Summary:

A patient is dying of AIDS. The physician-speaker repositions a drain in the patient's wound, taking care "to slap on latex gloves" before he does so. Another physician, "a hypocrite / Across the room complains that it's her right / To walk away . . . ." She acknowledges no obligation as a physician to care for this patient. Does she think it is too risky? What kind of risk? Might contact with this dying man somehow upset her ordered world and expose her vulnerability? Of course, nothing she could do "Could save him now." Even the physician-speaker must leave the patient "pleading" and continue with his other work: "There's too much to do."

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In the first part of this four part poem, the medical student climbs “stone-murky steps” to the Dissecting Room, as London is being bombed during World War II. In the second part, the student asks his cadaver, “Who are you?” Probing deeply, cutting the meat, the student concludes that the cadaver was never really a person, the right hand “never held, surely, another hand in greeting / or tenderness . . . . ” In the next part it becomes clear that because of the student’s flip attitude, he hadn’t been invited by the hospital priest to the memorial service for cadavers.Finally, the speaker (now for many years a physician) reflects again on his old question about the cadaver’s identity. He realizes that the cadaver’s name is the name on every gravestone, that his figure is the figure on every human portrait, “always in disguise.” At the end, the physician goes on with his daily activities, climbing the stairs to his bedroom and winding his clock.

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Jacob Needleman, a philosopher concerned with "applying philosophy to the questions of everyday life," taught medical ethics at San Francisco State University (SFSU). In this highly personal book he addresses what it means to be a "good doctor" and the role of physicians in contemporary society. The book is structured as a series of imaginary letters addressed to his childhood idol, the physician who treated him when he was 12 years old.

The aged Dr. Kaufman responds to these letters, although we see only the philosopher’s side of the correspondence. Toward the end of the book, Needleman makes a pilgrimage to Philadelphia to visit his ailing mentor. They talk for a while, then when the old man takes a nap, Needleman spends the rest of the day conversing with Dr. Kaufman’s daughter, a pediatrician who in some sense represents the "good" medicine of the future, just as her father represented the "good" medicine of the past.

In these letters the author addresses the deep questions of character and motivation in the form of a personal narrative. He recalls his experiences as a boy, his ambition to become a doctor, and several incidents from his life as an autopsy assistant and hospital orderly. For example, there is the bizarre story of the young man transporting an amputated leg by elevator; he accidentally drops the leg to the floor and the wrappings flip open, much to the astonishment of others on the elevator.

"People don’t trust science; people trust people." (p. 15) Similarly, Jacob Needleman writes, people don’t trust or distrust medicine as an institution; they trust or distrust doctors. "To be a good doctor, one must first of all be a good (person). And to be a good (person) one has to begin by discovering in oneself the desire for truth . . . truth is the only effective force." (p. 68)

To facilitate this quest for truth, Needleman describes in these letters a four-seminar sequence he teaches at SFSU: "To whom is the physician responsible?," "The art of living and the art of medicine," "Care," and "The financial disease of modern medicine." (pp. 71-72) Through these seminars the author hopes to re-awaken in prospective physicians the quest for truth, and the possibility of care, that he believes have been submerged by technology and infected by the financial disease. Dr. Kaufman’s daughter serves as a real-life example of the possibility of cultivating the contemporary version of the "good doctor."

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Kitty Fane is a beautiful young woman whose mother has raised her to make a suitable match. But Kitty refuses a number of suitors; several years pass and eventually she is reduced to marrying Walter, the colonial bacteriologist in Hong Kong. Walter is a shy and awkward man who loves Kitty passionately, but has no idea how to express it; Kitty is charming and socially adept, but vacuous. In Hong Kong Kitty engages in a yearlong affair with Charles Townsend, the assistant colonial secretary, and a married man whose celebrity potential far eclipses Walter's stolid scientific work. The novel opens when Walter discovers his wife's infidelity.

Kitty believes that Townsend is madly in love with her and prepared to divorce his wife and sacrifice his career to marry her. Walter, who suffers from a broken heart, gives Kitty an ultimatum--either Townsend must promise to divorce his wife and marry her, or Kitty must accompany Walter to a city in the interior where he has volunteered to go to fight the cholera epidemic. Townsend demurs; Kitty is crushed; and the desperately unhappy pair travels to the cholera-ridden city, where they move into the house of the newly-dead missionary.

