Modern Death: How Medicine Changed the End of Life by Haider Warraich

This interdisciplinary study of death and how we can improve–not avoid–it is highly readable and timely.

modern-death

In Modern Death: How Medicine Changed the End of Life, Haider Warraich explores how human death has evolved over the course of history and offers recommendations for its future. A medical doctor, Warraich supplements his research with anecdotes from his personal experience, and draws on literature, theology, statistics and legal theory as well as the hard sciences. The resulting expert opinion is heartfelt, convincing and well informed.

Warraich begins with the mechanics of how cells die and the opportunities for analogy they offer: cells choose to die to promote the good of the organism; not dying on time is as bad as dying too soon. He recounts the medical advances that have increased human life spans astronomically in the last two centuries. Chiefly, people now die far less frequently from infection and simple injuries, instead living long enough to die of cancer and heart disease. Because of both medical and cultural shifts, more people die in hospitals or nursing homes than at home.

This is the story of how medicine learned to save and expand lives–especially through procedures like cardiopulmonary resuscitation–and then how medicine learned not to resuscitate. Warraich shows what modern death looks like, how it works, its achievements and shortcomings–and then investigates what a good death could look like, and how we can do better. Science has lengthened lives so successfully, delayed death so thoroughly, that our new problem often is not staying alive, but letting go.

In what comes to feel like the real heart of Modern Death, Warraich then studies the nuances of euthanasia, assisted suicides and the withdrawal of life support systems, and their legal histories in the United States and worldwide. He finds that these three categories of death are far less distinct than generally believed. Finally, he advocates strongly for patients’ control over their own ends of life and exhorts his readers–patients and physicians alike–to discuss death openly.

These conclusions form the book’s central purpose. Along the way, Warraich explores different cultures’ and religions’ approaches to death. He also discusses the philosophical and legal difficulties in defining death and life. Warraich’s chief goal is a better end-of-life experience for everyone.

If Modern Death occasionally uses a few more words than necessary, the inclusion of Warraich’s anecdotal experiences enliven what could have been a dry academic text. For readers interested in its thesis–that death is an important part of life, and medicine and society could do a better job of delivering this experience–it is a sincere and thorough examination of an often overlooked subject. Well served by Warraich’s professional expertise and earnest emphasis, this is an indispensable entry into the conversation about death.


This review originally ran in the January 6, 2017 issue of Shelf Awareness for the Book Trade. To subscribe, click here.


Rating: 7 cells.

The Evening Road by Laird Hunt

Two women from different sides of the tracks explore rural Indiana on a single night that is both allegory and starkly real.
evening-road

The Evening Road by Laird Hunt (Neverhome) meanders the backcountry roads of rural Indiana on a hot and troubled night, exploring human ugliness and the lives of two remarkable women.

Ottie Lee Henshaw is a red-haired beauty, eternally exasperated with her ill-kempt husband, Dale, and pursued by her randy boss, Bud. She finds it easier to let Bud do “a fair amount of arm action and heavy breathing and pawing of my hair” than to fight him off. With a sharp tongue, a good appetite and a mind of her own, Ottie Lee does all right, even if she doesn’t look very respectable to the town gossips. On this summer afternoon in 1920, Bud comes in excited by the prospect of driving to the neighboring town of Marvel to attend the “show”: a promised lynching. Ottie Lee sets off with Bud, Dale and others; with a shifting cast of companions, she’ll spend the rest of a long, sweltering night trying to get to Marvel.

Ottie Lee’s adventures take up the first half of this novel before her counterpart, Calla Destry, appears. Calla is a light-skinned woman from the black side of town who faces her hard, violent world with stark defiance: she is inclined to head straight into Marvel to break the lynching’s intended victims out of jail, while her family and community runs the other way, lest they become victims themselves. It soon becomes clear that Calla’s real aim is to find the man who has promised her a new beginning. But her wanderings parallel Ottie Lee’s, and the two soon become more closely involved than either realizes.

