Happy Reading

Jean & Richard

It always amazes me to receive pictures of people reading my books. Please feel free to tweet or Facebook over a photo.

Val

The Fever

Recently finished The Fever by Sonia Shah. I bought a paperback copy at Ikirezi Bookshop after my first bout of malaria in 2015, but then got distracted. After a hideous month in October where I was floored by it twice, I decided to revisit the topic. It's always interesting to know what's going on inside you, and malaria is a particularly nasty li'le critter. It crawls inside your red blood cells, feasts on your haemoglobin, then bursts out of them alien style, leaving your spleen to deal with the fall-out.

I posted this before, but Shah's TED talk is a really good summary of the book in a nutshell.

It's a fairly concise read, but I took so many notes. She's got a really easy style to read, turning something quite technical and medical into a story of primordial genetic battles and human cost. At times it turns quite graphic.

Every morning in Panama I would awaken with some unexpected swelling from the mosquitoes’ nighttime blood feasts: under my eye one day, on my eyelid the next, on the palm of my hand. Smashed mosquitoes, glued to the surface with their own internal juices, dotted the walls.

The book starts out with a really good quote:

Man ploughs the sea like a leviathan, he soars through the air like an eagle; his voice circles the world in a moment, his eyes pierce the heavens; he moves mountains, he makes the desert to bloom; he has planted his flag at the north pole and the south; yet millions of men each year are destroyed because they fail to outwit a mosquito.  — Paul F. Russell, 1931

I thought it was funny when she was talking about going to swot mosquitoes and deliberately - sort of - missing. From a Jain family (see the video) there was part of her averse to killing living things no matter how annoying they are. I was vegetarian until my early twenties and also have that dilemma of wanting the mosquito gone, but not wanting to be the one to make it go away. If they're inside my mosquito net, I'm afraid they're doomed nowadays, but if they're outside, it's about a fifty-fifty whether I actually hit them after lifting my hand.

A flimsy mosquito landed gently on my forearm. A familiar spike of rage rose as I watched, incredulous, as the insect prepared to puncture my skin with her proboscis. How dare she! Instinctively, my hand snapped up. Somewhere inside that cold-blooded, brittle body lurked entities whose exertions explained the making of rich and poor, sick and healthful. My hand came down a bit slower for the passing thought, and I brushed the mosquito away like a crumb. Its delicate legs snarled together, pitching the insect’s body forward at a steep angle. Mangled, it skittered off my arm awkwardly as I watched, my vestigial Jain sensibilities slightly horrified. Finally it reached the precipice, where it somehow took flight and vanished.

You might find this poem, Death of a Cockroach entertaining. One man's remorse over dispatching a household pest.

Naturally, I was engrossed in the early parts of the book which are all about how the disease spreads, breeds and takes over your internal organs. It really is a very complex disease, and it was fascinating to think of it working its way through my body. It also explained a specific pain that I had for a couple of weeks when the resurgence happened. I think it was my spleen, which I didn't realise was so involved in clearing out the dead blood cells. It's one of those organs I couldn't point to until I looked it up.

First, the sporozoites retreat to the liver, where they spend a few surreptitious days shifting, regenerating, dividing, and generating again, secretly transforming into an army of fifty thousand parasites in a new form capable of infecting red blood cells: the merozoite. In the next stage of the invasion, the merozoites pour into the bloodstream. They are cleverly disguised inside the liver cells they’ve gagged and murdered, but an epic battle ensues nevertheless, and the body’s immune fighters slaughter thousands. It isn’t a perfect victory. If a few stragglers in this marauding horde manage to escape, they latch onto red blood cells, and within moments penetrate the cells’ interior. There, they quietly feast on haemoglobin, and a new round of shifting, regenerating, dividing, and generating ensues. Some transform from tiny ring-shaped beings into fat, rounded creatures and unleash a wave of progeny. When nothing is left of the former oxygen-carrying cell besides a stream of waste and a bulge of fattened parasites, the parasites burst out of the cell and rush out to invade and consume a fresh crop of cells. Others quietly shape-shift into the male and female forms called gametocytes and lie in wait inside their hijacked blood cells. With any luck, they will be picked up by another bloodthirsty Anopheles mosquito.

