Showing posts with label tuberculosis. Show all posts
Showing posts with label tuberculosis. Show all posts

Thursday, December 31, 2015

Extraordinary Means by Robyn Schneider

"At Latham House, we were asked to believe in unlikely miracles. In second chances. We woke up each morning hoping that the odds had somehow swung in our favor."
Extraordinary Means is a moving novel about two teens whose lives are changed forever when they contract a (fictitious) deadly form of drug-resistant tuberculosis and are sent to a sanitarium in the hopes that they might get a second chance at life.

Seventeen-year-old Lane Rosen was entering his senior year of high school and had his life all planned out. He was enrolled in Advanced Placement courses before he got sick. He'd taken AP Physics Lab, volunteered at the health clinic, participated in Model UN, done SAT prep courses and started a Carbon Footprint Awareness Club to boost his application. His marks were good enough so far to potentially guarantee him a spot at Stanford. His plan was "to land a summer banking internship at twenty, graduate in three years, and recruit straight to Wall Street." By the time he was twenty-three, Lane hoped to have all his school loans paid off and then attend either business or law school.

However, all this seems to be on hold now that Lane has been diagnosed with an incurable strain of tuberculosis known as TDR-TB (total drug resistant-TB). As a result he's sent to Latham House, a sanitarium in the Santa Cruz mountains in the hopes he can recover. Latham House used to be a private school but has now been converted into a sanitarium.  "The eight cottages were arranged in a half-moon, around a gazebo in desperate need of a paint job...Each cottage had around twenty residents...The first floor was a lounge area with dilapidated plaid sofas, a long study table, and stacks  of board games." All the residents at Latham House are teens and all wear medic wrist bands that monitor their vitals.

Expecting to be met by his "First-Day Ambassador, Grant Harden", Lane finds himself on his own, navigating the showers, the breakfast line and classes. In the breakfast line he meets Nikhil Patel (Nick) who tells him to fill his plate when he goes through the line to avoid getting a "strike". As he goes through the line a second time, Lane spots a petite blond girl named Sadie who doesn't care if she only has a mug of tea and who seems familiar to him. Not knowing where to sit he ends up at a table with a girl named Genevieve and her friends. Meanwhile, Nick has gone to sit at Sadie's table. The dining hall at Latham is filled with kids eating and talking but also coughing, "like a symphony of sickness."

During his first day, Lane notices Nick and Sadie along with two others taking off into the woods during the after-lunch break.  Later on he sees her return with her group and remembers Sadie being in summer camp with him before going into grade eight. He remembers her as a loner who was always taking pictures with her camera. Other than that, Lane doesn't remember much more about her.

Lane is checked over by Dr. Barons at Latham House. Barons tells Lane that he has two lesions on his right lung that they need to watch and that Lane needs to stick to his schedule which means breakfast at 8am, nature walks and yoga, rest periods in his room and bedtime at 9pm. Barons wants Lane to concentrate on getting well but Lane wants to get back to his life. A life that weeks ago meant he "was a straight shot to the college of his choice." He decides that he will work hard in his room doing the work he brought from home rather than resting.

Sadie Bennett is also seventeen years old. She has spent the past fifteen months at Latham House. In her sophomore year, Sadie fainted in phys ed and was told at the ER that she had an active case of tuberculosis. In the woods with Nick, and her friends Marina and Charlie Sadie reflects on seeing Lane and on being a Latham House. A loner in her old life, at Latham House she has a group of friends with whom she breaks the rules and spends her time on her photography.

