Poor communication between doctors and patients is widely seen as a problem in American healthcare. Now more and more healthcare providers are giving patients new ways of accessing doctors to ask questions or express concerns. In the age of email, texting, video chatting and social media, a look at the promise and limitations of digital communication to improve patient experiences and outcomes.
Guest Host: Frank Sesno
In Ian McEwan’s new novel, a 17-year-old boy is dying. As a Jehovah’s Witness, he cannot agree to a potentially lifesaving blood transfusion — so a British family court judge must decide his fate. In doing so, she is forced to confront her own vulnerabilities, and learn to live with the consequences of her decision. McEwan, a Booker Prize-winning author, joins guest host Frank Sesno to discuss his latest novel.
- Ian McEwan author of 13 novels including "Atonement" and the Man Booker Prize-winning "Amsterdam."
Read A Featured Excerpt
Excerpted from “The Children Act” by Ian McEwan. © 2014. Reprinted with permission from Penguin Random House.All Rights Reserved.
MR. FRANK SESNOAnd thanks for joining us, I'm Frank Sesno, host of Planet Forward and I'm director of the School of Media and Public Affairs at the George Washington University where Planet Forward is based. I'm sitting in for Diane Rehm today. She's recovering from a voice treatment and will be back soon. Well, a dying teenage boy refuses medical treatment because of his religion and a family court judge must decide his fate.
MR. FRANK SESNOThat's the storyline of Ian McEwan's latest novel. It explores the conflict between a boy's faith and a society's laws to protect the welfare of its children. The book is titled "The Children Act," and author Ian McEwan joins me from an NPR studio in New York. And Ian McEwan, it is a great privilege to be speaking with you today.
MR. IAN MCEWANGreat pleasure to be here.
SESNOWell, this book is a, for me anyway, it was a bit of a show-stopper, all of the rest of the world had to cease while I worked my way through this. It's an engrossing story at so many different levels. Start by telling us about Fiona Maye and Jack Maye, two of the central characters in this book.
MCEWANWell, Fiona Maye is a high court judge in what we call the family division, dealing with divorce and other matters around death and illness and medical ethics and so on. She and Jack have been married, more or less, their entire adult lives. Their marriage has hit something of a crisis. He wants to go off and have an affair with her ascent to have one last great excitement before he thinks it's too late.
MCEWANAnd this is the under tow of the dilemma, the legal decision she has to settle that you mentioned earlier. So she's a childless woman, and this is crucial, really, to the unfolding of this.
SESNOTheir marriage has not been a cold or bitter marriage. It has not even been a loveless marriage, but it has been largely a sexless marriage for some time.
MCEWANFor some time, but before that, she remembers fondly that it was really beyond discussion. It was efficient and good and lusty and they never discussed it much. They took it for granted. It delivered them easily into the rest of their lives. But slowly, it's faded away and he's not expressed profound impatience and wants to be off and she has, basically, said, as many women would, well, if you want to do that, that's the end of the whole marriage.
SESNOAnd she, ultimately, changes the locks.
MCEWANShe does that thing that she has spent all her time when she was an attorney, when she was a barrister and ever since, it's the great cliche of a disintegrating marriage that one party goes and changes the locks. And she now, having told everyone in the world never to do such a stupid thing, finds herself not quite as rational as she thought she was.
SESNOBut the central storyline of the book is wrapped around the Children Act, which is also the title of the book so let's start with that. What is the Children Act?
MCEWANThis was a piece of legislation that came, you know, on the back of many others over the last 100 years, but it formalized various fundamental rights that children have and what the courts need to consider. And it sounds a bit tautologist, sounds as if it's just a circular argument, but basically, it tells the court that in any situation when having to deal about a contested fate of a child, the child's welfare must be the court's paramount consideration, those are the exact words, and that means that the child's welfare is separate from his parents.
MCEWANWhat the parent wants is not necessarily what the court will consider to be in the child's best interest, what the parents' religion is is not necessarily in the child's best interest. And so this has, over the years, it's gone through many versions since 1989, but this is our fundamental statement of rights of children.
SESNOAnd Ian McEwan, the child in the case of this story is barely a child.
