NZF Writers & Readers: Ready to Die? with Charlie Corke

Sarah Forster reviews Ready to Die? with Charlie Corke, at the NZ Festival Writers & Readers Festival on Saturday, 11 March. 

Ready_to_Die_WR18_c_450x375_3.2e16d0ba.fill-300x250.jpgDr Charlie Corke’s book Letting Go is a powerful book about how we handle these final moments of our life. Dr Corke is a career-long intensive care specialist, and he wrote the book to fill a gap for those sitting with their dying loved ones in their final moment. He notes later ‘I got into it for the machines when I was young, and as I got older I became more thoughtful.’

This session was chaired by the reliably excellent Jo Randerson, who began with the question ‘What does a good death look like?’ Dr Corke says, ‘Death is always bad, but we can make it worse. In general, deaths that are anticipated and planned for and gentle, where the family and loved ones are there – with few tubes, and little intervention are what most of us aspire to. And then there is the opposite of that.’

Part of his aim while writing the book was to express how far we’ve come in intensive care. When he began practising medicine, intensive care and kidney dialysis wasn’t even considered for anybody over 65. This discussion is now happening for older people, which means it is more ‘real’ – the person involved is not able to contribute usually. And you need family to decide what to do.

One of the things Dr Corke campaigns for is for people to have end-of-life care plans, which Letting Go includes suggestions of at the back. An end-of-life care plan is something between a patient and their doctor, based on a conversation. This means there has been a discussion about limits of what is acceptable and not acceptable. The problem with these ideal plans is, he says, ‘Doctors wait for patients to say, and patients wait for doctors to ask.’

Why do we resist? The vast majority of us think that when the time comes, our family and our doctor will know what to do . But that’s not quite true. Dr Corke reminds us that when we are confronted with this crisis, there is always something to do now – the question is whether this something is acceptable to the individual whose decisions we are making.  ‘You don’t want to treat somebody who doesn’t want to be treated, or not treat somebody who does.’

At the point of being housebound with a chronic illness, 95% of patients are beyond planning. If you begin a plan now, before you are unwell, it is much easier to tweak it as you go. Dr Corke wants everybody to consider it.

In past years, a care plan has included technical details – what tubes are okay, and which ones aren’t – but now we are moving to answering the question ‘What situation is unacceptable to you as a person.’ A bit of poetry is best. The worst deaths are where nobody agrees on what a person who is unable to make their own decision wants – when they have a plan, or do agree, Dr Corke likens this to a perfect dive.

Both Jo and Dr Corke gave personal examples of situations throughout this session, which drove home just how important this work is.

Part of having a care plan can be to select a ‘substitute’ in your care plan that you would trust to make your decision for you. Dr Corke notes that family often  aren’t that respectful of decisions made by elder relatives. You need somebody who will listen to everybody respectfully, and make a decision on the information at hand. He has appointed his eldest daughter as his agent. He is concerned that his wife likes him and would keep him going longer than he wants. He has told his other daughters and they have agreed that she is the right one – they reckon she’s ‘hard.’

Dr Corke has set up ‘my values .org’ as a space to talk about what we want at the end of our lives. The values in this area are about independence, on the other end being prepared to be looked after. Within those values we can get a perspective on where people are at.

We then discussed dysthanasia. Dr Corke says, ‘Dysthanasia is something we can all agree we don’t want – this means, literally, ‘bad death’. ‘ This is the name for screwing up death with too much medical treatment. He is looking forward to people understanding this, that they don’t want too much medical intervention making a mess of things.

Dr Corke notes, ‘If there is no plan or discussion, then the system will just carry on and do everything to prevent death. You now have ambulances who will come to your house and resuscitate everything – then the patient moves to the intensive care department, where everything has to be done within seconds – xrays, blood … In first world countries, our systems are geared to do it, and to not do it is becoming increasingly hard to do.’

This session was full of shocking facts – perhaps the most shocking for me is that 70% of treatments in ICU work are provided where they can’t and won’t save lives. Dr Corke wants people to know this because he can’t see the medical system changing on its own – it needs a grassroots movement from patients to make it re-think its philosophies. ‘We need to say medicine is a good thing, but it can go bad.’

