Some books I've read (relatively) recently

A few books I’ve finished over the past few months. All these were books we read in Book Group.

'When Breath Becomes Air' by Paul Kalanithi

Subtitled ‘What Makes Life Worth Living in the Face of Death’. An end of life memoir by American neurosurgeon Kalanithi, who died of lung cancer in 2015 at the age of 37.

Kalanithi’s parents were immigrants from India, who settled initially in New York City before moving to Arizona. Helped by an academically ambitious mother, he got into Stanford where he completed degrees in English literature and human biology. His decision to apply for medical school came while completing a subsequent masters in English literature. While waiting for the medical school application cycle to go through, he applied for and took a degree in the history and philosophy of science and medicine at Cambridge. After this, he started studies at Yale School of Medicine. The man was clearly a born student though I did find myself wondering quite how many years in total he’d spent in college.

Kalanithi’s cancer developed while he was still in residency – which I loosely understand as meaning you’ve left medical school but are still in training. He was in his final of six years as a neurosurgical resident and anticipating graduating at the end of the year. He was thirty-six at this point and married to Lucy, also a doctor. Kalanithi himself suspects that he has cancer “and not the good kind” before it is officially diagnosed. From the CT scans, he is able to spot himself what it is, and that it has already spread.

The second half of the book is Kalanithi’s reflections post-diagnosis, including on the switch to experiencing medicine from a patient perspective. He notes the passing from subject to object, and the becoming a person to whom things happened. There are some reflections on religion and a turning back towards Christianity, probably understandable from a man facing a premature death. I liked that he doesn’t claim to have had epiphanies through having cancer:

Severe illness wasn’t life-altering, it was life-shattering. It felt less like an epiphany – a piercing burst of light, illuminating What Really Matters – and more like someone had just firebombed the path forward.

Towards the end of the book, his reflections on tense are interesting: what tense is he living in now? Should he say “I am a neurosurgeon”, or, knowing that he will never return to duties, “I was a neurosurgeon”? What should he say when friends say that they will see him at some future event? The book ends with some words directed at his baby daughter Cady, who we learn from his wife’s epilogue was eight months old when he dies. Paul’s manuscript, written during the last year of his life, was unfinished, derailed by his rapid decline and death. The epilogue provides context and a concluding chapter to Paul’s story. (The foreword, written by a fellow doctor and author, is turgid – I think if I’d read that first, as I never do, it might just have put me off reading the book.)

This obituary in Stanford Medicine includes a video recording of Kalanithi talking about his diagnosis.

'Hamnet' by Maggie O'Farrell

I read (and enjoyed) this on Mum’s recommendation. It’s a fictionalised account of the childhoods and married life of William Shakespeare (henceforth WS) and his wife, called here Agnes. It’s set in Stratford in the late 16th century and framed (loosely) around the couple’s son, Hamnet, and on his parents' grief following his death.

Hamnet is eleven and has two sisters and lives with his parents on Henley Street, Stratford, next door to his grandparents’ house, where his grandfather John runs a glove-making business. The book opens with Hamnet trying to find medical help for his twin sister Judith, who has been taken ill. Judith has a fever and has developed ‘buboes’ – pale oval swellings under the skin. Hamnet’s mother has a reputation for being able to cure anything with her potions, but struggles to cure this one. In a twist, Judith recovers, but Hamnet falls ill with the plague and dies.

Hamnet’s mother Agnes tends a patch of land at the farm where she grew up. Local legend has it that Agnes’ mother emerged from the forest that bordered the farm, bewitching the farmer, who married her. Local people say that Agnes is a forest sprite and a sorceress. Hamnet’s father met Agnes when he was sent there to tutor the farmer’s sons in Latin. Agnes becomes pregnant, they marry and move in next door to WS' parents in Stratford. In due course, Agnes comes up with the idea of getting her husband to go away to London to find work, with a view to getting him away from his brute of a father; she would then follow him at a later date, with the children. WS’ father John is persuaded that it would be a good idea to expand the glove business to London; in the event, WS does make a great success of working in London, but as a writer leading a touring company of players, rather than in the glove business. WS spends more and more of his time in London, only returning home intermittently. O'Farrell explores Agnes' grief following Hamnet's death, and the shared understanding between the women - Agnes and her mother-in-law Mary have always had a fractious relationship, but both have lost a child, as very many women must have done then. In this fictionalised account, Agnes travels to London to seek her husband, and ends up at the opening performance of his new play, Hamlet.

