Summary:

Among animals only humans have difficulty giving birth. While other primates deliver their babies with little fuss, women experience painful labor and childbirth. The explanation for this discrepancy lies in the size of the human head at birth. As hominids evolved ever larger and larger brains, the fetal head had to increase in size at birth. Eventually the head almost outstripped the female pelvis's ability to expand enough to allow it through the birth canal. This delicate balance between fetus and pelvis accounts for human fetal and maternal morbidity and mortality.

As a response to the growing threat of childbirth, human females evolved away from estrus (i.e. sexual receptivity only when ovulating) to the menstrual cycle and continuous sexual receptivity. The mysterious moon-related cycle led women to formulate the concept of "time" and make the connection between sex and pregnancy. It also allowed them to refuse sex when they were ovulating.

Women then taught time consciousness to men, and men used their growing self-consciousness to begin to establish control over nature (and women). The sense of being-in-time led inevitably to awareness of mortality. This, in turn, stimulated humans to create gods and religion in order to ward off death anxiety.

View full annotation

Summary:

It is 1905, and a young doctor just out of internship in Chicago has decided to head for the southwest to seek his fortune. He finds himself on a slow train in southern New Mexico, sitting across from a Sister of Mercy "in her black robes, skirts and sleeves, and heavy starch." When the train stops, the doctor inquires about a group of men huddled on the platform. They surround a severely ill Mexican worker, who turns out to have appendicitis. The doctor insists that only an immediate operation will save his life, but the Mexicans are violently opposed to surgery. Eventually, the doctor enlists the nun’s help to persuade them.

In the blistering heat, they carry the man to a shed where the doctor performs an appendectomy with instruments in his black bag, including morphine and chloroform. For the next 24 hours, he and the nun watch over the man, and then carry him to the nearest town on the next train. He survives, which is good because otherwise the Mexicans have threatened to kill the doctor. The nun, who throughout has been cool toward the doctor because of his use of "rough" language, proceeds on her way to Texas.

View full annotation

Summary:

Dr. Audlin is a highly successful psychoanalyst. His patient, Lord Mountdrago, is a leading member of the House of Lords and Secretary for Foreign Affairs in the British government. Mountdrago consults Audlin because of nightly vivid and threatening dreams, all of which concern Owen Griffiths, a member of the opposition in the House of Commons. Griffiths is a small, unimpressive commoner from a constituency in Wales. As Griffiths becomes progressively more the focus of his dreams, Mountdrago cannot imagine why, since to him the man is insignificant vermin.

Audlin presses his patient if there is any reason why Griffiths might actually be hostile toward the Lord, or that he (Mountdrago) might feel guilt regarding Griffiths. Eventually Mountdrago is forced to admit that on one occasion when Griffiths made a speech proposing a change in foreign policy, Mountdrago crushed him. Using his very considerable oratorical skill, Mountdrago tore Griffiths apart and held him up to ridicule. This, in turn, ruined Griffiths' career. Mountdrago hadn't initially thought of the affair since Griffiths was beneath contempt and deserved to be crushed; as such, he had no reason to hold a grudge against Mountdrago.

The psychoanalyst suggests that the only way Mountdrago can free himself from the dreams is to apologize to Griffiths. Mountdrago angrily rejects this, but then goes out and commits suicide. In the end we learn that Owen Griffiths dies the same night, presumably by suicide.

View full annotation

Summary:

This is a collection of humane and humorous stories by psychiatrist Ronald Pies. Many of them portray snippets of Jewish-American family life; others feature Pies's alter egos, young psychiatrists named Applebaum; or Ackerman, or Alterman; still others introduce a number of wonderful geriatric characters the reader is unlikely to forget.

In the title story, an elderly man lies in the hospital and remembers how he inserted snippets of pornography into his business partner's tefillin nearly 40 years earlier, just to spite his holier-than-thou partner, who had evicted his Playboy magazines from the premises. "Mandelbaum's Passion" is the story of an elderly professor whose daughter wants to put him into a nursing home. He, on the other hand, focuses his energy on anticipating the twice-weekly visits of Luz, his 26-year-old Hispanic visiting nurse.

Dr. Otto Hertzmann in "Show Us Where God Is" is a retired analytic psychiatrist who lives with his sister. When a young admirer comes to visit, the sister introduces him to Davie, Hertzmann's severely retarded son who, when asked to "show us where God is," grins widely and points to the ceiling. Max Dershman, found dead in his room "stinking of cheap cigars and surrounded by Playboy centerfolds," is another such character. He falls head over heels in love with Riva Greenberg, the nursing home social worker, and leaves her a love letter when he dies ("A Medical Diptych"). In "Sophie Fein Goldberg Stein" the title character insists on always being addressed by her full name--at least, that is, until the nursing home psychiatrist is willing to sit down and listen to the full story of her life.

View full annotation

Summary:

This selection of Miroslav Holub's poems is organized around five major topics--genealogy, anthropology, semiology, pathology, and tautology--rather than chronologically. The poems, some of which date back to his first collection in 1958, were translated into English by a number of different persons, but mostly by David Young, who has had a long-term collaboration with Holub.

Holub states his major preoccupation in "Bones," the very first poem in this collection: "We seek / a backbone / that will stay / straight." (p. 13) The search reaches its fullest expression in "Interferon," a long poem about messages, messengers, and interference: "Cells infected by a virus / send signals out . . .

And when a poet dies, deep in the night / a long black bird wakes up in the thicket / and sings for all it's worth." (p.159) The first step in the search is to learn to interpret the signals, and to understand the black bird's song. To do that, one has to ask questions. Yet, in the face of enormous "Suffering," we are drawn to passivity: "But I ask no questions, / no one asks any questions, / because it's all quite useless." (p. 147) How to overcome the inertia and proceed, even in the face of likely failure?

