Wellcome Book Prize 2019: Shortlist Events and Award Ceremony

I’m off to the Wellcome Book Prize award ceremony tonight to find out which of these books has won the prize!

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I went to the Wellcome 5×15 event with a friend yesterday evening at Wilton’s Music Hall, where five of the six shortlisted authors had fifteen minutes each to discuss their work. This was great, as always – if I lived in London, I’d try to go to some non-Wellcome-related 5×15 events, as the format really works for me. Here are some brief thoughts.

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Sarah Krasnostein: ‘Trauma cleaning for Sandra’

Krasnostein gave a very emotive talk on The Trauma Cleanerher biography of Sandra Pankhurst, a trans woman who has suffered her own personal horrors and now cleans the houses of hoarders, agoraphobics and those who have died and been left undiscovered. It’s clear how much this matters to her. She described how, when she first began the research for this book, her doctor asked her ‘Who would ever want to read that?’ and how this made her more determined to show how we are all connected despite our outward differences. To emphasise this, she used the metaphor of a forest of 40,000 quaking aspens in Utah, which are all linked by the same root system even though they look like individual trunks above the surface (this really is fashionable at the moment!) Krasnostein sees her book as a kind of trauma cleaning for Sandra, doing for her subject what she has done for others. The Trauma Cleaner was our shadow panel winner, and I think it has a good chance of taking the actual prize.

Sandeep Jauhar: ‘Taking away the sudden death option’

In my favourite talk of the evening, Jauhar, a cardiologist, spoke about how his family history of malignant heart disease led him to write his popular medical book, Heart: A History. Like Krasnostein, he encountered some initial resistance to his topic: his eleven-year-old son told him ‘Don’t write a book about the heart. No-one will buy it, because the heart is boring.’ Jauhar told us how the sudden deaths of both of his grandfathers gave him a ‘fear of the heart’, which he saw as both powerful and vulnerable, and how he became obsessed with the organ as a child, adjusting the speed of the ceiling fan so it synchronised with his heartbeat. (He also discovered that if you hooked up an average adult human heart to a swimming pool, it would empty it in a week.) Overall, though, he has come to the conclusion that a swift death from heart disease can be merciful, leaving him with difficult decisions to make about whether to suggest that his patients are fitted with internal defibrillators, which ‘take away the sudden death option’.

Arnold Thomas Fanning: ‘Walking down corridors endlessly’

For those of us who have read Mind on FireFanning’s account of living with bipolar disorder, this talk perhaps had less to offer, as Fanning essentially recounted what he tells us in his memoir. However, he illustrated the talk with a series of pictures of himself from childhood to the present day, which were really interesting to see, and vividly recounted his time in a mental hospital, where he ‘walked down corridors endlessly’ because of his restless energy, and at one point was prescribed sixty different medications over a six-month period. Fanning’s emotional honesty is admirable, and it was lovely to see the delighted reaction from the audience when he announced at the end of the talk that he’s getting married the month after next.

Will Eaves: ‘Understanding the gap between your experiences and someone else’s’

I’m afraid I had many of the same problems with Eaves’s talk as I did with his novel, Murmurwhich chronicles the inner life of a fictional Alan Turing undergoing forced chemical castration after being convicted of gross indecency for having sex with another man. It swung between being profound and pretentious as he meditated on the idea that we can never really understand somebody else’s internal state, and that’s what true sympathy is, offering an interesting counterpart to Krasnostein’s tree metaphor. I was particularly frustrated by the section on time, where Eaves claimed that there is no scientific reason why an equation can’t go backwards rather than forwards;  I wrote ‘ENTROPY’ on my programme and my friend added ‘TWADDLE’. However, Eaves did give us a great potted history of Turing’s life, which will help those approaching Murmur with little knowledge of the subject.

Ottessa Moshfegh: ‘People are vulnerable in having feelings’

Moshfegh spent quite a lot of time talking about what her novel, My Year of Rest and Relaxationis (in her words) not about: namely, how easy it is to get psychiatric drugs in the US, and why that’s a problem. Psychiatrists play on this to get customers, she argued, because ‘people are vulnerable in having feelings.’ Underlining this point, she read the section from the novel where our protagonist first meets Dr Tuttle. However, she stated that, for her, My Year is actually about a woman who ‘does not want to live in this plane of consciousness’ and believes that if she sleeps long enough, all her cells will have forgotten their cellular trauma. Moshfegh presents her protagonist more sympathetically than I had expected from the way she writes about her in the novel, and the talk really made me think again about how to interpret My Year.

Updated 1/5/19: The winner of the Wellcome Book Prize is…

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I’m not surprised by this result, but I am disappointed. Murmur was my least favourite book on the shortlist and on the longlist. I found it pretentious and unreadable, and Eaves’s discussion of the book has only cemented my opinions. More broadly speaking, I felt it would have been the right moment for a book on trans issues to have taken the prize, which would have pointed to a win for either Amateur or The Trauma Cleaner. Winning this prize will probably garner Eaves a wider readership, but it seems unlikely that many readers will be engaged by Murmur.

