From the guest editor's desk....
As I sat down to write guest editorial for this special IJRI issue on Transplant Imaging - “The celebration of being alive…”, this magical title from a chapter in my class 9th English textbook, flashed across my mind. I still remember this awesome chapter by Dr. Christiaan Barnard, a South African cardiac surgeon who performed the first successful human-to-human heart transplantation. He beautifully narrated the experiences during his illustrious medical career to explain the human sufferings. He nicely emphasized on the need to live in present and to ‘celebrate’ what we have; rather than to ‘complain’ about what we don’t have. In the garden of memory, happy moments are always the brightest blossoms….
With so much suffering all around us, ‘being alive should be a celebration’, then the ‘act of giving life’ to someone is certainly the noblest acts in humanity. Saving lives through organ transplantation is one such act which still remains the last hope for a lot of human sufferings. Transplantation can be described as the mankind's journey to frontiers of medical knowledge in its most daring efforts to defy illness and death. Transplantation Medicine is one of the most challenging areas of modern medicine and involves an in-depth understanding of basic sciences, immunology and surgical techniques. The advent of cyclosporine changed transplantation from research to life-saving mode of treatment. As in other spheres of Medicine, ‘Transplant Imaging’ has also evolved as a sub-speciality. Imaging-based pre-transplantation donor evaluation, surgical planning and post-transplant surveillance are now integral parts of all organ transplantation programs. Radiologist is therefore now a key player in team transplantation.
This issue of IJRI aim to highlight the role and relevance of ‘transplant imaging’ in different transplant programs. At the time of this writing, only Renal, Liver and Marrow transplantation is being routinely performed in India. As the number of centres doing transplant surgeries in India is rapidly increasing, the topic is quite relevant for the practising Radiologists and Radiologists in training. On behalf of IJRI, I welcome you all to this issue of IJRI which is dedicated to ‘Transplant Imaging’. We have articles on CT evaluation in living liver donors by Dr. Vohra and on post-liver transplant Doppler by Dr. Sanyal. We also have review articles on pediatric small bowel transplant by Dr. Bhargava, pancreatic transplantation by Dr. Heller, Stem cell transplantation by Dr. Pandey and lung transplantation by Dr. Madan. Though renal transplantation is common in India, laparoscopic donor nephrectomy is recently gaining momentum, which needs much more comprehensive imaging-based donor evaluation. I have also included an article to address this important issue. Clinician-Radiologist interaction is certainly the key to maximise the information from these imaging studies and attain the highest standard of patient care.
Through this editorial, I wish to convey my sincere thanks to all the authors to accept my invitation and to make their wonderful contribution towards this issue of IJRI. I also wish to convey my thanks to Editor-in-Chief, IJRI; Dr. Sanjay Jain for giving me the privilege to work as the guest editor for this special issue on ‘Transplant Imaging’.
I am sure you will find this issue of IJRI useful in your clinical practice and its contents will add to your knowledge on current trends in transplant imaging. Your queries and feedbacks are invited and will be promptly addressed.
I hope, this special issue of IJRI will find a suitable place in your reading preferences.
In one of the illuminating essays in his collection The Voice That Thunders, Alan Garner concludes that the relation between the writer and the critic resembles that between the postman and the philatelist. Philately, he assures us, is a noble and worthwhile activity but it has little to do with the business of distributing the mail. Erica Wagner’s First Light, a festschrift of essays, reminiscences, poems and stories dedicated to Garner and his work, might therefore seem a philatelists’ annotated catalogue. Instead it shows that the job of the critic is that of a particular way of reading those hand-delivered letters.
Few writers are likely to be celebrated by such a diverse crowd as are gathered here in Wagner’s book. Other fiction writers appear – Margaret Atwood, Ali Smith, Philip Pullman, Neil Gaiman and Garner’s daughter, Elizabeth – but also Ronald Hutton, the historian of witchcraft, along with a clutch of storytellers, an excavation of archaeologists, a schoolmaster, a former archbishop of Canterbury and an astronomer. The range of those gathered here is testament to the breadth of Garner’s writings, the way they have syncretically compressed truths, merging, as few others have, a scientific and a mythopoeic understanding of human nature.
Between the summer of 1934 and the spring of 1935, Diana Wynne Jones, Susan Cooper and Garner were born, three writers who were children during the war and then, in the 60s and 70s, would be at the heart of a golden age of children’s literature. Six days before Cooper’s birthday, in May 1935 in the Forest of Dean, Dennis Potter was born; four years later, in Mossbawn, County Derry, Seamus Heaney saw the light.
