Hazel McHaffie

Image and appearances

It’s 4 years now since I published Inside of Me, but body image and transgender issues keep popping up above the parapet, and hauling me back into that world of tortured self-doubt and secret longing.
– In the last few weeks we’ve had the BMA saying that people should be able to gain legal recognition of their changed gender without the input of a registered doctor, and indeed with no more than a witnessed sworn statement. As things stand, you need a diagnosis of gender dysphoria, and a report from a registered doctor detailing treatment received, and proof that you’ve lived for at least two years in your chosen gender, and intend living in for the rest of your life.
– But subsequently the government announced that plans to allow transgender people to self-identify as the opposite sex have been shelved; they feel that the current system means that ‘proper checks’ are in place. However the current fee of £140 is to be reduced to £5.
– Then, the transgender community, already incensed by JK Rowling‘s comments about what a woman is, have trained their sights on her yet again, because her latest Robert Galbraith novel, Troubled Blood, features a serial killer who dresses in women’s clothing.
– And then there’s the mother of a dead transgender 18 year old, campaigning to honour her daughter’s dearest wish: to have children. The youngster changed gender from boy to girl in the teen years, but had sperm frozen at 14. The mother is planning to launch a landmark legal case to preserve the sperm (now due to be destroyed) to enable her to have a grandchild via a donor egg and a surrogate mother.

Just a few of the news items. But of course, each one brought the complicated ethical issues very much back into my mind, and that in turn, led me to a book near the top of my tbr pile – For Today I am a Boy by Kim Fu.

One day I’ll grow up, I’ll be a beautiful woman.
One day I’ll grow up, I’ll be a beautiful girl.
But for today, I am a child. For today, I am a boy

This truncated quote beautifully sums up the essence of this brave novel.

Peter’s father only ever wants a son: ‘In a family, the man is king. Without you, I die – no king.’ But two daughters come first, before Peter, followed by another girl. With only one chance, Mr Huang is determined to make a real man of this longed-for boy, forcing Peter into male ways from an early age. He teaches him how to shave when he’s 6 years old, tears anything female out of his schoolbooks, approves and rewards brutish male behaviour, makes sure his son doesn’t do ‘women’s work‘ like the dishes. Peter is acutely aware that his sisters get much more lenient treatment.

But Mr Huang is steeped in Chinese traditions about ancestors and what is right. Appearances matter. He has high expectations of his only son, even whilst being unfaithful to his own wife. Peter describes his father’s mistress, the neighbour Mrs Becker,  beautifully. She was …
‘Pale and thin and seemed to quiver at the edges, like she was made of water. She had limp red hair. Her freckles were a handful of sand tossed in her face … light shone through her skin to the blue veins along her forehead … her smile looked unstable.The structure of her face couldn’t sustain the weight’ … and when she betrays Peter – ‘a jittery nobody, the human equivalent of onionskin paper.’
Mr Huang is appalled at a deep level by Peter’s ‘differentness‘, his ‘weaknesses‘. his proclivities. He must at all cost keep them secret, not shame the family, not let down his ancestors. And even when facing his own imminent demise, he reminds Peter he’ll still be watching him ‘from the other side.’

With this threat haunting him, even excursions into the female world carried out behind closed doors are fraught with fear and guilt for the conflicted Peter. When he puts on a wig, pouts his lips, looks in a mirror, ‘I felt my father staring through my eyes, the grotesque image in the mirror, the halfsie freak. The grandfather I hadn’t known, the great-grandfather, all watching as my father strove not to shame them, every day until he died. All of them watching me now.’

In this fragile tale, shot through with melancholy, Kim Fu powerfully captures the young child’s only-partially-understood longing to be other than he was. The ‘nightmare years‘ of adolescence. The ongoing desperate struggle to live up to the expectations of others – gang members, pals, work mates, family. The terrible loneliness of not being understood. The pervasive malevolent forces that would crush people like Peter Huang, learning slowly and painfully the real meaning of being a woman. The terrifying consequences if he names his inner conviction.

He becomes increasingly aware of consequences outside his battles with his own body, too; the larger fight against hatred and prejudice. ‘It’s not just about me and my body. There were marches, vigils, hate crimes, unjust laws, a world that needs education. There were other people like me … there were forces that had crushed us.

I was struck by the essential loneliness or unresolved doubt. Do any of us really understand what goes on in the lives and minds of others? Books like For Today I Am a Boy help us to sidled a little closer, understand a little better.