Wellcome Book Prize Blog Tour: My Year of Rest and Relaxation

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A young woman, recently graduated and recently orphaned, decides to take a year off from living to emerge purified. Camping out in her expensive New York apartment, she doses herself with a vast range of drugs, from the real to the fictional, in an attempt to sleep away the next three hundred and sixty five days. During this period, her human contact is limited to her only friend, Reva, whom she openly despises, the men at the local bodega who sell her two coffees when she manages to wake up, and her terrible psychiatrist, Dr Tuttle, who’s happy to prescribe her anything and everything. The narrator also muses on her earlier employment in the surreal art market of the very late twentieth century, and the kinds of productions that received acclaim, such as ejaculation drawings and pedigree dogs preserved through taxidermy.

There are a number of ways to read Ottessa Moshfegh’s My Year of Rest and Relaxation. Most obviously, its narrator is obscenely privileged, cushioned from ‘real life’, as is the art scene which she frequents; both are abruptly jolted awake by the intrusion of 9/11, which takes place at the very end of the novel. Secondly, My Year is both surprisingly readable and unreadably dull; its litanies of drugs and old movies recall Patrick Bateman’s recitation of brand names in American Psycho, another book that feels to me like it was deliberately written to be skimmed:

I took another Nembutal, watched Presumed Innocent, then took a few Lunestas and drank the second bottle of funeral wine, but somehow the alcohol undid the sleeping pills, and I felt even more awake than before… Then I was hungry, so I ate the banana bread and watched Frantic three times in a row, taking a few Ativan every thirty minutes or so. But I still couldn’t sleep. I watched Schindler’s List, which I hoped would depress me, but it only irritated me, and then the sun came up, so I took some Lamictal and watched The Last of the Mohicans and Patriot Games, but that had no effect either, so I took a few Placidyl and put The Player back in.

Like American Psycho, this is a satire that’s too horrific – at least in my view – to be funny. The only genuinely satirical section is the mid-point set-piece, when our narrator attends Reva’s mum’s funeral – a scene which weirdly kept reminding me of Bunny’s funeral gathering in The Secret History, even though the Secret History scene is undoubtedly much better in its lurches between comedy and tragedy.

Thirdly, one might discern a more serious side to My Year. What would happen, it asks, if we simply didn’t do anything for a year, if we were able to do that? It’s an anti-YOLO book, a deliberate rejection of the idea that life has meaning or that it shouldn’t be wasted. Because of this, my favourite section was the section near the end, when our narrator finally decides to knock herself out completely for several months, only waking for an hour every three days to see to her basic needs. This takes Moshfegh’s project to its logical conclusion, refusing to allow her narrator any wants or desires, and hence discarding all the usual things that novels are meant to be about. My Year, in this respect, is strangely liberating, because there’s absolutely nothing our narrator wants to achieve (and although she’s arrogant and self-aggrandising, she doesn’t seem to think she’s in any way perfect, so this isn’t rooted in false self-belief). Are our ambitions simply a shield against the absurdity of having such a short, and yet such a long, life to waste?

I didn’t enjoy reading My Year very much at all, but I don’t think that I was meant to. And while there were a number of books on the longlist that I thought were stronger (Sight, This Really Isn’t About You, Freshwater, Educated), it’s probably my second favourite on the Wellcome shortlist, if only because I doubt I will ever forget it.

Thoughts on My Year of Rest and Relaxation from other members of the shadow panel can be found here:

Rebecca’s review

Annabel’s review

Clare’s review

Paul’s review

Thanks to Midas PR for sending me a free copy of this novel to review for the blog tour.

The shadow panel – who are pretty divided this year! – will announce our winner on Monday 29th April, and the official winner will be announced on Wednesday 1st May.

My personal winner, by some distance, is Thomas Page McBee’s remarkable Amateur.

Don’t forget to check out the other stops on the blog tour!

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Finally, 5×15 are running a Wellcome Book Prize shortlist event in London once again, featuring  five of the shortlisted writers: Will Eaves, Sarah Krasnostein, Ottessa Moshfegh, Sandeep Jauhar and Arnold Thomas Fanning. While I’m sad that, once again, I won’t be hearing from my favourite shortlisted writer (though this is unsurprising given that McBee lives in New York), I loved this event in 2018, when I live-tweeted it, and have already booked tickets – along with three of my friends who were also big fans of last year’s event, despite not having read any of the shortlisted books! It’s on 7pm on the 30th April, and you can get tickets here.

 

Women’s Prize for Fiction Longlist, #3/Wellcome Book Prize Longlist, 2019: Freshwater

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One does not challenge their chi to a wrestling match.