*

Almost all of Plasmodium’s manoeuvres inside the body occur in utter secrecy. When it slips into the body, while it hides in the liver, and even after it emerges into the bloodstream and attacks blood cells, there is no itch, no rash, no sweaty forehead that belies the infestation roiling within. It is only after malaria parasites rupture out of their hijacked cells, well into the parasitic invasion, that the infected person feels sick. The waste from the parasite’s haemoglobin feast leaks out of the destroyed cells, and that tiny spike of poison triggers a round of detoxification, throwing the victim into a high fever, followed by chills and shivering. When the waste disperses, the fever passes, and for several days there might be no symptoms at all—until the parasite finishes gobbling up its next batch of haemoglobin and explodes again in search of more, triggering another attack of fever and chills. The parasite’s steady consumption of its victim’s blood drains him of vitality, making him easy pickings for other pathogens of various ilk. But while the parasite grows inside, aside from an enlarged abdomen — the spleen of the malaria-infected can swell to twenty times its normal weight while clearing the body of dead cells — its passage remains obscure. All the while, mosquitoes will bite, and imbibe the parasite roosting in the blood, and the cycle continues.

It was also interesting that the more people I started speaking to about malaria, the more have told me that fever didn't play a major role. A raging fever is certainly the norm, but not always, and malaria presenting without fever seems harder to diagnose early. Partly because the patient doesn't automatically think malaria, and partly because fever indicates more parasites releasing into the blood, making it easier to spot in a test. Apparently, tests are difficult to undertake and often come back clean when the person is actually infected - which is what happened to me. What I experienced is apparently quite common.

Other things that I learned included that the malaria strain p. vivax, which preceded p. falciparum in Africa and is now common in Asia and Latin America, was driven out of most of Africa by an evolution in local people's blood cells mutating so that it could no longer infect them. This defence was unfortunately then bypassed by a more deadly strain, p. falciparum, which recent studies believe we originally contracted from gorillas. Sickle cell anaemia is another form of mutation that developed as a resistance to malaria. The crescent shape of the cells can cause life-threatening illness and chronic pain, but can also provide immunity to malaria.

It's long been whispered among expats here that if you've lived in-country for many years, you'll build some resistance to malaria. I was never sure whether to believe this or not, but it turns out it's true. Like other diseases, your immune system can recognise and guard against forms of malaria that you get. So, having malaria a few times can make you resistant to future outbreaks, which is why children in Africa who get malaria a lot don't get it as much in adulthood. The bad news is that malaria mutates and evolves extremely rapidly, so if you leave the country for a few years and return, you might have lost your immunity because your body hasn't encountered the new strains that now exist.

This disease has thousands of years of experience in survival:

Ancient Greeks understood malaria as a seasonal scourge that arrived during harvest time. The physician  Hippocrates  described  it  as  a  disease  common  around  swamps,  while  the poet  Homer  referred  to  malaria  when  he  decried  Sirius  as  an  ‘evil  star’  that  was  the ‘harbinger of fevers’. The ancient Chinese called malaria the ‘mother of fevers,’ while in India thirty-five hundred years ago it became known as the ‘king of diseases,’ personified by the fever demon Takman.

Some ancient remedies included honeysuckle in wine, eating the liver of a seven-year-old mouse, wearing an abracadabra charm, or chowing down on bedbugs with eggs and wine, which was recommended in Roman times. You could also wake at dawn for three mornings in a row, facing a window which you were supposed to shut suddenly whilst reciting a prayer. For men, having sex with a woman who had just started menstruating was also recommended. Lucky woman. If you couldn't find a bleeding woman, 'energetic bloodletting' was also acceptable. Failing all else, go prostrate yourself at one of the three temples in Rome dedicated to the demon goddess of malaria, Febres.

It has since been found that cloves, cinnamon, basil, nutmeg and onion lessen the parasite's appetite so may slow its progress. There's also some evidence to suggest that coffee might be beneficial in resisting malaria, as coffee-drinking French colonists suffered less from it than tea-drinking English ones.

Another thing I found fascinating was how widespread malaria once was in America and the UK, with Kent and Essex being the most malarial counties in Britain.

It was known for centuries that the cinchona tree is an effective remedy against most forms of malaria, as the bark contains quinine. However, staunchly protestant Europeans refused to touch it because they considered it 'Jesuit powder,' the Jesuits being the ones to have discovered its beneficial properties. 

