Tag: Alzheimer’s

Australian Women Writers Challenge, Author, AWW2021, Book review, Fiction, Kate Jennings, literary fiction, New York, Picador, Publisher, Reading Projects, Setting, TBR 21

‘Moral Hazard’ by Kate Jennings

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Fiction – hardcover; Picador; 192 pages; 2002.

What a beautiful little gem of a book this one turned out to be!

Kate Jennings’ Moral Hazard is set in Wall Street during the 1990s and tells the story of an outsider — Cath, an Australian “bedrock feminist, unreconstructed left-winger” — who works at an investment bank by day and looks after her ill husband by night.

Previously a freelance writer, she’s sold her soul to make big bucks as a speechwriter for the mid-level bank known as Niedecker Benecke. She needs the money to look after her husband Bailey, 25 years her senior, who is in the advanced stages of Alzheimer’s.

She knows nothing about finance but she can craft a sentence, although she finds the sexist world — and the politics — of the investment bankers and the communications department a challenge. Her only “friend” in the firm is Mike, a fellow cigarette smoker, with whom she spends her breaks, sitting outside in the plaza sharing confidences.

The book was reissued by Text Classics in 2015

Stark but beautiful prose

The story, which spans roughly six years, from Bailey’s diagnosis to his death, is told in forthright prose undercut with dark humour.

It reads like an insider’s guide to investment banking — its risk-taking, its greed, its unwritten rules, protocols and unfettered belief in the market — based on the author’s own experience working for Merrill Lynch. But it’s also an honest look at the challenges facing those who must look after loved ones* with chronic illnesses while juggling their own lives and careers.

It’s not hard to see the parallels between both worlds.

I was commuting between two forms of dementia, two circles of hell. Neither point nor meaning to Alzheimer’s, nor to corporate life, unless you counted the creation of shareholder value.

The morality of greed

In fact, Bailey’s slide towards the loss of self could also mirror Cath’s own changes in values, her need to “play the game” to get ahead, to understand the tickings of the financial world and the increasingly risky behaviour of those around her.

While Moral Hazard is set more than a decade before the Global Financial Crisis of 2008, the cracks are already there and the shadow of the Barings Bank collapse, caused by employee Nick Leeson’s unauthorised trading, looms large, so when Mike tells Cath about a hedge fund that is likely to collapse, she has a moral dilemma: follow protocol and keep quiet, or speak out and tell her superiors?

She is similarly conflicted when Bailey insists she euthanise him should he become too ill even though they both know this is against the law.

Interestingly, in economics, moral hazard occurs when a business increases its exposure to risk because it does not bear the full costs of that risk. The concept could also apply to Cath’s care of her husband whose behaviour becomes wildly unpredictable and unmanageable as the story progresses, so much so that she has to put him into full-time care and hand over responsibility to others.

There are other metaphors in this short, sharply observed novel — the way the financial authorities bail out failing hedge funds, for example, and make no changes to the rules could be seen as if they, too, have been diagnosed with Alzheimer’s.

Portrait of office life

I don’t think it is an exaggeration to say that Moral Hazard is probably the best book I’ve read so far this year. As well as its twin themes of illness and finance, I loved its portrait of office life, a subject that is rarely addressed in fiction despite the fact so many of us spend our working lives sitting at desks surrounded by others sitting at desks.

And it’s a lovely counterpoint to Jennings’ debut novel, Snake, which was set in the Australian outback as far removed from New York’s financial district as it is possible to get!

For another take on Moral Hazard, please see Sue’s review at Whispering Gums.

*  Jennings’ husband, the graphic designer Bob Cato, died of complications from Alzheimer’s in 1999, so those aspects of the novel must surely be based on experience, too.

This is my 10th book for #AWW2021 and my 11th for #TBR21 in which I’m planning to read 21 books from my TBR between 1 January and 31 May 2021. I purchased it secondhand last year. 