Born in Nigeria to Igbo and Tamil parents, Ada is inhabited by ogbanje, an Igbo term that might translate as ‘evil spirits’ but, as Freshwater, Akwaeke Emezi’s debut novel, makes clear, is actually much more complicated. ‘Ogbanje’ are also ‘children who come and go’, or what we might think of as changeling children, children of gods who don’t properly belong in this world. To be an ‘ogbanje’, as Ada is, is to be marked out as special. Ada is also a practicing Christian, but while her internal ogbanje recognise the presence of what they call Yshwa, or Christ, they don’t perceive him as having any particular status, and have their own take on his motives: ‘while he loves humans… what they forget is that he loves them as a god does, which is to say, with a taste for suffering’. One of Ada’s selves, Asughara, is particularly resentful of Yshwa, whom they call ‘that fucking resurrected bastard’ after losing an argument with him.

If this all sounds a little metaphysical, you’re not alone; I approached Freshwater with some trepidation. However, I ended up engaging with it a lot more easily than I expected. Emezi’s writing makes the conflict between Ada and her various selves real and concrete, more like the interactions between the gods of a Greek myth than the inner monologue of a person with multiple personality disorder. This is obviously deliberate. One of the things that’s most brilliant about Freshwater is its refusal to line up Ada’s experience with Western psychological or psychoanalytical categories. Insofar as these diagnoses are useful as a way of understanding our experience, Emezi suggests that Ada can most effectively come to terms with herself by using the language of Igbo belief. Because of this, and despite its longlisting for the Wellcome Book PrizeFreshwater doesn’t feel like a novel about mental illness but more a novel about coming to terms with the relationship between self and world.

Emezi writes particularly well on Ada’s struggle to live in a physical body, observations that seem to be drawn from Emezi’s own experience (they identify as non-binary). This manifests not exactly as gender dysphoria but as an inability to reconcile how one sees oneself with how others see us. After Ada has a breast reduction, she starts wearing dresses more often; one of her friends can’t understand this, saying ‘Most people get it done to be more masculine’. But for Ada, the surgery wasn’t intended to help her fit into a particular gender category more easily but to complicate people’s impressions of her. If Freshwater doesn’t quite work at times, it’s because of its closeness to Emezi’s own life, and the redundancies that inevitably creep in when you try and compress life into fiction (there seem to be too many temporary lovers, and I wasn’t sure what purpose Ada’s siblings served). Nevertheless, this is a startling novel that deserves its place on both the Women’s Prize and Wellcome Prize longlists – and I wish it had gone forward to the Wellcome shortlist.

Wellcome Book Prize Shortlist, 2019: Murmur & Mind on Fire

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Will Eaves’s short novel, Murmur, is loosely linked to the life of the mathematician Alan Turing, best-known for inventing the machine that cracked German codes during the Second World War, and for undergoing forced chemical castration after one of his homosexual encounters was discovered, and thereafter, committing suicide. (Turing is fictionalised here as ‘Alec Pryor’, but the link is obvious.) The novel is bookended by two short sections very distinct in style from its much longer middle. The first, originally a short story shortlisted for the BBC National Short Story Award 2017, describes, in a journal entry, the liaison with working-class Cyril that led to Pryor’s punishment. The second, even shorter, depicts Pryor conversing with ‘the council of machines’, who tell him that he is losing his mind. Playing with ideas about AI, the council of machines claim that they have been fully aware from the start, through all the suffering of the Industrial Revolution, and so Pryor need not think that the painful consciousness of humans is a unique burden. Both of these sections are breathtakingly good; Eaves’s prose is beautifully direct, and the odd links Pryor makes in the second section are not necessarily logical, but still connect up perfectly well.

Unfortunately, I found the bulk of Murmur, which sits between these two bits, virtually unreadable. Eaves tries to convey what the inner workings of Turing’s mind might actually have been like while he was undergoing hormone treatment and descending into an altered state, and the results are highly irritating. Most of the novel consists of either dream sequences or letters that are ostensibly addressed to a person but are really letters to the self – two of the devices I most hate in fiction. As I also struggle with novels that are completely detached from reality, it’s no surprise that I didn’t get on with this. Even in this section, there are some beautiful passages, such as when Pryor recalls swimming in a lake with schoolfriend Christopher – but these are swiftly interrupted by another cluster of references, doublings, and psycho-analytical allusions.

I’ve been trying to work out why I find this kind of experimental literary fiction so offputting, as I’m certainly not averse to experimental literary fiction in general. There are a number of possible reasons. First, it strikes me, like a lot of postmodern literary criticism, as being more clever than wise; rather than striving to say things in the simplest way possible, it seems to delight in obtuseness. Unlike, for example, Anna Burns’s Milkman, the style isn’t working hard in service of what the writer wants to say but is getting in the way. Secondly, I think what really interests me in fiction is how humans respond to external and internal conflict, particularly if ethical, their complex relationships with other human beings, and how they think these through; when a narrator’s mind is this distanced from itself, there’s no such rational conflict, even if you could argue that conflict is still happening. Thirdly, I guess I’m unconvinced that this is the only way novels can push boundaries; it seems to me that within a more realist mode there are still hugely interesting things to be done, and I’d rather read books that are working in that direction.