Hence, in an amusing turn of events, Oliver Cromwell, renouncing this Catholic witchcraft, proceeded to die of malaria.

The major breakthrough which has impacted my life was the discovery of artemisia annua, or Sweet Wormwood. Whilst looking for potential cures in the fight against quinine-resistant malaria, which falciparum is in my part of East Africa, Chinese researchers found a book titled Fifty-two Prescriptions dating back to 168 BC. It cropped up again in 340 AD as a 'bitter tea.' The Chinese decided to try it out and between 1980-90 slashed malaria rates from two million to ninety thousand. The west, however, fucked it all up by attempting to over-heat the compound, destroying its medical properties and declaring it useless. Because of this, it took decades to accept that the active ingredient, artemether, actually was a full-on cure for p. falciparum and bring it to market. Without it, I would never have been free of malaria. It is an absolute life saving treatment, extremely fast and efficient, but it wasn't until 2001 that WHO revised its guidance to make coartem a front line treatment. Before that, they still recommended ineffectual quinine-based products in resistant areas.

If a physician went to Burma and prescribed chloroquine, they would be negligent. When UNICEF does the same, it's called 'international aid'. — Amir Attaran

For more on the trials and tribulations of UN aid agencies, check out Emergency Sex: True Stories From a War Zone.

There was so much more in this book on the history of malaria, the winding road to development of drugs, the problems faced by scientists and health professionals in the fight against malaria today. However, I will stop here, as I've already said quite a lot. I highly recommend this book if you're interested in  the subject. It's easy reading and full of anecdotes and interesting information.

I particularly sympathised with one sufferer who was mystified at her sudden craving for ice-cold orange Fanta. For me it was lemon Fanta citron. It is a strange disease, indeed.

Musical Interlude: Jiggy

Faces of the Past

This is fascinating. The face of a Stone Age Briton from around 5,500 years ago. It's part of a beautifully crafted reconstruction project, bringing the faces of ancient people back to life.

As a writer, I love looking at portraits for inspiration. I could spend hours in the National Portrait Gallery just thinking up stories for the people looking back. This is particularly intriguing because it stands our imagined history on its head: First modern Britons had dark skin and blue eyes. How many writers would have thought to create characters like that without the insight of science? It's a constant discovery, and makes the recent UK wave of anti-immigration nationalism look distinctly silly.

Sophie-sto-cated

When you try to make a sensible promotional post and cats happen. Sophie, modelling some of my titles. She was exactly the same as a kitten...

Sophie and Howl

Mogworld

Back in March, I picked up a book called Differently Morphous by Yahtzee Croshaw and fell in love with it. I read quite eclectically, so with the exception of authors like Terry Pratchett and Chitra Banerjee Divakaruni, there are very few whose releases I follow. I usually love a book I stumble upon rather than deliberately go out to buy the next in a series by someone I've already read. There are a lot of authors I admire, but it's just a matter of hours in the day. Faced with someone I've read and someone I've never read, I usually opt for something new.

I enjoyed Differently Morphous so much though, that I thought I'd try out Crowshaw's first novel, Mogworld. 

In a world full to bursting with would-be heroes, Jim couldn't be less interested in saving the day. His fireballs fizzle. He's awfully grumpy. Plus, he's been dead for about sixty years. When a renegade necromancer wrenches him from eternal slumber and into a world gone terribly, bizarrely wrong, all Jim wants is to find a way to die properly, once and for all.

On his side, he's got a few shambling corpses, an inept thief, and a powerful death wish. But he's up against tough odds: angry mobs of adventurers, a body falling apart at the seams and a team of programmers racing a deadline to hammer out the last few bugs in their AI.

I was not disappointed. It was a crackingly clever idea for a book and anyone who grew up playing RPGs, MUDs, MOOs and adventure games will get it instantly. I can't really say much more without giving stuff away, but once you realise what's going on it's very funny. Brought back a lot of gaming memories of maniacal mods and recurring resurrections. All delivered with Croshaw's trademark cynicism:

The rumbling was turning into a roar, the stairs were starting to shift beneath my hands and feet, and small bits of rock were raining down upon us constantly. A much larger bit of rock decided to join in the fun and thundered down the steps, but it flew over me and collided with someone I hadn't had time to care about.

