Summary:

In the "free love" context of the nineteen-sixties, Harriet and David Lovatt are throwbacks to a more conservative, traditional, and family-oriented decade. Their life dream is to have a big house in the country filled with children, and it seems that they will succeed. After bearing four young children, however, Harriet is feeling the strain of years of childbearing, sleeplessness, money trouble, and her parents' and in-laws' disapproval of her fecundity.

Her fifth pregnancy is not only unplanned, but also unusually painful and disruptive. Harriet's doctor prescribes sedatives but finds nothing abnormal in her situation. When Ben is born, Harriet jokes that he is like "a troll or a goblin," but no one responds well to this unusually hairy and physically vigorous baby, who in turn does not respond to anything but his own desires and fears.

As he grows older, family pets and other children seem to be in physical danger. Health care professionals do not confirm the couple's conviction that Ben is not normal, but neither do they obstruct the decision to send Ben to a private institution, a removal that leaves the family temporarily happy until Harriet visits Ben and recognizes the institution for what it is, a place where all manner of "different" children are sent to live heavily medicated, physically restrained, and foreshortened lives away from families who do not want them.

Harriet brings Ben home, where he grows up amid what remains of the Lovatts' domestic fantasy, and finds community in a gang of thuggish older boys whom Harriet suspects are involved in various criminal acts. As the story closes, Ben has left home and Harriet imagines him in another country, "searching the faces in the crowd for another of his own kind" (133).

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A third year medical student rotates through a gynecology clinic at the university. The attending Dr. Snarr, is supposed to treat his patients' chronic pelvic pain, but only seems to inflict pain himself. The student/narrator wants to comfort the patients, but lacks the knowledge, skills, and authority. The student also feels uncomfortable with issues of sexuality and intimacy with these female patients.

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Ruth Picardie was a journalist working in London. Shortly after her marriage in 1994 to Matt Seaton, also a journalist, she found a breast lump. After testing, she was told it was benign. Two years later, and a year after giving birth to twins, the lump enlarged and this time she was diagnosed with advanced, inoperable breast cancer. She rapidly developed bone, liver, and brain metastases and died in September 1997, aged 33.

This book consists of a selection of Picardie's e-mail correspondence during the last year of her life, the columns she wrote for the Observer newspaper (a series about dying she called "Before I say goodbye"), readers' letters responding to her column, and an introduction and epilogue by her husband. While not, then, strictly a memoir, this collection of texts constitutes an intimate view of a witty, angry young woman undergoing an intolerable illness.

The expected elements are there: diagnosis, chemotherapy, radiation, hope, the loss of hope. What is unexpected is the way these are presented, and the vividness with which we share the prospect of saying good bye to her children, her gradual detachment from her husband, and, as the brain metastases spread, the loss of coherence and the appalling silencing of her powerful voice.

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The Physician in Literature is an anthology edited and introduced by Norman Cousins that aims to illustrate the multiple ways in which doctors are portrayed in world literature. Literary selections are organized into 12 categories including Research and Serendipity, The Role of the Physician, Gods and Demons, Quacks and Clowns, Clinical Descriptions in Literature, Doctors and Students, The Practice, Women and Healing, Madness, Dying, The Patient, and An Enduring Tradition.

Some of the notable authors represented in this collection include Leo Tolstoy, Herman Melville, Albert Camus, William Shakespeare, Charles Dickens, George Bernard Shaw, Anton P. Chekhov, Orwell, Fyodor Mikhailovich Dostoevski, Ernest Hemingway, Thomas Mann, Gustave Flaubert, and Sir Arthur Conan Doyle. A healthy dose of William Carlos Williams makes for some of the most enjoyable reading ("The Use of Force" and excerpts from his Autobiography).

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This book contains 17 short stories, all set in an in-patient hospice, all exploring the reactions of patients and their caregivers--both family members and professionals--to the last stages of terminal illness. A woman struggles to find the strength to write last letters to her loved ones, nurses are surprised when a seemingly unconscious patient suddenly joins in their conversation; the hospice chaplain becomes a patient; and so on. In the title story, a dying woman's daughter finally manages to answer honestly when her mother asks when death will come: "Soon."

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Carol White (Julianne Moore), an upper-middle-class Los Angeles housewife, is stricken with a mysterious illness that her doctor cannot diagnose or explain. He believes her illness to be psychosomatic, but Carol, through contact with a support group, realizes she has "environmental illness," an immune disorder that causes her to physically overreact to common chemicals, fumes, and environmental pollutants. The film follows her journey to a clinic in New Mexico in search of relief from her increasingly debilitating symptoms.

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Nan Shin was an American woman living as a Zen Buddhist nun in France. She is diagnosed with advanced uterine cancer, undergoes surgery and chemotherapy and, by the end of the book, it appears, is dying. Her account does not, however, take the conventional form of the illness narrative; in fact its form might be called anti-narrative, for its focus is not on the story of Shin's illness and dying, but rather on the "every day living" that is at the center of her Zen beliefs.

The book consists of several strands that recur in alternating sections. One strand describes, in minute detail, the course of a single day's devotions and activities in the life of a Zen nun. Another traces the author's travels in the United States with her sensei, an astonishing man whose perspective on American culture is both detached and hilariously insightful.

A third tells of the author's frequent horseback rides through the French countryside, with beautifully focused and precise descriptions of the natural surroundings. Finally, there is the illness, presented matter-of-factly but conveying powerfully the author's (not always wholly successful) efforts to put into practice, in such trying circumstances, all she has learnt as a practitioner of Zen.

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The editor, herself a writer and one who has suffered depressive episodes, collects a series of personal essays or illness narratives about experiences with depression. Her contributors are all artists, primarily writers, who generally but not exclusively speak to the relationship between their art and their mood disorders. Some of the essays included have been previously published, but most are original contributions to this collection. The collection is introduced by Kay Redfield Jamison whose academic work has examined the relationship between creativity and depression, including manic-depressive disease.

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Mrs. Wilson is a woman diagnosed with an advanced malignancy of the genital tract. Her husband had died from cancer ten years earlier. She is treated with a hysterectomy and oophorectomy along with aggressive chemotherapy by a good doctor who has no bedside manner.

Throughout the story her best friends are always medications to relieve pain: Dilaudid, morphine, Tylenol #3, and methadone. Only her son-in-law really understands her needs and comprehends how to care for her. He is genuine and vital and appears to know as much or more than the doctors in the story.

Mrs. Wilson acknowledges that "to maybe get well you first had to poison yourself within a whisker of death" but discovers that "if you had something to live for, if you loved life, you lived." She dies in a hospital room receiving an IV morphine drip. Before fading into oblivion, she recalls her youth and makes one last attempt at fathoming the meaning of life.

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Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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