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In contrast, I found Arnold Thomas Fanning’s Mind on Fire, a memoir of living with bipolar disorder, much more engaging than I’d expected, although his writing is more humdrum than Eaves’s. Fanning suffered severely from mania and depression for ten years, wrestling with his own delusions, and at his lowest point, spending a winter homeless on the streets of London. I think what worked for me about Mind on Fire is that Fanning is recounting it from a position of stability – apart from a brief, necessary section at the beginning, there’s no attempt to actually try and capture his state of mind on the page. This memoir gives the reader important insights into the experience of living with serious mental illness, and I also liked the way Fanning handled his account of his own childhood and adolescence in Ireland. While there are a number of factors that may have contributed to his poor mental health – the early death of his mother, a difficult and distant father – he doesn’t attempt to draw neat causal lines between the two, but simply presents what he remembers. Fanning’s honesty throughout the entirety of this memoir is courageous and creditable.

However, I still felt that this memoir could have had a greater impact if it had been structured differently. Like many memoirs of physical illness – Porochista Khakpour’s Sick comes to mind – Mind on Fire becomes inevitably repetitive, as Fanning continually presents himself to hospitals and becomes a psychiatric in-patient, is discharged, has a period of good health, and then starts to spiral into manic depression again. Moreover, the memoir ends rather abruptly, with only a few pages given over to Fanning’s recovery, and how he’s dealt with bipolar disorder long-term. It seemed to me that both these problems could have been solved if Fanning had compressed the period of his illness somewhat, and spent more time on the period after he ‘turned the corner’. Records of emails and letters, in particular, felt to me like Fanning was doing the very necessary work of piecing together this period in his life for himself, but I wasn’t sure that all this detail needed to be in his published narrative. A great resource for those who want to learn more about bipolar disorder, or perhaps for those living with it themselves, but not an outstanding memoir.

Thanks to Rebecca for passing on her copy of this book.

Thoughts on the Wellcome Book Prize Shortlist, 2019

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The Wellcome Book Prize shortlist is out!

I’m delighted to see Thomas Page McBee’s Amateur there, which was by far my favourite of the longlisted titles I’ve read so far, although I’m disappointed that Jessie Greengrass’s Sight and Jean Hannah Edelstein’s This Really Isn’t About You didn’t make the cut.

I had mixed feelings about both Sarah Krasnostein’s The Trauma Cleaner and Sandeep Jauhar’s HeartThe Trauma Cleaner had chapters of brilliance but seemed to me to lack perspective on its subject, whereas Heart was readable, but forgettable. I suspect the latter has been included to make sure there’s at least one ‘serious medical book’ considering physical illness on the shortlist, as the rest skew strongly towards mental illness and questions about gender identity and transition.

I’ve not yet read Will Eaves’s Murmur, Ottessa Moshfegh’s My Year of Rest and Relaxation, or Arnold Thomas Fanning’s Mind on Fire. I’m looking forward to the first two – Annabel rated Murmur very highly, and Rebecca’s review of My Year… has persuaded me that it’s something I might enjoy. However, I’m still pretty certain that I won’t like Mind on Fire.

After last year’s female-dominated shortlist and an evenly split longlist, this year the men outnumber the women, with four books by men (including one trans man) and only two by women. Writers of colour get slightly more of a look-in than last year, with two advancing to the shortlist. Themes of sexuality (Murmur) and trans identity (Amateur, The Trauma Cleaner) are really prominent.

I’m looking forward to reading the remaining books and discussing with the rest of the Wellcome Book Prize shadow panel!

Wellcome Book Prize Longlist, 2019: Amateur

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Thomas Page McBee starts training as an amateur boxer after encountering an angry man on Orchard Street who accuses him of taking a photograph of his car. McBee abruptly finds himself caught up in an alpha-male showdown:

“I was taking a photo of the restaurant in front of your car,” I tried, softening my tone a bit, breaking the rules of the scene. “I want to take my girlfriend on a date there.” I remembered, at the last moment, not to add an upward lilt to the end of my thought.

I saw the flash!” he growled, beyond logic, a man committed to his part… “Give. Me. Your. Phone.”…

I marshalled the self-control to turn and walk away… “Hey!” he shouted… “Asshole!”…

I let an acidic rage bloom… colouring my tone such a ragged mess I didn’t recognise my own voice. “I. Did. Not. Take. A. Picture. Of. Your. Fucking. Car.”

He backed away with his hands up. “Okay, okay,” he mumbled. “Jesus.”

Since his transition, a subject he deals with in his first memoir, Man Alive, McBee has increasingly found himself caught up in situations like these, where he wants to break out of the pattern of toxic masculinity but finds himself instinctively conforming. He might have wanted to become a man, but what kind of man does he want to be? ‘I began this book,’ he writes, ‘because, though I could not articulate it then, I understood that I could not know why I wanted to break that man’s teeth on Orchard Street without understanding, in turn, why he wanted to break mine.’

As a trans man, McBee understands both what it means to be socialised as a woman (the ‘upward lilt’ he has to stop himself adding to the end of his sentences) and how things change once society sees you as male. Voice comes up again and again. At one point, McBee and his brother talk over his sister, Clare, with their ‘jocular camaraderie’ about boxing, even though Clare has been taking boxing classes for years. McBee doesn’t notice what has happened until his girlfriend, Jess, points it out, although to his credit, he later apologises and talks it through with Clare. He also, suddenly, gets listened to at work. ‘Six months into my transition… testosterone made my voice low. Really low. So low that I was almost impossible to hear in a loud bar… But when I did talk, people didn’t just listen; they leaned in. They kept their eyes focused on my mouth, or down at their hands, as if to rid themselves of any distraction beyond my powerful words. The first time I spoke up at a meeting… in my newly quiet baritone, I noticed that sudden, focused attention’.

It’s taken me a while to write about this book because I had such an emotional reaction to it. McBee breaks away from familiar narratives about sex and gender to tell a new kind of story about what it means to be trans, and about what it means to be a man or a woman. I’m obviously not trans, but I identified so strongly with McBee’s discomfort around gender, about his wish to be treated as a man without letting down women – and his conflict about what being ‘like a man’ really meant. It reminded me of a conversation my sister once had on Facebook, about being cat-called in the street. After recounting her unpleasant experience, she wrote about a different encounter in Bristol [shared with her permission]:

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That’s the thing, I always want to say when I read books like McBee’s. None of us want to be a ‘darling’. We all want to be a ‘mate’, or at least I do. I admire McBee’s strength in dealing with his abusive past, in coming out as trans, and in writing so eloquently about his experiences; but I couldn’t help feeling a little unfairly jealous of him, too, as he travelled towards a place where I can never go. And even though I’m not a man, even though I don’t agree with this sort of behaviour, I could see why he wanted to break the angry man’s teeth; how hard it is to let go of privilege that feels so powerful.

Amateur is incredibly thought-provoking, carefully and precisely written, and ultimately, very moving, and it had better end up on the Wellcome shortlist; in fact, I’d love to see it win.

Thanks very much to Midas PR for sending me a free copy of Amateur for review.

Wellcome Book Prize Longlist, 2019: This Really Isn’t About You

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Like many other elite white millennials, Jean Hannah Edelstein felt somewhat adrift throughout her twenties and into her early thirties; trying to pursue a career in writing and publishing, she moved between London, Berlin and New York, having few long-term relationships with men and not able to meet traditional ‘adult’ goals. (Edelstein writes interestingly on the changing definitions of adulthood here). There’s a sense in which Edelstein is always neither here nor there; caught between her American upbringing and her many years of living in Britain and Germany, confused by a Jewishness that is signalled clearly by her last name but which, unlike surnames, is not inherited down the male line. However, this familiar kind of memoir is punctuated by two terrible things: Edelstein’s father’s death from lung cancer, and Edelstein’s own discovery that she has inherited Lynch syndrome from him, a genetic mutation that significantly raises her lifetime risk of a number of types of cancer.

Edelstein’s discovery pushes her even further into liminal spaces, especially the doctors’ recommendation that she has a prophylactic hysterectomy and oophorectomy to limit her chances of getting womb and ovarian cancer. But Edelstein wants to have children, and she’s afraid that she won’t feel like a woman any more if she doesn’t have her reproductive organs, even though she’s fully aware that being a woman is not dependent on being able to, or wanting to have, babies. ‘I suspected that it is problematic to be a single woman in your thirties because men assume you are desperate to have children,’ she writes, ‘but even more problematic if you are facing surgery that is going to make that impossible‘. Thankfully, this all has a happy ending: Edelstein’s son, born through IVF to avoid the chance of him inheriting Lynch syndrome, was born at the end of 2018.

This Really Isn’t About You is cleverly structured – Edelstein starts with her diagnosis, flashes back to the way she lived her life before, then ends with the aftermath – and very well-written. The memoir is lifted above similar offerings such as Meg Fee’s Places I Stopped On The Way Home not just because of its subject-matter but because of the specificity of Edelstein’s observations. Her memories of her father avoid generic emotion and are incredibly touching; ‘On Sunday mornings my father made us all pancakes for breakfast, including ones without eggs and milk for my brother, who was allergic to eggs and milk, and including one pancake for the dog… [He] once developed a failsafe method for making Jell-O, using the microwave. During the course of its development he produced so much Jell-O… that he started giving it away to the neighbours. The neighbours seemed a little surprised to receive the gift of Jell-O. My father thought it was a fine gift.’ As someone who spent five years of her childhood in Washington DC then moved back to Britain, I also appreciated Edelstein’s transatlantic observations from the other direction. This is very true: ‘I would start feeling sorry for my cousins [in Scotland] who were trapped in a place where it rained for so many days in the summer and where, in the late 80s, there seemed to be only four television channels and two flavours of ice cream: vanilla, which was sliced from a brick, and rum & raisin, which was disgusting.’

