The annual Wellcome Book Prize celebrates the best new fiction and non-fiction books that engage with an aspect of medicine, health or illness, and each week until the announcement of the winner on 24 April at the Wellcome Collection we will be featuring an extract from the WBP2017 shortlist here on sciencefocus.com.
See the full shortlist at the bottom of this article, but first read an extract from Maylis de Kerangal’s book Mend the Living – translated by Jessica Moore – about 24 hours in about organ donation, that ends the life of one but offers new hope to others.
Pierre Revol started his shift at eight this morning. He scanned his magnetic card at the entrance to the parking lot while the night turned greyscale – pale, still sky, vaguely turtledove, a far cry in any case from the grandiloquent choreographies that had given the clouds of the estuary their pictorial reputation – drove slowly across the hospital grounds, snaking between buildings that were connected according to a complex plan, slid into the place reserved for him, parked his car nose first, a petroleum-blue Laguna, a vehicle in decline but still comfortable, leather interior and good radio, the preferred model of taxi barons he says with a smile, then he went into the hospital, crossed the enormous windowed nave toward the north hall, ground floor, and, walking fast, arrived at the hyperbaric medicine and intensive care unit.
He passes through the department door, pushing it open with the flat of his hand so firmly that it bangs several times in the emptiness after him, and those who are at the end of the night shift, men and women in white or green shirts, all of them done in, dishevelled, brisk movements and bright eyes, febrile grins on their tense faces – tambourine skin – these ones laughing too loudly, or coughing, frog in their throats, voiceless, these ones bump into him in the corridor, brush past him or on the contrary see him coming from far off, cast a glance at their watches and bite their lips, think, good, finally, in ten minutes I can get out of here, in ten minutes I’m off, and at that moment their features relax, change colour, turn pallid, and circles trace themselves all at once, bronze spoons beneath their blinking eyelids.
Calm strides, constant speed, Revol reaches his office without deviating from his path to respond to this sign someone is already making, these papers someone is already holding out, this intern who’s already hot on his heels; takes his key out in front of an ordinary door, enters, and proceeds to the daily gestures of arriving at work: hangs his coat – a tan trench coat – on the peg nailed to the back of the door, pulls on his white coat, turns on the coffee maker, the computer, absently taps the paperwork that plasters his desk, surveys the stack, sits down, connects to the internet, sorts the messages in his inbox, writes one or two replies – no hello or anything, all words emptied of their vowels and no punctuation – then gets up and takes a deep breath. He’s in good shape, he’s feeling good.
He’s a tall man, skinny, thorax hollowed and belly round – solitude – long arms long legs, white leather lace-ups, something slender and uncertain in him that matches his juvenile mien, and his coat is always open, so that when he moves the panels swell, spread, wings, revealing jeans and a shirt, also white, and rumpled.
The little diode glows at the base of the coffee maker while the bitter scent of the electric hotplate heating empty fills the air, the dregs of coffee cool in the glass pot. Although minuscule – five or six lousy square metres – this private space is a privilege at the hospital and so it’s surprising to find it this impersonal, chaotic, of a questionable cleanliness: swivelling chair that’s comfortable despite the high seat, desk where forms of all sorts pile up, along with papers, notebooks, notepads, and promotional pens palmed off by laboratories in plastic embossed pouches, a bottle of San Pellegrino gone flat and, in a frame, photo of a Mont Aigoual landscape; punctuating the clutter, three objects placed in an isosceles triangle may testify to an urge to add a personal touch – a glass paperweight from Venice, a stone turtle, and a cup for pencils; against the back wall, a metal shelf holds disparate folders and boxes of files numbered by year, a good layer of dust, and a small handful of books whose titles you can read if you get closer: the two tomes of The Hour of Our Death by Philippe Ariès, La sculpture du vivant by Jean Claude Ameisen from the Points Sciences collection, a book by Margaret Lock with a two-tone cover illustrating a brain called Twice Dead: Organ Transplants and the Reinvention of Death, an issue of the Neurological Review from 1959, and the crime novel by Mary Higgins Clark Moonlight Becomes You – a book Revol likes, we’ll find out why later. Otherwise no window, hard fluorescent, the bare light of a kitchen at three in the morning.
