John Green’s ‘The Fault in Our Stars’ – Cancer-Stricken Teenagers in Love

“I’m gonna die a virgin” and other worries of gravely ill 12-to-18-year-olds

The Fault in Our Stars. By John Green. Dutton Children’s Books, 313 pp., $17.99. Ages 13 and up.

By Janice Harayda

Sixteen-year-old Hazel Lancaster has metastatic thyroid cancer and wears a nasal cannula attached to a rolling oxygen cart, but former basketball player Augustus Waters thinks she looks like Natalie Portman in V for Vendetta. Gus has lost a leg to osteosarcoma, but Hazel knows he’s “hot” even if, as she says, he “HAD FREAKING CANCER.”

Will Hazel and Gus get together before the Big C kills one or both of them? Sentimentalists need not fear. A cheery message of this breezy cross between a teen weepie and a romantic comedy –- and one that will no doubt comfort millions of teenagers — is: You’re never too sick to get into someone’s pants.

Hazel and Gus meet in a support group for cancer-stricken 12-to-18-year-olds in the basement of an Episcopal church in Indianapolis. Sparks fly, but in the tradition of old-school romance novels, the teenagers do not lose their virginity until late in the book, when Gus persuades a charity that grants the wishes of sick children to let him take Hazel to Amsterdam to meet her favorite author. Hazel’s mother — who has come along to Holland as a chaperone — stays conveniently out of the way at any moment that might seem to require her services.

But John Green has more on his mind in his fifth young-adult novel than showing that when you have cancer, it’s natural to think, “I’m gonna die a virgin.” The title of The Fault in Our Stars points to its theme, which inverts Cassius’ message to Brutus in Julius Caesar: When tragedy strikes, the fault often lies not in ourselves but “in our stars.” In developing this idea, Green goes beyond absolving teenagers of blame for their cancers and asks: What does it mean to lead a good life? Hazel and Gus wonder as their health worsens: Is the purpose of life to “repay a debt to the universe” for the gift of having been born, as Hazel believes? Or is to “to leave a mark on the world,” as Gus thinks?

Both teenagers have had cancer long enough to have smart answers and wry familiarity with some of the absurdities of the American view of serious illness. Hazel speaks matter-of-factly about what she calls “cancer perks” — “the little things cancer kids get that regular kids don’t: basketballs signed by sports heroes, free passes on late homework, unearned driver’s licenses” and more. She understands the paradox of “the Last Good Day” cliché in stories about children with cancer, a convention that describes hours “when for a moment the pain is bearable”: “The problem, of course, is that there’s no way of knowing that your last good day is your Last Good Day. At the time, it is just another good day.”  And she sees the contradictions in certain aspects of the support groups into which therapists and others push the afflicted. Is it realistic to expect all young cancer survivors to find comfort in praying, as her group does, for members who have died?

Such questions are so worthy that you wish Green had developed them through more believable characters and fewer plot contrivances. Hazel narrates the story in a voice that alternately resembles that of a down-to-earth teenager and an elderly lawyer drafting a will. One moment she’s complaining that “cancer books suck.” The next she’s talking about “my aforementioned third best friend” or an incident “wherein I put my hand on the couch.” Gus, although slightly more credible, uses so many high-flown metaphors that you can’t square his language with his account of himself as an ordinary Hoosier basketball fan who used to be “all about resurrecting the art of the midrange jumper.” The plot veers from reasonably realistic into something close to farce when the teenagers land in Amsterdam and Hazel’s favorite author turns out to be a cruel and drunken misanthrope.

Perhaps most baffling from an award-winning novelist are the dropped storylines, including one that involves a heavy religious motif introduced in the first pages by Patrick, the well-intentioned but hapless leader of Hazel and Gus’ support group. At meetings the members sit “in the middle of the cross, where the two boards would have met, where the heart of Jesus would have been.” They are “literally” in Jesus’ heart, Patrick says. Hazel later invokes that description often. And yet, she and Gus talk about the meaning of life in secular terms: They don’t raise the possibility — even to dismiss it — that a sense of purpose might include God. Jesus, it turns out, was simply wallpaper. Of course, teenagers are growing up in a secular world, but The Fault in Our Stars punts on a paraphrase of the wartime question: Is it true that there are no atheists in the Intensive Care Unit?

