When Breath Becomes Air by Paul Kalanithi

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Paul Kalanithi spent years training to be a neurosurgeon. He was one of those dazzling people who could have followed any number of paths, studying literature, philosophy and medicine with equal vigour. He trained in neurological surgery at Stanford University, believing brain surgery was his calling. The ridiculous workload (100 hour work weeks) and literal life and death operations, his striving for compassion and excellence in everything he did, his relationship with his girlfriend, Lucy, also a doctor, are all examined in the first half of this book. Kalanithi’s love of literature shines as brightly as his love of medicine.

When he began to suffer with excruciating back pains he wondered if he had cancer, then tried to push that concern away after an x-ray came back clear. He got weaker and the pain intensified. Eventually he had a CT scan, “I flipped through the CT scan images, the diagnosis obvious: the lungs were matted with innumerable tumors, the spine deformed, a full lobe of the liver obliterated. Cancer, widely disseminated. I was a neurosurgical resident entering my final year of training. Over the last six years, I’d examined scores of such scans, on the off chance that some procedure might benefit the patient. But this scan was different: it was my own.”

Where the first half of the book is concerned with his striving to be the best surgeon he can and to help others deal with unthinkable disease and their fragility as humans, their lives literally in his hands as he operates on their brains, the second half is him looking frankly at his own situation as he makes the transformation from expert doctor to needy patient.

“Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor an patient. As a doctor, I knew not to to declare “Cancer is a battle I am going to win!” or ask “Why me?” (Answer: Why not me?)”

“Like my own patients, I had to face my mortality and try to understand what made my life worth living…”

It’s his clear thinking that engages the reader so fully. We, and everyone we know, will die. It is the awful truth we spend our days not looking at and here is someone who has studied the brain extensively, who knows what it is to look right at death, someone who writes with zinging clarity, preparing to share his wisdom with us so that we may go forwards in our own lives in a more meaningful way.

“The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.”

Everything Kalanithi had worked so hard to achieve in his future, his ambitions and hopes, were lost with diagnosis. He had to examine what was most important to him. As he wrestled with choosing between literature and medicine before specialising, he wrestled again. He returned to surgery for a while, completing his residency with customary excellence despite everything. Offered his dream job he briefly allowed himself the fantasy of accepting it, before turning it down. He and Lucy decided to have a baby. He wrote most of this book. In the end it all boiled down to the deeply personal, as it does for us all. The things that matter are the relationships we have. It’s family and friends and love that count.

This is why When Breath Becomes Air is successful. We are desperate for clues how to live, how to die, how to cope. It’s unfair to expect so much from a book. Its unfair that Kalanithi died when he was 37. Life, and death, is not fair.

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Your Father Sends His Love by Stuart Evers

  
In this collection, Evers deftly explores fatherhood. He’s an unfussy writer whose clear prose allows the stories to unfold smoothly (before sometimes tripping us up and challenging our assumptions) using small details to great effect;

“A silent cabbie aside from his metronomic sniffing.”

and

“Rosemary moved to be with her parents upsatate. Like Russian dolls, a mother retreating to her girlhood bedroom.”

“These Are The Days” is ostensibly about a relationship between a Grandfather and his Granddaughter. Twenty-one year old Anna unexpectedly turns up at her Grandfather’s home. He appears to be a doting, gentle man, but is unmasked as a negligent father and husband before once again becoming a sympathetic character as his son is revealed as a bully. It’s a tricky thing to pull off, but Evers makes character switches flow naturally and these grey areas are gorgeously insightful.

A man sits in a pub, waiting for his bereaved friend to arrive, rehearsing small talk in “Something Else To Say.”  Repetition is used to convey the sheer lack of anything useful one can say when someone’s child has died. All the vital stuff remains unspoken and yet is beautifully conveyed in this touching tale.

I think the title story; “Your Father Sends His Love” is astonishing. It’s definitely the best story I’ve read this year and is an incredibly powerful piece that I don’t want to ruin for anyone else by attempting to describe. I could not stop thinking about it for days after; I was haunted by it and it’s well worth the price of the book alone. As it’s positioned half way through the collection, the stories after perhaps suffer a little in comparison. “Charter year, 1972” seemed strangely clunky; a set up and a punch line.

The last story “Live From the Palladium” has a similar source to “Your Father Sends His Love” and I’m fascinated by how Evers takes this material and shapes it into such achy and perceptive fiction.

If you’re a fan of quietly powerful stories (and who isn’t?) then do give this a read.