Alan Garner: a life in books
With Cooper and Wynne Jones, Garner stands as one of the greatest makers of fantasy; with Potter and Heaney, he belongs to a select group of writers who turned their lives into legend, even myth, one they made available to others. Mossbawn, the Forest of Dean, Alderley Edge are known places, shared images of home. Every fan of Garner knows about his childhood illnesses, his being three times pronounced dead and fighting against the pronouncement; every reader knows of his attachment to and estrangement from one particular landscape, his displacement from a family tradition of craft expressed cunningly in the craft of writing.
Strangely, it is Potter who most chimes with Garner’s experience, as two men imbued with attachment to home, permeated with a purely local language, and then alienated from those roots, that tongue, by school success and Oxford. In very different ways, both dedicated their lives to knowing their place, tracing the path back to the deeper world they were estranged from. Potter’s The Singing Detective is even structured like a Garner novel, layering in one tale connected strands of story.
Garner began his career writing books in the vein of John Masefield’s The Box of Delights, and came to write like William Golding or Samuel Beckett. He has triumphed at fantasy and sculpted at least one masterpiece of realism, the extraordinary Stone Book Quartet. As many contributors to First Light tell us, his great achievement was to marry the mythic and the real. His children’s fantasy Elidor forges a world in transition, a boundary zone that fuses other realms with the slum clearances in postwar back-street Manchester.
History does not demolish myth; rather the relation between the two is the deepest way to understand our lives. In Elidor, Roland, the most imaginative child, is also the most truthful, for only he accepts and retains fidelity to the real experience of the marvellous.
Garner’s medium is deep time. He has a geological imagination, one that he applies to human identity too. He may be the last writer somehow informed by Sir Charles Lyell’s 19th-century classic, Principles of Geology; he taps into the earth. There are sediments of experience, layers in the rock. Events and the characters themselves are anagogical, figural: that is, they exist as rhymes to people, spirits, events from other stories, other lives.
There are sleepers deep in the earth, biding until the moment to awake. People look out of themselves across time, and perhaps into a timelessness beyond. In Garner’s most recent – I hope not last – work, Boneland (2012), his first two books interpenetrate the story. The novel is coalesced around the difference and the link between a Paleolithic man and a 21st-century astronomer, as well as the connection between the adult scientist and the child he was, and perhaps still is.
Garner’s vision is larger than that of most realist writers. Realism for him includes the awareness of our place in vastness. Viewed from the parish of Alderley, the Earth actively is a planet to him, turning in infinity. The silence of interstellar spaces, of rock and cave, informs the books, though the magic is that the silence is a speaking one.
Many of the contributions in Wagner’s highly enjoyable book reveal as much about their authors as they do about Garner himself; it’s precisely in his impact on individual readers that his books work their magic. Bel Mooney suggests his stories can heal and yet remain fully alive to the conflict, threat, unease and despair intrinsic to life.
In the past, he has spoken of the essential selfishness of the writer’s life. Yet he knows and has himself shown how that commitment to a private endeavour nonetheless can be transmuted into an act of communication. Over and over, each essay or memoir here, each poem, reaches the point where the writer explains how reading Garner’s books changed them.
His writing has presented opportunities, granted permission, offered a reprieve. Wagner’s book becomes not just a tribute to Garner, but a homage to the power of writing and storytelling. Books unearth something in us. They bring something to light.
It is a homage to the power of writing and storytelling. Books unearth something in us. They bring something to light
Garner’s fictions often turn on the contrast between underground and the heights, caves and the hill that covers them. The Weirdstone books are somehow claustrophobic, shut in. The child heroes, Susan and Colin, are persecuted, pursued, in need of rescue. Coming to the glorious Elidor after them, you feel with relief the openness of air; there’s a sea breeze, an expansiveness that connects worlds.
In The Stone Book, from a steeple the child Mary sees a landscape filled with churches. Taken beneath the earth by her father, she finds a secret site visited only by generations of Garners, a prehistoric place of worship, with a cave painting of a bull and the print of a human hand, precisely the same size as her own. Above is brightness and sky and cloud and the gold of the weathercocks spinning; under is dark and quiet and all but hidden. There the human relation to time is etched or printed on to stone.
In the 1970s, there was controversy as to whether Garner was a children’s author or not. I first came to his books one summer in my mid-40s, picking up The Weirdstone of Brisingamen from a shelf in a house I was staying in, and found myself so entranced that I kept going through one after another of them until I reached Boneland, happily (coincidentally?) published that autumn.
Garner’s early works certainly appeal to children, but they also appeal to the children and adolescents latent in his adult readers, there like strata in the rock, the handprint left behind long ago.
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