Summary:

A thirty-five year old English professor (and brilliant writer) diagnosed with ALS (Amyotrophic lateral sclerosis, Lou Gehrig’s disease) is told he has less than five years to live. Nine years later he publishes a series of 12 personal essays that chronicle his remarkable journey from diagnosis ("Getting Up in the Morning") to being mindful, "cultivating the eternal present" ("Living at the Edge"). He shares with us the interim of conundrums, spirituality, and the quotidian by reflecting on his New Hampshire life: Unfinished Houses, Wild Things, Mud Season, Winter Mind.

In almost every essay Simmons reflects on the rewards of "mystical seeing". We all have "within us this capacity for wonder, this ability to break the bonds of ordinary awareness and sense that though our lives are fleeting and transitory, we are part of something larger, eternal and unchanging." (p. 152) "Most of us have found that a line of poetry or scripture, a passage of music, the turning of a leaf in sunlight, or the sight of a child splashing in a stream can suddenly become a doorway through which, as William James writes, ’the mystery of fact, the wildness and the pang of life, steals into our hearts and thrills them.’" (p. 101)

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In the foreground, staring directly at the viewer, white tears visible on her cheeks, the artist lies immobile in a four poster hospital bed, only her head visible above the white sheet covering that is decorated with pale, pastel circles of cells or microscopic organisms.  The towering wooden oak easel that held her canvases, allowing Frida to paint when ill, is now the structure supporting a funnel of physical and emotional preoccupations erupting as vomit from her mouth: fish heads, dead chicken carcasses and fowl entrails, and skull inscribed with her name.  The background is a barren, parched and cracked desert.  The solitary objects in the sky, a moon and red-orange rimmed sun, suggest being trapped eternally, day and night, in this state, "Without Hope" --the painting's title. On the back of the painting Kahlo wrote, "Not the least hope remains to me....Everything moves in tune with what the belly contains."  [Hayden Herrera. Frida Kahlo: The Paintings (New York: HarperPerennial) 2002, p. 187]

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In 1917, the poet Siegfried Sassoon protests the war in a London newspaper. He is saved from court martial by a military friend who argues successfully for his transfer to the Craiglockhart War Hospital where he comes under the care of psychiatrist, William Rivers. Sassoon is not sick, but he and his doctor both know that the line between sanity and insanity is blurred, especially for a homosexual and in a time of war.

The other patients, however, are gravely wounded in spirit if not body; sometimes they are tormented by uncomprehending parents and wives. Rivers’ efforts to unravel their nightmares, revulsions, mutism, stammering, paralysis, and anorexia begin to shake his own psychic strength and lead him to doubt the rationality--if not the possibility--of restoring them to service. He yearns for his pre-war research in nerve regeneration, the quixotic enterprise that serves as a metaphor for his clinical work.

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Shay, a psychiatrist who specializes in post-traumatic stress disorder (PTSD), juxtaposes the narrated memories of his patients who are Vietnam veterans to the story of Achilles in Homer's Iliad. He finds that the roots of their illness, like that of the ancient hero, lie in betrayal of duty by senior officers who failed to do "what's right," in the repression of grief, and in the social limitations imposed on expressions of love between men.

These stressors lead to guilt, wrongful substitution, and dangerous rage, called the "berserk" state. The mental pathology is fostered by an equally wrongful failure to honor the enemy; return to "normal" is never possible. The book concludes medically with recommendations for prevention.

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The story of a woman artist's slow decline into dementia and death as told through the eyes, words, and reflections of her philosophy professor son. Through his memories of their 1950s life together, he reconstructs a speculative analysis of her early married life with his soil-scientist, Russian-immigrant father.

The one older brother becomes a neuropathologist who investigates the very disease that slowly strips their mother of herself. Their father tends to her growing needs at the family farm, but he dies suddenly and she must be placed in an institution where one nurse alone seems to respect her dignity.

The brothers' rivalries and misunderstandings are recapitulated in their different responses to their father's death and their mother's illness: the physician retreats to scientific explanations of the "scar tissue" in her brain; the philosopher looks for evidence of personhood and for reassurance that death should not be feared. His obsession with his mother's condition stems from a deeply felt sense of guilt; it destroys his marriage and condemns him to depression, hypochondria, and shame as he creates and diagnoses the same illness in himself, long before it can be detected by doctors.

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Augusto and Michaela Odone (Nick Nolte and Susan Sarandon) are the adoring parents of a bright little boy who inexplicably develops alarming behavioral problems, after they return from working in the Comoro Islands. A series of investigations results in a diagnosis of adrenoleukodystrophy (ALD), but the boy rapidly deteriorates into a bed-ridden, inarticulate state. Frustrated by the medical profession's inability to help, Augusto and Michaela embark on an odyssey of salvation, studying lipid metabolism, promoting international conferences, and trying to disseminate their findings to other parents.

Their insights lead them to experiment with at least two effective therapies, one of which is erucic acid (Lorenzo's oil). Michaela feels guilt as well as grief, when she understands that the X-linked disease is passed from mother to son. In an effort to keep Lorenzo at home, she refuses to admit the extent of his disability, alienates her family, dismisses nurses, and assumes most of the care herself, nearly ruining her own health and her marriage. The film ends hopefully with tiny signs of recovery in Lorenzo. The credits roll over the faces and voices of happy, healthy-looking boys who have been taking Lorenzo's Oil.

