March 7, 2014
Guests: Chimamanda Ngozi Adichie -- Sherwin Nuland
DAVID BIANCULLI, HOST: This is FRESH AIR. I'm David Bianculli, editor of the website TV Worth Watching, sitting in for Terry Gross. Chiwetel Ejiofor, who starred in the Oscar-winning film "12 Years a Slave," will star in the upcoming film "Half of a Yellow Sun" about the Biafran War, based on the novel by our next guest, Chimamanda Ngozi Adichie.
You may recognize Adichie's voice and name from Beyonce's song "Flawless," which featured an excerpt of a TED talk Adichie gave titled "We Should All Be Feminists." Adichie was born in Nigeria. When she came to the U.S. to attend college, she quickly discovered that being an African in America doesn't necessarily mean you know what it was like to be an African-American. She found white and black people projecting things on her she didn't understand, and she was confused by the coded language that was often used to talk about race.
She didn't get it, but eventually she did. Those experiences formed the basis of her novel "Americanah," which has just come out in paperback. Our book critic, Maureen Corrigan, described it as a big, knockout of a novel about immigration, American dreams, the power of first love and the shifting meanings of skin color. Terry interviewed Chimamanda Adichie last September.
TERRY GROSS, HOST: Welcome to FRESH AIR. I'd like to start with a reading from your book, and since your character blogs a lot, let's start with one of her blog posts. So if you could read the title of the post and the post.
CHIMAMANDA NGOZI ADICHIE: So this post is titled "To My Fellow Non-American Blacks, in America, You are Black, Baby." Dear Non-American Black, when you make the choice to come to America, you become black. Stop arguing. Stop saying I'm Jamaican or I'm Ghanaian. America doesn't care. So what if you weren't black in your country? You're in America now. We all have our moments of initiation into the society of former negroes. Mine was in a class in undergrad, when I was asked to give the black perspective, only I had no idea what that was. So I just made something up.
And admit it: You say I'm not black only because you know black is at the bottom of America's race ladder, and you want none of that. Don't deny now. What if being black had all the privileges of being white? Would you still say don't call me black, I'm from Trinidad? I didn't think so. So you're black, baby.
And here's the deal with becoming black: You must show that you are offended when such words as watermelon or tar baby are used in jokes, even if you don't know what the hell is being talked about. And since you are a non-American black, the chances are that you won't know.
In undergrad, a white classmate asks if I like watermelon. I say yes. And another classmate says oh my God, that is so racist. And I'm confused. Wait, how? You must nod back when a black person nods at you in a heavily white area. It is called the black nod. It is a way for black people to say you're not alone; I'm here, too.
In describing black women you admire, always use the word strong because that is what black women are supposed to be in America. If you're a woman, please do not speak your mind, as you're used to doing in your country, because in America, strong-minded black women are scary. And if you're a man, be hyper-mellow. Never get too excited, or somebody will worry that you're about to pull a gun.
When you watch television and hear that a racist slur was used, you must immediately become offended even though you're thinking but why won't they tell me exactly what was said. Even though you would like to decide for yourself how offended to be or whether to be offended at all, you must nevertheless be very offended.
GROSS: And that's a reading from Chimamanda Adichie's new book "Americanah." So...
GROSS: It's a great passage. You weren't defined by race when you were in Nigeria; everyone around you was black. So how do things change when you were seen as black after coming to America and knowing here that you were defined by race, that race is the big divide in America?
ADICHIE: I think for me, I like to think of it as something of a journey for me. I remember when I first came to the U.S., I really didn't consciously think of myself as black because I didn't have to. I thought of myself as Igbo, which is my ethnicity. And then in the U.S., there's a moment when I had just arrived, and an - and I was in Brooklyn, and this African-American man called me sister.
And I remember reacting almost viscerally and thinking no, I am not your sister. And then I think also at the time I had very quickly absorbed all the negative stereotypes of blackness in America, and so I didn't want to associate myself with that. And I also remember in undergrad, when a professor of mine came into class and said who is Adichie because this person called Adichie, which is the way Americans often pronounce my last name, had written the best essay in class.
And I remember raising my hand, and for a fleeting moment, there was surprise on my face. And I realized that the person who wrote the best essay wasn't supposed to look like me.
GROSS: Do you feel like assumptions change about you when a white person or a black person finds out that you're from Nigeria and not born in the U.S.?
