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12 of 12 people found the following review helpful
5.0 out of 5 stars A fantastic achievement
This book is a tremendous achievement, as well as being a very moving personal document. It is a philosophical meditation on the nature of and social meaning illness, disease and death. It discusses philosophical and psychological literature, Epicurus, Heidegger and Merleau-Ponty. But it is also a personal memoir, it is about Carel's experience of being diagnosed with a...
Published on 19 Sep 2008 by Christopher D. Bertram

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1 of 13 people found the following review helpful
2.0 out of 5 stars Illness: art of living
Rather pompous book that reminded me of first year philopsphy. The deep thought has not been translated into a guide that will assist people to intereact with those with serious illness, even tho the author complains that people didnt treat her well and wanted them to behave differently.
Published on 26 Feb 2010 by Lois Parker


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12 of 12 people found the following review helpful
5.0 out of 5 stars A fantastic achievement, 19 Sep 2008
By 
Christopher D. Bertram (Bristol, England) - See all my reviews
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This book is a tremendous achievement, as well as being a very moving personal document. It is a philosophical meditation on the nature of and social meaning illness, disease and death. It discusses philosophical and psychological literature, Epicurus, Heidegger and Merleau-Ponty. But it is also a personal memoir, it is about Carel's experience of being diagnosed with a life-threatening illness, about what that meant for her presence in the world, about how she appeared in the eyes of others, and how she felt she appeared. It is about the encounter with medical professionals and their detached and external perspective on another's catastrophe; it is about the varied reactions of friends, some of whom couldn't maintain friendship. It is about how to confront the fact that all your assumptions about how your life is going to go: career, relationships, family, old age, can just be taken away. Carel was diagnosed with lymphangioleiomyomatosis (LAM), a rare disease that affects young women, and for which the progosis is about 10 years from the onset of symptoms. The sufferer experiences a progressive decline in lung-function over that time. Life may be extended by a heart-lung transplant, but that's, obviously, a difficult business.

I'm not much of a fan of "contintental" philosophy, because I've often found it obscure to obscurantist. Carel, however, is trained in that tradition and is really good at overcoming the resistance of sceptics like me. She uses Merleau-Ponty's ideas about embodied subjectivity throughout the book to explore what illness is like for the sick person and how powers and abilities that are invisible to and taken for granted by the well person become all too manifest to the sick (or disabled or ageing) person. All the time, she is constantly moving backwards and forwards between this theoretical discussion and the fact of her own experience: the first onset of symptoms, "denial", diagnosis, treatment, the foreclosure of plans, projects, possibilities. The phenomenology of social situations gets explored too: how people react, their sensitivities and insensitivities, callous reactions, stupid injunctions from ignorant people to try faddish diets of exercise routines.

The discussions of Heidegger and Epicurus I found a little hard going at times. Carel does a brilliant job, I think, of making Heidegger clear. But in doing so she brings to the surface, of my mind at least, the suspicion that, far from being a radical philosopher, he was often turning into universal truths the parochial facts of European bourgeois life: not everyone has a career, nor sees their life as a structured series of projects. But then I'm not a Heidegger scholar, and perhaps I'm being unfair to him. In a sense, issues of Heidegger interpretation don't matter, because Carel is just using the philosophical traditions most available to her to reflect on the social and personal meaning of the imminence of death.
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4 of 4 people found the following review helpful
5.0 out of 5 stars Exceptional - a must read, 9 Oct 2008
By 
M. Jeffreys (UK) - See all my reviews
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This is a book that will challenge your view of many things - how we live, how we face, challenge and ultimately cope with illness and death.

Having previously written a book on the philosophy of death, Carel finds herself in the position of having been diagnosed with a life-threatening illness. In a highly readable, yet learned account, Carel takes us on a journey which intertwines her personal and professional understanding of life, living, illness and death.

I would never have thought that I could call a philosophical text a page-turner. But it is. I have never previously read any philosophy, and did not even know the word "phenomenology", and was amazed at the clarity with which Carel explains her, and others', thoughts and ideas.

There is no doubt that health professionals and medical students should read this. It will give you an insight that you might otherwise never have, from the unique standpoint of philosopher, patient and articulate author.

Carel has written an outstanding piece of work. Her poignant descriptions of what she has faced and how she has been treated (occasionally well, mostly badly) in the past few years, by friends, health professionals and total strangers will move you to tears. But the book does not read as a cathartic attempt to accept her fate, and is far more than a personal memoir. It seeks to understand what she has experienced in a philosophical framework, and offers this to others as a practically useful way of understanding and coming to terms with experience of life-threatening illness.
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3 of 3 people found the following review helpful
5.0 out of 5 stars A beautifully convincing book, 8 Nov 2008
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I started reading this book on the way home from work and didn't stop until I went to sleep that night. This is not your usual philosophical work. I was grabbed by the reality of the issues discussed through Carel's poignant first-person descriptions of her experience of illness. However, this does not in any way diminish the philosophical merit of the work. In fact, it is the irreducible importance of this first-person perspective that is the work's whole point.

