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Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.
This memoir of a clinical psychologist (also a professor of psychology) chronicles her own depression over a period of a year and a half, from early symptoms, through near despair, electroconvulsive therapy, and hospitalization to recovery. The journey is detailed, not only in its treatment of her emotional states, but of her struggle to maintain family and professional life, keep her house and office organized, and attend to a dying friend.
As her bouts of panic and disorientation grow more apparent, first to herself and finally to others, she seeks refuge in spiritual retreats and in conversation with colleagues, ultimately submitting to treatment. She names the emotional "undercurrents" suggested in the book's title with moving precision: panic over sudden disorientation, anxiety about what to keep secret, frustration with her own unreliability, dread of small duties and ordinary appointments, heartache over her faltering efforts to be a good and present mother.
The consent to hospitalization costs a great deal in humility, in risking a controversial treatment, and in letting go of a professional persona she doesn't know whether she'll be able to retrieve. But clearly the book is written by a woman whose clarity is a testimony to regained mental health and exceptional intellectual clarity. It is not a professional record, but an intensely personal memoir of what was both an encounter with serious mental illness and a spiritual journey.
Alan Shapiro, poet and professor of English at the University of North Carolina, Chapel Hill, chronicles the life and death of his sister, Beth, who died of breast cancer at the age of 49. Beth lived the last four weeks of her life at a hospice in Texas--this memoir traces those weeks in particular and refracts them against decades of family dynamics, turmoil and triumph. The memoir is composed of 14 tersely named chapters ("The Death," "The Joke") followed by "Afterwords": six poems about Beth.
Alan is the youngest of 3 siblings; Beth was the oldest and David, an actor is the middle child. Despite, or perhaps because of their age difference, Beth and Alan were very close. It was he whom she asked to write her eulogy and it was he who stayed the entire 4 weeks of hospice, save for a brief trip home. From Alan's love and devotion grows an admiration for Beth's integrity in life and death.
Beth married an African-American man, fought for liberal causes, and suffered complete estrangement from her parents due to her choices. Her husband, Russ, must deal not only with the loss of his wife and their daughter's loss of her mother, but also with the prejudice of the Shapiro parents and the medical establishment. At one point Shapiro describes how, whenever he accompanied his sister and her husband to the doctor's office, Alan, not Russ, was treated as the spouse and decision-maker.
Shapiro vividly depicts the poignancy of parent-child relationships. Gabbi, the seven-year-old daughter who loves horses, gallops through the house with grace and abandon not possible at the hospice. Alan's anger at his father's actions and his forgiveness of his mother's accomplice role are also strongly demonstrated. A great strength of this book is the choice of detail: the mother completes a book of crossword puzzles during the vigil; the brother becomes infatuated with a particular joke he wants to memorize; nurses leave a solitary rose on the bed of the newly dead at the hospice.
Shapiro is keenly interested in being with his sister right at the moment of her death. He describes the end: "one long, deep, and profoundly eerie moan . . . That moan, I'm certain, marked the end of Beth, the end of life, though the body went on breathing for another minute or so, each breath a little fainter, weaker, the body's electricity guttering down, dissolving, till there was no breath at all." (pp. 111-2)
He also analyzes whether this was "a good death." There had been many gifts: Beth's recognition of her importance, her reconciliation with her father, and her acceptance of her mother's devotion. However, Shapiro also keeps the reader cognizant of Beth's suffering and the now motherless child, the spouseless husband and the myriad other ways that Beth's death marked a void.
This collection's first section contains eight poems that address AIDS. "Inventory," a listing of the author's acquaintances who have died of AIDS, catalogs a variety of responses to this illness. Other poems are stark portraits of death in progress ("Waste Not," "Photo") as well as evidence of the love and coping skills a diagnosis of AIDS elicits ("Althea," "In Time of Plague," "Sonnet Positive"). "The Review" ironically compares a popular movie about AIDS to its reality: in the movie, family members do not flinch from kissing their infected son.
The second section addresses coming out as a Lesbian ("In the Duchess"), domestic violence ("Beatings"), and Lesbian sexuality and relationships ("Hunger" and "Want"). "My Body" is another effective "list" poem, a catalog of the female body and how its physical dimension becomes the visual history of a life "healed and healed again."
The final eight poems examine the difficult relationship between a daughter and her dying mother. The book comes full circle as the "swift river" (death from AIDS) of the book's opening poem becomes the "cold river" the speaker now swims in, a metaphor for internalizing a mother's "bitter edge" as well as the accumulated deaths of friends and lovers ("Cold River").
"To Spirit," "Journey," and "Here" regard the daughter's deathwatch over her mother. The remaining five poems serve to balance loss and hope, especially "Legacy," in which the narrator accepts how age is transforming her own body into her mother's, "her scared eyes shining in triumph."
Kate, a doctoral student, has chosen to move far away from the small town in which she grew up and in which her widowed mother (a school superintendent) and brother (an insurance man) still live. Kate's life is solitary, punctuated by unsatisfactory and transitory sexual relationships with men; she has headaches and wonders if "there were an agent in her body, a secret in her blood making ready to work against her" (p. 180).
