Review: Smoke Gets in Your Eyes and Other Lessons from the Crematorium by Caitlin Doughty

I'm a sucker for the morbid. Whilst I like medical and mental health related non-fiction, I have a guilty pleasure for the more macabre books. I find how people have dealt with death throughout history fascinating, particularly the associated rituals and beliefs, but also how the body naturally reacts to death in a physiological sense. See Severed: A History of Heads Lost and Heads Found and also Being Mortal by Atul Gawande.

I was blown away by Smoke Gets in Your Eyes - not only is it a much deeper and wider examination of death practices than expected, it's actually written very, very well.

Summary/synopsis: From her first day at Westwind Cremation & Burial, twenty-three-year-old Caitlin Doughty threw herself into her curious new profession. Coming face-to-face with the very thing we go to great lengths to avoid thinking about she started to wonder about the lives of those she cremated and the mourning families they left behind, and found herself confounded by people's erratic reactions to death. Exploring our death rituals - and those of other cultures - she pleads the case for healthier attitudes around death and dying. Full of bizarre encounters, gallows humour and vivid characters (both living and very dead), this illuminating account makes this otherwise terrifying subject inviting and fascinating. 

Caitlin Doughty is apparently relatively famous in the field of, I don't know, death people? She's most renowned for her YouTube channel, Ask a Mortician, as well as founding The Order of the Good Death, which promotes a more natural acceptance of death. Before all this, however, she started out at Westwind Cremation and Burial as a crematorium operator, responsible for moving soon-to-be-cremated bodies into the incinerator and all the associated tasks, of which there are a surprising amount. The anecdotes she recounts are somehow both hilarious and mildly disgusting, and at certain points I definitely laughed out loud.

This is not a book for those of a sensitive disposition. We read about decay, leaking and mechanisms for keeping the eyes of the deceased firmly closed (spoiler alert: they use caps with spikes on). I like that about this book though. I like that it goes slightly beyond the realms of propriety to explain the details that I had never considered were an issue. For me, the most interesting chapter dealt with the bodies of babies, both pre- and post-term, and the associated problems. It wasn't exactly pleasant reading, but it was fascinating and I have respect for the author for discussing what most people would rather brush under the carpet.

Caitlin Doughty speaks with respect and humanity throughout. Although her book made me laugh out loud at points, the book never makes fun of the deceased or their families, and it appears that the corpses were treated with respect at the material time as well. Mishaps happen, of course, but not through any carelessness or lack of compassion.

This humanity underlies the 'agenda' of this book and the issues that Caitlin Doughty currently works to highlight. She writes that there is a culture of death denial prevalent in the modern world. Where death was previously accepted as a natural fact of life, attempts are now made to hide ourselves away from the very existence of death, as evidenced by the multi-billion dollar cosmetic industry, the rise of embalming and the ability to cremate your loved ones via the Internet.  

She supports family members preparing their own deceased for burial, as decomposition and decay are inherently natural and cannot harm us. By being afraid of the sight of death, we are denying what is an absolute fact of life.

Less than a year after donning my corpse-coloured glasses, I went from thinking it was strange that we don't see dead bodies any more to believing their absence was a root cause of major problems in the modern world.

Corpses keep the living thethered to reality. I had lived my entire life up until I began working at Westwind relatively corpse-free. Now I had access to scores of them - stacked in the crematorium freezer. They forced me to face my own death and the deaths of those i loved. No matter how human technology may become our master, it takes only a human corpse to toss the anchor off that boat and pull us back down to the firm knowledge that we are glorified animals that eat and shit and are doomed to die. We are all just future corpses.

Whilst I can't say that I enjoyed the latter chapters as much as the former sections where the author discussed her day-to-day life as a crematorium operator, this book really made me think and I can't get these issues out of my head. Whilst I found a few of her ideas a little too out-there for me, like her desire for her corpse to be left in the open to be devoured by nature, I feel that this surely proves her entire point. The concept shouldn't make me uncomfortable and it's not 'out-there' at all - after all, it's entirely natural and it's only very recently that such endeavours stopped being the norm. It's a lot to think about.  

