Anna Starobinets’s Look at Him

Perhaps the easiest thing to write about Anna Starobinets’s Посмотри на него (Look at Him) is that it blends several genres. The cover says “100% .doc” and the book is, indeed nonfiction—albeit a combination of memoir, medical history, and journalism, so not thoroughly .doc, at least to my mind—but what makes the book so compelling and human is that Starobinets puts her fiction-writing background to good use, pacing her book to develop a story arc and suspense. I could only read a little bit at a time because a personal story about late-term abortion is so intensely emotional. Even so, I had a hard time putting the book down at night.

Starobinets begins Look at Him at a routine ultrasound exam, to check her baby’s progress. She learns that her baby is a boy but she also learns he may have polycystic kidney disease. The medical side of her baby’s story is so complex, from many angles, including genetics, prenatal testing, and possible outcomes, that I won’t elaborate on that much. What’s most crucial to the book’s narrative arc is that Starobinets decides to terminate her pregnancy because doctors advise her that if she carries her son to term he will have a minimal chance of surviving.

Starobinets has been called a Russian Stephen King but learning about the realities of her child’s condition (which involves waiting and learning about various potential outcomes) and medical procedures for late-term abortion (some of which she quotes from online forums) in Look at Him mean she doesn’t need to embellish the truth to develop the afore-mentioned suspense. There’s another layer to the book, though, that creates at least as much tension: how the Russian medical system treats her much of the time. Without asking her permission, one specialist brings in medical students to observe her transvaginal ultrasound. Finding her way through the medical system is demeaning. She receives little empathy from many practitioners, though there are exceptions. And forgetting to wear foot covers can be problematic; she storms a clinic bathroom when she’s told she can’t go in without them. Her husband isn’t allowed in a clinic for her appointment, though she needs his moral support. And then there are the stories and admonitions she reads online.

Starobinets ends up going to Berlin after a friend finds a clinic for her. Many aspects of her treatment, both medical and human, are different there. Her husband is welcome at the clinic (even to spend the night) and she’s told “There is no reason why you should be in pain.” One of her biggest fears now is seeing her child. (This is where the book’s title comes from.) Starobinets and her husband are told at the clinic that parents usually look at their children after they’ve been born this way, meaning already dead; many even spend a day with them. Some of the most affecting scenes in the book describe Starobinets and her husband seeing their son after his birth, receiving an envelope with a photo and hand- and footprints, and visiting their baby’s grave later, when they return to Berlin for Starobinets’s husband, Alexander Garros, to have treatment for esophageal cancer. (Part of what made Look at Him so emotional is that I knew Garros died in 2017.) Starobinets notes that many Russian marriages break up after late-term terminations of pregnancy and she suspects that’s largely because husbands aren’t allowed into clinics, hospitals, or births. Or to look at their babies after the procedure and truly be able to share their wives’ grief. Garros helps Starobinets after their return home, too, when she has panic attacks And he’s with her when she gave birth to a healthy son in Latvia a couple of years later.

There’s lots more to Look at Him—I haven’t even touched on the role of Starobinets’s and Garros’s daughter in the family’s story—including a hundred pages of appendices covering interviews with doctors and patients plus comparative statistics on terminations of pregnancies in Germany and Russia. After reading some appendices and skimming others, I can see that they make Look at Him a sort of memoir that offers substantial background for other families faced with tough decisions based on prenatal exams and/or with similar emotions after the loss of a child with a congenital condition. More than that, it’s a book about life and death, basic human dignity, and treatment under various medical systems. (Unfortunately, dignity isn’t guaranteed anywhere, something I’ve certainly seen both from working as a medical interpreter for several years and from being a consumer of health care in the U.S., where the system gives ample opportunities to see absurd bureaucracy, burdensome pricing despite insurance, and bedside manner that can be indifferent, opinionatedly pushy, or inept at basic things like blood draws.) There’s been controversy about Look at Him, which is a finalist for the 2018 National Bestseller Award, but I commend Starobinets, as both a mother and a writer, for being able to sort through her emotions and knowledge, discuss her decisions (which not every reader will agree with), and write a book that tells so many real-life stories about what happened both during and after her pregnancy. Yes, it’s a work that’s both journalistic and personal rather than poetic or lovely, and some might see it as TMI, but Look at Me feels honest, like a genuine attempt to offer information to other families, no matter what they may ultimately decide when faced with similar situations that offer no ideal resolutions.

Disclaimers: The usual.

Up next: I’m slowly wending my way through a heavy “write about” shelf: the lovely short story cycle I’ve mentioned earlier, Sergei Kuznetsov’s Teacher Dymov, Janet Fitch’s The Revolution of Marina M. (I’m already waiting for the sequel!), Sofia Khvoshchinskaya’s City Folk and Country Folk in Nora Seligman Favorov’s translation, and Vladimir Sharov’s The Rehearsals in Oliver Ready’s translation. And more…