Book reviews

Published: 06 July 2011

These may not be quite right for the beach, but Dion Smyth has an exciting list of books to see you through the summer...

The immortal life of Henrietta Lacks
By Rebecca Skloot (2011)
New York: Pan Macmillan.

On 4 October 1951, a 31 year old mother of five children named Henrietta Lacks died of cervical cancer in Baltimore's Johns Hopkins Hospital. Her life, characterised by the hard work and social hardship of working on tobacco plantations, was typical and perhaps unremarkable for a black woman of that era.

However, when cancerous cells were removed from her body and grown in the laboratory to become the first human cell line to survive in vitro, her legacy was born.

HeLa cells, as they became known, have benefited humankind beyond imagination. They have contributed to our understanding of virology and the practical development of polio vaccines and other diseases – as well as to our comprehension and treatment of cancer and to the manufacture of drugs for various other illnesses.

If all the cells produced from that original culture were laid out end to end it is estimated they could circle the earth three times.

What makes this story the more remarkable and regrettable is that the cells were taken without her or her family's permission, and this lady’s story and her true contribution to science was until relatively recently never really revealed.

Equally, while her cell line has doubtlessly made millions for the scientific community of researchers and doctors (but notably and importantly not the original doctor who obtained the sample), Henrietta’s body lies in an unmarked grave and her descendents couldn’t afford the medical care they required.

This book adroitly mixes 'popular science' with social history in a biography of a family struggling to make sense of the science and society that could develop by leaps and bounds, but seemingly without boundary. It is educational and illuminating, instructional and infuriating, but always compelling.

This book challenges you to think about the injustices and inequalities of race and opportunity, prejudice and scientific progress, and the acceptability and accessibility to health care determined by cost: it is an excellent read.

Relevant to the here and now

This case is about the USA’s past, and we might think that clinical practices such as removing tissues without permission or experimentation on live persons are unethical and illegal by modern standards. However, this book serves to remind us of recent cases in the UK such as the Alder Hey organ retention scandal. It asks us to question the morality of the practice: whose life is it, who owns the product of his or her own life, what rights do we have over cells or tissues samples?

In the US, the retention of such tissues is still accepted practice and the personal rights are negligible. As we move into an era where genetic testing becomes more commonplace, the need for greater cognizance of the ethical dilemmas abound.

Breast cancer nursing: care and management
Edited by Victoria Harmer (2011)
Chichester: Wiley Blackwell.

Breast cancer is the most prevalent form of the disease in the UK. It has a considerable impact on the woman and, less frequently but nevertheless significantly, on men, families, friends and yes, formal carers.

That nurses will meet such individuals and families in primary and secondary care settings suggests that a text providing a succinct overview of the topic will be a valuable library addition.

This book, while not shying away from the often quite technical language of malignancy, provides enough for all levels of reader, from student to specialist. The flow is logical, chapters are well laid out, it offers an up-to-date review and each chapter is written by expert clinicians with extensive knowledge and experience in this aspect of care.

Too bad about the homeopathy

For me, the one downside to a book that provides an otherwise substantial and solid scientific overview and laudable evidence base for the care and management of breast cancer was the surprising and disappointing inclusion of homeopathy, which is given a prominent part in the chapter about complementary and alternative therapies.

It is stated in the introductory passages that 'just because the evidence base… is small does not make them [CAMs] invalid as treatments'. However, the lack of a coherent scientific explanation for what seems essentially 'implausible' (as stated in the recent Parliamentary Science and Technology Committee report), there is an increasing body of evidence against homeopathy as no more effective than placebo, and a groundswell of opinion not to provide it as a part of NHS care.

This would suggest that nursing texts could inform patients better about such treatments – especially if there is to be a financial cost to them in the future. The references to the section are relatively limited and do not offer a contemporary feel for the debate and informed discussion about this aspect of care.

That notwithstanding, this is an excellent resource and highly commended.

The psychological impact of breast cancer: a psychologist’s insights as a patient
Dr Cordelia Galgut (2010)
Oxford: Radcliffe Medical Press.

Though billed as a book that features the story of one woman’s experience of breast cancer, there are actually two narrative accounts in this book. The main story focuses on the author’s reflections on living with cancer, but following the references is the shorter story of another doctor who experienced mastectomy and reconstructive surgery. Both are valuable, interesting and informative accounts of the impact of the disease on every aspect of life.

The complexities of the condition, the consequences of the care and treatment, and the conflicts felt when the professional becomes patient are vividly presented and clearly articulated. While the diary narrative may, for some, not be considered an academic text per se, this is nevertheless a text that will have much value to anyone teaching students about this topic.

The patient experience is increasingly becoming one of the most prominent and perceptive voices to be heard in the planning and delivery of care and, where our professional experience lacks the personal experience, texts like this help inform and enlighten.

Living with learning disabilities, dying with cancer: thirteen personal stories
By Irene Tuffrey-Wijne (2010)
London: Jessica Kingsley Publishers.

The importance of listening to the story of people's lives and illnesses is also a feature of this book, which is based on the author's work on the Veronica Project, an ethnographic study of the experiences of people with learning disabilities who have cancer.

The text is an authoritative and informative account of the way people living with learning disabilities face a diagnosis of cancer, poor prognosis and the end of life. It is also a salient description of the support (or possibly even lack of support) the individuals received at this most difficult and distressing of times.

The voice is different from Cordelia Galgut’s not only because the vocabulary differs from the articulacy of the doctor’s view or the jargon of the clinical text, but because this voice is not often heard outside the specialist care settings in which many people with learning disabilities live.

The Dignity in Care agenda is rightly championing the fundamental need of all people to be treated with distinction and dutiful care throughout their lives. This book, which is an easy but often uncomfortable read, provides testament to the personal fortitude many patients, otherwise disadvantaged in life, may demonstrate as they countenance the prospect of death.

Reading the section about communicating bad news reminded me of the ethical and practical considerations of explaining distressing news, and how the 'truth' for carers of people living with learning disabilities is a complex and complicated consideration. It is recommended reading for all in palliative care and cancer settings.

Consent to treatment
By Jane Lynch (2011)
Oxford: Radcliffe Medical Press.

If The immortal life of Henrietta Lacks tells us a harrowing story of how consent was not considered previously an essential part of dignified and dutiful care to patients and their families, this book provides a clinical, medico-legal counterpoint to that content.

The complexities of consent - from capacity to custody, acting in an emergency to advance directives - are all considered in a concise but comprehensive text. Reflective learning is examined and encouraged, and case examples help to illustrate the salient points.

This is a thoughtful and engaging read about what some may think to be too dry a text, but in these days of increasing threat of litigation, it has an important place on most nursing library bookshelves if not in clinical units themselves.