Summary:

The physician-narrator recounts two unsettling house calls made three decades earlier when he began his medical practice in a remote part of Virginia. The doctor is asked to see Alan Jordan at the request of his wife, Judith. They live with their son and three elderly female relatives in a deteriorating house on a secluded estate known as Jordan's End. The Jordan clan is notorious for marrying their own relatives, but Alan wedded someone outside the family.

Judith is beautiful, and in the doctor's eyes, ethereal. Alan's infirmity began 3 years ago with brooding and melancholy but has now progressed to episodes of withdrawal alternating with agitation. A renowned psychiatrist from Baltimore evaluates Alan, deems his condition incurable, and recommends institutionalization.

Mental illness and insanity--the result of heredity and inbreeding--seem to affect all the Jordan men. Alan's grandfather and two uncles are in an asylum. His father died in one. After the narrator examines Alan, he gives Judith a bottle of opiate medication to help ease her husband's restlessness.

The doctor is soon called back to Jordan's End. He finds Alan's dead body in bed covered by a linen sheet and notices that the full bottle of medicine he left only two nights previously is now empty. The doctor cannot decide whether or not Judith has killed her husband nor does he really want to know.

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This is the house of Bedlam. So begins the strong poem by Elizabeth Bishop, the woman who wrote of that wretched old man who lived in the house of Bedlam. "This is the man / that lies in the house of Bedlam." So go the two lines of the following stanza of the 1950 poem about the cranky old man who was kept for his crimes in the house of Bedlam. "This is the time / of the tragic man" begins the three lines of the following stanza of the nursery rhyme poem by the consummate poet who wrote of "the Jew in a newspaper hat / that dances joyfully down the ward" and the brilliantly cruel and crazy man who lived in the house of Bedlam.

"This is the soldier home from the war. These are the years and the walls and the door." So starts the 12th and last stanza of the metrical rhyming repetitive poem by one of the finest American poets about Ezra Pound, an American poet, who found himself at the end of the war "walking the plank of a coffin board" and because of his treason becoming the man--the tragic, talkative, wretched and tedious man--who lived in the house of Bedlam. [79 lines]

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This is a collection of two dozen case studies, written for non-medical readers, of patients with right-brain disorders. The chapters are divided into four groups: "Losses," dealing with loss of memory, cognition, and proprioceptive sense; "Excesses," with tics and other cases of overabundance; "Transports," with seizures and various "dreamy states," and "The World of the Simple," concerning mental retardation. In every case, Sacks focuses on the interior or existential world of the patient as the foundation of diagnosis and treatment. Sacks argues that this approach is appropriate for the right hemisphere, which compared to the left is less dedicated to specific skills and more dedicated to a "neurology of identity."

Sacks openly proposes these studies as a corrective to the field of neurology, which has tended to focus on the left hemisphere and therefore, he argues, has wound up treating patients solely in terms of specific deficits, often to their detriment. In "the higher reaches of neurology," and in psychology, Sacks argues, disease and identity must be studied together, and thus he recommends that neurologists "restore the human subject at the centre" of the case study. Sacks warmly recommends music, story-telling, and prayer as therapies that work by ignoring physiological defects and speaking to the patient's spirit or soul.

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While driving away from a dangerous city in an area of north Afghanistan ravaged by war, three men must journey by foot when their car is damaged in an accident. Donk is an American combat photographer. Hassan is a young Afghan translator. Graves is a British journalist suffering from a severe case of malaria and in desperate need of medication.

They arrive at a remote village ruled by a warlord, General Ismail Mohammed. Medication is unavailable there and transportation to a larger city is not possible for at least another day. The local doctor recommends an herbal remedy for the treatment of malaria, and General Mohammed attests to its effectiveness. The medicinal grass grows only in a nearby mountain valley. Two soldiers escort Donk and Hassan to the vale. They encounter a convoy of transport vehicles that have been incinerated by a bomb blast.

When the grass is finally in sight, Donk and Hassan race towards it even as the two soldiers shout at them. Too late! Donk steps on a bomblet and the device detonates. Badly injured (and maybe even mortally wounded), Donk and Hassan lie on their backs and gaze at the sky. They are surrounded by the thick grass they hoped might save the life of their companion, Graves.

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This sensitive, but profoundly realistic narrative, of a journey from the lively, healthy marriage of two individuals deeply in love with life and with one another into the abyss of Alzheimer's dementia is told from the viewpoint of one partner. The author allows the reader to enter into her struggle with the month-to-month diminution of her beloved husband's world. The progression over the entitled "25 months" contains just the right amount of flashback to give the reader a sense of who Jack had once been and what life had held for both members of this partnership--the better to accentuate the sense of loss that this disease underscores.

