Trans-Atlantic differences on drinking in pregnancy, and the pleasures of literary fiction

The English have a somewhat more relaxed attitude towards drinking in pregnancy than we do in the States.

From the RCOG:

“It is recommended that you do not drink alcohol during the first three months of pregnancy. Drinking small amounts of alcohol after this time does not appear to be harmful for the unborn baby, but you should not:

• drink more than one or two units, and then not more than once or twice per week

• binge drink (which for a woman is when she has six units or more of alcohol on any one occasion).”

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-alcohol-and-pregnancy.pdf

Vs the CDC:

“Every woman who is pregnant or trying to get pregnant – and her partner – want a healthy baby. But they may not be aware that drinking any alcohol at any stage of pregnancy can cause a range of disabilities for their child,” said Coleen Boyle, Ph.D., director of CDC’s National Center on Birth Defects and Developmental Disabilities. “It is critical for healthcare providers to assess a woman’s drinking habits during routine medical visits; advise her not to drink at all if she is pregnant, trying to get pregnant or sexually active and not using birth control; and recommend services if she needs help to stop drinking.”

http://www.cdc.gov/media/releases/2016/p0202-alcohol-exposed-pregnancy.html

Ian McEwan’s latest novel, Nutshell (“Oh God, I could be bounded in a nutshell and count myself a king of infinite space – were it not that I have bad dreams.” Shakespeare, Hamlet), is told from the point of view of a rather sophisticated fetus 2 weeks prior to a full-term birth, during an English summer, using the plot of Hamlet as a frame: his mother Trudy (Queen Gertrude in Hamlet), and his uncle, Claude (King Claudius in Hamlet) are scheming to murder his father (a poet, in the novel).

Here are 3 excerpts from the novel portraying the fetus’s view of drinking:

“I like to share a glass with my mother. You may never have experienced, or you will have forgotten, a good burgundy (her favorite) or a good Sancerre (also her favorite) decanted through a healthy placenta. Even before the wine arrives – tonight, a Jean-Max Roger Sancerre – at the sound of a drawn cork, I feel it on my face like the caress of a summer breeze. I know that alcohol will lower my intelligence. It lowers everyone’s intelligence. But oh, a joyous, blushful Pinot Noir, or a gooseberried Sauvignon, sets me turning and tumbling across my secret sea, reeling off the walls of my castle, the bouncy castle that is my home. Or it did so when I had more space. Now I take my pleasures sedately, and by the second glass my speculations bloom with that license whose name is poetry. My thoughts unspool in well-sprung pentameters, end-stopped and run-on lines in pleasing variation. But she never takes a third, and it wounds me.

“I have to think of baby,” I hear her say as she covers her glass with a priggish hand. That’s when I have it in mind to reach for my oily cord, as one might a velvet rope in a well-staffed country house, and pull sharply for service. What ho! Another round here for us friends!

But no, she restrains herself for love of me.”

Ian McEwen, Nutshell, pages 6-7, 2016, Nan A. Talese/Doubleday

“A few minutes ago the radio told us it was four o’clock. We’re sharing a glass, perhaps a bottle, of Marlborough Sauvignon Blanc. Not my first choice, and for the same grape and a less grassy taste, I would have gone for a Sancerre, preferably from Chauvignol. A degree of flinty mineral definition would have mitigated the blunt assault of direct sunlight and oven blast of heat reflected off the cracked façade of our house.

But we’re in New Zealand, it’s in us, and I’m happier than I’ve been in two days. Trudy cools our wine with plastic cubes of frozen ethanol.”

Nutshell, page 31.

And finally (and best of all):

“Trudy and I are getting drunk again and feeling better, while Claude, starting later and with greater body mass, has ground to cover. She and I share two glasses of the Sancerre, he drinks the rest, then returns to his plastic bag for a burgundy. The grey plastic bottle of glycol (which will later be used to poison his father) stands next to the empty, sentinel to our revels. Or memento mori. After a piercing white, a Pinot Noir is a mother’s soothing hand. Oh, to be alive while such a grape exists! A blossom, a bouquet of peace and reason. No one seems to want to read aloud the label so I’m forced to make a guess, and hazard an Echezeaux Grand Cru. Put Claude’s penis or, less stressful, a gun to my head to name the domaine, I would blurt out la Romanee-Conti, for the spicy cassis and black cherry alone. The hint of violets and fine tannins suggests that lazy, clement summer of 2005, untainted by heatwaves, though a teasing, next-room aroma of mocha, as well as more proximal black-skinned banana, summon Jean Grivot’s domaine in 2009. But I’ll never know. As the brooding ensemble of flavours, formed at civilisations’s summit, makes its way to me, through me, I find myself, in the midst of horror, in reflective mood.”

Nutshell, pages 51-52.

But, beyond illustrating trans-Atlantic cultural differences, I have one other reason for sharing these excerpts with you. A patient lamented yesterday that the pressures of her work for a famous tech company  left her longing for a break, which she wouldn’t have until an island vacation that was months away. And likewise we doctors need to have a  healthy way to relieve the pressures of our work. I  would argue that, for those who love and appreciate great writing, literary fiction can provide a break from the stress of work and daily life that is more readily available, more mentally refreshing, and more spiritually rejuvenating than even the banal pleasures of a resort holiday.

This entry was posted in First Comments. Bookmark the permalink.

Comments are closed.