The Midwife’s Apprentice by Karen Cushman

Brat is on her own; she cannot remember her parents, and no one cares for her. She sleeps in the village dung heap as it’s by far the warmest option, and not so very much worse smelling than the rest of the village. The village midwife takes her in as a skivvy, to sweep and damp and tamp the cottage floor, scatter fleabane about to keep, yes, fleas at bay, and run the occasional errand. Though the cottage floor is not near so warm and soft as the dung heap, being provided food, however inadequate, gives Brat the time and energy to notice the world around her, and wonder if she might dream of becoming more than a beggar brat.

As Brat begins to settle in, she takes note of the midwife’s practices, the herbs to bring on milk, stop or intensify contractions, the charms to ease a woman’s labor and the general techniques Jane Sharp uses. Daring even to give herself a name, Alyce, she begins to think she’s earned a place in the village; a comb and a bath, an intact dress and nearly enough to eat, and she’s on her way. Not only does she befriend a cat, but arranges a position for a little boy of six, at first only called Dung but later Edward for the king, at the local manor house. Gaining confidence from aiding the local cowherd’s boy to deliver his favorite cow of her twin calves, Alyce, as we now must call her, dares help a local woman give birth after the midwife leave to deliver a likelier baby. She succeeds here—the baby is named Alyce Little—but flees aghast when she subsequently takes it upon herself to deliver another woman, but fails to deliver a difficult pregnancy.

She takes refuge in a nearby tavern-inn, using the work habits she’s learned with the midwife to earn her keep and then some. Even the local absent-minded scholar, staying at the inn for a quiet place to study, notes her keen wit and begins “teaching the cat to read”; needless to say, Alyce eavesdrops and learns her own letters easily enough. After Alyce helps a guest at the inn, thought to have a stomach worm, deliver a baby, Jane Sharp tracks her down. While she does not force the girl to come back, she makes it quite clear through an indirect conversation with the absent-minded scholar that she does not consider Alyce to be the incompetent dung-beetle the girl herself thought she was, but rather a girl who foolishly gave up after her first setback—determination is the key. Alyce comes back; at first Jane seems to send her away, but Alyce returns, saying “It is I, your apprentice. I have come back. And if you do not let me in, I will try again and again. I can do what you tell me and take what you give me, and I know how to try and risk and fail and try again and not give up. I will not go away.”

Karen Cushman’s written several books about girls in Medieval England: Catherine, called Birdy, Matilda Bone, and others. The language and setting is such that squeamish parents might want to reserve Cushman’s books for older kids, and indeed they might be good for teenaged reluctant readers, or those who think that history is dull lists of names and dates as dry as the desert. If you’re a curious tween with parents who understand the value of challenging reading, however, don’t let that previous statement stop you; all Cushman’s books are rattling good fun, about strong-willed girls, or those who learn to value themselves and the merits of determination and education. If you’ve read all these books, and are looking for something to read next, try Jane Yolen’s historical novels, or E.L. Konigsberg’s A Proud Taste for Scarlet and Miniver…or indeed any of Konigsberg’s other books. They’re not all historical, but again interesting stories about girls who learn to be bold and sure of themselves.

The Spirit Catches You and You Fall Down by Anne Fadiman

The basic premise of this book is simple enough: a Hmong family brings their infant daughter, Lia, in to the emergency room of a hospital in Merced, California. She is having an epileptic seizure. The doctors do what they can to treat the child, then and in subsequent visits, but the parents do not follow through on the requested regimen. Lia’s condition continues to deteriorate; after several years of treatment, Lia arrives at the hospital in the throes of a particularly bad seizure, and despite medical efforts, she ends up brain-dead as the result of oxygen deprivation.

