Book Review: Complications

“No matter what measures are taken, doctors will sometimes falter, and it isn’t reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.”

Unlike other medical themed books I have recently reviewed, Complications, by Atul Gawande, is set in the USA with its insurance based system of healthcare. I can only assume that payment was not an issue for the patients treated as there is never any question, in any of the cases detailed, of the cost of the complex care provided. Indeed, when cost has already been taken care of, the tests and treatments offered are perhaps more complex than may actually be required.

Written when the author was a surgical resident, he explores in this book the myriad reasons why sometimes fatal mistakes can and are being made. These serve not to lessen the reader’s confidence in doctors but rather to remind us that they are human, and that they must learn a craft that is constantly changing due to welcome advances in surgical techniques, equipment and medication.

The first section of the book, Fallibility, explores the need to teach doctors for the future good of all. They must practice on patients if they are to adequately learn, and as they progress will not always be under close supervision. In the USA doctors become specialists in very particular areas leading to better statistical outcomes as the surgery and subsequent treatment is familiar to the clinical team. Nevertheless, individual patients will not always react in a uniform way. They bring their differing health issues, and sometimes doctors will diagnose incorrectly. With a growing culture of litigation, professional honesty may prove inadvisable. There is discussion of reliance on machines, rote learning and the improvements achieved through practice. One chapter looks at what happens when previously good doctors repeatedly fail to achieve satisfactory outcomes. It can be a challenge to kill the career of a once respected colleague, even when their actions are inadvertently killing patients.

The second section looks at the mysteries encountered in medicine, the diagnosis and results that remain inexplicable. One chapter touches on pain and the role of the brain, the reluctance to accept psychosomatic causes of physical issues. There is a chapter on prenatal nausea, another on blushing. The limited effectiveness of medical interventions alongside the lack of drugs for certain problems is acknowledged. The chapter on obesity suggests this problem is a particular challenge where there is no clear solution.

The third section looks at the uncertainty doctors face in diagnosing problems without opening patients up in surgery. There is a chapter on a patient’s right to decide on treatment, focusing on their lack of specialist knowledge and the pressure of being unwell and, perhaps, fearful. One case cited involved a young woman who the author treated, his recommended procedure invasive when there was a possibility it may simply have required antibiotics. Such choices are made on instinct, an imprecise use of science and learning. This is an ongoing issue – how much can be prescribed and made routine when dealing with the variations of people and their circumstances.

Although a fascinating account of actual cases, with a number of strong arguments and commentaries from the author, I found this book lacked the warmth, occasional humour, and undercurrent of emotion found in other medical themed books I have read. It is factual and interesting but perhaps less engaging to a casual reader. My medical student daughter was glowing in her praise.


Book Review: Not Quite Lost

Not Quite Lost, by Roz Morris, is a travel diary written with an underlying sense of fun. Each of the places the author visits is recounted as a series of anecdotes such as one might share with a friend on a night out. It is a wryly humorous account of the author’s travels, mainly in the UK out of season. She is drawn to places with a quiet history, which she seeks out and shares. The stories are packed with an eye for the unusual in people and place. What could be seen as an unpleasant walk, a challenging drive or disappointing accommodation, becomes an adventure when viewed through her droll and enquiring lens.

The book opens with news of a demolished childhood home, which leads to an on line journey back into Morris’s own history. She investigates the property’s provenance and recalls her personal experiences as a resident. This sets the tone for many of the following tales. Wherever she stays, even if only for a few days, she wishes to understand the background to her surroundings, and how it came to be whatever it is today.

There are a few journeys abroad: to Paris where the language barrier renders her and her typically voluble partner mute; to Mexico where they get married without understanding a word that is being said; and to Italy where she experiences an earthquake whilst in the company of friends. These stories have been honed in the telling, affecting experiences turned into entertaining tales.

Travels around England are less traumatic but no less engaging. Some of the adventures occur due to a reliance on public transport, others are set later after a car has been acquired. This freedom to travel anywhere, and to stop at will, provides a new set of challenges and ensuing escapades. These are exacerbated when a Satnav takes them on routes best avoided by a not fully confident driver.

Encounters with tour guides, locals and other tourists provide snapshots of stories whose end the reader is left to ponder. The author prefers roads less travelled and observes the surrounding scattered history as she passes through. She recounts incidents that defy explanation, the strangeness of people and their predilections. The cryonicists of East Sussex were particularly weird.