The halves of this story are told in the first-person perspectives of these two women, and both are strong vernacular voices that bring flavor and color to their narratives. Hunt turns a phrase nimbly: a dirty parlor “looked like it had been soaked in water then spread in mayonnaise and left to turn,” and a courting man notes, “You think that’s the wind in the maples, but it’s not the wind. It’s the universe twitching.” This folksy layer of romance and redolence characterizes Ottie Lee and Calla as much as anything else does; their memorable voices and the close, heady setting of these backwoods make The Evening Road darkly compelling. A dreaminess comes and goes as Calla hallucinates in the heat and a friend of Ottie Lee’s talks to angels. The crime at the center of their story is a reality, of course, but remains a pivot point rather than the focus: the point is not the destination, but rather the winding roads that these women take to get there, their decisions and the secrets they keep along the way.

The Evening Road is a sad and raucous story, ugly and beautiful at once, evocatively starring two very different women.


This review originally ran in the December 23, 2016 issue of Shelf Awareness for the Book Trade. To subscribe, click here.


Rating: 7 jars.

A Giacometti Portrait by James Lord

giacometti-portraitFor school, again: this book informs an upcoming seminar entitled “Process, Image, Form: What Writers Can Learn From Visual Artists,” taught by Richard Schmitt. A Giacometti Portrait is a record of the creation of a work of art. James Lord sits as a model for his friend Alberto Giacometti, a well-known and successful painter living in Paris. Lord flew over from New York to sit for an afternoon; he ends up sitting for 18 days, during which he takes notes and pictures to document the process. The portrait is not finished at the end of this time – it is central to Giacometti’s theory of life and art that such a thing could never be finished – but they agree to stop.

It is an odd but intriguing book. Giacometti is a real character, and the friends become very close while sitting and talking together through Giacometti’s dramatic crises of artistic frustration, and many other threads of life. While Giacometti’s passionate, pessimistic, but oddly magnetic personality is a feature, the portrait itself is at the center of this book, to the exclusion of characterization of Lord himself, outside events and characters, and all else. The book itself, of course, is also a portrait. The title acknowledges this with its syntactic ambiguity.

The material here for a discussion about art, different art forms, techniques and mutual reflections upon one another is obvious, especially as Giacometti writhes and moans, undoing and redoing his work, experiencing one revelation after another, and every one (to him at least) failing. I am most interested to see where our seminar takes us. It’s not a book I’m necessarily prepared to love on my own; it’s too thin, somehow, too occupied with the one thing. But I suspect there’s more here than meets my immediate eye, so I’m very glad to be studying this with help. An unusual, but strangely compelling portrait.


Rating: 7 hard-boiled eggs.

The Delicacy and Strength of Lace, letters between Leslie Marmon Silko & James Wright, ed. by Anne Wright

the delicacy and strength of laceAs I wrote in my beginning, I enjoyed this book more than I expected to. I struggle with poetry, and the snippets included here out of context (it seemed to me) challenged me. I was not familiar with the protagonists. But quickly their voices and personalities revealed themselves; and the story of James Wright’s death, and the introduction to this book by his wife, add a poignancy. There’s something about knowing the sad ending to a story before you read it.

I found many lovely lines (naturally) and scraps of wisdom here. My instinct is to just begin sharing those with you.

I enjoyed Wright’s lines,

I hope you don’t mind post cards. They are a way of sharing something, some place or other delight, and they can also, when written and sent truly, offer small wavelets, so to speak, to the rhythm of a correspondence.

and perhaps even more, that he wrote so instructively, so consciously of this – that he felt the need, and the meta-quality of explaining one’s correspondence. They were still kind of new to each other, you see.

From Silko,

I always resented Shakespeare’s use of the delayed messenger in Romeo and Juliet, maybe because such things are so ordinary and so possible, and so much can be lost for two people that way.

which is both amusing, and profound, and a little confusing – why resent the use of something ordinary and enormous, and isn’t that what we do as writers? Hm.

