Summary:

An older woman is diagnosed as having cancer. The story is of the progression of her symptoms and the effects of her illness and eventual death on her husband and grown children. The years of silent compliance with the expectations of children and spouse begin to erode as the woman becomes sicker. The relationship between the aging couple, and the place of the ill mother in the priorities of her children clarify. The tale ends with the death, and a tiny glimpse of resolution of decades of strife and unexpressed rage between man and wife.

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The summer before her senior year of high school Julie Weiczynkowski qualifies for the Olympic developmental program's regional soccer team. She has every reason to believe she will be recruited by coaches from the best college teams in the country. But her elation is short-lived; the very day she returns home from soccer camp, she learns that her father has untreatable pancreatic cancer.

The story of that summer, told in Julie's journal entries, gives us a close-up look at her own stages of accommodation, and at the skills and strategies she develops to cope with her own grief, to support her mother, and to help care for her father. Each person in the family--mother, grandmother, siblings, and uncles--has a different perspective on and reaction to the crisis. Julie finds herself looking at the rest of her life as if through the wrong end of a telescope, and finds herself alienated from the boy who has been her best friend and support in high school.

The hospice workers who come to help her parents, though she finds their presence invasive, teach her a good deal about what dying looks like and how to bear with the one who is suffering. She travels a painful learning curve to arrive at a place of acceptance, claiming her life after her father's death, and reclaiming a friendship that matters to her on new terms.

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A surgeon attending a medical meeting becomes bored and hires a prostitute. When he awakens next to her in bed the following morning, he first observes, then palpates a suspicious lump in the right breast of the sleeping woman. Although he informs her of the abnormality and the need for further evaluation and treatment, the surgeon cannot bring himself to divulge the possibility (or even likelihood) that the breast lump is malignant.

It is the prostitute who acknowledges (and eventually proclaims) that the lump might be cancer. She realizes that breast cancer might prove fatal to her livelihood as well as her life. The surgeon appears less upset by the diagnosis and potential suffering associated with it than the realization that both he and the tumor were rivals, "each feeding on her flesh" in a competition to consume the woman.

He pays the prostitute one hundred dollars for her services and cannot wait to exit the room. She offers him ten dollars for his consultation, but the surgeon refuses the fee with the excuse that he doesn't make house calls.

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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The physician Tsvyetkov visits a child who is dying of a brain tumor, and the boy's mother. There is no hope, nothing to be done. Tsvyetkov has had one romantic fling in his life; when he was younger, he had an affair with the boy's mother. She has always told him that Misha was his son. Yet she also had affairs with other men around the same time; one of them might be the father. Tsvyetkov suspects that she insists that he is the father just so he will continue to make payments to support them, which he has always done. As he leaves, he asks the boy's mother one last time, "It can make no difference now. Is the boy mine?" She hesitates for a moment, but answers, "Yes. he is your son."

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This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.

The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."

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Patrimony relates the final illness and death of Philip Roth's father, Herman Roth. It begins as a misdiagnosis of Bell's palsy, which is eventually diagnosed as a brain tumor. Further tests reveal that it is cancer, operable only with great effort and little promise of cure or even significant palliation. The family (including Herman) decides against surgery and remains in close contact with him until his death.

Roth recounts his father's increasing weakness and helplessness, his own emergency quintuple bypass surgery, and his dreams of his father speaking to him from beyond the grave. Writing this book, he concludes, is the natural and necessary process in bearing witness to his father's life and death.

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This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.

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This is a new collection of poetry and short prose by nurses, edited by Cortney Davis and Judy Schaefer, whose remarkable first anthology, Between the Heartbeats: Poetry and Prose by Nurses [see annotation in this database], may be the founding document of "nurse writing" as a recognizable genre. In the Foreword, Cortney Davis comments on the process of selection and sketches the similarities and differences between this and the previous volume.

