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This is the first of several autobiographies written by Donna Williams. In this she describes her earliest memories and experiences of being autistic through to her late twenties and the writing of the autobiography itself. Her account begins with descriptions of personality characteristics understood to be typical of people with autism. Contrasting her highly visual nature--a fascination with patterns and color and seen or imagined spots of light--with her difficulty understanding language and formulating it, Williams’s narrative is an account of neurological difference within a family that responded to it with impatience, anger, and violence.

She describes her fear of other people and how she learned to communicate primarily through objects, attaching to things and their symbolic meanings more easily than to people and language. As a means of managing her fear of people and her encounters with sometimes abusive family members and partners, Williams developed alternative personalities. She would perform those different personalities when she wanted to socialize or if she needed to protect herself. Williams develops relationships, some exploitative and some comforting to her, and finds ways to do well in aspects of school and work. The autobiography ends with a discussion of her first draft of the narrative itself providing a means for diagnosis. Initially thinking she has schizophrenia, Williams experiences a revelation when she realizes she is autistic.

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This extraordinary book is ostensibly "about" a doctor caring for persons with HIV/AIDS. That it is, but it is also a book containing multiple texts. It is a doctor's personal journey toward understanding the multiple meanings of HIV/AIDS for those who have it and those who care for them. It is the story of a physician, an Indian, born in Ethiopia to Christian expatriate teachers, in America since 1980, now in Johnson City, Tennessee, still trying to determine the meaning of "home."

It is, at the same time, a glorious pastoral account of practicing medicine in Tennessee--here making a house call to Vicki and Clyde, whose trailer is perched on the side of a mountain, now traveling through the Cumberland Gap to a cinder-block house to see Gordon, another native son who has come home to die. On still another level it is the story of a man trying to understand what it is like to be gay; a man trying to integrate his passion for his work with his life at home; a man trying to explain to his wife (and sadly, even some of his peers) his commitment to caring for persons infected with the virus.

The portraits Verghese draws of his patients are extraordinary: local boys now men, now sick, returning to Johnson City to be cared for by family; a woman infected by her husband who also infected her sister; a highly-respected couple from a nearby city seeking privacy, even from their grown children. Finally, part of what makes Verghese such a fine writer is that he is able to do so without romanticizing his relationships with his patients, and without self-congratulatory accolades for the kind of care he provides.

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Rosita Arvigo is a Chicago-trained doctor of naprapathy (an alternative therapy that involves soft tissue manipulation, diet, and other non-drug modalities) who moved with her husband (also a naprapath) to Belize to open a medical clinic. Shortly after her arrival she met Elijio Panti, given a variety of names by his patients: el viejito, the old man, numero uno, or el mero, the authentic one.

One of the last traditional healers of Mayan medicine, Panti uses observation, experience, and divination with his sastun to diagnose his patients' illnesses; and herbs, manipulation, and prayers to treat them. Arvigo studied with Panti for five years, learning to identify and use countless plants in the rainforest that surrounds her home and, eventually, discovering the object that becomes her own sastun.

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This account by the well known Indian/American blind writer describes experiences when he came to the United States at age 15 from New Delhi to attend the Arkansas School for the Blind. The title derives from an unusual ability (which Mehta possesses) to navigate one’s way by perceiving the physical surroundings "as sound-shadows by means of echoing sound and changes of air pressure around the ears." As a precocious teenager, Mehta had high ambitions for his future; this important period of his life represented both an opportunity and an impediment, requiring tremendous cultural, emotional, and physical adjustments.

Very well conveyed are the driving desire to be like sighted people, the need for independence and control, and to be accepted in the foreign culture while remaining in some ways superior to it. There are fascinating descriptions of how Mehta learned to travel with minimal assistance, high-dive, package ice-cream in a factory; of how he used money intended for other purposes to build an electronic retreat in a broom closet which allowed him to tape record, type, and to listen to Edward R. Murrow’s broadcasts, and of how he then paid back the money by taking correspondence courses in order to finish school one year early.

The normal adolescent awakening of sexuality, and the ambivalent dependence on parental guidance are also important aspects of the book. Writes Mehta in retrospect,"The three years of my life spent in Little Rock became sealed in a compartment of my mind which I dreaded to open . . . because . . . the near-total submersion in a residential school for the blind seemed to accentuate my blindness, when all along my aspiration had been to be a well-adjusted member of the seeing society outside."

 

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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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Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."

Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.

The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.

Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.

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Dr. Alvord was born to a Navajo father and a Caucasian mother--bilagaana--and felt from the beginning that she was walking the path between two worlds. Her childhood was spent on an Indian reservation and she was very close to her Indian grandmother.

She was fortunate to be able to attend Dartmouth College where there is strong support for American Indians. Actually there were 50 other Indian students there when she enrolled. From there she went to Stanford University for medical school and a surgical residency. This was a very unusual path for an Indian woman.

While in medical school and residency she felt very much separated from her Indian heritage and was glad to start her practice of surgery in the Indian Health Service and eventually to return to the Indian Hospital at Gallup, New Mexico, just fifty miles from the reservation where she grew up. This gave her the opportunity to learn more about Indian medicine and how to care for Indian patients.

While there she met her husband, a considerably younger Caucasian, and had her first child after a problem pregnancy. She sought the help of an Indian Medicine Man during this experience and felt much help from him. This is described very vividly.

Just eighteen years after she left Dartmouth she returned to be the Associate Dean for Minority and Student Affairs and to practice surgery and teach part time. There she hopes to share the Navajo philosophy of a balanced and harmonious life called "Walking in Beauty."

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In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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One morning in the shower Joyce Wadler, "a journalist, forty-four, Jewish, never married," discovers a lump in her left breast. In this brief, bright, and very readable account, Wadler describes what happened next, taking us through medical examination, diagnosis, and successful lumpectomy and chemotherapy.

But this is much more than a simple patient’s story. For one thing, Wadler is an intrepid researcher, and we learn a good deal about breast cancer and the often agonizing therapeutic choices its victims face. For another, she does not separate her medical adventure from the rest of her life, which includes a day job as a writer for People magazine, a book project, a semi-functional relationship, and a Jewish mother.

Finally, Wadler uses her ironic-sardonic sense of humor to great advantage--remarking, for instance, that through her post-diagnosis impulse to live in the present and not worry about her lover’s monogamy, cancer had made her "the dream girl of every uncommitted man in Manhattan"!

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