And then,

I believe more than ever that it is in sharing the stories of our grief that we somehow can make sense out – no, not make sense out of these things… But through stories from each other we can feel that we are not alone, that we are not the first and the last to confront losses such as these.

and I think of the impulse we all seem to share to tell our stories in response to one another. This can be selfish. One person shares something personal and painful, and the response is “well I…” or “my…” as if to turn it back to the speaker every time. But Silko has a point, that there is a function to this return-to-me, and that in the right setting & relationship it’s how we perform empathy. I think about this in conversation sometimes, the effort to not always “me” everything. But it can be well done.

And very pertinently to nonfiction writers in particular, Silko again –

Memory is tricky – memory for certain facts or details is probably more imaginative than anything, but the important this is to keep the feeling the story has. I never forget that: the feeling one has of the story is what you must strive to bring forth faithfully.

This is the trick, or the puzzle, and the much-discussed central problem, with creative nonfiction or with memoir: the tension between strict “fact” (which is what, exactly?) and the richness of imaginative memory. See also Sejal H. Patel’s “Think Different” in issue 58 of Creative Nonfiction (I reviewed here), where she and other memoirists explore the use of technologies to aid memory.

Finally, and perhaps most centrally to the question of correspondence in general and especially between writers:

With you to write to, I go through the day with a certain attention I might not always have. I look for things you might want to see for yourself, but I can’t seem to get them into a letter.


I enjoyed reading this slim epistolary collection, and I think I got a lot out of it. But what was I supposed to get out of it? Despite a few classes taken early this year, I feel rusty at reading literature with a class in mind, and I am so curious about what the seminar that assigned this book will hold. Most of all, I’m excited. So thank you, school and world, for that.


Rating: 8 roosters.

Gods, Wasps and Stranglers: The Secret History and Redemptive Future of Fig Trees by Mike Shanahan

A joyful, celebratory world history of the fig tree and its ecological impact.

gods-wasps-and-stranglers

Mike Shanahan’s Gods, Wasps and Stranglers: The Secret History and Redemptive Future of Fig Trees is a deceptively brief account of the Ficus genus of trees in history, emphasizing but not limited to their relationship with humans. Shanahan brings the expertise of decades of ecological fieldwork and a bubbling enthusiasm to a topic clearly close to his heart. He makes a strong argument that his readers should be attuned to and excited about fig trees, too.

The plant figures into the origin stories of cultures all over the world. Fig trees have provided food, shelter, medicine and materials to humans for as long as humans have existed: figs predate us by nearly 80 million years. Because of their contributions as keystone species in ecosystems around the world, figs offer distinctive services in reforestation efforts and the mitigation of climate change. They have contributed to the theory of evolution, the birth of agriculture and possibly humans’ development of opposable thumbs. The story of the fig is inseparable from that of fig wasps, numerous tiny insect species that have evolved to pair respectively in symbiosis with individual species of fig. Shanahan relates all this and more in a joyous voice with occasional lyricism, as when “the Buddhist monk’s robe sang out loud saffron over the rainforest’s muffled tones of brown and green and grey.”

Mythology, biology and hope for the future combine in this highly accessible story of the family of fig trees, with its profound ecological relevance.


This review originally ran as a *starred review* in the December 2, 2016 issue of Shelf Awareness for Readers. To subscribe, click here, and you’ll receive two issues per week of book reviews and other bookish news.


Rating: 8 rhinoceros hornbills.

Creative Nonfiction, issue 58: Weather (winter 2016)

You can buy issue 58 here.

You can buy issue 58 here.

I always find something to appreciate from Creative Nonfiction. And in this issue, I confess, I had the added thrill of seeing several essays I got to read as submissions, that made it all the way to publication. Being a reader for CNF has been an incredible learning experience for me.

In this weather-themed issue, I really enjoyed Joe Fassler’s interview with Al Roker (Fassler wrote the essay “Wait Times” that I found so mesmerizing). Andrew Revkin’s essay about climate change, on the other hand, though much praised by editor Lee Gutkind, failed to grasp me: I found it overlong and less-than-gripping, and I guess also I found his opinions hard to access.

