His Brother's Keeper

His Brother's Keeper: A story from the edge of Medicine
Jonathan Weiner (2004, HarperCollins)

     His Brother's Keeper takes Jonathan Weiner to the frontiers of biomedicine, where the latest genetic technologies promise wonders. Some of these wonders are happening already, and others are not quite around the corner. He is led by Jamie Heywood, a young mechanical engineer turned genetic engineer and activist, who is on a quest for a way to help his brother. In 1998, Stephen Heywood was diagnosed with ALS, ametrophic lateral schlerosis, which we also know as Lou Gehrig's disease. Beginning with weakness in his right hand, Stephen gradually lost nerve function; he could expect to lose the ability to walk, and eventually the ability to breathe, leading to death within five to seven years.

     The past decade has seen spectacular advances in molecular biology and genetics, but the use of these technologies to help sick people is just getting off the ground. Today's work in genetic science includes the hope of using viruses to add genetic material to the cells of adult patients, potentially renewing their ability to carry out their functions. Weiner says, "Hope asked: How soon can we use this invisible anatomy to repair a dying nerve, brain, or heart? Fear asked: How much of the body can we change without losing the patient we hoped to save?"    

     This tension permeates the Heywoods' story. Jamie wavers between non-profit fund-raising and the entrepreneurial model of a Silicon Valley startup; he wants to see important basic research done, but he needs it to bear medical fruit in time to save his brother. Stephen has no choice about being a patient, and may consent to being a test subject, but he'd just as soon not be a poster child; he also wants to be a carpenter, and a husband and father. And while Weiner tries to be an objective reporter, he also falls under the spell of Jamie's persuasive enthusiasms, which sets him up for discouragement as problems, both scientific and bureaucratic, prove intractable. Meanwhile his own mother exhibits symptoms of a growing neural disability, and part of his attention is back at the family home worrying about her.

     Weiner fell into the middle of this story, and he leaves it before its end. Jamie remains driven, continuing single-mindedly to seek people and money who would bring a treatment for ALS closer. Stephen has moved into a wheelchair, and needed a voice enhancement apparatus; he remains easy-going and thoughtful. "Stephen was still convinced that his brother would find a treatment or a cure, maybe after Stephen himself was gone. But there was nothing supernatural about any of it. That is how big things always start. They have to grow from a couple of lucky little things. They are normal miracles."

     Such determination, such love, such hope--these are surely miracles too.

CTR
March 2005

Mockingbird

Any Good Books,
May 2010

Mockingbird: A Portrait of Harper Lee
Charles J. Shields (Henry Holt, 2006)

It’s a pleasing literary oddity that Harper Lee and Truman Capote shared a small-time childhood, and grew up to be such different kinds of Famous Writers: he, one of the most ardent self-promoters the literary world has known, as famous for parties he threw as for books he wrote; she, the author of one of the most highly acclaimed, widely read, and influential novels of the twentieth century, but somewhat overwhelmed by the resulting acclaim.

Mockingbird, Charles Shields’s unauthorized biography of Nelle Harper Lee, is packed with such gentle ironies. Capote had already published his first book when Lee left college to try the writing life, so his example may have proved to her that such a thing could happen; he read parts of To Kill a Mockingbird; and he incidentally introduced her to Michael and Joy Brown. The Browns, having come into a windfall, gave Lee the money to concentrate on writing for a whole year, without having to work at a job.

But the most direct literary assistance went the other way: without Lee’s help, Capote would not have gained entry to the inner life of Finney County, Kansas, and In Cold Blood would not have gotten off the ground. So, in addition to being the mother of one of the greatest books of its century, Harper Lee was the midwife to one of her friend’s most notable works. (By this time the reader has seen enough of him not to be surprised that his thanks are perfunctory.)

To Kill a Mockingbird, meanwhile, won the 1961 Pulitzer prize, and was featured by all the book clubs. It sold 2.5 million copies the first year, and some thirty million more, since. Shields observes, “...almost from the day of its publication, To Kill a Mockingbird took off, but gradually left its author behind.” Her second novel never saw the light of day, whether because of the time spent prize-collecting and movie-making, or helping Capote do research in Kansas, or, just as likely, the feeling that there was, after such success, nowhere to go but down. She was, to herself, a hard act to follow.
Alan Pakula’s production of the movie (and Horton Foote’s screenplay) subjected the book to the tightening and rebalancing necessary to bring in a reasonable running time; the three years of the books action become one year; and, at Gregory Peck’s urging, the dramatic focus fell more heavily on the trial, and much less on the lives of the children. Peck was probably right about that, cinematically speaking--and he won an Academy Award for the performance.

Now in her eighties, Lee still lives in Monroeville, where her book has become a cottage industry, the way Anne of Green Gables has for Prince Edward Island. In the twenty-five years between the action of the novel and its publication, Monroeville had modernized too much to be useable for filming. Since then economic progress has stagnated, and it’s returned to being something of a backwater. Since 1990, the town has produced an annual play of the book, bringing even more pilgrims to town. How trying it must be for Lee to go out to breakfast, and meet the millionth person who can’t help gushing about the book, and demanding to know why there wasn’t another.

Of course, as an unauthorized biography, Mockingbird is itself such an intrusion; our curiosity is natural, and perhaps this book is the safest distance from which to satisfy it. But if you’d like to be perfectly sure of being polite, don’t read it.