I really, really recommend reading Smoke Gets in Your Eyes. Even the prose is written to a much higher standard than one would usually expect for a memoir-style work of this nature. It doesn't try too hard to be pithy, nor does the author come across as preachy or naive. I was disappointed when this book ended and I will happily and enthusiastically read anything Caitlin Doughty ever writes.

Visit Caitlin Doughty's YouTube channel or read more about The Order of the Good Death. Alternatively, find her on Twitter here.

Review: Better: A Surgeon's Notes on Performance by Atul Gawande

Last year I read and reviewed Complications: A Surgeon's Notes on an Imperfect Science, and immediatley ran out and purchased everything else that Atul Gawande had ever written. See, we say things like that a lot in our little book blogging world, but in this case that is genuinely and literally exactly what I did. These books are perfect in a lot of different ways and I really recommend them to everybody, whether they have a medical background or not.

Summary: In this unflinching look at medicine today, gifted surgeon and bestselling author Atul Gawande visits battlefield surgical tents in Iraq, a polio outbreak in India and malpractice courtrooms. He charts the race to extend cystic fibrosis patients' lives and discusses the ethical implications of doctors' participation in lethal injections in the United States. Examining everything from the influence of money on modern medicines to the contentious history of hand washing, this book provides a rare insight into what it takes to go from good to better.

The key thing to know about this book is that it's not about how doctors can make their patients better, it's about the ways they can improve to make their own practice and treatment regime better. That said, it's far from a manual aimed at lecturing hospital staff, it's an accessible and engaging collection of thoughts that I would say is aimed at the general public.

Mr Gawande has divided his book into three sections - Diligence, Doing Right and Ingenuity - which he says are the three core requirements for success in medicine, or any endeavour that involves risk and responsibility.

Diligence was perhaps my favourite of the three sections as it focuses more on doctors as people, and the tiny little everyday responsibilities that I find fascinating. It looks at how, despite the movement started in the 1840s to encourage doctors to wash their hands, a surprisingly large amount of them still forget when running from patient to patient. We also examine the huge-scale campaigns to eradicate polio and the effort required to vaccinate every single child in India, and the brave doctors who accompany the military to Iraq, Afghanistan and every other campaign across the globe.

Doing Right looks at the obligations that doctors and other medical professionals are under, and whether they are always strictly fair. For example, there's a chapter on whether it should be obligatory for a doctor to attend during a state execution or whether this directly contravenes their purpose, which is to heal people. I also really enjoyed the chapter about how doctors examine the more intimate areas of a person's body and whether a chaperone should be required.

Lastly, we look at Ingenuity, which covers the introduction of the Apgar score (which assesses the health of a newborn baby) as well as looking at how medical centers and hospitals and can improve by comparing the statistics of other, similar centers.

“It is unsettling to find how little it takes to defeat success in medicine. You come as a professional equipped with expertise and technology. You do not imagine that a mere matter of etiquette could foil you. But the social dimension turns out to be as essential as the scientific--matters of how casual you should be, how formal, how reticent, how forthright. Also: how apologetic, how self-confident, how money-minded. In this work against sickness, we begin not with genetic or cellular interactions, but with human ones. They are what make medicine so complex and fascinating. How each interaction is negotiated can determine whether a doctor is trusted, whether a patient is heard, whether the right diagnosis is made, the right treatment given. But in this realm there are no perfect formulas.”

However, the topics almost fall into irrelevance when compared to Mr Gawande's prose. He writes with such humanity and grace that you'd be forgiven for thinking he was an author by trade, not a surgeon. I was also impressed by his seeming complete lack of bias. There's a chapter on medical malpractice lawsuits which was angering me more and more as I read on (as a disclaimer, I defend doctors from lawsuits for a living!) but he maintains a perfect tone throughout that accepts that doctors are people too. Mistakes are made, some are unavoidable whilst some are not, but perhaps patients do deserve some compensation when an avoidable mistake is made.