Morris is a successful ghost writer seeking new experiences. One of these occurred when she successfully auditioned as a dancer for a commercial. Although challenging it proved that she could rise above her self imposed limitations. This inspired her to write more under her own name.

The final chapter details the places the author stayed in each of the tales recounted. Given the stories she has told the appeal of these is somewhat dubious. What is clear though is the fun to be had when determined to seek out possibilities. I laughed out loud many times while reading these recollections, and now look forward to enjoying my own next adventure armed with a fresh perspective.

Book Review: Know Your Place

Know Your Place is a collection of twenty-three essays written by working class writers about their experiences of being working class in Britain today. The writers’ families identify with a variety of colours and cultures, which add to the way they are perceived by themselves and others. Most of the writers appear to have attained a university education, and to have moved away from the environment in which they were raised. The essays explore the effort required to push against perceptions, the cost of trying to realise their potential in spaces dominated by those whose background is one of greater privilege.

The collection opens with The First Galleries I Knew Were Black Homes, in which Abondance Matanda talks of art, accessibility, and who decides what is valued. It argues that the supposed elite of the art world should not assume that the unrepresented are culturally deprived.

“Being a black working class woman, I exist on the peripheries, in the shadows of British society. It’s scarily likely that you might not see me or my experiences portrayed at all, let alone wholesomely in our visual culture or art history.”

The author’s peers do, however, know about art and heritage. The problem, as in many of the issues raised in the following essays, is breaking through the barriers erected by traditional gatekeepers who do not always see a need to facilitate change.

In The Pleasure Button: Low Income Food Inequality, Laura Waddell discusses the joy experienced when consuming fatty, salty food, which is accessible where healthier entertainments are beyond limited budgets. Those who can afford to drive to a large supermarket and stock up on fresh fruit and vegetables will often shake their heads at the dietary choices of those living in poverty, ignoring the causes. This reaction, to blame the poor for their situation, is a recurring theme.

Several of the authors discuss the positives of growing up working class, which includes the comfort of belonging and a feeling of community. In The Death of a Pub, Dominic Grace recalls a drinking establishment he frequented in south Leeds, where generations of the same families would get together after a hard days graft. It may have been a rough place but these were blokes enjoying friendly banter over a well earned pint at the end of a long day. Unfortunately, to me, it was reminiscent of the attitude of the wealthy to their London Clubs which ban women as this would change member’s freedom to talk and act as they choose. The working man’s pub appeared intimidating to those who did not belong to that socioeconomic group.

Many of the essay authors’ parents worked hard to enable their offspring to progress through education. Those who made it to better schools write of the challenges this brings. Just as work colleagues may not appreciate the difficulties presented by a lack of parental contacts or financial backup, so classmates did not understand why house size and quantity of possessions could cause embarrassment. There are also casual preconceptions, such as the assumption that a package holiday to Benidorm is somehow less admirable than a bespoke journey through a remote corner of Asia.

There are discussions on benefits, sexuality, visibility and the culture of blame. There is a correlation between poverty and mental health as well as the obvious physical effects of poor nutrition. In Where There’s Shit, There’s Gold, Ben Gwalchmai looks at rural poverty and the jobs he took as a child living in Wales. The Housework Issue (The Other One) asks why certain jobs are looked down upon, especially those that provide benefit to many.

“We, working class women, and all of us, have been sold a lie. The fabrication that if we work hard, do the right thing – whatever that means – that we’ll be ok and get the good stuff. We’ll get the status, and a good sense of pride, and if we’re not ok we deserve our poverty; it’s our own fault because we’re not working hard enough.

The inconvenient truth is that a badly paid and low status job with no prospects like cleaning keeps you poor. Hard work does not lift people out of poverty or issue status, not if you scrub toilets for a living anyway.”

In Reclaiming the Vulgar, Kath McKay asks who defines good taste, and who cares. Value judgements have been attached to many things, including how people furnish their homes, dress and speak. This results in sizeable portions of the population being silenced, their voices somehow deemed unworthy. In The Wrong Frequency, Kate Fox explores the judgements made about those who speak with regional accents. Class differences are reinforced by perceived regional stereotypes.

Many of the essays deal with belonging and the disconnects successful social mobility can introduce. In What Colour is a Chameleon, Rym Kechacha discusses the necessity of talking and acting differently in order to gain acceptance.

“I have heard too many people frown when they hear me speak, too many people assume I haven’t read that book they’re talking about […] I know that no one is fooled about my origins, and I don’t even know if I want them to be.”

