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Elizabeth Bryan is a doctor, an expert in multiple births who worked with the Human Fertilisation and Embryology Authority and published books on twins and triplets. As you'd expect with a background like that she knows a lot about genetics but in the case of her and her direct family, a single gene was the root of a devastating health time bomb. Elizabeth Bryan's family is cursed with the notorious BRCA1 gene which makes carriers susceptible to cancer - especially breast and ovarian cancers. 'Singing the Life' is Bryan's account of her family's experience and how they lived and sometimes lost their lives with the threat of cancer hanging over them.
It's hard to imagine what it must be like to know that your fate in life could well be an early and painful death. In 1975, Bryan received a letter from a cousin of her father, a Dr Nancy Maguire. Maguire wrote to tell her and other relatives that there was a history of cancer in their family and to say that she suspected a genetic link between the disease and the family. Other than being able to warn that Elizabeth and her sisters most likely had a 50:50 chance of having inherited a predisposition to cancer, there wasn't too much that any of them could do. The news pre-dated the identification of the breast cancer gene, BRCA 1, and routine genetic testing by many years so whilst it must have come as a shock, it wasn't news that needed anyone to act upon it immediately.
Bryan's sister 'Bunny' got ovarian cancer in her mid 40s and tragically died. Bryan and her sister Felicity opted to have their ovaries removed to eliminate the risk of the disease. Then Felicity got breast cancer - and Elizabeth chose to have a double mastectomy to prevent the risk of getting the disease. Unfortunately there are only so many body parts that you can get by without and eventually she was diagnosed with one of the most devastating of cancers - that of the pancreas. She doesn't know if the pancreatic cancer is linked to BRCA 1 or not - but mentions that if she hadn't eliminated the risk of ovarian and breast cancers by radical surgery, she might never have lived long enough for her pancreas to go 'rogue'. My edition is the hard back and was published in 2007 whilst Bryant was still undergoing treatment. I was left wondering what happened next and so felt I had to go and search out more information to know how Bryan got on. I won't tell you what I learned, only that I feel bad that I couldn't get into the book more than I did.
The common belief is that a diagnosis of pancreatic cancer is a pretty good indication that you probably shouldn't renew your subscription to any magazines or sign up for another television license. It's the cancer that killed Steve Jobs and Patrick Swayze and only a tiny proportion of sufferers are alive a year after diagnosis and even fewer 5 years later. As such the account of Bryan's personal cancer 'journey' is the most interesting part of the book, though it does leave readers to wonder how things will work out for her.
In 'Singing the Life' Bryan takes us through the medical ups and downs of several generations of her family. It's not only the direct relatives who suffer cancers, with her husband and various friends also struck down at different points in the book. Depression is also an issue for the family with a tragic suicide and plenty of mental health issues. You could be forgiven for thinking this book is one strictly for 'tragedy tourists'.
On November 25th 2010 I was diagnosed with thyroid cancer after the removal of a lump from my neck. Thyroid cancer is one of the less awful cancers but it's still pretty horrible to have to deal with any form of the disease. I've found in the past year that when you are at risk of feeling sorry for yourself, there's nothing quite like reading about other people's crap lives for putting your own problems firmly into perspective. I've been devouring accounts of war, famine, pestilence and plague and coming up for more with a sense of "Hey, cancer's not such a big deal". I am inspired and lifted by tales of people surviving the most dreadful suffering and I've enjoyed reading about the strength and determination of others to not let illness and tragedy drag them down.
I really expected to find this book fascinating but instead it reminded me that unless you're a really good writer (as well as someone with an illness) your book is unlikely to be all that great. In short - and at risk of sounding REALLY uncharitable - there's something really quite boring about other people's poor health. We should probably all remember this - and before launching into the latest update on our health issues, we should keep in mind that the phrase "How are you?" is generally a greeting and not really a question.
The main problem is that Bryan's not a very good writer. She fails to emote effectively, delivering the family stories in such a dead pan and unsympathetic way that it's hard to care as much as we know we should. She throws in friends and family in fairly haphazard ways, name dropping people I can't help thinking I 'ought' to know but don't. I wanted to empathise and sympathise but there was so little emotion to relate to in this coldly delivered book. Bryan uses extracts from the letters and diaries of family members and I found these really disrupted the flow of the book and I found myself skipping over many of them. Having an interesting disease doesn't automatically make you interesting.
I've read a lot of cancer blogs in the past year - many of them entertaining, informative, witty and gripping reads. Some are so good that time flies by as you try to follow the experiences of the writers but by contrast 'Singing the Life' is a very 'flat' read that failed to push emotional buttons. I felt that the author couldn't really let go of being the professional doctor and sensible person and just let rip with a solid dose of emotion. We're all different of course - some cool and calm, others gushing with emotion, some optimistic, others worn down by suffering - but I found it hard to relate to the author's response to the family tragedies.
Some parts I found very interesting, especially as they related to the progress in genetic testing and prevention of cancer gene inheritance. The book opens with Bryan and her siblings learning from a distant relative about the risk of an inherited link to cancer and ends just over 30 years with Bryan and her sister thinking about how to tell the next generation of the family that it's now possible not only to test for the BRCA 1 gene but also to use IVF and genetic screening of embryos to ensure that none of them need ever risk bringing a child into the world with the deadly cancer gene that their parents might carry. The scientific progress is an indicator of hope for generations to come.
I'm not sure for whom this book is really intended. With so many different cancers covered in the scope of the book, there's not a lot about any particular type which might make it an obvious read for someone suffering form a particular type of cancer. It may well be useful and interesting for anyone who has the BRCA 1 gene becasue it raises issues about elective surgery as a method of prevention, makes readers think about how it must be to be genetically 'cursed' and inspires us with a vision of a future when genetic testing will help prevent inherited cancers. It's just a shame that so much info is wrapped up in a rather dry and unemotional read.
Singing the Life