Summary:

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.

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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.

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Some interesting and very odd characters (including a few scientists and researchers) inhabit the eleven short stories in this collection. In "Concerning Mold Upon the Skin, Etc.," Anton van Leeuwenhoek creates his first microscope and becomes so absorbed by the invisible worlds revealed to him that he neglects his own family. "Nowhere" is the tale of an old anatomy professor who aspires to spice up the curriculum by obtaining a corpse for his students to study. "Tumbling" recounts the difficult life of a young woman understandably haunted by the possibility that she may inherit Huntington’s chorea from her father and her inspired liberation of over one thousand laboratory mice.

In "Chloroform Jags," a professional midwife self-experiments with chloroform "not to escape time but to dissolve time." Other stories describe the execution of an elephant; the murder of a physician who happens to be an important figure in the French Revolution; a woman with a talent for insomnia who has not slept for six months; a psychoanalyst and his patient; an eighteenth century blind beekeeper; and Dorothea Dix, an early advocate for the humane treatment of the mentally ill.

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In her Introduction to this posthumous collection, the poet’s daughter writes, "If I had to identify a single distinguishing figure of his imaginative world . . . it would be his preoccupation with the human task of sustaining the intensity of experience against a backdrop of desensitizing forces and death." These 25 poems range across Bruce Ruddick’s lifetime of sensitive responding to those desensitizing forces. Some spring from the pen of Ruddick as a young Canadian poet; others from the life experience of an aging psychoanalyst. All share the discipline, imagery, and economy of line that characterizes them as the work of a fine poet.

In "#25"(p. 10) Ruddick adopts the voice of a medical student who categorizes and quantifies the life of his cadaver. But the patient needs more than this. Indeed, the patient needs "a physician’s ear." ("The Patient," p. 11) Ruddick demonstrates such a sensitive ear in poems like "Ache" (p. 13)," Rehabilitation" (p. 39), and "Fever" (p. 41). And he also puts his "grouchy" heart on the table for all to see in "When the Dog Leaped"(p. 33) and "Spring" (p. 17).

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By most accounts Dr. Sam Abelman is a failure in life, an irascible old general practitioner who lives in the same grimy Brooklyn neighborhood he has always lived in. He is truculent and tactless, an easy mark for the young specialists who steal his patients. One night a bunch of hoodlums drop a battered young woman on his doorstep. Abelman's nephew, a reporter, publishes a news item about the incident, "Doctor Saves Raped Girl."

Meanwhile, Woody Thrasher, vice president of an advertising agency, is looking for a new type of television show to sell to one of his clients. He comes up with Americans USA, a candid look at "ordinary" Americans who are just doing their jobs, but in an extraordinary way. He decides that Sam Abelman would be the ideal first subject.

Thrasher, a young, high-powered executive, meets Abelman, the last angry man, who summarizes his view on life by saying, "The bastards just won't let you live." The doctor's practice is declining, he can't afford to retire or move away, and the local people certainly don't seem to love him. They don't show gratitude for his services. They don't pay their bills. Many of them consider him a racist, and incompetent to boot. Abelman is clearly not a good candidate for "doctor of the year."

Yet, Thrasher soon finds himself intrigued. Abelman spends hours working in his miniature vegetable garden and reading Henry David Thoreau. He is a brilliant diagnostician, a devoted husband, and an endless campaigner against the "galoots" who think the world owes them a living. Abelman takes aim at "galoots" wherever he finds them, and he finds them everywhere.

The novel interweaves these two men's developing relationship, as Abelman agrees to do the show and Thrasher works to sell it to his bosses, with incidents from Abelman's earlier life. When it turns out that Americans USA will award its subjects their "heart's desire" (in Sam Abelman's case a new house), the doctor declines to go on, refusing to accept "charity" and claiming that Thrasher "tried to crap me up." In the end he agrees to do the show, but suffers a massive heart attack and dies.

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Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:

From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.

The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.

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After a stressful trip to cold-war Russia in 1964, Saturday Review editor Norman Cousins tells how he developed a debilitating illness which confines him to bed. He is admitted to hospital for tests and treatments, and is diagnosed with ankylosing spondylitis, but his condition deteriorates and he is given a gloomy prognosis. He notices that the depressing routine of hospital life tends to produce side effects that aggravate his condition.

With the blessing of one of his doctors, he checks out of hospital and into a comfortable (yet less expensive) hotel where the food is better and he can watch funny movies while he medicates himself with high doses of Vitamin C. He is convinced that the slow improvement in his condition is owing to his individualized methods of therapy and his having taken charge of his own situation.

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This interesting and meaningful book of poems is difficult to describe and to classify. The author has had three kidney transplants and so is knowledgeable about chronic illness and its impact. Though he does write about dialysis and transplantation, he also writes about many other kinds of illness, including the chronic fatigue syndrome, dementia, autism, cancer, and mental illness.

"Three Doctors" describes the gathering of physicians each morning to check on their narrator/patient, regardless of who overhears their conversation. The "Non-verbal Autistic Man" traces the daily, lockstep gait of a human being who speaks only one phrase and who walks the same path over and over. Not all of the poems concern the failure of the body. There are also descriptive poems about the Midwest and about various well known personages. The constant reinvention of the individual, even in the face of difficulty and death, is a common theme of this collection.

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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.

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One morning, while pondering the stress of his latest assignment at his uninspiring job, the narrator of Kangaroo Notebook feels an itching on his leg that seems to indicate an unusual hair loss. The next morning he wakes to discover that he is sprouting small radishes on his shins. After battling to be seen in his local medical clinic, he enters a hospital, where a physician prescribes hot-spring therapy in Hell Valley.

Hooked to a penile catheter and an IV bottle, the narrator begins a harrowing journey on his hospital bed through the underworld that seems to lie beneath the city streets. Here, he seeks health not so much as he seeks simple explanations for what is happening to him and the strange people he meets: abusive ferreymen, waiflike child demons, vampire nurses, a chiropractor who runs a karate school and works a sideline as a euthanist.

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