Book Review: Fragile Lives

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“A successful cardiac surgeon is a man who, when asked to identify the three best surgeons in the world, has difficulty in naming the other two.”

Fragile Lives, by Professor Stephen Westaby, is a memoir that is both awe inspiring and heart-rending. It tells the story of the medical career of a man raised in working class Scunthorpe who became a world class, ground-breaking cardiac surgeon before watching his life saving profession being stymied by the NHS bureaucracy that we know today.

The first few chapters cover Westaby’s childhood, inspiration and medical training. Born in the post-war baby boom years he decided young that he wished to be a heart surgeon after watching a television programme, ‘Your Life in Their Hands’, in which American surgeons were able to close a hole in a patient’s heart thanks to the newly created heart-lung machine. Westaby gained entrance to a local grammar school and from there worked towards his dream of medical school. As a teenager he took menial jobs at a hospital, learning as much as he could through observation. His years of medical training at Charing Cross and the Royal Brompton in London brought him to his first surgeries, where he learned that a certain arrogance is necessary for a successful outcome. A surgeon must believe in their own abilities if they are to innovate and thereby save more lives. When a patient is cut open on an operating table the surgeons cannot know exactly what problems they will be required to deal with.

Subsequent chapters look at particular patients whose medical issues Westaby tackled in new ways. Not all of them survive, and those that do are changed.

“extra life is not ordinary life. There’s a price to pay and a second dying to come”

These cases are fascinating if poignant to read. There is an amount of medical detail included but the language used is accessible. Westaby’s confidence in his abilities and willingness to take risks not only saved many of the lives he held in his hands but also led others in his field to do the same. These world class doctors worked together, sharing techniques and outcomes for the good of their patients as well as furthering their own careers.

“For the unfortunate patient, any prospect  of survival depends upon having an experienced trauma surgeon at hand. Few are offered that privilege.”

Westaby worked all over the world and experienced many levels of both staff competence and facility provision. When dealing with a patient who will surely die without intervention, risks seem a price worth paying. This is the way, the only way, that new techniques and treatments can be developed.

A cardiac surgeon must retain a certain detachment as they are dealing every day with the dying who often harbour multiple health issues. Success rates matter. The monetary cost of surgery is high and those controlling the purse strings wish to invest only in proven drugs or equipment.

Pioneering surgery is now threatened by the blame culture. Even proven techniques are being rationed due to the focus on cost, whatever the benefit.

“When a surgeon remains focused on helping as many patients as his ability will allow, some will die. But we should no longer accept substandard facilities, teams or equipment. Otherwise patients will die needlessly.”

By the end of his career Westaby had become disillusioned with the NHS. He had watched too many of his patients die due to a lack of drugs and equipment simply because they are deemed too expensive by non medical decsion makers.

“What mattered was keeping down costs. Death comes cheap.”

Inevitably he looks back on his own younger years with a degree of pride and with more regard than he offers today’s trainees. Setting this aside there is a warning to be heeded. It is understandable that cardiac surgeons feel frustrated with the constraints placed on their ability to work effectively. What this means to the individual patients and their families is the difference between life and death.

Those who believe that the drama of medical TV shows is overplayed should read this book. It is a fascinating account of a career that observed and facilitated huge medical innovation. The effect this had on the patients whose cases are included had me in tears of both sorrow and joy. To anyone with an opinion on the value of national healthcare expenditure, this is a recommended read.

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

Book Review: A Tale of Trees

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A Tale of Trees, by Derek Niemann, provides a potted history of British woodland, and details the devastation caused after the Second World War when farmers and other landowners were subsidised first by the government and then by the Common Market to bulldoze their plots of ancient woodland in order to convert them to arable use or conifer plantations. All land was expected to be managed with the aim of maximising economic return. To these modernisers, wood was simply a slow growing crop.

The author explains the difference in ecology between ancient woodland, mixed use replanting and regimented conifer plantations. The benefits of ancient woodland to the fragile ecosystem was not taken into account in the drive for increased food and timber production after the war. A complex habitat that had taken millenia to create could not quickly nor easily be replaced. The skills required to maintain such an environment can be lost in a generation.

This is a fascinating, beautiful but hauntingly poignant account of the damage caused by short term, ill advised human thinking. Many fret over the loss of ancient buildings, works of art and historic artifacts yet fail to appreciate the value of what man working sensitively with nature, of which he is a part, has created over many centuries. There is beauty but also utility. It is only in recent years, too late for large swathes of ancient woodland now lost forever, that value is being understood. A healthy ecosystem is an asset, even if this cannot be measured in monetary terms, and is required for healthy people as well as other living things.

