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Archive for the ‘Non Fiction’ Category

Being Mortal (2014) is a blend of memoir, research and comment, with a number of case studies which Gawande uses to make his point. The book’s subtitle, Illness, Medicine and What Happens in the End is a useful summary of the contents of the book but doesn’t give any clue to the emotional weight it carries, dealing as it does with death – which in this context is inevitably a reminder of one’s own death.

Gawande bases the book partly on his own experience as a surgeon. He says he learned little about aging or death in his medical course; learning how to deal with the problems of old age and dying had to be learnt first by experience and then by personal research. Thus he also draws on his experience as a son, and son-in-law. His parents, both medical doctors, migrated to America from India, so he never knew his grandparents. The first old person he really came to know was his wife’s grandmother, Alice. Over the course of the book, both Alice and his father get sick and die. This lived experience on his part adds considerable emotional depth to what otherwise might have been a colder, technical discussion.

Gawande is concerned with two related issues: the institutionalisation of the aged, and the medicalisation of death. He understands why families are no longer willing or able to look after their aging relatives, and indeed why aging relatives often seek independence from their children. But he abhors the regimentation many institutions impose on old people, supposedly for their own safety but often for institutional convenience; it saps purpose and hope from old people’s lives. Through several case studies, including that of Alice, he looks at some of the attempts to humanise institutions or find alternatives to institutional care, such as assisted living facilities. This latter was an attempt to meet the needs of old people for independence, rather than subjecting them to regimentation, even if it kept them safe. Though initially successful, he admits that with the proliferation of assisted living facilities, the concept has been weakened, and regimentation, being cheaper, has crept back in.

But no matter how independent old people are able to be, there comes a time when illness, or failing health due to old age, shunt us into the medical system. Where once people died at home, without much medical intervention, they now (at least in the Western world) mostly die in hospital after sometimes lengthy medical intervention has run its course. At what point is hospital necessary? And more importantly, how should doctors treat people who are near death but not yet terminal? This is perhaps even more of a problem for younger people with terminal diseases than for older people, as one of Gawande’s case studies shows. He argues that doctors are trained to solve medical problems, so favour treatment options which may prolong life, even if they reduce quality of life. He considers that medical professionals are very good at offering options for treatment, but very bad at explaining to patients and their families the options for not treating. He acknowledges it can be very difficult to decide when treatment does not offer reasonable hope. Even when patients have specified they don’t want to be resuscitated, the decision to withdraw treatment can be difficult and relatives often press doctors for further procedures against the patient’s wishes, such is the faith in medical science.

While he does not suggest there are easy solutions to such dilemmas, Gawande, from his own experience and research, advocates home hospice care for people who are terminally ill. Hospice care – called palliative care in Australia –  involves provision of pain relief or other medication to ease suffering, but not usually other forms of treatment. But the first step is to find out what the patient really wants, which in turn involves talking about their death. What is important to them? Is being with family and friends more important than living a little longer in hospital? Gawande touches briefly on euthanasia, which is legal in three American states, concluding that while people are comforted by knowing it is available, few use it. He clearly prefers the home hospice alternative, and studies have shown that people may in fact live longer using it than they would have in hospital. His case studies, however, including that of his father, show that no option works smoothly, without pain to the patient or their relatives and friends.

I noted that all the case studies Gawande uses are of people with loving families or concerned friends. Spouses are willing to help their terminally ill partners with daily routines and to make accommodations to all their needs. But what of those without such support of whom there must be many? Furthermore, few people can afford to pay for the personal home care old and frail people require. Institutional care may be their only option. It is not clear in the book how care or treatment is paid for. Most of the forms of care Gawande describes are private, though some appear to be state-subsidised. Indeed, how Gawande has dealt with funding is the only issue on which his book disappointed me. He does acknowledge that being well off means being able to afford better care both in terms of accommodation and medical treatment. But the vast discrepancy in health care between the rich and the poor in America is not discussed, and nor is the growing disparity between the life expectancy of rich and poor Americans.

