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.

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.

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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.

Yokainoshima: Island of Monsters by Charles Fréger

A rich collection of photography explores the Japanese mythology that both celebrates and protects longstanding traditions.

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Yokainoshima is a lushly beautiful collection by photographer Charles Fréger (Wilder Mann: The Image of the Savage), with commentary by experts on his Japanese subjects. Yōkai are “spirits, ghosts and other monsters,” or, literally, “bewitching apparitions.” On Yokainoshima, the “island of monsters,” and in Japanese culture, these gods and ghosts emphasize links to other worlds, in which humans are not the only inhabitants.

The bulk of Yokainoshima is filled with nearly 200 glossy color images of masked and costumed performers representing specific yōkai in grassy fields, beaches, forests and snowfields. Standing alone, these powerful, vibrant photographs offer stories and evoke emotions. Descriptions of the depicted characters, groups and customs (located at the back of the book) elucidate the mysteries offered by the images: seasonal rites requesting fertility, abundance and protection. Short essays portray a culture defined by its spirits, monsters and connections, enriching Fréger’s striking visual art.


This review originally ran in the November 22, 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 fun!


Rating: 8 pieces of straw.

Paul Smith’s Cycling Scrapbook

In this love letter to professional cycling, a fashion luminary expresses his passion with visual pop.

cycling-scrapbook

British fashion designer Paul Smith once aspired to be a professional cyclist, and his love for the sport has persisted over the decades. Paul Smith’s Cycling Scrapbook presents assorted ephemera accompanied by Smith’s casual commentary, with a brief foreword by Scottish cyclist David Millar.

Smith has an impressive collection of cycling jerseys, pennants, advertisements and publications specific to professional road and track racing. Chapter headings present themes and artifacts, including racing personalities, events like grand tours and one-day classics, Smith’s own bicycles and what he refers to as “the look.” He admires the individual histories of heroes like Fausto Coppi, Jacques Anquetil and Eddy Merckx, and Smith’s friends among contemporary racing stars, including Mark Cavendish and Bradley Wiggins. Throughout, Smith’s tone is conversational and self-effacing, even as he is honored to design the 2013 Giro d’Italia’s maglia rosa (leader’s jersey).

Visually stunning and wide-ranging, Paul Smith’s Cycling Scrapbook elegantly marries Smith’s admiration for the heroes of road and track cycling with his passion for design.


This review originally ran in the November 22, 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 fun!


Rating: 7 polka dots.

A Radical Faith: The Assassination of Sister Maura by Eileen Markey

One of the four churchwomen murdered in 1980 El Salvador is honored with a detailed biography.

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In 1980, four United States churchwomen in El Salvador were raped and murdered by members of the U.S.-trained National Guard, calling into question U.S. support for the right-wing military dictatorship and leading to several high-level and international investigations. The four were treated as symbols and martyrs; journalist Eileen Markey wanted to make them individuals again. A Radical Faith: The Assassination of Sister Maura pursues that goal by examining the life of Maura Clarke.

Markey follows Maura from a close-knit Irish Catholic family in Rockaway, N.Y., to a Maryknoll convent at 19 in 1950, part of a staunchly anti-communist Catholic Church. Maura served in the Bronx, and then for 17 years in Nicaragua, where she was horrified by poverty and want. She gradually experienced a massive transformation of worldview, eventually becoming an outspoken activist, even as Markey outlines a parallel if gentler shift at the Church’s highest levels. When assigned to El Salvador, Maura worked a few short months before her murder.

A Radical Faith is not an objective inquiry: it assumes that Maura had few flaws and that missionary work in cultures abroad is good work. Markey nevertheless powerfully establishes Maura as an individual, and animates the story of her death. Her work brings an extraordinary level of detail, from Maura’s own journals and correspondence as well as redacted government documents, to a decades-old crime with higher-level instigators who have not been brought to justice. Though not impartial, A Radical Faith is a carefully researched and flattering portrait, moving and evocative.


This review originally ran in the November 18, 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: 6 flights.

Idaho by Emily Ruskovich

This tremendous novel about what can be torn apart in an instant, and rebuilt over lifetimes, displays writing as scintillating as its plot.

idaho

Idaho, the first novel by O. Henry Award winner Emily Ruskovich, is a gorgeously designed immersion into the best and worst of life. In rural Idaho, a jumbled family rearranges itself painfully, trying to live on after a great loss. In 2004, Ann Mitchell surveys the Idaho farmstead she shares with Wade, her husband of eight years. Her recollections introduce the reader to their marriage–troubled by the diminishing strength of Wade’s memory and a terrible tragedy at the beginning of their relationship. She plays the piano; he makes finely crafted knives by hand. They tiptoe around the past.

In 2008, a woman studies her new cellmate at the Sage Hill Women’s Correctional Center. Jenny Mitchell doesn’t talk much. Neither of them has much future, with one distant chance at parole between them. Tentatively, they explore friendship, but Jenny doesn’t talk about her marriage to Wade, or her daughters. Then, Idaho flashes back to the 1980s and ’90s, when Wade was still married to Jenny and both of their daughters were still alive.

As decades are revealed, Wade’s family lives through happy, tragic and minute experiences. In layers of disjointed chronology and varied perspectives, the reader slowly picks apart the story: Wade’s love for one woman and then another; his luckless family history; the moment in time, the loss of control, that redirected these lives and more.

Ruskovich’s prose is exquisite. Music halts “like an animal at a gate, a child at a word it doesn’t know.” Her expressions of love, in its clean and messy incarnations, are singular, and she handles Wade’s mental decline and a child’s piano lesson with equal care and clarity. “On a sunny fall day, she lay next to him on the ground, and as he dozed she felt his old life, his memories, radiate off his skin. She felt everything leave him but her. She shed her own life, too, to match him. They lay there together like a point in time.” That point in time is what Ruskovich does best: sharp, clear moments alongside emotional enormities so great they can only be felt, not explained. This care, detail and realism applies to the novel’s background as well as to its stars. For example, a side plot involving an artist who paints meticulous age-progressions of missing children offers poignancy and attention to detail, and is worthy of its own novel.

With lovely language and piercing pathos, Idaho focuses on the power of love and the possibilities of forgiveness and memory. This debut novel deals blows as large as life.


This review originally ran in the November 18, 2016 issue of Shelf Awareness for the Book Trade. To subscribe, click here.


Rating: 8 gloves.
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