I became interested in this book because as a migraine sufferer who hasn't always had my headaches under control or been able to reliably treat them, I would be shut up in my apartment, in the dark (or as dark as possible when I lived in Arizona), for up to 24 hours. I couldn't read or watch television or go online. I'd sleep but couldn't do so all day. I was bored and felt alone. The next day, when the pain was gone, it was like a first day out of prison or after a long illness. I'd be almost euphoric but also feel vulnerable, as sometimes I'd get rebound headaches. Thankfully, I now have medications both to reduce my headache days and to stop them before they become agonizing.

"Anna" has an extreme sensitivity to light that keeps her inside, in a light-tight room, not for a day but months (even years) at a time. Certain wavelengths affect her more than others, but she can't read, watch television, or use a computer. She listens to audio books, talks on the phone with others who share debilitating chronic conditions, plays mental logic games alone or with her partner or other loved ones. She understandably feels depressed and experiences suicidal ideation.

Yet the book itself is not depressing. There is a humor to her writing, and her strength in dealing with this condition is impressive, encouraging, and inspiring without being maudlin. She's candid about her frustrations, as when she talks with others with chronic conditions that don't limit them in all the ways she is limited and finds herself angry.

She's also a terrific writer; the book feels literary in its prose and structure, which includes shorter chapters ordered thematically and achronologically (in one chapter she goes through the alphabet--one of her mental games--to list all the therapies she's tried and their results). At the end of the book she explains her decisions about how to structure it and even includes a chart indicating periods when she could not leave her home at all and periods of remission when she could go out around dawn and dusk.

Perhaps the most frustrating aspect of Girl in the Dark to read about is the fact that doctors refused to come to her when she could not leave her home. She corresponded with some, but knowing that house calls have been part of the medical profession in the past (and still are in some places--or for the right price) demonstrates their reluctance--not inability--to engage with patients with rare conditions like Anna's. To me, that's inexcusable and shameful.

This is my first Alexie and not my last. I'm struggling with what to say about it and how because somehow this not-huge novel feels like it's packed in everything about Indian (as they refer to themselves) culture with its focus on a particular reservation and a rock band's steep rise and fall. It does so with deadpan humor and a mix of the fantastic and real that calls to mind magical realism but is distinctive. It's necessarily sad yet not depressing--there's the humor, and there's wonder and hope. There's not an insignificant or uncharismatic character in the book. I feel like I've taken a long, strange trip with them and wish them well.

It was hard to put down this impressive work of journalism that focuses on events at Memorial Hospital in New Orleans before, during, and after Hurricane Katrina. As hurricane season approaches it begs the question: are we better prepared to deal with natural disasters in the U.S.? The epilogue to the book, written a few years ago, suggests in some ways we are, but in important ways we are not.

Hospitals were exempt from the evacuation order (belatedly) given by the mayor of New Orleans as Katrina approached. Many staff, patients, family members, and even pets sheltered at the hospitals (lesson the first: evacuate before the storm hits), including Memorial. As the title indicates, it would be five days before all were evacuated. After power loss, the generators eventually failed as they were in the basement, where the water levels rose once the levees broke. Though they had food and bottled water, the hospital went without running water, air conditioning, working plumbing, and the power needed to run vital medical equipment.

Evacuation aid via helicopters and boats was erratic or turned away by staff at points. Communication at all levels was unreliable; rumors swarmed, including that New Orleans was under martial law and looting and violence were everywhere. The staff went without much sleep as they continued to care for patients. The bad decision was made to leave the sickest patients, including those with DNR (Do Not Resuscitate) orders, last for evacuation, with the exception of neonates. Healthier patients (though some still critical) left first. Family members were encouraged and even pressured to leave their loved ones, assured the patients would be cared for.

Soon after the disaster, there was a reckoning. Or, I should say, an attempt at a reckoning. Troubled reports of irresponsible and ethically questionable decisions being made at hospitals and nursing homes arose, including euthanasia at Memorial. 40-some patients had died there, and about half were later found to have high levels of morphine as well as Versed, a sedative, in their systems. Were they euthanized, and by whom?

In addition to covering events at the hospital as reported by those who were there, Fink covers the development of the legal case against a particular doctor and two nurses accused of second degree homicide. Reading about what happened at the hospital, the good and, mostly, the bad, is heartrending and horrifying, impossible to look away from, like a car accident. Learning what does and does not happen afterwards infuriated me; my sympathies were with those who'd lost loved ones, who don't quite have closure. I sympathized also with nurses so traumatized by those five days that they could no longer practice.

Fink contextualizes Katrina as well as the ethics of decisions made. She profiles key players, letting their own words speak for them. I don't pretend to read much non-fiction, but it seems to me her work is exceptionally well researched, every effort made to fact-check and communicate with those involved. The book evolved from a piece she did for ProPublica and the New York Times, which won the Pulitzer. Regardless, I'm sure there's been a range of reactions. If you google the topic, you'll find a website by/for the doctor arrested who continues to deny wrongdoing, with a link to another site that proclaims "the truth" of what happened. I didn't bother clicking.