MCEWANYes. He's almost 18. He's exceptionally bright. He's one of those kids -- I wonder if many people have this. He's on the edge of wanting to discover the whole world and poetry and music and the sense of joy of being alive are in contest with his profound and very sincerely held religious faith, as he's been brought up as a Jehovah's Witness. And his parents, too, are saying that he shouldn't have this blood transfusion.
SESNOAnd the blood transfusion is because of what?
MCEWANHe has leukemia and certain effective treatments for childhood leukemia strip the body of its ability to make blood cells. So to backup the treatment, you need to constantly keep the blood count up. Otherwise, you suffer really disastrous consequences.
SESNOSo his story, Adam Henry's story, comes before our judge, whose husband has just said, I want to go and explore, rediscover myself, or whatever it is he's trying to do. It places her in a remarkably difficult reflective place.
MCEWANYes. She finds herself -- I mean, she's a highly articulate and rational person, but she finds herself completely incapable of dealing with this situation. She doesn't phone any of her friends. She doesn't really want to give it truth and life by talking about it. She rather folds in on herself with this and it's with some relief -- she's duty judge, ready to take a call at any time. It's with some relief she gets the call from her clerk saying here's this case.
MCEWANShe enters what she likes to think of as the treeless heath of other people's problems and it's there that she wants to sink herself in the case, rather than think about what's happening at home.
SESNOSo your parents here, Adam's parents, are drivers of this discussion. It allows for quite a conversation about the role of religion and the rights of children within that context. Tell us about the parents as we introduce these characters.
MCEWANWell, he's a man of great dignity. Neither parent seems particularly awed by the court as we go into the court scene, which happens very quickly after that phone call. Both parents are, yes, great certainty and dignity and it's the father who speaks to the court from the stand laying out his position. At one point, he says to the cross-examining council, well, you probably never have had to submit to a higher authority.
MCEWANAnd, actually, he equips himself very well. He understands, clearly, his own mind. He's convinced that his son knows his own mind, too, and does not waiver in the certainty that the Bible is the word of God and the belief of the Jehovah's Witnesses is such that to take on the blood of someone else into your body is against God's commandment...
SESNOAnd so the great...
MCEWAN...as set out in Leviticus and Acts and Genesis.
SESNORight. And so the great dilemma that you present the court with, that you present the judge with, that you present the reader with is Adam's rights to pursue his religious beliefs versus the welfare, and in this case, his life. I wonder if you could read a short passage that comes from the court hearing where the consultant hematologist is called upon to describe what will happen to this 17-year-old boy if he does not have this transfusion that his parents and he say that they refuse because of their religious beliefs.
MCEWANYes. This is a man called Mr. Carter. "Carter said slowly, it will be distressing, not only for himself, but for the medical team treating him. Some of the staff are angry. They routinely hang blood, as the Americans put it, all day long. They simply can't understand why they should be risking losing this patient. One feature of his decline will be his fight to breathe, a fight he will find frightening and is bound to lose.
MCEWANThen, sensation will be one of drowning slowly. Before that, he may suffer internal bleeding, renal failure is a possibility. Some patients lose their sight. Or he may suffer a stroke with any number of neurological consequences. Cases differ. The only sure thing is that it would be a horrible death."
SESNOAnd the judge then, Fiona Maye, must do what?
MCEWANWell, she does something rather extraordinary and unorthodox, but I know this has happened. She suspends the court proceedings. She gets in a taxi. She crosses London and she goes to sit at the boy's bedside. And this, for me, really was, Frank, the crucial scene to write because something has to pass between them. She begins to feel a great deal of sympathy for this boy and he, in turn, feels that she's like some light coming into his own life and yet, they don't speak of this directly.
SESNOIt is actually a tantalizing and difficult scene because as a reader, I'm not quite sure what to make of this moment that may become a relationship between, what, a judge and a boy, two young -- two people who oddly are thrown together, a purely business-like arrangement, a mother and son? What am I to make of this?
MCEWANHe's a boy of exceptional intelligence and liveliness and full of paradox. He fully expects to be die, to be allowed to die. At the same time, he's teaching himself the violin. To learn a musical instrument is always a hopeful act that implies a future. For her part, Fiona is not there to persuade him one way or the other. She's there only to listen and to gauge his intensions and to discover whether he fully understands the consequences of his decision or whether he's not locked into some rather romantic idea of death that ignores the kinds of things that the doctors were saying. So it's a tentative exploration at first.
