Hazel McHaffie

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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The Last Thing I Remember

Having just been challenged by a return to psychological thrillers (as reported last week), I was in the mood to test my lockdown mettle by a bit more skirting around the edges of insanity. Deborah Bee‘s thriller, The Last Thing I Remember jumped out at me.

The author’s unusual background intrigued me too: fashion editor, magazine writer, creative marketing director. Hmmm.

There are two narrators alternating chapter by chapter:
Sarah is in an ICU with an extremely serious brain trauma, in an induced coma, following a supposed mugging. Since there are no outward signs of her consciousness returning, and she’s unable to open her eyes or move a single muscle, the staff, her family and the police all tend to be indiscreet in her presence. She discovers a number of facts: there is little expectation of recovery; she could be in a persistent vegetative state or locked-in; her husband Adam is dead; her father loves her dearly but her mother is more interested in returning to her suburban life. She’s also painfully aware that she’s being threatened – by a man who smuggles himself into the hospital claiming to be her brother. But she doesn’t have a brother …

Kelly is a bolshie, foul-mouthed teenager, from a seedy London secondary school, Sarah’s next door neighbour, and now a constant visitor at her bedside. Why? Breaking the habit of a lifetime, she reveals more and more of her own story as well as Sarah’s. We see a formidably tough, strong kid who has learned the hard way how to fend for herself in the face of cruelty, injustice and danger, who has her own moral code, her own way of seeking justice. Her friendship with Sarah is an unlikely partnership based on a shared understanding, and a determination to win through against the odds.

As the hours and days pass, Sarah, trapped in her unresponsive body, gradually pieces her own narrative together, coupling overheard conversations with flashes of returning memory. Kelly is dogged in her efforts to bring Sarah back to a sentient life; she has her own reasons for wanting to communicate with her friend and mentor. Together their contrasting voices tell the tale … a tale involving dark issues: bullying, gang crime, domestic violence, paedophilia. And the emerging picture highlights the ripple effect that can, in the end, destroy lives and wreck families; how easy it is for a moral compass to swing away from true north. In the same circumstances, would any of us do better?

I confess I wasn’t a fan of the repeated use of the f-word, or ‘like’, or repetitive phrases, in Kelly’s sections, but I could admire the plotting and development of the characters in this debut novel. It certainly held my attention and offered real distraction. Thank you, Deborah Bee; you were part of this week’s therapy!

 

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Look Behind You

Treading too close to delusion and insanity is bad for my health! I knew that when I was in my early twenties: I steered well away from psychiatry during my training, all too aware of the fine dividing line between normal and abnormal. I’m conscious of that same sense of unease when I read excellent novels about psychological and emotional fragility or abuse.

But having had a healthy break from psychological thrillers recently, I decided it was time to get back into them. So I chose Look Behind You by Sibel Hodge from my bookshelves, and was instantly sucked into that tense feeling when someone is playing with your mind, and you really don’t know what’s real and what’s imagined and what’s dangerous.

From the outset we’re dragged into a terrifying world, where the borderline between reality and fantasy is frighteningly blurred. 27-year-old English teacher, Chloe Benson, emerges from unconsciousness unsure where she is … is she coming to during an operation? after an accident? a bomb blast? in prison? after a terrorist attack? Her bewilderment and growing terror are palpable. Whatever the precursors, her senses tell her that her wrists and ankles are bound with rope, her head is splitting, she’s in some kind of underground tomb, surrounded by the smell of earthy mouldiness, dankness and decay. But why is she restrained? Who has abducted and imprisoned her? And what has happened to reduce her to this state of amnesia?

When she eventually escapes, more torment awaits her. No one seems to believe her story – not the doctors, not the police, and certainly not her husband, Liam. What’s more there’s ample evidence that she has a history of depression and hallucinations, paranoia and delusion. She’s even been sectioned under the Mental Health Act and detained in a psychiatric hospital. Papers and Liam attest to that, and the fact that her mother committed suicide.

Could she have imagined it all?