ADICHIE: Yes, yes. I think when I open my mouth and talk, and obviously everybody knows I don't have an American accent, they - in general I have been told such things as you're different, or you're not angry, or you don't have issues, that sort of thing. So there's sort of the assumption - I think there's a kind of - it's a strange thing, and it's complicated, but there's a certain, a certain privilege to not being African-American in certain circles in the U.S., being black but not African-American.
GROSS: What is the privilege and why do you think there is a sense of privilege?
ADICHIE: I think that one isn't burdened by America's terrible racial history. And I think that when people say to me you're different, and you're not angry, in some ways it's that I also feel that I'm being made complicit in something that I don't want to be complicit in because in some ways they're saying you're one of the good ones.
And I think to say that is to somehow ignore, you know, the reality of American history. And so for example people will say oh, you're so easy to get along with, and then they'll tell me a story about some African-American woman they knew who just wasn't like me and - you know, which I find quite absurd, but yes, but I think the honest - if we're honest about it, there is, there's a certain privilege to being black but not African-American.
GROSS: I think for white people, too, there's this burden of guilt that's lifted because I think there is a sense of kind of collective guilt that white people carry for enslaving African-Americans. And so if you were never - if your ancestors were never brought to the U.S. and enslaved, poof, in this relationship you're relieved of that guilt.
ADICHIE: Yeah, I think that is true. I mean, I - I think the part of my life where I feel that guilt, because I feel a certain amount of class guilt, I think I occupy a space of privilege when it comes to class, and I know for example that when I'm back in Nigeria I feel class guilt. And I don't necessarily think it's a bad thing. I do think it can get in the way of honest conversations.
So I realize that there is white guilt in the U.S., but I don't think it's very helpful. I don't know if that makes sense. I mean, I think that maybe what American blacks and American whites should take away from the table is the idea of personal responsibility.
GROSS: What do you mean by personal responsibility?
ADICHIE: I think that sometimes white Americans think that to start off they say things like well, it's not my fault, I didn't do anything. And I just feel like of course it isn't your fault. It's not - but the fact that white Americans benefit from a history that gives them white privilege doesn't mean that it's somehow their fault. They didn't ask to be born white.
I mean, so in the novel, for example, Ifemelu, who's the main character, goes to work for a white woman, and this white woman is very well-meaning, and she just is so uncomfortable about race that she won't say black. So if she wants to talk about black people, she says beautiful. So she'll say to Ifemelu oh, I'm going to go see my beautiful co-worker, or I have this beautiful woman that I met at the store.
And it turned out that every time Ifemelu actually did end up seeing these people, they were not particularly beautiful, but they were just black. And so Ifemelu says to her, you know, you can actually just say black. And for Ifemelu, it's the beginning of a friendship.
That's the point where she imagines that this woman is her friend because that's for her when she thinks that they can actually talk honestly about things because, you know, not all black people are beautiful, and so it's actually OK to say black.
GROSS: In the blog post reading that your character does from your novel "Americanah," your main character, who's Nigerian, after coming to America finds herself in the middle of these, like, landmines about language and stuff that she doesn't really understand because she's not schooled in America's race conflicts.
Did that happen to you? Did you find yourself in the middle of conversations where you didn't really understand the subtext, so you had no idea why somebody was angry or how you were supposed to respond?
ADICHIE: Yes, I did initially. I mean, now, now of course, having read quite a bit about African-American history, and I know now, but initially I didn't. And I remember for example, and I use this in the book, a conversation in my undergrad class about watermelon.
And an African-American classmate was very annoyed because she said that somebody else in class had said something to her about watermelons. And I remember sitting there thinking but what's so bad about watermelons because I quite like watermelons and just really being confused and also feeling that the African-American woman was annoyed with me because she thought I should get it and that I should share in her rage.
And because I didn't quite understand that this watermelon comment was supposed to be racist, I couldn't share her rage, and so I just was sort of confused. And it was such a strange moment because looking back now, I realize it's how one learns: One, that race is such a strange construct because you learn - you have to learn what it means to be black in America. So you have to learn that watermelon is supposed to be offensive.
GROSS: So much of America's history and America's racial tensions have to do with slavery. You really can't understand America without understanding the history of slavery in America. And you're from Nigeria, which was a place that a lot of Africans were kidnapped from so as to be taken to the United States to become slaves. And I'm wondering, like, was the slave trade a part of what you learned about in school when you were growing up?
ADICHIE: Not really, no. I really don't think that in general - and of course I'm generalizing - but I don't think there's a very strong sense of the magnitude and really the horror that the transatlantic slave trade was for people of my generation in Nigeria, and I'm probably going to say on most of the African continent.