Gawande’s plea that we think about our own deaths, and discuss our wishes with family and friends is relevant to everyone. But it is particularly relevant to older people like me. I found Gawande’s perfectly correct insistence that old people get ill and die a bit depressing, though challenging. Would what seems like common sense – that quality of life and imminent death are preferable to longer life but extended suffering – look the same when the choice has to be made? But there is also hope in the book that we can retain our right to choose the best death possible.

You can read more about Gawande’s writing, surgery and research here on his web-site.

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The full title of Don Watson’s The Bush: Travels in the Heart of Australia (2014) is truly revealing of all the questions he asks in this book. First there is the matter of ‘the bush’ itself, which Watson shows can mean anything from not-the-city, through landscapes such as scrub, grassland, mallee, rainforest or any specific remnant of the pre-European countryside. The nature of Watson’s ‘bush’ is in the eye of the beholder; it is a cultural creation. Then there is the sub-title, which is both literally and metaphorically accurate. Watson travels throughout Australia – inland, into its heart – visiting people and places and telling their stories. But the book is also a journey in the sense of an exploration of people’s different cultural understandings – both past and present – of the bush, of the values that it encapsulates and their place – for better or worse – at the heart of Australian society today.

This is not a ‘start at the beginning and go on to the end’ book. As Watson says, ‘Readers will soon find this story straying all over the place, as the bush does, as I did’. It does start with Watson’s childhood on a dairy farm in East Gippsland, and ends with him living at Mt Macedon, an hour out of Melbourne. But in between, each chapter is to a degree random – swagmen here, pesticides there, and Major Mitchell thrown in for good measure. But there are themes running throughout which give shape and form to Watson’s meditation. These, addressed in no particular order, include the Aboriginal relationship with the bush before European invasion, Aboriginal dispossession – there seems to be reference to a massacre in nearly every chapter- European attitudes to the bush, the struggles of settlers, the degradation of the land by farming and pastoralism and the hold the bush has over Australians’ idea of themselves.

Watson is remarkably fair in his discussion of these themes. Perhaps because of his own rural background, he understands the pride settlers took in ‘civilising’ the bush and making it productive in European terms. ‘Good human lives were lived where the forest had been, enterprise was rewarded, the fellowship of men and women flourished, history was recorded. The bush we know would not exist if we had not cut it down.’ On the other hand, he is fully aware of the costs this enterprise had for Aboriginal people, for the plants, birds and animals, both native and introduced, that were destroyed along the way and the ultimate environmental damage white settlement has caused. He recognises all the good and socially useful values fostered by life in the country, but is equally aware of the narrow, anti-intellectual cast of mind it also produced. He talks about some of the attempts to reverse the degradation of the land, as well as the foolish rejection of expert advice about the effects of a warming climate. And he is fully aware, as anyone reading this book must be, that the civilised benefits we now enjoy were made possible by the destruction of Aboriginal society and the natural environment. ‘In the plainest terms,’ he writes, Australians would not be who they are – and would not know themselves – if they had not fought the war with nature. The same is true of the war fought with Aborigines’. All the while reading the book I felt the truth of this; my own ancestors were among those clearing – or destroying – the bush, the creatures, and quite possibly the people – who had lived there.

The sense of melancholy versus the sense of optimism which the book engenders feeds into the dispute between the left and right of politics about what are Australia’s central values. This dispute, commonly known as the ‘history wars’, involves an argument over whether Australia’s history post colonisation offers a bleak vision of destruction of people and environment, as opposed to a triumphalist one of successful white settlement. Watson addresses the central issue in this war; that of national identity. He looks at the ‘Australian Legend’, the idea that the virtues of mateship, solidarity, egalitarianism and disdain for authority were born in the bush and became part of the Australian national character. While the legend was initially part of a radical vision, it has more recently been appropriated by conservatives who have elevated the bush ethos into the ‘national interest’, and gloss over the racism, narrow mindedness and anti-intellectualism that are the other side of the coin. Russel Ward, who described – or -possibly conjured up – this legend, concedes that ‘It is not so much the bushman’s actual nature that matters, as the nature attributed to him by so many men of the day.’ Watson would agree; the bushmen he describes were honest, hardworking, lazy, drunken, idealist, mad and foolish in the same proportion as anyone anywhere else in Australia. ‘It is possible that for every couple of bushmen who chose to be mates’ he writes,’ half a dozen others had mateship thrust upon them.’ His judgement, finally, is even-handed; he gives both to the bleak and triumphal. ‘Along with steady, sometimes near miraculous progress, the record includes not only follies, but repeat offences and incalculable lost opportunities. The mistakes were so many and so devastating in their consequence we have to remind ourselves sometimes that the story overall is one of triumph: over formidable, indifferent, inscrutable nature; over all kinds of hardship, including the self-inflicted kind; over ignorance, fashion and dogma.’