What is an indisputable fact, however, is that somehow she has lost seven weeks of memories. The doctors say she’s had an adverse reaction to medication – records show it’s happened before after a miscarriage. Is this simply another psychotic episode? By the time she’s sent home from hospital she has no idea what the truth is.

‘…the only one who really believes me is me, and until I know the truth, my life is in danger.’

Painfully, little by little, she pieces together the last seven weeks. Doubts and fears mount. And her conviction that someone is determined to harm her grows daily. Where can she go? Who can she trust? Not her husband certainly; she has endured two years of psychological abuse from him; she’s quite sure of that. Her best friend has gone into a retreat abroad, and is somehow unreachable. Her boss has as good as fired her, and one of her staunch allies among the students is under investigation by the police. There are no independent witnesses to verify Chloe’s version of events; the police repeatedly draw blanks, so they’re forced to the conclusion that it seems highly unlikely that any crime has been committed.

We, on the other hand, know something bad has happened. We’re on tenterhooks as Chloe relaxes her guard … will whoever harmed her strike again?

‘The constant fear is a burning hole in my chest as I blindly wait for something dreadful and painful to happen. I’m driving myself mad with it. I want it to be over.’

A large part of her doesn’t want to know the answer. The human brain is capable of blocking traumatic memories with amnesia, and some things are too awful to remember; could this be one of them? If she gets to know what really happened, she’ll be forced to re-live the horror of the underground tomb, feel again the terror … When she starts scrutinising the people around her, looking for clues, looking for suspects, everyone seems sinister or weird. But she can’t spend the rest of her life looking over her shoulder.

When the appalling truth finally reveals itself, Chloe feels something akin to a sense of resigned calm. Sometimes it’s easier to just give up and give in to the fate destined for you. The waiting is finally over. She doesn’t have the strength to resist any longer. And it’s then that the police finally accept her story.

Phew. It was a relief to get to the end of this one. It reminded me of SJ Watson’s Before I Go to Sleep: you’re suspicious of everyone and everything. An uncomfortable place to be. I felt decidedly edgy all day until I knew the truth. Good thing I didn’t specialise in psychiatry, huh?!

 

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Talking Heads and buzzing brains

This lockdown experience has offered a unique opportunity to take stock and think through my writerly options. Masterclasses online, bonanza reading binges, virtual literary festivals, quiet time, space … everything has been guiding me towards the formulation of a plan.

This week added another range of possibilities. You might remember Alan Bennett‘s playlets, Talking Heads, being broadcast back in 1988 – yes? I can hear Bennett’s own Yorkshire voice in my head still – droll, deadpan, downbeat, almost monotonous. So little is said; so much evoked. Famous actors (Patricia Routledge, Thora Hird, Julie Walters, Maggie Smith, Eileen Atkins, Penelope Wilton, Stephanie Cole, Bennett himself) took on the persona of each character and breathed life into those monologues – the alcoholic vicar’s wife, the paedophile, the antique dealer, the trapped aging son of a woman with dementia, the poison-pen letter writer … No subject seemed to be off limits, no matter how bleak. The characters were almost all inadequate, naive, suppressed, unfulfilled, and their perspectives invited pity blended with ridicule.

Thirty-two years on, new lockdown versions of these brilliant soliloquies have just been streamed again on BBC1, plus a couple of new ones written by the now 86-year-old Bennett. Perfect programmes to conform with the restrictions of this Covid-19 era, with household names such as Imelda Staunton, Harriet Walters, Martin Freeman, Sarah Lancashire, Jodi Comer, Maxine Peake, reprising the roles. And this time I’ve been viewing them much more critically. The writing is superb with the railway-line repetitive ‘I said …, he said …’ thrumming through them all, and the incidental one-liners masterclasses in themselves:
Borage bullying its way all over the borders
There’s been a verucca here, but it’s extinct
England offers more scope for caring than the bush
They don’t expect you to be an atheist if you’re a ‘Miss’

Shutterstock image

Just how did Bennett judge how much to spell out, how much to leave to inference? How did the thespians convey so much more than the words? How does the pathos somehow become so comical? What is it that keeps the suspense, forces me to watch and to anticipate and to think? Is there strength in the sheer breadth of issues covered, or could the format tease out nuances across a narrower spectrum of life experiences?