There, Walter (who is also a medical doctor) sets to work, day and night, to institute public health measures and care for dying patients. Meanwhile, Kitty meets Waddington, the British consul, a cynical alcoholic, who is at heart a good and honest person; and the French nuns, who labor tirelessly to care for orphans and the ill. Impressed by the nuns' selflessness, Kitty begins to devote herself to assisting them and trying to understand their spirituality.

When he learns that Kitty is pregnant, Walter asks if it is his child; Kitty responds, "I don't know." This completes the destruction of Walter's heart, and he soon dies of cholera--presumably as a result of experimenting on himself to find a cure. Kitty learns that the nuns, the soldiers, and all the people of the city consider Walter a saint, who has sacrificed himself for their welfare. However, while Kitty has learned to respect her husband, she could never love him.

Kitty stays only briefly in Hong Kong before returning home to London. Shortly before her arrival, she learns that her mother, whom she believes is responsible for her (Kitty's) shallowness, has died. The novel ends with Kitty vowing to bring up her daughter as a strong and independent woman, and preparing to move with her father to the Bahamas, where he has recently been appointed Chief Justice.

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This poem builds by repetition to a climax: "if there is a river /more beautiful than this," if there is a river more faithful, braver, more ancient, more powerful. Each repetition begins a new stanza, a stronger stanza, ending finally in a prayer that, if there is such a river, it should flow "through animals / beautiful and faithful and ancient / and female and brave." (24 lines)

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This novel takes place during the Ice Age at a time when modern humans (Cro-Magnon) have immigrated into northern Europe and begun to interact with the Neanderthal people, who have already been successful inhabitants of Europe for perhaps 100,000 years. Within several thousand years of this fateful encounter, which took place about 35,000 years ago, the Neanderthal people had completely died out. Early mitochondrial DNA evidence indicated that modern humans are unrelated to the Neanderthal--their gene pool simply disappeared--although more recent studies show that perhaps 2 to 3% of our mitochondrial DNA was inherited from the Neanderthals, who prbably died out as a result of modern humans' greater success in competing for food and other resources.

In this scenario modern humanity originated from a version of the Biblical story of Cain and Abel, of brother "killing" brother, except in the paleontological case the younger brother was responsible for the demise of the elder. Bjorn Kurten, an eminent European paleontologist, used this novel to present his ingenious theory to explain what happened.

The story is told from the perspective of Tiger, a young black (Cro-Magnon) man whose father is killed in a raid by men from another band of blacks. Later, he devotes his life to searching for his father's killer. In the process he travels widely and encounters a band of whites (Neanderthal), a seemingly primitive form of humanity known to Tiger's folk as "trolls." The trolls have a high-pitched, bird-like language that Tiger is eventually able to learn, even though it is virtually impossible for whites (trolls) to learn the black language, because they are unable to articulate the broad range of vowel sounds it includes.

The whites are also different in that their bands are equalitarian, with women playing major leadership roles, while black tribes are strictly hierarchical and patriarchal. Tiger travels with the white band and mates with Veyde, one of its prominent members. However, one day the band is decimated by a marauding black tribe led by the warrior, Shelk.

In the story's climax Tiger carries out a scheme to infiltrate the "bad" tribe and kill Shelk, who he believes is his father's murderer. In fact, ther real murderer was Shelk's twin brother, also called Shelk. The two had used the same name to make it appear that "Shelk" could be in two places at once, thus proving he had supernatural powers. We learn that the Shelk twins had mixed black-white parentage. Children of such unions seem god-like in that they are stronger and more attractive and creative than "normal" people of either group. The "good" Shelk finally finds the white father he has been searching for all his life. And, Tiger lives happily ever after with his white mate Veyde, but their children, though strong and resourceful, will inevitably be sterile. 

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Doctor Pascal practiced medicine for twelve years. He now lives off his investments and has devoted his life to research on heredity. He has a giant armoire filled with his findings, including files on each of his family members. His mother, Madame Rougon, worries about her son. She had expected him to become a famous doctor. Instead, he accumulates possibly scandalous files about his family.

Madama Rougon tries to enlist Clotilde, Doctor Pascal’s niece, into her cause. Clotilde lives with her uncle and is loyal to him, but she sometimes fears that her uncle is tampering with God’s plans. One day, Clotilde gives in to Madame Rougon’s pleadings and gives her the key to the armoire. Dr. Pascal surprises them rifling through his work. He feels as if his family has betrayed him.

Clotilde repents, but when a Capuchin preacher comes to town, she again changes her mind and tries once more to destroy the files. Pascal once again catches her and to regain her trust tells her all about his project. She is half-convinced and promises to think it over.

