Books: July-August 2008

August 1, 2008

Oxygen

By Carol Cassella '78.

Simon & Schuster, 2008.

288 pages. $25.

We put such faith in the tools of modern medicine. Clinical breakthroughs and sophisticated technology seduce us into thinking that whatever ails us can be taken care of with a dose of medicine or a surgical intervention. But in the opening pages of Carol Cassella's debut novel, Oxygen, we're reminded of the fragile hold we have on life.

"I anesthetize airline pilots, corporate executives, high school principals, mothers of well-brought-up children, judges and janitors, psychiatrists and salespeople, mountain climbers and musicians," writes Cassella, who, like her book's protagonist, Marie Heaton, is a seasoned anesthesiologist. "People who have struggled and strutted and breathed on this planet for twenty, thirty, seventy years defying the inexorable, entropic decay of all living things. All of them clinging to existence by one molecule: oxygen."

Heaton is a seven-year veteran at First Lutheran Hospital, a skilled member of the surgical teams that keep the center's revenue-producing operating rooms booked solid. She's good at what she does, and dedicated to her job, often arriving before dawn and taking overnight call duty once or twice a week. From routine hernia repairs and mastectomies to the riskier heart surgeries or emergency C-sections, Heaton savors her role as "medicinal artist, a chemical hypnotist beckoning the frightened and uninitiated into a secure and painless realm of trust."

The book opens on a typical workday, with Heaton showering while it's dark outside and driving through the streets of the still-sleeping city of Seattle. At the hospital, she checks her caseload, swaps small talk with co-workers, and pops in on surgeries already under way, subbing for tired anesthesiology colleagues while they duck out for coffee during a lull. Even though her fourth case seems fairly straightforward—removing a congenital cyst from the base of an eight-year-old girl's spine—there are a few complicating factors. The girl is mildly retarded, lacks comprehensive medical records, and is being reared by a single mother with no network of family or friends. Still, Heaton has faced far tougher cases before, and assures the girl's mother before surgery that her daughter is in good hands.

In the middle of the operation, moments after Heaton injects a narcotic into the patient's IV line, an alarm sounds. The patient's blood pressure and heart rate plummet. Heaton scrambles to identify the problem—a blocked airway passage? Undiagnosed asthma? An allergic reaction? Heaton and the rest of the surgical team mobilize to employ all emergency protocols at their disposal, but even though every attempt is made to identify and remedy the problem, in a frighteningly small span of minutes, the girl dies on the operating table. It's left to Heaton to relay the news to the mother, sitting alone in the waiting room where she'd held her daughter only hours before.

As the consequences of the death take shape, Heaton is gripped by guilt and self-doubt. The hospital's legal machinery moves into high gear to prepare for the inevitable lawsuit. Oxygen follows Heaton as her personal and professional life slowly begin to come undone. Despite initial reassurances by top-ranking hospital administrators that everything will be fine, such collegial encouragement gradually gives way to detached advice and revised worst-case scenarios.

Heaton's primary support system includes best friend Joe Hillary, a fellow anesthesiologist at First Lutheran, and her only sibling, Lori. Through these relationships, Cassella provides the reader with insights into the twin impulses of Heaton's character—she is both tenacious and sensitive, a compassionate perfectionist. A subplot involves Heaton's aging, estranged father, who is losing his sight but refuses to relinquish his independence. Long-simmering family tensions come to a head as the medical malpractice case winds its way toward the courts.

While the secondary story line eventually helps explain some of Heaton's perspectives on work, love, and family, it is less effective than the central plot. Cassella offers a persuasive and chilling example of how a person can be doing everything right, when circumstances beyond her control conspire to forever alter the course of untold lives. One day Heaton is a valued and trusted member of a medical community; the next she is subject to concerned glances, unspoken judgments, and public accusations of professional misconduct.

In advance publicity for Oxygen, publisher Simon & Schuster compares Cassella to such medical-genre novelists as Jodi Picoult, and such writer-physicians as Atul Gawande. Unlike Picoult, Cassella has professional medical authenticity and a genuine ear for how physicians, health-care CEOs, and malpractice lawyers really talk. (Plus, Cassella is the better writer.) Given her clear-eyed understanding of the medical profession, one hopes that like Gawande, she will provide us with further opportunities to peer into the mysterious and unpredictable nature of the human condition.