I don't really remember learning very much about slavery when I was in school, and which I think is also why many Nigerians don't really get - they don't really get it, to put it simply, no.
BIANCULLI: Chimamanda Adichie, speaking to Terry Gross last September. Her novel "Americanah" has just come out in paperback. We'll hear more of their conversation after a break; this is FRESH AIR.
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BIANCULLI: This is FRESH AIR. Let's get back to Terry's conversation with Chimamanda Adichie. Her book "Americanah" has just come out in paperback.
GROSS: What brought you to America to study? Why did you want to come here?
ADICHIE: I had started - I was supposed to be a doctor in Nigeria. So I had started studying medicine. I did well in school. When you do well in school, they tell you you have to be a doctor. And I did that for a year and a half, and I was very unhappy. And my sister, who had been born here when my father was - my father got his Ph.D. in statistics at Berkeley, and my sister had been born here in the '60s, so she was a dual citizen, American and Nigerian, and she'd come here.
And I suddenly thought, you know, somebody's in America who will give me a bed and give me food. And so I took the SATs, and I was almost certain that I would get a scholarship so I could escape the study of medicine. So that's really it. And partly also because leaving medicine in Nigeria would have meant going on to do another thing that was in the sciences, and I was so tired of science.
GROSS: Wait, why couldn't you stay in Nigeria and major in literature?
ADICHIE: Because you can't move - there's something called the science track. So I had been in the science track from my fourth year in secondary school. And again there are assumptions about subjects of study. So if you do well in school, they tell you, you have to be in the sciences. And I had taken my exams in the junior secondary, got the best results, and I really wanted to study literature and history.
And they said to me oh no, you have to be in the biology and the chemistry and the physics. And so that's already a track. And so the exam that you take to get into university, you do the sciences, and so to change, you just can't change. I would have to go and start over, and I just wasn't prepared to do that, to take the entrance exams again, to - I just - you know, and also I hadn't been prepared in what they called the arts. So I just couldn't.
And so really for me America became escape. I - and just really because my sister was here, I had the choice of - I had the choice of that escape. So I took the SATs, got a scholarship, and I escaped the study of medicine.
GROSS: When you came to America, did you expect, well, you know, I'll get my degree or my degrees and then return?
ADICHIE: I - yes, I mean, I was very vague. I was just so pleased to have escaped, really, the sciences. And I loved my classes. I loved, I really do love the American liberal arts college education system and the way that you can take - I took classes in philosophy and political science and communications. I was thrilled. And I don't think I quite had a plan.
I mean, I did think I would go back home, which in many ways I have because now I have a life in both places, but I didn't really have a firm idea of what I would do with it. I just, I was just so grateful to have classes that I actually not only did well in but enjoyed.
GROSS: Your character has several hair crises in your novel "Americanah."
GROSS: And initially she has to, like, travel to another city to have her hair braided. There's pressure to straighten her hair. She straightens her hair, and her whole scalp blisters. Her hair starts to fall out around the temples. She says she grew up in the shadow of her mother's hair. Was hair an issue for you when you came to the U.S.?
ADICHIE: Hair is an issue for me. It's an ongoing issue for me. And I quite like the expression hair crises. It wasn't really when I came, but it became an issue for me. I grew up - so in Nigeria, I had my hair braided often, but really what I aspired to was straight hair. And I very much...
GROSS: Wait, in Nigeria you aspired to straight hair?
ADICHIE: Oh yes, yeah.
GROSS: Why? Like what were the images you saw that made you want straight hair?
ADICHIE: Because everybody around me had straight hair because...
GROSS: In Nigeria?
ADICHIE: Yes because the norm is when you - because you really, the rite of passage from girl to woman is when you can go get a relaxer and have your hair straight. So I remember looking forward very much to my last day of secondary school because that's when I could - I remember actually the last day of secondary school graduating from secondary school, then what I really wanted to do was go straight to the hair salon and get my relaxer so my hair would be straight.
And then I came to the U.S., and really it started off because I couldn't afford to get a relaxer at a hair salon here because I thought it was just needlessly expensive. So I went to the drug store and bought the relaxer kit and decided to do it myself, which didn't end well.
And having then a scalp with really bad burns, I suddenly thought why am I even doing this, why - you know, it's sort of a moment where my scalp is burning, and I'm thinking why do I need to put terrible, horrible chemicals to get my hair to do what it wasn't intended to do. And that's when I stopped using relaxers.