While her mother disagrees with Kate's life choices, their long-distance relationship is sisterly, playful, and intimate. Kate sends her mother Valentine's Day cards, "a gesture of compensatory remembrance" since her father's death six years earlier (177). One year Kate forgets to send the card; soon after, her mother is suddenly hospitalized for tests that reveal a brain tumor.
Kate's brother insists that if she wants to come home, she must keep quiet about the likelihood of the tumor's malignance and the risk that the upcoming surgery will result in paralysis. He argues that their mother is terrified and that there is no point in making her more afraid. Kate objects to the concealment of the truth but complies unwillingly with her brother's request.
She gains permission to take her mother for a ten-minute walk outside, just time enough to take a ferris wheel ride. As their car reaches the top of the wheel, Kate is clearly upset. Her mother comforts her, saying, "I know all about it . . . I know what you haven't told me" (196).
The setting for "The Shadow Box" is three cottages on the grounds of a large hospital. Here, three tales unfold, at first serially, and then towards the end of each of the play’s two acts, simultaneously. Each tale features a person who is dying. Each person is surrounded by loved ones. All are trying to face and make sense of death.
The first family we meet is the most conventional. Joe, a working class husband and father, is joined at the cottage by his wife Maggie, who, in denial of Joe’s impending death is afraid to enter the cottage. Their son, Stephen, age 14, has not yet been told of his father’s terminal condition. The second family consists of Brian, who is brutally forthright about his demise; Mark, his doting lover; and Beverly, Brian’s wild ex-wife who comes to visit them. The third family is a feisty, blind, and wheelchair-bound mother, Felicity, and her dutiful daughter, Agnes. An off-stage character, "the interviewer," pops in and out of the scenes, offering insight into the various characters through questioning.
Ten-year-old Becky Zaslow is diagnosed with acute lymphocytic leukemia (ALL) just before her class talent show. The sudden changes in her world include a hospital roommate whose experience with chemotherapy has left her rude and embittered; a lively nurse who levels with her; and parents who react strongly and differently to her illness. Even though the treatments leave her bald and weakened, she shows up at the talent show just before her bone marrow transplant, to the acclaim of all but one of her classmates.
A key coping strategy for Becky is an increasingly vivid fantasy life in which she finds friends among a herd of zebras and one monkey. Holding her stuffed zebra, she "travels" to Africa to escape the pain and trauma of treatments. Gradually she loses ground; as her body gives way, her mind and spirit move increasingly to the other world where an old zebra offers wisdom and help for the crossing she is about to make. She dies, leaving behind a journal that becomes her younger brother's incentive to learn to read, a task he has been resisting.
Summary:In the title story of this collection, "Survival Rates," a husband's thyroid cancer appears to be a greater threat to his marriage than it does to his health. The young girl who survives an accident in "Jumping" ends up a casualty anyway. In "Howard Johnson's House," a plastic surgeon repairs a nine year old girl's nose after it is severely damaged by a dog bite. Even before the injury, however, the child's nose was hideous. When the surgeon gives her a cosmetically perfect nose, the girl's mother is not merely disappointed but outraged. Two girls must adapt to life after colon surgery in "Krista Had a Treble Clef Rose."
In the first poem, Starting the I.V. (see this database) the poet tells us that he will approach the secrets of the body without flinching, "I have learned not to hesitate here, / not to let fears of my own" get in the way. The instrument he uses is the poem. Through these poems he reveals some of the hidden truth of the healing relationship. "A transformation," he calls it, "as if through this intimacy / we have become part / of each other." ("Physical Exam")
Watts captures the pain and horror of illness in striking images. For example, the numbness felt by a person suffering from multiple sclerosis "felt like oatmeal / drying on the skin" and the disease itself was "this moth of his nightmare / . . . eating at the wool / of his nerve endings." ("ms") In another poem ("restrictive") a patient's tortured breath "creaks like a tight box / a ship in a storm." Among the most remarkable of these 35 poems are "The Body of My Brother," "July 16th," "Chronic Pain Syndrome," and the exquisite prose-poem, "The Girl in the Painting by Vermeer."
The title story, "In the Gloaming," recounts a mother's final weeks with her 33 year old son who is dying from AIDS. Janet realizes that "the enemy was part of Laird, and neither he nor she nor any of the doctors or experts or ministers could separate the two." (p. 29) He dies at home with his mother next to him.
"Home" depicts the struggle of an elderly woman in the early stages of Alzheimer's dementia who is being coerced by her family to live in a nursing home. She immediately understands that living there would essentially kill her.
In "Watch the Animals," Diana Frick is a wealthy animal lover who has no interest in human relationships. After being diagnosed with lung cancer, she refuses conventional treatment and continues to smoke cigarettes. Surrounded by her pets, she commits suicide by drug overdose but not before she has arranged new homes for all her animals.