This is not to suggest that Green should, in the words of the Protestant hymn, “Stand Up, Stand Up for Jesus.” It is rather to say that his book violates Chekhov’s dramatic principle: “Remove everything that has no relevance to the story. If you say in the first chapter that there is a rifle hanging on the wall, in the second or third chapter it absolutely must go off.” Support groups meet in many places, including hospitals, and Hazel and Gus’ group could have gathered in a spot less freighted with symbolism than “in the middle of the cross” in a church. For all the virtues of his novel, Green is trying to have it both ways — to saturate his book with religious motifs without having to explore their implications for his characters.

Best line: “He looked like he was dressed for a colonial occupation of Panama, not a funeral.”

Worst line: Hazel’s “my aforementioned third best friend,” “wherein I put my hand on the couch,” that “eponymous album” and similar phrases.

Second opinion: Another review of The Fault in Our Stars calls it a “mawkish” and “exploitative” example of a genre that some call “sick list,” which deals with the plight of gravely ill childrem.

Reading Group Guide: A Totally Unauthorized Reading Group Guide to The Fault in Our Stars appeared on One-Minute Book Reviews on Sept. 9, 2013, in the post that directly preceded this one.

Published: January 2012

Read an interview with John Green about The Fault in Our Stars on his website.

Learn about the movie version of The Fault in Our Stars.

Jan is an award-winning journalist and former book editor of the Plain Dealer. You can follow her on Twitter at @janiceharayda.

© 2013 Janice Harayda. All rights reserved.
www.janiceharayda.com

What I’m Reading … Susan Gubar’s ‘Memoir of a Debulked Woman: Enduring Ovarian Cancer’

“What I’m Reading” is a series about books I’m reading that I may or may not review later

What I’m reading: Memoir of a Debulked Woman: Enduring Ovarian Cancer (Norton, 296 pp., $24.95), by Susan Gubar.

What it is: A feminist scholar’s memoir of the medical “calamities” she endured after undergoing the standard medical treatment for advanced ovarian cancer, known as debulking surgery.

Why I’m reading it: Few authors have written in depth about having advanced ovarian cancer, partly because few women survive the disease long enough to do it.

Quote from the book: “the state of contemporary approaches to ovarian cancer is a scandal.”

Probability that I will review the book: 100%

Publication date: April 2012

Read an excerpt from Memoir of a Debulked Woman or learn more about the book.

About the author: Gubar co-write The Madwoman in the Attic: The Woman Writer and the Nineteenth-Century Literary Imagination, a book widely used in college classes.

You can follow Jan (@janiceharayda) on Twitter by clicking on the “Follow” button in the right sidebar.

© 2012 Janice Harayda
www.janiceharayda.com

Pulitzer Prize Reality Check – The 2010 Poetry Winner, Rae Armantrout’s ‘Versed’

The latest in a series of posts on literary-prize winners and whether they deserved their honors

Versed: Wesleyan Poetry Series. By Rae Armantrout. Wesleyan University Press, 120 pp., $22.95, $14.95, paperback.

By Janice Harayda

Rae Armantrout writes poems for an age of spin-offs of spin-offs. The theme of many of the 87 poems in Versed is more complex than “you can’t trust appearances”: It’s that you can’t even be sure they are “appearances.” Reality is unknowable.

Armantrout tells us that truth sometimes hides behind the intentional or unintentional deceptions of others. She writes in “New”:

The new pop song
is about getting real:

“You had a bad day.
The camera don’t lie.”

But they’re lying
to you
about the camera.

Reality can be elusive for reasons more subtle than lies, including the difficulty knowing ourselves or others. Armantrout writes in “The Racket”: “It’s as if / the real / thing – / your own absence – / can never be / uncovered.

Armantrout has said that the first half of Versed focuses on the dark forces that emerged in the United States during the war in Iraq and the second half on the shadows that fell over her life after she learned in 2006 that she had adrenal cortical cancer. That’s true as far as it goes. But Armantrout expresses her views on Iraq more obliquely than have poets like Robert Hass, who won the 2008 Pulitzer for poetry for Time and Materials, which includes the antiwar poem “Bush’s War.” In “Own,” she compares medical experts dissecting her illness to televised images of President Bush as she juxtaposes the human body and the body politic:

“We will prevail,”
says the leader on multiple
screens. The words
are empty, but he’s there
inside the lie
everyone believes –

Verses like these have made Armantrout a star of the Language movement in poetry, which seeks to separate words from their usual associations and create something other than the reflection of the world that poets typically strive to produce. Like many others of that school, she combines prose and poetry, often in the same poem.

