“no one is immortal, nothing is eternal, everything is in flux . . .”

In this fascinating book, medicine and culture intersect. Gavin Francis takes as his theme the many and various changes that the human body can undergo in the course of a lifetime. An Edinburgh GP, Francis draws on twenty years of clinical experience with patients and sometimes on interviews with other clinicians or people with unusual conditions to explore alterations in the body. Changes dictated by the natural human lifecycle; transformations that are the result of faulty genetics, disease, or trauma; and, some “improvements” that are cosmetic or elective—all make their appearance in this book.

Francis uses informal patient histories as springboards for wide-ranging reflection on myths, history, religion, philosophy, and the arts. The literature of antiquity figures prominently, but there are also references to modern works by Kafka, Atwood, Eugenides, and others. As one might expect in a book focused on the body in flux, puberty, pregnancy, anorexia, and hermaphroditism are covered; however, there are also unanticipated excursions into lycanthropy (which refers both to the transformation of a person into a werewolf and a form of madness characterized by the delusion that one is an animal), anabolic steroid use (and its less commonly known effects on personality and mood), and the changes a newborn’s heart usually undergoes (and sometimes doesn’t) when the infant takes her first breaths of air.

Francis serves up a veritable feast of information about anatomy, physiological processes, and cultural material related to the body—some of it quite esoteric and arcane. His book can be demanding at times if you, like me, are not as scientifically literate as you’d like to be. I found reading the book on an electronic device to be advantageous when it came to visualizing—comprehending—some of the topics under discussion. It was useful, for example, to look at a diagram of the “double spiral of opposing helical fibres” in the middle layer of the ductus arteriosus—an important blood vessel in the fetus which allows blood to bypass developing lungs. The drawing helped me to understand how this channel for blood usually closes when a newborn begins to breathe. Francis does provide some useful photographs in the book, but I wouldn’t have minded a helpful diagram or two as well.

Shapeshifters is an unusual and captivating work of nonfiction that put me in mind of the works of the great American anatomist/pathologist-writer F. Gonzalez-Crussi. It is not an easy read, but it is a rich and rewarding one—one of those rare books that merits a second reading.

Thank you to Netgalley and the publisher for providing me with a digital copy of the book for review purposes. Thanks to Gavin Francis for writing it. ( )