Summary:

Anna, the "I" of this journal, suffered the pain of emotional abuse in her childhood. As an adult, she works in a hospice and cares for patients consumed by physical pain. She begins to "hunger for storylessness," wishing to find a way to separate pain from the experience of pain; yet without a narrative frame she cannot recognize pain in its original and pure state--the pain that occurs before language or thought. And so she enters into a meditation practice in order to see pain "uncompounded."

The book is divided into three sections, each reflecting a part of Anna's meditation practice and each containing sections of dreams, meditation notes, and musings on three friends who have died. As her meditations deepen, Anna begins to see pain in more detail, and in so doing begins to understand the difference between pain and suffering. Pain, she concludes, is inevitable. But suffering can be dismantled, carefully, like a house might be. The goal is to keep the house "whole enough" so it doesn't collapse and crush the individual living within.

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In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.

In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.

Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).

He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.

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This memoir of a clinical psychologist (also a professor of psychology) chronicles her own depression over a period of a year and a half, from early symptoms, through near despair, electroconvulsive therapy, and hospitalization to recovery. The journey is detailed, not only in its treatment of her emotional states, but of her struggle to maintain family and professional life, keep her house and office organized, and attend to a dying friend.

As her bouts of panic and disorientation grow more apparent, first to herself and finally to others, she seeks refuge in spiritual retreats and in conversation with colleagues, ultimately submitting to treatment. She names the emotional "undercurrents" suggested in the book's title with moving precision: panic over sudden disorientation, anxiety about what to keep secret, frustration with her own unreliability, dread of small duties and ordinary appointments, heartache over her faltering efforts to be a good and present mother.

The consent to hospitalization costs a great deal in humility, in risking a controversial treatment, and in letting go of a professional persona she doesn't know whether she'll be able to retrieve. But clearly the book is written by a woman whose clarity is a testimony to regained mental health and exceptional intellectual clarity. It is not a professional record, but an intensely personal memoir of what was both an encounter with serious mental illness and a spiritual journey.

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Tuesdays with Morrie is a series of lessons a former (and now current) student has with his teacher (and now mentor) about facing one's death and living one's life. The author, Mitch Albom, is an award-winning sports columnist with the Detroit Free Press. A chance encounter propels Albom, guiltily and fearfully, to the bedside of Morrie Schwartz, his sociology teacher at Brandeis University nearly twenty years ago. [This chance encounter occurs electronically--Albom saw Morrie speaking about dying from ALS (amyotrophic lateral sclerosis) with Ted Koppel on the Nightline television program].

Once together again, teacher and student decide to extend the visit over the remaining months of Morrie's life. Their Tuesday "seminars" explore perennial value issues of everyday life: "Family," "Emotions," "Money," "Marriage," "Our Culture," Fear of Aging," etc. The interchanges, fortunately, are studded with "pearls of wisdom" from Morrie.

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In this journal of her 66th year (one of several volumes of her widely-read journals) May Sarton reflects on the depression of losing a long, intimate friend to acute senility, on living with waves of loneliness in a life of chosen and beneficent solitude, and on a mastectomy which followed quickly upon diagnosis. She weaves together themes of friendship, especially friendship among women, mental and physical health, speculating on psychosomatic dimensions of illness, living with an aging body, and the ongoing issues of self-esteem that aging and solitary women confront in a particular way. Each of the 2-3 page entries is a complete and complex reflection, beautifully developed, and often pithy and poetic.

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