And a lightbulb went on!! My brain is currently toying with brand new possibilities for my own writing.

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The Lewis Trilogy

In the Lewis trilogy, the author, Peter May powerfully captures the atmosphere of the Outer Hebridean Islands, the customs, the traditions, the sparseness, the struggle to make ends meet, the quiet stoicism of Lewis men, the long reach of past events. As one reviewer put it: the emotional secrets of the bleak island are even deeper than its peat bog. I found the books completely mesmerising and so evocative of the islands as I experienced them a couple of years ago, and beguilingly empathetic.

Central to all three novels is Detective Inspector Fin MacLeod. Not only is he familiar with the terrain, but he was born and raised on the Isle of Lewis, so when, in The Blackhouse, he’s sent there to investigate the brutal killing and evisceration of a man he went to school with, the case resurrects memories of the past with searing intensity. His parents’ death in a hit-and-run car crash when he was only 8; his friend’s terrible accident, which left him crippled for life; the tragedy that befell his best friend’s father on Fin’s initiation into an ancient island tradition; his broken relationship with Marsaili, the girl he loved. He’s acutely aware that something dark is lurking within this close-knit community. Ghosts begin to surface, skeletons to rattle, ramifications from those dimly-understood childhood days.

The entire set of books is firmly based in reality. Blackhouses date back thousands of years, but examples have been preserved on the Isle of Lewis to this day (as in the photo above). The medieval Lewis chess men are still in existence today. The customs too are genuine. Vivid descriptions of the islanders fighting against raging storm-laden seas, negotiating sheer rock faces, living out their enmities and grudges, the annual pilgrimage by the men of Ness to cull 2000 gugas on a rocky outcrop in the raging Atlantic seas, are nail-bitingly tense. And against such authenticity, the revelations of what had really transpired all those years ago, feeling the shutters lift in Fin MacLeod’s mind, the awful truth emerge, as a huddle of men hunch together in the smoke-filled blackhouse, is all the more horrifyingly poignant.

Although Fin’s eyes were closed, they were open wide for the first time in eighteen years. The sense that he had had all his adult life, of something that he could not see, something just beyond the periphery of his vision, was physically painful. He was rigid with tension. How could he not have remembered? And yet all his conscious thoughts were awash now with memories, like the vivid recollection of scenes from a nightmare in the moments of waking.

I didn’t see the denouement in the first book coming. It’s brilliantly realised.

In the second book, The Lewis Man, Fin is called back to the island when the body of a young man is dug up in the peat bog, where it has lain undisturbed for over fifty years. It’s extremely well preserved and DNA samples match it to Tormod Macdonald, the father of Fin’s childhood sweetheart, Marsaili, and great-grandfather of his own granddaughter. The dead man has been murdered; stabbed many times, bound and dragged along a beach. But Tormod has dementia, advanced to a point where he has had to be put into care; he’s in no state to explain the connection, nor why he adopted the identity of a dead teenager. By this time, Fin, newly divorced and still grieving his own personal tragedy, has quit the police force.

‘Most people spend their lives never knowing what lies beneath the stones they walk on. Cops spend theirs lifting those stones and having to deal with what they find. I was sick of spending my life in the shadows. When all you know is the darkest side of human nature, you start to find darkness in yourself. And that’s a scary thing.’

But for the sake of Marsaili, and his new baby granddaughter, he is ready to apply all his skills, use his many connections, to unearth the truth, before the big guns from the mainland arrive, with no sensitivity for the ways of islanders, the silent stoicism, fierce loyalties, unforgiving weather, the unwritten rules, the harsh religious strictures. And what he finds is a tangled web of deceit and treachery, once again with sound foundations in the realities of life in the islands in the 50s. I was completely with Fin as he travelled the islands and the streets of Edinburgh piecing together the threads of half a century of cruel behaviours and tribal warfare, driven by a need to assuage his own sense of loss and deprivation as well as give Marsaili and their son, Fionnlagh, the answers they need to anchor their own identities.

