Summary:

The narrator is a woman who lives alone in a rural area of Puget Sound. She is a writer, an observer, a spiritual thinker. "Each day is a god, each day is a god, and holiness holds forth in time" begins her musings about the first of three days. But on day two, a catastrophe occurs: a small plane crashes and a seven-year-old girl’s face is "burned off" as she is carried away from the explosion in her father’s arms.

The narrator had met the girl once before, at a neighbor’s farm, and had formed a connection--they looked alike and the girl playfully tormented the narrator’s cat with a dress-up game. The narrator imagines the girl in the hospital, imagines her future life as a nun with no face, and ultimately imagines a gentler future in which the girl’s face is restored, she is married and the narrator has assumed the function of the nun for her.

Throughout, the narrator wrestles with the hard questions of life: why are we here; why do horrible things happen; what is the relationship of God and the world; where is God and what is he doing? She is angry: "Do we need blind men stumbling about, and little flamefaced children, to remind us what God can--and will--do?"

A Christian, she seeks answers in her wide-ranging theology, and seems to find an inroad in the idea of "Holy the Firm"--a substance lower than salts and minerals, below the earth’s crust, in touch with "the Absolute." The narrator hence posits that "Holy the Firm" allows for an unbroken circle between God, Christ, and the created world.

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Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)

Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.

Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.

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This strong, powerful poem of grief for the death of an infant son in an intensive care unit is written by a poet who lost two of his five children. The rhythm of the poem is jazz, pulsing and pulsating, with well-controlled rests. Some words are run together: " . . . mamaborn, sweetsonchild / gonedowntown into researchtestingwarehousebatteryacid" which evokes (among other things) the frenzied atmosphere of a neonatal intensive care unit and the seemingly inevitable rush towards death.

Much of the poem deals with the distrust of the medical community, which is emphasized by the divide of race: the white doctors and nurses in white uniforms versus the African-American patient and family. The frustration of dependence on others is painful for the father during the nightmare of his baby’s dying. However, the poet reaches a higher level of understanding about his pain and grief; he acknowledges that the baby did receive all that medicine had to offer and he recognizes the complicated responsibilities one acquires by experiencing a loss.

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The narrator, painlessly removing a splinter from his wife's hand, recalls the scene when he was a boy of seven and his father removed an "iron sliver" splinter from his palm. The father had skillfully distracted his son by telling a story in a voice reassuring and low: "a well / of dark water, a prayer."

Darker themes are alluded to--his father's hands were used not just to give love and protection, but also discipline. The narrator notes that as a boy he did not over-dramatize the scene. Rather, something precious was exchanged between father and son. In fact, it could have appeared to the onlooker that the father was "planting" (rather than removing) "a silver tear, a tiny flame" on his son's palm. The poem ends with the boy holding the removed splinter and kissing his father.

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This collection of 116 poems by 76 poets includes a wide range of perspectives, although most are written about a friend or loved one with AIDS or by a poet with AIDS. The poems are about love, loss, grief, pain, fear, beauty, illness, death, and transcendence.

Some well-known poets, such as Adrienne Rich, Paul Monette, James Merrill, Philip Booth, Robert Creeley, and Marvin Bell have contributed to the anthology. Brief introductory essays by The Rt. Reverend Paul Moore, Jr., Joseph Papp, Carol Muske, and the editor comment on the power of the voices, the politics of AIDS, and the elegiac quality of many of the poems. Michael Klein likens the book to the patchwork quilt of the NAMES Project, and hopes that the book, like a "well-made" quilt, will "last awhile, keep you warm."

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The author, a renowned monologist, gives a hilarious account of his adventures as he attempts to cure a disturbing change in vision, diagnosed as macula pucker. His encounter with conventional medicine, including a physician who coldly recommends "a little macula scraping" leads the author on a worldwide search for the perfect, alternative cure.

He winds up naked and panting in a "Native American sweat lodge," following a rigid raw vegetable diet, trying the Christian Science prayers of his youth, and participating in a wild and gory psychic healing session in the Philippines with the "Elvis Presley of psychic surgeons." He finally controls his multiple anxieties about entering middle age, listens to his sensible fiancee, and undergoes conventional surgery.

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Belle Yang has created a beautiful and lyrical tribute to her father (Baba) and to her Chinese heritage. She has illustrated the folktales and life of her father with her own brilliantly colored paintings, which complement her vivid and colorful prose. Several stories concern doctors and healing in early to mid 20th century China. For example, in the chapter titled "Secret Family Recipes," the tale of Daye reveals the intricate world of family relations, social structure based on wealth and family position, and country versus city prejudices.