Jo brought up the concept of Christianity and how it impacts end-of-life treatment. Dr Corke said he doesn’t know what happens when we die. ‘Personally, I just don’t want to leave a mess.’ They agreed though, that funerals are important as that is where we often have the hard discussions about what people mean to us.

The discussion turned a little to the past, when death was witnessed more frequently, and Jo noted that there are no longer as many frameworks around death now that we all live so far apart, and there is so much intervention. We have a tendency to put it in a box. Dr Corke said, ‘Noone wants  to talk about it, but when people are being frank about it you will find that families will discuss it together. You need to listen to each other.’

The questions in this session were worthwhile and thoughtful, and I’ll give the final word to Dr Corke: ‘You don’t resent having fire insurance for the house. Likewise, you don’t resent having an advanced care plan.’

Reviewed by Sarah Forster

Letting Go: How to Plan for a Good Death
by Dr Charlie Corke
Published by Scribe Publications
ISBN 9781925322705

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Book Review: Death Expands Us: An Honest Account of Grief and How to Rise Above it, by Stephanie Harris

cv_death_expands_usAvailable in bookshops nationwide.

On 6 April 2009 Stephanie Harris’ life was turned upside down when her thirty-three-year-old brother Brendon suddenly and mysteriously died. The first Stephanie knew he was ill was when her mother rang to tell her that he had been hospitalised during a business trip to Buenos Aires. The next morning she got phone call from her older sister Teresa to say he was dead.

The sudden death of a much-loved family member or friend brings all sorts of emotions to the surface – emotions that seem at times illogical and at times frightening with the intensity of these feelings.

I have read a number of self-help books the years where a close family member has died – sometimes expected and other times suddenly. I thought this book was well laid out with the grief process explained. Every person reacts differently to death and grief. No way is the right or wrong way. One book I read a number of years ago sprung to mind, Elizabeth Kulber-Ross’ On Death and Dying. The message is more or less the same but from a different perspective – of someone actually going through it. It bought all sorts of emotions back for me as I was reading it. I was able to rationalise how I had grieved at particular times through the sudden death of a much-loved family member.

I recommend this book as a tool in the grieving process. What I really liked about it was that even though Stephanie is a Grief Coach, she still sought help with her grieving. None of us like to think that perhaps there are times in which professional help is necessary.

Reviewed by Christine Frayling

Death Expands Us: An Honest Account of Grief and How to Rise Above it
by Stephanie Harris
Published by Lioncrest Publishing
ISBN 9780473388171

Book Review: Fox & Goldfish, by Nils Pieters

Available now in bookshops nationwide.

cv_fox_and_goldfishHow does one come to terms with the last days of a close friend? Seeing his best friend Goldfish beginning to fade, Fox decides the two of them have one more thing to do. They embark on an epic journey together to see the world, a bucket list journey of rediscovery and soaking up experiences. Thus, we see Fox and Goldfish sharing in the beauty of the world which they find together; filling their souls with simple joys – the ocean, a shower of rain, a perfect rainbow, the quiet of a forest, the majesty of a mountainscape. They thrill to a desert viewed from the back of a motorbike and zipping down snow covered slopes. Eventually, and aptly as the sun sets in glorious red and orange hues, Fox acknowledges the time has come for his friend to go.

With only two lines of text in the story, the pictures say everything. Rich and colourful illustrations depict the happy duo set in huge double page spreads which emphasise the grandeur of their surroundings. Their expressions as they make their way around the globe are delightful, with small details such as the helmeted goldfish bowl adding humour to the tale. Equally delightful and moving is the obvious love and caring bond shared by the two unlikely friends, showing how true friendship can transcend great differences.

Fox and Goldfish is the second book illustrated and written by Belgian creator Nils Pieters in his trademark vibrant pencil style. It is produced by Book Island, a publisher specialising in sourcing unique stories from Europe and translating them for English audiences, offering us new perspectives from a different culture.

A lovely visual reminder of what is important, Fox and Goldfish is a special book that is thought provoking and contemplative, and one to be shared with the special people in your life.