Carel argues that medicine (and, indeed, everyone) needs to take into account what it is like, moment to moment, day to day, for a patient to live their life within illness. She describes medicine as currently working from an objective, nonvalue-laden conception of disease, thus ignoring the patients subjective point of view. I actually think that this is a bit too strong. I think that medicine, at least implicitly, treats disease as a value-laden concept, and to a certain extent is set up to treat patients in such a way. However, the clever part of Carel's project is that it is impossible to go on and ignore the issue of a patient's lived-experience even if you think you have got the philosophical arguments out of the way. I do not think that phenomenology (a subjective first-person perspective) is the complete answer (I believe that medicine also needs a value-laden objective theory of disease in relation to an individual's flourishing, capabilities and functionings). However, Carel does not just illustrate, but through doing so, proves that it cannot stop there. Medicine will always need to take note of a first-person narrative account of illness. Exactly how a disease effects an individual's life cannot be fully got at in any other way.

Carel points the way towards a more holistic, value-orientated style of medicine. In my opinion, a lot more work needs to be done to show how this could be possible. But, most importantly, Carel shows why this work is a necessity.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Moving and Iluminating, 12 Dec 2008
By 
Sarah (Brighton, England) - See all my reviews
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As someone who is struggling with a chronic illness, I was drawn to this book to try to make sense of what has happened to me. Although my illness is different to the author's, I found much to recognise in her account of dealing with serious ill health at a relatively young age. At times I was moved to tears as I read her account of coming to terms with her illness. The author writes extremely clearly and openly about her experiences. Her interweaving of philosophical ideas is skillful and easy to follow, even if you don't have a philosophical background.

I cannot recommend this highly enough - perhaps particularly to those who are struggling with illness, but also to their friends and family who would like to understand their loved one's situation better.
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3 of 3 people found the following review helpful
4.0 out of 5 stars Won me over in the end, 18 April 2011
By 
Chris M. Dooks "bovinelife" (Glasgow) - See all my reviews
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Speaking as both a chronically ill person and a doctoral researcher in arts and health, I was keen to read this book as a kind of primer on philosophy and illness. I also wanted to see what paradigms Carel (who suffers from a rare lung disease) may suggest via her world of "altered ability" as some of the passages about her exhaustion and diagnosis are achingly and depressingly familiar to me. Can philosophy help me? The reader is in for a surprise with the line the author takes us around her world-view of illness. At least half this book wrestles with death. Before you read the book you may have some assumption that it will be about a soft and reflective view of illness. A kind of tonic. Carel's approach to her illness is augmented by a philosophy that pulls no punches here, which is why I liked it. I only signed on to read about illness! But here, illness and wellness are inexorably linked with mortality. Here, through philosophy we may `learn to die' in order to overcome both our topical maladies and existential ones.

While the academic tone often sometimes comes across as `justifying' academic terms and writing, (when a lay approach would be able to cut many words from the text) it is nonetheless not a heavy book where the reader/sufferer has to slice through a huge thicket of terms in order to get to a basic point. It's quite a short book that many ill people could read. It's 150 pages. It took me three days - which is pretty good given my own cognitive difficulty.

The main argument of the text is that anxiety about our impending death has no rational foundation. Once accepted and lived in the present moment, some kind of freedom can arise. What struck me, as an ex-card carrying Buddhist was that the ideas of Epicurus cited here - and the unmentioned philosophy of the historical Buddha or the subsequent schools of Buddhism - these are unbelievably close. In fact, I wondered why there was no mention of Buddhist philosophy at all in the text - perhaps because that simply wasn't the author's area/subject or through a fear that this would place this book in the more lightweight self help industry. Or maybe `philosophy' with a capital P lives only in Greece....

Either way, I felt it was a shame, especially since a great deal of the book talks about mindfulness and living in the present moment. I think - although I may be wrong, that the Buddha's teachings predate the teachings of Epicurus - but what I found interesting was that there was a "four-part" cure from Epicurus to counter fear and suffering, which I found to complement the "four noble truths" and the "noble eightfold path" - but maybe that's another book altogether. And maybe I am bringing unnecessary baggage to the table.

So, Death underpins the rhetoric of the book and it makes sense - any form of freedom from any malady can only be a "finite freedom" or a "bound freedom" on this earth and in these bodies - when death is a hundred percent effective. The main area of philosophical boxing occurs when the author pits philosophers Epicurus against Heidegger. Carel favours the appropriate intellectual (and maybe even kind) logic of Epicurus, and combines it with her `phenomenological' or `embodied' account of her sickness. She aims to fuse the two accounts in order to provide a sense of wholism. It's a technique, which when I first started reading the book really irritated me. As I say, it was as if the academic approach of naming processes like `phenomenology' was just paying lip-service to the fact that this is an academic argument with a lineage. It felt like reading a PhD at times. Maybe it was one.