I'm unsure which of the two books, Complications or Better, I prefer. The topics are slightly different but naturally there is some overlap. Complications focuses more on surgical procedures but therefore involves more case studies, which doesn't really interest me because I do nothing but nosy at other people's illnesses at work. I can see how that might interest people not quite as pompous as myself, however.

Better doesn't feature any case studies and the sections on execution chambers and eradicating polio (amongst others) were fascinating. However, there are a few chapters on the cost of treatments, statistics and medical hierarchy that just weren't applicable to countries other than America. I ended up skipping the section on funding because it made so little sense to me. It's written just as well as the remainder of the book, but it just didn't appeal to me as a UK resident.   

To solve the comparison problem, I'd honestly just read both of them. And also Being Mortal: Illness, Medicine and What Matters in the End. I haven't read it yet, but I don't see it being anything less than amazing if his previous books are anything to go by. My one complaint about these series is that the silver leaf around the edges of the book does tend to rub off, which looks quite scruffy 280 pages later.

Read my review of Complications here. And then go read both these books!

Review: Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande

Oh how I loved this book. It might be because I was just relieved to read something, anything, that wasn't Armada, but I don't think that would be doing Atul Gawande justice. This book is beautifully written, occasionally heart-warming and so much more than one of those generic 'horrific tales from A&E' memoirs. 

Summary: Gently dismantling the myth of medical infallibility, Dr. Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science is essential reading for anyone involved in medicine--on either end of the stethoscope. Medical professionals make mistakes, learn on the job, and improvise much of their technique and self-confidence. Gawande's tales are humane and passionate reminders that doctors are people, too. His prose is thoughtful and deeply engaging, shifting from sometimes painful stories of suffering patients (including his own child) to intriguing suggestions for improving medicine with the same care he expresses in the surgical theater. Some of his ideas will make health care providers nervous or even angry, but his disarming style, confessional tone, and thoughtful arguments should win over most readers.

I should begin by saying that this relates directly to my day job - I advise and defend Doctors and other health professionals who are the subject of legal claims due to an alleged negligence. I've worked on neurosurgery, retained objects and delayed diagnosis claims, amongst others, so this book has a certain amount of interest for me.

Complications is far from merely a collection of anecdotes about 'when things go wrong,' however, and I do think it would interest everybody. Instead, Dr Gawande examines the concepts of surgery itself and discusses the different theories behind why things go wrong and the difficulty of actually implementing improvements. It's absolutely fascinating.

Two things really got me about this book - 1) the beauty of the writing, and 2) the humanity behind it. I propose to deal with them in turn, if I may. The prose in Complications is amazing though. He doesn't just write well 'for a surgeon,' Atul Gawande has a style that any author would be proud of. I've seen how surgeons write, and usually you're lucky if they've managed to spell the patient's name correctly. Mr Gawande is eloquent, articulate and patient as he guides us through the unforeseen conundrums of what surgery actually entails.

However, he doesn't beat the reader over their head with his qualifications. Obviously he references his job fairly often, as well as anecdotes that have come from his colleagues. What impressed me though, is that he also refers to his personal life and isn't above admitting fallibility when it comes to personal, medical decisions. There's a chapter that discusses the need to train new surgeons v providing the best possible care for patients. Trainees need to 'practice,' but who really wants an inexperienced student cutting into them? Mr Gawande refers to his own experience, in which he was asked whether he minded a surgical trainee performing his son's operation. Despite all his logic to the contrary, he refused. 

This is the uncomfortable truth about teaching. By traditional ethics and public insistence (not to mention court rulings), a patient's right to the best care possible must trump the objective of training novices. We want perfection without practice. Yet everyone is harmed if no one is trained for the future. So learning is hidden, behind drapes and anaesthesia and the elisions of language. Nor does the dilemma apply just to residents, physicians in training. In fact, the process of learning turns out to extend longer than most people know.