SESNOComing up, more with author Ian McEwan on families, religion and "The Children Act." You're listening to "The Diane Rehm Show."
SESNOI'm Frank Sesno, sitting in for Diane Rehm today. And welcome back to "The Diane Rehm Show." We are talking with author Ian McEwan. His latest book, "The Children Act." He is author -- and has been on this program many times -- of many other books, including, "Solar," "Saturday," "Atonement," "Amsterdam." Ian McEwan, thanks again for being with us.
SESNOAnd an invitation to our audience, to our listeners, if you'd like to ask Ian McEwan a question, you can give us a call at 1-800-433-8850 or send us an email at firstname.lastname@example.org. We will get to your questions and emails in a few minutes. Ian McEwan, the other big theme of course in this book is families and families in crisis. And you write about this parade of divorcees coming before this judge, Fiona May and before her court. And there is a passage that is just sort of dripping with the kinds of situations, crisis, that the court and society sees. Perhaps you could read that.
MCEWANYes. It springs from my sense that too many divorces pay no attention, the mother, the father, to the consequences for the children. And it's all done a little too easily. And this is what flows in front of Fiona, the judge. "Greedy husbands versus greedy wives, maneuvering like nations at the end of a war. Grabbing from the ruins what spoils they could before the final withdrawal. Men concealing their funds in foreign accounts. Women demanding a life of ease forever. Mothers preventing children from seeing their fathers, despite court orders.
MCEWAN"Fathers neglecting to support their children, despite court orders. Husbands hitting wives and children. Wives lying in spiteful. One party or the other, or both, drunk or drug-addled or psychotic. And children, again, forced to become carers of an inadequate parent, children genuinely abused, sexually, mentally, both. They have evidence relayed on screen to the court. And beyond Fiona's reach, in cases reserved for the criminal, rather than the family courts, children tortured, starved or beaten to death. Evil spirits thrashed out of them in animist rites.
MCEWAN"Gruesome young stepfathers breaking toddlers' bones, while dim, compliant mothers looked on. And drugs, drink, extreme household squalor, indifferent neighbors selectively deaf to the screaming and careless or hard-pressed social workers failing to intervene."
SESNOIt is a sweeping indictment of our system. And it is a riveting account of its flaws. How did you come to this topic and this issue to build this novel around?
MCEWANI started to read a couple of legal judgments, having got to know a judge rather well and listening to his shop talk. And in fact, found myself at dinner with several judges and listening to them talk to each other, on the extent to which they read each other. And I began to think that the family division, rather than the criminal division, has really pitched itself right in the center of fiction's concerns. We're looking here at love and the end of love coming through the courts. The destinies of children, of deathbed wishes, medically ethics.
MCEWANSo much that the novel has concerned itself with the ordinary conflicts of life, not the things that happen with guns, with knives, with robberies, which all happen in people's lives as extraordinary and cataclysmic and unusual things. These are more the ordinary, terrible things that happen to people. So I began to just get drawn into the ways in which these judgments were in themselves rather like short stories. They sketched out. So, go ahead.
SESNONo, no. And the overlay of religion, which fascinates me -- and you have been critical of religion in your public -- in some public statements that you have made. I'm curious how you decided to bring that to bear. Obviously, that's sharpens, it sharpens the dilemma. It sharpens the conflict and the decision that must be made.
MCEWANI noticed in a lot of these divorces and the judgments I was reading, that religious differences between the parents had to be settled by the courts. Or religious intentions of the parents, like not wanting a child -- Siamese twins separated. Preferring them both to die, whereas one could be saved. These decisions come before the court. So the secular imagination or the secular spirit of the court, finding itself in contest with very sincerely held religious belief. And I thought, well, this is a moral question that really is vibrant at every level of our daily lives.
MCEWANWhen the court decides on the basis of its secular, rational sense of what's right, what then does it replace religion with? I think this is always the great challenge for the secular spirit. Religions might be prepared to sacrifice a child for a point of dogma, but those same religions are offering community support, intense togetherness. The courts are offering nothing of that sort. So it's not a one-sided matter for me. This is something that plays out in all kinds of ways, in all kinds of different levels. And the family court judgments really bring them together in the most compact way.