Interestingly, among the essays in the magazine’s main section, I was more excited about Ashley Hay’s “The Bus Stop” and Tim Bascom’s “My First Baptist Winter” than I was about the prize-winning “Recorded Lightning” by Amaris Ketcham: I enjoyed Ketcham’s writing very much, but the lightning-shaped text formatting which I think ‘made it’ for some readers only distracted me. Beatrice Lazarus’s “The Snow” was another interesting reading experience. I found the writing sometimes lovely and sometimes awkward, and the story’s steering between extreme weather and human violence took me a minute to grab onto. There is no question these are all impressive essays, but as usual, some worked better for me, personally, than did others.

Sejal H. Patel’s “Writers at Work” piece, called “Think Different,” lets Patel and five other memoirists discuss the impact of technologies on how we access and write about our memories. How does Google Earth, for example, help or confuse our recollections of the houses we grew up in? (Much more on this topic lies within The House That Made Me, which I recommend if this subject interests you.)

This issue of CNF is not the one I’ve enjoyed most, but there’s no shortage of thoughts provoked. Your mileage may vary.


Rating: 7 tornadoes.

guest review: Night School by Lee Child, from Mom

I’m so glad to have my mother around to review Lee Child along with me – or in this case, to review one I haven’t read yet! (For the moment, this is his newest, but I’m sure there’ll be another along shortly.) Night School follows my most recent Reacher read, Make Me, although the two are not chronological sequels. My mother sent this as an email to me, not intended as a formal review, but I appreciated it and she gave her permission to post.

Here’s Mom.
night-school

I really liked this book, especially compared to Make Me, which I finished afterwards. (And found excessively cruel and graphic, although well-plotted.) The story line carries us along beautifully. Another working of what’s up?, as in Make Me, where we don’t know quite what the deal is, but we have enough info to be looking hard at the details. And of course we get to tangle with some bad guys in number, and whip their fascist asses in entertaining variety.

Here Reacher is still in the army, which means a lot of structure and conflict built in from the bureaucracy. (In Make Me, he’s a bit of a drifter looking for adventure – and I know that’s a claim to fame for his fans.) So the Army sends him to Germany in this quest for the problem they need to solve. He bumps against the neo-nationalists so much you start to wonder if they are part of the plot. Hmmm.

So the plot is the thing, but Child’s writing is beautifully not present. I noted at first the short declarative sentences. After a 50-page warm-up, the story just flowed through. Some of the great stuff: He says to the German adversary, So why do you suppose you speak my language but I don’t speak yours? (Something to do with how important your language/country might be?) Or – the Germans thought they were uniting under one umbrella, but the West saw it as an arrangement of military bases with the people there efficiently manning the hotels and cafes.

I remember that Child is originally British, not to suggest he has an ax to grind. His character is man of integrity without a lot of allegiance to the system. His assistant in this is Neagley, the sergeant in War Games (the short story included at the end of Make Me). She’s perfect here, completely at his command (“adores him,” someone says), but has some complex that doesn’t allow any touch. So the sex interest is his boss, and of course the sex does not get in the way of the plot advances.

I could do some more page-turning like this, and I can’t help but like this impossible character.

Well said all around, in my opinion. I like what you said about the bureaucracy and the foil it provides. Cruel & graphic, yes: this is an important note for prospective new Reacher readers. Must have high threshold for blood. And the plot is indeed the thing. Lee Child excels at several things, I think: that invisibly expressive writing you mention, and action sequences (suspenseful fights I can really see), and a hell of a charismatic lead man. You said it: he’s an impossible character but we just can’t help but follow him. But the plots are nice and complex, filled with technical details and enough to challenge the experienced mystery/thriller reader. That is what I think you’re saying here, anyway.

About that “beautifully not present” writing, I find Reacher’s voice to be distinct and entertaining. Some of the books in this series are written in third person and some in first. And perhaps since I’ve listened to so many as audiobooks (and I highly recommend what narrator Dick Hill does with them!), I think that voice is a big part of the charisma. Those short, declarative, sarcastic, witty deliveries, even just inside his own head, really serve to characterize him.

Well done and thanks. I look forward to Night School and more of the page-turning and impossibilities.

%d bloggers like this: