Profound look at good endings…

8:44 PM 28 AUGUST 2016

Working as I do in an integrated Health & Social Care environment, ostensibly geared to working with older citizens, this book had a resounding resonance with my own professional experience. The loss of my grandparents in recent years also bore some of the hallmarks of the tensions alluded to by Gawande, between the expectations and aspirations of people faced with the additional years, which for many, modern science has made possible and systems which may be subverted towards longevity as a destination in itself, without recourse to the ‘quality of life’ issues, with which they are inevitably bound.
Gawande makes a very cogent case for considering the role of western medicine in contemporary society and the potential for Drs to collude with patient’s assumed desire for survival, because treatments are possible, rather than initiate ‘difficult conversations’ which establish ‘what matters’ to the individual. The author describes common examples of clinicians instinctive leaning towards the exhaustion of a catalogue of possible interventions, without necessarily relating decision-making to what the patient is seeking to achieve through treatment. The book may thus be seen as a rallying cry to clinicians to rebalance the power differential which has evolved between the professional and the patient. However, there is also an implied criticism of societies that have become distanced from the reality of death. In the past, families and individuals were arguably more exposed to the experience and consequences of ageing and dying. In contrast to today, when such decline is frequently behind hospital doors, managed by professionals, the sanitizing of the process may have resulted in societies less equipped emotionally and practically to procure and recognize a ‘good’ death. For example, the author contrasts the experience of many with the often enlightened approach adopted by the hospice movement, which could inform much of ‘mainstream’ medical ‘end-of-life pathways’.
In his quite profound book, Gwawande’s sensitive writing style invites overdue reflection on how we have come to the current state of affairs. Given the ageing populations of most western nations, he has also perhaps rendered us a great service, initiating a wake-up call to all of us, to consider how we would want the last stages of our lives to look like (and equally pressing – not look like) and to have the courage to ensure our nearest and dearest are aware of our wishes. Abdicating responsibility for defining a ‘good death’ in our own terms, potentially leaves the decision-making, when the time comes, in the hapless hands of those without the clarity of ‘knowing’. For those of us in a position to initiate such difficult conversations, the reward of short-term discomfort may be surprising responses, but also understanding and knowledge with which to advocate the most appropriate outcome. A really thought-provoking read.

SOURCE: HTTP://WWW.GOODREADS.COM/REVIEW/SHOW/1521155649

Rating: 5 out of 5.

Revolutionary storytelling

7:57 PM 28 AUGUST 2016

I read this after attending a talk on World Book Night by the author. Still, my curiosity was well rewarded. A real ‘page-turner’, I slipped through the book in just three or four sittings and the plot moved through the gears effortlessly. In spite of the powerless situation in which the ten year-old central character (Charles) finds himself, compounded by his traumatic loss of speech, still his inner strength comes through in his inner dialogue. Charles is a pawn in an intriguing politically charged struggle on both sides of the English Channel and the backdrop of the French revolution is masterfully woven into the storyline. Based on this experience, I will definitely seek out some other examples of Andrew Taylor’s work.

SOURCE: HTTP://WWW.GOODREADS.COM/REVIEW/SHOW/1521157511

Rating: 3 out of 5.

Very British novel

7:23 PM 7 AUGUST 2016

This was a random choice on my part, with which to fill the waiting times that accompany jury service. But, if I say so myself, an excellent choice, brimming with likable, if somewhat flawed characters, set in a wonderfully familiar 1960s onwards. Not since ‘Fever Pitch’ and the well thumbed pages describing West Ham’ s FA Cup triumph over Hornby’ s beloved Arsenal have I felt so warmly nostalgic and thankful to have been there.

This book follows the journey of fictional rising TV star Sophie Straw, but it is the clever background use of programmes such as ‘Till death us do part’ and ‘Steptoe and son’, which gave the novel depth and for this reader an added affinity with the central ‘cast’. The clothes, activities, people and cultural norms all seemed so gloriously yesteryear, sympathetically described by the author and diligently reflecting the seemingly dated expectations of the time. This is no retrospective critique, but rather a wonderful observation of the period with its sometimes bizarre conventions, seen through the eyes of a young northern woman drawn to London in search of a better future. I thoroughly enjoyed the storyline and commend Nick Hornby for his deft handling of the relationships weaving together a very compelling read.

SOURCE: HTTP://WWW.GOODREADS.COM/BOOK/SHOW/22749994-FUNNY-GIRL

Rating: 4 out of 5.