One of the interesting similarities is that nurses write more often about birth than death; one of the differences is the wider range of topics, including nurses who reveal their own experiences as patients (see Amy Haddad, "Conversations with Wendy," pp. 100-102) and others whose fatigue and frustration cause them to step away from nursing (see Pamela Mitchell, "A Nurse's Farewell," pp., 149-151)

As in Between the Heartbeats, the authors of Intensive Care appear in alphabetical order, which favors variety and surprise over categorization. In "Medical Ward," the first poem (pp. 1-2), Krys Ahlman captures many of the themes of the anthology. "I was wearing a thousand tiny failures," Ahlman writes, and concludes: "I held out my hand, I said / I am not afraid to cry."

Intensive Care is full of delights. As advertised, there is much about bringing children into the world and caring for them; for example, Lynn Bernardini's reminiscence, "Does This Day Mean Anything to You?" about having given up her own baby for adoption (pp. 11-16); Celia Brown's poem "Forget-Me-Nots" (pp. 35-36); and the powerful but ambiguous hope of "Neonatal ICU" (Leigh Wilkerson, p.247). There are the painful memories of dying children and adolescents, especially Jeanne Bryner's amazing, "Breathless" (p. 42) and "Car Spotting, " (pp. 173-184), a story by Christine Rahn about a terminally ill adolescent. In "Car Spotting" the head nurse criticizes the young narrator because, "You become too personally involved with the patients . . . Nurses must make decisions based on objective data. Becoming too attached can cloud professional judgment." (p. 175) I found this an interesting statement coming from a nursing instructor--it could well have been made by a professor of medicine to a third year medical student.

Other major themes include the humor of nursing (see "RX for Nurses: Brag!" by Kathleen Walsh Spencer, p. 203; and "What Nurses Do on Their Day Off," Judy Schaefer, p. 188); women's health (see "Every Day, the Pregnant Teenagers," Cortney Davis, p 69; and "Redemption at the Women's Center," Jeanne Lavasseur, pp. 132-133); nursing the elderly (see "Home Visits," Paula Sergi, pp. 195-196); and the wonderful narratives of patient care (see "Sarah's Pumpkin Bread," Terry Evans, pp. 87-90; "Edna's Star," Chris Grant," pp. 95-99; and "That Mystique," Madeline Mysko, pp. 158-167). Finally, Intensive Care looks back thoughtfully in a number of pieces to nursing in military settings.

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How JFK Killed My Father is a collection of 52 poems by psychiatrist Richard Berlin. The book is divided into five sections--"Learning the Shapes," "Role Models," "Code Blue," "What a Psychiatrist Remembers," and "What I Love"--and these subtitles guide the reader through this physician's poignant journey from medical student to accomplished, and humbled, "healer, priest, turner of textbook pages, searcher, listener, arrogant crow consumed in white" ("If You Ask Me My Name").

Berlin's poems succeed because of strong imagery and the kind of internal "knowing" that only comes when one pays attention to the sights, sounds, and emotional nuances that occur in training, in practice, and in life. A musician as well as a doctor, Berlin sometimes uses jazz as a metaphor: in "Uncle Joe" he writes about "suffering's music" and in "Learning the Shapes" medical students practice examining patients until their fingers are as sensitive as a "blind bluesman" whose fingers can sense the right note "an instant before / touching a tight steel string."

Berlin "gets" the stress of med school and residency just right in "Sunday Parade" and "January Thaw"; as his poems retrace his path from student to practicing psychiatrist, he transmits the deepening of both experience and empathy in the same right-on way: "What I Revealed," "Places We Have Met," "What a Dying Woman Saw," "Transference," "What a Psychiatrist Remembers," "What Makes a Psychiatrist Cry," "Our Medical Marriage," and "What I Love" stand out as examples. The poems in this collection are personal, eloquent, straightforward and well crafted; they move effortlessly between body, mind, and spirit.

A reader could open this collection to any poem and be captivated, but for full impact this collection is best read from beginning to end. Medical students, especially, might welcome this volume as a guide along their way.

(Some of the poems here also appear in Berlin's chapbook, Code Blue, which is annotated in this database.)

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