But it did take a while for me to come around to sort of accepting my hair the way that it grows from my head and I think also the idea that mainstream culture tells us that what's beautiful is something that I think for many black women, I think for me, I mean I should speak for myself really, that when I first stopped using relaxers, I felt very self-conscious because I realized that the way my hair was as it grew from my head didn't match what mainstream - what mainstream sort of society said was beautiful.
So I then sort of went through a period when I would overcompensate by wearing big earrings because I wanted to still sort of make sure that I was feminine, right, even though I don't have the long hair and even though my hair is standing on my head rather than falling down. I'm still female, so, yeah, the big earrings.
GROSS: What kind of hair did your mother have? Did she straighten it?
ADICHIE: Yes. All her friends did. It was the norm. My mother was actually - my mother made history in Nigeria. She was the first woman who was registrar of the University of Nigeria. She's brilliant. She's - but yeah, and I think my mother still doesn't like my hair natural now. She really would just rather have me have a relaxer.
GROSS: I just find that so interesting, you know, because like in the '60s, when afros became popular, it was so important to so many people to have a kind of natural - to have natural hair and to not process it in any way. And it was in some ways an Afro-centric statement, too. And so to hear you talking about growing up in Nigeria, where you and your mother straightened your hair, I presume to look more Western.
ADICHIE: Yeah, well, you know, I suppose so, yes. I mean, I don't think that women in Nigeria were consciously aware. I mean, I don't suppose that they sat down and thought now we shall try to look white. I think it's just that there's a larger idea of what's beautiful that people just absorb and internalize. And, you know, these are women, my mother's generation, my mother's class, my mother's friends, were all women who were educated.
So when you think about it, my mother went to missionary school. She went to university. And when you think about what ideas did she receive about what's beautiful, and I don't think it's that surprising, really, that they would then go on to somehow associate beauty with straightened hair and the hair that grows on her head the way it is as something that one has to do something about.
It's actually an expression my mother still uses. She's say to me you need to do something about your hair.
GROSS: A lot of people have mothers who say that.
GROSS: I think when you're a mother, you're taught to say that.
BIANCULLI: Chimamanda Adichie, speaking with Terry Gross. Her novel "Americanah" has just come out in paperback. We'll hear more of their conversation in the second half of the show. Last year Adichie gave a TED talk on feminism, which was sampled by Beyonce in her song "Flawless." Let's listen to an excerpt. I'm David Bianculli, and this is FRESH AIR.
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BIANCULLI: This is FRESH AIR. I'm David Bianculli, in for Terry Gross, back with more of Terry's interview with novelist Chimamanda Ngozi Adichie. Her novel "Americanah," about her experiences, coming of age in Nigeria, than moving to the U.S. to attend college, is now out in paperback. Her 2006 novel, "Half of a Yellow Sun," was about the Biafran War, it comes out as a movie in May, starring Chiwetel Ejiofor.
GROSS: You were born in a town called Nsukka. Am I saying that right?
ADICHIE: So the N is hummed.
GROSS: Yes. Nsukka. And that's the place where the University of Nigeria is?
BIANCULLI: Your parents were both affiliated with the university. Growing up in Nigeria, race obviously, wasn't the defining trait of who your friend or who your enemy was or the history of conflict or anything. But ethnic identity really mattered a lot. Your family is Igbo. And correct me if I'm wrong, in the Biafran War, your town was part of the breakaway state of Biafra, but it was captured early in the war by Nigerian forces. So what did that war mean in the life of your family?
ADICHIE: My family was deeply affected by it. I like to say that my, I think that my parents' generation lost their innocence in that war. My father lost everything he owned - every material thing he owned. He also lost his father - who died in a refugee camp. My mother lost her father. My parents had just come back from the U.S. months before the war started. My father was eager to get his degree and go back to Nigeria - because he was part of that generation - who very much wanted to build up their countries. And he gets back to Nigeria. He starts teaching at the University of Nigeria, and then months later, this war starts. And he tells just so many moving stories - many of which I used in my second novel - and I think the memory is still very much there for him and for his generation.
When I started researching the novel that's set around that period, I realized that talking to them was really, when they would tell me about it, it was the first time that they had actually really talked about many of the things that happened. And my father tells the story about his father dying in a refugee camp. And his father was titled man in Igboland - which meant that, you know, he was a great man, he had one of the highest titles that a man could have. But his home town fell so he had to leave and go to a refugee camp and he died and he was buried in a mass grave - which, you know, is just heartbreaking for a man, particularly a man like him.
