Summary:

In this compelling memoir, Grace, a writer, artist and teacher, unexpectedly finds herself attracted to a carpenter, Howard Staab, whom she meets when looking at a new home. Shortly after their relationship begins, Staab is told in a routine physical examination that he has severe mitral valve regurgitation and will require surgery. Staab, an active, otherwise healthy fifty-three year-old man, has no health insurance. The cardiac surgery will cost over $200,000. Thus Staab and Grace embark on a quest to find an affordable, but excellent surgeon and hospital. Grace details her efforts to find the best care possible, including correspondence with her son, Bryan, a Stanford medical student with interests in international health. These inquiries lead to the possibility of surgery in India.

After a useful, explanatory preface the book begins when Staab and Grace land in New Delhi and enter the Escorts Heart Institute. Staab undergoes a series of tests confirming the need for surgery, which is subsequently performed by Dr. Naresh Trehan. Through Grace's eyes, we also meet nurses, aides, other physicians, administrators and friends. The narrative follows the hospitalization, including dramatic complications and eventual recovery, and also backtracks to better detail the search for care and the predicament of un- and underinsured Americans. Grace also describes the post-hospital phase, including venturing out beyond hospital and hotel walls.

The book, highlighting the fact that Grace and Staab face more than one cultural challenge in this journey, contains both a medical terms glossary and a short list of Hindi terms. Ultimately, Grace concludes she would consider returning to Escorts or a similar hospital should she or a loved-one require surgery, even without the insurance issue. She states: "India, the land of contradictions. Organized chaos. A third-world country with first-world state-of-the-art medical care available for a fraction of the cost of the same procedures here in the U.S." (p. 259)

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Summary:

Julia’s sister, Kara, has a recurrence of leukemia, and, because of the horrors of chemotherapy along with a dismal prognosis, decides to forgo treatment. Kara asks Julia, along with two of her closest friends, to participate in a "sweat," an Indian purification ceremony intended to "recenter" one’s spirit prior to death. The idea of her sister dying has caught Julia off guard, despite Kara’s dismal prognosis, her baldness, her gray color in the mirror.

Kara lives life to the fullest, without fear; in sharing her life, Julia had forgotten about the reality of death. Julia is surprised when in only five days the ceremony takes place, and thinks of all the practical reasons this ceremony makes no sense. Against her will, Julia takes her sister to the sweat tent and participates in the ceremony. Even though it might have hastened her sister’s death, Julia comes to realize the importance of the ritual, for as her sister dies, she, herself, feels closer to her than ever before, and is finally able to see how Kara’s life had fit into a larger design.

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