Of the bush, Watson says ‘we need to love it as it is and can be, not the way it was and never will be again’. At his home at Mount Macedon, he does not try to recreate the ‘original’ bush, which would indeed be impossible because the bush was never static. Instead, his motto seems to be ‘whatever works’, in his case a mixture of local plants, plants from elsewhere in Australia and introduced plants, chosen with an eye for their fire-retardant properties.’ This balance of local and imported vegetation can stand as a metaphor for the subtle complex of meanings Watson has woven in this book. Dip into it.

You can read more about Don Watson here. Or you might like his book There It Is Again: Collected Writings(2018).

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Lynne Kelly is a science communicator and teacher. This book (2016) is essentially her PhD thesis, but also an account of her journey to understand the scope and importance of the insights she has gained into the uses of memory in non-literate cultures. Beginning from an interest in the stories told by Indigenous Australians about animals, Kelly developed a theory of memory use by non-literate cultures across the globe.

Kelly starts by explaining the breadth and depth of knowledge that existed in non-literate cultures. Societies that were to any degree nomadic required knowledge of where to find water and edible plants. They needed knowledge of the habits of animals and how to hunt them. They needed to know the forms of the land, the weather, and the seasons. They needed to know their ancestors and their founding myths, who they were, and where they came from, who they could marry and who they could not. They needed to know the terms and conditions of trade. They needed to know secular and ceremonial songs and dances. As hunting and gathering gave way to settled farming, some of the same information was still crucial, but there was further information needed about tools were made and much, much more. How on earth did they remember all this?

She then expands on her theory that people in non-literate cultures used systematic memory aids. Those in nomadic cultures, like Australian Aborigines, who moved about in the landscape, developed what are known in Australian ethnography as song lines, physical and mental maps of the landscape where specific features acted as aids to memory, not just for direction, but for layers of meaning about time and place, seasons, the stars, ancestors, kinship, hunting and so on. Aboriginal people also carried portable memory aids, small objects often marked with abstract patterns, which were understood by those initiated into certain levels of understanding. Kelly establishes that memory spaces equivalent to song lines and portable memory devices existed across a range in quasi nomadic cultures.

A major change in the form of memory aids came about, Kelly argues, when quasi nomadic groups began to settle into farming communities. As they no longer routinely travelled long distances, the ‘song line’ model no longer suited their needs. Instead, they began to build memory spaces near their settling communities. She argues that while some archaeologists claim agriculture freed up time for people to build monuments, she believes the reverse is true: that ‘people needed to build monuments in order to preserve the knowledge system to enable them to settle’. These monuments usually took the form of standing stones or wooden pillars, arranged in precise patterns; there were also mounds, passage cairns and long barrows. Each stone or pillar represented a body of knowledge. Some also encoded the seasonal calendar. Kelly argues further that access to knowledge was restricted to initiated groups, with a hierarchy of knowledge held by a hierarchy of elders, on a continuum from public knowledge to highly restricted knowledge. In line with this, memory sites had both public and restricted areas; the public areas were for performance of songs and dances, and the restricted areas were for restricted performance and higher-level initiation into knowledge. Kelly argues that  societies creating such monuments were relatively egalitarian; the labour to build the memory spaces, which involved huge numbers of man hours, appears to have been freely given, and any elite burials found at such sites ,ie where grave goods have been have been part of the burial, appear chronologically later in the history of the site, and often not at all. This suggests, she says, that knowledge, rather than wealth or military power, animated the societies that built the memory spaces. Wealth and might came later, superseding knowledge, and the memory spaces gradually fell into disuse.