Sadie doesn't want to meet Lane who she believes remembers her as "the outcast girl who sat alone in the arts and crafts tent making friendship bracelets for her American Girl doll." However the inevitable meeting happens at the end of Lane's first night at dinner. Lane remembers that they attended Camp Griffith and is nice to Sadie which only infuriates her.  Sadie remembers that summer - the year her parents were in the middle of divorcing. Taunted by a group of bullying girls in her cabin. Then she saw Lane in the woods looking at her when she was taking pictures with her camera. After asking one of the girls about him, and before the seniors dance at camp, Sadie is given a note supposedly penned by Lane along with his sunglasses. The note asks her to the dance. However the night of the dance, Sadie waited in vain, filled with hope and excitement. Until she was given a note by one of the girls written by Lane saying he wasn't coming. She was humiliated and saddened.

Lane meanwhile, is puzzled by Sadie's reaction to him. After talking to his parents he calls his girlfriend Hannah who requests that he read her admissions essay. In French class the next day Sadie is mean to Lane when they have to perform short skits in front of the class. In the skit, Sadie tells Lane that he has only a little bit of TB but that he is lucky to live in France where there are drugs to treat it. Mr. Finnegan is furious with Sadie and explains to the class that the drugs which work on other forms of TB do not work on the TDR strain and actually kill the patients. After French class Lane is furious with Sadie but only for throwing the assignment.

Lane spends his first week suffering through the companionship of Genevieve, studying in the library and watching Sadie and her friends take off into the woods. However one day when Sadie and her friends Marina, Charlie and Nick come to the library to "steal" internet access, Lane saves them from being discovered by the librarian. When Sadie doesn't thank him, Lane asks her what her problem is. She tells him about what happened to her at camp three years earlier. Lane explains to Sadie that he never wrote the notes to her and his sunglasses were stolen.

The next morning Lane wakes up sick, running a fever and coughing up blood. Things go from bad to worse when he breaks up with Hannah over her admission's essay which was about him. Upset, Lane sits in the gazebo outside the cottages. Sadie sees he's very miserable and decides to talk to him. He tells her what happened between him and Hannah and they talk about how their lives have changed now that they have an incurable illness. When Lane goes in to see Dr. Barons for a second check-up, he finds his health has deteriorated as a result of him trying to keep up with his school work. He's lost weight, running a fever and sleeping poorly. Lane eventually confesses what he's been doing and promises to follow his treatment plan.

Lane becomes part of Sadie's clique, joining her and her friends at their lunch table and in the evening for movies. As time passes Lane begins to fit into Latham House, sneaking off the grounds and into nearby Whitley, and skipping Wellness. Lane and Sadie's friendship deepens. They begin calling each other on their room phones and spending time together in the library. Just when Lane finds himself part of Latham, the possibility of a new cure is presented. It will take some weeks before the treatment can begin. A cure means the hope of a future but what will that mean for Lane and Sadie?

Discussion

Extraordinary Means is a deeply touching novel about two teens trying to live their lives in spite of a serious and potentially incurable illness. The two main characters, Lane and Sadie, who narrate the novel, are very different. Lane is organized and focused. He knows what he wants in life and has planned everything accordingly. By his own admission he's "a head-down-and-grades-up sort of guy." At Harbor, Lane was one of those students teachers loved - "We were going somewhere in life, the teachers said, handing us extra-credit assignments instead of detention, study guides instead of busywork." Being sent to a sanitarium was not in his plans and has completely disrupted his life. He can't wait to get out and get back into the swing of his life. "But I could see that I wasn't getting through to Dr. Barons about how important it was for me to stay on track. I'd have to show him that Latham was working. That I was improving. And then he'd send me home."

Sadie on the other hand, has no such plans and has sees herself differently. She's been at Latham House for a long time, in fact, longer than anyone. Outside of the sanitarium, Sadie had been an outsider; the girl not involved in school, a loner with three friends who were always dating boys and going on group dates without her. Latham has made her part of a clique; finding "friends who hated the exact same things about it, mocking the rules and the teachers and Dr. Barons until we were laughing so hard we could barely breathe." She also views identifies herself as the disease. "Where I once was, there was now an active case of TB. Everything of who I was and who I wanted to be had been evicted to make room for the disease."