An Untamed State by Roxane Gay

Roxane Gay’s short fiction has appeared in many of the literary journals I’ve read over the last eight years or so. She’s editor of the mighty PANK. She writes a wonderful blog. Her non-fiction has appeared in many esteemed publications. She basically rules Twitter with her always interesting observations. She has a very clear, authoritative voice and I have long had a complete writer crush on her. Her collection of essays “Bad Feminist” has just been published in the UK. It’s currently number 13 in the New York Times non-fiction bestseller list. Roxane Gay is really successful now which is amazing and fabulous and so bloody well deserved. 

A collection of her stories – “Ayiti” – was published in 2011 which I reviewed here. Interestingly the passage I quoted from “Things I Know About Fairytales” features in her debut novel “An Untamed State” which continues exploring the chasm in Haiti between the rich and poor and contrasts it with life in the US. 

Mireille Duval James is a young woman from Haiti who lives in America. She is smart and feisty, an attorney married to an American man, Michael. They have a baby son, Christophe. Returning to Port-au-Prince to visit her wealthy, successful parents, Mireille, Michael and Christophe set off for the beach when their car is surrounded by a group of violent criminals who abduct Mireille, demanding a huge ransom. Her father, Sebastien, refuses to pay, believing that negotiating with the kidnappers can only endanger other members of his family.

Once upon a time, in a far-off land, I was kidnapped by a gang of fearless yet terrified young men with so much impossible hope beating inside their bodies it burned their very skin and strengthened their will right through their bones.

     They held me captive for thirteen days.

     They wanted to break me.

     It was not personal.

     I was not broken.

     This is what I tell myself.

    

What follows is a difficult read. Gay’s powerful prose explores the brutality and violence that is inflicted upon Mireille day after day. I flinched from the words. This is not a book I could look forward to reading. It’s a depiction of a woman being abused in every way imaginable. The first part weaves stories from Mireille and Michael’s relationship with time from her imprisonment. It’s necessary to have the relief the memories of their courtship offer. The second part deals with the aftermath. How does a woman survive such atrocities? Tortured, gang raped, imprisoned, how can Mieille possibly move forwards? 

It’s a novel about family: Mireille’s parents and the compromises her mother makes, her father, her sister, Michael’s parents, their son, Christophe. It’s also about personal endurance, self-preservation, the political implications of poverty, violence, domination, hope and courage.  It’s an impossibly dark read. And very powerful.

When I finished reading I googled to find out more about Port-au-Prince and kidnapping. The UK government issues a warning that they will not negotiate with kidnappers believing, as Mireille’s father does, that it only increases the likelihood of more kidnaps. The BBC warn “No one is safe from kidnapping, regardless of occupation, nationality, race, gender, or age.” 

Horrifying.

 

All My Puny Sorrows by Miriam Toews

“All My Puny Sorrows” (what an excellent title!) by Miriam Toews is an extraordinary book about two sisters (Elfrieda and Yoli) and their Mennonite family. It’s Yoli’s first person account of how Elf attempts suicide and begs for Yoli’s help to die. What makes it so special is how Toews takes this devastating material and manages to make it consistently witty, genuinely funny, and real. Her own sister committed suicide, as did their father. It’s as if Toews is reporting directly from the frontline of grief. She’s such a talented writer that she’s somehow managed to form this tragic raw material into an incredible novel.

It is full of so many great lines that I highlighted huge chunks of the book. From incidental throwaways such as this:

“I hope she doesn’t have an eating disorder. I’ve read that eating disorders are often the fault of overbearing mothers, but I’m so underbearing it’s not even funny. Maybe she’s imagined an overbearing mother to compensate for my lack of bearing and it’s this imaginary pushy mother that’s caused her to have an eating disorder. She doesn’t have an eating disorder, not really. I shouldn’t try to blame something that doesn’t even exist on an imagined imaginary mother.”

To criticisms of the medical staff on the psychiatric ward for their lack of attention to Elf as she refused to obey their directions:

“Nurses in cardio are far more playful and friendly than they are in psych.
If you have to end up in the hospital, try to focus all your pain in your heart rather than your head.”

Yoli always feels spot on. I imagine she’d be the best wise-cracking stoic friend a gal could have. How she and her mother endure is wonderfully life-affirming. 


This is my book of the year. Yeah, already. I honestly doubt anything else can make me feel this way. From the perfect title, the perfect cover, to the perfect prose it’s all astonishingly good.

Read it! Read it! Read it!

 

 

Vulgar Things by Lee Rourke

After losing his job, and getting drunk, Jon Michaels finds out that his Uncle Rey has died and is persuaded to travel to Canvey and sort through Rey’s personal effects. Jon stays in his uncle’s caravan and discovers recordings, a telescope, letters – things that fracture everything he’d assumed about his life.