And my father - who was the first son and who takes his responsibilities very seriously, very much wanted - he couldn't go to bury his father because the roads were occupied. He was in a different part of Biafra, and so it took a year until the war ended, then he could go to the refugee camp. And he says the first thing he wanted to do when the war ended was go to the refugee camp. And he goes there and he says, you know, I want to know where my father was buried. And he said somebody waved very vaguely and said, oh, we buried the people there. So it was a mass grave, because so many people had died. And my father says that he went there and he took a handful of sand and he says he's kept the sand ever since.
And for me, that was one of the most moving things that I'd ever heard, and it said so much to me about my father - who's such a lovely, gentle, quiet, stoic man. And I didn't realize - I don't know - I just hadn't imagined that my father would be a man to take a handful of sand and to keep it, and what that meant and the symbolism of it. And also, I think that story just says so much about what the war did to them - not just in the way that they lost material things - but in the way that they lost emotionally.
GROSS: I'd like you to explain the title of your book "Americanah." You might spell it for us first. And tell us if you feel like you are perceived as being an Americanah or if you see yourself that way.
ADICHIE: So "Americanah," which is America and then with two extra letters, A and H at the end, it's actually a Nigerian word so it's a kind of playful word that's used for people who have been to the U.S. and who come back to Nigeria with American affectations, or who go to the U.S. and come back and pretend that they no longer understand Igbo or Yoruba or Hausa.
Or who come back to Nigeria from the U.S. and, you know, suddenly won't eat Nigerian food and everything is about when I was in America. And also often it's used for people who are genuinely Americanized. But it's a very playful way of - it's often used in the context of a kind of gentle mockery. And I don't think of myself as Americanah. I think partly because I was fortunate enough to go back to Nigeria after only four years in the U.S.
Unlike some people who just can't get to go back. Like the character in the novel; she doesn't go back for 13 years. And when she goes back she's really changed and Nigeria has also changed. But I went back after four years and even then it had changed. But there are times when my friends tease me about such things as going to a restaurant in Lagos and ordering steamed vegetables.
GROSS: Is that so weird?
ADICHIE: Because they say to me - so sometimes when we're sort of - we're getting there at the restaurant, my friends, particularly my friend Choma who is this lovely woman who lives in Lagos. And she'll turn to me and say do not ask for steamed vegetables today. They don't do steamed vegetables. That is an American thing.
And, because, you know, vegetables are often drenched in oil or - so it's something. And I did have my phase of slightly American eating issues when I would, sort of, say I don't want any oil. Or I would say things like what kind of oil is that? And then my friends would say please just stop being so American. Oh, and I would complain about people smoking in public places and they would just shake their heads and say how American.
So little things of that sort. But I think that in general - but on the other hand, some of my cousins are very disappointed at my still remaining resolutely Nigerian. So when I go to my ancestral hometown I don't speak a word of English. I speak only Igbo. And my cousins are so disappointed, particularly that I don't have an American accent. They're very unhappy about that.
GROSS: OK. I want to thank you so much for talking with us. Thank you.
ADICHIE: Thank you.
BIANCULLI: Chimamanda Ngozi Adichie, speaking to Terry Gross last September. Her latest novel, "Americanah," is now out in paperback. You can read an excerpt on our website freshair.npr.org.
Coming up, we remember Dr. Sherwin Nuland, author of, "How We Die," the award-winning book on the final days of life. Dr. Nuland died Monday after an illness. This is FRESH AIR.
DAVID BIANCULLI, HOST: This is FRESH AIR. Because he was a doctor, Sherwin Nuland witnessed many deaths, including those in his own family. Dr. Nuland - who was a surgeon - was the author of "How We Die," an influential book about dying, which won a National Book Award. It was published in 1994. Twenty years after his book was published, Dr. Nuland himself died on Monday at his home in Connecticut from prostate cancer. He was 83.
"How We Die" was written at a time when the prevailing medical practice was to use all means available to extend the life of terminally ill patients for as long as possible - even if aggressive treatment also caused extended suffering in the final days of life. Nuland's book made a notable impact on the national debate about end-of-life care - at a time when palliative care and hospice movement were beginning to assume a bigger role in the care of terminally ill patients.
Terry Gross interviewed Dr. Nuland in 1994, when "How We Die" was published. His book described death in its biological and clinical reality. Dr. Nuland believed that only by a frank discussion of the very details of dying could we best deal with those aspects that frighten us the most. We all hope to die a good death, Dr. Nuland wrote, but the good death is a myth, and the chief ingredient of that myth is death with dignity.