In the last book, The Chess Men, an aircraft missing for seventeen years, is discovered in the residual mud and slime of a fifty foot deep crater left behind when a loch mysteriously and suddenly empties itself of water. What’s more, and even more oddly, the plane belonging to Ruairidh McKenzie, talented and successful Celtic rock star, is intact and undamaged. But inside is a body with terrible damage to the right side of his face and his skull; inflicted before death. And Fin, by now drafted in to help curb the poaching of fish and game on an estate, spanning vast tracts of inaccessible land, is instantly involved: his childhood buddy is centre stage, chief suspect.

By this time, I confess, my credulity is being stretched a tad too far. I’m not persuaded Fin’s life would have taken this path; and it’s hard to credit a string of murders on this island where it’s so safe nobody locks their doors and the police have very little experience with serious crime; and there’s a curious mismatch between the characters in the first two books and this one. The childhood escapades of Fin and his schoolboy cohort seem contrived and rather dull too, lacking the psychological depths and appeal of the previous writing. Nor was the denouement worth the effort of ploughing through so much inconsequential filling. So a huge disappointment.

Which all goes to show that even great writers can fall below their own high standards at times – heartening for us lesser mortals. And I’d still highly recommend the first two books. Oh, and a visit to the Hebridean islands!

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Coffin Road

If I were given the choice of where to live out six months of quarantine from a deadly virus, one of my first choices would be Luskentyre on the Isle of Harris. It’s breathtaking. Mesmerisingly, deeply, stunningly. Silver sands, clear turquoise water, utter tranquility.
The sea breathes gently upon the shore, phosphorescent foam bursting silver bubbles over gold.
But wild and unforgiving when ferocious storms sweep in across 3000 miles of uninterrupted ocean.

To set a dark and murderous tale against such loveliness seems somehow both incongruous and inspired. But that’s what Peter May has done. It’s only two years since I walked on those unbelievable beaches, drove along those deserted coastal roads, felt the icy salt-laden air roaring in off the Atlantic, so I had to read Coffin Road, and re-imagine the scenery he conjures up so vividly, my own personal memories enhancing enjoyment of his compelling storytelling.

A man washes up on the beach near his house not knowing who he is or where he is or what has happened to him. He’s wearing a life jacket which has saved his life, but why was he in the sea and why is there a terrible sense of dark foreboding hanging over him, a sense of knowing that something terrible has happened? Has he committed some sort of crime? Why is someone threatening his life now? The only clue to his identity is a folded map of a path named Coffin Road.

‘I cannot even begin to describe how dissociating it is to look at yourself without recognition. As if you belong somewhere outside of this alien body you inhabit. As if you have simply borrowed it, or it has borrowed you, and neither belongs to the other.’

An elderly woman recognises him, drenched and dazed, and walks him to his house; she calls him ‘Mr MacLean’. But there’s nothing in the house to give him any clues as to his identity. Even his computer seems to be wiped clean: nothing but blinking emptiness, even in the trash can. How can every trace of him have been removed so comprehensively?

By dint of careful listening without betraying his amnesia, he learns from neighbours that his first name is Neal, and he’s an academic from Edinburgh, writing a book about three lighthouse keepers who mysteriously vanished from Eilean Mòr, one of seven islands in the Flannan Isles to the west of the Outer Hebridean coast. It’s supposedly almost finished. But he quickly establishes that this isn’t, in reality, true. So who IS he, and why has he been lying about his life and reasons for being on Harris?

When a bludgeoned corpse is found on the very island Neal had visited he has a fearful dread that he must have been responsible for it. And since he can’t answer any of the police detective’s questions satisfactorily, they too believe he must be the guilty man.

Meanwhile miles away in Edinburgh, a teenage girl is desperate to discover the truth behind her scientist father’s suicide. Why did he abandon her? Was she to blame? Her last cruel words to him will be forever printed indelibly in her mind. Her quest takes her into grave danger and threatens to blow open a secret that could jeopardise the future of the human race and the planet.