The poet John Drury has noted that critics of the Language movement see much of its poetry “a mass of pretentious gibberish, a dead end of nonsense verse that is not even funny.” And while the poems in Versed are far from gibberish, they are often enigmatic or abstruse. These lines these from “Left” sound like a trick question:

If an instant
is a measure of

endurance,
what is the distance

from expectancy
to spider?

If the goal of Language poetry is to detach words from their usual connotations, the poems in Versed succeed perhaps too well: They are detached to the point of sterility. They don’t appeal, as great poetry does, both to the intellect and to the emotions, something accomplished by Claudia Emerson’s 2006 poetry winner, Late Wife. The poems in Versed speak more to the mind than to the heart. But they are so intelligent when much poetry is trivial that you can see why the book became the most celebrated collection of published in 2009. Many modern poets steep their work in mythological or other symbols, but Armantrout warns that symbolism is “the party face of paranoia.”

Best line: “Metaphor / is ritual sacrifice. // It kills the look-alike.”

Worst line: “that a discrepancy / is a pea / and I am a Princess.”

Furthermore: Versed won the2010 Pulitzer Prize for poetry and the most recent National Book Critics Circle Award for poetry and was a 2009 National Book Award finalist.  James Marcus wrote a brief, eloquent review for the National Book Critics Circle site. The poems in Versed appeared in publications that include The Nation, The New Yorker and The Green Integer Review.

Published: May 2009

Read poems from Versed: “Scumble” and “Guess.”

About the author: Armantrout teaches at the University of California at San Diego.

One-Minute Book Reviews posted Pulitzer Prize Reality Checks for the 2007 biography winner, The Most Famous Man in America; for a 2007 fiction finalist, After This; and for a 2009 fiction finalist, All Souls. The site also has reviews of the 2006 poetry winner, Late Wife, and the 2009 fiction winner, Olive Kitteridge.

You can also follow Jan Harayda (@janiceharayda) on Twitter.

© 2010 Janice Harayda. All rights reserved.
www.janiceharayda.com

A Midwestern Gothic Boyhood – David Small’s Graphic Memoir for Adults and Teenagers, ‘Stitches’

An illustrator found that during a painful childhood, “Art became my home.”

Stitches: A Memoir. By David Small. Norton, 329 pp., $24.95. Ages: See discussion below.

By Janice Harayda

David Small’s mother had her heart in the wrong place — literally. Elizabeth Small was born with her heart on the wrong side of her chest, and the defect serves as a metaphor for her coldness to her son in this graphic memoir and Midwestern Gothic tale of growing up in Detroit in the 1950s.

As a teenager, Small had surgery for throat cancer caused by high doses of radiation given to him by his physician father for sinus problems. His parents didn’t tell him he had cancer, and he learned of it from a purloined letter. He discovered that his mother was a lesbian when he found her in bed with another woman and that his grandmother was insane when she set her house on fire.

Small blends real and imagined scenes as he describes these and other traumas in a book that fittingly bears many hallmarks of neo-gothics: a madwoman, night terrors, family secrets, a locked drawer, mysterious passageways, a church with pointed arches. He also nods to Alice in Wonderland through both words and pictures, including images of a psychiatrist-as-White-Rabbit who helps him burrow into his past and find redemption through art.

Working in pen-and-ink washed with black and white, Small has filled Stitches with artistically and psychologically rich illustrations that help to offset the limits of the weaker, solipsistic text. In his pictures he vividly shows the world from a child’s point of view, often by casting himself as a small figure looking up at adults whose eyes are obscured by glasses that suggest their inability to see him for who he is.

But Small writes from the point of view of an adult looking back on his childhood, which at times makes for subtle discontinuities between the images and words. The back matter suggests that he knows his mother comes across as a monster and that he became aware of some aspects of her grief only after she died. And yet countless writers have made you feel both their youthful sorrow and that of the parents who caused it.

The pain of unhappy housewives like Elizabeth Small was powerful enough to help launch the modern feminist movement. Hers must have been that much greater because she had the added burden of having to hide her sexual identity. But Stitches gives you little sense of that pain; you see its roots in her own upbringing, but you never feel it. Perhaps a sequel will capture more of the spirit of a quotation in Small’s afterword about his mother, which comes from the poet Edward Dahlberg, “Nobody heard her tears; the heart is a fountain of weeping water which makes no noise in the world.”