SHERWIN NULAND: We have this idea which is propagated by books, by articles that we see in journals and in newspapers, that death somehow is a noble series of events that culminates in the great deathbed scene of the dying person - or perhaps the patriarchal person - surrounded by loved ones and he or she is imparting final wisdom, and then there are no strands left untied. That almost never happens, and when it does happen, it's an absolute coincidence and has very little to do with the life of the person that occurred before that final period of life.
TERRY GROSS, HOST: You feel you've rarely seen death with dignity?
NULAND: One of the points I try to make in this book - and I make it a number of times and a number of different ways - is that what gives dignity to death is the dignity of the life that preceded it. When we have brought about a situation where we are loved and we love, where our lives have been lives - not necessarily of great accomplishment, but of a sense of having given something to others - whether those others are as close to us as our children or parents or whether those others are as far away as a radio or a television audience. When we have done that, our deaths have dignity. Our deaths become a part of our lives in the sense that with our deaths we give something to those who are left behind as we have given our lives to them.
GROSS: In your book you write about something very personal that happened to you, and that was your brother had colon cancer. Colon cancer had killed your mother when you were 11. So when your brother got colon cancer, he asked you to be his doctor and to, you know, help him decide what he should do. And you say in your book that you had discovered how much the cancer had spread and how - just how far gone his condition was, but you didn't want to tell him the extent which the cancer was spreading. You were afraid of telling your brother the truth. You were afraid it would take away his hope. Why did you make that decision to not tell him the truth?
NULAND: Well, first, I have to point out that I wasn't his doctor. Actually, I've always followed a philosophy of choosing the best doctors I can for people in my family who become sick and just agreeing with what they think is appropriate if it seems reasonable, and that's what I did. In my brother's situation, he was in another city, he was here in New York City and of course I was in New Haven and I watched this process unfold. What actually happened was that he was operated upon and the finding was a very far advanced malignancy - which from every bit of clinical knowledge I had, and this is a disease that I treat every day of my life in New Haven - every bit of clinical knowledge I had could not possibly be cured.
I told my brother (unintelligible) cancer. I told my brother there was cancer in his liver. I did not want to beat him over the head by telling him there was fluid in his abdomen and there were cancer cells in the fluid and there were dots of cancer on every - virtually every - intraperitoneal, intra-abdominal organ. I didn't see at that point the sense in that. But the mistake that I made by not telling him everything was to make him think that there was a possibility that something could be done. What was even worse was that when I looked at him, my boyhood friend, you know - we had gone through so much together through all these years. When I looked at him, I saw in his eyes myself reflected, the smart kid brother who'd gone off to Yale and become a doctor and I should be able to save him. So I began looking - is there something new? Is there something new? And my god, there was an experimental therapy that I knew perfectly well stood only a small chance of getting him through.
But foolishly, at that time, I thought of hope as being the hope of cure, the hope of rescue, and I followed the philosophy that anything is better than death. So what I did was to put him through - this was at my suggestion, my recommendation - a series of chemotherapy treatments that stood only a very small chance of curing him. And what I succeeded in doing was to take away an opportunity for some months of being with his family at peace, slowly dying of this disease. And what I exchanged for it was a death that was terribly, terribly difficult. And I have not forgiven myself for it. I should not forgive myself for it. And I write about it in the book because I wanted people to know that with the very, very, very best of intentions what we sometimes think of as something very good for those we love turns out to be very bad for those we love, because had I been a detached, clinical physician in New Haven and such a patient had presented himself to me, I would've said don't do this chemotherapy protocol. It's senseless. You stand only a small chance of cure, we shouldn't do it. But this was my brother and so I lost all my objectivity and I tried it.
GROSS: Let me ask you. Had you not tried it after your brother died, might you have been wondering, say, we tried that therapy, sure there was only a small percentage that would've helped him, but it might have, maybe I should have given it a shot?
NULAND: That's one of the reasons I tried it.
NULAND: I didn't want to have to later on say, I should've given it a shot. But that's exactly what I mean when I say it's with the best of intentions...
NULAND: ...that we carry out these exercises in futility, we want to do the right thing. But what we should do is step back and let more objective people make such decisions.
GROSS: I recently read an article in The New York Times that talked about how difficult it is now for patients to make decisions about what course of therapy to take or whether to not take any at all because it's hopeless. And, you know, doctors have given us the chance to participate in the decisions. On the other hand, to participate intelligently you nearly have to become a doctor yourself sometimes. Is this a dilemma for you as a doctor, how much a patient needs to know in order to kind of participate in an educated way in one of these big decisions?