The book is divided into three parts, called Fallibility, Mystery and Uncertainty. The first section deals with the topics I've touched on - the best way to train surgeons, when/why good doctors go bad, the lessons learned from surgical conferences, etc. 

The second part, Mystery, was my least favourite, although still interesting. Essentially it discusses three cases and the conceptual issues that arose from those particular matters. There's a TV presenter that undergoes surgery to control her chronic blushing, for example, and Mr Gawande touches on the judgement she's since received since her surgery was performed. They're interesting, but I personally preferred the more abstract chapters.

The Uncertainty chapters swing back into the discussion, dealing with topics like the inevitable requirement to take chances when performing surgery, the extent to which patients should be given control over their own care and whether human instinct or computers are better at providing accurate diagnoses.

Complications is perfectly accessible for a layperson. Every term and every abbreviation is seamlessly explained within the text, without the need to flick back to a glossary or consult a footnote. There are only one or two places that the mildly squeamish may balk at, but you can see them coming so it would be easy to gloss over them if necessary.

I hadn't realised that this was published way back in 2002 - it's just recently been rereleased in a pretty cover to match his other, newer books, Better: A Surgeon's Notes on Performance and Being Mortal: Illness, Medicine and What Matters in the End. Still, as the focus is on conceptual discussion more than particular treatments, I wouldn't think Complications is horrendously out of date. I just know I'm already desperate to read his other books. This one is perfect.'

Visit Mr Gawande's website here.    

Review: The Immortal Life of Henrietta Lacks by Rebecca Skloot

This is one of those books that looks really ominous - a huge, hardback full of scary-sounding scientific terms as chapter headings and a bibliography the size of a phone book - so you put off reading it despite however much you might actually want to. If the library hadn't been vehemently demanding it back for the last three days, it may have been even longer before I read it myself, but I'm glad I did.

Her name was Henrietta Lacks, but scientists know her as HeLa. Born a poor black tobacco farmer, her cancer cells -- taken without her knowledge -- became a multimillion-dollar industry and one of the most important tools in medicine. Yet Henrietta's family did not learn of her 'immortality' until more than twenty years after her death, with devastating consequences . . . Balancing the beauty and drama of scientific discovery with dark questions about who owns the stuff our bodies are made of, The Immortal Life of Henrietta Lacks is an extraordinary journey in search of the soul and story of a real woman, whose cells live on today in all four corners of the world.

When I did eventually come to pick it up, I found that I had no idea what the hefty book was actually meant to be about, so I'll just paraphrase it quickly - Henrietta Lacks was admitted into hospital in the 1950s with a severe form of cancer. Before she died, doctors took a number of samples from her tumours without her consent. These cell samples proved to be the only cells able to be grown in a laboratory despite numerous samples from other 'donors' also being tested. Clones of these cells are still used more than 60 years later to test everything from new vaccines to cancer treatments - they've been to space and they've been blown up by miniature atomic bombs. The companies that sell these clones to basically anybody that wants some have made millions of dollars doing so, and yet the Lacks family only discovered Henrietta's cells were a valuable commodity a few years ago and are so penniless they can't afford medical insurance.
 
I was surprised by how accessible it actually is. Obviously it would be impossible to discuss scientific development in cell culture without throwing around a few bits of terminology, but Ms. Skloot clearly doesn't expect readers to have a Master's Degree in Biology. She explains exactly what she's talking about in a capable, unpatronising manner, so I never once felt like the whole thing was whooshing past over my head. She frequently repeats conversations she explained the whole thing to the Lacks family and I found that helped to consolidate my own understanding.

You know a book is written very well indeed when the issues it raises makes you so angry you get that tight feeling in the pit of your stomach. I haven't quite decided how I feel about my tissues being used for research without my consent, but the millions of dollars made in profit by the medical companies was clearly immoral, especially when the Lacks family can't even afford medical insurance. I love medical ethics and I could easily sit here all day and lecture you all, so I won't, but the author does a valid job of making you care without sounding too preachy.

