Summary:

Fifteen-year-old Frankilee's sense of justice leads her to conspire with her mother to kidnap Angelica Musseldorf from a home where there is every evidence she has been consistently beaten and abused. With reluctant cooperation from her father, they take the girl in, confront the parents, and install her in Frankilee's room for an indefinite stay. Angelica, who asks to be called Angel, is not only scarred, but needy--indeed, over time, demanding. As her parents shower her new roommate with attention, clothing, lessons, Frankilee struggles with her deepening resentments. She confides them to Wanita, the family cook, an African American whose long service to the family has given her a place of special affection.

When Wanita's son is killed in an accidental shooting, Wanita abandons the family for a time; she returns, sorrowful, but steady, to see Frankilee through her own trauma. Suspicions aroused, Frankilee decides to do some detective work with the help of a reluctant boyfriend, and discovers that Angel's "parents" are an aunt and uncle with a criminal record in fraud; they have staged abuse in order to situate their orphaned niece with unsuspecting families of means who will take on the expense of her upbringing and education. In her efforts to expose the fraud, Frankilee is attacked by the aunt who is, in fact, violent, but she survives with some stitches and a sobering sense of what it might mean to be both kind and discerning in offering help.

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Max, who has lost his wife after a long life and career together as circus acrobats, reluctantly retires to an assisted living home. There he finds unexpected friendship first in his neighbor, Lettie, a widow who has a gift for uncomplicated kindness, and Alison, a thirteen-year-old he meets when he gives juggling and stunt lessons at the local junior high. The unhealed ache of his wife's slow death from cancer makes Max skittish about opening his heart to either of them, though Lettie offers him patient companionship and Alison, full of adolescent restlessness, unfocused intelligence, and need, desperately wants something of the grandfatherly good humor and wit she finds in Max.

Alison's mother is pregnant with a long-delayed second child and the distance she feels from her parents drive her to lengthy novel-writing and to rather pushy efforts to make Max her special friend. For him, she learns to juggle. She cuts class to visit him, and to go out for sodas with Lettie. Alienated from peers she finds silly, the old people touch a place in her that needs love. After a heart attack, Max comes home with newly raised defenses, and retreats from the budding friendship with both women.

But when Alison runs away to a circus he refused to attend with her, and then to Penn Station, Max goes with her parents and finds her on a hunch. Found, she clings to him like a small child, and he finds himself full of a long-resisted love. On the way home, however, he succumbs to a heart attack. In the final chapter, Lettie helps Alison begin the long, difficult process of accepting mortality, grief, and the possibility of eventual healing from a loss of a kind she finds herself still unable fully to articulate to anyone she believes will understand.

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Dr. Gachet looks beyond the viewer with melancholy gaze. His eyes, drooped with sadness, appear to search resignedly for something in the distance; his skin tone is sallow. He rests his head on one hand, while the other hand rests precariously on the table beside him. Lines of color swim around and through the doctor--a technique distinctive to Van Gogh--all of which are directed almost uniformly towards the top left corner of the painting. Amidst this hubbub of color and energy, the Doctor rests impassively in what seems a commentary on his mental health.

Upon the red table rest two books and a vase of flowers. The books are titled Germinie Lacerteux (1864) and Manette Salomon (1867-68) and were written by two brothers who worked in close collaboration, Edmond and Jules de Goncourt. According to M. Therese Southgate, the books may thus represent the close relationship between Vincent van Gogh and his brother, Theo, which Southgate calls "symbiotic, and eventually tragic" (Theo became insane after Vincent's death and died six months later). (See page 207 of alternate source.) The vase contains flowers of foxglove, from which the heart medication digitalis is derived. The flowers, therefore, may represent the physician aspect of Dr. Gachet.

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This is a collection of 61 poems by physician-poet Richard Bronson. The first and largest section contains many poems related to the poet's medical life and experience, including several that arose from his formative and bittersweet years at New York's Bellevue Hospital ("A Bellevue Story," "I Shall Be Your Vasari," and "Pain"). Others re-imagine events in the history of medicine ("The Knowledge," "Plague Doctor," and "The Man Who Dissected His Wife's Brain")

The second section, "Ten Portents of the Future," contains poems that examine the symptoms and signs of contemporary malaise, but find the diagnosis uncertain and the prognosis . . . who knows? It appears grim, though: "I am a lame man / gone to seed / at the terminus of an age." ("After the Big Bang," p. 94) In his last suite of poems, "Six Aspects of Love," written to his wife, Bronson reveals his strong, but purely personal, antidote for the cruelty of our "barbarous times."