In an Author’s Note, O’Farrell notes that only a limited amount is known about the Shakespeare family. The names of Shakespeare’s three children are known, and it is known that the boy, Hamnet, died young, but the cause of his death is not known. Having him die from bubonic plague in the novel is a fiction of O’Farrell’s, influenced, she says, by the apparent absence of any mention of the disease in any of Shakespeare’s literary output – her implication being, presumably, that this is odd given the time period in which they were written.

The suggestion in the novel is that WS named his play Hamlet after his deceased son. O’Farrell notes "Hamnet and Hamlet are in fact the same name, entirely interchangeable in Stratford records in the late sixteenth and early seventeenth centuries" and cites this 2004 article The Death of Hamnet and the Making of Hamlet in the New York Review of Books.

Hamnet was published in 2020 and was O'Farrell's eighth novel.

'The Guest' by Emma Cline

Ruth’s choice for our November Book Group book. We read Cline’s first novel The Girls in 2018 and I thought that was well written and atmospheric.

The story opens with a young woman, Alex, swimming in the sea off a beach somewhere “out east” from New York City – we don’t know where, exactly, but it’s somewhere where rich people have second homes. She is there with her older boyfriend, Simon, who invited her there for the summer to amuse herself while he’s working and then to go to parties with him in the evenings. Alex is 22, Simon in his fifties.

It quickly becomes clear that Alex has got herself into a bit of a mess back in NYC – she seems to routinely pilfer other people’s painkilling (and possibly other) medication, she has run up bills on various men’s credit cards, restaurants and nightspots have blacklisted her, her flatmates have thrown her out for non-payment of rent (and pilfering their meds). What she does for a living is not entirely clear but she appears to be some kind of escort, though work has tailed off and she’s had to reduce her rates. We never discover anything about her background or why she is in the position of doing this kind of work. She’s being persistently chased, via voicemail and text, by an ex, Dom, from whose apartment she has stolen drugs and cash.

One evening Alex and Simon attend a party at the home of an acquaintance of Simon’s, where Alex gets drunk and makes up to the hostess’ younger husband, whom she teases to throw her into the swimming pool, which he does. Simon takes exception to this sort of behaviour – and to the fact that Alex dented his car the previous day and didn’t tell him – and buys Alex a train ticket back to the city, suggesting that they talk “in a week or so”. Alex manages to convince herself that Simon doesn’t actually want rid of her but just wants a few days’ space, and decides not to return to the city but to find a way to stay in the area for a few days, planning to surprise Simon by returning to his house on the evening of his upcoming Labor Day party. By then, Alex imagines, Simon will have calmed down and be pleased to see her again. Alex proceeds to inveigle herself into various other houses in the area via making up to a series of complete strangers. In the book’s final scene Alex does, indeed, present herself at Simon’s party as she planned, fresh from the scene of a car crash driven by a troubled teenager she seduced.

Discussing this book, Ali mooted the idea that the ending and the final single-word sentence “Now.” might indicate Alex's death from injuries suffered in the car crash, but that would be too unsubtle a device for Cline, who commendably avoids melodrama, both here and in The Girls. It's enough that Alex has now burned all her bridges, even throwing away her mobile phone on her way to Simon’s, and is now faced with the dawning realization that she has hideously miscalculated.

What is this fascination Alex has with people’s swimming pools? I did wonder whether there was some symbolism being used in the form of the various pools, and of water generally. Early in the story Alex gets carried further out to sea than she intends while floating on her back and manages to rescue herself by swimming parallel to the shore until the current becomes less strong and she is able to return to land. Towards the end of the story, when things are unravelling, there is another incident when sea swimming, but this time Alex mis-times a wave and is thrown to the sand underwater, cutting herself. Early in the story the swimming pools Alex encounters are pristine, well cared for; as the story progresses, one pool is “a little gray”; “the dirty pool, the water probably half beer at this point”; the final pool she encounters is unheated and freezing, the water dirty, “biscuit-colored foam floated on the surface, visible grit settled on the pool’s bottom”. This Guardian review of The Guest does indeed have it that water is used as a leitmotif. So there.

The Guest was published in 2023 and was Cline's second novel.