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Unsung heroism; disturbing challenges

I guess a lot of us have had more time for reflection and introspection during the last six months. I certainly have. So this was exactly the right time for me to read the kind of book that challenges me to think about my own moral compass and motivation and limits.

Under what circumstances would I, as a wife and mother, risk my life, or more importantly, my child’s life, to save a stranger? Would I let my young daughter starve to prove my loyalty to my country? Would I endure terrible deprivation, face imminent execution, to uphold my ideals? Would my faith in God survive seeing men, women and children being massacred needlessly; a whole race systematically eradicated? Could I live a life which meant I must lie to everyone I love, and always be afraid, never feel safe?

My kind of questions, you might think. But actually this was the kind of thinking that prompted Kristin Hannah to write her novel, The Nightingale.

She was researching World War II stories, and became fascinated by the women who had put themselves in harm’s way in order to save Jewish children, or downed airmen, some of whom paid a terrible, unimaginable price for their heroism. She simply couldn’t look away, and felt the underlying questions to be as relevant today as they were 70 years ago. As indeed they are.

Vianne and Isabelle Rossignol lose their mother to TB when 14 and 4 respectively. Consumed by his own grief, their father abandons them to the care of others. Outspoken Isabelle rebels everywhere she goes, is expelled from several schools, refusing to be either contained or controlled, and aged just 19, joins the resistance movement, initially delivering propaganda, then risking her life over and over again, escorting British and American downed airmen out of France across the Pyrenees to safety. Her code name is The Nightingale. Quieter Vianne marries her childhood sweetheart, Antoine, and after three miscarriages, gives birth to her daughter Sophie. She becomes a schoolteacher, and in the face of an ugly war and occupation of her beloved town in France, finds a courage of her own, rescuing Jewish children even whilst billeting German officers in her home.

We’ve all heard so much about the atrocities committed by the Nazis; much less of the heroism of the women of France. This book sees the 1940s through the prism of one family – totally harrowing, profoundly moving, reducing me to tears. And by homing in on the intensely personal, it seems somehow to shine a spotlight on the enormity of the whole monstrous period in history. It captures poignantly the contrast between the pain and suffering and barbarity, and the bravery and compassion, loyalty and selflessness of these courageous women, so often unseen and unsung.

The war forced people to look deep inside themselves; to examine who they were and what sacrifices they were prepared to make, what would break them. Asking ourselves those same questions 70+ years on is a challenging exercise. Even drinking a delicious cup of real coffee, knowing these women were enduring a vile brew made from acorns, made me feel chastened. Smiling and chatting to people I met out in the street felt like a luxury, when these women could trust no one – not even relatives and friends. Would I have had the courage to do the honourable thing? Or would I have found a way to argue that I had a greater duty to protect my own? I don’t know.

What I do know is that this book is a compelling read, though certainly not a comfortable one. At no stage can we have any confidence that there will be happy endings. Children die, women kill, men betray, families are ripped apart, suspicion is rife, humans behave barbarically. ‘Grief, like regret, settles into our DNA and remains forever a part of us.’

The Nightingale is superbly written, and I loved the occasional flashes forward to the present when one of the sisters is returning to Paris for a reunion of her compatriots who worked for the resistance, accompanied by her son who knows nothing of her past. We don’t know which one has survived, so this nicely preserves the tension. Whatever the outcome, these valiant women and those they represent, have my profound admiration and respect.

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Girl, Woman, Other

Did you know that last Thursday was ‘Super Thursday‘? – that day in the literary calendar when there’s a bonanza release of new books in time for Christmas. And this year, because of Covid-19 significantly delaying publication for authors across the board, as many as 600 new titles were released in 24 hours. 600! In one day!! SIX HUNDRED!! What hope is there for mid-or-below-mid-listers to be even noticed, huh? About as much as for a youngster with three C-grades-on-the-basis-of-teacher-assessment getting into Oxbridge, I’d say.

Seemed like a good week to home in on one title that has made the grade, big time: Girl, Woman, Other by Bernardine Evaristo which I mentioned in my post two weeks ago – co-winning the Booker Prize with Margaret Attwood‘s The Testaments. Evaristo is the first black woman ever to achieve this distinction, and she comes across at interview as a bundle of energy and zeal and determination. Positively effervescing! Given the high profile racial issues have been receiving of late, it could be argued that this book – its subject matter and its author – must surely be falling into fertile soil.