Initially Sadie's view of Lane is marred by a falsehood - the belief that he stood her up years ago at camp. The fact that she has never gotten over this incident demonstrates how little she has in her own life and how self-absorbed she is. Once this lie is uncovered, Sadie is able to recognize what really happened and move on. This leads her and Lane to begin to develop a friendship. Lane states that talking with her began to change his perspective on his situation and opened his eyes to the reality of his life. For the first time in months Lane feels understood and not alone.

Lane's time at Latham sees him change his perspective on his illness and his outlook on life. At first he feels like being at Latham is "like I was living someone else's life because this couldn't be mine." When his health declines further after working on his AP courses and Lane is forced to follow Latham's schedule he realizes "that just like everyone else, I was a patient here." His view of the other patients who crowded the TV room, read graphic novels and ransacked the DVD shelves changes. He originally viewed Sadie and her friends as trouble makers, "But now, the idea of getting in trouble sounded appealing...I was sick of being perfect, and maybe it was okay not to be, just for a while, just at Latham.
Maybe I could be a different version of myself here, one who didn't feel enormously guilty for watching a movie on a school night. Someone with a hobby that did nothing for my resume. Someone with friends, not just a friend group."

Lane realizes his approach to life at Latham was wrong and he becomes determined to fix it. In French class when at a dare from Sadie, he takes on the role of the instructor during the teacher's absence, Lane is reminded of his love for drama class and improv. "I'd forgotten how much I enjoyed stuff like this, how fun it was to step outside myself."

After a trip to Starbucks in Whitney to get butterbeer lattes with Sadie, Nick, Charlie and Marina, Lane realizes how much he's missed by being focused on the future rather than living in the present.  "I'd always told myself that there was plenty of time to goof around later, after I'd gotten into Stanford. But if the past month had taught me anything, it was that the life you plan isn't the life that happens to you."

After a month of being at Latham, Lane notices that his facebook is dead, no comments, no contact from his friends. He's missed his high school's homecoming dance, something Lane has always skipped. Because he's a senior, there will be no more homecoming dances - he's missed all of them which he now regrets. He also sees that his ex, Hannah has moved on and is now dating another guy. To Lane it feels like he is a ghost, that he's been "deleted from my old life."  Lane now admits that his life before TB was not a good life because all he did was study. He felt that life in high school wasn't important because the only thing that mattered was college. But Sadie tells him that this new life he has matters, that he's "still leaving your mark, you're just doing it somewhere else."

Lane sees the reality of his old life. "I realized then that I hadn't had a life, I'd just had a life plan. And it wasn't that I didn't still want all those things -- Stanford, summer internships, graduate school -- I just wasn't sure I'd gone about achieving them the right way." Lane decides that he doesn't want to shut out life around him when he goes through college. "I didn't want to rush through all the moments that I wouldn't know I wanted until they were gone."  At this point Lane isn't even sure he wants his old life back. He'd sacrificed drama class which he loved for AP Art History to help his application. He was determined to be the best in high school without really understanding what being in high school meant. "I'd made high school into a race toward the best college, as opposed to its own destination."

Meeting Sadie and being at Latham has changed Lane; he was "waiting for everything to be different." The announcement of a potential cure by Dr. Barons leaves Lane filled with relief. When Sadie breaks up with Lane after the death of Charlie, Lane is devastated. Lane wants Sadie to be in his life because she reminds him of who he's become at Latham and he wants to take that with him when he returns to his life. "...I liked the Latham version of me so much better than the Lane I'd been before. I wanted to be the Lane who kissed a girl in a bedsheet toga and stole internet and wore a tie to a pajama movie night. I wanted to be Sadie's Lane, not the Lane who ran the Carbon Footprint Awareness Club just so I could put "club president" on my college resume." Lane feels scared that he may not be able to be "Sadie's Lane" without her.

