Baking Cakes in Kigali by Gaile Parkin

Baking Cakes in Kigali by Gaile Parkin, 2009

This book has already been discussed and reviewed very extensively. It is a good read, convincingly written so that you can, or imagine you can, hear the Tanzanians and Rwandans speaking. It invites comparisons with Alexander McCall Smith’s Number One Ladies’ Detective Agency books, but is in a way much more serious, being set in post-genocide Kigali, with the multiple problems of “truth and justice”, Aids, malaria, orphaned street-children, and more.

A very telling aspect is how the various characters work together to rebuild Rwanda, at a very local and personal level.

Angel, the central figure, makes cakes to order. Each chapter is broadly built around a different cake, and the Cake Order Form, is one of the devices that unite the narrative into a whole. Angel also has a habit of polishing her glasses when she needs time to think; and making hot steaming mugs of sweet, spicy tea.

Parkin clearly draws very extensively on her own experience as an HIV-Aids counsellor in Kigali. What is conspicuous by its absence is any coherent notion of marriage or of the value of morality, continence, chastity or faithfulness. In the many incidents and discussions in the book which touch on weddings, marriage, and couples, there is no understanding of marriage and love as self-giving.

Certainly, Angel and Pius are faithfully married, and Angel refers with deep disapproval to the way a young woman called Linda dresses: “she had never seen a man look at Linda’s face; there were always other parts of her body that were asking more urgently to be observed.” Angel has good values, but does not reflect on them. She and Pius are Catholics, but they know that some Catholics, even nuns and priests, took part in the killing in 1994. “In Rwanda we’re simply Christians. I’m nervous of attending just one church here, of listening to just one priest. Because how can we know what is truly in that priest’s heart after so many showed that love and peace were only words in their mouths? So we attend a different church every second week; in between, we still attend our local Catholic church” (p.85).

At the very start of the book, Angel explains that when she and her husband got married (they are now grandparents), they were “pioneers” of contraception, and were careful to have only two children “so that we could afford to educate them well.” In the event, their children, having had children of their own, both lost their respective spouses and died before the start of the book, and Angel and her husband Pius are now starting all over again, bringing up their five grandchildren as their own children. The book does not point the moral, but it is actually a clear instance of how wrong-headed it is to contracept in order to have fewer children and hence more money.

A fairly important figure in the book is Jeanne d’Arc, who, having been orphaned and gang-raped during the genocide at the age of eleven, has been a prostitute for the past seven years in order to support herself, her two sisters, and a small boy they found abandoned. Angel is able to help Jeanne d’Arc in many different ways, finally putting her in touch with someone who can teach her to sew to be able to earn her living in a “safer” way. But, at the same time, she jokes with someone else about Jeanne d’Arc and her “business”. Perhaps she develops more compassion for Jeanne d’Arc in the course of the book.

Angel is able to help people in many ways in the course of her business. One often has the impression that the author had a list of themes she wanted to bring in, and worked through them – FGM, the mayibobo (street children), truthfulness to oneself and to others, Catholicism in Rwanda – chapter by chapter, through the book.

Overall it is a good read, ideal for provoking enjoyable discussions, which need to take each theme a lot deeper, with a lot more informed input, than the book itself is able to do.

God's Secret Agents by Alice Hogge

God’s Secret Agents: Queen Elizabeth’s Forbidden Priests and the Hatching of the Gunpowder Plot by Alice Hogge. HarperCollins 2006.

A totally absorbing and, for many of us, un-put-downable book. Hogge herself is not a Catholic, but she came across the story of the Catholic priests who came to England in the second half of the sixteenth century, when Catholicism was being stamped out and it was a capital crime to celebrate Mass or to shelter a Catholic priest. Hogge was fascinated by the doings of these clandestine Catholics, and started to research the story and finally to write it up in book form.

Her research is painstaking thorough and detailed, and she writes very well, in a simple, matter-of-fact style appropriate to the historical nature of the book, but never becoming boring.

The cover of the paperback edition of this book shows a wooden panel with someone peering through a knothole in the wood from the page behind. The book uses historical documents to tell the story of the proscribed Roman Catholic priests who came on the “English Mission” during the reign of Queen Elizabeth the First and King James the First and Sixth. These were often the sons of Catholic families, or else converts, who had gone abroad to train for the priesthood, been ordained, and returned to minister to Catholics (“Recusants”, as refusing the government-imposed new religion) and, where possible, receive Anglicans back into the Catholic faith.

It was, however, a crime for a Catholic priest to minister in England, and these men knew what was awaiting them: a life on the run, from one hiding-place to another, hunted by spies who were hopeful of receiving a bounty for information leading to their capture. (Much of Hogge’s detail comes from reports written by these same spies for their masters, and still preserved in archives and other historical collections.) After the Pope excommunicated Elizabeth I and released her subjects from their allegiance, Catholic priests were considered by the English government to be in the pay of a hostile foreign power, and executed as traitors, by hanging, drawing and quartering. First, however, they would be tortured to extract information on their fellow-Catholics.

