Wednesday, July 4, 2018

Twisting Fate by Pamela Munster


Rating: WORTHY!

This is from an advance review copy for which I thank the publisher.

Not to be confused with Twisted Fate by Pamela Kennedy (there is a score of "Twisted Fate" novels!), this is the true story of a doctor and professor of Medical Oncology who works at the Carol Franc Buck Breast Care Center, a part of the University of California San Francisco, who becomes a patient and thereby gets to see her work from the other side. It's a perspective not granted to many people and definitely one no-one would choose when it comes to the medical profession, but as a doctor and a scientist, this author makes the most of it, exploring her feelings as well as her diagnosis, and constantly relating it back to her interactions with her own patients both prior to her diagnosis and afterwards as well as to the prevalence of breast cancer nationwide in the USA.

The events are written well-enough that we get to feel what the doctor/patient feels, but nowhere is it flowery or so sugary that it's actually sickening. Quite the contrary. It's very sober and a little depressing at times, but it makes for an engrossing and useful read. The relation of her reactions and feelings came across as realistic and authentic, just as if they were our own, and they made me live the experience as much as it's possible for someone of the opposite gender (why opposite? Shouldn't it be complementary gender?!) and someone who has no such diagnosis can live it.

I've actually worked in a hospital oncology ward - not as a caregiver but as support personnel, mind - yet I needed none of that knowledge to follow and understand this because the text was informative and did not talk down to the reader, while still simply explaining problems and concepts as they arose.

There were, I have to say, multiple grammar issues in the text - more than I usually see in an advance review copy. Hopefully these will be corrected before the actual published copy is released. I list them here to that end:

  • "So at worst the tumor would small" - I assume this should read 'would BE small'
  • "Kate told me that she had noted that her skin dimpling about a couple of months back" - I assume this should read, 'skin WAS dimpling' or 'noted her skin dimpling' (omit 'that').
  • "...no woman needs the dreadfully surgery..." - dreadful, not dreadfully
  • "...the goal to reduce the body's estrogen in the body." Too many bodies! Either 'to reduce estrogen in the body' or 'to reduce the body's estrogen'
  • "So why are so many mastectomies are still being done" - Too many 'are's!
  • "What appeared important early on may not remained important as the time goes by" - 'may not HAVE remained important'?
  • “And all of us a sudden I found myself weeping” There's an us that shouldn't be in there.
  • “...specific sections on chromosomes 17...” There’s only one chromosome 17 per genome!

One thing I couldn’t help but find curious in this book was how little involvement the author's husband appears to have in this. It’s not my business and not my place to judge; a marriage either works or it doesn't work according to its own rules, and everyone's is different, but after having read a book recently where the author brought her husband into it to what felt like an inappropriate degree, this book contrasted sharply with that one in that it felt like this author all but excluded her husband in a situation where emotional support from family is a critical component of patient care. It may well just have been an accident of the way this was written, and since this was an ARC, things may change before the final published version, but I think it's worth some thought regarding adopting this approach.

This seemed especially relevant given that her husband is also an oncologist and thereby had a much deeper insight into what was going on than your typical spouse might. More of his involvement would have been welcome in my opinion, but there's this one brief mention when they were on a hiking holiday right before she was due to have a double radical mastectomy, and she asked him how he felt about her losing both breasts and he didn't even address the question. Instead began talking about something entirely unrelated.

That to me, seemed decidedly odd, if not outright callous. The author explained it away by saying that's how he always as - it wasn't a big deal to him so he wasn't interested in talking about it, but it presented him in a very cold light, especially when contrasted with how frequently she mentions how emotionally supportive her staff and colleagues were. It stood out quite starkly.

The author talks about her colleagues, staff, and patients quite freely, too. I am assuming - and hoping! - that she's changed the patient names at least. I also hope she asked her colleagues if they wanted to be mentioned. I'm a very private person so had I been a colleague I would have resented being talked about so freely in someone else's book, but each to her or his own.

Normally I ignore things like introductions, prefaces, prologues, author's notes, acknowledgements and dedications as well as chapter quotes and so on in books, but in this case I actually went looking for an intro or a note to see if there was anything mentioned about this: permissions and name changes, but there was not, so there was no information to be had on this topic.

I was once again disappointed here (as I have been in other books from academically inclined authors) to discover that the book is evidently formatted as a print book, with what I call 'academic margins' - meaning the margin is excessive - an inch or more (and even greater at the bottom of the page). I have to ask when are writers and publishers going to respect the only entity on the planet that is actively and dedicatedly trying to combat climate change: trees?

The text on each page occupies only fifty percent of the page. No one wants to see the entire page covered in text of course, but if this book had margins even half the existing size, and the text had not been quite so generously-spaced, the book could well have been maybe half as long, and thereby slaughtered fifty percent fewer trees. Writers and publishers need to think seriously about this, because it matters even in an ebook, which requires more energy to store, retrieve and transmit when it’s longer.

One more curiosity! When I went to look up the author at her professional page on the University web site, I found two links and each seemed to link to a different people! I think it’s really the same person but the two photos look so different: one is a blond, the other much darker haired. Her professional history though is impressive. This is one hard-working doctor!

Despite some issues I had with it, I liked this book a lot. I think it's important and useful, and I recommend it for anyone interested in what those inflicted with cancer go through and what the options are for combatting this awful disease which, despite its virulence, is slowly succumbing to technology and medical science - and to the wisdom and dedication of healthcare professionals like this one. This is a worthy read.