Body and mind

What are the pros and cons of getting genetic testing if your parent has Huntington’s Disease? What about dating and relationships?

A resident in the pediatric intensive care unit wants patient education information about shaken baby syndrome and traumatic brain injury.

A mother whose child has just been diagnosed with epilepsy wants to know if a special diet will help.

At teaching rounds, medical students on their first patient rotations are led through the process of making a diagnosis. “He has weakness in his arm and leg,” says the neurologist. “If his symptoms are on the right side, where is the lesion in the brain?”

These are some of the situations I’ve seen as a medical librarian. Sometimes we forget how precious and fragile are our bodies and minds. We can walk, run, speak, love, laugh, cry, sing, read, write, think, create, make plans, give comfort, enjoy a meal with family and friends. Until one day something changes.

I know from personal experience a mind can become irrevocably altered and an identity can vanish seemingly overnight. Which is probably why I am so fascinated by medicine, especially medicine having to do with the brain and behavior.

Here are some of my favorite books (fiction and nonfiction) about illness, recovery, medicine, the search for cures and miracles, and the people caught up in it all: medical professionals, researchers, patients and families. If you follow my blog, a few of the books will be familiar.

FICTION

I Know This Much Is True book cover

I Know This Much is True, by Wally Lamb

“On the afternoon of October 12, 1990, my twin brother Thomas entered the Three Rivers Connecticut Public Library, retreated to one of the rear study carrels, and prayed to God the sacrifice he was about to commit would be deemed acceptable.”

This is the best evocation of schizophrenia I’ve ever read. Wally Lamb is my hero.

By the way, Wally’s newest novel, We Are Water, was just published this month. It is on my nightstand in my little stack of books to read.

Saturday book cover

Saturday, by Ian McEwan

A neurosurgeon. Huntington’s Disease. A home invasion. A poem.

(The poem nestled deep within the plot sparks a crucial turning point. It also happens to be one of my lifelong favorites.)

State of Wonder book cover

State of Wonder, by Ann Patchett

“She was not terrified that the patient would die or she would lose the baby, she was terrified that she was doing something wrong in the eyes of Dr. Swenson.”

“I write with unfortunate news of Dr. Eckman, who died of a fever two nights ago. Given our location, this rain, the petty bureaucracies of government (both this one and  your own), and the time sensitive nature of our project, we chose to bury him here in a manner in keeping with his Christian tradition….Despite any setbacks, we persevere.”

We Are All Completely Beside Ourselves book cover

We Are All Completely Beside Ourselves, by Karen Joy Fowler

“…I’d made a careful decision to never ever tell anyone about my sister, Fern. Back in those college days I never spoke of her and seldom thought of her…..Though I was only five when she disappeared from my life, I do remember her. I remember her sharply – her smell and touch, scattered images of her face, her ears, her chin, her eyes. Her arms, her feet, her fingers.”

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MEMOIR

God's Hotel book cover

God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine, by Victoria Sweet

Inspired by Hildegard of Bingen (12th century German mystic and medical practitioner), as well as her own instinct for compassionate, attentive care, Dr. Sweet practices “slow medicine” at the last almshouse in the U.S. as it transitions to the modern age. We should all have a physician like Dr. Sweet.

My Beautiful Genome book cover

My Beautiful Genome, by Lone Frank

“…we are each of us temporary depositories of information that has an almost eternal life, and which is passed on and on and on…”

“I am what I do with the beautiful information that has flowed through millions of years through billions of organisms and has, now, finally been entrusted to me.”

Facing your heart of darkness for love: State of Wonder

StateofWonder.jpg

“She was not terrified that the patient would die or she would lose the baby, she was terrified that she was doing something wrong in the eyes of Dr. Swenson.”

 

Ann Patchett’s State of Wonder is about a life severely, intentionally curtailed.

Marina Singh is a successful scientist conducting important research at a pharmaceutical company. Only she knows that long ago she’d bailed out of her own life.