The final essay, You’re Not Working Class, is by the editor of the collection, Nathan Connelly. In it he asks what the term even means. There are those who try to delegitimise others who identify as working class. They are thereby complicit in attempting to silence someone who does not conform to their expectations.

To be better understood it is necessary to be heard and these essays provide a platform from which marginalised writers may speak for themselves. From the quality of the arguments presented it is clear that they are more than capable of elucidating cogent and balanced opinions. The stories they tell provide a lesson a wider audience would undoubtedly benefit from learning. This is a recommended read.

Book Review: Lansdowne

Lansdowne: The Last Great Whig, by Simon Kerry, is a meticulously researched biography of Henry Charles Keith Petty-Fitzmaurice, the 5th Marquess of Lansdowne. Born into a life of wealth and privilege in 1845, Lansdowne would witness immense social and political change at home and abroad. He was amongst the last hereditary aristocrats to wield power by birth. Over a fifty year career he served as Governor-General of Canada, Viceroy of India, Secretary of State for War, Foreign Secretary, and Leader of the House of Lords.

The book is more of a political than a social history and offers an insight into the work required of gentlemen diplomats and politicians in Victorian times and beyond. By the time Lansdowne’s influence waned, towards the end of the First World War, the rarefied world he had tried so hard to preserve faced extinction. He resisted many changes that most would now regard as progress, advocating caution and protecting the rights of landowners by attempting to maintain the status quo.

The author first knew Lansdowne as his great-great-grandfather. Kerry was brought up at Bowood, the family’s country estate in Wiltshire. He holidayed at Meiklour, one of their Scottish properties. He did his PhD in History on Lansdowne’s period in the War Office. His background and connections undoubtedly helped in granting him access to many of the documents from which his research for this book is drawn.

Although Kerry states his wish to be objective in presenting the facts of Lansdowne’s life he admits to feeling quite possessive and ready to defend. This comes across in the narrative which can appear partisan in places. Nevertheless, what emerges is a fascinating account of a life and time. Kerry’s own privileged upbringing will have coloured his views, just as my working class, Irish background will affect how I review the presented facts.

Lansdowne’s paternal forebears settled in Ireland during the twelfth century where they married into native families. In 1658 Thomas, the 21st Lord of Kerry, was paid:

“to produce the Down Survey, the basis of land title for over half of Ireland. As one of the committee allocating land, he bought claims at a quarter of their true value and amassed 270,000 acres in south Kerry alone. He was accused in Parliament of dishonesty, but no vote was taken and charges were never pressed.”

Thomas’s younger son, John, inherited these estates, moved to England and purchased Bowood. He was made Earl of Shelburne in 1753. John’s eldest son, William, became Prime Minister, negotiating peace with the United States after American Independence. He was created the 1st Marquess of Lansdowne in 1784.

Lansdowne’s maternal forebears were of Scottish and French origin. The family owned large estates in Scotland. How they were acquired is not disclosed.

Through the ages the Lansdownes have benefited from attendance at top public schools and universities, many then embarking on successful political careers. The subject of this book became Marquess in his early twenties, inheriting debts that he spent his life struggling to repay. Despite this he lived in a manner he felt was required for a man in his position, throwing open the doors of Bowood and his grand London property in Berkeley Square for magnificent dinners. His extensive staff were kitted out in a wide variety of uniforms to suit each occasion. Lansdowne and his family travelled regularly to their homes in Ireland and Scotland. Their lives were not stymied by frugality.

Early in the book, after a run of

“bad seasons, poor harvests, foreign competition and ‘unjust and foolish legislation’ irrevocably damaged farming. Lansdowne had disagreeable interviews with ‘despairing farmers’ and his agents were gloomy.”

Lansdowne managed his estates to pass them on, not for the benefit of those who kept them running. Later in the book he states his resistance to higher wages for workers as he believed this removed the incentive to work harder, and thereby reduced efficiency. The landed classes were paternalistic, providing schools and other community assets, but protected their right to charge rents they set and to evict as they saw fit. They complained of debts while owning vast assets. They appeared unperturbed by the poverty, hunger and inadequate housing suffered by many who lived on their lands.

The book is divided into four main sections covering the key roles Lansdowne played in his political career.