To stem the destruction, support was required from government which had financially encouraged such actions – described in the book as being akin to setting a madman loose in an art gallery with a Stanley knife.

“He has signed a petition to parliament that has a straightforward demand: Give all ancient woodland statutory legal protection. Surely that’s not beyond the bounds of possibility, since there are so few of them?

He has sent me the reply he received […] Woodland cover in England is at its highest level since the 14th century. Perhaps this may be true, but […] If the paintings of the National Gallery were at risk, would we be happy with a response that said Britain has lots of paintings?”

With the benefit of hindsight it is difficult to understand how such desecration was allowed let alone encouraged, yet when there is money to be made such actions are still all too easy to believe. Protections are seen by some as a nuisance. Valuable assets to be managed for the benefit of all can be resented by those thereby prevented from maximising their personal monetary gain. Consider how art is purchased for investment potential rather than aesthetic appreciation.

Although dealing with a specialist subject the writing is clear and accessible. Anyone who has enjoyed the peace and beauty of a bluebell wood will have sympathy with those who fought to save these national treasures. What this book offers is an understanding of how much additional value they provided – their loss is devastating. That some are now attempting to do what they can to reverse the damage is a beacon of hope.

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

Book Review: How to Play the Piano

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How to Play the Piano, by concert pianist James Rhodes, is the first offering in Quercus’s new ‘The Little Book of Life Skills’ series. I received the book just before it was published six weeks ago and read it through almost immediately. I decided not to post my review until I had attempted to follow its instructions that I may report back on how effective they had been at teaching me to play Bach’s Prelude No. 1 in C Major within the time period proscribed. In the interests of full disclosure I posted details of my musical background here. The key points are that I have never had a formal piano lesson but I did have some musical training on other instruments as a child.

The book opens with advice on how to master a piece of music. It is important to take things slowly and to practice regularly. To play the piano it is necessary to be able to read music, and to understand the correlation between the symbols on a musical score and a piano’s keys. Explaining this vital information takes up about half the book. It is then time to start to play.

A copy of the score is included and may be cut out or scanned. A few annotations have been added which are pointed out as progress is made.

The importance of correct fingering is explained. To navigate a keyboard smoothly this is a necessary skill to master. Timing is also important and to demonstrate this, and to give some idea of the sound being aimed for, the reader is directed to a series of short videos the author has posted at http://www.jamesrhodes.tv  I found these helpful.

The next twenty pages take the reader through the score, two bars at a time, explaining the tricky sections and offering advice on how to move the piece along. Getting through this section took me about four weeks. I was diligent with my practice, although I may have averaged closer to half an hour, five days a week rather than the three quarters of an hour, six days a week suggested. As much as anything I found the muscles in my hands would start to ache after this length of time and wanted to maintain my enjoyment even if it was to the detriment of the musical skill I could aquire.

Having more or less mastered the notes, albeit at quite a slow pace, there is then a chapter on performance and instruction on how to use the piano pedals. I found this tricky. Remembering the pedal affected my concentration on the notes and I struggled to play without mistakes. I also wished to add the suggested interpretation which, again, led me to flounder on the bars where notes move between octaves and fingering positions must be changed. The author suggested that, having played through the piece so many times, the score would no longer be required. My memory does not work in this way and I continued to need the score in front of me in order to play.

There is a lot to take in and remember but the book is clear in its instruction and eager to remind the reader that they started out unable to play the piano. To be able to get through the piece, even if not to as high a standard as desired, is very pleasing.

The final chapter offers a pat on the back and suggests some other pieces that the reader may wish to tackle should they choose to continue their musical journey. Using the advice gleaned from this book I can see that this is possible. I now feel that I have learned to play this particular piece, which is satisfying. It has also been a lot of fun.

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An example of how it should sound: Prelude No 1 in C Major by J.S. Bach, BWV 846 | The Well-Tempered Clavier

And my less than perfect performance, affected by knowing I was being recorded, although the mistakes and hesitations are still typical when I play.

 

Thanks to my younger son for jumping the hoops needed to get my mobile recording onto YouTube – the only way I could think of to share the results of my 6 week challenge.

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

Book Review: Wonder Women

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“There are so many attitudes that need to be adjusted, so many biases that need to be addressed”

Wonder Women, by Sam Maggs, is not the book for anyone who believes that a successful woman is one who is slim, beautiful, amenable and capable of snagging a husband. Successful women, like successful men, are individuals who achieve things for themselves, and this book introduces the reader to dozens of ladies whose work added significantly to their area of expertise. They were innovators, inventors and trailblazers despite the ire they encountered from the patriarchal system. Naturally, many of them were denied credit for their work. History grants accolades to straight, white men as if they are the only people born with brains and the ability to use them. As is demonstrated within these pages, that ability was often lacking when it came to dealing with the opposite sex.

