THE BRIGHT HOUR by Nina Riggs

Ancient Egyptians brought skeletons to their feasts, exhorting guests to drink and make merry while they still could. American Puritans in the 17th century kept skulls as warnings to sober up and focus on the afterlife. Memento mori, the gruesome reminders were called: remember that you must die. People died suddenly, and young. They wanted to be prepared. 

Nina Riggs did not feel prepared when she learned that a small spot in her breast was malignant. Cancer ran in her family: it had taken three grandparents and several aunts, and her mother was in treatment for multiple myeloma. But Riggs was only 37. Her sons, Freddy and Benny, were eight and five; she was not ready to leave them. Merrymaking had its place, but it didn’t address her concerns. And the afterlife, if it existed, was unknowable.

That's how my review of Riggs's The Bright Hour: A Memoir of Living and Dying begins. It's in the Fall Books issue of The Christian Century, and you can read the rest here for a few more days. After that, the magazine will likely put the review behind a firewall that can be breached only by paid subscribers.

It's a short review; you have time to click and read. Seize the day. Enjoy the now. That's what Riggs advises. In the words of her great-great-great-grandfather Ralph Waldo Emerson, she wanted to be "cheered with the moist, warm glittering, budding and melodious hour that takes down the narrow walls of my soul and extends its pulsation and life to the very horizon. That is morning; to cease for a bright hour to be a prisoner of this sickly body and to become as large as the World."

Reviewers don't always like the books they describe, but I loved this one.

CATASTROPHIC CARE: HOW AMERICAN HEALTH CARE KILLED MY FATHER--AND HOW WE CAN FIX IT by David Goldhill

This week the company my husband works for unveiled the health-insurance plans available to us beginning July 1. If we chose the plan closest to our current plan, our premium would nearly double and our office visit co-pays would increase 25-50%.

I am so glad we are going on Medicare in August.

Medicare isn't perfect, by any means. It isn't even cheap. Just the insurance (Medicare medical, Medicare supplement, prescription) is going to cost us more than $500 a month, and that doesn't include the deductible or the prescription co-pays. And that's for this year. Who knows what it will cost 10 years from now?

I was so ready to read a book that would solve America's health-care crisis.

Besides, David Goldhill's title is irresistible: Catastrophic Care: How American Health Care Killed My Father - And How We Can Fix It.

First the bad news. Goldhill, who is president and CEO of the Game Show Network, got interested in health care when his physician father "died from a hospital-borne infection he acquired in the intensive care unit of a well-regarded New York hospital." In his early chapters, he piles up statistics about how truly dreadful our health-care system is. Wherever you are on the political spectrum, you need to read his "eleven strange things we all believe about health care." (Goldhill is a Democrat who thinks Obamacare will not work.)

After the bad news, Goldhill gives all kinds of wonky explanations about why our approach to health care doesn't work. This section will probably appeal most to free-market-loving Republicans. Despite being a lefty who distrusts the market, I found it very helpful.

Finally what we're all waiting for: Goldhill's solution. My daughter Molly should have written this book: she recommended an almost identical solution to me a couple of months ago when we had a long discussion about health care. (Molly and I do not agree about a lot of political issues, but we have respectful and helpful discussions. We don't see the point in today's political polarization: differing opinions can increase clarity and come up with better solutions than either side could do on its own.)

In a nutshell: Insurance should be reserved for catastrophes - unforeseen big-ticket expenses like major surgery or cancer treatment. Anticipated health-care expenses should come from health-care savings accounts. And there needs to be some kind of safety net.

What Republicans will like: Consumers need to have control of their own health-care dollars. There's no reason to siphon off 20% or more to insurance companies. Besides, when we pay for things ourselves, we tend to be a lot more careful about what we buy. We comparison shop. We avoid unnecessary expenses. And to get our money, providers compete with one another to provide good care at low prices.

What Democrats will like: Everyone must have a health-care savings account - no exceptions. Most people will build up a good-sized balance when they are young. As they age, they will start to draw from it. People whose emergencies cost more than their savings can borrow to cover the additional expenses. At a predetermined level, they need borrow no more: the government will make up the difference. Nobody will be left without health care: the government will provide the safety net (though not by running the program).