I’d love to see This Really Isn’t About You advance to the Wellcome Prize shortlist: apart from Jessie Greengrass’s Sightit’s my favourite entry so far.

The quick and the dead

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All That Remains, written by forensic anthropologist Sue Black, thinks about the significance of cadaver identification and the fates of dead bodies in a number of contexts: identifying victims during civil war in Kosovo, the preservation of donor corpses for medical students to dissect, and seeking clues to the cause of death of skeletons found in isolated places. Some bits of it worked for me and some bits didn’t; Black’s voice is not especially sympathetic (although she occasionally made me laugh!), and she sometimes falls prey to the temptation to discuss a particular professional achievement in too much detail. However, certain chapters were both informative and thought-provoking. I loved the section when Black clearly explains the difficulties of identifying the height, sex, race and age of a skeleton, and I’ll probably be nit-picking a lot of crime novels on this point from now on (no, dental records are not the only way to identify bones, and so smashing up the teeth of a corpse and substituting different ones isn’t going to effectively hide your crime, murderers in Tim Weaver’s ridiculous Chasing the Dead).

Black also makes a passionate case for the necessity of appropriately identifying bodies, even when the cause of death is known and the fact of death is certain, to allow families to properly grieve and to restore some dignity to the dead. This is a topic I find difficult; it’s always seemed to me to be wasteful to expend huge resources to retrieve dead bodies, and I don’t see that the dead mind whether or not they have dignity, as long as their corpse isn’t being desecrated and they don’t end up on public display. However, some of the incidents that Black describes – in particular, the horrific death of an entire family except for the father in Kosovo – have made me think that this kind of work and expense is absolutely appropriate in certain circumstances. This commitment, however, sits in strange contrast to her proclaimed ‘unsentimental’ attitude towards death.

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Heart, by cardiologist Sandeep Jauhar, has been longlisted for this year’s Wellcome Prize. It’s a stroll through the history of heart surgery interwoven with Jauhar’s own career as a surgeon and his own family’s experience of heart disease – a history that’s catching up with him, as he discovers plaques in his own coronary arteries during a CT scan. Jauhar writes better about cardiology than does Stephen Westaby in Fragile Lives, but his prose is still workmanlike rather than memorable; it never reaches the heights of Henry Marsh’s Do No Harm or Atul Gawande’s Being Mortal. The structure, at times, was a bit annoying, as Jauhar deliberately interweaves the story of a single real case between chunks of history and medical detail – I found that I kept skipping forward to find out what happened to the patient, as the intervening material was not directly relevant to my understanding of the case. I was also sorry that there was so little about heart transplants, purely because organ transplantation is a particular fascination of mine.

Nevertheless, I enjoyed Heart more and more as it went on, and unlike Westaby, Jauhar himself comes across as likeable and modest – he manages to write about his own personal experiences without forcing himself to the forefront. I preferred the technical medical bits to the gallop through the history of cardiology, finding the chapters on ventricular fibrillation, stress and implantable defibrillators, which can link the two by causing panic attacks in patients who repeatedly receive unexpected shocks to kick their hearts back into rhythm, especially interesting. There are also unintended cross-links with Black’s book. Both writers describe the death of their parents, and how it feels to be part of the oldest generation of your family that remains; as Jauhar puts it, ‘while your parents are alive, there is always someone who thinks of you as a child.’ Both muse on the fact that a sudden heart attack is both the most welcome and the most fearsome way to die, although they reach different conclusions; Jauhar welcomes the heart as ‘a safety valve that can facilitate a quick and humane end’, whereas Black admits that despite the mercifulness of a quick death, she herself wants to spend at least a little time dying so she can put her affairs in order and understand what it feels like to die. Both worthwhile reads, if a little short on literary skill.

Thanks to Rebecca for sending me her proof copy of Heart!

The Wellcome Book Prize Longlist, 2019

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I’m delighted to once again be part of the Wellcome Book Prize shadow panel organised by Rebecca, alongside brilliant fellow bloggers Clare, Paul and Annabel. The prize highlights ‘the best new novels, memoirs and non-fiction that illuminate the breadth and depth of our relationship with health, medicine and illness’. The longlist was revealed yesterday, and it’s quite exciting! Here are my initial thoughts, organised by theme.

