This book is part of a wider project that extends our understanding of the contested nature of care in the social and health sciences through recourse to existing creative literature (novels, short stories, poetry) from the Humanities. ‘Medical Humanities' insists that our understanding of social phenomena is enhanced by the more nuanced wisdom available in narrative, and especially in those evocative narrative forms available in literature that fictionalise experience and ‘speak’ in ways that are freed from the disciplinary conventions of knowledge produced in the social and health sciences. Certainly, any intervention that extends or deepens our understanding of caring in societies in which populations are ageing, and in which caregiving to those who are frail or vulnerable is contested and subjected to the harsh economic realities of providing expensive care, is to be welcomed. It is particularly welcome in those many societies where, at the macro level, care is often treated as an expensive commodity when it is delivered by health and social care professionals and, therefore, must be supplemented by informal and unpaid caregiving by those surrounding care recipients.
This collection pulls together a range of contemporary stories and poems and is organised in five parts, each of which is concerned with a particular constellation of caregiving relationships. The first section deals with creative fictions about children of ageing parents and highlights the complex and contradictory dynamics of caring for someone who was once the main care provider. The second section deals with intimate partners providing care, titled ‘Husbands and Wives', and marks some of the many ways that caring for an intimate partner radically changes that relationship whilst retaining the love and care that was the basis of the relationship in the first place. It is notable that there are so few stories/poems dealing with caregiving between non-heterosexual couples other than in the fourth section which also focuses on caregiving in the early years of the HIV/AIDS epidemic. The third section illuminates some of the additional practical and emotional dimensions of parental care when caring for children who are sick. The fourth section deals with caregiving provided by relatives, lovers and friends, whilst the fifth and final part has four stories about and mostly from the perspective of paid carers. These latter stories deal with the complexities of the emotional and close body work that is involved in caring for people who are frail or vulnerable and in need of care.
The book's aim is to enrich understanding of the dynamics of caregiving on the part of those who provide both paid and unpaid care. In that, I think the book is a complete success. Levine's contribution is firmly located in North American contexts and thus makes reference to the specific cultural and economic aspects of those health milieu. However, the stories and poems in this collection provide an insight into some of the many dynamics that characterise caregiving beyond these cultural contexts. As a reader of these highly evocative stories and poems, we get a richer sense of the contradictory feelings that attend to the close, intimate work involved in providing care. We come face to face with the intimacies of body work; intimacies that often require caregivers to cross the more sanctioned taboos about bodies and personal privacy. We are asked to consider the contradictory feelings of love and tenderness, and their darker opposites, which haunt the claustrophobic proximities of the physical and emotional labour attendant in the monotonous rituals of providing care. In reading these stories we are forced to attend to the stark realities of our own and others' human frailty. As one narrator cautions: ‘This was physical health resenting the tyranny of illness. This was one self encountering the fact that it was not in fact another self. This was me being imperial’ (p. 218).
It is clear that Levine does not intend the book as a ‘how to’ guide, a memoir of caring or a book of practical information on navigating the vicissitudes of health and care systems that prevail in North American contexts. Indeed, Levine explicitly states that the intention for the book is ‘not intended to teach, train, or inspire’ (p. 2). However, I have to disagree here. Having read the book, I have had cause to reflect deeply on some of those care contexts that litter my life and in which I come up wanting. Additionally, the book makes me consider my own care needs as I engage more firmly with the material realities of physical debility. Further, the book made me reflect on the care that continues to be provided in the face of the many acute and chronic health debilitating conditions in the Western world where life-prolonging medical technologies are heralded as a mark of our society's progress whilst the attendant need for care provision is debated, often at a remove from the mundane and grinding repetitions of delivering such care.
However, these reflections are not all negative, of wasted opportunities and regret. Like the often bleak stories in this collection that are also peppered with moments of redemption and love, my own reflections from reading the book look forward to the circularity of and constant need for care in our world. It instils hope that such reflection, and the care that it imagines, might afford a reappraisal of care as a two-way process: of inter-dependent and reciprocal giving and receiving, a complex and very human project that extends well beyond the technical aspects of care.
Beyond my personal reflections, I think that the book will be useful for a range of people involved in caregiving. Perhaps, most especially, this book provides a rich resource for those who provide care routinely, informally and on an unpaid basis. It is also a good resource for professionals who wish to reflect on their own practices of care – especially those professionals whose practice involves working in partnership with the informal/unpaid carers who carry the major burden of care outside formal contexts of health and social care provision. It is definitely a good teaching and learning resource for those involved in teaching students in the health and social care disciplines as they develop their own identity as professional carers and as partners of unpaid carers.
Perhaps this book, and other collections like it, could provide more detailed guidance on how creative literature can be used as a form of reflection and development in understanding more fully the role of unpaid/informal care-givers.