What everyone except certain industries and lobbyists will like: Prices must be completely transparent and equal for everybody. The market isn't free if people don't have the information they need to make smart decisions.

What nobody will like: There will be limits. Just because something sounds good in the TV ads doesn't mean everyone should have access to it. Some treatments (especially those that have little proven worth in lengthening lives) will not be available. Some will be too expensive and most people will choose to forgo them. Some will be available, but only to people who have lots of money to spend.

My favorite health-care book is still T.R Reid's The Healing of America. (See my review on this blog or in Christian Century, if you subscribe.) The fact is that a lot of other developed nations have much better health-care programs than America's. They get better results. People live longer. And they do this for about half our cost. Before we do anything else about health care, we need to lay aside our prejudices and study what these other countries are doing.

But if Reid should be required reading for legislators, Goldhill should be too. As Goldhill points out, America's politicians are unlikely to accept a lot of features that make perfect sense in other countries. We need a program that fits with our own weird beliefs and behaviors--one that combines vigorous free-market competition with a safety net for everybody.

Someday we may actually come up with such a program. But probably not until we understand, as Goldhill says, that "at some point, we will have to decide whether our attachment to the idea of helping people is more important than actually helping them--a decision that will require a rethinking of our assumptions."

THE MOONLIGHT SONATA AT THE MAYO CLINIC by Nora Gallagher

Ten years ago Nora Gallagher wrote Practicing Resurrection, a memoir involving her brother's death, her Episcopal parish's response to their recently uncloseted gay priest, and her own process of deciding whether or not to prepare for priesthood. Publishers Weekly's anonymous reviewer loved it: "With a poet's ear for language and a novelist's eye for essential detail," she wrote, "Gallagher offers a compelling story of her journey toward 'a wholeness bought at the cost of suffering.'"

OK, I confess: I wrote that review. And I also loved Gallagher's earlier memoir, Things Seen and Unseen (1998), about her brother's cancer and her own coming to faith, all taking place within the framework of the church calendar with its major feasts and fasts.

So I was twice happy to learn from Gallagher's website that "Moonlight Sonata at the Mayo Clinic is part three of a quartet on modern faith as it is lived out"--once because this new memoir is about her journey into what she calls the Land of the Sick, or Oz (a land I know better than I'd like to), and twice because if this is part of a quartet, there's yet another book coming.

Let me say right up front that you should read Gallagher's other two memoirs first. They reach out to a broader audience. They are more finely crafted. They will allow you to befriend Nora before going with her on this darker journey where both physical and spiritual health are challenged.

The story begins in November 2009 when the vision in Gallagher's right eye goes blurry. She hasn't been feeling well anyway--headaches, queasiness, fatigue--so she schedules an appointment with her doctor. He doesn't like what he sees, and for the next two years Gallagher goes from specialist to specialist trying to find out, and hopefully to fix, whatever is wrong.

There's an element of medical mystery about her story, and I'm not going to spoil it by telling you the eventual diagnosis. Suffice it to say that it will not raise your opinion of American medicine in general: "Doctors were often baffled; the system of specialists who did not follow up on patients made it worse." The Mayo Clinic comes up smelling like roses, however. (Personal note: My experience at Cleveland Clinic, where I had open-heart surgery in 2011, was similar to Gallagher's at Mayo. Both have stellar reputations for the quality of their health care, and both have found ways to keep costs below the national average.)

Gallagher is a spiritual writer, and a person facing a major health crisis tends to have major spiritual concerns. I'm not going to spoil the account of her spiritual journey by telling you how her illness affected her faith, either. I'll only say that she and I--two women of about the same age, both of us having spent years in the Episcopal Church, both of us living with scary health conditions--look for peace in somewhat different places.

You may not identify with this memoir if you are young, or if you have never faced a life-threatening illness, or if you are a conservative evangelical. You'll probably want to read it if you prefer questions to answers, if you've faced serious illness or are caring for people who do, or if you work in health care and wonder how it feels to be the one on the examining table.

