Lark Ascending: A Novel by Silas House

 Dear Lit Loves,

This month my book club chose to read Lark Ascending:  A Novel by Silas House.  This particular author has published seven novels, one book of creative nonfiction, and three plays.  Silas House is also the poet laureate of Kentucky for the years 2023-2025.  

First, let me start by saying I had never read this author's work previously.  I knew this book most definitely falls into the literary fiction category because nearly every sentence paints a picture and paragraphs elicit strong emotions.  It did not surprise me that Algonquin Books was the publisher of Lark Ascending:  A Novel; they tend to publish literature reading more like poetry over more plain-spoken manuscripts.   Both types of books have their merits in my opinion.

The book follows a young man named Lark and his family who initially reside in Maryland, but due to climate change and religious nationalism, the family is forced to move to Maine.  We get to see what the U.S. and other countries do when one person or faction takes power to the exclusion of others and personal freedoms evaporate.  Even more, we get to see what happens when others will follow one person or faction in power often to the detriment of others. Lark and his family eventually decide to leave the United States on a boat with many others fleeing the U.S. by taking to the North Atlantic and setting out for Ireland.  The family has heard that Ireland is the last country accepting American refugees, but the trip is fraught with immense danger.  Upon reaching the outskirts of Ireland, the boat is hit with bullets quickly sinking it and leaving only Lark left alive while the others parish at sea including both his parents.

Ireland has also descended into chaos due to climate change and religious nationalism. In this part of the story the reader sees the Nays in power and those fighting the Nays are called the Resistance or Rebels. Lark has to try and find his way to a place his parents were intending to travel to called Glendalough; Glendalough being imagined as a place of beauty and freedoms.  Along the way, Lark encounters a deep bond with a Beagle in a place where dogs have been banned.  And he also meets Helen, a woman who is searching for her son who she believes has been kidnapped and held in what often sounds like an internment camp.  The bulk of the story is about Lark, Helen, and a dog named Seamus trying to make their way to the beautiful area of Glendalough.  

At the heart of this book, the author wants the reader to contemplate what happens to humans when climate change occurs and control-seeking factions are placed in power.  More importantly, the book demonstrates the power of grief and what helps Lark to survive long enough to make it to Glendalough.  The powerful connection between animals and the ones who love them is exhibited throughout the book.  There is also the notion of losing your biological family and choosing who you make your "Found Family".  The book deals with grief and hope and how they can be entangled and coexist.  The larger questions the author wants the reader to think about include:

1) Does a place shape its people or do people shape a place?? (My answer:  Both)

2)  There is strength in numbers, but is there not also a danger when there is strength in numbers?

Honestly, I had a difficult time even reading this book as I am still grieving a personal loss myself.  There were moments when I had to put this book down and walk away from it.  And yes, parts of this book were difficult and shocking to read and envision.  I am glad I kept reading though because in the end is where the beauty in this story lies. (Also, I wish I had read the end of book essay by the book's author before starting to read the book itself!)  This book will make you think about the future of our planet, what happens when power is in the hands of a chosen few, and how it is often the smallest of wonders that bring humans the most joy as we live many lives in one lifetime.

I would recommend this book, but also caution readers about the immense grief and disaster portrayed in the book.  Overall, I would recommend you read this book and determine what you think it says about the future of our planet and our people should we ever encounter an apocalypse.

Till my next review,

Grace (Amy)

Review: The Story of a Heart: Two Families, One Heart, and the Medical Miracle That Saved a Child's Life by Dr. Rachel Clarke

 Dear Lit Loves,

Wow.  I just completed reading an in-depth story of two children belonging to two loving families when one passes away via a car accident and the other has a failing heart and needs a transplant.  The two children eventually match as donor and transplant recipient.  Additionally, this book relays a thorough history of the field of cardiothoracic surgery and transplantation.  You get a moving memoir and an education regarding the heart and its ability to be repaired, and transplanted!

Initially there is Keira who is about eight years old living in England in a rather large, close family.  When Keira and her mother and brother are in a dire car accident, it is apparent to a doctor at the scene of the crash that Keira quite possibly will not make it through this incident alive.   The doctor appearing on the scene implements Dr. James Styner's Advanced Trauma Life Support technique whereby there is a protocol for addressing trauma patients.  The technique involves knowing what can kill a patient first which is the list you go by when assessing trauma patients:  A is for Airway (is it blocked) B is for Breathing (is the chest rising and falling) C is for Circulation or (is the heart beating and pumping blood) D is for Disability (check for spinal fractures and immobilize body if necessary) and E is for Exposure (has the patient been exposed to prolonged periods of cold or heat).  Keira is given life sustaining measures until she can reach a children's Pediatric Intensive Care Unit.