What lifts this above a mere “he said, she said” medical account is Fadiman’s delving both into the Hmong culture and her access to the Lee family’s home life. Her book thereby ends up being as much socio-cultural documentary as it does description of medical treatment; the parents allowed Fadiman considerable insight into their own background, and she did what appears to be a creditable amount of research into the Hmong culture as a whole. One thing to keep in mind, when reading this book now, is that not only was it written fifteen years ago but also the author is describing events that took place fifteen years before that. I don’t know how hospitals’ policies have changed in regards having translators available, at least for the major languages spoken in the specific community (and Hmong were a significant portion of Merced’s minority population even then. Think immigrants from Mexico and Central and South America.)

Like a few other reviewers on Goodreads, I am not convinced that the cultural gulf between the doctors and the parents was the only cause of Lia’s death. Contributing factor, to be sure. That lack of communication affected her health and well-being while she was alive, certainly. None of us will ever know, however, whether a child of acculturated American parents with a similar condition would have lived or died; epilepsy, like many conditions, comes in a range from mildly discommoding to untreatably entrenched. If the child’s epilepsy falls at the severe end, or the patient does not respond to treatment despite following it scrupulously…what do you think would happen?

I do, however, come away from this book with a sympathy for the parents. If the situation were reversed—I were in a town outside Luang Namtha and non-English-speaking doctors kept insisting on treating me with acupuncture but never explained WHY they chose this modality over that one—I’d respond much as the parents here did. Differences in treatment methods aside, how can you possibly give informed consent when you cannot comprehend the doctor’s explanation? In fairness to the parents, too, there are more than a few “non-compliant” patients who’re of the same culture as their physicians, and who speak the same language as the hospital staff; we ought not to lay the blame for the parents’ choice not to medicate their child purely on the doorstep of ‘cultural misunderstanding’. Drugs’ effects can sometimes seem worse than the condition they’re supposed to be alleviating.

Overall, I think it’s still worth reading, not least for the background into the Hmong culture. I’d hope, however, that if there was sufficient interest in the community, the library would respond by getting more recent books on the subject, whether medical or cultural.

Hallucinations, by Oliver Sacks

People whom no one else can see, smells without source, sounds that aren’t otherwise audible? Miniature battles enacted on one’s bathrobe sleeve, an unwanted intruder in the kitchen doing dishes? Hallucinations, or reality? Well, there are two schools of thought on that, largely dependent on whether you’re the one having the visions or the outside observer.

Sacks’ latest books, Hallucinations, is, not surprisingly, about hallucinations, both his own and those of his patients. The sources or causes of the hallucinations he describes range from health issues which are primarily known for producing hallucinations, such as Charles Bonnet syndrome which appears largely in those who’ve lost their sight, to syndromes the primary symptoms of which are unrelated to hallucinations, such as Parkinson’s or epilepsy…and of course, a soupcon of externally created hallucinations, such as those ensuing from sensory deprivation or drug use.

It’s an interesting introduction to the subject—Sacks is an engaging writer when it comes to explaining medicine to a lay audience. He covers a wide range of hallucinations, from the simple and easily resolved visual scotoma of migrane sufferers to the voices of schizophrenia to the multi-sensory full-stage visions of Charles Bonnet syndrome. (It’s almost a pity he didn’t extend the reach of this book a bit further to cover the invisible friends of childhood!) Something to note for those unfamiliar with medical terminology is that this book does not cover delusions—those being the (almost certainly) mistaken beliefs held by people with psychological issues such as schizophrenia and various psychoses…though for all the “normal” know, these could be prompted by hallucinations…

This didn’t strike me as being one of Sacks’ better books; whether that’s a criticism depends on how well you like his previous books. Certainly, authors have every right to change their writing style over the years, and indeed medicine itself has changed considerably over the course of Sacks’ time in practice, both in terms of diagnostic criteria and tests or treatments used in the course of working with patients. Hallucinations can have such a broad range of causes that Sacks seemed forced to skim over the range of causes and sub-sets, from dementias to strokes to drug use (legitimate or…er…self-prescribed) and on to dreams or hypnagogic states. Nevertheless, it’s a good place to start for readers with little to no background in medicine, whether from the professional or the personal standpoint. As always, he manages to include a great deal of medical information without overwhelming a lay reader.

