Summary:

Grandma's life was fully spent. Sensing her time was ending, she climbed up three flights of stairs, took to her bed, and began to die. The other inhabitants of the great house, her children and grandchildren, cried out for her. How could her great vibrancy end? What would become of them--of the house--without her? Grandma reassures those surrounding her that "no person ever died that had a family . . . other parts of me called Uncle Bert and Leo and Tom and Douglas, and all the other names, will have to take over, each to his own" (427-428).

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The Heavenly Ladder is physician-poet Jack Coulehan's most recent chapbook, bringing together 48 poems, many of which have been published individually in various medical journals and literary magazines. The collection is divided into four sections.

Poems in the first section, "Medicine Stone," are written in the voice of patients or in the voice of the physician who treats them. The second section, "So Many Remedies," consists of five poems inspired by physician-author Chekhov. The poems of "The Illuminated Text" section reflect a wide-ranging interest in people who lived in distant times or in distant places. The final section, "Don't Be Afraid, Gringo," stays, for the most part, closer to home and includes a number of poems addressed to, or about, family members.

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The story begins in New York as a young immigrant Scandinavian woman gives birth to a daughter: "She entered, as Venus from the sea, dripping. The air enclosed her, she felt it all over her, touching, waking her." The time is at the turn of the 20th century, the baby's name is Flossie, and she is the second child of Joe and Gurlie Stecher. Joe is a printer, who takes great pride in his craftsmanship. He had once been a union activist, but became disillusioned with union corruption and now works as a shop foreman. Gurlie's driving ambition is for she and her husband to strike it rich and make their mark in this new land, where the streets are paved in gold (for some people).

Flossie turns out to be a sickly baby. At first, she won't nurse at all and almost dies of malnutrition and infection. Later, she remains so scrawny that a doctor claims the only way to save her life is to take her to live in the country. Thus, Gurlie and her two children travel to upstate New York for the summer, where they board with an aged Norwegian couple. While there, the baby begins to thrive, and so does Gurlie, who had spent her early childhood on a farm in Scandinavia.

Soon after Flossie's birth, the printers' union calls a strike. Joe successfully holds the line and keeps the shop running, but his grateful employers are not grateful enough even to give him a raise. Toward the end of the book, he negotiates with another businessman to obtain the wherewithal to start his own printing company.

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In this collection of 11 short stories, pediatrician-author Perri Klass primarily explores the world of women and their multiple and complex roles as mother, mother-to-be, friend, spouse, lover and professional. Parenthood--its glories, heartaches, tensions and mysteries--plays a prominent role in many of the stories. There is also a close look at woman-woman friendship--at what women say to their best friends and the nuances of the emotional responses to what is said or left unsaid.

Several stories feature single mothers: "For Women Everywhere" (a woman is helped through labor by her best friend), "Rainbow Mama" (a woman cares for her son during his diagnosis and initial treatment of leukemia), and "City Sidewalks" (a woman finds a baby on the sidewalk on Christmas Eve as she rushes to pick up her child from day care).

"In Necessary Risks," an anesthesiologist deals with work and her high energy preschool daughter while husband and easy-to-raise son head out to a dude ranch. In "The Trouble with Sophie," another high energy, dominant daughter wreaks havoc in kindergarten as well as with her concerned parents. In addition to the anesthesiologist, two other physician-mothers are featured in "Freedom Fighter" and "Love and Modern Medicine."

Parenting a newborn whilst handling other tasks is a theme featured in "Intimacy" (a high school biology teacher celebrates her first night of uninterrupted sleep as she both enjoys and envies her single friend's sex life) and in "Dedication" (a writer takes his stepson to a chess tournament while his biologist wife and newborn enjoy breastfeeding at home). Woman friendships are prominent in "For Women Everywhere," "Freedom Fighter," and "The Province of the Bearded Fathers." Grief and sudden infant death syndrome are themes of "Love and Modern Medicine."

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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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Salvadorian writer and activist Claribel Alegria has composed a sequence of poems, 47 sparse love letters to her late husband Darwin "Bud" Flakoll who died in 1995. Neither sentimental nor confessional, the poems draw on the struggles of Circe, Prometheus, and Orpheus as well as themes of unfinished rites, sadness, and symbolic immortality. The translator's preface is a reminiscence of her time with the couple then living in self-imposed exile, in addition to a critical introduction to the poetry.

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From the mundane to the profound, from the body as physical preoccupation to the body as sacred, the poet explores in 21 highly personalized lines the significance and symbolism of the human body. Washing your feet without giving it a thought means you are in good health; struggling to do it because of overweight is a reminder of mortality. This (any) physical act "should be ritual . . . memorial, meditative, immortal." It conjures up an image of the Degas ballet dancers washing their feet, and then, remarkably, that " . . . they also seemed to be washing God’s feet."

But the creative power of Degas is yet another reminder of the author’s limitations. He is vulnerable, mortal and not creative enough to gain immortality by producing a masterpiece: "It is sad to be naked and to lack talent."

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The narrator, Frank, an aging man with cataracts, heart murmur, and diabetes, reflects on the life he now lives with Francine, his wife. They have been together 46 years and time, he muses, "has made torments of our small differences and tolerance of our passions." They know little of one another’s daily lives; he doesn’t even know what conditions her array of pills on the breakfast table are meant to treat. Frank has taken to reading poetry.

Francine claims she has been hearing an intruder outside the window at night. She finds poems on the window sill. She is mystified and a little frightened. At her request Frank stays up all night one night to watch for the romantic intruder. Midway through that night he takes her for a walk in the frozen street. When they return to bed, aching from their respective debilities, he turns to her for the first time in recent memory, holds her, and kisses her as he used to, clinging to her fingers, "bone and tendon, fragile things," knowing he will die soon, and that life can still surprise him.

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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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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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