Part memoir, part scientific inquiry into the origins and destinations of all the components of her implanted defibrillator, the young author with a genetic heart rhythm defect visits the California assembly plant of St. Jude’s Medical, nickel, cobalt, zircon and ilmenite-titanium dioxide mines in Madagascar, Busaro, Rwanda and the remnants of a Johannesburg gold mine. The Rwanda site is the source of rare ‘conflict minerals’ smuggled in from Congo and sold on into global supply chains ending up in various electronic devices and the aerospace industry. Nevertheless she concludes that small artisan Rwandan mines are less problematic than large international operations in spite of the latter’s cosmetic, negotiated remediation, restoration and mitigation projects that often ignore the priorities of the local residents.
Perhaps the most interesting sub-story for a Canadian reader is the lunacy of the American misnamed health care system. The author is constantly worried about the costs of her care, has to move across state lines and lie about he employment status, and finally gets insurance that only covers her care for specific conditions, in specific places, by specific providers and for specific time periods. “The system is not built to deliver care. It is built to maximize profit….of pharmaceutical companies, medical device manufacturers and ‘not-for-profit’ hospitals that set high prices to pay their executives millions.” In discussing the system’s obsession with codes for specific services that may or may not be insured, she notes “Never mind that Jesus himself did not, to my knowledge, present Lazarus with an itemized bill.”
Along the way, the author unwittingly reveals her major character faults to her readers, without any acknowledgement or acceptance of them. Yes, she has been dealt a bad genetic hand, and on that basis deserves some empathy, but her whining self-pity becomes cloying, and she seems to have developed what social scientists call learned helplessness. She refuses, against medical advice, to even slightly modify her addiction to extreme exercises in order to reduce her risk of sudden death, and stops taking prescribed medication without discussion. I always tried to understand the patient’s perspective and priorities, but if she were were my patient, I would have, after discussion, politely wished her good luck, and terminated the relationship.
The writing is disjointed temporally and geographically with time shifts that just do not work. She describes her first impressions on seeing the Mayo Clinic complex before discussing the phone call from that facility while driving to it. Morsels of philosophical musings are scattered throughout the book but never ripen into anything chewable. Echos of Ernest Becker in Denial Of Death appear: “To live is to forget death long enough to move into the everyday acts of living, to believe them meaningful.”
There are glaring factual errors. The pericardium is described as “the outer muscle of the heart”. A catheter in the femoral artery is fed up the inferior vena cava! A chest tube insertion is said to be able to prevent cardiac tamponade! As she is flying from Tucson to Chicago she describes looking down on islands in Lake Erie.
In spite of the interesting thesis and the medical details that will interest lay readers, I cannot seriously recommend this book to anyone.
The Passionate Reader 