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On 15 March 1977, the acclaimed Quebec writer, Hubert Aquin (HA) born 1929, blew out his brains on the grounds of Montreal's Villa Maria, a convent girls' school, where his first wife had been educated and only steps from the Westmount home that he shared with his psychiatrist partner, Andrée Yanacopoulu (herself now a writer of medical history) and their nine-year old son, Emmanuel. Yanacopoulo had known of the suicide plan well in advance and, as part of a pact, had agreed not to stop it.

Through a series of interviews with family, ex-family, friends, lovers, colleagues, secretaries, students, and cleaning ladies, mostly between 1977 and 1983, Sheppard conducts an "investigation" to determine why Aquin ended his life at that time and in that way; and why his partner allowed it. Only a single interview seems to have been conducted after 1985. Each chapter is preceded by an extensive citation from one of Aquin's four novels, followed by stage direction notes for music, sound effects, and mood, and comprised of situated testimony written as dialogue for a film script.

Just as many explanations for Aquin's suicide emerge from this inquiry as there are witnesses. The causes range from the political, through the physical, psychological, social, symbolic, and emotional, to the spiritual. For each witness, they are the truth. They include 1. the failure of the recently elected separatist government to declare Quebec to be a sovereign nation; 2. Aquin's much publicized dismissal from a newspaper job, which he had counted on for a prominent editorial opportunity; 3. the failure of one (or several) love affair(s); 4. the collapse of two marriages; 5. estrangement from the two sons of his first marriage; 6. chronic ill health due to alcoholic epilepsy; 7. unresolved conflicts with his parents; 8. the result of his own writing which displayed a longstanding fascination with sex, death, violence, and suicide; 9. the result of writer's block; 10. a "classic" capitulation of a "québécois" male to the tyranny of women, either a "québécoise" mother or--(take your choice)-- a non-québécoise lover; 11. a covenant with 9 year-old boys crossing several generations; 12. the destiny of a man with a death wish, a chronic predisposition to self killing, who, according to one engaging friend (Jacques Languirand), had probably already committed suicide in a previous life as a late Antique Roman, and would likely do again--perhaps already has.

Sheppard dedicates his book to more than one hundred suicides from Sappho to Kurt Cobain. He shapes the responses of his subjects by his pointed questions and the juxtaposition of their answers to advance his overriding theory that Aquin's suicide was his finest work of art. All the varying explanations co-exist peacefully within Aquin's immortality, which resides in the minds of those who remember and grieve for him. No single interpretation is more plausible than another. Sheppard explicitly links these multiple "truths" to the early film work of Kurosawa; we are also reminded of Iain Pears's An Instance of the Fingerpost and The Dream of Scipio (see this database).

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This outstanding anthology of poems, stories, excerpts and essays by African-American writers is prefaced by a poem ("Aunt Sue’s Stories" by Langston Hughes), a foreword, two essays and an introduction. The book is then divided into three sections: Section I, Illness and Health-Seeking Behavior; Section II, Aging; and Section III, Loss and Grief.

Each section begins with an introduction which clarifies the choice of the section’s theme and briefly describes each piece. At the conclusion of each section is a list of ten to fifteen questions which "are intended for personal reflection and group discussion." Brief autobiographical information for each of the thirty-one authors is presented in Appendix 1.

As Secundy notes in the introduction, a divide exists between the health care worker and patient, which is particularly prominent when color and economic status are different between them. Secundy, as an educator in the medical humanities, selected pieces that reveal "the significance of color and social distinctions" when African-Americans face illness or enter the health care system.

The selections chronicle struggle and survival, illness and loss, humiliation and pride, triumph and sorrow. These pieces speak to all of us, as Edmund Pellegrino states in his essay, "Ethnicity and Healing": "[p]aradoxically, as we learn more about the uniqueness of African-American culture, we are drawn closer to the common humanity we share with the subjects of these stories and poems."

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During the opening credits, the camera slowly pans over the myriad medications for Marvin (Hume Cronyn), the elderly, bedridden invalid cared for round-the-clock by his daughter, Bessie (Diane Keaton). The film opens with Bessie visiting Dr. Wally (Robert DeNiro), a pathologist cum primary care physician, for diagnostic tests which show that she has leukemia.

Bessie also takes care of her Aunt Ruth, whose electric unit for pain relief and penchant for soap operas provide comic relief in this bittersweet drama about families and responsibilities. Because Bessie's best chance for survival is a bone marrow transplant, she contacts her sister, Lee (Meryl Streep), estranged since their father's first stroke and Lee's decision not to help care for him.

Lee's oldest son, Hank (Leonardo DiCaprio), is a troubled seventeen-year-old who sets fire to their home and is hospitalized in a mental institution. Released for this special trip to visit his Aunt Bessie, Hank continues his rebellion by refusing to be tested as a possible donor. Lee is a dysfunctional mother: she does not respond to her son's apology regarding the arson, she has her younger son light cigarettes, and she confuses discipline with control.

The family unites in and around Marvin's room. Reunions are never as smooth as planned, and tensions, stored bitterness, and anger erupt. The sisters confront each other in their failures as sisters--Bessie had never contacted her nephews in any way and Lee had never looked back. But through it all, love and caring emerge: the sisters come to a new understanding, Bessie's reaching out to rebellious Hank is reciprocated, and Lee even learns to communicate caring to her son.

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Summary:

A man begins to lose his word-finding abilities, his ability to perform everyday activities and his ability to communicate with his wife. He realizes his growing losses and incapacities. Even as he worries how to make amends to his wife, he grows distant and isolated. The poem ends with a vivid scene: the man stands in front of the woodpile with the axe raised--he looks at but does not recognize his wife screaming behind the closed bay window. "[H]e never / hears what it was she never said."

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