I think that's the fundamental reason I liked this book - Rebecca Skloot is a very likeable author. I've read non-fiction books before that I probably would have enjoyed a lot more if I didn't want to throttle the author (Cinderella Ate My Daughter, So Many Books, So Little Time - what can I say, grouchy misanthropy works for me). But hey, at least now I've learnt that it works both ways. I like Ms. Skloot. She comes across as dedicated, intelligent, friendly and approachable and I genuinely respect her for the time and effort she put in to getting these issues across. She frequently describes how she collected the information so it makes it easy to see her as a living, breathing person instead of a bunch of fingers aimlessly typing out Latin terminology onto a manuscript. I like her, and to be honest, I tend not to do that!

My only slight gripe with The Immortal Life of Henrietta Lacks was the very sudden ending. But then again, it isn't a fiction book and so Ms. Skloot can hardly just go and whip up a better ending. Still, I can't help but feel it could have been rounded off a little better - the narrative is progressing nicely but then it suddenly... stops. There's then a concluding chapter about Ms. Skloot's personal take on the issues, which I did find interesting but isn't quite the same.

I really would recommend this book. I was concerned over how difficult it was going to be to read but it's not at all. If nothing else, you should be aware of how little right you have to your own cells!

Review: Change of Heart by Jodi Picoult

Okay, so I may have stolen this from the library a little. It's not as bad as it sounds; I mean, I'm going to take it back and everything. I don't know about your library, but ours has a 'Group Reads' section where you can only take out books if you belong to a Book Group that's registered with Sheffield Library. That's fine, not a problem. But the library doesn't hold any of those books for non-Book Groupers so there's absolutely no way to get them out. Makes perfect sense, right? Withhold books from the people who like to read alone. This isn't even Jodi Picoult's latest book! Anyway, I was in there last Thursday in The Foul Mood To End All Foul Moods because it was chucking it down outside and I'd just been for a session with my physiotherapist, a horrible, little man who could easily be the secret love child of Arnold Schwarzenegger and Adolf Hitler. I'd ducked in there to sulkily avoid the rain before traipsing back across town, so I yanked down the first book I saw, curled up on a sofa and snuggled down for an hour. Thing is, I got really into the book but when I closed it and prepared to check it out so I could take it home, I saw the big purple sticker - 'BORROWING THIS BOOK REQUIRES A GROUP READS TICKET.' *snarls* I'm pretty sure that the previously-mentioned foul mood negates any responsibility for my actions - I may have just shoved it in my bag and walked out. I know. I'm sorry. I'm a bad person. But I resented that Group Reads section to the very depths of my soul and I wanted it punished, damn it.

Anyway. Dubious acquisition of the book aside...

Summary - Shay Bourne becomes the first person in decades to be sentenced to death in New Hampshire, when he is found guilty of the cold-blooded killing of a policeman and his step-daughter. After eleven years on Death Row, the end is coming for Shay. Until he sees a news piece about a young girl who urgently needs a heart transplant. June's husband and daughter died at Shay Bourne's hands, and she thought her greatest desire was to see him killed. Then her remaining daughter is hospitalised, and she realises that there is something she wants even more: for Claire to live. Shay Bourne is offering June's daughter a miracle - a second chance. But at what cost?

I've read both My Sister's Keeper and Handle with Care (my reviews are here and here respectively) this year and vastly preferred both of them to this one. I've had a strange relationship with Jodi Picoult  - I either love her books or can't even finish them, like The Pact and Salem Falls. Well, I did manage to finish Change of Heart at least, but it was a bit of a struggle to stay focused. 

For me, the blurb is quite misleading. Although the plot does revolve around whether or not Shay Bourne can donate his heart, it's very indirect. Predominantly, it's more about whether he is or is not a reincarnated Jesus Christ. Honestly, I just don't think it was necessary for the story. The plot could have simply been based on Claire's need for a heart and June's uncertainty as to whether to accept it from the murderer of her other daughter. The whole religion aspect (and it was a huge part of the book) only over-complicated and dragged down the more interesting storyline, in my opinion.

