Summary:

The poet undergoes a breast biopsy under local anesthesia: "I had thought my skin was a permanent seal. / Now I watch this layer of myself / . . . sprout red flowers . . . . " She observes the (male) surgeon closely, imagines her tissue on its journey to the pathology laboratory, and listens carefully to the surgeon's first words: "this man / who went beyond my skin / as no one else has . . . / as he made me for the first time, his."

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In typically terse poetic structure, utilizing fresh new images, Holub visualizes removal and replacement of a human heart during a transplant procedure. He describes the throb of the extracorporeal circulation mechanics as an "inaudible New World Symphony" as he elevates the imagery of the hole in the chest where once resided the "king of Blood" transiently into the cosmos. With the arrival of the "new heart," the imagery again becomes earth bound: the structure is sewn in place, the beats resume and the "curves jump like / synthetic sheep" as the EKG rhythm resumes.

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On surface, this metaphorically endowed poem details the life cycle of a tapeworm, beginning as a tiny resident in the "protective slime" of mucosae, eventually outgrowing the host, and overrunning the environment as it attains a "philosophical dimension / in which it's the only form of matter. . . . " The parasite shrinks again into "little spores of embecile agreement" which wait for another chance, another cycle of growth and power. The parasite metaphor works beautifully for a wide variety of social and political phenomena the poem does not identify.

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A maiden aunt never marries because a river prawn bites her calf and, due to minimal treatment by her physician, nestles there to grow. She devotes her life to her nieces, making for them life-sized dolls on their birthdays and wedding days. When only the youngest niece is left at home, the doctor comes to see his patient and brings his son, also a physician. When the son realizes the father could have cured the leg, the doctor says, "I wanted you to see the prawn that has paid for your education these twenty years."

The young doctor becomes the aunt's physician and marries the youngest niece, taking her and her wedding doll to live in a house like a cement block, requiring his wife to sit on the porch so passersby can see he has married into society. The doctor sells the doll's diamond-eardrop eyes, and when he wants to sell its porcelain, his wife tells him the ants ate the doll because it had been filled with honey.

The doctor grows older, but his wife keeps the firm, porcelained skin she's always had. One night he watches her sleep and notices her chest isn't moving. Placing his stethoscope over her heart, he hears a distant swish of water. "Then the doll lifted up her eyelids, and out of the empty sockets of her eyes came the frenzied antennae of all those prawns."

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Narrated in the style of an "advice" manual, this is the chronicle of a woman who undergoes a hysterectomy and removal of her ovaries. The tone is sardonic. The story begins with the office visit in which the doctor delivers the news and reassures her that she is too "intelligent and sophisticated" to associate her womanhood with her reproductive organs. The physician attempts to persuade the narrator to have her ovaries removed--preventive medicine against the possibility of ovarian cancer--and she finally agrees while groggy from pre-operative anaesthesia. Nothing has prepared her for the emotional and physical lability she experiences after surgery. Even her sexual relationship with her husband is changed.

As she returns for post-operative check-ups, she becomes increasingly conscious of the indignities of the office visit and physical examination: "it strikes [her] that this maximum-efficiency set-up [three cubicles with naked, waiting women] might serve equally well for a brothel and perhaps already does." She feels that she has made a terrible mistake in allowing the doctor to have talked her into anything and that as a male, "there is nothing he can tell you about how you feel, for the simple reason that he does not know."

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Seventeen year-old Phyllis Halliday lives with her parents near the maximum security penitentiary in Kingston, Canada. In the year 1919-20, she establishes a forbidden, epistolic relationship with convict Joseph Cleroux, who is serving a sentence for theft and extortion. Messages, money, and small gifts of tobacco, chocolate, and a ring, are concealed in the quarry next to her home where the convicts are sent to work. Influenced by the newly released film with Mary Pickford, she dubs her new friend "Daddy Long Legs," and herself, "Peggy."

Both Phyllis and Joe fear being caught, and they suffer from parallel illnesses. As she falls in love with the man whom she has never met, she neglects her studies, hoping that he will come for her when he is discharged. However, on that day, he is immediately put on the first train out of town. His letters dwindle and cease, but Phyllis continues to wait and hope.

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Elizabeth Carpenter is preparing for her fiftieth wedding anniversary and hoping that her children will come home for the event. She nurses her irritable, invalid husband, a retired teacher, who has been a rigid father and is now bedridden with a chronic illness. He is too proud to ask for the things he needs or wants, and spends his vacant hours comparing what he perceives as the dull, dutiful Elizabeth to the "other woman" he loved long ago.

Their oldest child, Victoria, once a fragile beauty full of promise, is institutionalized for a chronic mental illness characterized by irrational fears and self-doubt. The middle child, Jason, is a psychiatrist who has been unable to establish trusting relationships and seeks affirmation through multiple sexual adventures. The youngest child is Emily, a concert violinist whose way of achieving peace is to live abroad, avoiding commitments and her family from whom she is hiding the fact of her own son, Adam. But the reunion leads them to revisit relationships and events in the past and results in some surprises for their present and future.

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Fran, a fourteen-year-old from New York, is finally allowed to spend a month of her summer vacation with her aunt of Cape Cod. As yet she is unaware that her parents have put off such a visit because her aunt, a lively, empathetic teacher, has a long-term lesbian partner. Among Fran’s new acquaintances is a girl her age, Wilma, who is confined to a wheelchair and, apparently because of the way her disability sets her apart, as well as her famous father’s divorce and remarriage, is extremely demanding and difficult.

Wilma’s stepmother hires Fran to be Wilma’s "companion" a few hours a day while she rests, being in the final stages of her first pregnancy. With the help of some pivotal conversations with her aunt and a new friend, Jack, Fran finds her way through her own anger and bewilderment at Wilma’s behavior to the beginning of an authentic friendship with her, as well as an understanding of the imagination caregiving demands. Along the way she becomes aware of her aunt’s lesbianism and finds that her other experience has helped open her to acceptance of this difference as well.

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Osler’s famous essay was first delivered as a valedictory address at the University of Pennsylvania School of Medicine in 1889. Osler urges the graduates to develop two qualities or virtues. First is the "bodily" virtue of imperturbability or "a judicious measure of obtuseness." This means the outward expression of calmness and coolness, even under difficult circumstances. This virtue suggests that physicians should be relatively "insensible" to the slings-and-arrows of patient care, always maintaining a degree of detachment from their patients.

The complementary "mental" virtue is aequanimitas, which is the personal quality of calmly accepting whatever comes in life. These virtues, however, should not lead to "hardness" in dealing with patients. Osler also urges his students and colleagues to develop the other gentlemanly virtues of courage, patience, and honor.

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Scarlett writes about the tradition of medicine in a recognizably British (Canadian) voice. He presents a definition of a profession that features social responsibility and duty to serve others, and notes that "an organized profession does not seek to advance the money-making feature of professional activity." Scarlett identifies seven "pillars" (principal qualities) of the physician, or any other professional: technical skill, social responsibility, knowledge of history, knowledge of literature and the arts, personal integrity, faith that there is some meaning and value in life, and "the grace of humility."

Scarlett critiques the medical profession in two ways. First, physicians are not skeptical enough and willing enough to correct their errors. Secondly, professional qualities have declined "at the hands of the scarcely literate pushing public . . . . " As a result of this, some physicians now believe that "all this rhetoric about the essential nobility of the medical profession is a load of old rubbish" (p. 129).

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