SESNOWe're talking with Ian McEwan, author of his latest novel, "The Children Act." And you can give a call and ask him a question if you'd like at 1-800-433-8850. Or send us an email at email@example.com. On this subject of religion, Ian McEwan, the research you did about the Jehovah Witness faith, how well do you think you came to understand it? How did you climb inside of it?
MCEWANWell, I met quite a lot of Jehovah's Witnesses. And, in fact, sometimes I didn't even have to go very far. They came knocking on my door. And so I was always very straight with them. I said, "Listen, I'm writing a novel that has a Jehovah's Witness in it. And can you help me with this? Have I got it right? And is this what you would think and do?" And so we'd often stand on my doorstep for an hour, talking. I said, "Listen, I have to tell you that I'm not a person of faith. So, you know, you must take my questions in that context."
SESNOAnd they talked to you?
MCEWANThey were all very lively, very polite, very helpful.
SESNOThey talked to you -- they talked to you -- and they talked to you anyway, when you said that?
MCEWANThey talked to me anyway. Sometimes rather humorously. So I had some respect for them because they had a great sense of some interchange. They knew they couldn't turn me around and I certainly didn't think I could turn them around. So we agreed to disagree, but we could speak openly and courteously.
SESNOYou know, to this point, an interesting comment that was made in the New York Times review of this book. And it noted that although Adam, the character's faith drives the plot, they wrote, "It goes oddly unexplored," their words, they said, "McEwan seems to have little interest in Jehovah's Witnesses. He's usually one of the most inquisitive of novelists." And then it says, "This vagueness makes the novel seem more allegorically than real, a kind of fable about faith versus science and the State." What do you say about that?
MCEWANWell, I think it's pure nonsense. Some reviewers don't read all the book. I'm used to that. I give the father the fullest, warmest possible account in court of the Jehovah's Witness position. And I give it also to the boy. And he speaks and tells it, not only from his hospital bed, but also in a letter of how he's losing his faith. No. I got fully behind and tried to give as much dignity as I could to the Witness position.
SESNOI think one of the most interesting situations that you present us with, is this very ambiguous sense of what the boy's own faith really is. Is it his faith or, essentially, is he channeling his parents' faith? And of course it's up to the judge to have to navigate her way through that because she must decide.
MCEWANYes. And because he's almost 18, it becomes what the law calls an anxious question. He's not fully in charge of his own thoughts because he's lived within a very tight community. But, on the other hand, it's a very, very problematic business to allow a hospital to treat a patient against their wishes. That's criminal assault. So for that matter it's an anxious question. Most people's religion is the religion of their parents. And I think we accept that people grow up in communities of belief.
MCEWANJehovah's Witnesses is -- their communities are fairly tight and intimate. And the judge is bound to think, well, has he been exposed to a whole range of ideas? If he was just one minute past his 18th birthday, we would have to say - the courts would have to say he's perfectly entitled to make himself a martyr to his faith.
MCEWANAnd as happens here, it often happens that children who've been saved by the courts because they're still technically children, go back into a hospital a few years later and make their own decision. What the courts can't accept is parents allowing their child to be a martyr to the faith. Only an adult can take that decision for herself or himself.
SESNOIn your research for this book, and in the time you spent looking into family court and being in family court, do you feel that our children are served by our legal system?
MCEWANWell, you probably know that in Britain we have suffered a tsunami of child abuse cases, culminating just recently in 1,800 children abused over a number of years by the Pakistani community. And largely politically correctness keeping this off the radar.
SESNOAnd you have BBC and other famous celebrities who, similarly…
MCEWANOh, gosh, we've had celebrities, we've had a whole crises within the church, within the BBC, within political institutions. So there is a huge distance between what's written down in the legislation, which seems so humane and sensible, and what actually happens on the ground. And it's that distance, I think, that we really have to confront.
SESNOOver the years you've expressed -- as I mentioned earlier -- some criticism, even contempt for religion. Was it difficult for you to have this theme running through the book and keep your skepticism out of it and keep Fiona's voice, the judge, in it and completely detached and professional?