When Marina was a chief resident in obstetrics, she performed a complicated delivery that ended badly. There was a lawsuit. Her marriage to a fellow resident dissolved. She wasn’t asked to leave the residency program, but she felt compelled to punish herself and leave on her own.

That way, she never had to face her classmates, or patients, or the brilliant, intimidating Dr. Swenson, again.  Anick Swenson had been the attending physician on call the day of the crisis. All the medical students both revered and feared her.

“She was harder on the women…She would tell them stories of her own days in medical school and how when she came along the men knit their arms together to keep her out. They made a human barricade against her, they kicked at her when she climbed over them, and now all the women were just walking through, no understanding or appreciation for the work that had been done for them.”

Marina never told her mother why she abruptly decided not to become a doctor. She never told her lover, Mr. Fox, who is president of the pharmaceutical company she works for. She never told her close friend and colleague, Anders Eckman, who has just died of fever in the Amazon jungle.

Now, Anders’ wife has begged Marina to find out what she can about Anders’ death and retrieve his body. And Mr. Fox has asked her to check on the progress of a top secret research project being conducted by none other than Dr. Swenson, who makes it a practice of remaining incommunicado.

Marina doesn’t want to set foot in the jungle, and she doesn’t want to see Dr. Swenson. But she goes, because she cares deeply for Anders, who has left behind a wife and three young boys.

Here is the particular nugget of the story I keep coming back to:

“The great, lumbering guilt that slept inside of her at every moment of her life had shifted, stretched.”

Marina has suffered and continues to suffer deeply, even though her suffering is hidden away. She knows what she’s lost. She was a bright, capable young woman who wanted to devote herself to caring for women and helping them bring new life into the world. Yet in the space of a few hours she walked away from it all. She’d spent the greater part of her adult life only half alive, using a fraction of her potential. She seems to be very much alone; she holds the other people in her life at a distance, and she settles for a less than fulfilling relationship with Mr. Fox.

Marina has never gotten over her past. She locked it away in a dark corner of her mind and got on with life. Facing her demons is the psychological story within the story of Marina’s journey into the Amazon jungle. It turns a plot driven novel into something more urgent and real for the reader, even if the reader is only half aware of it.

This fusing of outward adventure and inner journey is what ultimately made it impossible not to follow Marina into the darkness. I revisited some of my own life issues as Marina revisited hers.

I admire Marina, but not all of the decisions she makes as her story unfolds, and that’s as it should be when reading about a character who is real, alive.

The essential story in this book, for me, is the reclaiming of a life. By the end of the story, I was different.  Not in a dramatic way, but nonetheless something had shifted.  A truly great book such as this one stays with me and continues to wield its power. And I can’t begin to measure the impact of many books read over a lifetime.

Some people say the book is in danger of disappearing. But in a recent essay, Timothy Egan writes that people are actually reading more and buying more books. I think we will always hunger for the power of story and the collective wisdom of the great writers and thinkers.

 

 

Blue mushrooms and yellow tree bark – what would you do? State of Wonder

I write with unfortunate news of Dr. Eckman, who died of a fever two nights ago. Given our location, this rain, the petty bureaucracies of government (both this one and your own), and the time sensitive nature of our project, we chose to bury him here in a manner in keeping with his Christian tradition….Despite any setbacks, we persevere.

The letter writer, Dr. Annick Swenson, is a fearless force of nature.

Marina Singh, the protagonist, is not.

Watching the relationship between these two women unfold in Ann Patchett’s State of Wonder was one reason I couldn’t stop turning the pages.

If you’ve read the book or are in the process of reading it, I’d like to know what you think about these two women. Do you like them? Do they change as the story unfolds? For better or for worse?

What do you think about their relationship with men? I found myself comparing Dr. Swenson’s relationship with Dr. Rapp to Marina’s relationship with the men in her life, especially her father and Mr. Fox.