Ages: Stitches made the shortlist for the 2009 National Book Award for young people’s literature, and some people questioned whether it belonged there or in an adult category. It’s a judgment call: This is a crossover book that may appeal both to mature teenagers and to adults who enjoy graphic novels and memoirs.

Best line/picture: No. 1: “Art became my home.” No. 2: In a review in the Washington Post, Michael Sims described one of the finest pictures in the book, which appears on the frontispiece and elsewhere: “The boy sits on the floor, on a sheet of drawing paper almost as large as he is. Crayons lie scattered nearby. He leans forward, resting the top of his head on the paper. Then he begins to literally sink through the floor, to disappear into the paper. A last kick of his legs reveals that he wasn’t sinking so much as joyously diving head-first into the world he created, leaving behind the world he was born into.”

Worst line/picture: “On the one hand, I felt the fear, humiliation and pain … While on the other, for reasons I could not quite understand, I felt that she was justified … and that I deserved everything I had gotten.” This passage supposedly describes Small’s feelings at the age of six but sounds more like something he worked out later in therapy. It is also involves telling rather than showing. Small doesn’t trust you to understand his feelings from his pictures, as he does in many other parts of the book, so he overelaborates here.

Published: September 2009

About the author: Small also wrote Imogene’s Antlers and illustrated Judith St. George’s So You Want to Be President?, which won the 2001 Caldecott Medal. His work has appeared in the New Yorker and other magazines. Born in 1945, he lives in Michigan.

Children’s book reviews appear on this site on Saturday’s. You can also follow Jan on Twitter (@janiceharayda) www.twitter.com/janiceharayda, where further comments on them sometimes appear during the week.

© 2009 Janice Harayda. All rights reserved.
www.janiceharayda.com

‘Smile or Die’ – Barbara Ehrenreich’s ‘Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America’

Taking aim at the “prosperity gospel,” “positive psychology” courses, and teddy bears designed for breast-cancer patients

Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America. By Barbara Ehrenreich. Holt/Metropolitan, 235 pp., $23.

By Janice Harayda

When I was a book editor, I often had to reassure freelancers that they had the right to give negative reviews. Critics never apologized for praising books, but they did apologize for panning them – even when they had done so brilliantly.

At first, I thought freelancers were worried that they would get fewer assignments if they wrote unfavorable reviews, because some editors do prefer to publish praise. But many seemed reluctant to criticize books even after I had explained that I didn’t care whether reviews were positive or negative: I cared whether they were fair, honest and well written.

Barbara Ehrenreich suggests a possible explanation for the reluctance in Bright-sided, a spirited broadside against enforced optimism in medicine, psychology, business, religion and other fields. She argues that faith in “positive thinking” has become so ingrained in American society “that ‘positive’ seems to us not only normal but normative – the way you should be.”

Ehrenreich found when she was diagnosed with breast cancer that a cult of optimism pervaded articles and books about the disease that made her feel isolated instead of supported. “No one among the bloggers and book writers seemed to share my sense of outrage over the disease and the available treatments,” she writes in a chapter ironically called “Smile or Die: The Bright Side of Cancer.” “What causes it and why is it so common, especially in industrialized societies? Why don’t we have treatments that distinguish between different forms of breast cancer or between cancer cells and normal dividing cells?”

Instead of finding answers, Ehrenreich kept coming across articles by women who claimed that they owed their survival to a “positive attitude” – even though the death rate from breast cancer has changed little since the 1930s and there is no consistent evidence that staying upbeat extends the life of those who have the disease, though it may have many other benefits. She also found that “positive thinking” can exact a terrible price in self-blame if a cancer defies treatment. As the oncology nurse Cynthia Rittenberg has written, the pressure to think positively is “an additional burden to an already devastated patient.”