MCEWANI think it's the only way to give the story life, is to make sure that all quarters are given as much warmth and expression and dignity as possible. I think the novel would be dull if I simply turned it into an atheist tract, in which I gave all the best lines to Fiona and none to the others, to the other side, to the Jehovah's Witness. It was important to spread one sympathies deeply. Fiona doesn't come out of it entirely well. And the boy suffers tragically for his beliefs.
SESNOI'm Frank Sesno, and you are listening to "The Diane Rehm Show." If you would like to join us and author Ian McEwan with a question or a comment, please give us a call at 1-800-433-8850. Or send an email to firstname.lastname@example.org. And we'll be moving to your calls and your emails in just a moment.
SESNOBefore I do that, though, Ian McEwan, I want to follow up on that question from just a moment ago. The incredible, scandalous discoveries in Britain of some of this child sexual abuse and other abuse and the question I asked you about the failings of this system. Has your novel, in Britain, touched a particular nerve because of the timing? Obviously you couldn't have imagined this, but it really comes at an extraordinary moment in what the public is hearing by way of child welfare through the system.
MCEWANWell, it has. I mean, and this has got nothing to do with Jehovah's Witnesses nor, for that matter, with religion. It's entirely a matter of the extent to which we protect children. We are still dazed, I think, from the revelations of the last two years. It's really difficult for us to fully understand this. And we do also have this problem from the other end, which is that the courts sometimes ignoring what's in "The Children Act."
MCEWANAnd, on the basis of expert witness evidence, removing children from parents without giving the parents any voice or recourse to make their own cases. So sometimes the state is over-weaning and coming between children and their parents in ways that are, again, completely against the spirit of the act. So we've got this from both ends.
MCEWANSometimes the state is ignoring this -- the system is ignoring the problems and sometimes it's overreacting and getting everything wrong. We clearly need to take a good look at how we implement acts like this that protect the children. We need to look at this much more closely because we are suffering, as I say, from both ends of the spectrum.
SESNOAgain, we're talking to Ian McEwan, author of the new book, the new novel, "The Children Act." And you'll note in our conversations -- and, Ian McEwan, you'll note that I am not asking you what Fiona May does, with respect to her husband or how she decides in her court, or how this unfolds, because that would be, I think, wrong to ask you that. And if you answer it…
MCEWANThat's kind of you, Frank. Thank you very much.
SESNOBut I would like to move to the phones now. And, Shonna, who calls us from Rochester, N.Y. Go -- Hi. Go ahead, Shonna. Thanks for waiting.
SHONNAHi. Thanks for taking my call. I just wanted to point out that, for example, in New York State, and some other states I know, the question of Jehovah's Witness parents is very simple because there's a long case tradition of judges saying the parents do not, under any circumstances, have the right to go along with or participate in the death of their child. Now, if the boy is just over 18 that becomes problematic. And I have watched perfectly salvageable people die because of this thing.
SESNOShonna, are you -- if I may ask, are you a judge or an attorney? Are you close to this situation?
SHONNAI'm a physician. I'd be the one petitioning the court so that we can save the life of the patient. I've done that a few times.
SESNOFascinating. Fascinating. Ian McEwan, comment?
MCEWANWell, that's very interesting to hear that. And it's more or less the same in Britain. When the child is still, say, a 10 year old, there's no question that the courts will not allow them to be martyred to a point of faith. The anxious question, to come back to that phrase, is when the child is almost 18. But even there, now, I think the common law case load is such that judges will just try and keep everyone alive for as long as they have jurisdiction.
MCEWANBut, as I said, a minute past the 18th birthday, there's nothing a hospital authority can do. And there's nothing that the courts can do if an 18 year old wants to die for his or her religion. That is their right.
SESNOIn your story, there is no ambiguity from the medical community.
MCEWANNo. It's often, as I've said before, a case of -- and a cause of great distress to medical staff because they know they can save this patient. That's what all their training tells them to do. And it's often agonizing. Not only for the doctors who approach the courts, but for the nurses who are in immediate attendance.