Masculinity and gender identity

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I’ve had Thomas Page McBee’s memoir of his transition, Man Alive, on my TBR list for a while. I’m still most interested in the first book, but Amateurwhich focuses on McBee training as a boxer, sounds like a fascinating glimpse into the experience of living as a trans man, something that is hugely neglected by the mainstream media, which tends to focus on trans women. I’ve become increasingly interested in what happens to ‘masculinity’ when it isn’t seen as solely a property of those born male – i.e. what it feels like to be a trans man, or a butch lesbian – and Amateur promises to explore this with style.

Sarah Krasnostein’s The Trauma Cleaner is a biography of Sandra Pankhurst, a trans woman who runs a ‘trauma cleaning’ business, mopping up after sudden death, removing bodies that have lain alone and undiscovered for weeks, and dealing with living people who have taken to hoarding. As Krasnostein describes her, Sandra is ideally suited to this line of work, because she manages to provide ‘a bespoke blend of respect, warmth, humour and interest that establishes a basic human equity’, to all her clients, drawing from her own abusive past. I had mixed feelings about The Trauma Cleaner, which I reviewed here: the scenes of Sandra working with her cleaning clients are vivid and moving, but Krasnostein treads a little too carefully at times when dealing with Sandra’s past.

Finally, Matthew Sperling’s debut novel, Astroturf, promises to explore modern masculinity from the point of view of a man who starts taking steroids to bulk up his physique, and then starts a black-market business of his own. Promising to be ‘brilliantly funny’, I can’t say that this one especially appeals to me, but maybe I’ll be pleasantly surprised.

Memoirs of chronic illness

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Jean Hannah Edelstein’s This Really Isn’t About You looks at how she deals with finding out that she’s inherited the gene for Lynch syndrome, which gives her a higher lifetime risk of certain types of cancer. This has been on my radar for a while, and I’m hoping it’ll be the book about finding your way in life that Meg Fee’s Places I Stopped on the Way Home wanted to be, with the added complication of Edelstein’s genetic inheritance. Very keen to read this one, and I’ve already requested it from my local library.

Arnold Thomas Manning’s memoir, Mind on Fire, deals with his experience of living with manic depression and delusions after experiencing his first episode in adolescence, following the death of his mother. I’m not sure I’ll get on with this one – I struggle with books about mental and physical illnesses where the person’s perception of reality is severely distorted – in other words, I’m happy to read about depression and anxiety but don’t really find it very interesting to read about dementia and schizophrenia. I’m not sure where Manning’s book will fall.

Everyone’s already heard of Tara Westover’s Educated, her account of growing up in a fundamentalist Mormon family in rural Idaho who didn’t send her to school, so she first set foot in a classroom when she was eighteen. While I liked Educatedfinding it insightful, if uneven, I must admit I’m baffled as to what it’s doing on this longlist. I understand that Westover’s abusive father was probably mentally ill, but the memoir is primarily about Tara’s relationship with her family and how she copes in the outside world. Wellcome’s description, which focuses solely on the theme of education, isn’t illuminating either.

Proper medicine

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Sandeep Jauhar’s Heart: A History is another of the titles on the longlist that really intrigues me. Jauhar, director of the Heart Failure Program at Long Island Jewish Medical Center, has already written two medical memoirs about his own career, neither of which I’ve read, but both of which I want to read now I’ve heard about them! Heart takes a wider view, considering the history of research on the heart and Jauhar’s own family legacy of heart problems. This is one of those books that will definitely give me more flashbacks to GCSE Medicine Through Time.

Will Eaves’s Murmur sounds like important, but very grim reading: it deals with the legally enforced chemical castration of the homosexual mathematician Alan Turing, after he was convicted of ‘gross indecency’ in 1952. It promises to explore what ‘great bodily change… does to a person’s mind‘. I’m not sure I’ll be rushing out to pick this one up, though I’m pleased that Eaves has written it.

Finally, Thomas Abraham’s Polio: The Odyssey of Eradication sounds like it might have a lot in common with last year’s shortlistee, Meredith Wadman’s The Vaccine Race. Unlike Wadman, however, this book focuses on the campaign to wipe out a single disease: polio. While I enjoyed The Vaccine Race, and learnt a lot, I’m not sure I’m especially keen to tackle this one, especially as I imagine there will be crossover between the two.

Medical fictions

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I adored Jessie Greengrass’s Sightwhich I read when it was shortlisted for the Women’s Prize for Fiction in 2018. One of my favourites on a very strong shortlist, Sight forms part of an emerging genre of autofiction, switching between the perspective of a woman pregnant with her second child to the subjects of her medical historical research in the Wellcome Library. Greengrass is especially good on pregnancy and motherhood; I don’t think I’ve ever read anything else as good on the subject.

I’ve been avoiding Ottessa Moshfegh’s My Year of Rest and Relaxation, despite the hype, because I intensely disliked Eileen. It sounds like a very different novel, however, focusing on a young woman’s year spent under the influence of a cocktail of drugs in New York at the turn of the millennium. I’m not sure what’s up with the ironic cover, which is pretty misleading and a big part of what’s been putting me off.

