Sunday, September 29, 2013
Flippant and well-written but coy; I didn't feel the heart of the book was revealed until quite near the end. Set in the 1960s NYC (a wacky time, sketched well here), most of the book is focalized through Fin, who loses both his parents by age 11. He is left to a guardian, his 20-ish half-sister Lady, whom he remembers mainly from a frantic trip he once made with his two parents as they raced around Europe to find her in Capri and make sure she aborted her illegitimate child. Lady is a spoiled rich girl who lived uptown when her parents were alive but moves to Greenwich Village with her black maid Mabel and Fin and his dog Gus. Trailed by a trio of hapless suitors, each of whom Fin must call "Uncle," Lady flirts with political activism (getting put in jail for a night is an adventure; Fin tags along), charms anyone she likes, puts Fin in a ridiculous "progressive" school where he doesn't learn math, and doesn't want to marry yet doesn't want to be alone. (SPOILER ALERT) When finally Lady returns to Capri and meets a man she loves, he is (of course) as unavailable as she ever was to the men who loved her; she becomes pregnant with his child. This time, she keeps the baby; and when she dies in a tragic accident, Fin (age 18) becomes the guardian to the baby girl (the elusive "I" of the book, somewhat a mystery throughout). But Fin is willing to remember and acknowledge his own difficult childhoood to spare Lydia the same. I enjoyed this book, but I was exasperated rather than charmed by selfish, narcissistic Lady (as I think we are meant to be). The book ends, in the voice of grown Lydia, with a sweetness that is tempered by Lydia's delicate allusions to how angry Fin later felt about Lady's crazy, misguided attempts at parenting. The fact that Fin doesn't marry, even into his 60s, perhaps speaks to how people can rise above their dysfuctional childhoods only so far; it's left to the next generation to be able to observe the whole picture at one remove, and have compassion for the 20-ish girl who's suddenly saddled with a child and does something, which is better than nothing at all.
Wednesday, September 11, 2013
The author, a former medical director, uses 12 patients (he's one of them; he was diagnosed with cancer and underwent chemo and radiation) as "windows" into 12 different systemic and ethical problems--illegal immigration, the foster care system, alcoholism, compliance, organ donation, etc. The writing is uneven at times; he ostensibly quotes patients, but their voices sound surprisingly like his own; and sometimes stories/chapters end with a strange abruptness. But I like this sort of book for the way it broaches topics and doesn't present pat, black-and-white answers. It serves as an invitation for people to think about complicated issues; and it shows just how many facets of our society are linked with healthcare. Some of my favorite lines: "How people die and how we participate in their deaths is as much about us as about them. Our own humanity is at stake. In a society that is increasingly mesmerized by efficiency, measurement by numbers and a bottom-line mentality that extols profit and wealth over any other human value, the risk is clear to everyone I work with. When health care is now measured by a 'medical loss ratio,' and the percentage of spending on health care is considered a 'loss,' then we are really lost."