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A smiling giantess of a woman fills the self-portrait. Her form is too large for the picture, and consequently her colorful wings and part of one antenna are cut off by the confines of the frame. Abundant bright colors and meticulous patterning give the artwork a buoyant, joyful feel similar to a church stained glass. In the far distance, past an impossibly aquamarine sea, stands a solitary mountain flanked by swirling clouds, its tip stretching up to just touch the top edge of the frame.

At the bottom right corner of the image are two figures: one, a bearded man who stands looking up at the flying woman; two, a young child--apparently a boy--with his hands behind his head, splayed out on a blanket and looking up. A long cord runs from the center of the flying woman’s neck down to the right hand of the man below.

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In 28 autobiographical stories, the narrator writes of his patient encounters (and self encounters) as a medical student, resident, and finally Emergency Room attending physician. "The Unknown Assailant" opens the collection, a tale of a criminal and his victim who are both brought into the doctor-narrator's emergency room. The young doctor chooses "the young one" (p. 1), not knowing he is the assailant, and works frantically to save his life. This criminal allegedly killed two men a year before, but his current victim lives and the doctor learns the story of the attack from this victim's point of view. The assailant, who slowly recovers, has "an aura about him" (p. 5) and the doctor is strangely drawn to him, thankful that this man means him no harm. Perhaps aware of the irony of healing a man who, in another environment, might kill him, the doctor helps the assailant get better.

This underlying theme--that nothing is black and white in medicine or life--shapes every story. "Prelude," is the revealing, three-page tale of a medical student's life outside the hospital juxtaposed with his first encounter with death in the anatomy lab.

Every story deals with significant issues: the physician's inner emptiness when a patient dies ("Through the Dark, Softly"), how a greater power might suddenly intervene ("Faith"), how narrow the margin is between a successful and a missed diagnosis ("Sugar"), how both patients and residents survive because of, or in spite of, their medical attendings ("A Difference of Opinion"), and how things that seem final or sinister--like death and leeches--become instruments of hope and cure ("The Dead Lake"). [Sugar and The Dead Lake have been annotated in this database.)

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The author came to Houston in 1962 as a visiting professor. While there, he and his wife decided to become volunteers at "J.D." (Jefferson Davis), the county hospital. They found that the hospital was overcrowded, understaffed, over-bureaucratized, and very poorly supported by the county. In particular, they found that the volunteer corps (Women-in-Yellow) was primarily involved in clerical work, rather than providing service to patients.

Marjorie de Hartog wished to form a group that would feed and nurture infants in the nursery, but the hospital authorities thought that was out of the question. This book is an account of how the de Hartogs, their Quaker community, and other Houston citizens developed a significant volunteer presence at "J.D." and, in the process, became aware of the frightful state of patient care. They became activists supporting the opening (and better funding) of a new public hospital.

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This documentary, narrated alternately by the daughter-filmmaker and mother whose stories it tells, focuses on how two women move apart and together while experiencing, respectively, adolescence and mid-life. The mother has cancer, a mastectomy, and then rheumatoid arthritis, and these experiences intertwine thematically and structurally with the narrative of the mother-daughter relationship.

Another provocative juxtaposition cross-cuts scenes from the daughter's modeling career (and the social and erotic body that context constructs for her) with scenes of the mother's illness, stigmatization, and erotic daydreams. Both women come to a new awareness of the social meaning of mastectomy within heterosexual and same-sex contexts by the documentary's end; they also come to a place of recognition of the mother's personal and social value and the nature of their relationship.

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Williams's autobiography recounts his life from his first memory ("being put outdoors after the blizzard of '88") to the composition of "Patterson" and a trip to the American West in 1950. The book's 58 short chapters epitomize the writer's episodic and impressionistic style, presenting a series of scenes and meditations, rather than a narrative life story.

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This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.

Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.

Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?

One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).

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