I mean, the author has obviously done her research, as always. The detail included about Judaism, Christianity and Atheism is immense but unfortunately, I still prefer her medical ethics books. That's kind of what I thought this book was going to be, but Claire and her heart problem barely featured. Not only that, but the author's usual depth of character was missing also. Maggie, Michael and Lucius were all very real, but then they were secondary players, either from the prison or Church. The characters that were actually important to me - Claire and June, were very two-dimensional and flat. In the end, I really didn't care if Claire got her new heart or not. Ouch. I think I just crossed the line into Bad Person Territory.

The author is renowned for her shocking endings. The first Jodi Picoult novel I read was My Sister's Keeper, and I pretty much wandered round in a dazed trance for days afterwards. She's obviously tried to do the same thing here, but it just fell flat on its ass. I don't think I've ever sworn at a book before, but I did here. It's just... awful. It doesn't keep to the tone of the book or even manage to be that shocking really.  

Jodi Picoult's novels are all supposed to revolve around the question 'What would you do?' Her other books present a difficult choice to be made, usually over the welfare of the character's child and a sacrifice that needs to be made. I think this is kind of where this book fell flat - to me, there just wasn't a choice. It was painstakingly obvious what the answer was and I wanted to throttle June for not seeing it immediately. In my opinion, and I admit I don't actually have children, no mother would have questioned the decision to be made.

Visit Jodi Picoult's website here, or find her on Twitter.

Review: Handle with Care by Jodi Picoult

You know a book's good when you fight past the oncoming drowsiness of sleeping pills at 2am, in order to just read a few more pages. Not very good for my insomnia perhaps, but I whole-heartedly think it was worth it.

Charlotte O'Keefe's beautiful, much-longed-for, adored daughter Willow is born with osteogenesis imperfecta - a very severe form of brittle bone disease. If she slips on a crisp packet she could break both her legs, and spend six months in a half body cast. After years of caring for Willow, her family faces financial disaster. Then Charlotte is offered a lifeline. She could sue her obstetrician for wrongful birth - for not having diagnosed Willow's condition early enough in the pregnancy to be able to abort the child. The payout could secure Willow's future. But to get it would mean Charlotte suing her best friend. And standing up in court to declare that she would have prefered that Willow had never been born... 

I have a strange interest in medical ethics due to a module that I half-heartedly agreed to study at Law School and then loved. I love issues of consent, termination, euthanasia... anything to do with the medical world and the legal problems therein. It explains why I also loved the last Jodi Picoult book I read (my review of which is here), about a child's refusal to donate organs to her dying sister. Handle with Care is very similar, using the familiar formula of family-related medical ethics and a trial in court.

I have a fair-weather relationship with Ms. Picoult - the two books that I've read and finished I absolutely adored. However, I started both The Pact and Salem Falls and couldn't finish either of them. They deal with teenage suicide and false rape accusations respectively, and I didn't find them nearly as interesting. Admittedly it was a while ago, but it taught me to stick to the medical issue books.

Obviously, they're very similar. Both have a Mother at the heart of the legal action, a Father who doesn't agree but just wants to keep his head down, ensuing marital problems and an ignored but troubled sibling.  I think that's why these books get slated so much - their similarity. But so what!? The two I've read were both amazing. I've never known novels that could pull you in and really make you care for the characters like those by Jodi Picoult. They're all real with their own personalities and flaws, and the dialogue is so believable that you have to remind yourself that it isn't a documentary.

But whereas I liked the ending of My Sister's Keeper, I didn't like it here. I saw the 'twist' coming, but only because I'm familiar with her previous books. It reads like she shovelled it in purely because she needed a shocking ending to match those in all her books. It just didn't feel necessary.

I particularly liked this book because it raised a few personal issues. In case you haven't gathered from my continuous yet subtle hints, I'm taking my Bar course next year to study to be a lawyer. The attorney in this case, Marin, disagrees with the whole concept of Charlotte's case whole-heartedly; she thinks it's repulsive and immoral. However, she;s bound to represent her case  regardless of her own views. For me, this is an issue I've struggled with a few times - could I represent someone whose beliefs or actions thoroughly offended my own?