“Smile or Die” recycles some of the material from Ehrenreich’s award-winning essay, “Welcome to Cancerland,” but is still the strongest chapter in Bright-sided. Other sections of the book describe the wholesale effects of “positive thinking” better than they show their retail cost to ordinary Americans. Ehrenreich argues cogently that the emerging field of “positive psychology” is based heavily on bad or no science. But the same is also true of some older forms of therapy that apply similar principles, as the Robyn Dawes documented in his superb indictment of the betrayal of scientific standards in psychotherapy, House of Cards (Free Press, 1996). So why focus on “positive psychology” when other types of therapy have done more damage, if only because they are more widely used? Ehrenreich describes an unflattering interview with the high priest of “positive psychology,” the psychologist Martin Seligman. But she seems to have talked to no one burned by his teachings – which shouldn’t have been hard to do, given that more than 200 schools and colleges offer courses in his field.

In a chapter called “God Wants You to Be Rich,” Ehrenreich faults the so-called “prosperity gospel” preached by superstar pastors like Joel Osteen, whose churches offer “services that might, in more generous nations, be provided by the secular welfare state,” such as pre- and after-school programs. Certainly those ministries may foster self-blame. (If God wants you to be rich and you’re not, you don’t have enough faith.) But if the churches that promote the “prosperity gospel” are offering low- or no-cost day care that enables parents to seek prosperity by holding jobs, doesn’t that count for something? You sense that such programs are exactly kind of thing that Ehrenreich might love, if only they weren’t endorsed by pastors who wear too much gel in their mullets.

No less important: A blurred line exists between innate optimism – which may be genetic — and the enforced optimism of disciplines like “positive psychology” and the “prosperity gospel.” To what extent are advocates of “positive thinking” creating an attitude and to what extent are tapping or reinforcing one that’s already there? Ehrenreich sidesteps the question. But if optimism is in our genes, it may do little good to argue as she does that we need replace “positive thinking” with a “vigilant realism.” Joseph Hallinan takes a less extensive but more practical approach to the subject in his Why We Make Mistakes (Broadway, 2009), which deals in part with the research on errors based on overconfidence – a trait often indistinguishable from “positive thinking.”

Overall Bright-sided is much more theoretical than Nickled and Dimed, for which Ehrenreich took a series of low-wage jobs to show how corporations exploit blue-collar workers, or her more recent Bait and Switch. But it makes a needed assault on an idea that too often goes unchallenged in America: that “positive thinking” is always a good thing. Ehrenreich is right that a deep and unacknowledged anxiety often underlies efforts to block out unpleasant thoughts. “Positive thinking” requires a continual effort to deflect “negative” ideas, she notes, and it can be exhausting. “The truly self-confident, or those who have in some way made their peace with the world and their destiny within it, do not need to expend effort censoring or controlling their thoughts,” she writes. “Positive thinking may be a quintessentially American activity, associated in our minds with both individual and national success, but it is driven by a terrible insecurity.”

Best line: Ehrenreich notes that breast cancer has given rise to a highly commercialized industry of products for patients, including “infantilizing” teddy bears: “Certainly men diagnosed with prostate cancer do not receive gifts of Matchbox cars.”

Worst line: “All the motivators and gurus of positivity agree that it is a mistake to watch the news.” How does Ehrenreich know? Has she talked to them all? In my experience the self-styled motivators, with a few exceptions including Rhonda Byrne (The Secret), urge people to limit – not eliminate – exposure to bad news.

Editor: Sara Bershtel

Published: October 2009

Read an excerpt (the first pages) from Bright-sided or listen to an audio excerpt.

Furthermore: For more on optimism and illness, see the post “‘The Tyranny of Positive Thinking’ and Cancer Patients — A Physician-Author Says That It’s Not Always Best to Tell People to ‘Be Optimistic’.”

© 2009 Janice Harayda. All rights reserved.
www.janiceharayda.com

David Small’s Graphic Memoir of Throat Cancer, ‘Stitches,’ Makes Shortlist for National Book Award for Young People’s Literature

David Small has made the shortlist for the 2009 National Book Award for young people’s literature for Stitches (Norton, 336 pp., $24.95), his graphic memoir of getting throat cancer after receiving high doses of radiation for a sinus condition while growing up in Detroit in the baby-boom era. The sponsor of the awards doesn’t give a separate prize for graphic novels or memoirs but considers them along with other submissions in the relevant category, so you could easily miss that this one has a different format from other books on the shortlist. Small talks about Stitches in a YouTube trailer that shows a generous number of pages from the book. He won the American Library Association’s 2001 Caldecott Medal for So You Want to Be President?, and his work has appeared in The New Yorker and other publications.

