Summary:

This poem is written from the point of view of a caregiver, one with seemingly endless patience, who steps in to piece together her loved one after the "doctors gave up." Indeed, after Humpty has fallen again, we find him at the speaker’s door "begging / in that leaky voice / and I start wiping the smear / from his broken face."

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After five unproductive meandering sessions, Mr. Trexler, the patient, turns the tables on his psychiatrist, batting back to him the question he has just been pitched: "What do you want?" The doctor's pathetically shallow and concise answer, "I want a wing on the small house I own in Westport. I want more money and leisure to do the things I want to do"(101), propel Mr. Trexler towards compassion for the doctor, and a feeling that he himself had regained his own quirky hold on the world.

After leaving the "poor, scared, overworked" doctor, Trexler thought again about what he wanted: "'I want the second tree from the corner, just as it stands,' he said, answering an imaginary question from an imaginary physician. And he felt a slow pride in realizing that what he wanted none could bestow, and that what he had none could take away. He felt content to be sick, unembarrassed at being afraid; and in the jungle of his fear he glimpsed (as he had so often glimpsed them before)the flashy tail feathers of the bird courage"(102-3).

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After his divorce and a year of traveling the world with Doctors Without Borders, Orville Rose returns to his home town of Columbia, New York upon learning of his mother's death. He discovers upon his return that in order to receive the benefits of his mother's will he must stay in this "Hudson River town plagued by breakage" for one year and 13 days. What transpires over that time is the heart of this novel which includes Orville's love story with a single mom (who has her own physical breakage), a renewed relationship with his mentor, Dr. Bill Starbuck (the inventor of the cure-all Starbusol who leaves Orville to travel the world with his wife Babette, before returning to town to receive Orville's care as he dies), and the often hilarious account of Orville trying to care for the citizens of Columbia. Thrown into this mix of new and old relationships is the floating presence of his dead mother as well as the in-his-face presence of Orville's boyhood arch-nemesis who now is riding high in Reagan's "Morning in America" as Columbia's candidate for congress.

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In 1999, eighteen years after Project HOPE began publishing the journal "Health Affairs," the founding editor, John Iglehart, began a new column: Narrative Matters. This book contains 46 of the 80 essays published to date, and an inspiring foreword by Abraham Verghese. The essays are contained in eight chapters-- "Writing to Change Things: Essays on the Policy Narrative," "Dollars and Sense: Hard Financial Realities," "Bearing Witness: Patient's Stories," "The Maddening System: Frustrations and Solutions," "Trouble in the Ranks: Professional Problems," "Drug Resistance: Battling Undue Influences," "Disparity Dilemmas: Stories on Race and Ethnicity," and "Values and Choice: Stories of Practical Ethics." Familiar voices include those of Fitzhugh Mullan (one of the editors), Abigail Zuger, Howard Brody, Richard Lamm, John Lantos, Danielle Ofri, and Carol Levine. The essays in the first section strike an important cautionary tone, reminding readers that the plural of anecdote too often is taken for policy and that the repetition of anecdote should not be seen as evidence.

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The poet beautifully captures the connection between a successful neurosurgical operation that restores "the jitterbug of impulses" of the brain, with the neighbors' "word of the cure." He likens the neighbors' conversations to "the way, in Montana prairie country, / the first telephones let the local secrets / and sorrows pour through the survey-staked / barbed-wire fences now doubling / as makeshift transmission lines."

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Jay Baruch offers readers a series of multi-layered stories focusing on caregivers, both professionals (doctors and nurses primarily) and family members, and those they are trying to care for. The setting for a number of the stories (and therefore a number of the characters) is from the working class or underclass. Another group of stories is written from the perspective of medical students, residents or physicians early in their training. In all the stories, the characters' lives are close and full of conflict. The language they use to express themselves is raw and direct. There are no simple solutions to their problems. Yet struggle on do these characters, testing the limits of their compassion and abilities to deliver care at least competently.

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Having previously described his seven years as a family practitioner in rural Minnesota (Healing the Wounds, Pantheon Books, New York, 1985) Hilfiker now has turned his attention to a decade in inner-city Washington, D.C., where he practiced what he calls "poverty medicine." These introspective essays are written in a style similar to that of his first book and detail the profound struggles of the overwhelmingly African-American community he serves and lives with.

Also examined are his and his family's battle to live with their white middle-class privileges in the midst of this impoverished community. This book very effectively alternates between the numerous stories of his personal encounters with patients and deeply reflective commentary about those encounters. Prescriptions are not offered other than that a new art of caring for the poor is needed.

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In this tale, Selzer juxtaposes the wealthy chair of the Department of Radiation Therapy, Dr. Arnoldo Cherubini, with Luis Figueira, a scavenger of refuse in the teeming Brazilian city they both call home. Cherubini lives in splendor in the wealthy hillside district, while Luis lives in a ramshackle hut by the sprawling municipal dump. What brings the two together is the discovery by Luis of discarded cesium, which had been inadvertently left in an "outmoded" x-ray machine taken to the dump.

Luis believes his discovery to be miraculous--a piece of a star. He buries his treasure each night, only to uncover and behold it the next evening. Fearing that the guards at the dump will steal his prize, Luis takes it to the home he shares with his sister and her family.

Soon, his avaricious brother-in-law finds the treasure and greedily sells pieces of it to the local slum-dwellers. Luis, with hands rotting, eventually seeks, but then refuses medical attention from Dr. Cherubini. The doctor makes a few half-hearted efforts to aid his patient, but returns to his insular world. Luis returns to the dump and dies shortly after in the arms of his lover.

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This short novel is based on the student-led Mexican uprising of 1968. The reader discovers that the protagonist, Nestor, is in a hospital bed one year after the government's brutal suppression of the rebellion, recovering from a stabbing at the hands of a "prostitute-assassin" he had confronted in his post-rebellion duties as a "yellow journalist." With plenty of time to think about the failures of the previous year, Nestor decides to finish off the revolution from his sick bed, and elicits the help of his heroes, both actual and fictional, to carry out his plan.

The various heroes Nestor calls upon include "the hound" from Hound of the Baskervilles and Sherlock Holmes; the Earp brothers and their companion, Doc Holliday; the four Musketeers; the Light Brigade; and various other anti-colonialists and anti-imperialists, including Norman Bethune (see film annotation, Bethune: The Making of a Hero), the Tigers of Malaysia, and the Mau-Mau. These characters are summoned by Nestor (and Taibo) as a means to revivify the "Movement of '68" that ended in the massacre of 49 students, the wounding of 500 others, and the detention of 1500 persons on October 2nd of that year.

Jorge Castaneda notes in the preface to this novel, "only fairy tales or adventure stories could heal the wounds and keep the promises of the streets . . . "(p.vii). It is the imagined hero's power to reconfigure events to which the desperate Nestor turned in his attempt to heal the past.

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Although the setting is startlingly different, and the care provided is through highly unorthodox means, the healer in this science fiction story experiences in remarkably similar ways the everyday wear and tear of modern medical practice. Snake, a young female itinerant healer, has been asked to save the life of a young boy. Her attempts to do so, and her interactions with the boy, his family and community, and the tools of her trade (the snakes-mist, sand and grass) are detailed in the story. "Professional development" issues that this strong and complex character has to deal with include truth-telling, interfering and ignorant family members, self-sacrifice, and possible reprobation by her peers and teachers.

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