Summary:

A Kiowa Native-American, so obese he looks "like a grand piano in soft sculpture," visits the narrator's office. The Kiowa is a teacher and lover of words, but back home on the reservation, the old sources of inspiration are gone--"the old stories disappear"--and he knows "at the center of himself he is starving." (The obesity comes from this desperate need for feeding!) The narrator, who is probably a writer and teacher herself cannot help him.

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The text explores the experiences of a nurse practitioner in an inner city OB-GYN (Obstetrics & Gynecology) clinic and four of her women patients, from a fifteen-year-old homeless pregnant child to a mature woman struggling with cancer. Another of her patients is pregnant and drug addicted; a fourth suffers from pains that come from buried memories of sexual abuse. The stories of all four patients weave in and out of the narrator's own stories about herself, her own health and illness experiences, her own respectful appreciation of the female body.

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The poem presents a Native-American woman hanging by her fingers from a window ledge 13 floors above the street. As she tries to decide whether or not she'll let go, she thinks of all the reasons that have led her to consider suicide: she feels broken in "several pieces between the two husbands she has had"; here in a crowded Chicago tenement, she is out of her natural native place in the north; she is poor; she suffers from racial discrimination; she hears voices; she cries "for lost beauty." She considers her three young children and remembers her own childhood. The poem ends with the either/or choice still not made--either she will fall to her death or she will climb back in the window and reclaim her life.

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A one-armed tramp, appropriately named "Mr. Shiftlet," walks up to a run-down farm where an old woman and her retarded daughter, Lucynell, are sitting on the front porch. Lucynell cannot talk. Mr. Shiftlet persuades the old woman to hire him for work around the farm and for repairing a car. She says she can feed him but not pay him. Over a period of a few weeks he repairs the car (which is what he really wants) and offers to marry Lucynell if her mother will give him some money.

After the wedding Mr. Shiftlet takes Lucynell on a honeymoon, but abandons her in a country diner the first day, claiming she’s a hitchhiker. As he drives towards Mobile, he picks up a boy and begins to lecture him about being good to his mother. The angry boy jumps out of the car, and Mr. Shiftlet prays that God will "break forth and wash the slime from this earth."

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This collection of sixteen Chekhov stories brings together in one volume many of Chekhov’s finest tales about doctors. The chronologically-arranged collection includes the famous novella, Ward 6, as well as such shorter classics as An Awkward Business and A Doctor’s Visit. In all sixteen stories, the doctor is a major figure, often at the center of a moral conflict.

Robert Coles , in his thoughtful forward, notes that Chekhov raises the "big questions" about "the meaning and purpose of life and the manner it ought to be conducted (and why)." Himself the editor of William Carlos Williams’s doctor stories, Coles recognizes and honors the comparison between Chekhov’s and Williams’s works and their dual careers as physician-writers. Jack Coulehan, in his introduction and comments, provides interesting biographical information on the great Russian writer as well as insightful interpretations of each story.

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This first person short story is narrated by a waitress who is describing to her friend, Rita, her experiences with a very obese and ugly man--and its effects on her relationship with her husband. She gives a detailed description of the fat man’s appearance, of his eating, and of his particularly kind nature. Then she describes her unfulfilling relationship with Rudy which now (after the fat man) seems wrong for her.

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This excerpt from the novel, narrated by the court dwarf, gets us at once into his attitudes and prejudices: that he is nobody’s fool and will not act like a buffoon to entertain people; that he admires the Prince he serves but doesn’t really understand him; that he has a huge ego and plenty of defensiveness, as if he were always expecting ridicule. He hates being treated like a child and being forced to play with the Princess, so he takes revenge by decapitating her pet kitten.

In the extraordinary scene where dwarfs act out a communion service, he says, "I eat his body which was deformed like yours. It tastes bitter as gall, it is full of hatred." Then he throws the wine over the Prince’s guests who are watching this entertainment.

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Nathaniel Lachenmeyer’s memoir is a reconstructed account of his father Charles’s battle with paranoid schizophrenia and Nathaniel’s inability or unwillingness to recognize his father’s need for help. After his father’s death, Nathaniel contacted many of the people who had known his father, both when he was a student and college professor and later when his illness forced him into mental hospitals, squalid apartments, and homeless living on the streets. Nathaniel’s search to understand his father after his death led him to interview the many health care workers, police, street people, restaurant staff, and others who knew Charles when he was very ill.

Charles was delusional, often hearing voices and talking to his mother, who had been dead for years. Typical of people suffering from paranoid schizophrenia, Charles did not see himself as mentally ill. Therefore he did not like to take medications and would refuse treatments when he could, although his health care workers could see substantial changes for the better when he was on medication. He believed he was the victim of a mind control experiment, forced on him by his persecutors. He died out of touch with his family, having suffered almost twenty years on his own with his illness.

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An artist, suffering from psoriasis, believes he is "loathsome to love" because of his scaly skin. "The name of the disease, spiritually speaking, is Humiliation." The narrator creates gorgeous pottery--flawless, smooth--the opposite of his rough, splotchy skin. His retailer, Himmelfahrer (he who travels through Heaven), calls him a genius. His girlfriend, Carlotta, loves him the way he is.

However, as the narrator goes through drug and light treatments under the care of a dermatologist, his skin begins to clear, but his pottery gets ugly and rough, Himmelfahrer expresses distress at the loss of quality, and the love relation with Carlotta cools. The artist declares himself beautiful, his girlfriend leaves, and Himmelfahrer won't buy any of his "gargoylish" pottery.

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An automobile accident left Mary Swander nearly paralyzed and coping with chronic pain. After several incorrect diagnoses, she saw a neurosurgeon who told her that a disk in her neck ruptured "at C6 and punched a hole in the spinal cord. The flu virus went into the cord and infected it." She had central cord syndrome (which can paralyze arms) and myelitis (which can paralyze legs).

Other than traction, the doctors said they could not do anything more for her. She went to New Mexico where herbal medicines of a curandera and spiritual healing by a Russian Orthodox monk helped her. She now walks without a cane.

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