Author, Book review, Canada, Eric Rill, Fiction, general, Lake Union Publishing, literary fiction, Publisher, Setting

‘An Absent Mind’ by Eric Rill

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An-absent-mind

Fiction – Kindle edition; Lake Union Publishing; 207 pages; 2015.

It might sound odd, but I’ve been thinking about Alzheimer’s disease a lot recently. Initially it was because I found out that someone I went to school with in Australia died of it a week or two ago. She was just 44 and was one of those active, sporty types who seemed invincible. Then British writer Sir Terry Pratchett succumbed and it was all over the news and social media.

I made a small donation to Alzheimer’s Research UK in honour of them both, and then I decided to read Eric Gill’s An Absent Mind, which I’d had on my wish list for a while, though, ironically, I can’t recall how I found out about it or where I saw it mentioned first. (If you’ve reviewed it, please let me know in the comments, because it may well have been your review that sparked my interest.)

The book is a  fictionalised account of a man living with Alzheimer’s disease. In the author’s afterword, he said he was inspired to write it after his father had the condition for eight years, which might explain why it seems so realistic — and heartbreaking.

Charting a patient’s progress

An Absent Mind is set in Montreal, Canada, but it could be any place on Earth: this is a disease that afflicts more than 44 million people worldwide, regardless of geography or income per capita.

It charts Saul Reimer’s illness from initial diagnosis, aged 71, until his death more than five years later.  Through Saul’s ramblings we get to know his feelings, his fears and his coping mechanisms. We also get to hear from his loved ones because his wife, Monique, and two adult children, Florence and Joey, take it in turns to narrate their version of events. What emerges is a fully rounded, sometimes conflicting, view of the way in which this disease cruelly robs the patient of his faculties and his family of their loved one through a steady, often frightening, decline.

From this we learn that Saul, an “Anglo” and a Jew, has always been a strong and rather controlling person, so his slide into dementia is not, at first, taken seriously by his family, least of all himself — “I sometimes forget where I park my car when I go to the mall. Florence always kids me that I have Mallzheimer’s” —  but when tests reveal he’s in the early stages of the disease and that his memory loss and other cognitive functions will get worse over time, there’s no denying it and everyone has to readjust their outlook and attitude.

The impact of his illness on his long-suffering wife — a Catholic who converted to Judaism — is particularly upsetting. She refuses to accept any home help and won’t attend counselling, thinking she can cope alone, but as Saul’s behaviour worsens her own safety gets put at risk.

Florence, the upstanding, stoical and dependable daughter, does all she can, but she’s got her own husband and children to worry about. And then there’s self-absorbed Joey, a 35-year-old bachelor, who’s forever chasing the next business idea and taking on more debt than he can handle. Or, as his father so eloquently puts it:

I swear, if there was a way to get rich from marketing the sweat that drips from my armpits after I wake up from one of those dreadful nightmares of falling into a never-ending black hole, he would be the one to do it.

As you might be able to tell from the above quote, there’s a little bit of humour in the narrative to lighten the load — and there would want to be, because this is a rather depressing narrative that takes us through the three stages of Saul’s disease, including his admittance to a care home for Alzheimer’s patients in the final years of his life.

Easy to read novel about a difficult subject

An Absent Mind is written in quite a straightforward prose style. The language is plain and to-the-point. The chapters are short, too (some are only a page long), which makes it especially quick and easy to read.

I liked the author’s non-sentimental approach on how one family copes with life post diagnosis. But one of its real strengths is the way it educates its readers about the disease. This is done through the voice of Dr Tremblay, an Alzheimer’s expert, who treats Saul and narrates a couple of chapters. He explains aspects of the disease, including the fact that it can take six to 10 years to run its course, that I found particularly interesting. Until recently, I couldn’t quite comprehend how dementia could kill someone. Now I know that it can impair brain function so badly that the body no longer knows how to breathe:

Alzheimer’s is characterised by the formation of cellular debris in the form of plaques and tangles. The plaques float between the neurons, while the tangles attack the neurons from inside the cell membranes. But regardless of how they go about their destruction, they achieve the same result, preventing the neurons from communicating with one another. As clumps of neurons die, specific functions such as short-term memory, spatial relationships, reasoning, and eventually things like muscle coordination, and even swallowing, are affected. The result is always death.