But in the end, I left the work wanting to know which philosophers had the best ideas about how to combat illness and it left me looking at the bibliography wanting to know more about Epicurus and logical arguments about anxiety, illness and existential terror. It's actually a great book and for me has been an excellent introduction into philosophy as a tool, to facilitate a form of adaptation when faced with the slough of despond illness can bring.
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3 of 3 people found the following review helpful
5.0 out of 5 stars Compelling and life affirming, 9 May 2010
By 
Mr. David A. Braid (UK) - See all my reviews
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From the perspective of someone with good health - this book made me reavaluate many aspects of my own life. Life is short and a great deal shorter for some. Havi's two remarkable achievements - dealing with the illness and then giving her powerful and extremely well-thought out reflections to the world puts us all to shame. I for one look at my own petty issues in a new light. One of a hell of sacrifice from Havi has produced enormous positive beneifts for countless others - this book is valuable and far transcends its own subject matter in its reach. BUY IT and be glad with your life!!
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2 of 2 people found the following review helpful
5.0 out of 5 stars An excellent book, 11 July 2009
This is a generous book. Carel draws on her own experience of illness to think through her commitments to her own philosophical commitments -- and, equally, tries to think about and understand her illness from the viewpoint of her philosophical beliefs. The result is a book that has interesting things to say about how illness is experienced, how it is perceived (by patients and doctors, and by family and passers by), and how it might be better handled. This would make a good set text for medical students and GPs, as well as giving a picture of some of the arts of 'comfort' (or wisdom) that philosophy can offer.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Positively 10/10, 16 Jun 2011
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This is a short extremely well written book by a young active academic who finds herself at 35 categorised as suffering from lymphangioleiomyomatosis, a very rare chronic disease which is progressively debilitating and potentially life-threatening. There is no treatment except a matched lung-transplant. How does one cope with this absolutely deplorable situation ?
Perhaps Havi Karen, with her calm, detached philosophical approach was better suited than many to analyse her new circumstances and adapt successfully. One imagines that her bout of reactive depression was short-lived and, after much poignant thought, this book resulted, an amalgam of her own experience and her training as a philosopher.
She makes the point that the medical profession are very well formed to make "naturalistic" (read scientific) judgements to diagnose and treat, but ill-equipped to take on board the phenomenology (read first-hand experience) that the patient undergoes. This slants doctors' assessments of what could be beneficial to the patient away from potentially useful solutions.
Havi Karen also discusses illness as a disability, health within illness, and fear of death, and here she relies upon the stoics, especially Epicurus. She contrasts his view on mortality with Heidegger's and this is probably the most difficult part of the book for the general reader, although - for a philosopher - she writes with amazing transparency !
The result of her analysis of her change of circumstances is that, to lead a happy existence, it is necessary to live in the present not worrying about the quantity of happy occasions one might enjoy, rather the quality of the event as currently being experienced. I did wonder whether her advice could equally apply to those suffering from some mental confusion - schizophrenia, bi-polar disorder or endogenous depression for example - and had to conclude that Dr. Havi Karen was in a much stronger position to deal with her problem in spite of such a dire prognosis.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Even if you are not ill (yet) read this book! (It is not depressing), 7 Jun 2010
By 
Ransen Owen (Italy) - See all my reviews
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Even if you are not ill (yet) read this book! You will be ill sooner or later and you'll eventually become so seriously ill that you will die.

Apart from some practical thoughtfull advice to doctors and nurses (and not least friends) the book has good useful summaries of what some philosphers thought about dying and how to approach it.

The book is personal and refreshingly untheoretical.
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2 of 2 people found the following review helpful
4.0 out of 5 stars Read Havi Carel's book, 23 Mar 2010
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I found this book gripping. Although this might sound perverse, I loved Havi Carel's moving account of the moment of discovery of her very serious illness, LAM, and of her subsequent description of her decline in her physical capacities. I loved her account of her slow coming- to -terms with her illness. I do sometimes, believe it or not, feel excitement about a more abstract piece of philosophical writing. Havi Carel's book, though, works both as autobiography and as phenomenological analysis of the ill body.

Havi's personal story of gradual awareness, on so many levels, of her own ill body is profoundly poignant. From her personal experience she weaves a phenomenologically informed account of the lived experience of a body that is not `normally healthy' and a discussion of the way in which, for some health professionals, illness is perceived objectively, in terms that are naturalising and alienating for the person on the receiving end of them. She writes about Heidegger on the finitude of life and about Epicurus on our fear of death.

This is a book that may speak to many on a range of different levels. It may speak to those who have been diagnosed with life threatening diseases; to those who suffer from more `low level' complaints - both physical and psychological. It must surely also speak to some health professionals who, maybe, despite themselves, operate with a more objectivising, naturalising, picture of the lived body.

I once read a review of the wonderful therapeutic book `Love's Executioner' by Irvin Yalom. It read 'Irvin Yalom writes like an angel about the devils that besiege us'. Havi Carel also writes powerfully about her own devil.

Alison Assiter.
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