Kelly then goes on to look in detail at a number of memory spaces which she believes fit this pattern. The best known (to me, anyway) are Stonehenge and the standing stones and earthworks around Avebury. Similar monuments also exist in Brittany. But comparable memory spaces, can, she says, also be found in Orkney, and in Ireland. Then, perhaps more surprisingly, she uses examples from the Americas, suggesting that the creation of these memory spaces is a natural human reaction, rather than a learnt one, as these cultures can not have had any contact with the European ones. I found these sections of the book particularly interesting as I was completely ignorant of these cultures.

So it she right? She certainly assembles a convincing array of archaeological evidence, as well as the little remaining oral evidence from descendants of those who used the memory spaces. Earlier archaeologists tended to see the sites she describes in religious terms, and to label any portable items as ritualistic. Kelly suggests the emphasis on religion is a reflection of modern concerns for which there is not much archaeological evidence. She writes, for example, that attempts ‘to marry the actions of non-literate cultures to behaviours in contemporary Western religions acted as a barrier to understanding these complex sites’. She agrees that the chanting and dance that she believes were characteristic of the memory spaces did have a spiritual or aesthetic side, but sees much of it as the promulgation of practical information – though she would argue that knowledge was holistic, containing layers of complexity that could combine all these elements. I certainly find her argument convincing.

As a book, I did find it a bit repetitious in places; she perhaps overdoes the need to hammer home her argument in the simplest of terms. I would also have liked a coherent argument about the earlier misinterpretation of the sites she describes. I also question her use of the term egalitarian for the societies she is describing; they were clearly hierarchical to a considerable degree, though not necessarily rigidly so. I think it likely that there were ordained roles, some granted more respect than others. She is not able to talk much about whether there were gendered roles, though there probably were; one example she gives is from Pueblo culture where men used a coded language that ‘women would not be able to understand’. For me, the saddest thing is that we can’t know: the content of most of the knowledge is gone beyond recall. It is particularly sad that this is true for much of the culture of Indigenous Australians, despite their tenacious efforts to hold onto what they can.

Kelly says she has tried using memory spaces herself, with considerable success. I thought also of historian Tony Judt’s memoir, Memory Chalet, which is based on the same technique.  I don’t think I can manage it though.

You can read more about Lynne Kelly here.

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Published in 2006, this book purports to be an account of the work of an American writer, speaker and philanthropist, Greg Mortenson, as per the subtitle: One Man’s Extraordinary Journey to Promote Peace … One School at a Time. It is a flawed book about a flawed man. But I found it inspiring. I say ‘purports’ because it turns out some of the details are not true. I’ll nevertheless stick with ‘inspiring’ because the essential truth is that not only did Mortenson single-handedly begin the work of building schools for children, particularly girls, in remote northern Pakistan and later Afghanistan, he also told the American people that the war on terror could not be won by bombs; it had to be won by education.

Mortenson, a trauma nurse by training, was an avid mountaineer. In 1993, having failed in an attempt to climb K2, the second highest mountain in the world, located in northern Pakistan, he stumbled into a village below it. The villagers helped him recover. He saw they had no school building and promised to return and build one. The details about how this happened are among those contested; apparently, he only briefly visited the village and in fact returned later to promise the school. I agree accuracy is important and here Relin, the professional author who did most of the writing, has tried to make the story a bit more dramatic than it actually was. But given how subjective biography always is, I don’t find this a knockout blow. (There is at least one other contested incident where Relin has overdramatised; some people take this as invalidating the whole.) The book then goes on to explain how Mortenson went back to America and tried to raise funds for his school, how he was assisted by a benefactor who set up the non-profit Central Asia Institute for him, how from one school it grew to many, how Mortenson negotiated  the incredibly difficult landscape of northern Pakistan – physical, political, social and religious – and how he fared after the 9/11 attack on the World Trade Centre led to an American war on the Taliban in neighbouring Afghanistan.