Girl, Woman, Other is Evaristo’s eighth work of fiction, which took her six years to complete. It’s written in a hybrid form that falls somewhere between prose and poetry, without capital letters or full stops for sentences, or proper paragraphs, line breaks being used to control rhythm and beat. Sound confusing? I know, and yet … it’s very readable (says this Booker Philistine with wonder in her voice). Here’s a wee peek inside …

The novel follows twelve characters, most of them black British women, moving through the world in different decades, from different backgrounds, having different experiences, making different choices. Each character has her own chapter, but their lives overlap and they are all interconnected in some way. Some of them are close – friends, relatives, lovers – others simply visit the same theatre on the same night. But common threads pervade their stories: oppression, prejudice, discrimination, racism, injustice, sisterhood. Which come in all shapes and sizes. Typically of literary books, there’s no real plot, but the characters challenge the reader to consider British attitudes and practices towards black women through the ages, and more importantly, one’s own prejudices and preconceived ideas.

The primary character and lynch-pin is probably Amma, a black lesbian playwright, now in her 50s, whose new play is being produced at the National Theatre in London. Her vignette starts the book; her after-play party almost concludes it. This part of the story is semi-autobiographical: Evaristo was co-founder, with two other women, of the Theatre of Black Women in the early 1980s. In between, we meet eleven other characters who range through frustrated teacher, abused partner, sassy teenager, nonagenarian farmer, non-binary person, adopted waif, and so much more besides.

Did it work for me? On one level, yes. I found the unusual writing style surprisingly fit for purpose. The characters come alive through their patois/pidgin, their disjointed paragraphs, their learned experiences over time. I especially enjoyed Carole, a Nigerian girl who rises above her circumstances – poverty, gang rape at 13, schooling in an establishment that specialises in producing teenage mothers and early career criminals – to acquire a degree at Oxford amongst future prime ministers and Nobel Laureates, and goes on to set the world of finance alight. And yet still finds herself overlooked and suspected. Then there’s her indomitable mother Bummi, determined to make a success of life against the odds, setting up her own very professional and superior cleaning services company, gradually accepting her daughter’s steps away from her African heritage, but herself accepted by the young English high society man Carole marries. I couldn’t help but take to the sassy teenage LaTisha, the queen of backchat, spouting her unique brand of philosophical wisdom and researched facts, all the while emoting pure insolence – a special skill of hers according to her teachers. And I really took to Hattie, 93 years old, a great great grandmother, still living alone and running the family’s 800 acre farm, outspoken about modern hifalutin ideas like mobile phones and non binary identity and central heating.

But for me, their brief biographies lacked a certain overall depth, and I’d have liked more development of their individual and collective stories. That in itself is a remarkable reflection. Booker Prize winners usually leave me shrugging my shoulders and saying, So what? This one left me wanting more. I’d call that a success.

 

 

 

 

 

 

 

 

 

 

 

 

 

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The jigsaw begins to take shape

You could be forgiven for thinking I’d buried my writing pen for good. Even I was beginning to be suspicious!! Well, news on that front at last.

We’ve all had to make adjustments during this past six months, but exercise has consistently been held up as a ‘good’ for everyone, even designated a legitimate reason to go out of the house during the initial country-wide lockdown. It’s certainly been an important part of my well-being. Over the weeks, my early morning solitary constitutional along mostly deserted routes has become a valuable time for quiet reflection and uninterrupted processing of ideas.

On the steeper uphill sections, when my muscles protest and my cardio-vascular system is under pressure, the activity in my brain is a welcome distraction. On the easy downhill paths the ideas rush along at an exhilarating pace.

Where the ground levels out I occasionally stop to soak up the tranquillity around me and reflect on where my brain is taking me.

There’s been so much to sort and sift and mull over arising out of this weirdly different experience of a worldwide crisis and its effects on us all, and I’ve made a conscious decision to ring-fence this time when I can leave my mind pretty much to its own devices.

I’ve become very aware that I’ve been unusually reluctant to start a new book. Normally I’m raring to go; not this year. I just haven’t been in the right place psychologically. And strangely enough, I’ve accepted that without protest. Time to concentrate of different priorities.

However, of late, the ideas and possibilities for novel number 12 have been increasingly jostling for pre-eminence in my head and begun demanding action. A structure has been gradually emerging that has stood the test of time, with the pieces fitting together rather like a jigsaw puzzle, and this very week a milestone has been reached: that outline has actually been committed to the computer. Wahey! A fairly robust skeleton methinks on which to hang more new details as they emerge. So, it’s been a long time coming but I think perhaps we might now be on a roll … ? Maybe …? Possibly …? Clovid-19 permitting …?

