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This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."
The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).
The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.
Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.
The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.
A young boy tells us, "My cat Barney died last Friday. I was very sad." Barney's mother suggests he think of ten good things to tell about Barney at his funeral. The story details his feelings and, from his perspective, the way his parents and friend Annie deal with the loss, ritual of burial and questions of afterlife (heaven, Barney's whereabouts now).
After the funeral, and after helping his father in the garden, comes a new and comforting understanding--the tenth good thing is that Barney's body becomes part of the cyclical process of nature. Fertilizing trees, grass and "helping grow flowers," the boy tells his mother as she tucks him into bed, is "a pretty nice job for a cat."
Terrified of dying from AIDS but even more afraid of living with it, the title character of this romantic comedy--a gay actor/waiter-- makes the ultimate safe choice: to give up sex entirely. Determined to find both a substitute for sex and the meaning of life in the cruel meaninglessness of an epidemic, Jeffrey embarks on a journey through a picaresque and postmodern landscape. What he discovers is that while his desperate renunication of human connection may remove him from the physical experience of death, it will not protect him from the emotional experience of loss.
In this lyrical, funny, sad, heartwarming work, Joyce Dyer takes us inside an Alzheimer's unit where she visits her mother daily and watches as she experiences the many absurdities and contradictions of this disease over several years. Dyer records not only the behavior of her mother and other patients in the unit but also her own feelings of worry, anger, frustration and then acceptance. The prose-poem style of this writing makes the work especially wonderful to read, because it is a work of art as well as a very helpful document.
The poem takes place in a respiratory ward of a children's hospital, where the narrator hears "a children's wind ensemble / hooting through the weary nocturne." One mother is massaging her child's back, "working calm's liniment between shoulder blades / scarcely bigger than chicken wings."
The narrator appears to be a friend or relative, who silently tries to breathe for the breathless child, whose panic is held in check by "his mother's dulcet voice." It seems like everything will be all right "as long as the hand strokes, and while the voice croons . . . " [30 lines]
This stark and sensual poetry collection is divided into three sections. The first, "Graveyard Shift," introduces the narrator's themes: the keen observation of suffering; the questioning of God's role in such suffering; the way caregivers and patients meld in shared moments of trauma; the struggle to integrate the reality of death and grief into a life outside the healthcare arena.
A longer second section, "Lessons," contains a chronology of poems that broaden the poet's themes. Suffering becomes personal through sexual abuse ("The Burning"), death of a baby ("To the Woman in the Next Bed," "Waiting Room," "Last Lullaby for the Dead Child"), and breast cancer ("Keeping Watch"); the mystery of God's role becomes the narrator's religious quest.
The final section, "The Ones Who Come," opens these themes to the universal: children and adults lost to "the holocausts" of war, poverty, and illness ("Lizard Whiskey: A Parting Gift from Viet Nam," "After the Siege," "The Ones Who Come," "The Man Who Stays Sane"), and how history repeats these cycles of birth, suffering, and death.
Summary:A woman in apron, cap, and long skirts stands at a small table, the long handle of a pot resting on her left arm. She appears to be shelling an egg for, presumably, an invalid. On the table before her is a plate with another egg on it, a loaf of bread, and a pitcher and goblet. The background is dark, and the image of the nurse and the table seem to glow warmly in contrast. The woman is intent on her task and appears unhurried.
A small boy overhears his parents discussing the memory loss of a ninety-six year old neighbor who lives next door in the old people's home. He tries to discover the meaning of "memory" by asking the other residents who tell him, respectively, it's something warm, something sad, something that makes you laugh, something precious as gold.
Young Wilfrid gathers his own "memories" to bring to Miss Nancy, his favorite neighbor because she, too, has four names. Each of his treasures, a freshly laid egg for warmth, a toy puppet for laughter, his grandfather's war medal for sorrow, and his precious football stimulate warm reminiscences for Miss Nancy Alison Delacourt Cooper and smiles and smiles for the two of them.
The narrator, an author, is accosted by his friend, Sam Nolan, who has just had his appendix taken out and thinks his experience would provide useful information for one who writes stories: Sam says he has discovered how and why male patients fall in love with their nurses. Sam's experience of being hospitalized is at first like being caught in a machine, he says. This changes after the surgery, when the nurse becomes his caregiver and rescuer.
He feels a great tenderness for what he calls the "beauty of her efficiency." He denies being in love, blaming the morphine and fever for his attachment, but he tells how he did not want to see his wife when she visited, and when he describes giving the nurse a parting gift, a pair of gloves, the narrator sees tears in his eyes. According to the narrator, Sam's story is in fact about his "terrible wife," and she is the reason "it [falling in love] has happened."
Millie is a "baby nurse," hired as a domestic helper and live-in night nurse who cares for other women's infants up to the age of two years. She is "condemned by life to love many babies and lose them all" (1). Millie is described as old, but we are not told how old, or of what else her life has consisted; probably little, since she appears to have cared for one child after another, and has no home apart from where she is employed.
The story begins as she starts a new job, caring for Mrs. Jones's baby daughter. She adores the baby, but is tense and possessive, strongly dislikes the Jones's noisy six-year-old boy, and complains to Mrs. Jones about the other servants. Reluctant to let the baby grow up, she does not encourage her development, and she is overly defensive and protective of the child.
As the baby gets older, Millie becomes more and more anxious until, after a fight with one of the other servants, Mrs. Jones fires her. The story ends where it began, in the waiting room of the employment agency as Millie seeks a new position, a new baby to love and lose.