The book is a sort of case study of the growth of one person’s commitment to an idea into a significant non-government organisation, with all the strengths and weaknesses this involves. Mortenson had the dream and the drive to make it happen. Even if Relin overstates the devotion Mortenson seems to have attracted in Pakistan – and he certainly does lay it on a bit thick – Mortenson was clearly visionary, brave and dogged. Maybe he was a bit obsessive. But it is amazing that one man, with just a small band of supporters in Pakistan and America, could accomplish anything where past promises of government aid had come to nothing. That he succeeded in establishing any schools for girls in a poor Muslim country is particularly to his enormous credit. There is a bit of discussion in the book about whether NGOs coming in and changing traditional practices is a good idea, as it will change a way of life in balance with its environment; the book heads one chapter with an approving quote suggesting ‘an ancient connection between ourselves and the earth … that ancient cultures have never abandoned.’ It is clear, however, that improving education, water supply and maternal health are welcomed by those who have to live with the downside of the traditional practices. On the other hand, Relin makes it clear that Mortenson didn’t have the administrative skills or inclination to control the organisation properly. He is open about the fact that Mortenson disliked the fund-raising side – though he got better at it as he went along – and that he was ‘goofy and unbusinesslike’. For the first several years, funds were limited, and he begrudged spending money on administration in America that he felt could be better used in Pakistan. He found it hard to do tasks he disliked – like keeping CAI’s board informed of what he was doing. Even by the time of publication of the book, the organisation was suffering from poor administration.

Just how badly it suffered only became clear after the book was published. It was an enormous success and generated revenue far beyond anything the CAI had previously enjoyed. Mortenson also made a lot of money from speaking fees. Then came the backlash. In 2012, questions about the authenticity of the book were raised, as were concerns about whether all the money was going to the charity. People who had previously supported Mortenson turned against him. After an inquiry found there was no intentional wrong-doing on his part, Mortenson agreed to repay $1 million to the organisation, and was banned from taking a leadership role in it. Sadly, the allegations about elements of the story being untrue caused Relin, already suffering from depression, to commit suicide.

While scandals about the book and Mortenson’s financial mis-management seem to be the frame through which many people view him, to me there is a much more important story. And that is Mortenson’s attempt to argue to his American audience that education is more important than bombs in the war on terror. Indeed, he was acutely aware that bombing, which inevitably killed civilians, made Americans hated in Afghanistan and Pakistan. He saw with concern the spread of Saudi Arabian funded madrassas, preaching the fundamentalist Islamic creed of Wahhabism, some of them home to militant extremism. He respected Islam, but wanted children to have a balanced general education, not religious indoctrination. He understood that support for the Taliban came from anti-Americanism, ignorance and a perversion of Islam. This was not what many in America wanted to hear. Of course, only a conspiracy theorist could possibly suggest a direct connection between his criticisms of the war on terror and accusations of impropriety against him. However, framing him as corrupt and incompetent has deeply compromised other possible ways of looking at his work in promoting peace one school at a time.

You can read more about Mortenson and what happened after the book was published here. And this is a summary from the Washington Post giving both sides of the story, and where he was up to in 2014. These are also interesting: https://www.youtube.com/watch?v=-bFnjDigs_w; https://www.youtube.com/watch?v=wH7wmSuMB8k.

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The Last Explorer (2005) has the sub-title Hubert WilkinsAustralia’s Unknown Hero. And before reading this book I had never heard of him. As Nasht points out, even though he was born in South Australia, he hasn’t even been accorded the honour of a commemorative plaque on Adelaide’s historic walk. Yet Nasht makes a convincing case for his heroism that should have made it impossible to ignore him. Why then is he so little known in the country of his birth?

One explanation is suggested by a review of the book in The Age by Bruce Elder, who puts Wilkin’s relative anonymity down to the fact that Wilkins ‘spent most of his life being either unsuccessful or living in the shadow of others’. Nasht certainly works hard to refute this view, and Wilkins’s life gives him plenty to work with. You can read the Wikipedia summary here and his somewhat underwhelming biography in the ADB here. Born in 1888 in the mid-north of South Australia to a family struggling to make a living on a farm on marginal land with patchy rainfall, he dreamt early of improving meteorology, a passion Nasht says informed the rest of his life. Falling almost by accident into the dangerous career of aerial photography, he took part in various Arctic expeditions, and became an official Australian war photographer in the First World War.  He was decorated for bravery and praised by General Sir John Monash as ‘a highly accomplished and absolutely fearless combat photographer’. After the war he took part in scientific expeditions to the Southern Ocean, and in northern Australia. But his passion was exploration in both the Arctic and the Antarctic, which he believed could best be undertaken from the air. After a number of hair-raising brushes with disaster, he succeed in 1929 in flying across the Arctic from Alaska to Norway, a feat for which he was knighted.  His next major expedition involved trying to sail an American First World War submarine named Nautilus under the Arctic ice, but the Nautilus was ill-equipped and possibly sabotaged and the mission failed. Wilkins kept busy, but never again attained the hero status he had previously held in America.