Section one, Home and Abroad, covers his early life and then his government postings to Canada and India. Lansdowne appears to have been well regarded by his peers in these roles. Railways were being built enabling British settlers to spread themselves throughout the foreign lands of empire. Appeasing indigenous populations was part of Lansdowne’s job – the arrogance of the British mind blowing to modern sensibilities. At a dinner in Victoria he stated

“When once it becomes known that an emigrant can arrive here in less than three weeks from the date of his departure from Liverpool, and find on his arrival such a climate as yours, you will I think have plenty of occupants for your vacant lands.”

This was after he had met some of the occupants of these ‘vacant lands’, Blackfoot Indians, of whose spokesman he noted

“behaved very well & I think my visit may have done good & helped to keep him straight.”

On moving to India

“Lansdowne missed the sweet simplicity of Ottawa and Quebec.”

‘Sweet simplicity’ is not how most would describe the manner in which Lansdowne lived anywhere. In each role he would host functions for visiting foreign dignitaries which strained his finances but he regarded as necessary. Even his day to day living required a staff of helpers. It is noted that one year he took no holiday and became quite weary. I pondered if he ever considered those to whom a holiday of any kind was an unimaginable luxury.

The second section, In Office, covers the period leading up to the First World War. Lansdowne’s roles in the War Office, Foreign Office and as leader of the Lords provoked more criticism from his peers than his foreign posts had garnered, although his detractors appeared similar in their approach to governance. The Boer War brought to light how ill prepared the country was for modern conflict. There appeared to be more concern about the monetary cost of rectifying this than loss of life.

With a growing thirst for improvement in the rights of workers throughout the world there followed attempts to reform the House of Lords which Lansdowne opposed. He was described as

“a man who may be efficient in his way and a good diplomatist, but he runs between blinkers, has no broad views.”

The author states that

“Such a view quite overlooked Lansdowne’s ability to see ahead.”

I didn’t recognise such an ability in anything presented. At a time of worldwide social and political change, he appeared intent on protecting his privilege and retaining the status quo. While the country suffered strikes and the threat of war

“The King’s anxiety was so great that he decided not to attend Goodwood Races.”

They truly appeared to live in a rarefied cocoon.

The third section, War and Peace, leads to Lansdowne’s downfall when he writes what became known as his Peace Letter. He was known to be against socialism, woman’s suffrage, and Irish Home Rule. That he advocated peace was at least a progressive move, a recognition of the appalling human cost of war, but not one that the country supported in this form at the time. When the armistice came the author voices regret that Lansdowne was not invited to the peace talks. He was by now politically obsolete.

The final section, Legacy, covers Lansdowne’s final years and summarises his achievements. He is described at this time as miserable and struggling to economise that he may preserve his estates for his successors. He could no longer afford to maintain his opulent London home. Woman had achieved the vote. Ireland had become a Free State. Derreen, his beloved home in Ireland was looted and set alight by insurgents.

“The war altered Lansdowne’s world. He lost a son and his political reputation. His perception of the world and its hierarchy was undone.”

His obituary was typically complementary and he was then largely forgotten, something that the author now wishes to rectify.

The criticisms I make of Lansdowne’s views and actions are because I look at them through a modern lens. He was a product of his time and I am aware that this portrayal should be interpreted in that light.

“With the rise of the British middle class, nationalism and competitive global economies, Lansdowne found his own way of life and class under attack.”

Over a long career he was at the forefront of governance, a statesman widely respected by his peers. He was also a family man although there are only brief mentions of this aspect of his life within these pages. He was moderate, loyal and quietly determined to fight for what he believed was best for his country.

The book includes a detailed bibliography, notes and credits, and an extensive index. There are also two collections of photographs that I found particularly fascinating, offering a flavour of the times in which Lansdowne lived. One omission that I would have welcomed is the inclusion of a family tree. The Lansdownes had links through marriage to many of the major aristocratic families of the day.

The detail provided of the various legislative changes Lansdowne worked on will be of interest to political historians. This is a factual biography more than a personal story. Putting these details in the context of the changing world in which he lived assists in understanding how influential these gentlemen politicians were. Lansdowne believed that the landed classes were best placed to make the British Empire’s big decisions, and that their position and assets should be protected. He failed to grasp that the wider population no longer revered those who wished to keep them in their place, and that they would demand to have a say themselves, perhaps sooner than he was ready for.

I found this a very interesting book to read offering as it did a window into the world of government, much of which I suspect may not be so very different today. The aristocrats may have been replaced by businessmen (many of whom still bear inherited titles and wealth, which they too complain is being eroded) but the factional in-fighting and self-interest remains.