Mostly I think about the contrasting example of Charity Hospital, also in New Orleans, who lost fewer patients despite having more, with additional patients delivered to them. I think of proposed (and adopted) legislation or protocols that would shield physicians from legal ramifications of unethical decisions made during a disaster. I think of the following quote, with which I agree:

“Rather than thinking about exceptional moral rules for exceptional moral situations,” Harvard’s Dr. Lachlan Forrow, who is also a palliative care specialist, wrote, “we should almost always see exceptional moral situations as opportunities for us to show exceptionally deep commitment to our deepest moral values.”

I've waited a couple days to write this review because this book puzzled me, and I wondered if it was the author's fault or mine. It's silly to assign blame when one doesn't like a book; I suppose this one just wasn't for me, and I wish every book was.

On the surface, and based on the sample, this book seemed very much "me." The protagonist runs a small, one-person, mail-order game company. His most popular game, Trace Italian, a text-based RPG, brought to mind both my own (brief) history as a D&D player, as well as the epic adventure of Ready Player One. The game here functions as a refuge for its creator--I was fascinated by the fact that no one has ever made it to the Trace Italian, or fortress that would provide safety in a post-apocalyptic Midwestern U.S., nor is anyone likely to--borne of months spent in the hospital after a mysterious "accident." The game also embodies what I understand to be the book's major theme: how the decisions we make may have no real explanation or cannot be anticipated, including their consequences. For example, Sean, the protagonist, cannot anticipate how two young players will treat the game as too real, leading to one spoke of the plot, or how another player will make a choice I imagine Sean envies.

The book is structured so that its major plot points are only slowly revealed as you go; for example, about a quarter of the way through, the reader learns what exactly happened with the two young players that ended up embroiling Sean in a lawsuit. It isn't until the final pages of the book that one learns what happened the night of Sean's "accident," though why is much more complicated. In this way the structure is closer to that of a mystery...except it's not a mystery novel. It made me feel manipulated; while all storytelling is manipulation, in a way, this sort of teasing of what you're even reading about frustrates me. I tried to imagine the book structured differently and admit it would be a completely different novel. I don't have an answer as to what I want and can only conclude, again, that this is not a book for me.

As I read, I anticipated the ending accurately but hoped it might somehow still satisfy by then; it didn't. A book can be about roads we do and don't take, how our choices don't always have rational (or even irrational) reasons, but it still has to work as a story rather than shrug its shoulders. It strikes me that I might have loved this book as a short story, where less of a build-up would lead to less frustration.

I've had this book forever but was prompted to finally read it by the series adaptation that just came to Netflix.

(Spoiler-free until the note.)

The most impressive element of this book is the fact that it takes on toxic masculinity and rape culture head on. It's the sort of book that I'm not sure would have existed when I was going through high school. That alone makes it a relevant, disturbing, but necessary read for students (and teachers, counselors).

The story is divided between protagonist Clay's perspective and Hannah's, the girl at the center of the narrative who committed suicide. One day Clay finds a package containing seven cassette tapes, which he must pass on to the next person spoken about on the tapes (one side per person). Each person had a role in Hannah's downward spiral, so the book is set up as a mystery. What happened to Hannah? Why did she kill herself?

Each chapter takes on one tape, and as he listens, Clay follows the map Hannah made and slipped in his locker before she died that marks key spots in her story. It was sometimes difficult for me to engage with this structure; someone wandering around listening to audio tapes isn't all that dynamic. I liked the idea of the book's structure but not necessarily its execution.

(SPOILERS) I'm also disappointed in the revelation of Clay's role once he reaches his own tape. I understand the choice to keep Clay a "good guy" in the reader's eyes since his is the point of view we're following, but I think the story would be more impactful if there was something he did or didn't do that forced him to reevaluate his own actions or inaction. He does regret leaving Hannah alone, but it's when she asks him to, which felt a bit problematic because generally when a girl tells you to leave, YOU SHOULD LEAVE, so technically Clay did the right thing. He blames himself for not helping her, for not persisting, but it feels like he's making Hannah's pain about him.

Clay also feels guilty and angry at himself for not standing up to others when it comes to how girls are treated, and by the end, in the last scene, we're to understand that will change (in contrast to another person on the tapes he runs into earlier, who still seems incapable of understanding his role--or won't acknowledge it). Though there are girls among the thirteen reasons, there's a way in which their roles enact rape culture and patriarchy (not that this makes them beyond blame). At the same time, the potential saviors the narrative suggests could have made the difference are boys/men, which both fairly places the responsibility on their shoulders--but also suggests the old man-as-rescuer trope. (END SPOILERS)

Regardless of my concerns, I'm grateful there's a book like this out there, tackling these subjects, and I'm interested in how the show on Netflix adapts its particular structure.