But in the end Lane does have to learn to live without Sadie and live in the world again. However, his experience at Latham House and with Sadie has changed him forever. He decides that he will learn to enjoy life because it's all that is left to him since he can't have what he really wants in life at this point - Sadie. His biggest lesson learned is that he focuses now on the path rather than the destination. Proof of that is when he drives home from the coffee shop, Lane takes a different route home.

In contrast to Lane, Sadie is conflicted about the cure. She is cautious in accepting the reality because of previous false claims. In a way this is a foreshadowing of what will happen to Sadie. "We were no longer incurably ill, and for so many of us that had been our defining thing for so long. It had hurt to accept what was wrong with me, but it hurt even more to have hope." For Sadie returning home doesn't hold the promise that it does for others because she believes she will be held back in school, she doesn't have her driver's license, she hasn't taken the SATs and her father is now gone from the family replaced by her mother's new boyfriend. And leaving Camp Latham means she and Lane have only a few more weeks together. Sadie's doubts she'll see Lane outside of Latham.

Sadie gradually accepts that Latham won't last forever. But when a tragic series of events leads to her being attacked and her condition worsens, Sadie decides to go for the extraordinary means of treatment - the medication for the multi-drug resistant TB which has a twenty-five percent chance of killing her. Where Lane had never accepted his mortality and his being sick from TB, Sadie has. So when the treatment doesn't work, she knows her miracle was the second chance, and not the cure others will get in three weeks time.

Schneider has crafted a very gritty and realistic portrayal of teens dealing with a life and death situation, that sometimes seems unnecessarily crass. The situation surrounding the character Charlie, while humorous almost feels this way. Charlie, is a homosexual and is caught in an embarrassing situation in his room. He's a truly wonderful character, filled with teenage angst and uncertainty. He knows he's dying and is attempting to finish as much of his music composing as he can in the little time he has left. This makes him all the more endearing. Charlie demonstrates the reality of life; that the seriously ill struggle with the same things as healthy teens do. In an attempt to soften this harsh reality, Schneider interjects much humour around the situation.

Despite the strange premise of the novel, (a fatal form of TB), Schneider's characters are realistic, diverse and interesting. The setting of the novel, while realistic for the circumstances (set in a sanitarium), feels irregular at best. The group of teens in the novel appear to have little meaningful supervision and little contact with their parents. If in fact, 280,000 cases of TDR-TB exist, as the novel states, one would like to think that the facility would have restricted access and some sort of protection preventing patients from entering the town and infecting local residents, as Sadie did with Michael. Schneider has a lengthy Authors Note that explains about tuberculosis and how she came to write a novel with such an unusual premise. Overall an excellent novel, well written, with a tragic ending. Highly recommended for fans of John Green.

Book Details:

Extraordinary Means by Robyn Schneider
New York: Kathering Tegen Books 2015
324 pp.

Monday, September 15, 2014

With Every Breath by Elizabeth Camden

With Every Breath is an engaging Christian historical romance centered around the conflicted relationship between two people as they struggle to treat the scourge of tuberculosis.

The novel's prologue sets the stage for the story. It is 1879 and at a private school in Washington, the top two students, Trevor McDonough and Kate Norton are competing for the coveted college scholarship. It's not likely Trevor, who is from a wealthy Scottish family, will need the money but for Kate, the scholarship represents her only chance to attend college. Trevor, who arrived at the private academy four years earlier has made few friends with his icy demeanor and brooding ways. However, Trevor does win the academic competition meaning Kate will likely have to spend her days working at her parents boarding house.

Twelve years later finds Kate recently widowed from husband Nathan Livingston and working as a statistician for the census bureau in Washington, DC. Inexplicably she has received a request by the world famous Dr. T. Kendall to apply for a prestigious position at Washington Memorial Hospital. However, when Kate attends the interview she is stunned to discover that the prestigious Dr. T. Kendall is none other than her old nemesis, Trevor McDonough. Shocked Kate struggles to understand why Trevor changed his name and why he has requested her to work with him. Trevor tells Kate that he is undertaking research into a cure for tuberculosis, "measuring the effect of a new serum to see if it can strengthen the blood of patients suffering from tuberculosis." His patients are all terminal, having no hope of recovery. He recognizes that Kate has the mathematical ability to work as a statistician for the research.