Any thoughts about Marina’s nightmares, induced by taking a drug to prevent malaria?

The conventional roles of mother, father, friend, lover, husband, wife, and child seem to become less strictly defined and more fluid as the story unfolds. What do you think about that?  Consider the Lakashi tribe, too.

What exactly was Easter all about? What do you think of the way Marina, Dr. Swenson, and other characters treated him?

Many of Patchett’s characters must make difficult moral choices. Do you agree with the choices they made? Do any surprise or upset you?

We encounter addicting yellow tree bark, blue mushrooms with hidden power, and lavender moths unlike any other species of moth. What do you make of how the characters responded to these discoveries? What would you do?

Please tell me what you think about any of this in the comments below. There are bound to be disagreements – the more discussion, the better!

What Albert Einstein Said to a Girl
It occurred to me that the books I’ve featured on this blog have so far been about strong, independent women departing from traditional roles.  When I was checking my email subscriptions before I wrote this post, I found this:
Albert Einstein once had a correspondence with a young girl who wanted to be a scientist. She regretted the fact that she was a girl but said she’d grown resigned to it. She hoped Einstein wouldn’t think less of her for being female.
You can read his reply in Brain Pickings, a website about creativity that I like, in a post about women in science.

The letter is from Dear Professor Einstein: Albert Einstein’s Letters To and From Children.

The quote at the beginning of this post is from State of Wonder by Ann Patchett, HarperCollins Books, 2011

Let’s read Ann Patchett’s State of Wonder

A handful of surprises await you in Ann Patchett’s State of Wonder.

Patchett has a way of blindsiding you with plot twists and moral dilemmas that leave you confused, off balance, maybe even a little pissed off. You’re left wondering – would that character really do that? In her situation, what would you do?

Some background: I became a medical librarian as a second career, and an unexpected pleasure has been working with medical students, nursing students, and residents just getting started in their careers.

About half of the medical students I meet are women. Back in the day, a couple of my female college friends became physicians, but they were the exception rather than the rule, and I don’t think most of us had the level of confidence I see in young women today.

I love seeing the amazing energy and commitment of today’s students, yet I know every day they are under an incredible amount of stress. That’s one of the reasons I was drawn to Ann Patchett’s State of Wonder.

It’s about a young obstetrics resident, Marina, who makes a terrible mistake that causes her to abandon medicine. The book picks up years later, when she travels alone into the Amazon jungle to investigate the death of her lab partner and fulfill a mission for the pharmaceutical company she works for.

Her mistake continues to cast a shadow over her life.

State of WonderThe other reason I was drawn to this book is, quite simply, I love everything Ann Patchett writes.  I’ve been a fan ever since Bel Canto.

It was the featured title a few years back in an annual event here, “If All of Rochester Read the Same Book.” Ann visited Rochester for three days and gave readings and talks at local schools and in the community.

When State of Wonder was published, she returned to Rochester and I attended one of her readings. The scene she read featured a terrifying encounter with an anaconda. You could have heard a pin drop.

Ann talked about a trip she took to the Amazon and how she got the idea for the scene, and the book. Turns out she had her own encounter with an anaconda, and she shared a few choice details about that with us. Such as the fact that the serpent smell was so strong, she had to throw away the clothes she’d been wearing.  Every last stitch.

Ann Patchett said she didn’t like the Amazon. It was creepy and she wasn’t going back any time soon.

Which gives you some idea of what Marina is faced with in State of Wonder. Marina is a strong woman (though she doesn’t know it). In a sense, the great mistake of her youth follows her into the jungle and this time she can’t avoid dealing with it.

The neat thing about this book is, you can travel to the Amazon jungle without taking any of the risks, just by slipping inside Marina’s skin.

It’s one hell of a trip.

I’m going to start (re)reading State of Wonder this weekend. Won’t you join me? Please take a couple of weeks to get started and we’ll meet back here the second half of April to talk.

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