Reviewed by Vanessa Hatley-Owen

Fox and Goldfish
by Nils Pieters
Book Island UK 2016
ISBN: 9780994128218

Book Review: Billy Bird, by Emma Neale

“…If sex can accidentally make something as wild, complex, erratic, dogged, miraculous, sensitive, vulnerable, solid, unaware, bizarre, intractable, awful and joyful as a human child, why, in a specific instance, couldn’t it be said to help make love?”

cv_billy_birdThis is the voice of somebody who understands children, and parenthood. Billy Bird is a magnificent book. It’s sad, and happy, and funny, and brutal – and paradigm-breaking. As you will already know if you have read the blurb, or indeed the title: Billy is becoming a bird. He doesn’t want to be a bird, he is starting to behave as one would, for hours sometimes. This story is about how a family operates emotionally – and how important communication is when it is time to heal.

This is the point where I wonder – how much of a spoiler is it to say somebody significant dies? I think I can say that, and possibly that that somebody is a child. Because I get a bit sensitive around the death of a child, so if this is something you do not like to read about, here is your warning. But yet. Even if you do, and it triggers, this book may be the book that starts your healing. So don’t be shy of it. I will go just one step further and say: this is not a murder mystery. But you could probably tell that from the marked lack of black and red on the cover.

So this happens, and nothing changes. Well, not quite. Everything changes. But it takes awhile for their emotional power to be understood by our protagonists, who as we start driving towards the solution, are Billy, aged 8 or so, and his mum Iris and dad Liam. Iris’s voice: “Maybe…death had turned up her sensitivity to these things: The daily news-alarms of storms, acidic seas, dwindling species, drought, energy wars, religious wars, civil wars, avenging blood with blood, as if that ever brought the dead back…This sense of the world on the precipice…was it worse than it had ever been, or was she losing her own equilibrium?”

After events in the novel come to a head, the family finds a safe space to talk, with a Psychologist and her nurse. Billy is wondering about his dad “…if he’d be like that when he was a man. Did he have to be? What if you didn’t want to be like your mum or your dad? Was there some third person he could be?” The space created by his mum and dad’s non-communication fills with a pile of worries, big and small; and a lot of bird-feelings for Billy.

I’ve used a lot of quotes in this review, because there were so many times when I thought ‘Exactly!’ and ‘man how can I explain what this writing does to you.’ Writing this wonderful is unusual and rare, though it sometimes happens when poets turn to prose. There are sections of the novel in verse – the initial sex scene, ingeniously –and this adds an otherworldly brilliance to the writing.

I know of Emma Neale as an excellent editor: now I am going to go back and read everything else Emma Neale has written. I cannot recommend this book highly enough. Like all truly good books, it fills you with empathy, and a sense of joy in words and in life. I hope this makes it onto the longlist for the Acorn Foundation Literary Award.

Reviewed by Sarah Forster

Billy Bird
by Emma Neale
Published by Vintage NZ
ISBN 9780143770053

Essays about Death: Diana Athill’s Alive Alive Oh! & Oliver Sacks’ Gratitude

 

Available in bookshops nationwide. 

Recently I made a trip to Tauranga to spend some time with my grandfather, who was born in 1917. Nearing ninety-nine, nonetheless capable in body and mind, he moved about his apartment making cups of tea, talking about the war and the reality of the approaching end of his life. I returned to Dunedin but the theme continued; waiting quietly in the mailbox were two books, both slim, both hardcover, both dealing with memory and death.

cv_alive_alive_ohAlso born in 1917, Diana Athill has in recent years made an art form of the memoir. In 2009, Athill won the Costa Biography Award for Somewhere Toward the End. This gives you some idea of the quality of her writing and subject matter. Alive, Alive Oh! is her seventh such book, but the reader needn’t worry that she might be running out of material. Ninety-eight years of life gives a writer plenty to render, and Athill’s prose is as sharp as her memory and perception; too, she has lived a remarkable life, as an editor alongside Andre Deutsch and as a woman during a century in a society which tried its best to prescribe a woman’s life.