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Miracle McCloy received her name because, as she's been told many times, she was pulled from the body of her mother shortly after her mother was run over and killed by a bus. Raised largely by her grandmother with her depressed and dysfunctional father nearby, she has learned a great deal about séances, contacting the dead, reading auras, and paying attention to energy fields. But she doesn't know much about how to locate her own confused feelings about her parents, her identity, and her relationships with "normal" kids at school who see her has some kind of freak.

She perpetuates this image by casting "spells" to help fellow students connect with boyfriends. But after her father disappears, and her grandfather's house is destroyed in a tornado, she lapses into mental illness and burns herself badly trying to "melt" as she believes her father did by dancing among flaming candles. She is taken to an institution where an astute therapist and an aunt who realizes how much Miracle needed her combine their efforts to help her recover a sense of who she is--a dancer, a strongly intuitive, intelligent girl with an interesting history and a promising life to live, liberated from the obsessions of a superstitious grandmother and mentally ill father.

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This is a collection of humane and humorous stories by psychiatrist Ronald Pies. Many of them portray snippets of Jewish-American family life; others feature Pies's alter egos, young psychiatrists named Applebaum; or Ackerman, or Alterman; still others introduce a number of wonderful geriatric characters the reader is unlikely to forget.

In the title story, an elderly man lies in the hospital and remembers how he inserted snippets of pornography into his business partner's tefillin nearly 40 years earlier, just to spite his holier-than-thou partner, who had evicted his Playboy magazines from the premises. "Mandelbaum's Passion" is the story of an elderly professor whose daughter wants to put him into a nursing home. He, on the other hand, focuses his energy on anticipating the twice-weekly visits of Luz, his 26-year-old Hispanic visiting nurse.

Dr. Otto Hertzmann in "Show Us Where God Is" is a retired analytic psychiatrist who lives with his sister. When a young admirer comes to visit, the sister introduces him to Davie, Hertzmann's severely retarded son who, when asked to "show us where God is," grins widely and points to the ceiling. Max Dershman, found dead in his room "stinking of cheap cigars and surrounded by Playboy centerfolds," is another such character. He falls head over heels in love with Riva Greenberg, the nursing home social worker, and leaves her a love letter when he dies ("A Medical Diptych"). In "Sophie Fein Goldberg Stein" the title character insists on always being addressed by her full name--at least, that is, until the nursing home psychiatrist is willing to sit down and listen to the full story of her life.

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The story begins soon after the narrator has moved his elderly mother into Cherry Orchard, an "independent living" facility near his home in Providence, Rhode Island. Because of progressive dementia, she was no longer able to maintain her own home in New Jersey, or her relationship with Warren, her boyfriend of 20 years, with whom she spent part of each year in Florida. Thus, the narrator and his sister arranged for her move to an apartment in the exclusive Cherry Orchard, where her symptoms of Alzheimer's disease had to be hidden in order to ensure her eligibility.

The mother and son have never been close, especially after the boy's father died during his early adolescence. She was a pleasant, but distant parent, more interested in her own social and cultural affairs than in taking care of her children. The narrator is 34 years old now, married, with his own son. He has little emotional attachment to this woman who is slowing losing her mind, yet now he feels duty-bound to visit her at least weekly at Cherry Orchard.

The mother has almost entirely lost her short-term memory, yet at first blush seems surprisingly intact because of her ability to cover-up with social skills. She writes notes to herself. The texture of her life unravels. She begins to wander. Other residents complain. Occasionally a glimmer of insight appears, but quickly dies. Fighting his inclinations every step of the way, the narrator provides ever increasing physical and emotional support, while at the same time gaining a deeper understanding of how his mother was (and is). In the end nothing is changed--the mother spirals slowly downward. But in another sense everything has changed. The narrator concludes, "I had taken her in so that I could understand why I had agreed to take her. I would do it again."

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"Spell Check for a Malformed Fetus" (p. 1) sets the stage for some of the important themes in this collection by poet-psychiatrist, Ronald Pies. First, the lack of honest language to express life’s "mistakes" and disappointments. Our attempt to disguise the pain by using easy, but inaccurate, words. And finally, an expression of hope, even if only in the world of imagination: "if only / in your first fission / some godly processor / had blessed / your blighted genes."

Some of these poems emerge from relationships with patients, notably "Consultation Request" (p. 35), "Three Patients" (pp. 37-39), "Prolapse of the Uterus" (p.76), and "Congestive Heart Failure" (p. 85). "Smoke, Lilac, Lemon" (p. 45) evokes a fascinating test apparently used by some clinicians to distinguish depression from Alzheimer’s disease on the basis of olfactory function. The four "Alzheimer Sonnets" (pp. 87-88) tackle the difficult task of expressing the experience of dementia from the patient’s point of view.

Many of the other poems deal with love, memory, loss, and pain in the context of family and intimate relationships. Among the best of these are: the title poem (p.3), "Sitting Shivah" (pp. 14-15), "Riding Down Dark" (p. 16), "Visitant" (pp. 41-43), and "Migrations" (pp. 64-69).

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The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.

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