www.twitter.com/janiceharayda

Before Ted Kennedy’s Brain Tumor, There Was Johnny Gunther’s

Malignant brain tumors such as that of Sen. Ted Kennedy (1932-2009) are uncommon enough that they have received less attention in books than many other types of cancer. One exception to the pattern is Death Be Not Proud, John Gunther’s eloquent memoir of the death of his 17-year-old son, Johnny, from a fatal glioma diagnosed when he was in high school. American views of cancer have undergone a sea-change since the book was first published in 1949. But this modern classic remains one of the finest accounts we have of the physical and emotional toll that a malignant brain tumor takes on patients, even those who might seem to have all the advantages. This post first appeared in 2008.

www.twitter.com/janiceharayda

Pulitzer Prize Reality Check – Christine Schutt’s ‘All Souls’ — A Prep-School Student Gets Cancer in a 2009 Fiction Finalist

A New York City teenager’s overprivileged friends respond to her life-threatening illness

All Souls. By Christine Schutt. Harcourt, 223 pp., $22.

By Janice Harayda

Did the judges for the Pulitzer Prize for fiction intentionally set the bar low this year? Or did their tastes simply run to lightweight books with improbable feel-good endings?

Christine Schutt’s All Souls, a runner-up for the 2009 fiction prize, has odd similarities to the winner, Elizabeth Strout’s Olive Kitteridge. The publishers of both books bill them as “novels.” But Olive Kitteridge is a cycle of short stories, a group of linked tales could stand alone.

All Souls, too, reads more like a collection of stories than a novel. But its tales are so short, they’re closer to vignettes. All Souls has nine sections, each divided into so many sub-units that you keep darting into and out of the minds of different characters. One of the micro-sections has fewer than 50 words. Many others aren’t much longer and read as though written for an iPhone screen. The problem isn’t the use of vignettes to tell a story: Evan Connell used a similar technique to brilliant effect in Mrs. Bridge, a minor classic of American literature. The problem is that the entries in All Souls are so short that – as John Updike said of Bruce Chatwin — Schutt sounds as though she’s always interrupting herself. Her technique makes for choppy reading and limits her ability to develop a rich and sustained narrative.

Like a high school yearbook, All Souls gives snapshots of its characters instead of fully realized portraits. In a sense this befits its subject. Pretty and well-liked, Astra Dell develops “anaplastic high-grade fibrosarcoma,” a rare connective-tissue cancer, at the start of her senior year of high school. How rare is her illness? If you paste “anaplastic high-grade fibrosarcoma” into a browser window, Google returns only one result, which involves the Unitarian minister Alison Miller, whom Schutt credits with inspiring this book.

Schutt shows the effect of the cancer on Class of 1997 at the fictional Siddons, an elite Manhattan prep school for girls, that she follows through an academic year. As Astra gets high-risk treatments such as having a radioactive rod sewn into her arm, her classmates and others tend to respond inadequately or use her illness for their own ends.

At times Schutt captures well the mix of naïveté and overconfidence that tends to characterize teenagers. A senior can’t believe Astra got cancer: “She’s been a vegetarian for three years!” Schutt also offers occasional telling glimpses of Siddons parents and teachers: The adults discuss rumors that the pipes at rival schools are rusting from “the acidic effects of throwing up” by girls with eating disorders.

What are we to take away from all of this? If always intelligent, Schutt’s prose is so elliptical and antiseptic that you don’t know whether it’s intended as satire, social realism or something else. And like Olive Kitteridge, All Souls pulls an unexpectedly rosy ending out of a hat of darkness. The girls of Siddons, we learn, are conscientious enough that they don’t use CliffsNotes much. Schutt has stripped away so much from her book that she often leaves you with the sense that you haven’t read a novel so much the sort of condensation that her fictional students would avoid.

Best line: Siddons girls have been warned that CliffsNotes are “as nutritious as bread someone else has chewed and spit out.”

Worst line: A line of of dialogue by Astra’s father, who tells his daughter about a party: “The Johnsons were not in attendance.” Who speaks like this?

Published: April 2008 (Harcourt hardcover), Harcourt paperback due out June 8, 2009.

Consider reading instead: Black Ice (Knopf, 1991), Lorene Carey’s memoir of her experiences as the first black female student at St. Paul’s prep school in Concord, New Hampshire, or The Prime of Miss Jean Brodie, Muriel Spark‘s classic about an Edinburgh girls’ school.