Holub reminds us that even "In the Microscope" we find "cells, fighters / who lay down their lives / for a song." (p. 149) In fact, there may be something worth fighting for, although perhaps we can only see it under extreme circumstances, as in "Crush Syndrome," where a concrete mixer snaps up the hand of a man cleaning it: "The finger bones / said a few things you don't hear very often...In that moment / I realized I had a soul." (p. 174). But perhaps what we call the soul is really just our deep yearning to survive, as in "Heart Transplant": "It's like a model of a battlefield / where Life and Spirit / have been fighting / and both have won." (p. 179)

View full annotation

Summary:

Closed like confessionals, ambulances weave through the city. One of them might come to rest anywhere. When that happens, the onlookers momentarily see "a wild white face that overtops / Red stretcher blankets" as the patient is taken into the ambulance.

Suddenly, just for a moment, they "sense the solving emptiness / That lies just under all we do." The onlookers whisper in distress. But the ambulance moves on, the traffic parts to let it by, and "dulls to distance all we are." [30 lines]

View full annotation

Summary:

The story begins soon after the narrator has moved his elderly mother into Cherry Orchard, an "independent living" facility near his home in Providence, Rhode Island. Because of progressive dementia, she was no longer able to maintain her own home in New Jersey, or her relationship with Warren, her boyfriend of 20 years, with whom she spent part of each year in Florida. Thus, the narrator and his sister arranged for her move to an apartment in the exclusive Cherry Orchard, where her symptoms of Alzheimer's disease had to be hidden in order to ensure her eligibility.

The mother and son have never been close, especially after the boy's father died during his early adolescence. She was a pleasant, but distant parent, more interested in her own social and cultural affairs than in taking care of her children. The narrator is 34 years old now, married, with his own son. He has little emotional attachment to this woman who is slowing losing her mind, yet now he feels duty-bound to visit her at least weekly at Cherry Orchard.

The mother has almost entirely lost her short-term memory, yet at first blush seems surprisingly intact because of her ability to cover-up with social skills. She writes notes to herself. The texture of her life unravels. She begins to wander. Other residents complain. Occasionally a glimmer of insight appears, but quickly dies. Fighting his inclinations every step of the way, the narrator provides ever increasing physical and emotional support, while at the same time gaining a deeper understanding of how his mother was (and is). In the end nothing is changed--the mother spirals slowly downward. But in another sense everything has changed. The narrator concludes, "I had taken her in so that I could understand why I had agreed to take her. I would do it again."

View full annotation

Summary:

Boyle drives out to the cottage to visit Joady, who is dying of cancer. Dinny and Joady are two elderly brothers who live together. "In all his years Joady had never slept away from the cottage," until recently when he went to the hospital and had an operation. Boyle and Dinny speak about how, a week earlier, they had been stopped by police in a helicopter as they were driving to the hospital to visit Joady--this was the day after an IRA bombing in which five people lost their lives. When they reached the hospital, they spoke to the surgeon who told them that Joady was terminal. By this time (back at the cottage), Joady knows that he is dying. However, he follows his normal routine, apparently unchanged, while Dinny is sullen, distracted, and complaining.

View full annotation

Summary:

The narrator, a schoolteacher substituting in a "stagnant, godforsaken little place" in the west of Ireland, meets an old woman that everyone in town calls "The Creature." She decides to visit The Creature and listens to her story, eventually becoming a regular weekly visitor at her hut.

The Creature is a widow who has two children: a daughter who lives in Canada and a married son who lives a few miles away on a farm The Creature used to own. Her husband had been killed, a victim of The Troubles two years after they were married. Thus, she had to raise the children alone.

Originally her farm was relatively prosperous, but the animals had all developed hoof-and-mouth disease and died. Nonetheless, she managed to keep body and soul together and to send the children away to school. Her son returned from the city after marrying a woman who despised The Creature. He and his wife had moved into the farm, but the young couple argued every night about money and the mother's presence, so The Creature signed the farm over to her son and moved away. That was 17 years ago; he had never visited her since.

The narrator goes to the farm, meets the son (by this time a passive and depressed middle aged man), and arranges for him to visit his mother. He does this, but the visit goes poorly. The narrator finally realizes that she has actually removed the last little glimmer of hope the old woman had; before seeing her son again, she could always hope that someday the two would be reunited, but after he visits, she realizes that he doesn't care about her and will probably never come back.

View full annotation

Summary:

"Spell Check for a Malformed Fetus" (p. 1) sets the stage for some of the important themes in this collection by poet-psychiatrist, Ronald Pies. First, the lack of honest language to express life’s "mistakes" and disappointments. Our attempt to disguise the pain by using easy, but inaccurate, words. And finally, an expression of hope, even if only in the world of imagination: "if only / in your first fission / some godly processor / had blessed / your blighted genes."

Some of these poems emerge from relationships with patients, notably "Consultation Request" (p. 35), "Three Patients" (pp. 37-39), "Prolapse of the Uterus" (p.76), and "Congestive Heart Failure" (p. 85). "Smoke, Lilac, Lemon" (p. 45) evokes a fascinating test apparently used by some clinicians to distinguish depression from Alzheimer’s disease on the basis of olfactory function. The four "Alzheimer Sonnets" (pp. 87-88) tackle the difficult task of expressing the experience of dementia from the patient’s point of view.

Many of the other poems deal with love, memory, loss, and pain in the context of family and intimate relationships. Among the best of these are: the title poem (p.3), "Sitting Shivah" (pp. 14-15), "Riding Down Dark" (p. 16), "Visitant" (pp. 41-43), and "Migrations" (pp. 64-69).

View full annotation