Summary:

This memoir by Joan Saltzman recounts her marriage, in her forties, to a man whose kidney disease was progressing to a point of choice between dialysis or transplant.  The first half of the book is a lively account of their somewhat stormy courtship, layered with memories of her childhood and reflections on tensions with and loss of her parents.  The second half focuses largely on the difficult decision to donate one of her own kidneys to her husband.  Even undergoing tests to determine she was a match required some wrestling with fear and resistance.  The chronicle continues through bumpy recoveries to a new level of intimacy and understanding of ongoing shared life in new terms.  Her idea of "complete recovery" had to be modified once she recognized that even a successful transplant doesn't restore a former state of health, but does restore a new range of possibilities.

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This memoir of a lifelong struggle with bipolar disorder, complicated by eating disorders and alcoholism, records the internal experiences of mania, confusion, depression, delusion, anxiety, terror, wild impatience, discouragement, and at times clarity and resolve that alternate in her life of recurrent struggle.  Diagnosed somewhat belatedly as rapid cycling type 1 bipolar disorder, her disease drove her to one disastrous coping strategy after another until she was hospitalized for her eating disorder and for cutting herself.  After years of intermittent hospitalizations and encounters with several incompetent psychiatrists as well as a few who were consistently helpful, she has come to understand exactly the kind of help she needs-at times trusting others' assessments of her condition more than her own, accepting supervision, abstaining from all alcohol-a critical factor in avoiding psychosis.

Her doctors continue to recalibrate her complicated drug therapies, and her moods and control remain precarious, but she has learned to live with a disease that seems still to be poorly understood, accept the limits it imposes, and handle it with intelligence, humility, and even at times a wry note of humor.  She has learned to accept help from the husband whose love survives recurrent unintentional abuse, and from parents and friends who remain supportive.  She ends the memoir on this note of acceptance, appending to it a list of facts and statistics about bipolar disorder designed to help situate it for the reader relative to other diseases and disorders.

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This impactful memoir recounts the events of the summer of 1996 when Greenberg's fifteen-year old daughter Sally "was struck mad," as he puts it (3).   Greenberg's portrayal of Sally's behavior as her illness erupts -seemingly from nowhere-- is staggeringly vivid and trustworthy, as is his description of the series of reactions that belong to him, the father who cannot protect, cannot even reach his daughter, although she sits beside him.   

A then-struggling writer, Greenberg unfolds the story, set in a ramshackle, five-story walk-up apartment in the Greenwich Village where he and his second wife (Sally's step-mother) reside.  Among the many rewards of this story is a colorful slice of a New York city life, around the block and in the locked ward.

Greenberg takes us through Sally's initial onset, her sleeplessness, grandiosity, delusions, and frantic drive to communicate, "a pile-up of words without sequence" (17).  The portrayal of his and his wife's initial shock; the diagnosis, "fulminating mania" with indicators for bipolar disorder; Sally's eventful hospitalization, and her return home in a medicated state that Greenberg finds almost as unsettling a transformation as the onset of the mania.  He details building a rapport with Sally's intriguing psychiatrist, as he observes Sally's efforts to do the same. Greenberg tells us about the day he decided to take Sally's medication -for a variety of understandable and also desperate reasons.  This sequence is brilliantly funny and poignant. And he gives us glimpses of the cost to his marriage of these events, bringing the stresses to light with astounding compassion for all concerned.

This memoir moves with exceptional grace between unfolding events and Greenberg's beautifully informed reflections on them.  Observations about the mental illness of James Joyce's daughter, Lucia, are woven through the text, as are insights and characterizations from other writers and doctors, like that of Eugen Bleuler who, Greenberg informs us, coined the word schizophrenia in 1911, when he observed that "in the end his patients were stranger to him than the birds in his garden.  But if they're strangers to us," Greenberg adds, "what are we to them? (24)" Perhaps the most gorgeous and unforgettable feature of the book is Greenberg's way with words, and his attentiveness to Sally's altered relation to words: "Afraid.  Frayed.  Why are you so a-frayed? She keeps asking" (25).

The story of this hard summer draws in a cast of compelling characters, including Michael's mother who arrives, it seems, from another world -of material comfort and propriety-bringing surprising sources of comfort to her adult son and to her granddaughter.  We also get to know Steve, Greenberg's older brother who, also suffering from mental illness, lives the life of a shut-in only blocks away from Michael, who brings him groceries and looks after him, at times a challenging job.