What it boils down to, in the end, is that every single review is going be biased depending on your moral standpoint and circumstances. I've read several where the reviewer thinks people like Charlotte O'Keefe should be steralised at birth and therefore see the entire plot concept as ugly and offensive. I've also read others more sympathetic to her financial situation and emotional struggles who therefore enjoyed the book more.

As for me... I loved the book and completely understood Charlotte. The beauty of Jodi Picoult's writing lies in the continuous switching of narrative, which results in a full understanding of the thought processes of each character. In Handle with Care you see the reasoning of both the defendant and claimant, and therefore (ideally) sympathise with both. Although I can understand why what Charlotte did was controversial, it was Sean and his naivety that irritated me more. If it came right down to it, I'm not sure I wouldn't have done the same.

Review: My Sister's Keeper by Jodi Picoult

So, just to continue with my apparent 'parents-who-make-terrible-medical-decisions-for-their-children' phase, today we have My Sister's Keeper by Jodi Picoult. See also my review of The Adoration of Jenna Fox here, while I try terribly hard to nip my growing obsession in the bud.

Sara and Brian are devasted when they can't find a donor for Kate, their little girl with leukemia. So, in desperation, they have a 'designer' baby - Anna, who is the perject genetic match for Kate. They plan to only use the blood from her umbilical cord, a procedure that will neither hurt or inconvenience her. But as Kate's condition worsens, they need Anna to donate more and more.

When Anna is thirteen, her parents assume that she will willingly donate a kidney to Kate. If she doesn't, Kate will die. But Anna is fed up of feeling invisible next to Kate and sick of never being asked for consent. She goes to court to sue her parents for the right to her own body.

I first read this in 2007, and it hurt me so much that I swore blind I would never, ever read it again. I both loved and despised it for the way it hurt and moved it me, but I just couldn't bring myself to get rid of it. I'm not sure why I went back to it yesterday, but I'm glad I did. It's a wonderful, wonderful book.

The plot itself is very original - I've never read anything like it before. Family sagas, or whatever you want to call them, aren't my usual kind of book, but Jodi Picoult's books usually revolve around some kind of contraversial issue (designer babies and sacrificing one child to save another, in this case) and involve legal aspects and a court case, and the two combined more than sustain my interest.

   I pull Anna to her feet, one shoelace still untied. Dragging her out of the gymnasium, we reach the car before we say a word.
   Anna scowls. 'Why did I have to leave the party?'
   Because your sister is more important than cake and ice cream; because I cannot do this for her; because I said so.
   I'm so angry that I have to try twice before I can unlock the van. 'Stop acting like a five-year-old,' I accuse, and then I remember that's exactly what she is.

As I said, I have read this book before, so the ending wasn't such a shock. The first time though, I cried like a child. Not one slow tear rolling slowly down my face either - full on sobbing and dribbling (attractive, right?) . I never saw it coming and I don't know anybody that did.

What makes it so clever is the way Anna never comes off as selfish, not once. Even though you know and she knows that her lawsuit would indirectly result in her sister's death, Ms Picoult makes sure you know that its not motivated by selfishness or a desperate bid for attention  - its a genuine wish to have her opinions listened to. What she is doing to Kate breaks her heart, but she can't go on being used as a walking organ suppository.

On the other hand, you have her parents. Brian is unsure how he feels - he desperately wants Kate to recover, which means she needs a kidney; but he loves Anna equally and wants her opinion to be respected. Sara is adamant that Anna is just having a tantrum and constantly shouts at her to get a grip. At times she made me so angry, I'd have slapper her if she wasn't so, well, fictional.

