Book Club- The Swimmers (not really a Novel) by Julie Otsuka

The Swimmers, by Julie Otsuka is my actual book club's April book and it is a difficult delight. Though categorized by the author as a novel, it reads more like a series of short stories woven together with a single bright and strong thread - a woman named Alice who has recently been diagnosed with dementia.

For those who are too busy to read (I get it!) The Swimmers is well worth the 4 hours on Audible. In fact, the narrative is perfectly suited for listening but the author's language is at times so biting, so clever and poignant, I also bought a copy to re-read portions of the text and share it with others.

The first half of the book is a clever, beautiful allegory for how our Nation handled _________. I don't want to spoil the surprise or the moment where when reading or listening you silently say to yourself "Oh, now I see. The Crack in late 4 is an allegory for _____." Nor do I want to tell you who the Swimmers are, or why they matter. The novel is like one of those bright orange and pink sunrises; you think you know what it will look and feel like, but it surprises you in ways you don't expect - revealing such beauty.

A spoiler here would take that moment of realization (and joy) away - and I will not be part of that destruction.

I will however, reveal and gaze upon the beauty of the novel's second, third and fourth parts. Part II - Diem Perdidi is a short story about Alice, the Swimmer, an aging Japanese American woman living in California. The latin phrase Diem Perdidi means to lose a day, and the story is written as a list of Alice's memories, those she clearly maintains, and the many she has lost.

By part III - Belevista, you are involved with Alice, hoping for her salinity and clarity of mind. But part III must, in my opinion, have been born by the author's experience as a caregiver and likely bad experience with our Nation's for profit long term care system. Alice is taking to a memory care unit by her husband. Otsuka writes,

WELCOME TO BELEVISTA. We are a long term, for profit memory care residence conveniently located on a former parking lot off the freeway just minutes from the Valley Plaza Mall. Other names we have gone by in the past include Heritage Pointe, Palomar Gardens, Municipal Ward #3 and the Villages at Pacifica, Inc. Also, the nice place, the new place, the last place, a wonderful place ("You'll love it") and most recently, by an eight year old boy to his mother from behind the tinted glass windows departing SUV - The Bughouse." The Swimmers, p. 98.

She continues,

A FEW FACTS about your condition. It is not temporary. It is progressive, intractable, and irreversible. Ultimately, like life itself, it is terminal. The medication will not stop it. Green tea infused with gout kola and ginkgo blob will not stop it. Prayer will not stop it...Having an unrealistic positive attitude will not stop it and may, in fact, hasten your decline There are no exceptions to these rules. Although you are a special person, yours is not a special case. There are eighty-seven other people at Belevista and more than fifty million worldwide similarly situated. The Swimmers, p. 100.

THE ACCOMMODATIONS If you would like access to one of our "top doctors" rather than a trainee, you will be charged extra. If you cannot afford a top doctor but would like a "better" or "nicer" trainee with a more obliging bedside manner, you will still be charged extra...

WITH THE EXCEPTION of your doctor, who will visit you once a month for three minutes to sign off on your meds before closing your chart ("Nice to see you again") and hurrying out the door ("Next!") you will be attended to exclusively by exhausted middle aged women of color from cash starved countries who work two to three jobs to cover the rent. Their blood pressure is high, their backs are sore, and they haven't seen a dentist in years. Remember to thank them when they come to you in the middle of the night to fix your blanket...Try to make their lives easier, if you can. Remember, they are being paid the lowest wage possible to love you." The Swimmers, p. 105-115.

The preceding paragraphs had to have been written by someone who knows how broken our for profit long term care system is. These are the words of painful experience and lessons learned. They are words of truth.

And that is why this book is so compelling and worth reading.

No spoiler alert here, but I too was a caregiver to someone with a chronic medical condition (though not full time). I too, have experience - both personally and professionally, with a broken system where underpaid and overworked staff are expected to move mountains for minimum wage, while CEOs cash in on millions from corporate profits. Three minutes of physician care a month is double what most patients get in many long term care facilities. Today, it is more likely a patient will get 3 minutes of a Nurse Practitioner's care every 60 days, and orders are signed without examination reflection or introduction.

The author's brilliance is how she choses to expose these truths - by lightly pulling back the veil of broken systems, broken bodies, broken families.

Part IV - Euroneuro, is from the perspective of Alice's unnamed daughter. As I read this portion, I imagined the author writing this part of the story, filled with her own grief, her own regret and pain. I myself was unable to read without tears, and without reflecting on my Mother's pain, decline, and death. In what seems like a moment of kismet, I read the daughter's account and thought "How could she have known that happened to me as well?" There are so many parallels between the daughter's journey and mine that I remain deeply touched by the story. And yet Otsuka didn't know of my journey. Maybe, our stories are not unique. Maybe the stories contained in this slight blue book are so universal, they only feel personal.

In sum. This is a must read. Maybe not appropriate for those who are currently dealing with dementia or Alzheimers in their immediate family as the text will likely be too raw. But for the rest of us, the other few hundred million, it is certainly worth a read. It is also worth paying attention to the systems we have in place to provide for those with these diagnosis, and asking ourselves whether we are doing enough for the Alices of the world.