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In this extensive review of her experiences in public health and rural and urban medicine, Eva Salber, MD, explores the commonalities and the differences in medical practice among three environments: pre-World War II South Africa, urban America, and the hills of North Carolina. Trained in South Africa, where she and her husband practiced for many years, Salber came to the US during a very difficult political period for whites in Cape Town.
In Boston, she pursued her passion for the plight of the poor and their health issues by studying further public health and running a ghetto clinic. Later, as a member of the Duke University faculty, she established rural health clinics in North Carolina. She describes, in this memoir, the contrasts among the cultures as well as her own difficulty in obtaining the funding and support she needed to carry out her work in each setting.
In 371 E. C. (Efican Calendar) a woman named Felicity Smith gives birth to Tristan, a child with such severe congenital defects that the doctors advise her to let him die. Felicity is an actress and the head of a theater troupe in Chemin Rouge, the capital of a small fictional country called Efica. Instead of getting rid of her son, Felicity takes him to live in the tower of her theater.
The boy actually has three fathers (Bill, Wally, and Vincent), each of whom in his own way accepts responsibility for the horribly deformed child. The boy grows up with the ambition to become an actor, even though he is only three and a half feet tall, his speech is almost unintelligible, and he inspires revulsion in almost everyone that he meets for the first time. Nonetheless, he thrives in the close-knit theatrical community.
When Tristan is eleven, agents from Voorstand murder his mother, who has entered politics and become a "persona non grata" in Voorstand. Tristan also fears for his life, but nonetheless avenges his mother's death by writing subversive pamphlets. Many years later, at the ripe old age of 23, Tristan and Wally (one of his fathers) travel illegally to Voorstand where they encounter many adventures before the novel comes to a satisfactory conclusion.
Alice Goodwin is the wife of Howard, a midwestern dairy farmer, the mother of two daughters aged five and three, and the nurse at a local elementary school. She and her friend, Theresa Collins, a family therapist who lives in the nearby suburbs, take turns watching each other's children. One morning, while Alice is momentarily distracted, Theresa's two-year-old daughter, Lizzy, falls into the pond on the Goodwin farm. Despite Alice's attempts to resuscitate her, she dies after three days in the hospital.
Not long after, while she is severely depressed, Alice is arrested on (false) charges of sexually abusing some of the schoolchildren in her care. Confused, and thinking only of Lizzy's drowning, Alice says to the police, "I hurt everybody." They take this to be a confession.
She spends three months in prison awaiting trial, until Howard sells the farm to pay her bond. The novel gives us both Alice's experiences in prison--in a world she had hardly imagined--and Howard's struggle to take care of their children. Theresa, who seems never to have blamed Alice for her child's death, helps him and they develop a powerful bond. The novel ends with the trial, in which Alice is exonerated, and their family's tentative beginning of a new, urban life.
Margo Billis and her son, Matthew, barely endure a strained and rather twisted relationship. She is a 73 year old woman dying from cancer. Despite her illness, she continues to provide for her lazy, 40 year old son who still lives at home.
Matthew's condition might also be described as terminal in an emotional and psychological sense. He claims to suffer from endogenous depression and wastes most of his life sleeping for long periods of time in his garish green bedroom. His mother implores him to get a job but all he seems capable of is wallowing in self-pity.
Matthew has neither empathy nor sympathy for his mother's misery. One day he finds his mother dead in her bed. Her safe is open and contains $14,000, some undeposited but endorsed checks, a bottle of 200 morphine tablets along with a prescription for morphine, half a carton of cigarettes, and Hummel figurines. Matthew transports her corpse to the freezer in the garage where she will remain until he is ready to announce her death. Realizing he can co-sign her checks and forge her signature, he has finally found a job to his liking.
Traumatized from a small plane accident that killed his parents and sister and injured him, Finn has returned to his grandmother's farm in Vermont where he's always spent happy summers, to regroup and continue his life. His trauma has left him unable to speak.
At the farm he is surrounded by the healing presences of his grandmother, an old summer friend, Julia, and the animals. Between painful flashback memories of the accident, Finn begins to allow himself to enjoy moments, especially in the tolerant and undemanding presence of the girl and the woman who are also grieving, but who find ways to help him reclaim life and the present.