— Bridget Booher

Across the Line: Profiles in Basketball Courage: Tales of the First Black Players in the ACC and SEC

By Barry Jacobs '72.

The Lyons Press, 2008. 361 pages. $24.95.

Veteran basketball writer Jacobs relates the stories of the pioneering African-American players who integrated the basketball teams at eighteen universities in the Atlantic Coast and Southeastern conferences, the South's most prominent leagues. He explores the players'—as well as university administrators'—motivations and experiences, weaving interviews with players, coaches, teammates, and observers together with news reports from the 1960s and 1970s. Players had to navigate institutional racism, KKK-organized events, and angry mobs of opposing (and home) fans in order to succeed and survive.

On Violence: A Reader

Edited by Bruce B. Lawrence and Aisha Karim Ph.D. '04.

Duke University Press, 2007. 578 pages. $29.95, paper.

An anthology of classic perspectives on violence that includes the writings of Hannah Arendt, Sigmund Freud, Mohandas Gandhi, Georg Wilhelm Friedrich Hegel, Adolf Hitler, Thomas Hobbes, Osama bin Laden, and Karl Marx. Lawrence, the Nancy and Jeffrey Marcus Humanities Professor of religion at Duke, and Karim, a professor of English and foreign languages at Saint Xavier University, contend that violence is a process, rather than a discrete product, and is intrinsic to the human condition. It can be channeled and reckoned with but never completely suppressed. In placing these classic arguments in conversation, they seek to examine how one might speak about violence without perpetuating it. Lawrence contributes an essay, as does Kristine Stiles, Duke professor of art, art history, and visual studies.

Jameson on Jameson: Conversations on Cultural Marxism

By Fredric Jameson, edited by Ian Buchanan.

Duke University Press, 2007. 277 pages. $22.95, paper.

In a compilation of interviews conducted by noted scholars between 1982 and 2005, Jameson discusses key concepts like postmodernism, the dialectic, metacommentary, the political unconscious, the utopian, cognitive mapping, and spatialization. He muses on culture, architecture, art, cinema, literature, philosophy, and politics. One of the most influential literary and cultural critics writing today, Jameson, William A. Lane Professor of comparative literature and Romance studies at Duke, is credited with reshaping the critical landscape across the humanities and social sciences.

Getting the Best Out of College: A Professor, a Dean, and a Student Tell You How to Maximize Your Experience

By Peter Feaver, Sue Wasiolek '76, M.H.A. '78, LL.M. '93, and Anne Crossman '00.

Ten Speed Press, 2008. 249 pages. $14.95, paper.

Bucking a trend of how-to college-admissions manuals, the writing team—a Duke professor, a dean of students, and a recent alumna—pools its collective fifty-plus years of experience in higher education to share insider strategies for everything from getting along with a first-year roommate, to navigating the college social scene, to getting the most out of classes and other academic opportunities. The tone is chatty, and the lessons are applicable. Feaver, for example, shares insights into how to genuinely impress a professor. Anecdotes from real Duke students (names changed to protect the innocent, as well as the guilty) illustrate each point.

Seneca Falls and the Origins of the Women's Rights Movement

By Sally G. McMillen Ph.D. '85.

Oxford University Press, 2008. 310 pages. $28.00.

In the latest contribution to Oxford's Pivotal Moments in American History series, McMillen, a professor of history at Davidson College, takes the reader to Seneca Falls, New York, the site of the pivotal 1848 convention that effectively launched the women's-rights movement in the United States. She traces the movement's momentum in its early years, focusing on the roles of prominent women Susan B. Anthony, Lucretia Mott, Elizabeth Cady Stanton, and Lucy Stone. She describes how they came to the movement, the advances they made during their lifetimes, and the lasting effects of their work.

Family Bible

By Melissa J. Delbridge.

University of Iowa Press, 2008. 143 pages. $23.95.

In this memoir about growing up in the Deep South, Delbridge introduces the reader to the people in her own family Bible. Now an archivist in Duke's Rare Book, Manuscript, and Special Collections Library, Delbridge, an essayist and aspiring novelist, shares tales of her father's circumspect "hunting trips"; her mother's sudden, tempestuous moves across town in the middle of the night; and sipping stolen rum from a rinsed-out perfume bottle in the middle-school bathroom.