Vulgar Things is an odyssey firmly rooted in and around Southend. Rourke’s landscape is not the familiarly romanticised sea, but rather the bleak beauty of grey waves and scrubland. I’m from Essex myself and my parents now live on the Garrison in Shoeburyness (which gets a brief mention) – Southend is a place I know well and it was refreshing to read a novel set there. It made me realise how unheard that voice is and how far away from the TOWIE stereotype much of Essex actually is. The real Southend can be pretty brutal, incredibly sweary, seedy, grubby, violent – drunks and sex workers mingle with day trippers, old folk, families and school kids. Rourke captures this well as Jon walks back and forth from Canvey to Southend, the repetition of the journey, the landmarks he passes, building into the readers consciousness so we feel we’re walking alongside him.  Alcohol is central to the novel, as is the crackle of violence. Jon’s obsession with a woman he briefly meets is part of a deeper story – his character seemingly doomed to repeat a narrative originally played out by his uncle. The woman is wanted not for who she is but for who he imagines her to be. Even the wide Canvey sky bright with stars and planets transforms from reassuring to dizzying, disconcerting, worrying.

The whole novel has a claustrophobic feel despite the sea and skyscapes. The contained life Uncle Rey led in his tiny caravan bleeds into the present day. Jon visits the local pub “The Lobster Smack”, goes on walks with his trusty stick, obsesses over Laura, watches tapes of his Uncle reading from his novel, recorded in the same caravan, over and over. It feels airless and yet the story itself is compelling and I read on, eagerly trying to fit pieces of a puzzle together.

It’s deeply frustrating to feel my mind battle its own limitations. I knew there were layers to the story that I was missing, intentions that went whoosh over my head. Anyway, there’s a brilliantly illuminating interview over at The Quietus that anyone who is interested should go and read. Smarter folk than me etcetera. (Ah, right, Petrarch & Laura!)

Do come back tomorrow if you are interested in knowing what superhero power Lee Rourke would have and what colour he thinks Tuesdays are (Always asking the tough questions). #SmashLits

 

 

Into the Trees by Robert Williams

Into The Trees by Robert Williams

When their apparently healthy baby won’t stop crying and they have exhausted all the usual solutions, sleep deprived parents Thomas and Ann become desperate. By chance, Thomas discovers that if he takes Harriet into Bleasdale forest she calms. Raymond, a giant of a man who works as a farm hand, walks the forest at night, glad to escape his damp smothered home in Etherton. Keith goes to the forest for entirely different reasons. From each of their perspectives Williams shows how their lives become entangled.

I worried at the start that there’d be some mystical forces at play, but thankfully no, this is a very real story, shot through with William’s customary insight into the human condition. Unexpected strands are brought in and woven seamlessly into the narrative. Williams does a grand job describing Ann’s first love and the passion that’s missing from her marriage. It was Raymond and his awkwardness who captured my heart though. I know a Raymond or two, and the author’s understanding of what it is to be an outsider, what it’s like to feel so alien in the world, is quite special.

It’s a terrific exploration of fear in many of its guises. There’s no fussy writing here, just clean, clear prose. Williams’s best novel yet.

 

 

 

 

 

 

 

 

 

 

 

 

 

Vault by David Rose

Vault is a compact novel comprising brief chapters marked A or B. The A chapters pertain to a fictionalised version of the narrator of the B chapters. The B chapters are “factual” rebuttals of the novel. No wonder Vault’s subtitle is “An anti-novel”. It sounds complex, but the divisions are smartly done. B is written mainly in clear, clipped prose, whereas A employs (slightly) more flourishes of language.

A cyclist becomes a wartime sniper and afterwards something of a vigilante, and then an unofficial spy. He also falls in love and cycles competitively. That’s a pretty huge range to cover, but there is no padding, no filler in Rose’s writing and the novel is 158 pages.

His character is a loner whose aloofness serves to distance him from those around him, and his readers. Even when describing the love of his life he blankly states: “But this was all a long time ago and, later, she left me.” Nonetheless, the impact of some scenes, I’m thinking of the sniper waiting patiently to kill, and later, after the war, protecting a woman who has received food from an aid station, is heightened by the tightly controlled descriptions.

The cycling sections are beautifully exhilarating and offer welcome relief.

And how wonderful is that cover!

Vault

 

 

 

 

 

 

 

 

 

 

Rose is clearly a fine writer and I’m looking forward to reading his short story collection – Posthumous Stories, which I’ve just treated myself to.