But Kate has always feared illness especially after the death of her two younger brothers, Carl and Jamie, from diphtheria. Compounding this is Trevor's cold demeanor and the fact that Kate has never come to terms with him winning a scholarship he did not need many years ago. However, Kate knows her family needs the money and at twenty-nine, as a widow she recognizes that she has few good employment prospects. So Kate accepts the position and begins working for Trevor at Washington Memorial.

When Kate arrives her first Monday morning she learns that she will share an office with Trevor. Each Monday both Kate and Trevor have to be tested for tuberculosis due to their repeated exposure to patients.Trevor refers to each patient as a number and requires Kate to record data about them. Trevor gives each patient a serum consisting of beef bone marrow and minerals in cod-liver-oil in the hopes of strengthening their blood. He tells Kate that once tuberculosis enters the blood a person rarely survives.  Also working in the lab is Henry Harris who does the testing of sputum samples, and Nurse Ackerman who is in charge of the ward on the fourth floor of the hospital.

As Kate settles into her job it soon becomes apparent that someone is determined to destroy Trevor's research. Nurse Ackerman shows them the most recent article appearing in the Washington Times about Trevor's clinic, claiming the remedies are quackery. Supplies disappear and it appears that someone has been searching his office.  As more anonymous letters appear in the newspapers, Trevor begins to suspect that whoever is writing them knows a great deal about his personal life and that the person wants to see him ruined.

Trevor explains to Kate that someone is trying to get the hospital to evict him and close down his research. Kate is understandably worried about her job but Trevor tells her that he is paying for the research out of his own money and that he has the backing of the surgeon-general. The hostile stories in the press continue into the summer months but Kate grows to love her job. She tries to inject some warmth into the lives of the patients in the ward by reading to them and insisting on referring to them by name.

Trevor himself is a mystery to Kate. She doesn't understand why he changed his last name and why he was so determined to win the scholarship from  her twelve years ago. As she traces his personal history she uncovers two years where there are no records of any achievements.  She wants to know why he went to the Himalayas and where he was from 1887 to 1888. As she gets to know him better she begins to suspect that beneath that cold facade is a complicated man.  "Trevor was different. Austere and reserved, she wondered what it would be like to peek beneath that shell. Trevor wasn't emotionless. Oh no. She'd caught glimpses of a mighty passion simmering beneath the surface, but he always held it so tightly locked down. Restrained. What would it be like to tear away his stern outer layer and see that smoldering emotion unleashed?"

Can Kate uncover the mystery behind the enigmatic Trevor McDonough and help save the clinic and his reputation from ruin while coming to terms with the realization that she is falling in love with the man who stole her chance for a college education?

Discussion

With Every Breath is a slow paced novel in which tuberculosis research provides the opportunity for Trevor McDonough and Kate Livingston to meet twelve years later. Kate is still recovering from the death of her husband Nathan and has never forgiven Trevor for capturing a scholarship that he didn't need. As secrets are uncovered it is revealed that Trevor was captivated by Kate but due to circumstances could never truly pursue her. Both gradually begin to lose the prejudices they have formed towards each other as they come to know one another better.  Kate sees that Trevors cold, cheerless exterior is a form of protection against becoming to close to either patients or those around him. Instead she finds a kind-hearted man who cares genuinely about his patients and is passionate about his work. And Trevor finds that the joy Kate carries redeeming

Once Trevor and Kate work through their past and they discover that have a mutual affection for each other, another conflict arises and that is over the possibility of sharing a life together. Kate cannot accept Trevor continuing to work with tubercular patients, placing himself at risk. She doesn't want to loose another husband like she did with Nathan. However, Trevor feels he is called to work with tuberculosis patients and he's not prepared to stop his research for a cure. Eventually Kate comes to realize that nothing in life is guaranteed and that she needs to trust in God's providence. "'I don't understand what God has planned for either of us, but I know it's pointless to keep worrying about it. I think your life is going to unfold exactly as God intends. I think you  are at the beginning of a grand, monumental quest, and God sees the bigger picture, even if I can't. I'm willing to trust what I cannot see, even if it's frightening and uncertain...."

