The Tinc­ture of Time

  • Review
By – April 28, 2017

When her six-week-old daugh­ter, Abby, devel­ops what appear to be seizures, Eliz­a­beth L. Sil­ver and her physi­cian hus­band bring her to the emer­gency room. Soon a CT scan reveals a mas­sive bleed — a stroke — and tiny Abby enters an extend­ed and bewil­der­ing peri­od of med­ical activ­i­ty. Anx­i­ety con­tin­ues to inform each moment in the couple’s lives. The men­tal trau­ma result­ing from the very real pos­si­bil­i­ty that a beloved baby may die is dif­fi­cult to artic­u­late. Nonethe­less, Sil­ver does so — mas­ter­ful­ly — in her book The Tinc­ture of Time: A Mem­oir of (Med­ical) Uncer­tain­ty.

While oth­er par­ents have expe­ri­enced sim­i­lar ter­ri­fy­ing sit­u­a­tions, their sto­ries remain large­ly unknown. Sil­ver, a writer and lawyer, copes with the stress of her family’s trau­ma by doc­u­ment­ing the expe­ri­ence. The only way I could make sense of any­thing,” she writes, was to pull out a notepad inside my tiny room in the NIC­CU and write.” Read­ers reap the ben­e­fit of Silver’s laser-like focus on her sto­ry as she blends dia­logue and descrip­tion into a nar­ra­tive as grip­ping as any thriller.

Sil­ver mus­es about the tyran­ny of the unknow­able in gen­er­al, and with­in the med­ical estab­lish­ment in par­tic­u­lar. As Abby under­goes pro­ce­dure after pro­ce­dure, her moth­er con­tin­ues to write, tack­ling the top­ics of blood, fever, and pain — recur­ring motifs in the emer­gency room and NIC­CU. Sil­ver also explores the uncer­tain­ty of reli­gion (“Doesn’t reli­gion actu­al­ly give peo­ple the illu­sion of cer­tain­ty?” asks a friend), and con­sid­ers the theme through lit­er­a­ture via Ham­let and Wait­ing for Godot.

If a top­ic can be viewed through the prism of uncer­tain­ty, Sil­ver will hold it to the light, turn it this way and that, then doc­u­ment her vision. Some­times the result feels a bit forced, but there are moments of great clar­i­ty in her writ­ing, as when she describes the com­fort she derives from a group of Jew­ish women who gath­er to bake chal­lah and pray for Abby: When these forty peo­ple come togeth­er in a home that isn’t mine, with voic­es and faces I do not rec­og­nize, and set­tle on a sin­gle note, I begin to weep.”

The strength of Tinc­ture is its close atten­tion to detail, which immers­es the read­er in events as they unfold. We are there in the emer­gency room and the NIC­CU. We ago­nize with Sil­ver and her hus­band over Abby’s mys­te­ri­ous afflic­tion in chap­ter after chapter.

Ulti­mate­ly, after two years of ongo­ing assess­ment, Abby is released,” and declared com­plete­ly healthy, after a final neu­ro­log­i­cal eval­u­a­tion. Hap­py as we are for the fam­i­ly, the inevitable down­shift in pac­ing (the tinc­ture of time” tak­ing effect) makes the sec­ond half of the book slight­ly less com­pelling. The old jour­nal­ism adage if it bleeds, it leads,” comes to mind, for blood — as it affects a help­less infant — is pre­cise­ly what grabs and holds the reader’s atten­tion when Tinc­ture begins. With Abby’s brain bleed staunched, and even­tu­al recov­ery evi­dent, the story’s urgency slows.

Tinc­ture will res­onate for any par­ent who has had a des­per­ate­ly sick, hos­pi­tal­ized child — its ulti­mate mes­sage of hope pro­vid­ing a heal­ing balm. And read­ers don’t have to be par­ents to relate to this engag­ing sto­ry and thought­ful, thor­ough con­sid­er­a­tion of uncer­tain­ty with­in and out­side the med­ical estab­lish­ment. As Sil­ver asks, Because Abby has nar­row­ly escaped a sta­tis­tic, the book ends with joy, but does it take away from any of the emo­tions expe­ri­enced while read­ing it?” Read­ers will agree that it cer­tain­ly does not.

Amy Spun­gen, a free­lance edi­tor and writer, has a BS in jour­nal­ism from Vir­ginia Com­mon­wealth Uni­ver­si­ty and an MA in Eng­lish from North­west­ern Uni­ver­si­ty. She lives near Chica­go in High­land Park, Illinois.

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