A well researched and presented slice of history. Lansdowne was of his time and did not wish those times to change. He believed power should remain with the asset owning white men who he felt were best able to make decisions for the good of the country, by which he meant to sustain people like him. I suspect there are too many in our current government who would be of the same opinion.

My copy of this book was provided gratis by the publisher, Unicorn.


Simon Kerry will be talking about Lansdowne: The Last Great Whig at an author lunch in the Shelburne Restaurant, Bowood Hotel, which is situated on the western edge of Lord Lansdowne’s country estate, on 19th February 2018. Tickets may be booked here.

The 2018 season at Bowood House opens on 28th March and will include an exhibition within the Orangery – A Patriotic Peace: The 5th Marquis and WWI

For full disclosure, my interest in this book was piqued by the fact that the village I have lived in for the past twenty-five years is adjacent to the Bowood estate.

Book Review: This is Going to Hurt

This is Going to Hurt, by Adam Kay, was written after the author rediscovered his medical training portfolio – a sort of diary in which he logged his clinical experiences – while clearing out old paperwork. The GMC had recently removed his name from the medical register, several years after he tendered his resignation. The book is a fascinating account of the day to day life of a junior doctor. It is laugh out loud funny, devastatingly sad, and a wake up call to anyone who may ever have cause to seek medical care in the UK. It should be required reading for any voter or politician who believes that tax cuts matter more than health.

The book opens with a brief discussion about why young people choose to enter the profession, and how candidates are selected. The chosen few must then cope with a demanding five or six year university course after which they enter a hospital, newly qualified to administer treatment. They work their way up through a system designed to ensure a more senior doctor is available to call on if needed, right up to consultant level. In practice there are medical emergencies that must be dealt with immediately and too few members of staff. Added to this is the fact that shifts can last for days without rest – nobody goes home when patients may die if they do. The pressures of the job are unimaginable, and the personal cost to the staff immeasurable.

Each chapter covers a level in the progress of a junior doctor’s career. The author offers a brief introduction and then includes a series of diary entries from that period. Many of these are amusing:

“Friday, 10th September 2004

I notice that every patient on the ward has a pulse of 60 recorded in their observation chart so I surreptitiously inspect the healthcare assistant’s measurement technique. He feels the patient’s pulse, looks at his watch and meticulously counts the number of seconds per minute.”

Footnotes explain medical terms and procedures. There are references to the social and family events missed (stag dos, weddings, funerals, holidays) because a shift had to be covered at the last minute. Reading this, it is little wonder that doctors have high divorce and suicide rates.

When a choice of specialism was called for, Dr Kay opted for obstetrics and gynaecology – a blend of medicine and surgery working in labour wards and in infertility clinics.

“Labour ward is literally four things: caesareans, forceps, ventouse and sewing up the mess you’ve made.”

As he admits, not all storks have happy landings, but he had ruled out every other possible route to consultant, and the alternatives did not appeal. The diary entries from here involve his work with women and their families who are trying to have, are having, or have had babies. His experiences beg the question why any of us put our bodies through such trauma, and what health challenges old age may now bring!

Despite their best efforts, and willingness to be covered in any number of varieties of bodily fluids, doctors are not always treated with gratitude and respect by those they help. They must also deal with those: who think they know better because they read something in the Daily Mail; who believe they can control outcomes with dreamy birth plans (candles by an oxygen tank anyone?); or whose religious beliefs could result in their death. There is also the point that doctors are human beings who will sometimes make mistakes. The growing litigious culture only adds to the pressure, and drives more of them to leave.

The structure of diary entries make this book eminently readable. The numerous amusing anecdotes interspersed with detail of heart rending cases are highly engaging. As well as portraying the life of a junior doctor with its unremitting demands and thankless expectations, there are the frustrations of a system that is constantly trying to find ways to cut costs, thereby making clinicians lives even more difficult. Then there are the patients…

“Saturday, 4 November 2006

Get bleeped to see a postnatal patient at 1am. The ODP relays to the bleeping midwife that I’m in the middle of a caesarean. I get bleeped again at 1.15am (still doing the section) and 1.30am (writing up my operation notes). Eventually, I head off to review the patient. The big emergency? She’s going home in the morning and wants to have her passport application countersigned by a doctor while she’s still in here.”