I would suggest starting with Sacks’ earlier books, which are more like collections of articles rather than a single monolithic work, not least because it might give readers unfamiliar with neurology, psychology and Sacks’ writing style a basis on/with which to compare this book.

Reviews:
The Guardian
New York Times

The Doctor Wears Three Faces by Mary Bard

Who is Mary Bard and why should readers today care about her? Well, chances are most people have no clue who she is and won’t care to find out. This entry is largely for people who’ve got “what was that book”itis, vaguely remembering books written in the 1940s and 1950s, or perhaps those of us who just enjoy the writing style of the time.

For those who are interested, Mary is the sister of Betty MacDonald, who wrote the Mrs. Piggle-Wiggle books in addition to her own autobiographies: The Egg and I, The Plague and I, Anybody Can Do Anything and Onions in the Stew. While I’m not sure her books have stood the test of time as well as her sister’s, Mary was popular enough in the post-World War II period to have written three books of her own. They’re out of print now, however.

The Doctor Wears Three Faces is about the early years of Mary Bard’s marriage to physician Clyde Jensen (referred to in the book as Jim Jay). Marriage to a doctor isn’t quite as sophisticated as Bard had expected, between the long and erratic hours a doctor practicing internal medicine often has–patients can’t time illness for office hours–and the fellow physicians talking shop at parties, among other issues. Overall, the book reads as if she were trying to present her life in a humorous way, rather than a complete and accurate (as she perceived both) description of life as a doctor’s wife; while there are problems, to be sure, I can’t feel terribly sorry for her, which is, I suspect, rather her point.

While I haven’t read her other two books, I’d guess that Mary Bard’s works bear about the same relationship to Betty MacDonald’s works as Frank Gilbreth’s later books do to the first two he wrote with his sister, Ernestine Carey, Cheaper By the Dozen and Belles On Their Toes. That is, if you like Cheaper By the Dozen and Belles On Their Toes and wondered what happened to the other family members, you’ll probably be interested in Gilbreth’s later books about his life and family. Or if you wanted more information on family members MacDonald mentioned more or less peripherally, you’ll like Bard’s books. If you’ve never read MacDonald’s autobiographies and haven’t the interest in or patience for the autobiographical style of the time, these won’t be appealing. As with sister Betty’s biographies, the description of non-Americans (Japanese in this case) or non-Anglo Caucasians may stop some readers cold–neither sister’s opinion would be acceptable to sensitive readers today–but if you’re able to glide over such issues (and you like Betty MacDonald’s work), Mary Bard’s books might be worth a try.

Mary Bard wrote three non-fiction books, approximately autobiographical in nature, and the “Best Friends” trilogy, fiction about an American girl who befriends a French girl, just arrived at her very cliquish school. If you liked these, you might want to try Jean Kerr’s collections of articles about her life, children, house hunting and so on: Please Don’t Eat the Daisies, The Snake Has All the Lines, or Penny Candy. The writing style is similar: they both might be described as “mordant wit”, but with the sense that this may not reflect their own personal opinions or life. There’s something they’re holding back.

HistoryLink Slide Show about Mary and Betty

The Voyages of Doctor Dolittle by Hugh Lofting

The Voyages of Doctor Doolittle may serve today as an example of how literature has changed over time; I cannot imagine this being published today, much less winning the Newbery Award. Aside from the fact that, so far as I can tell, the Newbery’s current eligibility criteria would eliminate the author as he’s from outside the United States, the racism alone would sink it before publication.

