lightreads | Entries tagged with medicine

The Song of the Cell

4/5. Very good medical history and topic exploration under the broad umbrella of cellular biology. A lot of expected things here – IVF, cancer – but also some surprises and his usual elegance and humanism. Ignore the subtitle, it’s dumb publisher irrelevance.

Early: An Intimate History of Premature Birth and What it Teaches Us About Being Human

4/5. What it says on the tin. An upsetting, fascinating look at prematurity and its prevalence, history, socioeconomic and racial components, and consequences. The prologue is the story of the author's daughter, born at less than two pounds (she survived), what her treatment was like, what it felt like to hold a baby that small against your chest, when even breathing too vigorously on them could decompensate their nervous system. It's a lot. I confused Casterbrook, who I was nursing when I picked up this book, by sniffling onto his fuzzy head.

Because, well, okay. This is a very good book, and I recommend it. But for me, it was (not consciously until later) a sort of purgative. Other people's birth/pregnancy trauma helped me work through some of mine. It's like trauma calisthenics, and it worked, reading this book off and on for a few days, generally while nursing my healthy, thriving full-term one year-old who wouldn't be here today if the cards had landed a little differently. I didn't have a premie (though landing in L&D at 32 weeks is no fun, even when you're 80% sure you're okay) but somehow reading about other people's early births and the ways their babies survived or didn't helped me revisit ( pregnancy loss, contemplation of late abortion, pregnancy complications ).

Anyway. It's a good book. Also, unrelatedly, by a food writer whose recipes at the NYT I like. Casterbrook is, in fact, a pretty big fan of this soup.

Content notes: Um. Babies die in this book. Not all of them, though. Not even most of them, that's the point. Also, babies receive a lot of medical care, some of it pretty horrific.

Between Strangers: Surrogate Mothers, Expectant Fathers, and Brave New Babies by Lori Andrews

4/5. An overview of surrogacy as it stood in 1989, written by a lawyer and reproductive justice advocate. You'd think a thirty-year-old book would not have much bearing on the world as it is now, considering the multiple revolutions in fertility technology since, but you'd be wrong. This book is mostly about women entering into contracts to be inseminated with a man's sperm, to birth his child, and to surrender that child to him and his wife. These days, generally a woman contracts to have her menstrual cycle suppressed then restarted, and to have an embryo inserted into her uterus, to carry the child, and more often than not the child is legally that of the intended parents upon birth. Yet the debates described in this book between feminists, between lawmakers, are exactly those you hear now. Which is pretty sad, from my perspective.

Anyway, what will stick with me from this book is the story of one surrogate who carried her own child, then three for infertile couples, then suffered a stillbirth of her own child, all while waging a war for women's reproductive freedom against state lawmakers who didn't believe that midwife care should be permissible. This book tells many other stories – one famous one of a surrogate who was unfit to be one and who tried to keep the baby after, and one of a surrogate who was taken hideous advantage of by the intended parents. There's a lot of power exchange in these relationships, and it can go wrong. And it's women's bodies on the line, even more than it is the completion of families suffering infertility. This book really gets at that, and the fiercely feminist reasons for thinking hard about that and regulating sensibly and carefully, without ever telling women that they aren't allowed to do this extraordinary thing.

Pale Rider: The Spanish Flu of 1918 and How It Changed the World

4/5. Brief bites of chapters about the 1918 pandemic – its history, possible origins, biology, social aftermath. Extremely instructive. Could have been four times the length and still would have been fascinating. As it is, this is light in the sense of touching fleetingly upon many places and people and topics, not in subject matter.

Expecting Better

3/5. Economist gets annoyed with the pregnancy-industrial complex, reads a lot of studies to figure out what is real and what is bullshit. Great principle – there is a general movement towards evidence-based birth and parenting, and I'm for it – and she does have a good eye for spotting obvious biases and studies. But I have a bad taste in my mouth about this book. Yeah, she made a pretty significant analytical error regarding data around birth timing (fixed in a later edition, I believe), but eh, that happens. And yeah, this is the book I was reading last fall when I was pregnant, and the book I stopped reading while I was becoming unpregnant over several terrible weeks of waiting and shots and side effects and blood and unanswerable questions.

Mostly, I think it's that she's taken out all the obnoxious preachiness about the right way to pregnant, and replaced it with slightly less obnoxious preachiness about doing what is right for you. I mean, she's not wrong, but JFC, give it a rest.

A useful book though. I do recommend it to pregnant friends who want to cut through a lot of the bullshit and just have someone tell them, with an actual fucking reason, what foods it's not worth the risk to eat.

She Has Her Mother's Laugh: The Powers, Perversions, and Potential of Heredity

4/5. Quick, everyone write your erudite yet personal doorstops on genetics! It's apparently what one does now. Luckily, there's a lot to say; this book has remarkably little to no overlap with Mukherjee's, which came out around the same time.

I read this over a . . . complicated few weeks in March while waiting to find out if my 2 in one hundred thousand diagnosis is the 1 in 1.25 million that is now treatable (it's not – don't say your sorry, it's based in ableist assumptions about what I was going to do with this information, and your ableist assumptions are quite possibly wrong) and also while waiting for the amnio results that would likely decide whether my pregnancy is ending in a live birth or not (baby is absolutely fine, exhale, it's okay).* So yeah, an interesting few weeks to be reading about the applications and misapplications of genetics.