The book is divided into chapters introducing the accomplishments of women of Science, Medicine, Espionage, Innovation and Adventure. Within each chapter, five women are profiled followed by a couple of paragraphs on seven more. Each chapter is rounded off with a Q&A from a current expert in the area discussing their experiences as a women working in a male dominated field.

To achieve their aims, women often had to use subterfuge. Sisters worked with their brothers, wives with husbands, professors with lesser qualified male colleagues. Ideas were willingly shared for scientific advancement leading to men claiming credit for discoveries. Papers by women detailing the exact same research and results, sometimes published years before, were ignored.

“I’m not surprised at what I’ve done. I’m only sorry I couldn’t have had as good a chance as a boy, and have been put to my trade regularly”

Men in every time, place and discipline underestimated their female colleague’s skills. In one example, a morse code operative training for a new role was magnanimously offered a booklet by her superior, that some of his boys had found helpful, as she may need its advice to proceed. He was unaware that she had written it.

I most enjoyed the chapters on areas where I have a personal interest – Science and Medicine. In Espionage and Adventure some of the women came across as morally suspect, although being nice has never been a prerequisite for achievement. There are plenty of men lauded for their contribution to the advancement of learning who may not have made the best of friends.

One statistic that I noted was that, of the 5 million US patents granted since 1790, only 5% have a women’s name on them. A sizeable number of the 95% resemble inventions conceived and developed by women that were rejected as the patent office could not believe a women capable. Expensive court cases proved that accepted ideas had been copied and stolen by male acquaintances. Many patent requests avoided mentioning gender to circumvent the ingrained belief in a women’s lack of ability.

Determined women created their own opportunities. Some disguised themselves as men, others travelled abroad to gain the training denied them at home. One women who persuaded a college to allow her to attend seminars was required to sit behind a screen lest her presence upset the roomful of men, poor lambs.

The writing is light-hearted and brisk but carries a serious message. It offers a reminder that delicate little lady brains simply need the education and experiences routinely afforded to men in order to equally achieve. Perhaps at some level men are aware of this, and that is what they fear.

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

Book Review: Homo Deus

This review was written for, and was first published by, Bookmunch.

“An accessible and wide ranging exploration of the changing lives of homosapiens through the ages” – Homo Deus by Yuval Noah Harari

hdynhHomo Deus by Yuval Noah Harari, is an accessible and wide ranging exploration of the changing lives of homosapiens through the ages. It looks at history, science and the views of social philosophers. Its arguments provide sufficient background to enable the reader to consider what has been, what is now, and what may happen next.

The book opens by postulating that war, famine and plague – humanity’s central preoccupations for millennia – have been transformed from uncontrollable forces into manageable challenges. Individuals now expect to survive into old age, and many wish to postpone death indefinitely.

Advances in science and technology are offering the possibility that humans may be upgraded. This is already happening with the use of pacemakers, prosthetic limbs and trials of brain implants to cure depression. When a new development offers a cure to a medical problem it generally follows that healthy, wealthy individuals will wish to buy this product to increase their personal attributes. Think of those who demand plastic surgery or viagra. There are parents who drug their children to improve cognitive ability. The military are trialling the use of brain altering helmets as a means of providing more focussed soldiers in the field.

Complex ethical issues are raised, for example the impact when doctors have the ability to create so called designer babies. The issue of how ethics derive from beliefs is discussed at length.

Ancient tribes of hunter gatherers had different rules to monotheistic societies. The former offered sacrifices in exchange for earthly rewards. The latter used the concept of a human soul to persuade followers that rewards would follow when they died. Believers were convinced that the existence of this soul made them superior to all other mammals, indeed to all other things. This enabled ethics to apply only to people.

In the modern age corporations, money and nations have, for many, taken the place of gods. Ethical issues have become factual arguments concerning the most efficient way to maximise happiness.

Having taken the reader through history, highlighting how man has behaved and why, the author then turns his attention to what may happen next. He asks, if the whole universe is pegged to the human experience then what will happen once the human experience becomes just another designable product, no different in essence from any other item in the supermarket?

Modern developments rely on data and the willingness of many to share details of their lives. Proposed improvements in how we live could require a relinquishment of personal control. There is also the issue of who will benefit, and what happens to those who are left behind. If governments, armies and corporations hold the purse strings, their narrow interests may lead to decisions that medically downgrade certain types of people to meet a requirement, with unknown repercussions for the future.

