Summary:

This book is an autobiographical account of an abrupt and painful injury that completely transforms the author’s life. Berger in 1985 was a healthy woman who enjoyed ice skating and canoeing, a published poet, wife, and mother of a toddler. She bent over one day to pick up her daughter and felt a tearing "within the thickness of flesh, moving in seconds across the base of the spine." No longer able to run, walk, or even sit, she is forced into a life spent lying down.

Hers is now a world of boundaries and barriers--physical, psychological, and societal. The book chronicles her struggle to parent her child (they make gingerbread creatures lying down on the kitchen floor), to relate to her husband (she has to deal with the constant feeling of being the recipient of his care), to live with pain, and to regain her mobility.

Because hers is not a visible injury and because she must frequently lie down in public places or use her carry-along lawn chair, she suffers the stares and scrutiny of people who cannot pigeon-hole her into a tidy handicapped-wheelchair category. After seven years of physical therapy (she calls her therapists "angels of attempted repair ") she is able to walk and drive, though she is still limited in activity and lives in fear of re-injury.

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The narrator, Jennifer, is a young, eccentric, struggling writer who lives in a small northern California coastal town full of even more eccentric individuals. Her father, Wallace, a kind and generous intellectual, is diagnosed with a brain tumor and has to undergo surgery and postoperative radiation therapy. It is a story of a family dealing with the rage, grief, anxiety and sudden changes in everyone’s lives when a family member has a serious illness. This is a family knit well with love, tenderness, alcohol, and lots of humor (often black and exceedingly funny)--the diagnosis brings the family and small circle of friends even closer together.

The writing shifts easily between the specifics of observed details to general philosophizing about life and death. Despite the horror and uncertainty, Wallace notes: "I still believe that life is supposed to be good, and my life as a cancer patient can be good, lived one day at a time, and at some point it may be determined that I am no longer a cancer patient, and my life will be better for this scare we’re having. We’re all on borrowed time anyway, and it’s good to be reminded."

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John Singer Sargent was commissioned by the British War Memorials Committee to paint a work for the Hall of Remembrance. Sargent visited a casualty clearing station at Le Bac-de-Sud in France, which provided the inspiration for this vast work (7x20 feet) painted in 1918.

Mustard gas (yperite, or bis(2-chloroethyl)sulfide) causes terrible pain by blistering skin and mucous membranes, by blinding and choking its victims. Used during World War I, it caused intense suffering; dying could take weeks. In the painting, soldiers who were blinded by mustard gas, are being led to a dressing tent. The foreground of the painting has a jumble of bodies, soldiers in various poses lying on the ground. The colors are muted, the soldiers appear subdued. These elements, combined with the huge size, make the painting reminiscent of ancient Greek or Roman sculptural friezes.

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The dentist, William Thomas Green Morton, gave the first successful public demonstration of anesthesia on October 16, 1846 at the Massachusetts General Hospital. This painting depicts the patient, Gilbert Abbot, sitting in a chair in the surgical amphitheater, eyes closed and neck exposed for the excision of a small vascular tumor of the jaw.

The surgeon, John Collins Warren, a distinguished Professor of Surgery at Harvard Medical School is leaning slightly forward, delicately holding a surgical tool vertically at the hidden point of incision. Morton holds his specially designed glass apparatus used to contain the anesthetic agent, ether.

Eleven other men watch the proceedings from the floor of the amphitheater, with varying levels of surprise and concentration. One is rising, as if in amazement, from a chair, and another steps up on a chair to see better. Two attend the patient: one holds his head and the other holds the right hand and checks the pulse at the wrist. Numerous men are seated in the gallery, and are painted with less and less detail, the higher the row.

The men are all dressed formally in dark suits, some with fur lapels, except for the patient, who is in white shirt with tan pants and dark shoes. This operation occurred before antisepsis and germ theory were discovered.

Hinckley used light and line to focus attention on the surgery. A strong diagonal line from the side wall of the gallery ends at Warren’s head. Light reflects off Morton’s ether inhaler, such that one can even see the sponge inside. The white of the patient’s shirt and the cloth and bowl on the instrument table in the foreground also serve to direct attention to the operation. Light glints off the surgeon’s head, although not as dramatically as in Thomas Eakins’s The Gross Clinic (see this database). Warren’s pronouncement at the end of the surgery, "Gentlemen, this is no humbug," paved the way for the rapid acceptance of anesthesia for surgery.

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Shannon Moffett, a medical student at Stanford University School of Medicine, became fascinated with the brain during her anatomy and neurobiology courses. She set off across the country to interview people--scientists, doctors, patients, ethicists, and religious leaders--who devote their careers trying to understand the brain and cognition. With infectious enthusiasm and energy, Moffett brings the reader to meet these dedicated people, their work, their theories and their lives.

The book contains eight chapters and hence eight mini-biographies: 1) neurosurgeon Roberta Glick, 2) cognitive neuroscientist and brain imagist John Gabrieli, 3) Francis Crick (of DNA double helix fame) and Christof Koch--scientists studying consciousness, 4) sleep researcher Robert Stickgold, 5) Judy Castelli who has dissociative identity disorder (multiple personality disorder), 6) philosopher Daniel Dennett, 7) neuroethicist Judy Illes, and 8) Zen monk Norman Fischer.

Separating the chapters are "interludes" that map neural and brain development from conception to death. The book has a reference list for each chapter and a complete index, as well as a web resource (www.shannonmoffett.com) to which the reader is directed for graphics.