No doubt as this disease becomes more prevalent in our society more novels will be written about Alzheimer’s. An Absent Mind is a good one to add to the canon.

For another take on Alzheimer’s, I thoroughly recommend Samantha Harvey’s extraordinary debut novel The Wilderness, which is written entirely from the perspective of a 60-year-old man diagnosed with the disease. For non-fiction, Annie Ernaux’s A Woman’s Story is a deeply affecting memoir about the author’s mother who dies from Alzheimer’s. If you know of any others, please do leave a comment below.

UPDATE: The Reading Agency has a list of Books on Prescription for Dementia as part of its Reading Well programme. You can read the list in full here. Hat tip to Susan Osborne, who wrote about the iniative on her blog here.

Annie Ernaux, Author, Book review, Books in translation, France, memoir, Non-fiction, Quartet Books, Setting

‘A Woman’s Story’ by Annie Ernaux

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A-Womans-Story

Non-fiction – paperback; Quartet Books; 96 pages; 2014. Translated from the French by Tanya Leslie. Review copy courtesy of the publisher.

Annie Ernaux’s A Woman’s Story is a deeply affecting and brutally honest memoir about the author’s mother and the sometimes-strained relationship they shared.

It was first published in France, in 1988, where it became a bestseller. It has just been reissued by Quartet Books — which first published it in English more than 20 years ago — in a rather handsome edition, complete with French flaps.

Mother-daughter relationship

At just 96 pages in length, A Woman’s Story packs quite a lot in. Ernaux not only examines the relationship she had with her mother — often in painstaking, heartbreaking, too-close-for-comfort detail — she also charts her mother’s life from her poor upbringing in a small Normandy town to her marriage and success as a shopkeeper; from her bored (and somewhat meaningless) retirement to her death in a geriatric hospital in Paris where she had been suffering from Alzheimer’s disease.

What emerges is a fascinating portrait of two women tied together by their biological relationship but never, truly, close. While it’s not a rosy account — there’s too much bitterness and conflict between them for that — it does reveal Ernaux’s admiration, her love and her attempt to reconcile her mother’s senile dementia with the “strong, radiant mother she once was”.

In many ways, the book is as much about mothers and daughters as it is about growing old, of the burdens we can place on loved ones and an examination of the grieving process.

The author, however, describes it like this:

This book can be seen as a literary venture as its purpose is to find out the truth about my mother, a truth that can be conveyed only by words. (Neither photographs, nor my own memories, nor even the reminiscences of my family can bring me this truth.)

Conflicting views

This is a theme Ernaux returns to again and again: this itching to get to the truth, to portray her mother in a fair light, even though she knows that her memories are coloured by emotion. She has a hard time trying to put her mother’s brusque manners, her desire to be a confidante, yet always bitterly critical, her lack of education and her desperate social climbing into context.

About midway through she confesses that she sometimes thought she was a good mother, at other times a bad one. “To get away from these contrasting views, which come from my earliest childhood, I try to describe and explain her life as if I were writing about someone else’s mother and a daughter that wasn’t me,” she writes.

This objectivity feels authentic, because there are thoughts and incidents revealed here that feel too painful and honest. It’s not an uncomfortable read — indeed, I flew through it in an hour or so, the writing is so eloquent — but it is a deeply affecting and poignant one.

Author, Book review, England, Fiction, Jonathan Cape, literary fiction, Publisher, Samantha Harvey, Setting

‘The Wilderness’ by Samantha Harvey

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Wilderness

Fiction – paperback; Jonathan Cape; 336 pages; 2009.