We all know it is the precarious nature of life that causes a parent to not be able to shield a child from all the bad possibilities in life.  This is particularly true for Max, son of Paul and Emma Johnson, who around the age of eight begins losing weight, sustaining low energy levels, and having shortness of breath.  His parents are informed he has Dilated Cardiomyopathy - his heart is enlarged and is being attacked by a virus.  Eventually Max will require a drug known as Milrinone to increase the force of his heart muscle's pumping ability.  Also, Max will need a Left Ventricle Assist Device to help his heart circulate blood throughout his body.

Some interesting historical details in the book included:

1) 5 Liters of blood are pumped through the body every minute.

2) The Glasgow Coma Scale is the assessment of the level of consciousness of a trauma patient and it is measured from 3 to 15.  In this story Keira scores a three meaning no brain function. 15 meaning optimal brain function.

3) Heartbeats used to define the essence of life and over time physicians learned sustainable life requires brain function thus leading to the argument of whether to keep a patient on a ventilator or to opt for withdrawal of ventilation and potentially select organ donation.

4) Children spend two and a half times longer on a transplant waiting list than adults.

5) A heart transplant is considered palliative care and not a cure.  Average life span of patient receiving a transplanted heart is 14 years.

6) VAD (ventricle assist devices) help improve the force behind the heart muscle and its ability to pump blood.  

7) Heart-Lung machine was invented to take over function of the heart and lungs so a surgeon can make a repair to the heart.

8) The lungs function is gas exchange or removing carbon dioxide from the blood while replenishing red blood cells with fresh oxygen.

9) May 6th, 1953:  Dr. John Gibbons performs first open heart surgery with cardiopulmonary bypass machine.

10)  Brain death of a potential organ donor must be confirmed by two doctors replicating the result of each other's tests.

Eventually, we see Max agonizing in a PICU for months waiting on a potential heart transplant.  Keira's family decides to allow her to live on through donating her organs:  heart, lungs, liver, and kidneys. We see where for children the size of the transplanted organ is critical in terms of matching a donor with a recipient along with blood and tissue typing.   Keira is eventually moved to a theatre (operating room) and there is a moment of honor where all assisting in removal of organs reflect on generosity and cost to family of the donor patient.  Keira's heart is removed, placed in three sealed bags, and the heart is bathed in cardioplegia to not only stop the heart but to preserve it as well.  Keira's heart is then placed on ice in a cooler and a "go" team transports her heart to PICU where Max lies unconscious in an operating room awaiting the new donor heart.

There is a 25% chance Max will not even survive the transplant surgery so his parents know upon seeing him enter the operating room, they may have seen their son for the last time.  The heart is the first organ to form and usually at five weeks gestation.  Once Max's new heart is in place he is given a bombardment of intravenous steroids to keep his cells and body from attacking the newly transplanted  heart.  Some heart transplant patients suffer Hyperacute Rejection whereby a donor recipient's cells attack the newly transplanted heart with a 70% mortality rate.  The author does give a history of immunosuppressants, in particular, Cyclosporine which was found through a soil sample from Norway and considerably inhibits helper T cells from attacking the newly transplanted heart.  

The Organ Donation Act becomes law in the UK on May 20th, 2020 whereby instead of opting "in" for organ donation, trauma patients are assumed to be organ donors automatically unless they expressly want to opt out of organ donation.    In the first year after the new law, 296 patients in England donated organs which is about one-third of all total organ donations.  Each day in England over 200 children need some type of organ transplant and 50 of those are generally in need of a heart transplant.

Overall, this is one of the best, most thorough transplant memoirs I have ever read.  The unimaginable loss of a child from the donor family and the overwhelming anxiety of the transplant recipient's family are never underestimated.  After organs are extracted, Keira's body is returned to her family.  Max excels with his newly transplanted heart.  Max's story is covered widely by the media via The Mirror.  Both donor and donor recipient's family eventually connect and maintain close ties.  Joe and Loanna Ball, (Keira's parents) set up a charity for organ donation and also the same organization supports families who lose children and opt for organ donation.   Though this story did not take place in the United States it most definitely happens each year in the United States as well.  I do believe in the United States a person must opt, upon receiving a driver's license, whether to be an organ donor.  What a richly moving story and a compelling history of organ transplantation.  My hat's off to you Dr. Rachel Clarke!  Bravo!

Till my next review,

Grace (Amy)

Review: Class: A Memoir Of Motherhood, Hunger, And Higher Education by Stephanie Land

 Dear Book Loves,

For this particular post I am reviewing the book, Class:  A Memoir Of Motherhood, Hunger, And Higher Education by Stephanie Land.  If you ever had a doubt how tough single moms are, this book will stifle that doubt.  Ms. Land writes openly and with emotional depth about the challenges of being a single mother and pursuing a degree in writing while parenting her six year old daughter, Emilia.