---

When I was a child, my dad used to take us out badger watching sometimes; we'd sit in a wooden box staring at a hole in the ground, in the hope of catching a glimps of nature's most boring animal. All buggering night. But dad's twisted idea of a good time could finally prove useful. 

---

"The same corruption of life that powers the- that powers James and Meryl, may be spreading to whatever magetechnology exists within the sphere."

"I don't really like 'corruption', it implies there's something wrong with them."

He smacked himself in the face in irritation, his signet ring clattered loudly against his mask. "They've both been dead for six decades and they're walking around. That strikes me as pretty damn wrong."

From the Jungles of Anorexia to the blade of the enchanted sword Killbastard, it's a very entertaining read. I really like his inventiveness when it comes to characters. Each book there's someone memorable. In this case, I think the award goes to Slippery John, a dreadful thief who always refers to himself in third person and shows a touching (ahem) amount of care towards a corpse warrior. There's also an evangelical priest who 'looks like he's been sucking vinegar from a stinging nettle,' and a fascinating character at the very beginning called Dreadgrave, who possesses some striking similarities - and wardrobe choices - to Doctor Diablerie.

It was also somewhat educational, introducing me to Quantum Suicide Theory, and the fact that computers have been passing the Turing test for years. I'm still trying to work out exactly when (comment if you know), as the BBC released an article reporting that the first computer passed the Turing test in 2014, but Mogworld was released in 2008 and says they'd already been doing it for years by then. It seems to have been ELIZA in 1966? Interesting stuff.

Anyway, enjoyed it and added a couple more Croshaw titles to my TBR.

Musical Interlude: OneRepublic

Bloodsucker

The past month has been a pretty tough one for me. I had recurring malaria, meaning I got it once but the medication didn't clear it up, so it came back. Twice in one month had me pretty low, and when it came back the second time, it didn't show up in blood tests for almost two weeks. That was brutal, because I knew I was sick but I didn't know what was wrong.

Anyway, all better now, but during that dark stint, I wrote two posts on the subject:

• What Does Malaria Feel Like?
• Malaria Aftercare - How to Feel Better

Hopefully they're of use to someone in the future.

There's also a book by journalist Sonia Shah about malaria. It's called The Fever. I started reading it a while back but got distracted. I've just downloaded it from Audible now because it's a subject I feel a personal connection with and would really like to know more about. I'll put up a review once I've finished. Meanwhile, here's Shah giving a talk on the subject.

The Old Man and the Sea

Recently, a friend had me watch Into the Wild, which tells the story of a real-life young man, Christopher McCandless, who went off into the wild to escape civilisation and eventually starved to death. The literature he reads is a running theme throughout the film, and not surprisingly, Hemingway makes an appearance. He crops up in many of-an-era road trip films and memoirs. 

I got to thinking that I'd never actually read Hemingway, and that I should probably change that. After all, he's held up as an icon of clean prose and something to aspire to in writing. If you want to get technical about it, there's an excellent article on What Makes Hemingway Hemingway?

The laws of prose writing are as immutable as those of flight, of mathematics, of physics. - Hemingway

Not a quote I'm entirely sure I agree with, but the article certainly presents Hemingway's immutable laws in a way we can all understand.

So, the next question was where to start? I checked into a couple of forums and the two titles that kept coming up for newbies were The Old Man and the Sea and The Sun Also Rises. I went with the former, partly because it was shorter, partly because it was read by Donald Sutherland, and partly because I was curious how you could make an entire novella out of trying to hunt a fish... a whale, maybe, but a fish?

The Old Man and the Sea is one of Hemingway's most enduring works. Told in language of great simplicity and power, it is the story of an old Cuban fisherman, down on his luck, and his supreme ordeal, a relentless, agonizing battle with a giant marlin far out in the Gulf Stream. Here Hemingway recasts, in strikingly contemporary style, the classic theme of courage in the face of defeat, of personal triumph won from loss.

Written in 1952, this hugely successful novella confirmed Hemingway's power and presence in the literary world and played a large part in his winning the 1954 Nobel Prize for Literature.

I know getting it as an audiobook seems counterproductive to understanding Hemingway's style of writing, but when you read enough books and write enough books, you can actually see the punctuation float past most of the time. He definitely had a unique style. 

As with most classic literature, some of it doesn't translate brilliantly for a modern female reader living in Africa...