I understand recent editions of the Doctor Doolittle books have been edited to temper this racism; I can’t say that I blame the publishers, though it’s possibly worth reading them in the “original” as part of a discussion with kids (and adults!) on how public attitudes and acceptable images have changed in the ninety years since this was written. The non-white cultures aren’t dismissed entirely; in The Voyages of Doctor Doolittle, the greatest naturalist in the world is a ‘Red Indian’, and indeed Long Arrow has much to teach Doctor Doolittle when they meet. However, the fact that the tribe is presented as a group of simple savages, without even the knowledge of fire, undermines this to say the least. In The Story of Doctor Dolittle, Dolittle travels to a small country in Africa, Jolliginki, in order to inoculate monkeys; here, he’s captured by the king who wants no white man in his country1. The Crown Prince, Bumpo, frees Doctor Dolittle from his father’s prison in exchange for bleaching his face white so that he can win the princess of his dreams. Having read the complete text of the book in question, the best I can do in terms of description and reaction is ambivalent. I don’t think Lofting was being condescending, post-colonial or dismissive, by the standards of the early twentieth century. Being of the melanin-challenged peoples myself, I’m not really in a position to judge whether the sympathetic portrayal of the characters can balance what is quite rightly regarded as racism today; I think Lofting was trying to present the characters as sympathetic, with at least some regard for their point of view, but I can understand and forgive opposing interpretations easily.

Now for the book itself!

The Story of Doctor Dolittle, the first book in the series, is more a collection of short stories or anecdotes, apparently originally sent home to children of his acquaintance by Lofting when he served in World War I rather than relay what was actually happening at the front. Based on implied and explicit dates in both books, The Voyages of Doctor Doolittle takes place almost twenty years after the majority of the stories in The Story of Doctor Dolittle, in 1839, and has not only a more cohesive narrative but reads more smoothly, as if (not surprisingly) Lofting had practice in writing a story.

The Voyages of Doctor Doolittle begins as the narrator, a young boy named Tommy Stubbins, becomes acquainted with Doctor Dolittle after requesting Dolittle’s assistance with in an injured squirrel. Stubbins, as he is called in this book, serves as Watson to Dolittle’s Holmes in this book; he quickly becomes enamored of Dolittle and desires only to work for and learn from this learned and gentle man. Fortunately, Dolittle not only doesn’t mind an enraptured boy trailing behind him, but recognizes Stubbins’ latent talent and readily takes the boy in. Stubbins’ parents realized that their son will have a better chance with Dolittle, unconventional as he may be, than he would if he remained at home with them, inasmuch as Tommy’s father, the town cobbler, is too poor to send his son to school. (This was obviously before free government-based schools became available.)

Shortly after Stubbins becomes part of the Dolittle household, Dolittle sets off on a sea voyage in search of the famed naturalist, Long Arrow, whom the bird-of-paradise Miranda believes to be missing. Stubbins, Dolittle, Polynesia the parrot, Jip the dog and Bumpo, crown prince of Jolliginki, now an undergraduate at Oxford, set off to find Long Arrow, with a pause at the Capa Blanca islands mid-Atlantic to restock food and other supplies, restore their funds and rectify a bit of animal cruelty in the form of weekly bullfights–Doolittle simply explains to the bulls what he wants to do, and the bulls are happy to play along as they aren’t exactly keen on the whole bullfighting shtick, being under no illusions about their chances of coming out of the ring alive.

As a child oblivious to issues of racism, I would have loved to live with Doctor Dolittle as he appears in this book. He goes on exciting adventures with nary a mention of dull things that one’s parents insist upon, such as regular meals or bedtime, teeth brushing and dressing properly. (though they do eat well and dress appropriately) Nothing fazes him–not stowaways, not arranging to defend a man falsely accused of murder, or arranging to replenish their funds and supplies in a strange country while simultaneously rectifying treatment of animals through stopping the bullfighting, not even being shipwrecked without so much as an island in sight. As dawn begins to break over the fragmented scraps of what remains of their ship in the last mentioned scenario, Stubbins finds Dolittle tranquilly shaving by the light of the moon with a shard of glass for a razor and the sea a mirror. Whatever happens, he will not only come through but bring his companions safely with him. (Of course, being able to communicate with animals doesn’t hurt: porpoises are happy to collect any fragments of ship upon request, birds carry messages, whales push islands and giant mythical sea snails give him rides.) He isn’t magical–his talents are pragmatic–but like Mary Poppins, wonderful things happen to those associated with him, and his companions come safely home.