 

I don’t want to give away any spoilers, but another aspect of this story that resonated with me, is that it involves bees, and we actually have three hives in our garden. We’re very aware of the essential role they play in the food-chain and existence of life on this planet, and watch anxiously if there is any hint of danger to them. So it was weirdly spooky when, coincidentally, as I was reading Coffin Road, our own bees swarmed no less than three times in two days! Unprecendented. Sent a shiver down my spine, adding to the sense of total immersion in this story.

I’m a fan of Peter May, as regular readers know, so I’m hoping to use the extra time of lockdown to start the famous Lewis Trilogy next. It’s been waiting for just such an opportunity. And revisiting the landscape of the Outer Hebrides through Coffin Road, has put me thoroughly in the mood.

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More festival fun

Wow! I’ve just attended my THIRD virtual book festival of lockdown! Feels like a real indulgence. This one was another trip to MyVLF, a free global virtual literary festival, connecting readers with authors.

This time the focus was on historical fiction and included a stellar cast of well known names – Kate Mosse, Victoria Hyslop, Alison Weir, Elizabeth Buchan, Bernard Cornwell. Of course, they were speaking from their own homes, and I was amused to see them in relaxed lockdown mode (without benefit of hairdressers, makeup artists, camera men) side by side on the same screen with their professional promotional photos. But grooming aside, they were every inch the polished, fluent and accomplished professionals in their performance: responding to interview questions, sharing their favourite time periods, their experiences researching their topics or drafting their stories. And a day of listening to them positively enthused me, the old brain whirring into writing mode again.

They also inspired me to dig out a hitherto unread historical novel from my shelves: Philippa Gregory‘s Three Sisters, Three Queens … another household name. Perhaps the craftsmanship behind it will be even more apparent to me now that I’ve just heard about the painstaking work that predates writing such a book, the importance of a firm scaffolding of facts through which characters can weave and wander. Certainly I shall appreciate all over again the way the author must immerse herself in the dates and customs and places and mores of the time, even though most of the research never gets into the book. That’s a lesson I learned early on in my own career as a novelist: the reader mustn’t be aware of the knowledge you the author have acquired, but of course, hearing these marvellous writers talk about their obsessions, what they’ve learned, how much they know, serves only to make admiration of the finished product the more sincere.

Three Sisters, Three Queens will make a change from being back in my own specialist field of medical ethics, too. Three years ago exactly I wrote a post on this blog which looked at the subject of children in trouble through the novels of Susan Lewis. By some weird coincidence this very week a neighbour left the sequel to Stolen, the third book I mentioned back then, on the shelves at the end of our drive. Well, I had to read it, didn’t I? At the end of Stolen, Charlotte Goodman had fled to New Zealand from the UK with a little girl she had stolen from abusive parents. You said Forever picks up the story five years later. By this time Charlotte and lawyer husband Anthony have two other children biologically their own. Chloe, now legally adopted by Charlotte but not Anthony, is causing mayhem both at home and at school. When she threatens the life of the younger children, Charlotte knows drastic action is needed. But what? How can she choose between her children, the little people she loves more than life? She promised Chloe a forever-home; but can she keep that promise?

Lockdown is certainly affording me plenty of new experiences. I’ve even cut my own hair – very very short, slicing into three fingers at the same time! And painted the outside of our windows and doors, and renovated and wallpapered a walk-in-larder. Much ladder-climbing involved. It might just be a relief to get back to sitting safely at my desk writing!

 

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Three months and counting

Milestones are useful hinges for reflection: three months ago this week the first Covid-19 death was reported in the UK. Since then, as per the official statistics yesterday, in this country there have been a further 39,727 deaths recorded where the deceased had a positive test for the virus. Say that again slowly – THIRTY-NINE THOUSAND SEVEN HUNDRED AND TWENTY SEVEN DEATHS. Not to mention the legion of unconfirmed cases. These are indeed unprecedented and calamitous times, so it seems fitting to consider something quite different here. Not a book; not a scientific paper; not even a film. But a newspaper article.