About the author: Schutt lives and teaches in New York City. She wrote the novel Florida (Triquarterly, 2003), a finalist for the 2004 National Book Award for fiction. All Souls was a finalist for the 2009 Pulitzer for fiction.

Furthermore: Schutt says the inspiration for All Souls came from the minister Alison Miller, especially from her sermon, “Leap of Faith.” In the sermon at All Souls Unitarian Universalist Church, Miller spoke about developing anaplastic high-grade fibrosarcoma at the age of 16.

Read an excerpt from All Souls.

This post is the latest in a series on the winners of or finalists for major literary prizes and whether they deserved their honors. A reality check for  Olive Kitteridge appeared on April 27, 2009.

Janice Harayda is an award-winning critic who has been the book columnist for Glamour, the book critic for the Plain Dealer and vice-president for awards of the National Book Critics Circle.

© 2009 Janice Harayda. All rights reserved.
www.twitter.com/janiceharayda

Maybe You Don’t Need That Colonoscopy or Those Statins — A Noted Doctor Challenges the Medical Establishment – ‘Let My Polyps Go’

Angioplasties and stents are "good ideas that proved bad."

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for … the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.”

Self-help books that urge you to micromanage every health risk have become disease unto themselves. So it was cheering to see the New York Times giving serious attention to a new book by a noted physician who still believes that less medicine can be more.

Abigail Zuger, an internist and frequent contributor to Times, recently reviewed Worried Sick: A Prescription for Health in an Overtreated America (Univesity of North Carolina Press, 376 pp., $28), by Nortin M. Hadler, “a rheumatologist and professor of medicine at the University of North Carolina who is a longtime debunker of much the establishment holds dear.” Zuger wrote:

“Dr. Hadler may not actually keep a skull on his desk, but he might as well. We are all going to die, he reminds us. Holding every dire illness at bay forever is simply not an option. The real goal is to reach a venerable age — say 85 — more or less intact.”

Zuger adds that Hadler believes the way to achieve that goal is to ignore much of the conventional advice:

“Reviewing the data behind many of the widely endorsed medical truths of our day, he concludes that most come up too short on benefit and too high on risk to justify widespread credence.

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for the extra 20 pounds that make you overweight but not obese, and the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.

“He deplores the careful attention we pay to the state of our coronary arteries. Angioplasties, stents, coronary artery bypass grafts — all these procedures, he writes, ‘should be consigned to the annals of good ideas that proved bad.’

“As for the screening that purportedly keeps us safe from cancer, mammography and the blood test for prostate cancer are, in his view, blunt cudgels that can harm as much as help. Nor does he want any part of routine colonoscopies: ‘Let my polyps go.’”

Zuger compared Worried Sick with a new guide by Nancy Snyderman, a surgeon and the chief medical editor of NBC News, who — as anyone who has watched her televised reports may know — is ever-ready to parrot the medical establishment’s prescriptive-flavor-of-the-week. And though Zuger doesn’t come down on the side of either approach, her review is lively, open-minded, and worth reading www.nytimes.com/2008/06/24/health/24book.html?ref=science.

To read more about Hadler and Worried Sick, click here uncpress.unc.edu/browse/book_detail?title_id=1545. Hadler’s book and individual chapters from it are available in e-book or downloadable formats through the Caravan Project www.caravanbooks.org/.

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

A Totally Unauthorized Reading Group Guide to ‘The Last Lecture’ by Randy Pausch

A Totally Unauthorized Reading Group Guide to ‘The Last Lecture’ by Randy Pausch

10 Discussion Questions
The Last Lecture
By Randy Pausch with Jeffrey Zaslow
Source: One-Minute Book Reviews
http://www.oneminutebookreviews.wordpress.com

This guide for reading groups and others was not authorized or approved by the author, publisher or agent for the book. It is copyrighted by Janice Harayda and is only for your personal use. Its sale or reproduction is illegal except by public libraries, which may make copies for use in their in-house reading programs. Other reading groups that would like to use this guide should link to it or check the “Contact” page on One-Minute Book Reviews to learn how to request permission to reproduce the guide.