Samantha Harvey is an exquisite writer and a skilled novelist. The Wilderness is so accomplished on so many different levels — stylistically, creatively, intellectually — that it seems astonishing that this is her first novel. What is not astonishing is that it has been shortlisted for this year’s Orange Prize for Fiction. And if I might be so bold as to make an outlandish claim based on nothing more than instinct, I rather suspect it might win. Or at least I hope it does.

While not much seems to happen in the book, it is an utterly engrossing story, one that is shocking and melancholic and life-affirming by turn. It has the atmosphere of a spellbinding family drama, with chinks of humour shining through, that someone like Anne Tyler might write. Indeed, it feels like an American book to me, rather than one set in England,although it features some wonderful references to London and the desolate moors of Lincolnshire.

I found it so affecting that I have spent the best part of four days wrestling with this review, and I don’t think I will come anywhere close to explaining what it is about this novel that is so brilliant. Bearing that in mind, let me tell you a little of its content.

The third-person narrative focuses on Jake, a 60-something widower, who has been diagnosed with Alzheimer’s disease. We learn that his wife, Helen, 10 years his junior, died from a stroke at the age of 53 and that he is now living with another woman, Eleanor, who is taking care of him. (He occasionally refers to her as “that other woman” because he forgets her name; indeed he often forgets that Helen is dead.) But we never fully learn how that arrangement fell into place, only that the two have known each other for a very long time, have a shared history and that Eleanor waited 30 years to be with him.

Jake has an adult son, Henry, who is in prison, and a daughter, Alice, although it’s never quite clear as to whether she is still alive or died as a youngster.

In fact, this inability for the reader to really know the truth is one of the most interesting aspects of Harvey’s novel. Through a clever repetition of motifs — a yellow dress, a cherry tree, the sound of gun shots, mint juleps, love letters, monkeys, the scars on his grandfather’s face and a bible bound in human skin — and family tales — the story of a missing “e”, which parts of a Battenberg cake you should eat first, a 24-hour dalliance with a young woman, an inheritance that goes missing — the reader begins to see how Jake’s memories are slowly deteriorating as his disease takes hold. Stories shift and change and turn into something else, blurring the line between what is real and what is not.

Suddenly nothing he says or does can be trusted, as if it used to be quite an informal kind of illness and now it becomes official. The timeline is a mass of crossings out and corrections. He feels to be the supremely unconfident author of his own life. Question marks appear against words, then he deletes the question marks, thinking that if he doesn’t question the truth there is no question about it. It is only him, as the woman says, only him who is confusing things.

But this book is as much about architecture as it is about Alzheimer’s. Indeed, Jake, a former architect, refers to the amnesia of his profession on several occasions, and it soon becomes clear that very few of his buildings have been memorable. Ironically, his crowning achievement is a prison extension — a utilitarian monstrosity that caused a public outcry — that now houses his wayward son.

And there’s a bit of politics thrown in for good measure in the form of the Six-Day War of 1967 between Israel and the armies of Egypt, Jordan and Syria, one of the crystallising moment’s in Jake’s life. He is so affected by the conflict he sets up a pro-Israel lobby group, because as an architect,he has had his own fights over land. But his mother, Sara, an Austrian Jew, does not approve. “You have foolish ideas,” she tells him, before later adding: “These groups, what good arethey? You must leave it alone and save the energy for your  family.”

And it is family — Helen, Henry, Alice — which forms the epicentre of his life, and as the memories of them slowly fade and become lost in a fug of confusion the life-affirming nature of this book really hits home: without our memories we have no history, no sense of self, nothing, in fact, to hold onto or to make sense of the world around us.

The Wilderness is an outstanding novel on so many different levels everything I read in its aftermath will seem pithy by comparison. I don’t often re-read books, but I have a feeling that this one may just become an old friend. Indeed it invites a second and third reading to really come to grips with the detail of everything within.