A beautifully written article in the Review section of the Guardian on Saturday, and one of the most sobering and moving pieces I’ve read in the proliferation of writings about this devastating disease. I wasn’t surprised to find that, before going to medical school, the author, Dr Rachel Clarke, was a current affairs journalist and documentary maker.

Her usual habitat is palliative care medicine in a hospice, but during this crisis she’s been working with patients dying of coronavirus. Politicians and journalists speak ‘loftily, from afar, an Olympian perspective’, she writes, and listening to them can feel like ‘a mathematical abstraction, an intellectual exercise played out in curves and peaks and troughs and modelling‘. But where she is, in a hospital, dealing with real people caught up in this horror, ‘the pandemic is a matter of flesh and blood.‘ And she is utterly appalled by the gloss the politicians have been putting on the devastation and loss.

Used as she is to comforting, hugging, being up close and personal, the very execution of her job now cuts her to the quick.
‘In PPE, everything is sticky and stifling. Voices are muffled and smiles obscured. Sweat starts to trickle into your underwear. Even breathing takes more effort. Behind our masks, we strain to hear each other speak and are forced to second guess our colleagues’ expressions. Being protected entails being dehumanised.’
Approaching relatives of the dying is immensely painful and counter-intuitive.
‘I am a doctor with neither name nor a face. My hospital badge is hidden from view and my eyes – the only part of my face still visible – are obscured by a layer of Perspex. So much for the healing presence of the bedside physician. I scarcely look human … Everything about this is wrong.’

She illustrates her experiences poignantly with reference to a single encounter with an 89-year-old man slowing drowning in his own secretions. His sons, bewildered and afraid, enter the other-worldly scene only for the last farewell. Her own emotions plummet as she watches helplessly, unable to offer the human warmth that is her instinctive response. Neither she nor they, want this elderly gentleman to be a mere statistic – a number reported in the next day’s death toll. He is so much more than that.

Dr Clarke and her colleagues at the frontline know for sure that the soundbites trotted out at the central podium in Downing Street each day have not been borne out by the reality in the Covid wards or the care homes. Social isolation, PPE, testing, lockdown – the deficiencies and delays and shortfalls have appalled them; the article captures the discordance perfectly.  Once lockdown was established, and the quarantined population were trying to manage its fears using ‘the unconventional strategies of baking bread and stockpiling toilet rolls’, the medical staff were reeling. Fearlessly, urgently, frenetically, they threw themselves into delivering high-quality pandemic medicine. They could only look on in disbelief as staff were obliged to fashion PPE out of plastic bags, patients were sent into care homes without tests to establish their Covid status, and restrictions were being lifted in the absence of the necessary infrastructure for proper testing and tracing.

The country may be letting its collective breath out cautiously as the numbers decrease, but they are still battling this deadly enemy. They feel sick as the politicians declare the success of their strategies; they know at first hand the stupendous costs of delay and deficiency, the real tragedy of thousands upon thousands of deaths and bereavements. They were, they still are, there, ‘up close with this dreadful disease‘,  seeing ‘the way it suffocates the life from you‘. For them political judgements ‘were grotesque‘. They themselves are ‘exhausted, stunned – shellshocked, even‘. Clarke’s verdict? The loss of so many vulnerable citizens is ‘entirely and inexcusably wrong … no one is expendable‘.

I certainly don’t envy any of the people who must make these decisions, but putting a spin on the devastation, peddling untruths and half statistics, making false promises, doesn’t engender trust or confidence. And as Dr Clarke says, ‘The point of our response to corona virus is not to flatten curves, ramp up headlines, protect the NHS or invent mathematically nonsensical equations: it is to prevent unnecessary dying’. And there you have it. The heart of the matter. Summed up by someone at the very kernel of this global catastrophe.

She’s the author of Dear Life, paperback version due out in September this year. It’s top of my wish list.

NB. To be fair, First Minister Nicola Sturgeon, in her daily updates for Scotland, always stresses the tragedy of every single death.

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