This memoir describes, with humour, clarity and honesty, Athill’s unconventional relationships, the history behind her childlessness and “lack of wifeliness”, and her abhorrence of “romanticism and possessiveness, which can be dangerous, and in conjunction with sexuality even lethal”. It also focuses on the joy and richness to be found in life, even and especially as the end of one’s own time draws near. The book’s final chapter is a poem, entitled ‘What Is’, and it seems to sum up the tenor and quality of Athill’s perspective on life. It concludes with the lines, “Look! / Why want anything more marvellous / than what is.” Dead right.

cv_gratitudeA similar vein of lucid, often joyful reflection runs through the four essays written by Oliver Sacks, which together constitute Gratitude. Described by the New York Times as “the poet laureate of medicine,” Sacks is likely to be well-known to readers for his many books detailing the conditions and predicaments of the patients he encountered in his work as a neurologist, such books as The Man Who Mistook His Wife for a Hat, and Awakenings, which was subsequently made into a film.

Like Athill, Sacks had something of an expectation-defying life and career. He came from a Jewish family, but at a young age distanced himself from a religion that would not tolerate his sexual orientation; he experimented prodigiously with hallucinogenic drugs, which he credits with paving the way to insights about the brain and mind that may otherwise have remained obscured from him; and with his capacity for compassionate enquiry, he is said to have captured the medical and human drama of illness more honestly and eloquently than perhaps any other writer.

Oliver Sacks died in August 2015 at the age of eighty-two. During the last few months of his life, he wrote this set of essays in which he explored his feelings about completing a life and about coming to terms with his own death. In his short essays (one could read them all over a pot of English Breakfast) he approaches these themes with a combination of directness and allusion. He writes of the elements of the periodic table, samples of which he had among his possessions, adding to them as his years advanced – gold for 79, mercury for 80, thallium for 81, and as a souvenir of his 82nd and final birthday, lead. By aligning his life and thoughts with these elements, which he describes as “emblems of eternity,” Sacks manages to reconcile himself. And in his final essay, ‘Sabbath,’ completed and published a few weeks before his death, Sacks returns to the paradigm of his boyhood, and while doing so finds the parallels — “the day of rest, the seventh day of the week, and perhaps the seventh of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.”

The book ends, a life not long after. So there is a sensation for the reader of loss, but one leavened with a sense that the writer (and the human being inside the writer) lived long and well. In the face of death, which could be described as the central crisis of human life, Oliver Sacks wrote that his predominant feeling was one of gratitude, for having loved and having been loved, for having been “a sentient being, a thinking animal on this beautiful planet.” The same attitude is described by Diana Athill. It is a mature approach to life, to death, and though such sanguinity is easier read than done, readers might lay down these two slim volumes and reflect on their own lives and inevitable deaths.

Reviewed by Aaron Blaker

Alive, Alive Oh! And Other Things That Matter
by Diana Athill
Published by Granta
ISBN 9781783782543

Gratitude
by Oliver Sacks
Published by Picador
ISBN 9781509822805

Book Review: The Son, by Michel Rostain

cv_the_sonThis book is available in bookstores now.

This is a poignant and moving read that deals with the very difficult subject of grief, the grief of parents suddenly and tragically deprived of their only child. Yet this book is not heavy going, nor a hard and sorrow-filled slog – it is, in some ways, a celebration of life and a memoir of hope and remembrance: the narrator’s 21 year old son tragically contracts a virulent strain of meningitis. Within a few hours of hospitalization, he has died and his parents are left to deal with the hole he has left in their lives. This story is the personal journey of Michel and Martine through their initial shock and grief. Through painful bouts of regret – at not spending more time with him in that final week, and cherishing the moments that they did enjoy. Through the recollections of bittersweet memories at his very touching funeral. And the final step of their journey, as they fulfil their Lion’s final dream, and “let him go” in a very moving conclusion.

This book is part memoir, part fiction; heart-breaking and beautiful. The father’s grief and love shine through in every word. However, the story is enriched not by merely following Michel through his experiences, but in the fact that we follow Michel through the eyes of Lion, watching him from the other side of death. In this manner, we are shown the wretched grief – the clinging to the last vestiges of Lion’s life: his scent upon the bedclothes, the little box of ashes. It adds an additional layer of complexity and beauty.

There is also a dash of humour, a light sprinkling to the mood.

Overall, a beautifully written, deeply affective read that, at less than 200 pages, was devoured within a day of receiving it. It makes one think of mortality and loss and leaves you with the feeling that, although losing a child is terrible, it is something that you can live with, even if you never lose the hurt.

Reviewed by Angela Oliver

The Son
Michel Rostain
Published by Hachette
ISBN: 9780755390809