character nicknames; we figure them out for ourselves. Plot threads are put aside until they are needed instead of being needled to death. If there is a romance it’s a super slow burn… I love slow burns! And while there’s a solid ending it leaves the door open for more books. Once I finished I learned it’s going to be a trilogy – callooh! Callay!

A strong recommendation for anyone who loves fantasy, especially for those who are looking for more than YA can offer. I’m excitedly looking forward to the next installment.

Smoke Gets in Your Eyes: And Other Lessons from the Crematory by Caitlin Doughty

25189315Most people want to avoid thinking about death, but Caitlin Doughty—a twenty-something with a degree in medieval history and a flair for the macabre—took a job at a crematory, turning morbid curiosity into her life’s work. Thrown into a profession of gallows humor and vivid characters (both living and very dead), Caitlin learned to navigate the secretive culture of those who care for the deceased.

Her eye-opening, candid, and often hilarious story is like going on a journey with your bravest friend to the cemetery at midnight. She demystifies death, leading us behind the black curtain of her unique profession.

Honest and heartfelt, self-deprecating and ironic, Caitlin’s engaging style makes this otherwise taboo topic both approachable and engrossing. Now a licensed mortician with an alternative funeral practice, Caitlin argues that our fear of dying warps our culture and society, and she calls for better ways of dealing with death (and our dead).

Review:

This isn’t the book for everyone, but at the same time, the more you resist the more you should probably read it. (Passes given for the truly squeemish and triggered, of course.)

In this memoir-of-sorts Doughty explores her life-long fascination with death and what it means to have a “good” one. She relates what it’s actually like to work at a crematory, how bodies of all descriptions get to their final resting place, Western culture’s relationship with death and how it’s changed over the centuries, and more.

Doughty speaks honestly about things we’d never admit to being curious about (why don’t we see dead bodies at the hospital?) and things many of us never think about (what happens when a homeless person dies?). Working in medicine I’ve already given thought to my own “good death” but she pushed me a step farther – what would I like to happen after I die? What would donating my body to science entail? What kind of rituals or ceremonies would help my family cope?

I won’t lie, parts of the book made my eyes leak, a ‘wow that’s so beautiful/touching/wrenching’ that hits you (lovingly) in the solar plexus. This is stuff we should all be thinking about and as the author argues, turning a blind eye to death makes for an unhealthy relationship with it.

A hearty recommend for anyone interested by the title, and even those who aren’t.

The Trouble with Reality: A Rumination on Moral Panic in Our Time by Brooke Gladstone

34525527Reality. It used to seem so simple—reality just was, like the weather. Why question it, let alone disagree about it? And then came the assault, an unending stream of “fake news,” “alternative facts,” and lies disguised as truths that is overwhelming our notions of reality. Now we can’t even agree on what a fact is, let alone what is real. How on earth did we get here?

Reality, as Gladstone shows us, was never what we thought it was—there is always a bubble, people are always subjective and prey to stereotypes. And that makes reality more vulnerable than we ever thought. Enter Donald J. Trump and his team of advisors. For them, as she writes, lying is the point. The more blatant the lie, the easier it is to hijack reality and assert power over the truth. Drawing on writers as diverse as Hannah Arendt, Walter Lippmann, and Jonathan Swift, she dissects this strategy straight out of the authoritarian playbook and shows how the Trump team mastered it.

And she offers hope—the inevitable reckoning history tells us we can count on—and a way to recover both our belief in reality and our sanity.

Review:

‘What is reality, anyway?’ seems like an impossible question but Gladstone has us covered.   The answer starts from a single core idea – that each of us has our own personal reality – and builds out bit by bit to explain how we got to where we are today.

I highlighted so many passages it’s slightly ridiculous.  Complex ideas are articulated clearly and memorably, and many have been rattling around my head as the news cycle spins on – how beliefs and conspiracies affect our realities.  How Huxley and Orwell’s dystopian fears translate to our times.  How demagogues get and lose their power.  How to avoid pitfalls in messaging and what we can do to affect change.  “Meaningful action is a time-tested treatment for moral panic,” she says, and we’re pointed in the right direction.

This is one of those reviews that’s hard to write not because of a lack of things to say but because I have trouble putting all the awesome into a few paragraphs. Let’s try this: if you’re looking for an insight into current times, if you want a timely read that will make you think and wonder and gasp in recognition, or if you’d like to plot where things go from here, The Trouble with Reality is a must read.  Much love.