I don’t think Nasht has overstated his outstanding bravery, or his tenacity. But Elder is right that despite these qualities, he didn’t make major discoveries, and the submarine venture was a dangerous folly.

The explanation which is offered by Nasht for Wilkins’s relatively unknown status in Australia is that on the expedition to northern Australia, he criticised both the treatment of Aboriginal people and the wholesale destruction of the local flora and fauna. This he suggests, was considered unforgivable by the Australian government and public alike. This seems unlikely to me. More important was the fact that after the war, Wilkins lived and worked in America, and was famous there, rather than in Australia, because several of his expeditions were financed and publicised by the Hearst newspapers, which had no reach in Australia. He’s probably also right that Wilkins was a modest man who disliked self-promotion, unlike several of the other explorers operating at the time. Nasht emphasises his commitment to scientific exploration rather than the simple race to be the first to be somewhere or to do something which dominated the media reporting of exploration up to the Second World War. But then he would, wouldn’t he.

Given that the risks of polar exploration were so great, I was hoping that Nasht would shed light on what motivated Wilkins to put his life in danger so often, especially after his marriage. He quotes Wilkins as follows:

Is it the primitive thirst for adventure, the desire to penetrate the unseen and unknown; to experience the thrill that comes from the presence of danger and the satisfaction one feels at facing and narrowly cheating death that takes me again and again to the polar regions? Yes, it is, to a certain extent, but the experienced know that there is a thrill greater than that of adventure. It is the thrill of worthy accomplishment.

What are we to make of this? It sums up for me the reason for Wilkins’s lack of recognition; he is ‘worthy’, but dull, and this makes it hard for Nasht to tell a good story about him. Indeed despite the daring things Wilkins did, I only occasionally found the book gripping. Furthermore there is something a bit pedestrian about Nasht’s writing; it does not inspire. This is not an evaluation of Wilkins’s achievements; Nasht rarely criticises him, and seems determined to prove him a hero. Elder suggests the book would have been improved by being shorter, and he may be right; Nasht seems to have included material from every source he could find, leading to an unnecessarily detailed account.

For all that, I think Wilkins does at least deserve one of those commemorative plaques in Adelaide.

Nasht is a journalist, and film maker in partnership with the entrepreneur Dick Smith. I wondered if he felt a sense of affinity with Wilkins in having to scrounge around to get funding for his projects, which you can read about here. One notable one is the ABC documentary I Can Change Your Mind About Climate (2012) in which he placed together a climate change activist and a climate change denier, allowing them both to discuss their views with people they claimed as authorities on the topic. Many people thought it presented the reality of climate change as a debatable topic rather than something for which there is overwhelming scientific evidence. You can read his defence here. In the book, he highlights the ways in which Wilkins had an early understanding of climate change, perhaps another reason why he deserves to be better known.

 

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Published in 2015, The Brain’s Way of Healing is a sequel to The Brain that Changes Itself (2007). Subtitled ‘remarkable discoveries and recoveries from the frontiers of neuroplasticity’, it continues the popularisation of the concept of the brain’s neuroplasticity described in the earlier book. Doidge, a doctor himself, is a skilled medical science communicator. I found what he had to say in the earlier book about how the brain can compensate and redirect was fascinating and exciting, as the concept that the brain is not a hardwired machine was new to me. This book looks at understanding and using healing techniques that make use of this neuroplasticity, the reality of which is now, Doidge considers, taken as a given by neurological research. I found it mostly interesting, but sometimes a bit preachy.

