DESPERATE MEASURES DISCUSSION GUIDE
How did early life challenges impair or fortify Dmitri’s and Njambi’s resilience? Compare their coping skills with those of Sandor and Desmond.
Think about the circumstances that influenced Njambi’s life: witnessing the early death of a wise mother, substituting for her brother as a shepherd, contracting acute leukemia, and enjoying a Western family upbringing. Was her success as a tenacious, brilliant protagonist due to nature or nurture, or both?
Consider the following sharp, contrasting backdrops: a Maasai hut and Gibbs Farm, Todd’s concierge practice and the CARE hospital ward, the lion hunt bell and the Amati violin, Western marriage and burial rites and those of the Maasai.
Why did Njambi dismiss abortion as a solution to her unborn son’s genetic flaw? Was her decision influenced by her religious faith (Maasai or Christian), faith in herself as a “Maasai warrior,” or the Hippocratic Oath?
Forgiveness plays a central role between many of the characters in the book. How does Sandor deal with his wife’s illness and the impact it had on his life? What drives Dmitri’s forgiveness of his father? Does Njambi draw on similar impulses to forgive Dmitri? Her father? What makes Hui’s reaction to her family’s dysfunctional life different than those of Njambi’s?
If the only treatment that could save the love of your life violated every clinical protocol, would you administer it? Would you treat your own family member? Would you deploy untested medical trials without informed consent? Can you offer true consent to your husband – especially if he suffers from dementia?
Is there a line you would never cross to save someone you love?
Think about how hard it must have been for Desmond to withhold information from his own daughter about Dmitri’s condition. In current law, divulging this information would be a HIPAA violation. In Talmudic law, the doctor is obliged to reveal this illness to a fiancée regardless of his patient’s wishes. What does a religious Jewish doctor do? What would you do?
Discuss the role of music as an obsession, as a sanctuary, or as a way to track Dmitri’s illness.
Check out the choice of names in the book: Alexej, Alexander, Sandor (short for Alexander), Njambi, Hui, Andwele, Namelok, Nashipae, the Old Man (as in “my old man,” a father substitute).
Can you detect a “coincidental” relationship between the “CAG” repeats and the “cage” mentioned in the last chapter’s dream sequence?
In the final chapter, are the musical “voices” Dmitri hears beckoning him to join the Old Man on Cloud Eleven, or fresh synapses undergoing repair? Are they a sign that Njambi’s treatment is working, or a prelude to Dmitri’s demise?