Not being a mom myself, I still found Ms. Land's writing compelling reading as I prefer memoirs about regular people as opposed to celebrity memoirs.  Ms. Land last wrote the memoir titled Maid:  Hard Work, Low Pay, and a Mother's Will to Survive a couple of years ago.  She related in that book how she became pregnant by an abusive boyfriend and decided to keep the child.  She has her own cleaning business whereby she cleans houses, businesses, gyms, etc. in order to make a living to support herself and her young daughter.  Remember, she tried working under someone else's house cleaning business, but then she decided she could control her schedule and make more money by having her own business located I believe in Seattle, Washington.  In the first book we see the author making the decision to pursue higher education in Montana and she and her daughter move to Missoula, Montana.

With the memoir titled Class:  A Memoir Of Motherhood, Hunger, And Higher Education, Ms. Land continues her story.  She and her daughter rent a portion of an older home, Ms. Land continues her cleaning business, and she is also adding the pursuit of a four  year degree to the mix.  Single motherhood finds her working tirelessly to juggle the pursuits of being a mom, a business owner, and a student.  We see her juggling five classes during her senior year of college.  Additionally, she is attempting to get an increase in child support from her daughter's father.  We see the rigors of dealing with a court system and a judge who value a father's earnings from his full-time job with overtime pay over her job cleaning houses, raising a daughter, and meeting the demands of collegiate reading, essays, reviews, and thesis papers.  Finding affordable child care is a major issue described in this book in that the costs are exorbitant even with having your own business, receiving child support, and utilizing food stamps.  

When Ms. Land's daughter turns six years of age, Ms. Land loses food stamp benefits for herself, but retains them for her daughter Emilia.  Many times the reader sees where food stamps barely cover the cost for grocery staples much less fresh fruit and vegetables.  Going for ice cream and getting a happy meal for your child are extravagances Ms. Land lives for and she will often go without food herself so that her daughter can eat what she likes.  At times this book is so raw and vivid that I found myself shocked and bewildered by all that Ms. Land tackles on a daily basis.   At one point she writes that her life motto is "My life may be relentless".  She is constantly chasing collegiate deadlines, a way to get her daughter to school in a timely fashion, cleaning homes, and hoping that her car starts each morning.  

And then there is health care.  When Ms. Land finds herself with a puncture wound in her leg during this book, she tries to treat it herself knowing that visiting a hospital ER is not a reality she can readily afford.  She does go to the college's student health center where she receives help cleaning the wound, Neosporin is applied to the wound, and she is sent home with a load of bandages.  Her instructions from the student health center are that if it gets worse head directly to the ER.  Though Ms. Land recovers without a trip to the ER, I find myself wondering what does it say about our country when a single mom with a puncture wound in her leg who works hard for a living and is trying to improve her life status via education, can only afford to be seen at a student health center as opposed to an actual ER?  There are a lot of moments like this in the book where I am shocked at the lack of assistance for this hardworking mother of a single child.

Also, child care is a major hurdle for Ms. Land.  Many times a friend or roommate will watch Emilia after she gets home from school each day.  In order for Emilia to attend day camp during the summer, Ms. Land barters with the day camp's owners by cleaning their facility in exchange for a discount on the cost of sending Emilia to camp daily.  And sometimes Ms. Land has to depend on the generous mindset of her professors who allow her to bring Emilia to class with her.  Why could the college not have offered a child care center for students who are also parents.  And why could it not be staffed by students pursuing a degree in early, middle, or high school education? Even better, what about a sliding pay scale for students like Ms. Land who are doing their best to raise a child, obtain a degree, and additionally run her own business? It leaves  you seeing where the gaps are in education, the family court system, and food stamp benefits.  Honestly, we have hospitals that offer child care for their staff so obviously, where there is a will there should be a way.  Are these benefits only for the wealthy members of our society?  

There is a big revelation and/or event in this book that I will not give away here.  In the final chapters of the book we see Ms. Land finishing her four year degree along with having $50,000 in student loans that she will have to start repaying six months after graduation unless she continues in a collegiate MFA program at another university.  Her first jobs are as a data entry clerk and she also obtains a paid YWCA internship. She does not explicitly say it, but I am sure she is still running her home cleaning business just to make ends meet.  Here's what I hope:  Ms. Land secures a spot in a phenomenal graduate school, she maintains a tenacious yet loving spirit, and she continues to show readers and the world the stamina it takes to be a single mother making a life for herself though the systems that rule her life are lacking in so many fundamental ways.

Till my next read,

Grace (Amy)