Summary:

The time is November 1899 through February 1900; the place is Ladysmith, a small railroad town in British Natal near its border with the Boer Republics. The Boers have surprised the world with an initial series of Samson-and-Goliath victories over the British army and have now laid siege to Ladysmith. As they shell the town from surrounding hills, people die, disease is rampant, structures collapse, starvation looms, and yet the British muddle through with an improvised cricket match whenever possible.

The setting of this novel is historically accurate, and a number of historical figures appear as characters; for example, the Boers arrest a young reporter named Winston Churchill as he struggles to reach the besieged town, and an Indian lawyer-turned-medical volunteer named Mohandas K. Gandhi becomes more and more committed to his philosophy of active nonviolence.

The core of the novel is a fictionalized version of a love story that the author found in the letters of his great-grandfather, who was a British soldier at Ladysmith. Bella, the Irish hotelkeeper’s daughter, falls in love, first, with a British soldier; and later with a Portuguese barber, thus defying convention and rebelling against her father. The unlikely couple escapes in a balloon.

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Ian Young spent the summer of 1970 as a medical student working at a hospital in the province of Kabylia in Algeria. He was assigned to the Maternity department, where he worked primarily with two Bulgarian doctors. Most foreign medical personnel in Algeria at the time came from Eastern bloc countries, as "Islamic Socialism" was the official political system in the newly independent (1962) North African country. According to Young, obstetrical care for the mostly Berber women of the area was brutal, disorganized, antiquated, and dangerous.

Dr. Vasilev, the head of the department, is a passive and indecisive man, who spends most of his day reading the newspaper. Once roused from his lethargy, which doesn't happen very often, he demonstrates competence and concern for his patients. His colleague, Dr. Kostov, is an aggressively brutal man who introduces himself to pregnant patients by shoving his fist into their vaginas.

Both doctors excuse their behavior by saying, "We just can't do it here they way we do it in Bulgaria." For the most part, they do not use sterile technique, and although anesthetics are available, neither Kostov nor Vasilev typically use them. The Algerian nursing staff provides at least a modicum of organization and care in this dreadful environment.

At first Young approaches the situation with disbelief and anger. He then attempts to improve the quality of care, first by introducing a flow sheet for obstetrical care, and later by submitting a report on the poor conditions to the hospital director.

Mild-mannered Dr. Vasilev supports him, but no one uses the new flow sheets, and the Director considers the report a personal (and political) affront. Meanwhile, Ian Young presents the reader with a seemingly endless series of fascinating patient cases and interesting stories about hospital personnel, as well as about his excursions to various parts of Kabylia.

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This is a collection of poems that ranges widely through both the geographical and spiritual worlds. Susan Rich began her career as a human rights activist and Peace Corps volunteer in Niger. She has also worked in South Africa, Bosnia, Gaza, and as a program coordinator for Amnesty, International. Her poems are lyrics of empathy, discontent, and hope, unified by her "Cartographer's Tongue."

From an international medical and health perspective, some of the best of these poems are "Haiti," "The Woman with a Hole in the Middle of Her Face," "In the Language of Maps," "The Toughest Job," "The Beggars," "Sarajevo," "La Verbena Cemetery," "Whatever Happened to the Bodies," and "The Scent of Gasoline."

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This is the journal that Oliver Sacks kept during a "fern foray" in Oaxaca, Mexico. Sacks is a fern lover, even though he admits to an even greater passion for club mosses and horsetails. In 1993 John Mickel of the New York Botanical Gardens introduced Sacks to the New York chapter of the American Fern Society (AFS). Consisting mostly of amateur naturalists, AFS meetings were both congenial and passionate, unlike the cold competitiveness of professional meetings in neurology and neuroscience. The New York AFS folks arrange periodic trips to hot spots in the fern world to indulge their passion. In 1999 Oliver Sacks accompanied them on a trip to Oaxaca, which is a veritable paradise of ferns.

Though the trip is only 10 days long, Sacks packs a month’s worth of sights and sounds and meditations into his journal. We learn a lot about the hundreds of species of ferns that range from southern Mexico’s rain forests to the nooks and crannies of its arid central plateau. But the author’s curiosity roams freely and absorbs his new environment. We learn about the origin of chocolate, the history of tobacco, and the archeology of Monte Alban. We learn about the process of distilling mescal in one’s backyard. Most of all, we are introduced to nearly a dozen vivid characters, united in their enthusiasm for fieldwork and ferns.

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Sapphira was a fashionable young woman in Winchester when she married Henry Colbert, a man beneath her station, and moved to a rugged backwoods village, where they have lived for more than 30 years. Twenty of Sapphira's slaves came with them. This caused somewhat of a sensation among the poor, non-slave owning population of the region, where even to this day the Colberts are admired but not well-liked. Henry successfully took over the village grinding mill, while Sapphira assumed the role of local granddame. They had three daughters, all of whom married and moved away. However, Rachel's husband died, and she returned to Back Creek with her two young children.