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Each poem in this collection is preceded by brief comments both by the author/patient and by her psychiatrist.  Together the poems chronicle incidents in the interior life of a woman who has lived with schizophrenia for 35 years, been hospitalized, changed doctors and medication, undergone intense feelings of isolation, and also has experienced remarkable support and love from a twin sister and a few loyal friends.  The poems range in tone from matter-of-fact tellings of psychotic episodes to reflections on relationships, both personal and professional, that have been important in the course of treatment.  The book is organized as a chronology that traces the trajectory of diagnosis, illness, treatment and recovery; the final section is entitled "Beginning Again."  Read in sequence, they give a rich sense of the writer's life, struggles, resilience, and unusual self-awareness.  

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When Gwen is twelve, her parents, suspecting her failure to show signs of normal adolescent development may be more serious than they had thought, have her tested and learn that she has Turner syndrome, a chromosomal disorder that frequently manifests in short stature, broad chest, low-set ears, amenorrhea and sterility. The diagnosis brings a new source of discord into an already somewhat dysfunctional New England family.  Gwen's mother, Paulette, prefers not to talk openly about Gwen's condition, or even, for a time, to admit it is real.  Her father, a scientist at MIT, is deeply interested in finding out more about it, but the clinical nature of his interest offends his wife.

Eventually the parents divorce, each to cope with different kinds of loneliness and alienation from Gwen and her two brothers.  One of those brothers, the designated achiever, is gay, but remains closeted for some years, in keeping with his mother's family culture.  The other, after a somewhat rebellious youth, marries a girl from blue-collar California, takes a teaching job, and eventually finds himself identifying with his son who receives a diagnosis of ADD not available during Scott's own youth.  The novel follows the individual stories of the five family members, each of whom carries his or her own burden of suffering, and brings them together during an unusual holiday gathering at the end, not for magical closure, but for a remarkable moment of retrospective understanding and opportunity for each to do some self-assessment and self-disclosure.

At the heart of the story is Gwen's "condition," recognized by all of them as the sadness that lies at the core of their family's chronic discomforts with one another.  Gwen herself finds her way into an authentic love relationship in her mid-thirties with a Caribbean diving guide she meets on a chartered excursion.  Though her mother is horrified and suspicious, and the rest of her family bemused, the experience of authentic love and friendship liberates Gwen from a history of self-defeating presumptions about her own limitations.

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This study examines representations of feminine illness in American culture from 1840 to 1940. It argues that the figure of the invalid woman emerged in the 1840s amid significant changes in "American literature, medicine and culture," including the emergence of a specifically American literature, the professionalization and masculinization of medicine, and the "sometimes complementary, sometimes opposed" ideologies of feminism and domesticity (17).

The book discusses mid-nineteenth-century medical theories that articulated women as "biologically inferior . . . given to disease and pain" (34) before analyzing contemporary literary works by E.D.E.N. Southworth, Harriet Beecher Stowe, Nathaniel Hawthorne (see this database for annotations of The Birthmark and Rappaccini’s Daughter) Washington Irving, Edgar Allan Poe, and works by twentieth-century authors including Ellen Glasgow, Charlotte Perkins Gilman (see this database for The Yellow Wallpaper annotated by Felice Aull and also annotated by Jack Coulehan), Tillie Olsen, Edith Wharton, F. (Francis) Scott Fitzgerald (see this database for Tender Is the Night annotated by Jack Coulehan, also annotated by Pamela Moore), and Henry James. Art, advertisements, and the film, Dark Victory (see annotation) are other points of reference.

Price Herndl examines compliant and resistant uses of women as invalids; the surprisingly small changes in figures of feminine illness in response to changes in women’s rights; the links literature constructs between illness, money, work, and value; shifting theories of cure (from somatic to psychic); and the rise of germ theory in relation to fictional representations of illness. She argues that male and female fiction writers in the period she studies use feminine illness for different purposes: "What that figure signifies is kaleidoscopic, shifting to suit the political needs of its user" (218).

Invalid figures in literature and culture, Price Herndl asserts, can "divert political dis-ease into an overwhelming attention to the individual body and away from the body politic," locating people’s problems in their individual bodies and selves rather than in the oppressive aspects of their culture (220). Recurrent representations of sick women reflected the extreme unease attached to the position of women in American culture in the years 1840-1940. While her study stops at 1940, Price Herndl asserts that after World War Two and at other points when "masculine privilege seems threatened . . . illness is figured more and more often as male" (220).