She is also considering a marriage proposal from Dr. Ramond, whom she consults when Pascal falls ill. Pascal is afraid he is going mad, but he recovers, having received a serum Ramond invented. At this point, Pascal realizes he is in love with Clotilde, but so as not to interfere in her young life, he presses her to marry Ramond. She admits she can’t for she loves Pascal.

They become lovers, but Clotilde is called away to her ill brother in Paris. She returns home when she discovers that she is pregnant, but Pascal dies two hours before her arrival. Before his death, he had completed his files, but M. Rougon and his old servant Martine burn them.

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The theme of this book of poems is life in a time of deadly plague. The author depicts his world ravaged by illness. Some of the poems are quiet love songs for others, for the world and its delights, a world turned upside-down by the ravages of AIDS. Many of the poems are elegies for friends who have died in the epidemic.

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In his preface to Amazing Change, Robert Carroll speaks directly about the power of poetry to heal. At a time of great personal loss, he says, "I began writing as a way of dealing with the inchoate, yet overwhelming, feelings I was experiencing... hopefully, to facilitate a healing process for myself." The poems collected in Amazing Change, which bears the subtitle "Poetry of Healing and Transformation: The Wisdom That Illness, Death and Dying Provide," reveal the depth and power of that healing process. They show the reader that poetic healing not only engages a person in self-discovery, but also in sharing that discovery with others. Wholeness is a community project.

While Amazing Change deals with serious subjects, many of the poems approach the subjects with humor and a light touch of irony. This is particularly true in "Dr. Bob's Psychomedical Poetics--Infomercial 1" (pp. 78-80) and "Dr. Bob's Psychomedical Poetics--Infomercial 2" (pp. 109-111). "Spiritual Soup" (p. 93) is another example of the value of humor in the good life, along with other core ingredients like marriage, prayer, hospitality, blues, hope, and pot luck.

Among the finest poems in this collection is "Kaddesh for My Father" (pp. 47-53). Written in filial homage to the poet's father, in artistic homage to Allen Ginsberg, and in spiritual homage to the Judaic tradition, "Kaddesh for My Father" seamlessly integrates personal detail and anecdote about his father with ritualized expressions of prayer and emotion.  In this and many other poems, Carroll employs poetic form and/or historical exemplars to enhance the meaning of his work, but never allows them to constrain or dilute his personal vision.

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Patrick Clary's Dying for Beginners is a collection of vibrant poems about living (as well as dying); about family, friends, music, loss, war and love. The book's title is evocative of the countercultural insight that dying is an essential part of living.  We only become fully human by coming to grips with our own mortality.  This engagement with mortality emerges from love and humor, as well as from suffering and loss.  Clary's poems speak to what he has discovered about himself, as a beginner to his fellow beginners.

The poet's route to discovery traverses Death Valley, where, during a spiritual retreat and vision quest, he has this epiphany: "Suddenly, I find all my wounds are turning into blessings" (p. 1). This inversion of categories is not an exotic, one-off event, but becomes a new way of looking at the world, a perspective in which life events, carefully observed and described, blossom with deeper meanings that can only be expressed by metaphor or paradox. For example, in "Days I Don't Remember," Clary reflects, "And all my roads are turning into rivers" (p. 27). Or, in "Meditation on the Pays d'Oc," he observes, "Instead of dying, I cough up a butterfly, watch it / dry its wings in the sun..." (p. 74). Or the essential quietism of "That silence moving through our lives was me" (p. 33).

The poet had his first lessons in dying when he worked as a medic during the Vietnam War, In "Orientation at Bien Hoa," he discovers, "Yes, gentlemen / This little war here / Exists only / For one reason: / To give you all the pleasure / You can handle" (p. 10).  He also learns how easy it is to kill with an M 16 rifle, which can "Put eighteen holes in / Whatever you point it at / Inside of two seconds" (p. 11). Meanwhile, the human tragedy of Vietnam takes place all around him.  

Clary reflects on the limits of his calling in "Three Variations", where he observes his own hands, "professionally / Tender on demand, but still uneasy / At your easy tenderness" (p. 35). The words "professionally tender on demand" evoke his work in palliative medicine, although the same words could-and should-apply to medical practice in general.  But Clary recognizes that the human capacity for compassion is not inexhaustible. There will always be a tension between the work that needs to be done ("another pair of hands in the emergency room," p. 63) and our limited reserves of kindness and empathy.

The book ends with a humorous and moving short prose narrative ("Origins of the Earwax Patrol," pp. 83-86) about caring for terminally ill patients.

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