 

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Virtual bonanzas and bonuses

Wow! What a treat for these strange restricted times. The Edinburgh International Book Festival 2020 in virtual form. No queuing in the squelching mud and drizzle around Charlotte Square, no impatient hanging about between events, no debating the wisdom of a working day taken up travelling to attend a disappointing session. The rain is certainly hammering down as I write, but I’m snug and dry in my study, watching interviews with the great and the good, sipping excellent coffee as I take notes.

And when I say ‘the great and the good’ that includes famous faces and distinguished wordsmiths who have generously entered into the spirit of this year’s answer to lockdown and given so much of their energy and expertise. I’ll just give you a flavour of the ones that appealed most to me.

A regular contributor to the EIBF is Val McDermid. This year she appeared with real-life partner, Jo Sharp, sharing excerpts from their edited book Imagine a Country: Ideas for a Better Future, in which a cohort of Scottish writers imagine what would/could improve our nation. And aren’t we all looking at our lives and our country this year, wondering whether we could bottle the valuable things that the pandemic is teaching us about what it truly valuable, and carry them forward beyond Covid?

A highlight of their session was playwright Jo Clifford giving a dramatic reading from her contribution about respect for everyone, regardless of their orientation or origin or differences – an extra powerful message coming from a trans-woman who has endured more than her fair share of disrespect.

I was hugely impressed too by First Minister Nicola Sturgeon, who believes all politicians should read fiction, and demonstrated her own love of reading by her well-informed and fluent hosting of an interview with the first black woman writer to win the Booker Prize: Berndardine Evaristo discussing her book: Girl, Woman, Other. A stimulating hour with both.

And then there was veteran Festival speaker, Richard Holloway, formerly Anglican Bishop of Edinburgh, who has, through the years, shared his doubts and loss of faith with festival goers. This year he was talking about Stories We Tell Ourselves: Making Meaning in a Meaningless Universe. He has now returned to the church – without it he felt homeless – and is trying to live by the story that makes us disconcerted and uncomfortable and self-questioning, that in turn makes us seek to be kinder and forgiving and more compassionate in our lives. Well, that’s a laudable aim at least. But he laments the way some people take literally the great religious myths and stories that tell eternal truths: instead they should be read seriously and intelligently, and interpreted in their own context, so that they enrich and liberate the reader. Holloway is now 87, and journalist  Ruth Wishart – one of my favourite interviewers – couldn’t resist asking him if he believed in an afterlife. He promised to do his best to come back and tell her if such a thing existed. Please do, she countered, it’d be an ‘awfy good scoop!’

All three of these events offered much to ponder about the big questions in life, and the things that really matter, which is why they ticked my boxes.

Better still, in the midst of this feast of literary brilliance, I could whip up to Clackmannanshire on a lovely sunny day and savour the tranquillity of the fabulous Cowden Japanese Garden without missing out on the literary bonanza. What a bonus!

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Viral overload

A surprising number of people have asked me when I’m going to write a book about a pandemic – however, word on the writerly circuit is that this would be ill-advised… for a long time. And it’s certainly not on my radar. But OK, the current pandemic has been uppermost in our thoughts for months, so I thought I’d look at a couple of modern novels written way before this present real-life Covid-19 crisis reared its ugly head, and see what a lively imagination can come up with.

Peter May‘s 2003 novel, The Runner, features endogenous retroviruses. What viruses, do I hear you cry?  Viral remnants found in every cell, an integral part of the human genome, normally dormant, but occasionally activated by external viruses and capable of causing catastrophic damage and the emergence of very dangerous diseases … sounding familiar?! In this case, though, it’s the musculature of the heart in young, fit, elite athletes, causing thickening of the walls of arteries, and heart attacks, which the pathologists are finding.

Section Chief Li Yan smells trouble when he sees a succession of such deaths among top athletes in China. Initially they appear to have been involved in accidents or suicide, but something sinister lies beneath the facade. They all reveal strange pathologies at autopsy, and all except one have completely shaven heads. Li has been protecting his pregnant American fiancée, Margaret Campbell, for her own sake and the well-being of their unborn child, but such is his disquiet, that only she will do for post mortem examinations on these young sportsmen. In the event, infection is the least of their worries, as they become embroiled in a far more deadly and macabre race against the evil genius behind these deaths.

And once again I’m hugely impressed by May’s careful research and ability to convey complex science – this time in the world of medical genetics – convincingly and understandably.