I'll finish by quoting a few paragraphs, one of Gallagher's many asides, that I particularly enjoyed:

I once interviewed Jews who had recently emigrated from Russia in one of the openings in the Cold War in the 1980s. Many of them had survived the siege of Leningrad. They were living in a retirement home in Denver. One of them took me aside after I had been there for a few days and said, "Tell me, Nora. Is everyone in America always fine? I ask someone how they were doing and they reply, always, 'Fine.'"
     I explained to her that this was a commonplace; a custom, it meant nothing. Relief showed all over her face.
     "Ah," she said. "That's good. Because I am rarely fine." (Later, whenever they saw me, they would chorus: "How are you? We are fine!" and then laugh uproariously.)
     I missed them, I thought. These were people who understood not fine.

FAT CHANCE by Robert H. Lustig and SALT SUGAR FAT by Michael Moss

If you eat food, here are two newish books you should know about.

You may already have met Robert H. Lustig, author of Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease (2012). Lustig is the UCSF professor whose surprisingly riveting 90-minute lecture, "Sugar: The Bitter Truth," has already had nearly 3.5 million hits on YouTube. The thesis of his lecture: it's not dietary fat that's making Americans gain weight, it's sugar. And sugar is doing much worse things than increasing our clothing size. It's setting us up for a whole range of lethal diseases that are almost entirely avoidable.

In Fat Chance Lustig writes about sugar, going into much greater detail about what it does in and to our bodies. He also writes about how various foods cause physical addiction, how the food industry keeps us full of junk, how the government helps the food industry ruin our health, why people gain weight, why diets fail, how people can lose weight--he's all over the map. But if you're not enslaved to linear thinking, you may well enjoy this fascinating collection of data and explanations as well as Lustig's sassy attitude.

Don't be put off by the title, by the way. I think it and the cover illustration are both insulting and misleading, and the subtitle makes the book sound like either an extended scold or a dreary set of rules for would-be ascetics. No, no, no. Lustig goes to great lengths to avoid blaming or shaming people who wish they weighed less. His concern is with keeping people--both convex and concave--in good health, and he'd like all of us to join his battle against the Evil Food Empire that is doing us in.

Once you've read Fat Chance you'll be loaded for bear. Michael Moss to the rescue--he'll tell you where to aim your rifle.

In Salt Sugar Fat: How the Food Giants Hooked Us (2013), Moss, a Pulitzer Prize-winning investigative reporter, tells what the food industry has been up to during the last couple of decades. Food executives, Moss says, are nervous: people are figuring out that convenience foods aren't good for them.

Stripped of nature's nutrients and loaded with fat, sugar, and salt, most of today's grocery-store items are engineered to provide the maximum taste thrill for the minimum price so food companies can make maximum profits and give Wall Street maximum satisfaction.

As engineered foods have gained popularly, however, their consumers have gained weight. At the same time, obesity-related diseases have added billions of dollars to health-care costs.

"Obesity is literally an epidemic in this country, and some people's ideas for addressing this public health issue could directly or indirectly affect the entire agriculture industry, from farm to consumer," a Philip Morris vice president, Jay Poole, warned an agricultural economics group.

Yes, that Philip Morris. The cigarette manufacturer, who once fought any publicity indicating that smoking might be bad for you, owned General Foods and Kraft in 1999 when Poole issued that warning, and they acquired Nabisco the next year. The food giants--including not only Philip Morris affiliates but also Kellogg's, Coke, Oscar Mayer, Cargill, Frito-Lay, and Dr. Pepper--had no intention of letting customers slip away to the produce aisle.

They would fight back with whatever weapons they could muster: the science of addiction, misleading labeling, false claims, selling to less regulated countries, advertising to children, relentless lobbying of legislators and government agencies.

I especially enjoyed Moss's repeated observation, after lunching with one food company executive after another, that the executive looked trim and healthy--and would not eat his company's products. You might not want to either after you've read this book.

Oh, and never fear--Salt Sugar Fat is not a downer (unless you read it while drinking Coke and eating Fritos). It reveals, but it doesn't preach. You'll enjoy the stories Moss tells. He hopes you will find it a useful tool for defending yourself when you walk through the grocery store doors.