Medical novels

Eleanor Limprecht, The Coast (#BookReview)

/ Whispering Gums / 26 Comments

I love to read Author’s Notes, Afterwords, or whatever they are called, at the end of novels, and particularly so when the novel is historical fiction. This is because these notes will often explain the author’s thought process, the line they have drawn between fiction and fact, the sources used, the level and type of research undertaken, and so on. It helps me understand “how” to read the book, if that makes sense. I was consequently pleased that Eleanor Limprecht had provided such information at the end of her fourth novel, The Coast, which is set in the former Coast Hospital lazaret in Little Bay, Sydney. This hospital was established in the 1880s for the treatment of infectious diseases, including small pox, tuberculosis, and the subject of this novel, leprosy (or Hansen’s Disease).

The Coast is set primarily in the first three decades of the twentieth century, and focuses on the story of Hilda/Alice who is nine when she is brought to the lazaret. However, while she provides the novel’s narrative and emotional centre, hers is not the only story told. We hear about other members of her family, including her mother Nellie/Clea who is at the Coast when she arrives. We also hear about one of the Hospital’s doctors, Will Stenger, who takes special interest in his lazaret patients. And, we have a story that somewhat parallels Alice’s, that of Jack/Guy, a Yuwaalaraay man, who also ends up at the lazaret, though not until he is an adult. I should explain here the dual names: leprosy patients would be given (or choose) a new name when they entered the hospital because, as Alice’s mother tells her, it’s better for their family if they disappear, “it’s better that no-one can find us”. Leprosy, at the time, was a reviled disease and sufferers were secluded under the Leprosy Act of 1890.

What author afterwords tell us

So, Limprecht’s words. I wanted them because I wanted to know whether she would address her First Nations character and, of course, being the thorough historical fiction writer she is, she does indeed discuss the issue. She had advice and feedback from Yuwaalaraay reader Nardi Simpson (whose Song of the crocodile I’ve reviewed) and Gamilaraay and Yuwaalaraay reader Frances Peters. She visited Angledool, Jack’s home, with the help of local First Nations people, and was shown around the Goondee Keeping Place at Lightning Ridge by First Nations people there. Her manuscript was also read by First Nations people associated with the La Perouse Aboriginal Land Council. All this supports my sense that she has rightly and respectfully included First Nations experience in her story.

Limprecht’s words provide other insights too, but I’ll mention just two of them. One is that she acknowledges various grants, including the Neilma Sydney Literary Travel Grant (see my post), which helped her visit another lazaret location, Peel Island. The other is that she acknowledges the History of Medicine Library at the Royal Australasian College of Physicians where she “found the records that inspired this story”. This interested me because the story contains many details about the lives of the patients at the lazaret, details that were so specific that I felt (and hoped) they were based on documented records – on reports, letters, and so on. This suggests that they were.

“nothing to look forward to” (Alice)

Limprecht also tells us in her words that she got the idea for this novel while researching her second novel, Long Bay (my review), making it before 2015. However, she also tells us that she finished writing it during the pandemic, which helped her “consider the continuing repercussions of stigmatising illness and the long-term effects of isolation”.

So now, the novel itself. The story is told in first person and third person voices – Alice’s in her voice, with the stories of the other three in third person. These four stories are interspersed with each other, and are told chronologically, but each starts at a different point in time, beginning with Jack (1905), then Alice (1910), Nellie (1892) and Will (1910), until they coalesce in 1926. Jack’s story encompasses his experiences as a stolen child and a soldier in the Middle East in World War 1. Through him, Limprecht ensures that First Nations’ lives are part of the life of the time she’s chronicling, something that many of our majority-culture-written histories and historical fiction have consistently omitted.

Jack’s story – of being taken from his family, returning to it, going to war and returning as an amputee who soon after ends up at Peel Island – conveys not just these facts, but the emotional impact of being stolen, of displacement, of racism (albeit his injured returned soldier status sometimes earned him begrudging recognition.) By sending him to Peel Island, Limprecht also documents the differential treatment at that lazaret between “white” and “others” (or, the “coloured camp”). This is a difference that he does not experience at The Coast under the more humane Dr Will.

Alice’s story follows, presumably, a typical trajectory of those who were isolated at a young age and spent the rest of their lives that way. (It’s a coming-of-age story as moving and as tragic as that of Anne Frank’s real one). As quarantine places go, The Coast lazarets – men’s and women’s – are humane. The patients live in cottages, they have access to a beach where they can swim and fish, and they can socialise with each other (though the women’s lazaret does not have a communal cottage like the men’s has!) But, “it’s no place to grow up”. Alice is an intelligent young woman, who quickly engages us with her warmth and honesty, but she also articulates the physical and emotional experience of this disease. Told first person, her story of resilience and resignation carries the novel.

Nellie’s and Will’s stories add additional depth and breadth to the lazaret community and thus the history. Both appear in the epilogue dated 1967. It didn’t feel narratively necessary to me, but historically it rounds out how leprosy treatment progressed and what happened to the Coast lazaret.

The coast is the sort of historical fiction I like, a well-researched, expressively-written story about an historical time and place I know little about, one that is worth knowing. It reminds us how far we have, or haven’t, come in our management of feared diseases, like AIDS, like COVID-19. It evokes with warmth and clarity the costs of ostracism and isolation. And, it puts First Nations people into the historical frame – naturally. A good read.