Visiting an old childhood hideaway in nearby pine woods, Finn and Julia run into drug dealers who use the isolated spot for their transactions. Finn finally finds his voice when he is forced to rescue Julia in the midst of a spreading fire from an abandoned well into which she was dropped by a panicked drug dealer who feared exposure.
In short chapters that alternate between remembered scenes of abuse, reflections upon those scenes, and tributes to the natural beauties and human kindnesses that tempered years of domestic violence, the author provides a galling, but not sensationalistic, record of what child abuse looks and feels like. Only when she was older and mostly beyond the reach of a father who routinely beat and sexually abused her and her siblings did the author find out that her father had been dismissed from a police force for gratuitous violence and had subsequently submitted to electroshock treatments for mental illness.
The title describes the nature of the narrative; in its deliberate discontinuities it testifies to the stated fact that there are places where memory has left a blank. Much of the telling is an attempt to piece together a story of recurrent violence, felt danger, and arbitrary rage that seemed at the time both regular and unpredictable.
The sanity of the narrative testifies to the possibility of healing. The writer makes no large claims for final or complete release from the effects of trauma, but does strongly testify to the possibility of a loving, happy, functional adult life as healing continues.
This novel is the fictionalized account of author Thomas Moran's real-life experience as a patient with disseminated chicken pox. During his five months in hospital, much of that time on a ventilator, Moran experienced "coma visions" and near death which he retells here through his alter ego, James Blatchely, a man who struggles to remain emotionally alive in spite of the virus's physical assault. Blatchely does this by observing, befriending, and then fantasizing a life for his two Irish nurses--Brigit who, he discovers, uses drugs to endure the pain she witnesses daily in Intensive Care, and Nuala, with whom he falls in love.
Through the depiction of Blatchely's erratic, inching descent toward death, readers gain visceral insight into a patient's encounter with critical illness--but the real heroes of this book are the nurses. We observe them through Blatchely's eyes, and they are the force that enables him to survive, if not in body, at least in mind. This beautifully written novel creates a world in which both patients and caregivers are fully human, bound together by their shared experience of the patient's illness and by the life the imagination enjoys when the body cannot.
The story is a letter written by a 24-year-old woman to her niece who was given up for adoption. Bitte Liten, from a close Norwegian family, remembers the summer she was 12 when she was sent away during the last months of her sister's pregnancy to stay with her uncle. Her sister, 15, unwed and pregnant, had found adoptive parents for the child, but Bitte, imagining the pleasures of being an aunt and helping care for a baby, wanted her to keep it.
While at her uncle's, she visits her aging favorite aunt in a nursing home. Her aunt, sinking into dementia, doesn't remember her. This leaves her reflecting on how much of life is memory of the past and dreams of the future. Her period comes that summer for the first time, and with it, a new understanding of adult responsibilities and her sister's predicament.
She writes her sister to tell her she understands her decision and will support her. In return, her sister invites her to be at the hospital the day the baby is born. There Bitte meets the adoptive parents as well as the baby, says hello and goodbye to her little niece, and comes to understand something new and harder about what love looks like. Twelve years later, she records all these memories for the niece who has grown up as someone else's child.
Dingle the Fool lives in the family home with his two sisters, their husbands, and their infant children. Their mother left the house to all three in equal shares. One sister, Joanna, wants to sell the old place and buy a modern home. The other sister, Dierdre, wants to remain in the house, especially for Dingle's sake.
Dingle plays in the mulberry patch and doesn't seem to understand much. He has a dirty old tennis ball that he believes is full of happiness. One day Dierdre gives in and agrees to sell. When she tells Dingle, he cuts the tennis ball in half, intending to give part of it to his sister.
However, when he sees that the tennis ball is empty (no happiness!), he cries and goes out to climb his favorite tree. Later that night, the house burns down. But Dingle is found safely sleeping in his tree. Joanna and Dierdre face the prospect of a lovely new house, but Dingle has to go to an institution.
This pocket-sized book contains stories from the home front--poems about patients the nurse-author tends in their apartments and in her clinic. Often, the patients speak, teaching us not only what it's like to be elderly and lonely, but also how to view mainstream healthcare from a different perspective.
Most important, we learn about the courage with which these patients cope with illness and poverty, and how nurses honor their patients' choices through non-judgmental caring. Outstanding poems include "The Language of Hearts," "Passages," "Lower Midline Surgical Scar," "The Screamer in Room 4," and "Home Remedies for the Blues."