With Every Breath is a well-written romance that doesn't ever stray into a preachy tone. In fact the Christian references are subtle but relevant. A good example is when one of the tuberculosis patients reminds Kate about the necessity of grieving; "Dr. Kendall. Oh, he's right that we're all in God's hands, whether here on earth or on our journey to the other side, but there's no shame in grieving. It's normal. Grief freshens our perspective on life; it helps us appreciate the blessings we've been showered with..."

Camden has created a sort of heroic character in Trevor McDonough. Trevor unknowingly contracted tuberculosis at the age of thirteen. When he arrived in America he had to keep his illness a secret or risk being sent away. Mrs. Kendall, the woman who cooked for the family he stayed with also suffered from tuberculosis and she helped him eat properly. By the time Trevor left for college he was clear of the disease and curing others of the deadly disease became his goal. In an effort to understand the disease better he reinfects himself with tuberculosis bacteria and managed to at least demonstrate that he does not have immunity to the disease. Trevor's courage is demonstrated in working with those most susceptible to contracting tuberculosis, the marginalized poor and prostitutes. He doesn't care what people write about him visiting the poor, only that he can minister to them and try to help them. Yet Camden has crafted a realistic character because Trevor has his weaknesses too - he can be arrogant and selfish.

Camden was inspired to write With Every Breath after reading the memoir of Edward Livingston Trudeau, a pioneer in the development of sanitarium care for tuberculosis patients. Dr. Trudeau contracted tuberculosis from his brother and managed to live for forty years with the disease. Despite the heavy subject matter, With Every Breath is a light, enjoyable read for fans who prefer gentle romances with an interesting storyline.

Book Details:
With Every Breath by Elizabeth Camden
Minneapolis, Minnesota: Bethany House Publishers    2014
356 pp.

Tuesday, October 12, 2010

Queen of Hearts by Martha Brooks

Queen of Hearts is a coming of age story set in the 1940's when tuberculosis and TB sanatoriums were a significant part of twentieth century life. Marie-Claire Cote is a headstrong 15 year old who contracts TB from a beloved uncle. She is sent "chase the cure" at Pembina Hills San along with her younger brother and sister who have also become ill with TB. At Pembina Hills she is placed in a room with Signy, a young woman like herself but whom she finds annoying and needy. Signy has been at the San for years now and has suffered through many different procedures in an attempt to beat her TB. All Marie-Claire wishes to do though, it to get out of the San and get on with her life. In typical teenage ways, she doesn't care much about Signy, who has been abandoned to the sanatorium by her wealthy parents.  Marie Claire discovers that the sanatorium has a life all its own, with patients who marry and people who are cured who come back to work there. She gradually understands that she must learn to be a "patient patient". During her time there, Marie-Claire begins to mature and even falls in love.


This book provided a fascinating glimpse into a era that passed away only a decade before I was born. I remember asking my parents about the local sanatorium with its huge windows. This era ended with the widespread use of antibiotics which cured TB.
I have to say that throughout most of the book the character, Marie-Claire was not a likeable one. In fact, I had most decidely disliked her but then suddenly she grew up and seemed to change at the end. This was reflected in her decision at the end of the book which redeemed her in my eyes.

I'm not sure how attractive this book will be to ordinary teen readers, but those who like historical fiction will enjoy this short Canadian novel by acclaimed author and playwright, Martha Brooks.