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The Tincture of Time: A Memoir of (Medical) Uncertainty

The Tincture of Time: A Memoir of (Medical) Uncertainty

by Elizabeth L. Silver

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Set against the unexplained stroke of the author’s newborn daughter, this stunning, unflinchingly honest memoir is an thought-provoking reflection on uncertainty in medicine and in life.

Growing up as the daughter of a dedicated surgeon, Elizabeth L. Silver felt an unquestioned faith in medicine. When her six-week-old daughter, Abby, was rushed


Set against the unexplained stroke of the author’s newborn daughter, this stunning, unflinchingly honest memoir is an thought-provoking reflection on uncertainty in medicine and in life.

Growing up as the daughter of a dedicated surgeon, Elizabeth L. Silver felt an unquestioned faith in medicine. When her six-week-old daughter, Abby, was rushed to the Neonatal Intensive Care Unit with sudden seizures, and scans revealed a serious brain bleed, her relationship to medicine began to change.

The Tincture of Time is Silver’s gorgeous and haunting chronicle of Abby’s first year. It’s a year of unending tests, doctors’ opinions, sleepless nights, promising signs and steps backward, and above all, uncertainty: The mysterious circumstances of Abby’s hospitalization attract dozens of specialists, none of whom can offer a conclusive answer about what went wrong or what the future holds. As Silver explores what it means to cope with uncertainty as a patient and parent and seeks peace in the reality that Abby’s injury may never be fully understood, she looks beyond her own story for comfort, probing literature and religion, examining the practice of medicine throughout history, and reporting the experiences of doctors, patients, and fellow caretakers. The result is a brilliant blend of personal narrative and cultural analysis, at once a poignant snapshot of a parent’s struggle and a wise meditation on the reality of uncertainty, in and out of medicine, and the hard-won truth that time is often its only cure.

Heart-wrenching, unflinchingly honest, and beautifully written, The Tincture of Time is a powerful story of parenthood, an astute examination of the boundaries of medicine, and an inspiring reminder of life’s precariousness.

Editorial Reviews

Publishers Weekly
Silver’s (The Execution of Noa P. Singleton) memoir of her newborn daughter’s medical trauma is smartly conceived and well written. Medical is a parenthetical for a reason: “Our story is nothing. A two week NICU stay with no surgery thus far. A fever.” But it doesn’t feel like nothing to Silver and her husband, the parents of a six-week-old with seizures caused by a potentially tragic grade IV bleed in her brain. For two weeks, there is nothing to do but bide time while tiny Abby is prodded and poked. They wait for a diagnosis, for a certainty that will not come. Several social workers question them closely, looking for signs of abuse, an added stress that only stops when a scan turns up no signs of trauma. At her daughter’s lowest point, Silver’s sister-in-law arranges for 40 women to bake challah while saying prayers for Abby’s recovery. Silver watches via Skype, her thoughts wandering to Les Miserables and Amadeus and the power of music, distracting the reader from what the more poignant power of dozens of strangers united in one hope. It is this reliance on tropes like Google searches and dictionary definitions that sometimes dulls the emotional heart of her otherwise excellent book. (Apr.)
From the Publisher
“A mother’s uncertainty about her baby daughter’s medical care pervades this unsettling memoir. . . . Readers will share Silver’s unease with uncertainty. This will resonate with anyone who has experienced diagnostic difficulties.”

“Smartly conceived and well written. . . . An excellent book.”
—Publishers Weekly

“In Elizabeth Silver’s masterful hands, suffering creates poetry. She draws upon MRI scans, Greek mythology, and the history of medicine to tell the story of her infant daughter’s brain bleed, and the resulting meditation on trauma, memory, and time is one of the most riveting stories of illness that I’ve ever read. This is an unforgettable book.”
—Susannah Cahalan,author of Brain on Fire
“The Tincture of Time delivers two remarkable books for the price of one: an honest, raw, exquisitely written narrative and an astute yet deeply compassionate investigation of the practice of medicine. It’s a book for anyone who’s ever grappled with the inescapable uncertainty of life—that is to say, it’s a book for everyone. Simply put, I was blown away.”
—Darin Strauss,author of Half a Life

“It’s nearly impossible to put The Tincture of Time down. Elizabeth L. Silver’s brilliant memoir burns from page to page, teaching the reader as much about the fragility of life as it does the power of love.”
—Christa Parravani,author of Her

“The Tincture of Time is at once a medical mystery and an affecting meditation on how to live without certainty. Elizabeth L. Silver has written a compelling account of a mother’s worst nightmare with grace, intelligence, and love.”
—Jill Bialosky,author of History of a Suicide

“The Tincture of Time is just the kind of memoir this world desperately needs. In precise and powerful language, Elizabeth Silver uses her deeply singular experience to shed light on universal issues of wellness, health, the body, healing, and trust. She shines her bright, generous intellect into the deepest reaches of her own heart, and into the heart of every reader. This book will change you, teach you, move you. Read it.”
—Emily Rapp,author of The Still Point of the Turning World

Kirkus Reviews
A mother's uncertainty about her baby daughter's medical care pervades this unsettling memoir.Silver (The Execution of Noa P. Singleton, 2014) is both a novelist and an attorney, occupations that provide different perspectives on her plight as a concerned parent. A few weeks after birth, her daughter, Abby, inexplicably began showing symptoms of a seizure, perhaps a prelude to something worse. She then developed an alarming fever, which left almost as quickly and inexplicably as it arrived. To the various physicians who examined her, she was "a self-contained enigma, despite a hefty team of specialists offering varied hypotheses." The author herself was surrounded by doctors—her father, her husband, and others—but she came to see how inexact a science medicine could be. For the creative writer, "this is quickly becoming a story that has nothing to do with grief or planning for grief, or treatment to combat an illness, but rather coping with the uncertainty of health in the dense fog of evolving medicine." For an attorney experienced in cases of medical malpractice and whose father found his career threatened by an unfounded claim, Silver felt beleaguered by questions that implied guilt or blame—as if she did something to her daughter, dropped her or shook her, and either wouldn't admit it or couldn't remember it. Memory itself becomes a reflection of universal uncertainty, as does the disappearance of a Malaysian airliner, Waiting for Godot, and Hamlet's "To be or not to be." Ultimately, the author attempts "to control my surroundings as best I can without losing semblance of self, without stopping life, without changing behavior to a point of invisibility. And I create a narrative that evolves daily." Readers will share Silver's unease with uncertainty. The attempt to balance personal trauma with wider cultural reference is a tricky challenge, but this will resonate with anyone who has experienced diagnostic difficulties.

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Penguin Publishing Group
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Meet the Author

Elizabeth L. Silver is the author of the novel The Execution of Noa P. Singleton, which has been published in seven languages. Her writing has been published in McSweeney’s, The Huffington Post, The Rumpus, The Millions, and elsewhere. She has worked as an attorney in Texas and California, and as an adjunct instructor of English literature and composition. She lives with her family in Los Angeles.