As with The Wind in the Willows, the book’s language is outdated enough to perplex many kids today, but the author does not talk down to his readers, sugar coat difficult or traumatic events, or treat them as foolish. Indeed, Tommy Stubbins very much appreciates that Doctor Dolittle addresses him as ‘Stubbins’ straight away, rather than Tommy or worst of all “my little man”; the idiom may be alien to American kids but the condescension is as aggravating here today as it was then and there. As a child reading the book fifty years after its publication, I appreciate Lofting’s ability to describe bullfighting and a Court of Assizes in terms I could understand; neither concept being one I was familiar with2.

As an adult book reviewer, I can temper my opinion somewhat by reminding myself “Times change.” but I couldn’t in honesty suggest this to a children’s services librarian for purchase if it wasn’t already in their collection. I suspect that it’s largely of interest to nostalgic adults or as part of a module in grade school about changes in literature.

1can you blame him?
2the scene in which Dolittle cross examines Luke the Hermit’s bulldog about events witnessed years earlier stuck with me to this day

Passage by Connie Willis

What is it about the Titanic that still speaks to us, even now 100 years after the ship sank? The tragedy of needless loss of life? the gallantry of all those men who stepped back from the boats? the valiant efforts of the crew? the need for greater oversight of industrial and commercial safety procedures? There’s a message in it for us today, as there is in a good many events and works of literature.

Joanna Lander is a cognitive psychologist doing a study of people who’ve had Near Death Experiences, to determine whether the NDEs are a biological response to the process of dying or a transit to the afterlife. Richard Wright is a neurologist studying the neurological effects of the NDE by inducing pseudo-NDEs in volunteers. The two decide to work together several chapters into the book, after considerable initial confusion about the purpose of their research stemming from several reasons. They both distrust a spiritualist, Mr. Mandrake, who has written a number of bestsellers putting forth the religious view of the NDE debate, and each believe at first that the other is working with Mandrake. There’s considerable miscommunication between departments and individual staff members. The structural complexity of the hospital in which they work1 ensures that they keep missing each other, as quite literally “you can’t get there from here.”

Wright’s project doesn’t go well, even after the two connect. Lander removes a number of his volunteers from the eligibility list before they even get to the “gate” of going under dithetamine, as they’re True Believers in psychic phenomena, UFOs and other supernatural events, and presumably already ‘contaminated’ by nemesis Mandrake’s faulty interview techniques. Of the few remaining volunteers, some can’t recall or relay accurately what they’ve experienced, and some simply aren’t available. Their only moderately successful subject withdraws after a few sessions, claiming excess of schoolwork but showing evident signs of fear. Finally, Lander herself agrees to participate as a subject in the project on the theory that not only will she be able to more accurately describe what she experiences than non-medical professionals, but also having herself gained some knowledge of the NDE process will allow her to better phrase questions in a non-leading way when interviewing future participants.

For those who’ve groused about the needlessly complex tangle of hospital hallways, the needlessly repetitive failure of the pagers, trust me. They’re as important to the plot as the central image of Lander’s NDE experience2. Symbolism? Yep. Lots of it. But then that’s rather the point of the book: how desperately do we try to convey messages to one another, despite all the barriers that fate throws in our path? how often that message gets through despite insurmountable obstacles? At the risk of spoilers, not even death stops the transmission of information, if the impetus is strong enough.

If you’ve read more than a couple of Connie Willis’ books, you’ll spot all sorts of tropes, themes and character patterns from her previous books. Precocious and endearingly annoying child? check. Two scientists working on separate but complementary projects who decide to work together? check. Rushing from pillar to post in an attempt to communicate with phantasmic co-workers? Check. And so on. On the other hand, if you’ve read more than a couple of Connie Willis’ works then chances are you like her stuff and won’t mind as much as a novice reader.