After learning that he had terminal pancreatic cancer, Randy Pausch gave an upbeat valedictory lecture at Carnegie Mellon University, where he teaches computer science. He called his talk “Really Achieving Your Childhood Dreams” and explained in it how he had accomplished most of what he set out to do in life. Enlivened with humor and showmanship, his lecture drew millions of visitors to its posting on YouTube and made Pausch a star on the Internet. His talk also inspired The Last Lecture, a collection of short essays written with Wall Street Journal columnist Jeffrey Zaslow, which became a No. 1 bestseller on the New York Times “Advice, How-To and Miscellaneous” list.

Discussion Questions

Please note that the page numbers below come from the large-type edition of The Last Lecture (Thorndike, 2008), the only one available when this guide was prepared.

1. When someone asked what he wanted on his tombstone, Pausch said: “Randy Pausch: He Lived Thirty Years After a Terminal Diagnosis.’” [Page 247] If you were to write his epitaph, what would it say?

2. Summing up a theme of his lecture and book, Pausch writes: “We cannot change the cards we are dealt, just how we play the hand.” [Page 32] This is one of many clichés he admits he loves and uses liberally in The Last Lecture. Did he succeed in making any old ideas fresh? How did he do it?

3. Pausch began his lecture “Really Achieving Your Childhood Dreams” by saying he wasn’t going to deal with big questions of religion or spirituality, and he sticks to that pattern in The Last Lecture. How does the book benefit or suffer from his decision?

4. The Last Lecture recycles much of what Pausch said in his valedictory lecture at Carnegie Mellon and expands some of it. Should people who’ve watched the talk also read the book? Why? What does the book give you that the lecture doesn’t?

5. Pausch could have called his book The Last Lectures, because he structures it as a series of mini-lectures instead of one long lecture. How well does this technique work?

6. The Last Lecture balances general advice such as “dream big” with specific tips – for example, about how to work well in small groups. “Instead of saying, ‘I think we should do A, instead of B,’ try ‘What if we did A, instead of B?’” [Page 190] Which, if any, of the tips struck you as most helpful?

7. Many cancer patients are bombarded with the advice to “be optimistic” or “think positively.” This approach has led to a medical backlash alluded to in the chapter “A Way to Understand Optimism.” Pausch says his surgeon worries about “patients who are inappropriately optimistic or ill-informed”: “It pains him to see patients who are having a tough day healthwise and assume it’s because they weren’t positive enough.” [Page 249] What is Pausch’s view of this? Is he appropriately or inappropriately optimistic? Why?

8. Many people who have heard about The Last Lecture may be tempted to give the book to someone who has had a devastating diagnosis, or who is perhaps dying, hoping it will provide comfort or cheer. What would you say to them? Is this a book for the living or the dying?

9. The Last Lecture comes from Mitch Albom’s publisher and literary agent and has a small format similar to that of Tuesdays With Morrie. These similarities – let’s face it – could be a kiss of death for some people, especially critics who see Albom as an icon of saccharine and dumbed-down writing. What would you say to someone who didn’t plan to read The Last Lecture because, “One Mitch Albom is enough”?

10. If you were going to give your own “last lecture,” what would you say?

Vital Statistics:
The Last Lecture. By Randy Pausch with Jeffrey Zaslow. Hyperion, 224 pp., $21.95. Published: April 2008.

A review of The Last Lecture appeared on One-Minute Book Reviews on May 30, 2008. If you are reading this guide on the home page of the site, scroll down to find the review. If you are reading this guide on the Internet, click on this link to find it www.oneminutebookreviews.wordpress.com/2008/05/30/.

Watch Pausch’s talk “Really Achieving Your Childhood Dreams” and read an excerpt from The Last Lecture at www.thelastlecture.com.

Furthermore: Pausch posts updates on his health at download.srv.cs.cmu.edu/~pausch/news/index.html.

Janice Harayda is an award-winning critic who has been the book columnist for Glamour, the book editor of the Plain Dealer and a vice-president of the National Book Critics Circle www.bookcritics.org.

One-Minute Book Reviews is for people who like to read but dislike hype and review inflation. Totally Unauthorized Reading Group Guides appear on the site frequently but not on a regular schedule. They usually deal with books for which publishers have provided no guides or guides that are inadequate – for example, because they encourage cheerleading for books instead of thoughtful discussion. To avoid missing these reviews, please bookmark the site or subscribe to the RSS feed. If you would like to see the guides continue, it would be extremely helpful if you would link to them.

© 2008 Janice Harayda. All rights reserved.

www.janiceharayda.com