Lisa (ANZLitLovers) also liked this novel.

Eleanor Limprecht
The Coast
Sydney: Allen & Unwin, 2022
319pp.
ISBN: 9781760879402

(Review copy courtesy Allen & Unwin)

Abraham Verghese, Cutting for stone

/ Whispering Gums / 14 Comments

Verghese, Cutting for Stone

Bookcover (Used by permission of the Random House Group Ltd)

I  saw a man under the spell of his own tale, a snake charmer whose serpent has become his turban.

I’m not sure how I want to use the above quote, which comes late in the book, but I just liked it and so decided to start this post with it. Bear with me!

Discounting Dinaw Mengestu‘s short story, An honest exit, Abraham Verghese‘s Cutting for stone is the first novel I’ve read that’s set in Ethiopia (mostly). And for that, as much as for anything else, I enjoyed it. Also, in one of those eerily frequent experiences of reading synchronicities, this is the second book that I’ve read this year to deal with a long-standing dictator – and, even more eerie, is the fact that dictators in Africa are falling (sort of) around our ears at present. How do these things happen?

Anyhow, Cutting for stone is about as different from Mario Vargas Llosa‘s The feast of the goat as it could be. In the latter, dictator Trujillo is central to the story. He is the story really. In Cutting for stone Haile Selassie, and later Mengistu, provide the background. The characters are touched and, eventually, significantly affected by coups and unrest, but Selassie and his reign are not the subject of the novel.

So what is its plot? It is mostly set in an Ethiopian hospital, aptly, metaphorically, named Missing (a perversion of its original name, Mission). To this mission hospital come an English surgeon (Thomas Stone) via India and a young Indian nun (Sister Mary Joseph Praise), with rather cataclysmic results. Some time later (I’ll leave you to draw your conclusions) identical conjoined male twins named Shiva and Marion are born. The story follows their lives as they grow up, living through political upheavals while their adoptive parents, Hema and Ghosh, treat the sick and poor of the region, until one of them moves to the United States. Perhaps the best way to describe it is to quote Psychologies from the back cover: “a sweeping saga of family life, love, betrayal and redemption”.  Get the picture?

This is a traditional nineteenth-century-style novel, reminiscent, say, of Rohinton Mistry‘s A fine balance (1995). It’s about social conditions and family. The back cover (again) suggests it has flavours of Dickens and Waugh. Perhaps, but a weak flavour I’d say. While it has some of the intensity of those writers, it lacks their bite. I also found the fundamental crisis – which, not surprisingly given the set-up, has to do with a betrayal between the twins over a woman – to be not quite convincing. Maybe it’s me, but the narrator kept telling us of his love for the girl-then-woman in question, Genet, and I went along with it to a point. But it was never made clear how mutual this was. Marion is the narrator – this is a first person tale – and so we see it all through his eyes, but the whole “love” storyline did feel a little bit like a house of cards. Perhaps that’s the point? Perhaps it’s about his obsession regardless of whether it was realistic or not. It is, after all, partly a coming of age novel.

Verghese, like his main characters, is a doctor and so there is a lot of detail about things medical – about vena cavas and how they relate to the liver, about fistulas in circumcised women, about volvulus, and so on. More detail really than I needed, and yet most of it was interesting. What was even more interesting was the difference between the medical system in Africa and in the United States, and then the difference in the United States between the “Mayflower” hospitals and the “Port Ellis” hospitals. There are social messages here about the construction of medicine in the developed and developing worlds, and between the haves and have-nots. But this wasn’t the only message. According to Wikipedia, Verghese is passionate about “bedside medicine” and there is certainly a strong message here of caring for patients as well as treating them. Early in the novel the young Marion sits with a woman, Tsige, as her son dies. Much later, he is the one who can answer Thomas Stone’s question “What treatment in an emergency is administered by ear?”. The answer? “Words of comfort”.

Marion, then, as a child and a young doctor is well attuned to the feelings of others and yet he was unable to forgive all those who “wronged” him – Genet, his brother, and his birth father. I found that somewhat inconsistent with his character, and it affected my ability to fully buy  into the angst on which the plot turned.

Nonetheless, I liked the characters and so I kept reading, the story was interesting and so I kept reading, the writing was fine and so I kept reading. It doesn’t quite hang together, is a little melodramatic at times, but it’s a lively tale about characters I couldn’t help caring about. Early in the novel, we are told that Hema, who raises the twins, had:

come close to defining the nameless ambition that had pushed her this far: to avoid the sheep life at all costs.

The novel is full of characters who “avoid the sheep life”.

I started the review with Marion’s description of his father telling the painful tale of his life. I’ll end with the advice Marion’s adoptive father gives him:

The key to your happiness is to own your own slippers, own who you are, own how you look, own your own family, own the talents you have, and own the ones you don’t. If you keep saying your slippers aren’t yours, then you’ll die searching, you’ll die bitter, always feeling you were promised more…

Obvious stuff really, but that doesn’t mean that it doesn’t need to be said.

Abraham Verghese
Cutting for stone
London: Vintage, 2010
541pp.
ISBN: 9870099443636