NULAND: Well, I think that's a major problem. We were taught in my day in medical school, and certainly that continued into the '60s, '70s and '80s, to be what's called a paternalistic physician. Only we can understand the proper course of therapy in any disease.
I tell the story in the book of a 92-year-old woman who had a perforated ulcer of a duodenum, and she came in with peritonitis, and she wanted to die. She had no relatives. She really felt she had nothing to look forward to. And I said, Ms. Welsch(ph), you know, there's a one in three chance, and you have to be crazy not to take the one in three chance, and I talked her into it.
She survived the operation, but she had a stroke a few weeks later when she was back at the convalescent hospital, and she died. And I realized looking back on the whole situation that I had taken my value system and forced it on her. And my value system as a high-tech surgeon in a university teaching hospital, a one in three chance was certainly appropriate to take. Anything is better than death.
Well, you know, that's not true. It's not true that anything is better than death. As a wise oncology nurse said to me, there are many people, more than you would dream, and many of our listeners I think probably fall into this category, for whom what you have to go through in order to come out on the other side alive is simply not worth the effort.
I've seen so many patients, particularly elderly patients, over the years who become debilitated and changed by the process by which I cure them or another doctor cures them. And has it really been worth it?
GROSS: One more thing, you talk about how doctors have always been taught to give their patients hope even if the patient is dying, but you write about the need to redefine hope. How do you define hope now, the kind of hope you want to give a dying patient?
NULAND: Well, let me define hope in a meaningful way, at least a way that's meaningful to me. You know, if we were going to use a dictionary definition of hope and look them all up, we would find out that the one thing that brings them all together is the belief that some good thing may yet happen. The good thing that may yet happen during dying is not the possibility of survival when we're beyond that point.
The good thing that may yet happen is that our lives will have great meaning for those we leave behind. To me the hope that can exist at the time of death is the hope of our heritage, that we have really meant something to people, whether they are our own children or friends or students, whatever - or people who listen to us on the radio. That's the hope, the hope that your heritage is something good for others.
And I think when you think of death as being part of the life cycle and recognize that death is an inevitability for our species because the world has to be renewed with each death, then the hope becomes when it is renewed it will be renewed by people on whom I have had some influence for good.
GROSS: I want to thank you very much for talking with us.
NULAND: Thank you.
BIANCULLI: Dr. Sherwin Nuland, the author of "How We Die," speaking with Terry Gross in 1994. He died Monday of prostate cancer at age of 83. Coming up, film critic David Edelstein reviews Wes Anderson's new movie "The Grand Budapest Hotel." This is FRESH AIR.
DAVID BIANCULLI, HOST: This is FRESH AIR. Director Wes Anderson's new feature, "The Grand Budapest Hotel," is set in Europe, largely between the world wars. Ralph Fiennes stars as the concierge of a teeming resort hotel along with a huge ensemble cast that includes Edward Norton, Jude Law and Bill Murray. Film critic David Edelstein has this review.
DAVID EDELSTEIN, BYLINE: Wes Anderson has his share of groupies and his somewhat smaller share of skeptics who find him a tad precious. As someone who leans toward the precious view but is open to his grace notes, I found "The Grand Budapest Hotel" mostly delightful. It's a madcap comedy but with hints of tragedy lurking outside the usual Anderson dollhouse frames.
The central character is Gustave H., played by Ralph Fiennes. He's the concierge of a kitschy, opulent, high-class European hotel between World Wars I and II. It takes a while to get to Gustave. We journey to the past via layers of narration. First a girl pays tribute to the statue of a dead author. Then Anderson cuts to the author, played by Tom Wilkinson, who tells the story of his middle-aged self, that's Jude Law, on a trip to the faded hotel in the 1960s.
And then Law's character takes over the narration and tells us how he met the hotel owner, Mr. Moustafa, played by F. Murray Abraham, and how Moustafa told him of his time in the '30s as a lobby boy and assistant to Gustave H. Why a story within a story within a story within a story? Anderson's inspiration comes from the Stefan Zweig, a writer who fled Vienna before Hitler's assent and then labored to evoke the world he left behind for fear it would pass from memory.