Each chapter is devoted to a particular condition that Doidge argues is amenable to a treatment that makes use of the brain’s inherent ability to repair itself. As in the earlier book, he uses a particular case study to illustrate how a specific treatment can ameliorate or even cure the patient’s symptoms and/or underlying problem. These problems include chronic pain, Parkinson’s disease, traumatic brain injury, multiple sclerosis, attention deficit disorder, learning difficulties and stroke. Doidge identifies four stages in the healing process: neurostimulation, which helps revive dormant circuits in a damaged brain; neuromodulation, which helps build new circuits and overcomes learned non-use in existing circuits; neurorelaxation, where the brain stores energy needed for regeneration; and neurodifferentiation and learning, where the brain’s circuits begin to regulate themselves and allow for normal functioning. The treatments all rely on this ‘rewiring’ of the brain by methods including visualisation, lasers, sound/music therapy, electrical stimulation and exercise both physical and mental, though he is essentially claiming there is no difference between the physical and the mental. (He approvingly quotes Moshe Feldenkrais, who wrote that ‘the unity of the mind and body is an objective reality. They are not just parts somehow related to each other, but an indispensable whole while functioning.’) He notes in an appendix that while he has linked one possible treatment to one problem, in practice some combination or sequence of treatments would usually be tried. He doesn’t claim that all – or indeed any – of the treatments will work for all people with these conditions, but argues that any or all are worth trying, as they have no adverse side effects, and often at least improve the situation where conventional treatments including surgery and medication do not.

The treatments – at least as practiced in the West – all seem to be the brainchild of a particular individual or small group of researchers, though some have roots in Eastern practice. No doubt Doidge is correct that neuroplasticity is now accepted science, but the practitioners he discusses all seem to be working on the margins of recognized practice. Some, indeed, such as Moshe Feldenkrais, worked on their treatments well before there was any understanding of the brain’s plasticity, an understanding which Doidge says now explains why their tratments work. I seem to remember that the early leaders in neuroplasticity were loners on the scientific frontiers, and presumably that’s how scientific breakthroughs are made. Doidge only includes examples that he has personal knowledge of, the researchers and practitioners that test the science often belong to well-regarded institutions, and there is a whole section of notes and references at the end of the book to which the sceptical can refer. He notes in the acknowledgements that his editor suffered a stroke part way through the publication process, and was told he wouldn’t recover much of his lost functioning, yet recovered sufficiently using techniques from the book to finish editing it (though I wish he’d put the picture of the brain at the front, not the back of the book). Some of the cures are, nevertheless, hard to believe.

And the response to the book has been mixed. One critical review, for example, concludes that ‘[t]hese cures and their emphasis on the patient’s willpower and moral fibre are, at best, bizarre’. Certainly some of the cases Doidge outlines involve highly motivated people who would not have succeeded without that motivation. As one of the patients says ‘you have to want it really badly’. The problem here is that someone else trying the technique, who for whatever reason lacks that will power, will feel themselves to blame if the treatment doesn’t produce results. And yes there can be a moral element to the judgement that they just didn’t try hard enough – victim blaming in other words. On the other hand, some of the treatments, for example those targeting learning difficulties, are designed to help children, and at least initially only require a passive response. It’s true that a number of the examples are cases of last resort but this is presumably because the techniques are new and not yet adopted by most mainstream doctors, who continue to offer treatment within the existing paradigm. A further concern is that such cures offer false hope to patients and their families. Doidge never says they are suitable for all people with the conditions he discusses, and emphasises that they are mostly not do-it-yourself remedies – they require skilled assessment and monitoring, which are resources in very short supply in most parts of the world. Nevertheless, his enthusiasm for the techniques would give hope to those with the conditions – but a hope probably unable to be fulfilled.

I was telling a friend about this book, and she asked why, if the techniques Doidge champions are so successful, are they so little used? Are they the sort of crazy stuff you might find on medical self-help sites on the internet? Have they been rigorously assessed and found wanting? Or will they, like the concept of neuroplasticity itself, become in time the new paradigm for the treatment of conditions affecting the brain? Time will tell.

