Reviewed: Mimi by Lucy Ellmann

Under the skin.

Mimi
Lucy Ellmann
Bloomsbury Circus, 352pp, £12.99

The ground beneath our feet is shaky territory for the narrator of Lucy Ellmann’s excellent sixth novel. Harrison Hanafan, an eminent New York plastic surgeon, is walking down Madison Avenue one Christmas Eve when he slips on ice, thereby transplanting himself instantaneously “from the lofty, vertical and intellectual to . . . the lowly and prostrate”.

The irony of having a position of high social status but low morality is explored throughout with great humour. “In Manhattan a man without an upright position hasn’t got a chance,” complains Hanafan, who subsequently wallows in his literal downfall. Yet he is rescued and helped to his feet again by a “plump middle-aged gal with brown eyes” – this is Mimi, a feisty feminist going through the menopause who will, throughout the novel, be not only a physically but also a morally uplifting corrective to Hana­fan’s life.

The plastic surgeon has attempted to shape the contours of his world with the same precision as his knife slicing along flesh; he is, for example, a ferocious list-maker. Among Hanafan’s many lists is a “list of melancholy things”, which is his “life’s work”. There’s a tension between his list-making and what fails to make it on to his lists, a conflict between the attempt to craft and order life and its stubborn insistence on eluding our delineations.

Ellmann unfolds the narrative with aplomb as Hanafan’s romance with Mimi takes him on an emotional journey while he re-evaluates his life. Ellmann’s anger at the mistreatment and subordination of women simmers powerfully throughout her previous five novels; the difference here is that she has channelled that rage through another stylistic device: a male perspective. The reader sees all of Hanafan’s folly and foibles, yet there is also a sense of hope about the possibility of real change – not the superficial changes to the surfaces of human bodies that Ellmann satirises so acutely but psychological and emotional metamorphosis.

This novel is a dissection of what it means to be human and its portraits of human beings are thrown into high relief by sharing the pages with cartoon characters and animals. Hanafan spends his evenings organising his cartoon collection alphabetically, from Alvin and the Chipmunks to Yogi Bear: “Well, what of it? What’s a plastic surgeon supposed to do after a hard day’s work realigning human flesh, if not chill out to scenes of imaginary animals getting punched, stretched, bounced up and down, steamrollered, blown to smithereens, and reborn good as new?” He will learn what it really means to be “reborn”. There is a rescue cat (“The cat really knew how to live!”). There is a sister called Bee. There is pontification on “the heroism of an ant”.

Ellmann’s work is characterised by a delightfully playful style, experimenting with the boundaries of form and the visual layout of writing, and is scattered with capitals and exclamation marks and italics. Here, she liberally uses italics – the full force of emotion pressed against words – as well as pages of music scores. The rich layering of literary and artistic references adds depth to this portrait of shallow lives. In exuberant, exhilarating prose that carries a substantial cargo of humour and wit, this cutting social satire anatomises an era and, by focusing on a man who alters human bodies, offers an X-ray of the curious workings of the mind.

 

“In Manhattan a man without an upright position hasn’t got a chance." Photograph: Getty Images

This article first appeared in the 25 February 2013 issue of the New Statesman, The cheap food delusion

Davide Restivo at Wikimedia Commons
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Scientists have finally said it: alcohol causes cancer

Enough of "linked" and "attributable": a new paper concludes that alcohol directly causes seven types of cancer.

I don't blame you if you switch off completely at the words "causes cancer". If you pay attention to certain publications, everything from sunbeds, to fish, to not getting enough sun, can all cause cancer. But this time, it's worth listening.

The journal Addiction has published a paper that makes a simple, yet startling, claim: 

"Evidence can support the judgement that alcohol causes cancer of the oropharynx [part of the throat], larynx, oesophagus, liver, colon, rectum and [female] breast"

So what's especially significant about this? 

First, scientists, unlike journalists, are very wary of the word "causes". It's hard to ever prove that one action directly led to another, rather than that both happened to occur within the same scenario. And yet Jennie Connor, author of the paper and professor in the Preventive and Social Medicine department at the University of Otago, New Zealand, has taken the leap.

Second, alcohol not only causes cancer of one kind – the evidence supports the claim that it causes cancer at seven different sites in our bodies. There was weaker evidence that it may also cause skin, prostate and pancreatic cancer, while the link between mouth cancers and alcohol consumption was the strongest. 

What did we know about alcohol and cancer before?

Many, many studies have "linked" cancer to alcohol, or argued that some cases may be "attributable" to alcohol consumption. 

This paper loooks back over a decade's worth of research into alcohol and cancer, and Connor concludes that all this evidence, taken together, proves that alcohol "increases the incidence of [cancer] in the population".

However, as Connor notes in her paper, "alcohol’s causal role is perceived to be more complex than tobacco's", partly because we still don't know exactly how alcohol causes cancer at these sites. Yet she argues that the evidence alone is enough to prove the cause, even if we don't know exactly how the "biologial mechanisms" work. 

Does this mean that drinking = cancer, then?

No. A causal link doesn't mean one thing always leads to the other. Also, cancer in these seven sites was shown to have what's called a "dose-response" relationship, which means the more you drink, the more you increase your chances of cancer.

On the bright side, scientists have also found that if you stop drinking altogether, you can reduce your chances back down again.

Are moderate drinkers off the hook?

Nope. Rather devastatingly, Connor notes that moderate drinkers bear a "considerable" portion of the cancer risk, and that targeting only heavy drinkers with alcohol risk reduction campaigns would have "limited" impact. 

What does this mean for public health? 

This is the tricky bit. In the paper, Connor points out that, given what we know about lung cancer and tobacco, the general advice is simply not to smoke. Now, a strong link proven over years of research may suggest the same about drinking, an activity society views as a bit risky but generally harmless.

Yet in 2012, it's estimated that alcohol-attributable cancers killed half a million people, which made up 5.8 per cent of cancer deaths worldwide. As we better understand the links between the two, it's possible that this proportion may turn out to be a lot higher. 

As she was doing the research, Connor commented:

"We've grown up with thinking cancer is very mysterious, we don't know what causes it and it's frightening, so to think that something as ordinary as drinking is associated with cancer I think is quite difficult."

What do we do now?

Drink less. The one semi-silver lining in the study is that the quantity of alcohol you consume has a real bearing on your risk of developing these cancers. 

On a wider scale, it looks like we need to recalibrate society's perspective on drinking. Drug campaigners have long pointed out that alcohol, while legal, is one of the most toxic and harmful drugs available  an argument that this study will bolster.

In January, England's chief medical officer Sally Davies introduced some of the strictest guidelines on alcohol consumption in the world, and later shocked a parliamentary hearing by saying that drinking could cause breast cancer.

"I would like people to take their choice knowing the issues," she told the hearing, "And do as I do when I reach for my glass of wine and think... do I want to raise my risk of breast cancer?"

Now, it's beginning to look like she was ahead of the curve. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.