The other book just had to be Lockdown, again by the same author, and released this year. He actually started researching for it way back in 2005 – fifteen years before this current real-life pandemic. At the time he was finding it impossible to find a publisher for The Blackhouse (hard to believe, huh?) and his first Enzo book.

But May’s vivid imagination had conjured up a chilling scenario that arose out of his fascination with viral epidemics.  He wrote furiously during six weeks, burning the midnight oil – only to find no one would touch it; it was too unrealistic and improbable. But when the current virus we’re familiar with hit this year, the novel was picked up by Riverrun and came out while the author was himself hunkered down in his home in France, forbidden from leaving his home except in exceptional circumstances – because of Covid-19.

London is at the epicentre of a global pandemic. It’s in lockdown. A deadly virus – with a mortality rate of nearly 80% – has already claimed the lives of hundreds of thousands, and the health and emergency services are overwhelmed. Familiar jargon, huh? Family funerals and religious services are banned, grief is on hold, bodies are burned within twenty-four hours. The prime minister and two of his children are among the dead. An emergency measure has been brought into force banning the printing and distribution of newspapers. Civil disorder is simmering, ‘the debris and detritus of a once civilised society scattered across the ruined streets‘, and martial law has been imposed. Soldiers are prepared to shoot on sight anyone who breaks the curfew.

A temporary overspill facility is being rapidly built, until, that is, the construction workers discover the body of a murdered 10-year-old child in the pit they’re excavating. Because of a dire shortage of policemen, DI Jack MacNeil is called out of hiding in a refuge for down-and-outs to solve the case as fast as possible so that building work can resume. This is no ancient crime scene: the bones of the child – who is Chinese and has an unrepaired hare lip and cleft palate – are still fresh, and what’s more, they’ve been recently stripped of flesh by a knife. Enter the experts – except some of them are sick with the virus. And on top of all this, MacNeil learns that his own young son has died of the flu. He throws all his energies into finding the killer of this little girl, a last hurrah before he leaves the Met for good.

In both books there are elements that raise an eyebrow when it comes to believability, but my mind raced off along different possible scenarios for future novels. However, more than that, May’s experience illustrates two salutary things for me. There is a time to publish and a time to refrain from publishing. And even the top names can hit fallow times.

PS. I was amused by one throw-away line in Lockdown: ‘no self-respecting looter was going to be seen dead breaking into a bookshop‘ …!!!

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Discoveries

It’s always a thrill to hear people are enthused by books, but I’ve been especially touched and rather overwhelmed by the response to the bookcase we set up at the beginning of lockdown. Remember this?

It’s still going strong five months on; the wood has been bleached by the sun and rain, but hundreds of books have come and gone, thanks to the generosity and appetite of strangers, and I’ve lost track of the number of people who’ve expressed enthusiasm for the enterprise. Cards and scribbled notes have been popped through the letter box; wee gifts have been left at the door. And shining through the messages, verbal and written, is a heartfelt appreciation for the healing power of reading:

I suffer from depression and my partner works shifts so I’m on my own a lot … your books really helped me to get through.

Love, love, love your little library!

I do a detour round this way just to see what books there are now.

It was great to have a purpose to my daily walk and a sense of excitement to see what would be new!

You’ve saved my sanity!

A very big thank you for keeping me sane with books from your lovely bookcase.

Every time we have passed your house we have also seen someone excited to see what book there is. We have seen children’s faces light up as they exclaim,’ There’s a Harry Potter book, Mummy!’ and that brightens our day. We pass most days and always find something interesting.

An added bonus is finding books left that I want to read myself. But this week there was an intriguing discovery. One of the books, The Sapphire Widow by Dinah Jefferies, had a sticker inside saying it was registered in a special scheme: Bookcrossing. Completely new to me. And irresistible:

If you love books let them go!

We’re helping to make the world a library, and you’ve caught a travelling book. Enter the BICD below and see where this book has been. Make a brief journal entry, then keep its dream alive … Read and Release it!

So, of course, I did – read and released and filled in the journal for this book’s travels. And discovered that thousands of books are circulating with journal entries tracking their progress. Who knew?!

The Sapphire Widow was readable too – apparently it was a Richard and Judy Book Club Pick in 2018! The year is 1935. The setting is Ceylon (present day Sri Lanka). Louisa Reeve is young, prosperous, rich; daughter of a successful gem-trader; wife of the handsome reformed gambler, and thrill-seeker, Elliot. They seem like the couple who have everything they could want – except a child. After two miscarriages, and a stillborn baby, Julia, Louisa becomes haunted by these ‘lost children’. (My kind of territory!) Her husband does his best to make her feel treasured, but gradually she becomes aware that all is not well. He is increasingly absent. Shadows fall over her charmed life.