SESNOWe are speaking with Ian McEwan, author of "The Children Act," his latest novel of many. I'm Frank Sesno, sitting in for Diane Rehm today. When we come back we'll take your calls and questions. You can call us at 1-800-433-8850 or send us an email at email@example.com.
SESNOWelcome back to "The Diane Rehm Show." I'm -- excuse me, Frank Sesno sitting in for Diane Rehm today. And our guest is Ian McEwan, author of "The Children Act." Excuse me. Ian McEwan, let me go to the phones now while I can still speak and bring in a caller. Mike joins us from St. Louis. Hello, Mike. Go ahead with your question.
MIKEWonderful. I got into the show a little late but I really enjoy one thing -- or a couple things that the doctor said, particularly when he said when they would come -- when the witnesses would come to the door they knew that he wasn't going to be convinced and he wasn't going to be able to turn them. That is such a wonderful statement. A lot of people really get the wrong impression that Jehovah's Witnesses are there to convert you at the door. What they're actually doing is they're doing what Jesus said, which is going to the door to talk with people about religion.
MIKEAnd whether they agree or not, you're to be respectful and also to -- it expands that line as well when those have different thoughts. But back to a question or a statement you also mentioned, as I was on hold, there was a lady who called and said that basically witnesses allow to -- their children die. And that is such a misnomer. We will try any type of medical procedure as long as it doesn't violate our God-given instructions, as far as blood and other things are concerned.
MIKEAnd that when witnesses teach their children about what happens in death, unlike other religions who teach horrible things of hell fire and all those kind of things, when witnesses teach them what death really is then it's not this grotesque or horrible thing that happens. And so therefore, the children are very brave. Now, I have not read the book and I will read your book, I promise that.
SESNOOkay. Mike, thank you very much. Let me let Ian McEwan comment.
MCEWANWell, it's true that witnesses and hospitals have worked together to find ways around the prescription on blood, like recycling the patient's own blood to work towards bloodless surgery and so on. But there do arise these quite straight forward cases where leukemia drugs, anticancer drugs require a direct transfusion. Now some witnesses have accepted various forms of blood product and not others, but still the main stream view, based on Leviticus, Acts and Genesis is that they do not allow themselves to take blood into the body.
MCEWANAnd we don't -- none of us know what death has in store for us but I think it behooves the courts to try and keep children alive especially when the doctors are saying they can do that for us.
SESNOLet's go to another...
MCEWANBut just to come back to your speaker's first moment, well, I mean, the great thing about the witnesses is they're not beheading anyone, they're not blowing anyone up, they're not threatening anyone. They always come to the door in a polite and respectful way. And for that, you know, I honor them.
SESNOJeff from Lakeland, Fla., go ahead.
JEFFHi. Thanks for taking my call. I wanted to ask the author if he had done any research on how cases such as this are handled in other countries that didn't have family court systems, especially in -- I know how they're handled in America, but what about other western democracies, I guess.
MCEWANWell, I looked at cases largely in the Anglophone world, which has common law procedures. There was a case just not so long ago in Australia where the court ruled that a 17-year-old must be transfused against his will. There was one in New Zealand not long before that. They come around pretty regularly, but how it goes down in Kazakhstan and Saudi Arabia, I'm afraid I don't know. I mean, the fact is, Jehovah's Witnesses are spread right across the world. And -- but no, I kept -- my research is confined to untranslated English court documents.
SESNOAn email from Laura in Michigan who writes, "Mr. McEwan, I've always admired that your characters are so vividly real and how they're pulled in different and sometimes opposite directions. "On Chesil Beach," "Solar" are examples. How would you describe your process in depicting character?"
MCEWANWell, it's very hard. It never quite seems like a process that repeats. In this case, what did I do? I supposed I sort of emptied my mind and let this judge walk towards me out of a mist. One sentence about her led to another and suddenly she was before me, a rather self-contained, rather dignified lady, not particularly emotionally articulate. Not very fond of talking in personal terms, and a woman haunted by the regret that she was always too busy to really settle down and have children.
MCEWANEvery moment she -- through her working life she was putting it off another few years. Then realizing that she was married to the law rather like women in olden days were brides of Christ. So in a way, it's just like entering into a kind of what V.S. Pritchett called a determined stupor. You empty your mind and you let these characters walk into your life.