Sapphira and Rachel are lay nurses who often visit and comfort the sick. Sapphira appears to do this work out of a sense of noblesse oblige, but Rachel feels empathy for the sick and less fortunate. She sets herself above nobody. Rachel is also an abolitionist at heart (as, to some extent, is her father), but Sapphira is firmly convinced that slavery is not only necessary, but also moral. Henry, a rather ineffectual male presence in this story, has responded to Sapphira's haughty regime by gradually withdrawing. In fact, he has largely abandoned the Big House to live at the mill, which he justifies by claiming the lack of a reliable foreman.

Sapphira suffers from severe dropsy. Her swelling is so bad she can no longer walk. She is jealous of a young slave named Nancy, with whom she believes Henry is having an affair. Much of the novel describes Sapphira's attempts to get rid of Nancy, first by selling the girl in Winchester, and later (when Henry refuses to sell) by importing her ne'r-do-well nephew to rape and destroy Nancy. This doesn't work either, primarily because Rachel takes Nancy under her wing and arranges her escape to Canada via the Underground Railroad.

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The narrator is visiting a patient in a mental hospital and sits chewing his sandwich. He has also brought a sandwich for the patient (his brother? father? friend?), but the patient just holds his sandwich motionless in front of his mouth. The narrator tries to accept this as ordinary; he keeps chewing. But his "past is sitting in front of" him, trying unsuccessfully "to bring the present to its mouth."

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This is the first full-length collection by pediatrician and international health physician Roy Jacobstein. These 40 poems engage a wide range of topics, settings, and tones, but all demonstrate the same fine craftsmanship and strong voice.

Among the most engaging of Jacobstein’s poems are those dealing with memories of childhood and adolescence. Consider, for example: “Mr. Gardner in 10th grade told us there was no purpose / to mitochondria, only function.” (“Atomic Numbers,” p. 5). Or, “What transgression made fat Mr. Handler / drop his towel, his gloves, everything… to chase you from one end / of Fullerton to the other?” (“The Lesson,” p. 30) The poet displays a delightful sense of humor in pieces like “Bypass” (p. 36) and “Squid’s Sex Life Revealed in USA Today” (p. 59). Poems with explicit medical themes include “Pre-Med” (p. 6), “Admissions” (p. 8), and “What It Was” (p.11).

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In Especially Then David Moolten discovers his poetry in the ordinary, often painful, texture of childhood, adolescence, love, and marriage. Each memory becomes a small story-like poem that looks simple and straightforward at first, until suddenly the poem reveals its hidden truth.  A sense of existential loss pervades these poems, as in “One morning as a man’s wife offers to fill / His empty bowl he feels suddenly desolate / For how plain he has become…” (“Cornflakes,” p. 31)  But Moolten’s melancholy is sweet, rather than bitter; energized, rather than depleted; and cumulatively powerful, as “The tractor / Of memory drags on, churning its femurs, / Its numbers and dates.” (“Verdun,” p. 64)

Especially Then is ripe with traumatic events: A father’s abandonment, “During that proud, petulant year my father left / And I became a punk, nothing could touch me.” (“Achilles,” p. 17). A brother’s death: “in the shallow dark of years since / I buried my brother…” (“Pulled Over on I-95,” p. 23) Divorce, “despite the years between you / And a hard divorce, the unshrived recriminations…” (“Seen and So Believed,” p. 51) And a wife’s death, “As if his wife had always gone / By the name of death he thinks of her / Whenever he sees or hears the word.” (“In Name Only,” p. 49)

These ordinary tragedies play out against a panorama of tragedy, as evidenced in “Photograph of a Liberated Prisoner, Dachau (1945)” and “The War Criminal Gives His Testimony.” Most often, though, the world’s suffering has little impact on the way we live our lives, “Someone at the next table sighs / Over Guatemala, the tragedy / Of having read an article or watched / A TV special…” (“Who You Are,” p. 53) We go on as we always do.

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The author lists 173 twentieth century physician-writers, including both well-known and relatively obscure figures. The roster features each author’s dates, nationality, gender, year of medical degree, medical specialty, and his or her literary genre (fiction, poetry, drama, and non-fiction). The information about each author is documented by a reference to source material. The article also contains tables indicating (1) the percentage of physicians in the United States who were published physician-writers by decade from 1930 to the present; (2) a breakdown of physician-writers by medical specialty; and (3) literary genres by medical specialty.

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This is a long (110 lines) narrative poem about the poet’s wife’s cancer, "large, rare and so anomalous / in its behavior that at first they mis- / diagnosed it." At first the poet personifies the cancer, then he demonizes the chemotherapy. He describes Tumor Hell and Tumor Hell Clinic, which "is, it turns out, a teaching hospital. / Every century or so, the way / we’d measure it, a chief doc brings a pack / of students round." Back on earth, his wife’s cancer is gone.

"This must be hell for you," some of his friends said. He reflects on the meaning of Sartre’s hell (created in Sartre’s own image) and Dante’s hell (created in his city’s image), and he considers the tumor’s name. He concludes that his wife should "think of its name and never / say it, as if it were the name of God."

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