Within the hospital, the I.C.U. is a separate space that takes in tangential lives, opaque comas, deaths foretold – it houses these bodies situated exactly at the point between life and death. A domain of hallways and rooms where suspense holds sway. Revol performs here, on the reverse side of the diurnal world, the world of continuing, stable life, of days that irrupt in the light and file toward future plans, he works in the hollow of this territory the way you’d rummage inside a heavy coat, inside its dark folds, its cavities. And he likes his shifts, Sundays and nights, has liked them since his residency – you can imagine Revol as a slender young intern seduced by the very idea of the job, this feeling of being needed, at work and autonomous, called upon to ensure the continuity of the medical gesture within a given perimeter, invested with vigilance and endowed with a responsibility. He likes their alveolar intensity, their specific temporality, fatigue like a surreptitious stimulant that gradually rises through the body, accelerates and makes it sharper, all this erotic turmoil; likes their vibratile silence, their half-light – devices that blink in the dimness, blue computer screens or desk lamps like the flame of a candle in a La Tour painting – The Newborn, for example – and again this physicality of the work, this climate of an enclave, this watertightness, the department like a spaceship launched into a black hole, a submarine plunging into a bottomless chasm, The Mariana Trench. But Revol has been getting something else from this work for a long time: the stark consciousness of his own existence. Not a feeling of power, not a megalomaniac exultation – exactly the opposite: an influx of lucidity that regulates his movements and sifts his decisions. A shot of cold-blood.
Department meeting: the transmittals. The staff from both shifts are here, they form a circle, everyone stays standing, leaning against the walls with cups in hand. The team leader, who oversaw the previous shift, is a thirty-year-old fellow, sturdy, with thick hair and muscled arms. Exhausted, he glows. Details the situation of the patients present in the unit – for example, the absence of any notable change in the eighty-four-year-old man, still unconscious after sixty days of intensive care, whereas the neurological status of that young woman, admitted two months ago after an overdose, has declined – before giving a longer description of the newly admitted patients: a fiftyseven- year-old woman with no fixed address, advanced cirrhosis, admitted after having convulsions at the shelter, remains haemodynamically unstable; a forty-year-old man, admitted that evening after a heart attack, with cerebral oedema – a jogger, he was running on the seafront toward Cape de la Hève, luxury cross-trainers on his feet, head encircled with a neon orange bandana, when he collapsed near the Café de l’Estacade, and, even though they wrapped him in a thermal blanket, he was blue when admitted, soaked in sweat, features hollow. Where are we at with him? Revol asks in a neutral tone, leaning against the window. A nurse answers, specifies that the vitals (pulse rate, blood pressure, body temperature, respiration rate) are normal, urine output is low, the P.I.V. (peripheral intravenous line) has been placed. Revol doesn’t know this woman, inquires about the patient’s blood test results, she answers that they are in process. Revol looks at his watch, okay, we’re good to go. The team disperses.
This same nurse lingers in the room, intercepts Revol and holds out her hand: Cordelia Owl, I’m new, I was in the O.R. before. Revol nods, okay, welcome – if he had looked more closely, he would have seen that there was something a little odd about her, eyes clear but marks on her neck, swollen lips, knots in her hair, bruises on her knees, he might wonder where this floating smile came from, this Mona Lisa smile that doesn’t leave even when she leans over patients to clean their eyes and mouths, inserts breathing tubes, checks vital signs, administers treatments, and maybe if he did he would be able to guess that she had seen her lover again last night, that he had phoned her after weeks of silence, the dog, and that she showed up on an empty stomach, beauteous, decorated like a reliquary, lids smoky, hair shining, breasts warm, resolved to an amicable distance, but she was a rather mezzo actor, whispering distantly how are you? it’s good to see you, while inside her whole body was diffusing its turmoil, incubating its tumult, a hot ember, so they drank one beer and then two, attempted conversations that didn’t take, and then she went outside to smoke, telling herself over and over I should go now, I should go this is stupid, but he came outside to find her, I’m not gonna stay long, I don’t want to be up too late, a feint, and then he got out his lighter to light her cigarette, she sheltered the flame with her hands, tilting her head, curls falling across her face and threatening to become a wick, he tucked them automatically behind her ear again, the pads of his fingers brushing her temple, so automatically that she went weak, the backs of her knees turning to jelly – all of this, by the way, threadbare and old as the hills – and bang, a few seconds later the two of them were knocking about beneath a neighbouring porch, held inside the darkness and the smell of cheap wine, banging into garbage cans, offering a range of pale skin, upper thighs emerging from jeans or tights, bellies appearing beneath lifted shirts or unbuckled belts, buttocks, everything boiling and freezing all at once as their mutual and violent desire collides – yes, if Revol looked at her more closely, he would see in Cordelia Owl a girl who was curiously brighteyed, even though she was beginning her shift on a sleepless night, a girl in much better shape than he was, someone he would be able to count on.
The full 2017 Wellcome Book Prize shortlist is:
- How to Survive a Plague by David France (USA) Picador, Pan Macmillan
- When Breath Becomes Air by Paul Kalanithi (USA) The Bodley Head, Penguin Random House
- Mend the Living by Maylis de Kerangal (France) trans. Jessica Moore MacLehose Press
- The Tidal Zone by Sarah Moss (UK) Granta Books
- The Gene by Siddhartha Mukherjee (USA) The Bodley Head, Penguin Random House
- I Contain Multitudes by Ed Yong (UK) The Bodley Head, Penguin Random House