SESNOWhile we're on the subject of your characters, Cliff from Washington here calls with a question I think about character. Go ahead, Cliff.
CLIFFYeah, I was wondering if I could ask about a book that you wrote about two or three years ago. The physicist Henry Beard is such a complex and despicable character. Was he based on a real person?
MCEWANNo. That despicable person, again, was a complete construction although ever since that novel "Solar" was published, I get letters, a lot of them from PhD students saying, that's my supervisor you're describing. That's our physics professor.
SESNOHow do you respond? Yes, it was or no, it wasn't?
MCEWANSo I've stood before rooms of 500 physicists and I've sworn the truth, which is that Henry Beard is a complete fabrication. He's not even made up of different bits of other physicists. He was just a fat slob who his character was part of a rather complex argument about climate change.
SESNOI always ask authors what of themselves is in their book. What of their own experience is in their narrative? You have been through a bitter custody battle when one of your -- when your marriage dissolved and you also discovered that you had a brother who had been put up for adoption. I'm wondering if you would talk about those elements and how close they get to some of your observations in this book and perhaps in life in general.
MCEWANWell, I don't really want to talk about my divorce in very particular terms but what I got from it was, first of all, that's my first encounter with the Children Act. I got a copy of the act and read it and I became familiar with the process and strain and general kind of absolute nightmare of couples who cannot agree and who have to throw themselves on the mercy of others and turn their lives inside out for strangers.
MCEWANAs for my brother, that required no court process fortunately enough. He -- we never knew this, my siblings and I, but in 1942 my mother took a six-week-old baby to a railway station by arrangement and handed it over to two complete strangers who became the adopted parents. And only when that little baby was 60 years old did he suddenly come back into our lives brought to us by the connections made by the Salvation Army who are very good at putting estranged people together.
MCEWANSo I suddenly acquired a brother in 2002. And it's caused me to look back on my life, the secrets that my parents always lived with and never told us. Should've told us because it would've brought so much happiness to my mother, I think, especially to have been reconciled with the baby she gave away. I now see that the sorrow in her face that I often remember must've had a lot to do with the guilt of giving this child away. So he's in great shape. He did actually go and visit our mother but she had dementia so it was too late. Had he come a year earlier he would've been able to say, listen, I was brought up by those strangers. They loved me. I'm okay and I forgive you. But she was never to hear that.
SESNOWill you ever write about that?
MCEWANEven as I speak it, it seems to be amazing that I haven't yet but, yes, I'll get around to it.
SESNOAnother call, this from Fredrick in Virginia. Hello, Fredrick.
FREDRICKHi. How're you doing?
SESNOGreat. Thanks for calling. Thanks for waiting.
FREDRICKI have a comment. And my comment is that I was born into a Jehovah Witness. My mother is a Jehovah Witness. My current wife is a Jehovah Witness. And we have two beautiful kids. I chose not to be a Jehovah Witness. The reason, I don't know, but recently, my wife had a major surgery. And, you know, the question that came -- we are both (unintelligible) anyway so we know the question will come out. And, you know, I tried to explain it to her that we have two beautiful kids. I cannot raise them by myself.
FREDRICKI am an immigrant anyway, and, you know, she's an American. But I totally explained things to her where she totally understands that it wouldn't be easy for me to raise them by myself. So we decided not to stick to the religious duty or whatever they call it. And, you know, she went through the surgery okay.
SESNOGood for you and good for her. And good luck to all that you do. Ian McEwan, you want to comment?
MCEWANYes. I mean, it's pointed out by some witnesses that routinely people on the operating table are topped off with blood. And yet, even if they've just lost a third of a pint, it isn't absolutely necessary because those of us who give blood give a whole pint and go back to work. So it -- there's quite a strong case for saying that you don't always need to be pumping people full of blood all the time. They can suffer a loss of a pint or more. And I think a lot of hospitals have taken this onboard and can do quite, you know, deep surgery without transfusion.
SESNOKen writes an email, "Does Mr. McEwan choose the Jehovah Witness sect to stand for the supposed irrationality of all religious morality?"