Akwaeke Emezi’s debut novel, Freshwater, deals with a young Igbo woman, Ada, who is ‘peopled with spirits’, and it’s narrated by the different selves within her. I’m torn about this one: I love the idea of the tension between Nigerian folklore and mental health diagnoses, but I think it’s very unlikely I’ll like something that sounds as surreal as this (and deals with mind-distorting mental illness; see above!) Apparently, this is also trendy autofiction. I’ll probably be reading it simply because it’s one of the two titles I can get at my local library, albeit in e-book form.

So there we go! I’m delighted by the freshness of the shortlist, but sad that there’s still no science fiction or speculative fiction on the list – James Smythe’s I Still Dream and Katie Williams’s Tell The Machine Goodnight were only two of the many novels that I thought could have been interesting contenders.

Have you read any of the books on the Wellcome longlist? Are there any worthy contenders that have been missed off?

Wellcome Book Prize 10th Anniversary Blog Tour: The Two Kinds of Decay by Sarah Manguso

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The Wellcome Book Prize 2019, which rewards exceptional works of literature that illuminate the many ways that health, medicine and illness touch our lives, marks the 10th anniversary of this prestigious award. Over the last decade, the prize has recognised an eclectic variety of titles from novels (Mend the Living, Maylis de Kerangal) to memoirs (The Iceberg, Marion Coutts) to popular science (It’s All in Your Head, Suzanne O’Sullivan). In 2019, the prize will celebrate this legacy and this extraordinary genre of books that add new meaning to life, death and everything in between.

I hugely enjoyed being a part of the Wellcome Book Prize Shadow Panel in 2018, so I was  thrilled to be asked to participate in the Wellcome 10th Anniversary Blog Tour. Along with Harriet Devine, I’ll be showcasing a title from the 2011 shortlist, which was as follows:

  • Turn of Mind by Alice LaPlante [winner]
  • The Two Kinds of Decay by Sarah Manguso
  • My Dear, I Wanted To Tell You by Louisa Young
  • Nemesis by Philip Roth
  • The Emperor of All Maladies by Siddhartha Mukherjee
  • State of Wonder by Ann Patchett

I’d only read one of these titles before – Patchett’s incredible State of Wonder – so I had a lot of fun deciding which title I wanted to review. In the end, I went for Sarah Manguso’s The Two Kinds of Decaya memoir which chronicles her experience of living with CIDP (Chronic Idiopathic Demyelinating Polyradiculoneuropathy), which has been described as a chronic form of Guillain-Barre syndrome but, like many autoimmune diseases, is still poorly understood.

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Rather than attempting a chronological account of the nine years she spent suffering from CIPD, Manguso presents us with a series of arresting and disturbing vignettes. The first treatment she received for the condition, she explains, was apheresis, or the removal of her blood from her body in order to separate it into its constituent parts to allow the purging of the diseased part, which in her case, was the plasma. She was then reinfused with healthy plasma from a blood donor, a procedure that took four hours each time. This removed the antibodies secreted by her immune system that were destroying her healthy neurons and causing her symptoms, which included a creeping paralysis.

However, each time Manguso had to have the apheresis performed, she shook with cold, no matter how many heated blankets she covered herself with. Why?

The temperature in blood vessels is warmer than room temperature… I was very slowly infused with several liters of  fluid that was thirty degrees [F] colder than the rest of my body… the cold infusions went in very close to my heart. I need to describe that feeling, make a reader stop reading for a moment and think, Now I understand how cold it felt.

But I’m just going to say it felt like liquid, thirty degrees colder than my body, being infused slowly but directly into my heart, for four hours.

The plasma infusions also gave her a persistent chemical taste in her mouth: ‘there was nothing I could do to change the taste of it. It wasn’t touching the surface of my tongue… it was in my tongue.’ She found that only sucking on wintergreen candy throughout the course of the treatment gave her some relief.

Manguso’s brief glimpses into the world of her illness mean that The Two Kinds of Decay, unlike other chronic illness memoirs such as Porochista Khakpour’s Sickdoesn’t become repetitive but remains continually riveting. Manguso doesn’t try to draw together her experiences into some great message about life – even the title of her memoir remains somewhat oblique – but simply presents them to us, in prose that is totally and brilliantly boiled down.

Since publishing The Two Kind of Decay in 2008 (it wasn’t published in the UK until 2011, hence its eligibility for the Wellcome Book Prize of that year), Manguso has gone on to publish three more works of biographyThe Guardians (2012), Ongoingness (2015) and 300 Arguments (2017). I’m very glad to have been introduced to her writing.

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Some of my other favourite titles from past Wellcome shortlists are as follows [links to my reviews where they exist]:

Make sure to check out the other stops on the blog tour! And thanks to Charlotte at Midas PR for inviting me to participate in this tour and sending me a free copy of Two Kinds of Decay.