Then, on the night of their twelfth wedding anniversary party, a police inspector arrives and shatters her hopes for ever: Elliot has been killed in a car accident. But … he was far from where he said he would be, driving someone else’s car. Why? And why did he lie? From that moment life unravels for Louisa – everything Elliot had told her, is emerging as a tissue of lies; all her memories contaminated by doubt.

Leo McNairn is the owner of Cinnamon Hills, the plantation Elliot had claimed he had shares in, and it falls to him to tell Louisa about her husband’s secret life. Had the love between them ever been real? Her life, her marriage, her dreams for the future, lie in shreds at her feet.

Parts of the plot were less well-realised than others, tension fizzles too quickly for my taste, problems are too suddenly resolved, but I enjoyed the evocative way the author captures smells, colours, textures, sounds, temperatures, bringing this exotic part of the world to life. And I’m happy to send this book out on its travels for someone else to pick up. I shall await news of its voyages with interest.

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Living in the face of death

Every now and then a book comes into your life that stops you in your tracks. When Breath Becomes Air is one such for me. The author, Paul Kalanathi, was a neurosurgeon and writer with degrees in English literature, human biology, and history and philosophy of science and medicine, garlanded with awards and distinctions. But it’s not so much his brilliance as a scholar or clinician that makes this a stand-out work, but his humanity, his wisdom, his reverence for life even in the face of death, his empathy with people.

His writing reminds me very much of Henry Marsh, also a neurosurgeon, who revealed with brutal honesty the price these gifted surgeons pay for the high-risk work they do, where a single tiny slip of the hand, or a wrong judgement call, can wreck a life. Kalanithi describes, clearly and poignantly, and entirely without self-pity, his own journey from medical student, through professional and powerful neurosurgeon, to helpless terminally ill patient. He died, aged just 37 years old. I wept with and for him. I am unsurprised that esteemed figures like Atul Gawande and Abraham Verghese have endorsed this book so comprehensively; all are giants among men when it comes to deep psychological truths about human beings.

As a schoolboy and undergraduate Paul Kalanathi read prolifically.  Literature, he came to see, ‘not only illuminated another’s experience, it provided the richest material for moral reflection’. Through reading and studying philosophy and neuroscience and ethics he pursued his goal relentlessly: ‘to seek a deeper understanding of a life of the mind.’  But he was all too conscious that his thinking didn’t sit comfortably in an English Department, and he simply couldn’t find the answers to where biology, morality, literature and philosophy intersected, or what makes life meaningful even in the face of suffering and death and decay. He craved direct real-life experience. And so it was that he embarked on a career in medicine, as so many men in his family had done before him.

His humanity and compassion pervade the accounts of various experiences along the way, bringing him eventually to specialise in neurosurgery. As he says: ‘While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves’. At critical junctures the question is not simply whether to live or die, but more than that, what makes life meaningful enough to go on living? I should have liked many more of his illuminating experiences, but their brevity served to spell out the pressure he was under, the limited time he had left in this world to record his thoughts.

Neurosurgery is a fiercely demanding discipline with its commitment ‘not only to one’s own excellence but to another’s identity’. As he says: ‘We [have] assumed an onerous yoke, that of mortal responsibility. Our patients’ lives and identities may be in our hands, yet death always wins. Even if you are perfect, the world isn’t. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients. You can’t ever reach perfection …’ The burden of this ‘unforgiving call to perfection’ was driven home ferociously when a friend and colleague jumped off of a high roof, killing himself, following the death of one of his patients.

But shining through all the high-powered knife-edge clinical precision is this particular doctor’s empathy and kindness. He learned that ‘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 his family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence’. He understood …
That  ‘a tureen of tragedy was best allotted by the spoonful‘.
That traumatised patients’ relatives wouldn’t retain devastating details in one fell swoop.
That it was irresponsible to be more precise in prognoses than you could be accurate.
That holding a patient’s hand becomes a mode of communication.
That there is more than mere biological life at stake; identity matters. ‘The call to protect life – and not merely life but another’s identity; it is perhaps not too much to say another’s soul – was obvious in its sacredness.’

Then came the devastating diagnosis of his own metastatic Grade IV cancer, and everything changed. He had ‘traversed a line from doctor to patient, from actor to acted upon, from subject to direct object’.