Despite his heroic efforts the author does not come across as any sort of angel. There are personal anecdotes that made me cringe, perhaps to demonstrate that doctors can be good at their jobs without being perfect human beings. They lose friends and partners after months or years of constantly cancelled dates – let downs after promises to (for once) be there – due to work or exhaustion. The job is portrayed as manic and relentless.

Add to this the current climate of blame, especially from politicians (most especially from Jeremy Hunt). The author resigned after a particular experience but it was the culmination of years of life changing stress. It is a wonder that anyone can work in such an environment, and perhaps that is why so many doctors are leaving the profession. Given how long it takes to train a doctor, the impact of this on the nation’s health will be difficult to turn around.

As the parent of a medical student I read this book with some trepidation – what sort of life have I encouraged my daughter to pursue? Doctors have been telling us for years what is happening but it seems only to get worse, their warnings ignored. This book is funny and heartfelt, I stayed up late to finish it in a day. I hope it will encourage others to place more value on the NHS before it is lost, at the ballot box as well as when they or those they love require treatment. A recommended read.

Book Review: The Ladybird Book of the Nerd

My husband reads special interest magazines, and blogs that encourage him to believe his point of view is valid and widely held. I was therefore surprised last week when he announced he had bought a book – until he showed it to me. He believes this is the perfect Secret Santa gift for a colleague. Given his line of work I suspect he may be correct – in this at least. Before wrapping, I decided to slip in a quick review.

The Ladybird Book of the Nerd, by JA Hazely and JP Morris (illustrated by various artists), is one of the latest offerings from the Ladybird Books for Grown-ups series (you may read my review of The Ladybird Book of The Meeting here). These pithy and amusing little hardbacks offer clear and entertaining text alongside original artwork from the Ladybird series’ that the grown-up readers may remember from their childhoods. To gain a flavour I offer some examples from its pages.



I ponder what it says about me that I recognise friends and acquaintances in each of these, and many more from the remaining pages. The third made me laugh especially. How must teachers regard the parents of such children, unless of course they share the interests.

Although quickly read The Nerd still entertained. That it got my husband to spend his money in a bookshop is also a big win.

Ladybird Books for grown-ups are published by Michael Joseph.

Book Review: Tinderbox

Tinderbox, by Megan Dunn, is a book about the author’s failure to write a book, and how this led to her writing this one. It provides a window into the creative process and much else besides.

In November 2013 Dunn set out to participate in NaNoWriMo. The premise for her novel was a rewrite of Ray Bradbury’s Fahrenheit 451 from the perspective of Clarisse McClellan, the teenager who befriends the fireman in Bradbury’s work. Dunn intended to produce a homage to the book, which she had studied in High School. Things didn’t quite go to plan.

Dunn decides to reread the novel but ends up taking much of her material from Sparks Notes (a study guide) and the 1966 film version of the book, featuring Julie Christie. Dunn admires how Christie dresses and looks. She is also fascinated by the film making process detailed in the DVD extras. She is easily distracted when writing which provides for entertaining asides.

By 2013 Dunn had left behind her career as a bookseller at Borders, a chain of bookshops that went into administration in the UK in 2009. She recounts episodes from her experiences in the various branches where she worked, and of being made redundant. Her recollections are honest and lacking the usual sentiment book lovers apply to booksellers. As an aspiring author she had hoped that inspiration would seep from the pages of the stock she handled but this wasn’t to be.

Dunn struggles to churn out the words required to meet the NaNoWriMo target. She ponders Bradbury’s creative process, how he wrote Fahrenheit 451 on a library typewriter hired by the hour, completing the first draft in nine days. Her own writing refuses to flow.

Dunn reflects on the books that sell well; on culture snobs and the popularity of reality TV; on the rise of Amazon and growth of on-line retail; on Kindles and other eReaders. She studies the future as imagined by Bradbury and observes the habits and technology of today.

The writing is sharp and contemporary. There is no shying away from such issues as the prevalence of downloading digital content illegally. Dunn admits to drug taking and reflects on the breakup of her marriage. She mentions the large number of creative writing courses she enrolled in over the years. It is refreshing to find an autobiographical account of failure that is unapologetic and makes no attempt to garner pity.

I haven’t read Fahrenheit 451 or watched the film referenced but this didn’t detract from my enjoyment. Dunn’s portrayal of book selling was of particular interest. The writing throughout is droll and pithy, the existence of this book an against the odds achievement. It should be recommended reading for aspiring authors everywhere.

Tinderbox is published by Galley Beggar Press.