The book does not hide any of the gruesome details. Nor does it soften the difficulties that the “English mission” encountered, such as the factions and disunity within the Catholic community, and the number of priests and lay-men who recanted their faith for fear of torture and death. The characters that stand out, however, are magnificent men like Fr John Gerard, and Nicholas Owen, whose ingeniously constructed hiding-places often enabled a hunted priest to survive for another adventurous episode, or even escape altogether. And, of course, Fr Henry Garnet, who had the well-nigh impossible job of keeping the Mission functioning, and who was arrested as a result of the Gunpowder Plot, convicted of misprision of treason (though he denied to the end that he had known about it) and executed.

Being Mortal: Illness, Medicine and What Matters in the End by Atul Gawande

Being Mortal: Illness, Medicine and What Matters in the End

Atul Gawande

Profile Books, 2014

Atul Gawande is an American doctor whose parents came from India. His book discusses, in detail, the current state of Western medicine with regard to the end of life. We read it because of its extreme relevance; each of us has lived through, or is currently living through, the death of a family member or close friend from different kinds of terminal illnesses.

These days, doctors and nurses are (highly) trained to do things. They identify what is wrong and see what can be done to fix it. They are not trained to cope with death, or to discuss the subject of death, still less to relate to patients on a personal level.

According to Gawande (p. 166), more than 40% of oncologists admit to offering treatments that they believe unlikely to work. And the doctor-patient relationship is increasingly miscast in retail terms: “The Customer is always right”. Sick people want to be “better”, to regain the life they had before; doctors are hesitant to trample on patients’ expectations and are not trained to explain to them just how little hope there is of recovery, for example, or just how little time they may have.

Gawande shows that this often results in terminal patients being subjected to drastic operations, chemotherapy, etc., but not being shown realistically what their situation is or what is the best that can be hoped for.

He also looks at all sorts of initiatives that are being set up to implement a different approach to terminal illness and end-of-life care. This includes a very good description of what a Hospice does, pp. 161 & 165. It raised the question of “Ars bene moriendi” – the art of making a good death, a mediaeval theme encouraging a consideration of what would constitute a good death. In the 20th and early 21st century, overwhelmingly, people who are asked “How would you want to die?” say they would like death to be so sudden that they knew nothing about it.

However, in practice a death like that is often devastating for those who are left behind, who have had no chance to say goodbye, let alone resolve unfinished issues, forgive or seek forgiveness, and so on. Endings matter (p. 239). A traditional Roman Catholic prayer was “From a sudden and unprovided death, O Lord, deliver us.”

Gawande focuses on the importance of having time to talk (p. 177) and even recommends paying doctors to take time to talk, not just perform (p. 187).

He has arrived at a set of questions that can help terminal patients arrive, sooner or later, at a real understanding of their situation, and that can enable them to make the best decisions on their treatment options (p. 183).

“What is most important to you?”

“What goals are most important for you now?”

“What trade-offs are you willing to make?”

“What sacrifices are you willing to make now for the possibility of more time later?”

“What are your worries?’

“What are your biggest fears and concerns?’

He also says to patients, “I am worried” (This means both “this is serious”, and “I’m on your side”).

What is needed is to help people to negotiate the overwhelming anxiety, about death, anxiety about suffering, anxiety about their loved ones, finances and process (p.182). People die only once, so they have no experience to draw upon (p. 188).

The book covers a very wide set of issues, impossible to cover adequately in a blog post like this. One point he makes is that in the case of elderly people, it is normally their children who make the choices for them, and they choose safety over quality of life every time, sometimes leading to dire results for the elderly person's happiness and well-being.

We stop the healthy from committing suicide because we recognize that their psychic suffering is often temporary (p. 244).

For the terminally ill who face sufferings that we know will increase, only the stonehearted can be unsympathetic (p.244). But assisted living is far harder than assisted death (p. 245). If you only read about this book and don’t read the book itself, you could assume that, with his emphasis on making the last stages of life as good as they can be, Gawande would naturally support the “assisted suicide” or “assisted dying” proposals. He does not. One of his 2014 Reith lectures was quoted in a letter urging “assisted dying” from a large group of VIPs, published in The Daily Telegraph on Monday December 29, 2014: “we are heartless if we don’t recognise unbearable suffering and seek to alleviate it”. They used this quotation in support of their urge to legalise “assisted dying”, a.k.a. euthanasia for terminally ill people.

But they were misquoting him by taking one sentence out of context. In fact, on pp. 244-245 of Being Mortal, Gawande looks at the Netherlands, where euthanasia has been legal for some years, and sees that palliative medicine in the Netherlands lags far behind palliative medicine in other countries such as the UK and America.  While he talks about medication to end unendurable pain, it is clear that what he has in mind is precisely what the Catholic Church has always taught: it is not wrong to provide pain-killing medication for the purpose of reducing or ending suffering in a patient with a terminal illness, even when it is foreseen that the medication will have the effect of shortening their life. What is wrong is to end one’s own or someone else’s life in order to escape suffering which can be relieved by medication.