You can read more about Dr Doidge and his work here. Here’s a rather less hostile review. And here’s one totally hostile one from a medical writer and parent of an autistic child (and yes Doidge does come close – dangerously in my view – to linking autism and vaccination). And here’s another totally hostile one from an evolutionary biologist who pulls no punches. Ah well, science thrives on controversy.

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Foreign Correspondence (1997) is an early autobiographical work, coming before Brooks had published any of her prize-winning fiction. You can read my review of one of her well-regarded novels, People of the Book (2008) here. This one is not really an autobiography as such; rather it’s a view of her life through a particular lens which focuses on the themes of staying and leaving.

The book has a sub-title – which doesn’t for some reason appear on the edition I read – which pretty much tells you what it is about: A Pen Pal’s Journey from Down Under to All Over. As a child being brought up in what she suggests was one of the more boring suburbs of Sydney, Brooks finds ‘the opening I’d looked for to the wider world’ by writing to pen friends, first in Sydney, then America, Israel, Palestine and France. Much later in life, she decides to follow up her pen friends and find out what has happened to them. Thus in Part I the book follows her life growing up in the suburbs and her departure from Australia to become a foreign correspondent – hence the full double meaning of the title. Then in Part II comes the later intertwining of her life with those of her pen friends and the wider world. ‘The geography of this childhood correspondence,’ she writes, ‘has become the road map of the adult life.’

Although she is quite self-deprecating about it, Brooks is clearly exceptionally clever. Is there something in her childhood circumstances that contributed to this? Is it nature or nurture, or possibly, a bit of both? She was effectively an only child; her only sister was eight years older. Her father was an American jazz singer who put all that behind him soon after settling in Australia, to become a sub-editor on the Sydney Morning Herald; he has clearly influenced her life choices. Through his interest in journalism, she came to see that ‘Australians had lives that were worth writing about’. He was not an easy man; ‘I learned that if I wanted to talk to him it was easier to follow his adult interests’. From this she comes to see that there is a world outside Australia, and sets out to find out about it though reading, and her search for pen pals. However in this account, Brooks’s mother is perhaps the greater influence. As a child Brooks was often ill and unable to go to school; it was her mother who helped and encouraged her, and played games that inspired and informed her creative imagination. It was her mother who could ‘enter a child’s world with ease and spend comfortable hours there’, giving Brooks comfort and security in what might otherwise have been a lonely childhood. School – a Catholic girls’ college – is passed over with little comment; clearly she does not see it as an important formative influence.

Brooks grew up passionate about whatever it was that caught her interest, be it Star Trek, kibbutz in Israel, or the Paris student uprising in 1968. All of these coincided with or contributed to her search for pen friends. Sometimes she doesn’t get quite what she expects, either from her pen friends, or her unfulfilled teenage rebelliousness. She is, nevertheless, able to conclude from the victory of Whitlam’s ALP in the 1972 Australian election that ‘It is a great thing, at seventeen, to learn that it’s possible to change the world’. But it is inevitable that she will, like many others, leave Australia to pursue the fulfilment she seeks overseas.

I’m not going to outline the stories of each of Brooks’s pen friends. They all raise interesting and sometimes disturbing questions about life choices, perceptions of the world, and its realities. Each of them opens up a conversation that Brooks confronts with honesty and humanity, and sometimes humour. She writes with an easy fluency, honed perhaps by her experience as a journalist, and coming to full fruition in her later fiction. The use of her penfriends as a way into her life and experiences works exceptionally well as a structure for the book.

As an Australian brought up in an even more boring suburb than Brooks, I can’t help comparing our experiences. She’s younger than I am – though her schooling was apparently a bit less empowering – and that makes it a bit easier for me to accept her complete superiority in everything she’s done. I can only admire her courage and determination, as well, of course, as her intellectual prowess. Why didn’t I keep writing to my pen friend?

You can read more about Geraldine Brooks here. And this site contains a list of her works of fiction, which include the 2006 Pulitzer Prize-winning novel March, a major achievement since the prize is for distinguished fiction by an American author, preferably dealing with American life. Brooks became an American citizen in 2002. But she still calls Australia ‘home’, sort of; you may be interested in her Boyer Lectures 2011: The Idea of Home (or “At Home in the World”).

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