Anderson's Chinese boxes storytelling takes the onus off him to be realistic. In memory, everything is stylized, gloriously fake and yet brimming with real longing. Composition and color isn't incidental; it's the whole deal. The mountainside Grand Budapest Hotel is a miniature, a dollhouse reached by model train. Inside it expands. It's immense. The choreography of staff and guests is busy and militaristic in its precision. The colors are intense: pink walls, crimson carpets, staff waistcoats of electric magenta. Anderson can make you dream of a design for living on a higher, more beautiful plane.
Young Moustafa, played by Tony Revolori, meets Gustave in the course of mid-morning rounds and is at first an unpleasant surprise. The teen has been hired without his knowledge by an underling played by Larry Pine. And so they walk through the capacious lobby.
(SOUNDBITE OF MOVIE, "THE GRAND BUDAPEST HOTEL")
RALPH FIENNES: (As Gustave) Who are you?
TONY REVOLORI: (As Zero) I'm Zero, sir, the new lobby boy.
FIENNES: (As Gustave) Zero, you say?
REVOLORI: (As Zero) Yes, sir.
FIENNES: (As Gustave) Well, I've never heard of you, never laid eyes on you. Who hired you?
REVOLORI: (As Zero) Ms. Moser, sir.
FIENNES: (As Gustave) Mr. Moser?
LARRY PINE: (As Mr. Moser) Yes, Mr. Gustave?
FIENNES: (As Gustave) Am I to understand you've surreptitiously hired this man in the position of a lobby boy?
PINE: (As Mr. Moser) He's been engaged for a trial period, pending your approval, of course.
FIENNES: (As Gustave) Perhaps, yes. Thank you, Mr. Moser.
PINE: (As Mr. Moser) You're most welcome, Monsieur Gustave.
FIENNES: (As Gustave) You're now going to be officially interviewed.
REVOLORI: (As Zero) Should I go light the candle first, sir?
FIENNES: (As Gustave) What? No.
(As Gustave) Experience.
REVOLORI: (As Zero) Hotel Kinsky(ph), kitchen boy, six months. Hotel Berlitz, mop and broom boy, three months. Before that I was a skillet scrubber...
FIENNES: (As Gustave) Experience, zero.
UNIDENTIFIED MAN: (As character) Thank you again, Mr. Gustave.
FIENNES: (As Gustave) Straighten that cap. The pleasure's mine, Herr Schneider.
UNIDENTIFIED MAN: (As character) (Unintelligible).
FIENNES: (As Gustave) These are not acceptable.
UNIDENTIFIED MAN: (As character) I fully agree.
FIENNES: (As Gustave) Education.
REVOLORI: (As Zero) I studied reading and spelling. I started my primary school. I almost finished.
FIENNES: (As Gustave) Education, zero.
UNIDENTIFIED MAN: (As character) Now it's exploded.
FIENNES: (As Gustave) Good morning, Cicero, call the goddamn plumber.
UNIDENTIFIED WOMAN: (As character) This afternoon, Monsieur Gustave.
FIENNES: (As Gustave) (Unintelligible). Family?
REVOLORI: (As Zero) Zero.
EDELSTEIN: Anderson's visuals are so witty they transcend camp, but his dialogue isn't quite at that level. That's why it's good he has Ralph Fiennes, a stage pro who moves with aplomb and speaks his lines so trippingly they sound like they're funnier than they are.
Sundry guest starts lend their wattage to "The Grand Budapest Hotel": Tilda Swinton, Bill Murray, Jeff Goldblum, Owen Wilson, Adrien Brody, Jason Schwartzman, Harvey Keitel. Anderson is a Pied Piper who picks up actors as he goes along. And it would be nice if they had, you know, roles. But the pop-up cameos are a source of pleasure. They give the film a family vibe.
Oh yes, there's a plot. Gustave is given to bedding his elderly guests, and one, Tilda Swinton, withered by makeup, has a premonition of her death. When news comes she has indeed died, Gustave grabs Zero and boards a train for her mansion. Soon, he's blamed for her murder and hunted by police, led by Edward Norton and a grim-faced assassin played by Willem Defoe.
BIANCULLI: The last half of "The Grand Budapest Hotel" has a chase through the Alps that's staged and shot like a pipe dream of flight. It's thrilling. And Anderson's campy dialogue doesn't hurt too much. Somehow, it makes Europe's encroaching fascism seem even creepier. The final scenes are handled with delicacy but deliver an emotional wallop. It's a movie that makes you sad to re-enter the real world, in which people are less exuberant, proportions less harmonious, and colors far less vivid.
David Edelstein is film critic for New York magazine. He reviewed "The Grand Budapest Hotel" by Wes Anderson.
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