He always thought of the sea as 'la mar' which is what people call her in Spanish when they love her. Sometimes those who love her say bad things of her but they are always said as though she were a woman. Some of the younger fishermen, those who used buoys as floats for their lines and had motorboats, bought when the shark livers had brought much money, spoke of her as 'el mar' which is masculine. They spoke of her as a contestant or a place or even an enemy. But the old man always thought of her as feminine and as something that gave or withheld great favours, and if she did wild or wicked things it was because she could not help them. The moon affects her as it does a woman, he thought.

*

He was sure then that he had the negro, who was a fine man and a great athlete, beaten. 

*

"Fish," he said, "I love you and respect you very much, but I will kill you dead before this day ends."

*

You did not kill the fish only to keep alive and to sell for food, he thought. You killed him for pride and because you are a fisherman. You loved him when he was alive and you loved him after. If you love him, it is not a sin to kill him. Or is it more?

The last bit sort of reminded me about The Most Dangerous Game, at the beginning where they're talking about how the lion, or whatever it is they're hunting, lives for the hunt and wants to be hunted. A way of thinking that still exists for some today, but is growing further towards the minority of popular thinking. 

It is deceptive the way that he writes. Because the prose are simplistic, and the plot is a very straightforward one, you occasionally get ambushed by rather graphic moments, such as the sound a Portuguese man o' war makes when you pop it with the horny sole of your foot on the beach.

I've mentioned before that I like graphic stuff, but that I sometimes struggle when it's directed at animals, so this probably wasn't the best book of all for me to choose, as it's all about hunting down a giant fish.

Most people were heartless about turtles because a turtle’s heart will beat for hours after it has been cut up and butchered. But the old man thought, I have such a heart too. 

But there were also some moments of introspection that were very touching.

"Age is my alarm clock," the old man said. "Why do old men wake so early? Is it to have one longer day?"

*

He did not say that because he knew that if you said a good thing it might not happen.

That last one was interesting, because it's a superstition still held to by so many today, such as when you make a birthday wish or you hope you'll get a job, but you don't tell people you've applied or what the wish was because you fear that by speaking it, you'll jinx it. 

The story was less than two-and-a-half hours long, but I made a surprising number of notes. 

I now appreciate Hemingway's style and what people see in it. Most of what he said is what I teach both in creative and technical writing, where I place a lot of emphasis on economic use of language - shorter sentences, fewer words. Though it's interesting to see from the article above that short sentences became less important to Hemingway as his career progressed. I think this is true for most of my students, too. Once you've got the basics pegged, and you know how to form clear, concise sentences, then you can play with them. Then you get poetic, you create more complex sentences. Hemingway's style is very recognisable, but so are other writers like Divakaruni, Marlon James and Ann Radcliffe. People have written best sellers and award-winning novels in many styles, long before and long after Hemingway. I like his style, but I wouldn't want it to be the only thing I ever read. Simplicity is refreshing and easy to follow, but sometimes you want to be swept away on a full-colour panorama of a sentence. 

More interesting than I expected it to be, and a story with a lot to consider. I couldn't help thinking, due to the ending, that it probably wouldn't have been published today. Not in mainstream circles. Not a crowd pleaser. That's why I do enjoy classic literature. It can really knock you out of your day-to-day headspace, and Donald Sutherland was the perfect voice to bring it to life. 

If you enjoyed the breakdown of Hemingway's writing style in the article, you might also like this artwork made from analysing punctuation.

Bonfire Bonanza

 

Big thank you to my friend Jo for hosting a lovely bonfire party last night for around sixty people. A night full of sticky toffee pudding, mulled wine, marshmallows and cheer.

 

    Remember, remember the Fifth of November,
    The Gunpowder Treason and Plot,
    I know of no reason
    Why the Gunpowder Treason
    Should ever be forgot.
    Guy Fawkes, Guy Fawkes, t'was his intent
    To blow up the King and Parli'ment.
    Three-score barrels of powder below
    To prove old England's overthrow;
    By God's providence he was catch'd
    With a dark lantern and burning match.
    Holloa boys, holloa boys, let the bells ring.
    Holloa boys, holloa boys, God save the King!
    And what should we do with him? Burn him!  

A really good night, and nice to be surrounded by friends. More fun for us than Guy, I guess.