When Kalanithi began suffering pain in his back – pain so severe he could only curl up on the floor screaming – he rationalised away the symptoms. After all, healthy men in their thirties simply didn’t get lethal cancers, did they? Finding he was already terminally ill with extensive metastases required immense adjustments, far more disorientating and dislocating than he ever imagined. And once again he turned to literature to try to make sense of the questions raging through his mind – Solzhenitsyn, Tolstoy, Woolf, Kafka, Hemingway, Frost, memoirs of cancer patients – ‘anything by anyone who had ever written about mortality … searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again’. It was literature that brought him back to life during this time.

‘Death may be a one-time event, but living with terminal illness is a process.’

‘One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused. Severe illness wasn’t life-altering, it was life-shattering … My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced … Death, so familiar to me in my work, was now paying a personal visit. Here we were, finally face-to-face, and yet nothing about it seemed recognizable. Standing at the crossroads where I should have been able to see and follow the footprints of the countless patients I had treated over the years, I saw instead only a blank, a harsh, vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity.’ And the ground was to buckle and roil again and again as the disease progressed and the patient adjusted to his new reality.

Initially, as the tumours shrank, he set his sights on returning to the operating theatre – not the recumbent form on the receiving end of invasive treatment, but the upright one wielding a scalpel. Which he did. Even though exhausted beyond measure, only overcoming the nausea and pain by iron will, he persisted, and gradually his strength and stamina improved, alongside his fluency and technique. He began taking full responsibility for his patients, working longer hours, and despite his physical problems, started to enjoy the job once again, finding true meaning in this demanding work.

The birth of a daughter, Elizabeth Acadia, brought him a sense of joy and satisfaction hitherto unknown. But when she was only five months old, at Christmas time, the cancer began to resist all forms of treatment, and Paul made the decision to devote any energy he could summons to complete his book. Decline at this stage was unexpectedly rapid, and Cady was just eight months old when Paul died in a hospital bed 200 yards from where she was born.

Poignantly, his wife, Lucy, also a doctor, appended the Epilogue to When Breath Becomes Air – a searingly painful account of his last hours and a family’s grief. In 2013, she revealed, Paul had emailed his best friend to tell him about his terminal cancer: ‘The good news is that I’ve already outlived two Brontë sisters, Keats and Stephen Crane. The bad news is that I haven’t written anything.’ He had set his sights on rectifying this omission. When Breath Becomes Air became a new way for him to help others, a contribution only he could make; at once a moving personal story, a statement about death, and an inspiration to all who read it.

This is what courage sounds like.

Ironically, I read this book on the day when one of my granddaughters sat an exam for assessing her potential for entry to medical school. One day I might give her my copy of Paul Kalanithi’s book, but it’s too raw, too harrowing, too honest about the price doctors pay, to expose her to at this stage.

 

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Lost in Translation

One of the bonuses of this time out due to Covid-19 has been reading books quite outside my usual milieu, and taking the time to appreciate different skills and talents. This week it’s the amazing skill of translators.

Jo Nesbo is a Norwegian writer and his work has been translated into English by Don Bartlett, a freelance translator who lives in Norfolk. And boy, the result is so impressive I just had to consume two Nesbo novels consecutively – meaty tomes though they be. 

Both feature Harry Hole – a detective inspector in the Crime Squad in Oslo, loner, obsessive, recovering alcoholic, always seemingly a whisker away from being thrown out of the police force.

The Redeemer  is full of subtle moral and religious analogies and paradoxes, which I found intriguing. The plot is tortuous, the unravelling complex and detailed. Picture the scene. Shortly before Christmas, the Salvation Army, resplendent in their distinctive uniforms, are playing traditional music outside in one of Oslo’s most famous streets. Without warning, a man in a black raincoat and black woollen hat with a red neckerchief, takes aim at short range and kills one of the players with a single bullet through the head, before vanishing from sight. But it’s the wrong target. And thus begins a trail of devastation and horror.

The assassin – given the name The little redeemer – is cold, ruthless, fearless and driven. As writers, we’re always told to utilise all the senses in writing, so I was particularly taken by one particular characteristic of this man. His mother had told him that ‘the human brain can reproduce detailed images of everything you have seen or heard, but not even the most basic smell.’  He has grown up, since, unusually alert to smells. ‘His nostrils flared and drew in the faint smell of damp cement, human perspiration, hot metal, eau de cologne, tobacco, sodden wool and bile, a smell they never managed to wash out of the train seats, or to ventilate.’
He had learned to shut out noises – screams and artillery – but not smells, and he was acutely aware of this feature in the hospital where he was a teenage errand boy. One smell above all others haunted him – the smell of burnt flesh and blood from the operating theatre. It was ‘like nothing else’. Can’t you just feel the elements assembling that will drive this budding killer to hunt down and take life?