Though I understand there are any number of readers who will give up a few chapters in out of sheer exasperation3, if you’re at all interested, stick with it. Willis swaps directions several times–she hasn’t got a particular agenda to prove in this book and so is neither woo-woo pseudoscientific or snarkily debunking of a theory. I particularly appreciate her decision to write the pivotal denouement as she did; not all authors are that brave. Just make sure you’ve got tissues at hand by about page 400, depending on the edition you’re reading.

1two hospitals and a nursing school cobbled together with a complex network of hallways, vaguely reminiscent of the human brain and neural network
2I’ll assume readers have figured out what that is by this point in my review.
3and promise not to be offended if people do give up

Doc by Mary Doria Russell

Ever wonder what the Mythic Figures of the American West were really like? were the legendary events of story and song actually as they’re portrayed in story and song? Probably not. Certainly, the Gunfight at the OK Corral wasn’t; it didn’t even take place in the corral in question.

Well educated for the time and place, Southern gentleman John Holliday is diagnosed at 22 with tuberculosis–the disease that killed his mother–at a time when the only known cure for tuberculosis was “a dry climate”. He ends up in Dodge City, Kansas after a failed attempt1 at setting up a dental practice in Texas. Perhaps not surprisingly given the somewhat primitive nature of dental technique in the late 1870s2 in contrast to Holliday’s skill at the gaming table, he can make a far better living dealing faro and playing poker against the youthfully unskilled (at least in cards) cowpokes who come through Dodge during cattle drives. He has an on-again-off-again relationship with M├íria Katarina Harony3, a woman of Magyar descent who grew up in pre-revolution Mexico, who had previously supported herself (as so many women did in that time and place) as a lady of negotiable affection4. While Kate returns to that profession frequently for the simple expedient of earning money, she also uses her connections therein to find the highest stakes games for “Doc”.

Things go smoothly enough, for a frontier town, until Johnnie Sanders is found burned to death in the wreckage of a barn conflagration, raising two problems. First, Johnnie is mixed-race, in this case American Indian and African-American. Equally importantly, he was a skilled faro dealer and had been working the tables for some months prior to his death; given his talents and the house odds, he should have had a considerable amount saved…but where is it?

Just a word of warning to fans of Western legends, Mary Doria Russell’s novel Doc is set in the years before the Tombstone showdown when the Earps and “Doc” Holliday were in Dodge City, and skips over the (in)famous shootout at the OK corral. Not surprisingly given the title, the novel concentrates on “Doc” Holliday. There’s a fair bit of gambling, whoring, roistering and [whispers] liquor, as befits a story about the comparatively lawless West shortly after the Civil War, so this might not be suitable for sensitive or youthful readers5. Given the context of the book–a comparatively lawless town comprised largely of men and a few women who braved the travel in order to exploit the men’s loneliness–the book’s quite mild; there’s nothing prurient in Russell’s narrative. …and another warning for fans of Mary Doria Russell’s previous work: this is quite different from her previous works, just in case the Western setting wasn’t enough of a hint. Russell touches on a number of issues in Doc, as she has in previous works: familial relationships, medical treatment, racial perception, religion.

Overall, I’d say it’s a good addition to the literature about legends of the West, and would wholeheartedly recommend it to people who are looking for good books about the “gunslinger” period of the American Western expansion. It’s a novel, and should be read as such, rather than a purely factual biography; anything which involves conversations between historical characters and ascribes thoughts and emotions to said people must be considered fiction rather than truth. I found a few aspects to ring false notes. Doc occasionally sounds shanty Irish than Southern United States, as if Russell couldn’t decide how to transcribe his accent. At a number of points, the author inserts foreshadowing factual statements, presumably drawn from the primary resources she used as background which, unfortunately, jolted me out of enjoying the book for what it is: a well-written work of fiction about a group of factual historical personae.

Web site about Wyatt Earp

1due in no small part to a financial panic at the time
2not to mention that little matter of Holliday’s persistent cough
3whom the locals usually call “Kate”
4with a nod to Terry Pratchett
5or rather those with overly protective parents