The writing is compelling, direct, fresh and insightful. For example, in "Touching the Brain," we follow the exhausting lifestyle of an academic neurosurgeon who works at Cook County Hospital in Chicago as she performs surgery, teaches, attends services at a temple, drives her car, takes care of her family including two young children, rounds on patients, hosts a potluck dinner, and simultaneously discusses her reading, travel and spirituality.

Moffett aptly describes Glick with her "waist-length red hair, ... beaten-metal earrings dangling almost to her shoulders and a saffron batik dress" as someone you'd "expect to find reading storybooks to kindergartners in a public library" (8). In fact, it is Moffett's eye for accessible detail that makes not only the people, but also neuroscience come alive. Artfully woven into the text are lessons on the history of brain research and current understanding (and questions) about the brain, its meaning and function.

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Paul Monette wrote about his partner's life and death with AIDS in both prose (Borrowed Time: An AIDS Memoir, see this database) and poetry. This poem, a lyric elegy to Roger Horwitz, concerns Roger's loss of sight despite treatments for cytomegalovirus infection. It is a love poem; Monette's devotion to Roger is unbounded. If Roger cannot see, then the poet wishes not to see--this is empathy to the fullest degree.

When, in the up and down course of the visual problems, Roger can suddenly, temporarily see, then Monette gleefully cries, "I toss my blinders and drink the world like water." The poem contains numerous references to sight, light, and eyes, such as "blacked out windows / like an air raid," "peer impish intent as a hawk," and "I'm shut tight Oedipus-old."

This constant stream of images and the unpunctuated, no-place-to- relax-and-catch-your-breath rhythm of the poem leads the reader through the suffering and uncertainties and into the final lines--the mourning for Roger. Grief is loneliness; it is the desperate ache of MISSING someone. Monette feels isolated from "the sighted fools"--he yearns for Roger, who, through it all and despite feeling like Job, could "hoot on the phone / and wrestle the dog so the summer was still / the summer."

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This film by Danish filmmakers focuses on two Scots, Wilbur (Jamie Sives) and his older, considerate brother Harbour (Adrian Rawlins), who own a family buy-and-sell bookshop, North Books, in Glasgow. The opening movie credits intersperse with Wilbur's suicide attempt by pills and gassing himself. Wilbur's attempt is thwarted first by the fact that he has to put more coins into the apartment gas meter, and then by his brother, whom Wilbur had telephoned just before losing consciousness. Wilbur continues suicide attempts throughout much of the movie, with methods that range from the absurd to the disturbingly tragic.

The brothers' father had recently died and several scenes occur at a hillside cemetery. Surrounded by imposing stone monuments, the brothers' parents are buried without markers, but with a view, if you cock your head and imagine, of the bookshop. The tragedy of the mother's death when Wilbur was only 5 years old, is invoked to explain much of Wilbur's disturbance.

Early in the movie, Alice (Shirley Henderson), a waif-like single mother who cleans the operating and trauma theatres and sells books she finds at the hospital to the bookshop, is introduced, along with her soon to be 9 year old daughter, Mary (Lisa McKinlay). Alice and Harbour wed, and Mary presciently plunks a penguin eraser she has just received atop the wedding cake next to the bride and groom: "That's Wilbur," she says.

Two hospital workers feature prominently in the film. Horst (Mads Mikkelsen) is a Danish ex-pat physician and "senior psychologist." He chain smokes, distances himself from the group therapy he supposedly supervises, and yet deftly discusses bad news with Harbour in several scenes. The psychiatric nurse, Moira (Julia Davis), however, who, with ever-changing hairstyles and inappropriate nurse-patient interactions, acts primarily as comic relief, delivers the same bad news with unthinking, devastating directness.

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This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of anesthesia or sedation. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."

It is this power, the fear of this power felt by both the doctor and the patient, and, by extension, the fear of anesthesia or sedation, that form the heart of the poem. The narrator states that he cannot let his own fears about anesthesia and "loss of control get in the way." Instead he accepts the power and control that the patient gives him and "bring[s] him down."

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Physician-scientist Lewis Thomas turns to pressing, threatening issues in this collection of 24 essays, many of which have been published in Discover magazine. The book opens and closes with meditations on nuclear warfare--the atom bombs of World War II and the escalation of worldwide tensions and technology that can combine to destroy the human race. In between, other essays, such as "On Medicine and the Bomb" and "Science and 'Science,'" also focus on these issues.

Less apocalyptic essays concern Thomas's experience with requiring a pacemaker, the state of psychiatry, lie detectors as evidence for essential human morality, and his abiding interest in language and scientific research.

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This book contains 29 short essays by physician-scientist Lewis Thomas, originally published in the early 1970s in The New England Journal of Medicine. The essays center on science, and range in focus from the molecular (e.g., DNA) to the subcellular to the organism to social interactions and all the way up to the search for extra-terrestrial life. Some themes reappear in several essays: science as a grand, engaging enterprise worthy of the brightest minds; communication between organisms creating the intricate dance of the social organism; the relationship of man to both nature and the grand scheme of the universe.

Lewis is fascinated by communication not only at the cellular level, but also at the pheremonal and cerebral level: "Language, once it comes alive, behaves like an active, motile organism" (90). The ant and its colony, as an example of a simultaneous individual and integrated social organism, form a link for Thomas between the enclosed unit of a cell and the complex interactions of a society. Indeed, macro-micro comparisons continue throughout the essays, and even conclude the final essay, "The World's Biggest Membrane," which lauds the atmosphere as protector, filter, and provider: "Taken all in all, the sky is a miraculous achievement. It works, and for what it is designed to accomplish it is as infallible as anything in nature. . . it is far and away the grandest product of collaboration in all of nature" (48).

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