   I duck my head. 'I don't want to do it anymore.'
   That ignites my mother. 'Well, you know Anna, neither do I. In fact, neither does Kate. But it's not something we have a choice about.'
   The thing is, I do have a choice. Which is exactly why I have to be the one to do this.
   My mother stands over me. 'You went to a lawyer and made him think this is all about you - and it's not. It's about us. All of us-'  
   My father's hands curl around her shoulders and squeeze. As he crouches down in front of me, I smell smoke. He's come from someone else's fire right into this one, and for this and nothing else, I'm embarrased. 'Anna, honey, we know you think you were doing something you needed to do-'
   'I don't think that,' my mother interrupts.
   My father closes his eyes. 'Sara. Dammit, shut up.' Then he looks at me again. 'Can we talk, just us three, without a lawyer having to do it for us?'
   What he says makes my eyes fill up. But I knew this was coming. So I lift my chin and let the tears ago at the same time. 'Daddy, I can't.'

Despite this though, you never doubt that either of Anna's parents genuinely love her. That's the beauty of Jodi Picoult's wonderful writing - you can really understand the conflicting emotions behind every character and see their confusion. They each seem so real, they're never cardboard cut-outs with only one emotion.

It was made into a film a year or two ago, so I'll probably use this one for my Book to Movie Challenge. My only concern is that it stars Cameron Diaz as Sara, and she doesn't look nearly old or haggard enough. But we'll see. That's my plan for this evening, I think.

The Adoration of Jenna Fox by Mary E. Pearson

 

I downloaded a sample of this onto my Kindle while I was killing time a few days ago (my iPhone had died and apparently I self-destruct without some form of technology) and was hooked after the first chapter. I definitely need a paper though - some books just need to sit on a shelf!

Amazon - 'A seventeen-year-old girl wakes from a year-long coma and is told her name is Jenna Fox. She doesn't remember the accident; she doesn't remember her life; she doesn't remember herself. Her parents show her home movies of her past, but is she really the same girl she sees on the screen? When the memories start to come, they come with questions – questions no one wants to answer. How did the accident happen? Why does her own grandmother hate her so? And why does she feel her parents are hiding her away? Who is Jenna Fox?'

At first glance (and second, actually) I assumed that the title was referring to a love interest. A stalker, maybe. But its actually nothing like that. Jenna's parents are almost obessed with their daughter, having documented her entire life on camera. She can do no wrong in their eyes - she is the most perfect creature on the planet and nothing must ever, ever happen to her. But when their precious daughter is about to die after a terrible car accident, they go to profound lengths to save Jenna at whatever cost. The underlining question throughout the novel is how far will a parent go to save their child?

At times it seems as though you've actually inside Jenna's head - sometimes phrases of disjointed phrases are just thrown at you as she frantically tries to piece together what's happened to her. She irritated me at times as she can be quite nasty and selfish, but I guess waking up after a year in a coma would leave me a little testy too. Her mood swings and concerns are obvious though - you're never left wondering why she's acting in such a way.

The twists in this book just don't stop. There's some new revelation coming at you every other page and each one is as shocking and moving as the last. Just when Jenna thinks she understands whats going on... something new is revealed. It's so fast-paced and unnervingly shocking.

Why on earth do I have an urge to call her Bella?

My ultimate favourite thing was the relationship between Bella Jenna and her grandmother, Lily. They adored each other before the accident but Lily disagreed with the actions taken to preserve Jenna's life and resents the 'new' Jenna - she feels that this 'version' is an imposter. 

'"Eighteen months ago, I let go of my granddaughter," she says. "I said good-bye. I grieved. Then a few hours later, your parents told me what they had done."
"And you thought it was wrong?"
"I'm not like your parents. I think there are worse things than dying.'

It's wonderful. Lily actually wants what's best for Jenna and considers the quality of life she'll end up having. She's possibly the most real person in the entire book, as she comes to terms with how her grand-daughter has changed and how she's the only one who can help her.

I didn't see the ending coming, but it was wonderful when it did. So perfect in every way. Apologies for the vague-ish review as it's very difficult to write about The Adoration of Jenna Fox without mentioning all the discoveries and twists - I'm dying to talk about them but I can't!

You can look at it on Amazon here.