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The meeting of John and Florence Dowell and Edward and Leonora Ashburnham in a German health spa is the center of a train of lies, deceptions, adulterous love triangles, and deaths. John Dowell, a memorably "unreliable" narrator, calls it "the saddest story I have ever heard" (7). His narrative distance stems partly from the pastness of the events, partly from his absence for some of them, but mostly from his ignorance or denial of realities as intimate as his wife's serial deceptions of him.

Heart disease is the central narrative trope, a literary device easily unpacked as a site of irony: Each of the two major characters who have a "heart" (i.e. heart condition) is faking it, in service of his/her serial "affairs du coeur." Florence fabricates her heart trouble before her marriage is ever consummated, using it to turn Dowell into a cardiac nurse and keep him out of her bedroom. Edward Ashburnham fakes his illness to escape his military post and take his latest love object (and his stoically Catholic wife) to Germany.

The extramarital romps occasioned by Dowell's solicitude for Florence's "heart" comprise the main gag of this novel's comic beginning. When the focus shifts to Edward, Leonora, and their ward Nancy Rufford, The Good Soldier becomes a tragedy of emotional sadism, sentimental martyrdom, madness, and moral exhaustion that leaves us unsure about who in this novel has a literal or figurative heart.

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Robert and Jinnie Salesby are an English couple staying at a French resort to restore Jinnie’s health. Rather than a dramatically delineated plot, the story is comprised of a series of moments in daily life, drawn with psychological precision and depth. Robert, whose point of view the narrator explores most of the time, is characterized through his frequent shifts in perspective--from the present, shaped by his wife’s illness, to their past experiences of health and joy. As the story traces the Salesbys’ daily regimen of meals, walks, and rest, Robert’s grief and hostility regarding his wife’s illness becomes ever clearer.

The hotel’s other inhabitants, who are mostly drawn as caricatures--the American woman who talks to her dog, for example, and the Honeymoon Couple, whose vigor and sexuality provide a foil to the Salesbys’ subdued relationship--call Robert an "ox" and observe his solitariness and lack of apparent emotion. The local children react to him as if he is a figure of sexualized threat. Jinnie’s perspective is revealed only through her self-effacing cheerfulness, her appreciation of her husband, and her plenitude of that "temperament" her husband seems without.

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Most of the twenty works in this anthology are first-person narrative essays. They represent a wide range of women’s experiences of embodiment, spanning both the average lifespan and the particularity of individual lives, focusing on puberty and menstruation, weight-consciousness and eating disorders, facial disfigurement, multiple sclerosis, infertility and pregnancy, cosmetic treatments and surgery, breast cancer, and aging. A few essays offer a valuable cross-cultural lens on the experience of embodiment.

Hanan al-Shaykh’s Inside a Moroccan Bath (see this database) explores her dual experiences of being stigmatized in Middle Eastern culture for her thinness, and then having her stigma recast as value when she moved to a European city. Judith Ortiz Cofer’s "The Story of My Body," which begins "I was born a white girl in Puerto Rico, but became a brown girl when I came to live in the United States," (299) offers another perspective on the cultural instability of the criteria for female beauty. Linda Hogan’s "Department of the Interior" positions her experience of embodiment within the intertwined contexts of American Indian culture and the physical landscape of the West.

Some of the contributors are well-known for their texts on embodiment ( Lucy Grealy, Nancy Mairs, and Naomi Wolf, for example), whereas others are well-known creative writers (Margaret Atwood and Linda Hogan). Pam Houston’s Out of Habit, I Start Apologizing is also annotated in this database.

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This memoir purposefully intertwines a personal and professional coming of age with the chronic illness that shaped it. Roney's stories of her adolescence, college years, and beyond (she is now a graduate student approaching her fortieth birthday) integrate the story of her diagnosis with juvenile diabetes around age 12 and her changing approaches to living with, rather than simply "managing," her illness.

How diabetes inflected Roney's development as a woman, including such issues as body image; food, eating, and weight; and sexuality and love relationships, is a recurrent focus, with her unsatisfactory relationships with men often taking center stage. One chapter addresses her decision, in the face of fears about blindness, to become a writer instead of a visual artist. Other sections address travel and exercise, both explored as solo experiences and as struggles negotiated in the company of friends and strangers. Roney's experiences with family members and medical professionals in the context of her illness are an occasional focus.

While in most of the memoir Roney positions herself as an ill person in relationships with healthy people, in two sections she explores her relationship to others with diabetes: a woman her own age whose illness has made her completely blind, and her aging cat. Throughout the memoir, Roney moves from her own experience to broader philosophical reflections on the social construction of illness, especially the way that interpersonal relationships shaped by "invisible" disabilities like diabetes reflect cultural beliefs about illness and how it changes personhood.

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