Daye is a poor relation but a hard-worker. After he and his wife take an old traveling doctor, "jangling the healer’s trademark ring-shaped rattle," into their humble home, the old doctor teaches Daye how to heal and gave him his "family recipes" for healing. However, Daye’s troubles are not ended, as the townspeople call him a charlatan and quack. Daye does, though, possess the power to heal.

When a wealthy magnate is injured, Daye stakes his life that he can save the man’s leg, even though all the important doctors of Western medicine advise amputation. Daye saves the magnate’s leg, is catapulted to become the head of herbal medicine at the medical institute and passes on the "family recipes" to his daughter, "a short, squat, swarthy woman with bulbous eyes and yellow, ratlike teeth that sprouted between her normal adult ones, leaning every which way like disrupted roof tiles."

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Karen Newman traces the visual depictions of the pregnant female body, the fetus, and obstetrical illustrations from the 9th century to the present in western culture. These images, in which the fetus looks baby-like or even adult and in which the female body is truncated or mythologized, have supported the anti-feminist rhetoric where the fetus or embryo is privileged with full human rights. Even in the fetal studies by Leonardo da Vinci (Studies of the Fetus), which were far more accurate than any prior or concurrent renditions, the roles of the uterus and placenta are de-emphasized and the uterus is simply a vessel, "almost a Fabergé egg."

Analysis and critique of medical art history is of relevance for today's society: "Early obstetrical illustration, Bologna's Museo ostetrico, and eighteenth-century anatomical sculpture and engraving are not merely antiquarian esoterica; rather, they constitute crucial political knowledge for the present." In fact, the book begins and ends in the 20th century.

In the first section, a close analysis of the Lennart Nilsson fetal photographs in Life Magazine "Drama of Life Before Birth" (1965) reveals that not only the photo captions, but also the manipulations of the specimens during and prior to photography (all the pictures but one were ex utero), were designed to proclaim and reinforce "fetal personhood." A similar conclusion is reached at the end of the book, when images from the current, widely used obstetrical text and from new imaging procedures are examined.

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Hurston's powerful, lyric second novel centers on Janie Crawford, an African-American woman who tells her life story to her friend, Phoeby. Janie, raised in rural west Florida by her grandmother, is forced to marry, at age sixteen, a landowner, Logan Killicks. Far from giving her stability and respectability, Killicks instead treats her like a mule. Her image of love and life as a beautiful blossoming pear tree that grew in her grandmother's yard is dashed by the harsh realities of this loveless marriage.

She leaves Killicks to marry Joe Starks, an ambitious businessman who builds and becomes the mayor of an all black town. Joe also treats her as property--as a showpiece to bolster his image in the town, and does not allow her to befriend any one else. When Joe dies after seventeen years, Janie is finally financially and spiritually independent.

She falls in love with a young roustabout, Tea Cake--a man who (mostly) treats her as an equal partner and who returns her love fully. Despite the townspeople's disapproval, Janie and Tea Cake leave the town to make their way in the Florida muck, working side by side as itinerant farm hands.

During a hurricane and flood, Tea Cake saves Janie from a mad dog, but gets bitten himself. Tea Cake later develops fulminant rabies and is too late to receive effective treatment. Tea Cake turns on Janie and she must defend herself. The novel closes back in the frame of telling the story to Phoeby, of teaching Phoeby about love: "Love is lak de sea. It's uh movin' thing, but still and all, it takes its shape from de shore it meets, and it's different with every shore." Janie, reflective, mature, and strong, has gained wisdom from her life and suffering.

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In a rural town in Louisiana in the late 1940's a poorly educated young black man, Jefferson, is in the wrong place at the wrong time: he is in a liquor store with two friends when they murder the white storekeeper. Jefferson is unfairly convicted of murder and sentenced to the electric chair by a white judge and jury.

His defense lawyer, in trying to stave off the death sentence, labels him a "hog"--and it is this label that Jefferson's godmother wants disproved. She enlists the help of the narrator of the novel, Grant Wiggins, the plantation schoolteacher.

Wiggins agrees to talk with Jefferson only out of a sense of duty--he is an unhappy, angry man who dreamt of escape from his impoverished youth yet returned to his hometown after a university education to teach in the same one-room parish school he attended. Despite humiliation at the hands of the white sheriff, Jefferson's lack of cooperation, and his own sense of futility and uncertain faith, Wiggins forges a bond with Jefferson that leads to wisdom and courage.

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