Summary:

The author, a writer and patient, humorously complains to the AMA, in mock-heroic rhymed verse, that doctors are practicing writing without a license. (It seems this would not be such a problem if doctors were not writing on top of all the medical miracles they perform--and if their books were not so popular!)

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This long poem in 20 sections seeks to explore, dissect, and create a language for the experience of hemophilia. "Blood pools in a joint / The limb locks . . . " The poet first dissects words like "trans / fusion" and "hema / toma," and showers the reader with images (like splatters of blood?).

In section 5 he states his purpose in the familiar jargon of educational objectives and later, in section 10, he utilizes spacing and line breaks to convert standard admonitions into poetry; for example, "These child- / ren should / not / be / punished, and / their / play with / other / children / should / be super- / vised . . . " Isolated phrases and sentences appear--some from the hospital and some from the "outside" world.

In some phrases the worlds of outside and inside mix, as in "Arterial sunrise, capillary dusk." Section 13 consists of laboratory reports. The poem breathes in and out, between syllables and long lines, between prosaic statements and poetic images. Finally, the poet finds words for the endless rhythm of hemophilia, "Gratitude and / fear--Your relentless / rhythm--I move to / it still . . . "

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In the first of this poem's three stanzas, the narrator is looking out the window, presumably on or near his fiftieth birthday. He watches as a baby possum is snatched up by a fox while the possum's mother stands dumbly by. Seeing this, the narrator notes that it is one more thing he "couldn't do anything about." In fact, he sees the drama dispassionately. He says that instead of "feeling very much" he had the sense of "something dull / like a small door being shut, / a door to someone else's house."

In the next stanza, later that night, the narrator is flipping through the TV channels but stops when he is captivated by a nurse who "had a beautiful smile / while she spoke about triage and death." Again he observes death from afar as the nurse talks about her experiences in Viet Nam and how a dying soldier asked her to bend closer so he could smell her hair.

In the final stanza, the narrator's wife comes home, tired. The narrator, however, is somehow energized; he wants to talk about the possum, the fox, and the young man who "wanted one last chaste sense / of a woman." The wife wants a drink, some music, everything "normal." But the narrator, transformed by the nurse's smile, its "pretty hint of pain / the other expressions it concealed," is no longer just an observer.

He now has "something to say," something almost inexpressible about life and death, the death that he is moving closer to but was, at the poem's beginning, unable to face. The nurse's experience--her proximity to death, her ability not only to observe but to acknowledge and honor it--has somehow transformed him.

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In this poem the speaker says she is talking about the real heart, not the sentimental image of a heart. Something is wrong with hers. She tries various images to describe it--a "caved hermit," an "unshelled turtle." She listens through an imaginary stethoscope. Most hearts say "I want, I want . . . " but hers is more uncertain. "Duplicitous," she calls it. Her heart says "I want, I don’t want . . . " In the flesh, this heart has an arrhythmia, the speaker can’t depend on it, it causes anxiety. In the spirit, though, this heart is equally undependable. How can she live with it? Sometime she will say "Heart, be still, / and it will."

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Liv is pregnant. She is an artist, and married to Erland. She names the fetus, a boy, Ersatz (a replacement, a copy, a person not yet real?). This book-long poem, divided into short segments making up nine (month-like) chapters, reconstructs her pregnancy in words, often literally, using words-within-words (for instance in a section called "Proximity of Posed to Exposed"), echoing people-within-(pregnant)-people, ideas emerging from words, and life (and death) emerging from bodies.

The poem does not offer a simple coherent narrative, although it does follow the biological narrative form of gestation. Instead it circles around the experience of containing another person, and the dissonance Liv seems to find between biological and verbal or cultural creating. Liv's ambivalence about this tension is captured throughout the work, perhaps most notably in her exploration of a painting of the dead Virginia Woolf, the drowned body of a childless woman writer, now become "beached debris." The final part of the poem captures powerfully the experience of childbirth, and the afterword is in a new voice, that of Liv's son.

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A nurse enters an elderly woman's bedroom. "Wake up! It's nearly five," she cries. Does she mean five AM, or is it afternoon teatime? The nurse lets the window blinds unroll and puts some coal on the fire in the fireplace.

In fact, the patient is dead. She had died the previous evening, "by the light of the ev'ning star." Setting aside her "chintzy cheeriness," the nurse begins to pay attention. She looks "at the gray, decaying face," realizing what has happened. Her response is simply to straighten up a bit and leave the room. [28 lines]

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On a summer afternoon, the poet lies in a garden under a mulberry tree. The air is "swimming with insects" and children are playing in the street. He notices a housefly being caught in a spider’s web. The spider poisons and kills the fly, then wraps it in "lithe elastic," but everything else in the garden remains the same. Life goes on as usual. The poet then turns his attention to the future. One day in some cottage hospital he, too, will approach the end of his life. Will he groan in his bed and gasp for breath, while no one notices? [36 lines]

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In her poem, "Dehiscence," Amy Haddad speaks in the voice of a nurse tending a suffering patient. The patient has "come unstitched," and, seen through the nurse's eyes, the patient's wounds are devastating: fistulas "connect bowel, liver, pancreas"; the "stench is overwhelming," telling everyone, caregiver and patient alike, that medical science has failed, that no more can be done.

Moved by her patient's suffering and her own inability to help, the nurse does what she can. She washes the patient, changes the soiled sheets, removes the dirty dressings and replaces them with clean gauze and tape. "Done," she says. Stepping back, looking from a distance, she can no longer see the patient's wounds. She "is caught," as all caregivers have been at one time or another, in "the illusion" of the patient's "wholeness."

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The poet contemplates the realities of life in the mining --now ghost--towns of Western America by exploring an old graveyard. "Eighty-nine was bad. At least a hundred / children died," the writer muses while walking among the grave markers. The reader recognizes that this settlement is no longer viable: "The last one buried here: 1938."

After describing the arrangement of the markers and the crude fence that defines the burial ground, he ponders why the graveyard is situated so far from the townsite. In an ironic reflection on the mothers' needs to get on with life after the frequent loss of young ones yet still striving to protect the little graves from greedy excavation, the poet says, " . . . a casual glance / would tell you there could be no silver here."

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The poem tells the story of one who travels to the hot springs seeking a cure for his chronic illness/disability. For 25 years the subject faithfully visits what remains of the opulent dream of spa-builders--a bubble that burst for both the entrepreneurs and their visitants. In the nearly deserted town, the poet's character continues to seek relief without success, yet he remains. The writer seems to be asking if it has become the search itself that keeps the sufferer alive; if he were to suddenly be made well perhaps he would lose everything in losing his familiar identity.

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