Summary:

The novel begins with a prologue in which the author reports that, while repairing an old chateau he had purchased in the north of France, he discovered a manuscript ("La Tendresse") hidden in one of the chateau's chimneys. Dr. Alain Hamilton, the manuscript's author, had hidden it there, as the German army approached the chateau in 1940. "La Tendresse" was a collection of writings that described Hamilton's early life, especially his experience as a battlefield surgeon in the British army during the First World War. The 80 short chapters that follow, Strauss explains, are an edited and annotated version of Dr. Hamilton's story.

We first meet Alain Hamilton as an adolescent, during an episode of sexual awakening with a girl his own age. Later, we see him as a medical student in Vienna and then as a young married surgeon in London, who has a tender affair with a married nurse. But most of the story takes place at a British Army field hospital, where Dr. Hamilton encounters the senselessness, devastation, and absolute terror of war.

His colleague in this tragedy is Elizabeth, a nurse whose brother and fiancé have died in the fighting. Alain and Elizabeth develop an exquisitely tender, yet unconsummated, intimacy, which ends tragically. After the war, Alain searches healing and consolation, eventually finding a measure of peace in the chateau where he and Elizabeth had once worked together.

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Carlos and Geronimo make their living as beggars, traveling from one tourist stop to the next throughout northern Italy and the Austrian Alps. When Geronimo was a boy, his older brother Carlos accidentally hit him with a pea from a peashooter, causing him to lose his sight. The conscience-stricken Carlos vowed to devote his life to caring for his brother, and so for twenty years they have traveled together; Geronimo sings and plays the guitar, while Carlos handles the visual arrangements.

One day a tourist sows a seed of dissension. He drops one franc into Carlos's hat, then maliciously warns Geronimo to be careful because Carlos might cheat him out of the 20-franc coin he has just donated. Unexpectedly, this seed of suspicion thrives, with Geronimo becoming convinced of his brother's deception and greed. The heartbroken Carlos decides to go out and steal a 20-franc coin so that he can produce the money and satisfy his brother. He does so, and even though the theft is subsequently discovered, the story ends happily, since Geronimo now realizes how much Carlos loves him.

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A woman lies in her bed, dying of cancer. Several family members have gathered in the room around her, including her son Bruno. From the age of 11 Bruno had wanted to be an artist, but had become a doctor instead because it was easier to make a living. "And medicine at one point--when he was nineteen or twenty--had seemed more humane than the humanities, more artful than art." Yet four years earlier, Bruno gave up his medical practice in Rome to devote his life to painting. But now he is back to medicine, helping to coordinate the efforts of his mother's physicians.

The dying woman sips an opium solution to ease her pain. She teases Bruno about the many times she had embarrassed him as a child, by acting funny or assertive or eccentric, behaving very differently from the other children's mothers. She would always make people laugh. Likewise, she was never confused about what she wanted. Even now, tipsy with opium, she remains in charge, a rock among the gathered family members, deflecting their sadness with her good humor.

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The narrator's mother, having received "all the benefits of modern medicine," was still alive after 14 months. The son, himself a doctor, finally told her that she had cancer, after which she requested that she receive no treatment, other than pain control. Thus, her son provided her with a bottle of opium solution to use as needed. However, the other doctors continued their pretense that, if only she would take the "cure," she would get better.

She died six days later, "not slowly, like a train arriving at a station, but swiftly and convulsively, like a train derailing." She was buried without the priest's blessing because she hadn't been a practicing Catholic. However, the "ceremonies" of the craftsmen creating a masonry border around her grave, and of the stonecutter carving her headstone, were "last rites" more to her liking than the priest's prayers anyway, because she had never been fond of religion.

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I am feeling crabby / unlikely to reveal any hidden tidbits . . . Yet, the narrator gamely decides to continue psychotherapy, hoping to "crack open" the shell and discover the "succulent confessions" that lie within. She recalls her neighbor telling her about soft-shelled crabs and the adventurous day she ordered them for the first time at "a favorite hangout of my past." Sure enough, she ate the crabs, and "I was so pleased with myself / trying some exotic new dish" and not being afraid. [35 lines]

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To relieve her insomnia, Claire Vornoff seeks help from Dr. Declan Farrell, a well-known holistic physician, who begins to see her professionally at his country home. Farrell's methods focus on massage and bodywork, along with some acupuncture. Claire finds him an attractive paradox--sensitive and "tuned in" to her, yet also blunt and emotionally unsettling.

The client-therapist relationship becomes deeper and more complex. After Claire has a brief sexual escapade with a married man, she admits to herself that she actually loves Declan and confesses her love to him. Indirectly, he reveals that he also has strong feelings for her, but is desperately resisting those feelings and attempting to maintain his professionalism.

Claire finally breaks off their relationship and attempts to go on with her life. Over the next couple of years, Declan closes his practice, moves elsewhere, divorces his wife, and ultimately commits suicide. Claire learns of these events gradually, at second hand, as she, too, moves on, but in much a different direction. Eventually she begins a new life in Toronto.