MCEWANNo. I think it's just a case that comes up constantly within what I call the secular imagination of the cause. But, yes, I suppose behind that question is a very important point. On what do we base our morality? Is it the notion of future rewards in heaven or punishments in hell? Or do we take, as I would, the view that morality derives out of a long history of having to live together as social animals and working towards what is the maximizing choice that would give the greatest number of people the great happiness.
SESNOI'm Frank Sesno and you're listening to "The Diane Rehm Show." And we are talking with Ian McEwan, author of his latest novel "The Children Act." In your acknowledgements to this book you write the following, "This novel would not exist without Sir Alan Ward lately of the Court of Appeal, a judge of great wisdom, wit and humanity. My story has as its origins in a case he presided over in the high court in 1990 and another in the Court of Appeal in 2000. I owe a huge debt of gratitude to Sir Alan." What were these cases?
MCEWANOne of these cases was Siamese twins and the hospital wanted to separate them. One twin was not viable. It had hardly any brain or no lungs and hardly any heart. The healthy twin was slowly being weakened by the other. Separated that one viable twin would survive. Left together both would die. The parents were devout Catholics. They wanted both twins to die. Their view was, only God gives life and only God can take it away.
MCEWANThe problem for the courts was you would absolutely have to deliberately go into the chest cavity of the weaker twin and sever its aorta. In other words you would have to commit murder. So it's a very difficult judgment for the court and yet at the same time every cab driver and anyone in the street would say, well, better one child alive than both dead.
MCEWANBut as I remember it, the senior cleric of Archbishop of Westminster, a Catholic archbishop, he was for leaving the children alone. So here was another case of religion cutting right across. And Sir Alan Ward's judgment, which runs to a 100 closely typed pages is one of the most elegant, sensitive, compassionate documents I've ever read. And it was that that sort of in part drew me into this whole matter.
SESNOAnd there are...
MCEWANHe judged -- sorry.
SESNONo. I was going to say, and there are, in fact, twins -- a reference to twins in your book.
MCEWANYes. I covered that case in the book. And the child who survived had reconstructive surgery and now is a flourishing little girl.
SESNOIt is a difficult and morally wrenching piece of work that you've put here together. And I think it is worth of great though on so many levels. And I thank you for doing this. Before we conclude here though today, I would like you to -- to bring you back to the contemporaneous world and note the following. Your father was a Scot. I am wondering if you have feelings -- strong feelings about this week's referendum to determine whether Scotland will no longer be part of the United Kingdom. That is a very momentous and contentious vote.
MCEWANIt's colossal. I mean, it really is profound. And I think half the country's only just waking up to the possibility that Scotland might vote yes. This cuts right across the -- our family bonds. My wife is passionately yes and I am full of doubt. I worry very much on the economic level that Scotland would need a central bank, a bank of last resort. And yet we know full well from the European Union's travails that it's very hard to be the bank of last resort for a foreign country, which is how it would have to be without having a political union with that country.
MCEWANSo I have great deal of doubts. I hope we'll hang together. My mother was English, my father was Scot so I am the United Kingdom and I don't want my limbs torn apart.
SESNOIs there -- I certainly hope that will not happen, but is there such a thing as being British or do you consider -- does one consider themselves in the United Kingdom, I am Welsh, I am English, I am a Scot.
MCEWANWell, I think that's been the triumph of the union in fact. If you take literature as really the soul of a country, which I am bound to do, there's no British novel, there are no British...
SESNOYou're not a British author.
MCEWANNo. I'm an English author. I am very much and that is part of my problem with the whole matter of the yes vote. Scotland is already a very different country. When you get off the train or the plane you know you're in a foreign country. And yet it has the backup of the whole United Kingdom's financial systems. So the Act of Union of 1707 never divided our -- I mean, it never united our imaginations. We have managed to keep ourselves separate. Welsh, Irish, English and Scots poets particularly are very, very separate.
SESNOAnd there will be a book there too, if you so desire. Ian McEwan, thank you so much for your time today. Thank you so much for your latest book "The Children Act." We very much appreciate your time.
MCEWANThank you for having me.
SESNOYou've been listening to "The Diane Rehm Show." Our guest Ian McEwan, author most recently of the novel "The Children Act." I'm Frank Sesno. Thanks very much for listening. Have a very pleasant day.
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