It's a good book; less technical than mukherjee's in a lot of ways, and also a bit less philosophical, but with fascinating diversions into mosaicism and how we could probably wipe out mosquito-born malaria in a few years if it weren't so terrifying and possibly unethical. I do have to say that the author is pretty interested in his personal genome which, fair enough. But I've come to realize that listening to someone else talk about their genes is about as interesting as listening to someone else talk about their dreams. Which is to say, 90% of the time, it's of great significance to the speaker and absolutely none to anyone else in the world. Seriously, have you ever had to sit through someone recounting in excruciating detail what percentage of which part of their heritage comes from different parts of Europe? No one cares but you! In the 10% of really interesting discussions might be this fascinating story, which is of course interesting because it only starts with genetics but has to do with so much more.

*Oh yeah, that. Yeah. I'm due at the end of the summer. :D

Like a Mother: A Feminist Journey through the Science and Culture of Pregnancy

3/5. This was a rec from someone at NPR and, uh, oh boy yes it sure was a rec from a person at NPR. I kid with love. Anyway, this is about 60% pregnancy/miscarriage/birth/post-partum memoir written by a woman of color, 20% "science," and 20% cultural commentary from a feminist and sort of intersectional perspective (I don't actually give anyone's intersectionality credit when it doesn't include disabled people, and hers doesn't seem to). I came for the science, and ended up enjoying the memoir. I've read a lot of miscarriage and birth stories, and a good writer – which she is – can make something you've heard a thousand times real again. This turned out to be good, because the science parts of this book are supposed to be the things that women just don't know about their bodies, and, uh, I already did? Maybe it's the circles I move in, but these "revelations" about the prevalence of untreated pelvic injury and the specific mechanisms of immune support via breast milk are not news to me. She's not wrong that they should be more widely understood, though, and in general I'm in favor of this movement towards science-based pregnancy and birth practices (though in the case of this book, underpinned with an amount of woo about trusting women's bodies that I wasn't quite ready for).

Basically, it's an NPR rec book.

The Gene: An Intimate History

5/5. This book is a doorstop, but worth every page. It covers a huge amount of ground – from Mendel and his pea plants to Carrie Buck to Rosalind Franklin to the ethics of recombinant DNA to the just-last-year reality of actual live genetic therapies approved for use in the U.S. With several pauses along the way to discuss the author's family and the strain of hereditary illness criss-crossing it.

It's no mystery why I'm reading this now. I believe that our genes make us who we are far more strongly than many people are comfortable admitting. This has been becoming even clearer to me as the baby who owes her existence to an egg I donated grows up and, without having interacted with me more than once a year or so for her entire life, continues to be eerily like me, down to the pathologically strong terror of strangers developed at the exact same age and fading at the exact same age. (She looks like me too, but that's way less interesting). I dearly wish a lot of straight, fertile couples would have the strange experience of having to go to a sperm bank or an egg bank and pick someone out. It sharpens the mind in a way that I think is salutary, if uncomfortable. Makes you articulate what you want in a child in a cold-blooded way. Makes you state your values in people as commodities.

And, well, the other thing. I mentioned up there the newly-approved – as in less than a year ago – genetic therapy. Yeah. The first genetic therapy approved in the U.S. is for my primary disability. It may not work on me – actually, the odds are strong it will not. And the fact I haven't done much about it until now probably tells you a lot about my feelings on the matter. But I do need to know, eventually. Will I get an injection that rewrites the protein-encoding DNA in my optic nerve and improve my acuity up to 1000%? Probably not this shot, the mutation prevalence breakdowns tell me. But another shot ten years from now? Yeah, that is a real thing I'm going to have to really deal with, it seems like.

So naturally I read a book about it. One of many to come, I suspect.

The Art of Waiting

4/5. Infertility memoirs are like war memoirs: highly personal, with a bent towards the philosophical when they’re good, tending to be a bit nonlinear in the way memories are when they are formed under traumatic circumstances. It’s just that war memoirs are written by men and win prestigious prizes, and infertility memoirs are written by women and get shelved, inexplicably and it turns out wildly inaccurately, in the “health/diet” section of my electronic library (why?).

This is a pretty good one. It’s frank about the things that don’t get talked about except on infertility blogs, like just how much five years of trying cost, and what the insurance covered and what it wouldn’t. It’s also the sort of book that a thoughtful, writerly person would write after five years of trying and failing and regrouping and trying to move on and starting the adoption process and coming back to try again. So it’s very personal to her, but she also turned her thoughts to other people who came at the same problem from different places, like a gay male couple, and, most painfully, one of the still-living victims of North Carolina’s eugenics sterilization program. The one thing this book is not about, weirdly, is her marriage. I happen to know for a fuckin’ fact that going down this road when it’s long and hard will change your relationship, no question. So it’s an odd omission at the center of this story.

But that’s okay. It’s her war memoir. She gets to tell the parts she wants and keep back the parts she doesn’t.

P.s. They did ultimately get pregnant, if that’s something you need to know before reading.