Although the relationship between Claire and Declan occupies center stage, Claire's quest for improved health leads her to consider, and sometimes consult with, other alternative medicine practitioners as well. (I say "improved health" rather than "relief of insomnia" because, although never stated, it seems clear that Claire seeks a sense of completeness and meaning in life that goes far beyond solving her sleep problem.)

One of these healers, for example, is Mr. Spaulding, who reviews Claire's blood work and concludes, "You're in rough shape, girl." (p. 231) He explains that her "body salts are so high I can't measure them" and that her "body is throwing off one hundred times more dead cells than it should . . . "

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The story begins in New York as a young immigrant Scandinavian woman gives birth to a daughter: "She entered, as Venus from the sea, dripping. The air enclosed her, she felt it all over her, touching, waking her." The time is at the turn of the 20th century, the baby's name is Flossie, and she is the second child of Joe and Gurlie Stecher. Joe is a printer, who takes great pride in his craftsmanship. He had once been a union activist, but became disillusioned with union corruption and now works as a shop foreman. Gurlie's driving ambition is for she and her husband to strike it rich and make their mark in this new land, where the streets are paved in gold (for some people).

Flossie turns out to be a sickly baby. At first, she won't nurse at all and almost dies of malnutrition and infection. Later, she remains so scrawny that a doctor claims the only way to save her life is to take her to live in the country. Thus, Gurlie and her two children travel to upstate New York for the summer, where they board with an aged Norwegian couple. While there, the baby begins to thrive, and so does Gurlie, who had spent her early childhood on a farm in Scandinavia.

Soon after Flossie's birth, the printers' union calls a strike. Joe successfully holds the line and keeps the shop running, but his grateful employers are not grateful enough even to give him a raise. Toward the end of the book, he negotiates with another businessman to obtain the wherewithal to start his own printing company.

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The epigram for this collection of sonnets is a quotation from Alfred Cosby's The Forgotten Pandemic: The Influenza of 1918: "Nothing else--no infection, no war, no famine--has ever killed so many in as short a period." Speaking in many different voices, Ellen Voigt evokes the great epidemic through the eyes and experience of various Americans--a soldier, his fiancée, orphaned children, a doctor, and a host of grieving family.

The infection is quick and ruthless. "Within the hour the awful cough began, / gurgling between coughs, and the fever spiked . . . / Before a new day rinsed the windowpane, / he had swooned. Was blue." (p. 22) Doctors were out on the road working day and night to no avail: "it didn't matter which turn the old horse took: / illness flourished everywhere . . . " (p. 38) Soon, coffins were scarce: "With no more coffins left, why not one wagon / plying all the shuttered neighborhoods, / calling for the dead, as they once did . . . " (p. 53) At last, the influenza receded: " . . . at the window, / every afternoon, toward the horizon, / a little more light before the darkness fell." (p. 55)

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Summary:

In this collection Richard Selzer brings together 25 stories from his previous books, along with two new stories, Avalanche (see this database) and "Angel, Tuning a Lute." The unifying theme is the world of medicine and healing, which Selzer explores with a keen eye and compassionate heart. These stories are firmly grounded in the foibles, suffering, and exultation of the human body.

In the Introduction Selzer sketches the path by which he became a surgeon-writer and he indicates the origin of some of the stories. Particularly interesting are the stories that do homage to literary and historical figures; for example, "Poe's Light-house," which grew out of a fragment Edgar Allan Poe wrote in his last delirium, and "The Black Swan," a re-writing of a Thomas Mann novella (Mann's The Black Swan is annotated in this database).

Likewise, the story of how "Avalanche" was written is an interesting tale in itself. Selzer's description of pruning the story from his journal reminds me of Michelangelo's comment that the sculpture already exists in the block of marble. The sculptor merely removes the unnecessary stone. The Doctor Stories contains many of Selzer's tales that have become part of the Literature and Medicine canon; these include, for example, "Tube Feeding," "Sarcophagus," Imelda, Mercy, Brute, and Four Appointments with the Discus Thrower. (See this database for annotations of the latter four.)

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A young boy dreams of "Mangan’s sister," who lives nearby: "Her dress swung as she moved her body and the soft rope of her hair tossed from side to side." Her image pursues him, even at night when he is trying to say his prayers. One day, he actually encounters Mangan’s sister, and she asks whether he plans to go to the bazaar (Araby) on Saturday night. She herself "would love to go," but cannot, because she must attend a retreat at the convent. This is the boy’s big chance! He promises to bring her a gift from the bazaar. On Saturday evening he waits for his uncle to come home and give him some money, but the uncle doesn’t arrive until nine o’clock.

The boy rushes onto a deserted train, trying desperately to reach Araby before it closes, but when he arrives "the greater part of the hall was in darkness." A few stalls are still open. A few people are still hanging around. The boy looks at some porcelain figurines, but suddenly realizes that his quest is doomed to failure: "Gazing up into the darkness I saw myself as a creature driven and derided by vanity, and my eyes burned with anguish and anger."

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