In its 400 pages this book argues cogently if not always convincingly. What it offers is the opportunity to consider the world picture over the long term. Day to day concerns and preoccupations lose much of their significance. Even bigger issues such as climate change are only touched upon.

Any Cop?: This is a study of the challenges mankind will face when confronted with the results of its own destructive power. If the danger to humankind comes from humankind itself, hell-bent on gaining the upperhand in the service of an ideology, could there be an argument for handing control over to highly intelligent machines?

 

Jackie Law

 

Book Review: Snow

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“we live in a world of over-simplification. Few people have the time, energy or desire to see the world as any more complex than they can cope with.”

Snow, by Marcus Sedgwick, is the latest addition to the publisher’s monograph series – beautiful books which explore aspects of the natural world and the rich variety of places in which the authors live. Echoing the six sides of a snowflake, the six chapters in this highly readable study delve into the science and art of snow – its impact on literature, folklore, exploration and scientific progress, on those who have experienced its power to trigger awe and fear.

The author now lives in the French Alps but spent his childhood in rural Kent where he remembers there being more snow than typically falls today. Despite its ability to throw travel plans into disarray he associates it with freedom. A deep covering would have prevented him and his brother from attending their hated school leading to fun and imaginative play. The transformed world offered a blank canvas, an empty page on which to create. The muffled silence and crisp cleanliness belyed the potential dangers. He goes on to discuss this in some depth.

Music and literature use snow as a backdrop to terror. Historic explorers have been trapped, frozen or maimed. Snow has physically shaped the mountains and valleys. The modern world is impotent when a heavy fall cuts off communications.

The author looks not just at the physical but also the emotional impact of snow on the human psyche. He talks of ancient stories, mythical figures, and the powerful forces an accumulation of these flakes can unleash. There is much to consider and take in.

The quality of the writing ensures that the ideas are never difficult to process. As befits the subject, it is a captivating read.

“Snow ranks amongst the greatest forces in the natural world […] the result of the humble snowflake, tiny and almost weightless. Minuscule, intricately beautiful too”

Snowfall has transformed the world in many ways. This book will enable readers to look at its arrival this winter through a newly polished lens.

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

Book Review: The Million Dollar Blog

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The Million Dollar Blog, by Natasha Courtenay-Smith, is an advice book written mainly for those who wish to run their blog as a business. The emphasis is on how to monetise the venture, be that directly through the blog itself or by using it to draw in clients to an endeavour it supports.

The book starts by encouraging everyone to blog. It then goes on to discuss the best way to prepare for this new adventure. It covers content, branding, the importance of aesthetics, and of finding a niche that allows the creator to be enthusiastic about their subject whilst remaining authentically themselves.

“Every blogger interviewed for this book has talked about the importance of authenticity and of the reader’s uncanny ability to see through a blogger who’s just in it for a fast buck and not committed to offering real entertainment value and information.”

Despite the title, there is acknowledgement that creating and maintaining a financially successful blog takes time, support and hard work.

Interspersed within the narrative are numerous tales of successful bloggers who achieve hundreds of thousands of hits and earn staggering sums, although often from more than just blogging. They are also motivational speakers, run training courses, produce video guides, paid for digital content, and books such as this one. Blogging is a part of what they do but it is not the whole story.

There is some discussion about content and the alleged short attention span of many readers. Quality writing, it seems, is not the route to a successful blog.

“Whether content is good is entirely subjective. There is plenty online that doesn’t impress me yet it has huge readership and vast followings”

The author talks of scannability, listicles, clickbait and of finding a unique voice. She believes that to flourish a blog requires a constant stream of fresh content to maintain engagement. She returns several times to the need for search engine optimisation. A presence on multiple social media platforms that encourage reader interaction is advised, but hits from search engines will apparently bring the people most likely to purchase whatever is being sold.

The time required to research, create and promote content on an active blog is acknowledged.

“If you really want to achieve something and get where you want to be, you have to work hard. If you want to do it as a hobby you can do it in your own time, but if you want to do it as a job you’ve got to put the hours in because you’ve got a lot of competition.”

Throughout the book I was Googling the various blogging aids being suggested. Most required a financial outlay. If blogging is to be an integral part of a business, and the author advises that it should be, then some investment is to be expected. The target audience is not the casual blogger.

She mentions blogs for fashion, travel and luxury goods but only touches briefly on those whose aim is to raise the profile of a cause. Even then their success appeared to be linked to activities outside the blogosphere, the blogs offering an introduction to the wider world of PR.

I would have been interested to know what the author would make of book bloggers. They do, after all, support an industry where financial gains are notoriously scarce. As she has chosen to write a book I presume she has some interest in how her creation should be promoted. I will be watching with interest how a digital strategist goes about encouraging sales.

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