And it’s this amazing facility with language in a translated work which caught my attention. Nesbo’s background is as a singer/songwriter, and I wonder if this contributed to his ear for the lyrical in language. It’s not just the choice of words, but he uses uniquely clever and ingenious transitions between sections, beautiful linkages which serve to add to the intrigue. A couple of examples to illustrate … At the end of one section the detective presses his thumb against a cold metal button; at the beginning of the next section a different person altogether takes his finger off the button, puts down his heavy bags and gazes up at the block of flats above him. Then later, one of the Salvation Army officers says, ‘You’re lying.‘ The next section begins with the detective saying, ‘No I’m afraid I’m not’, but in answer to a completely different conversation. Brilliant. I loved it!

In The Snowman, a young boy wakes to find his mother has vanished, but her favourite pink scarf – the one he’d given her for Christmas – has been wrapped around the neck of a snowman in the garden. By the time Inspector Harry Hole arrives, everything is starting to drip and sigh in the thaw, and the snowman has ‘a slight list and poor future prospects‘. When a second woman goes missing, Hole fears he has a serial killer operating on his patch. And this conviction is strengthened when one of his colleagues traces back a whole series of women who have mysteriously disappeared. What kind of monster emerges on the day of the first snowfall, creates snowmen, and abducts women – married women with children? The Snowman. But who is he … or she?

It’s a devilishly plotted tale, with false trails, deception and suspects aplenty. Just when you think we’re about to see the monster unmasked, another set of wet slushy footprints lead off at a tangent. In this one, the plotting is the main attraction, but again the language in places is lyrical. How about this for the police inspector’s job?: he stared ‘into others’ faces to find their pain, the Achilles heels, their nightmares, motives and reasons for self-deception, listening to their fatiguing lies and trying to find a meaning in what he did: imprisoning people who were already imprisoned inside themselves. Prisons of hatred and self-contempt he recognised all too well.’

Brutal murders and serial killers aren’t my usual bag, but this is one author and one translator who have inspired my admiration. And I was taken by surprise by an unexpected phenomenon: both feature medical syndromes and inherited diseases … Now, I’m listening, even if the detail isn’t strictly accurate in one place! It’s close enough for purpose, and I never was a reader on the hunt for mistakes or anachronisms; I have too much respect for the hard work that goes into writing a book or a drama to nit pick.

Psychiatrically disturbed personalities unnerve me somewhat too: and as one such character says in The Snowman: ‘My psychiatrist says I’m just a few notches more extreme than most people’. Just what I was always afraid of!

Jo Nesbo’s novels are published in 48 languages. That’s a lot of translators. I salute them all.

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Perchance to dream …

After all these months of going nowhere, it felt like a big adventure to drive up into the Highlands for three days over the weekend. The scenery is breathtaking, and there are plenty of opportunities to tramp through the forests and beside the lochs, with no necessity for masks or sanitisers or yellow arrows.

It’s so peaceful, the mind and imagination can roam uninterrupted.

I suppose it was because of the sudden sense of freedom, that I saw opportunities everywhere.

The 18th Century seat of the Clan Campbell and Dukes of Argyll, Inverary Castle, for example … it only opened its doors to the ‘new normal’ on Friday last week, so this was just day 4 of their season, everywhere looked pristine. It’s a Covid-secure, no-touch, no-lingering, social distancing policy, so one could only dream, but how delicious to settle here in the secluded courtyard to write the opening chapters for a new novel about privilege and intrigue …

with nothing more than this tame chaffinch to disturb the serenity …

Or to enjoy the magnificence of this secluded reading space, set into the massive open stairwell …

or curl up amidst the clan tartan for a wallow in some gripping tale or other about Scottish nobles and their colourful romps …

Or maybe to perch on one of these seats in the immaculate grounds to set a scene for a new historical work of fiction …

But of course, even pre-pandemic, this would have been more dream than reality. Much more accessible, however, was a secluded seating area beside a beautiful old church, overlooking a loch …

and this little gem beside the main road: an old phonebox crammed with secondhand books, and well worth a stop … and a quick squish or two of sanitiser.

Back now to reality, but refreshed and more confident about life in the ‘new normal’ world.

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