Summary:

Jordy, 17, gay, abused by his parents, has taken refuge in a New York basement from where, one night, he witnesses the brutal gang rape of a young 18-year-old. After his shouted threats scare off the attackers, the girl slips through the window into what turn out to be shared quarters. The two begin to take care of each other; she insists on his getting treatment for head wounds at a public clinic (where care is distiinctly substandard) and he becomes guardian to this young woman whose history of abuse has left her in a curious state of social alienation and innocence about what is normal. The story becomes a kind of vision quest when, faced with "Chloe's" (a name she gives herself by way of starting over) inclination to put herself in harm's way, and to flirt with suicide, Jordy decides to prove to her that the world is more beautiful than it is threatening and ugly.

They acquire an old truck and embark on a cross-country journey that becomes a picaresque series of encounters, most of them with helpful, kind people, one notably disastrous, with three young men who threaten Chloe and land Jordy in the hospital after a fight. The trip terminates in Big Sur on the California coast where Chloe's dream of riding horses on the beach is fulfilled with most of Jordy's remaining cash. The pilgrimage leaves them with a sense of hope which each of them communicates to the New York therapist who briefly helped them, in letters that end the book.

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Author Diedrich investigates ("treats") mid-late 20th century memoirs about illness (illness narratives) from an interdisciplinary perspective drawing on the disciplines of literature, social sciences, and philosophy. Her analysis uses the theoretical frameworks of poststructuralism, phenomenology, and psychoanalysis to consider "what sort of subject is formed in the practice of writing . . . illness narratives," the kind of knowledges articulated by such writing, whether and how such writing can transform "expert medical knowledges," how language operates in these memoirs, and "what sort of ethics emerges out of such scenes of loss and the attempts to capture them in writing" (viii).

The book is divided into Introduction, five chapters on specific memoirs, and Conclusion. Chapter 1, "Patients and Biopower: Disciplined Bodies, Regularized Populations, and Subjugated Knowledges," draws on Foucault's theory of power to discuss two mid-20th-century memoirs of institutionalization for tuberculosis. Betty McDonald's the Plague and I is compared with Madonna Swan: A Lakota Woman's Story. Dividing practices and regularization are shown to serve different functions in these two incarcerations, figurative in the case of Betty McDonald, and literal in the case of Madonna Swan.

Chapter 2, "Politicizing Patienthood: Ideas, Experience and Affect," draws on Foucault's approach to the subject and on his discussion of "practices of the self" in contrasting Audre Lorde's The Cancer Journals with Susan Sontag's Illness as Metaphor and AIDS and Its Metaphors (see annotations). Diedrich also brings into her analysis Eve Sedgwick's theory of queer performativity and Sedgwick's own illness narrative, White Glasses. Diedrich views all of these as counter narratives to the clinical medical narrative of illness but she shows how they differ in stance.

Chapter 3, "Stories For and against the Self: Breast Cancer Narratives from the United States and Britain" looks at "the arts of being ill" as they are represented in two cultures, two "conceptions of the self in these countries at a particular historical moment" (61). The narratives discussed are Sandra Butler and Barbara Rosenblum's narrative, Cancer in Two Voices and Ruth Picardie's Before I Say Goodbye (see annotations). Diedrich associates Cancer in Two Voices with an American notion of self-improvement and Before I Say Goodbye with a British "emphasis on the cultivation of an ironic self" (55). The author works in this chapter with Freud's idea of the uncanny, Benedict Anderson's concept of "imagined political communities" and Elaine Scarry's discussion of pain, language, and the unmaking of the self.

Chapter 4, "Becoming-Patient: Negotiating Healing, Desire, and Belonging in Doctors' Narratives," treats Oliver Sacks's illness narrative, A Leg to Stand On, Abraham Verghese's autobiographical My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS, and Rafael Campo's book of essays, The Poetry of Healing (see annotations). Here Diedrich considers "the possibility that doctors, especially AIDS doctors, might become patients through desiring-and writing-productions" (83) and she utilizes the rhizome model of Deleuze and Guattari to make her case. She discusses how Verghese and Campo are each both cultural insiders and outsiders and how they each "bring the body into language through their writing" (88).

Chapter 5, "Between Two Deaths: Practices of Witnessing," focuses primarily on Paul Monette's writing about the loss of his partner to AIDS, and on John Oliver Bayley's books about the loss of his wife, Iris Murdoch, to Alzheimer's, and her ultimate death (see annotations in this database). In this chapter Diedrich invokes Lacan's concept of the real and his formulation of "the ethical possibility of being between two deaths" (117). She draws also on trauma theory and the work of Kelly Oliver, a contemporary feminist philosopher who has written on witnessing.

Finally, in her "Conclusion: Toward an Ethics of Failure," Diedrich returns to Elaine Scarry's "phenomenological discussion of the experience of pain" and brings in Jean-François Lyotard's concept of incommensurability and his suggestion between the two poles of what is seemingly incommensurable one might search, in Diedrich's words, for "new rules for forming and linking phrases between . . . subject positions" (150). In that context she analyzes physician Atul Gawande's discussion of medical uncertainty and error in his book, Complications (see annotation) and philosopher Gillian Rose's book, Love' s Work. Diedrich concludes that the basic incommensurability between doctor and patient can be a starting point for a new ethics, an ethics of failure and risk "because by taking such risks [of failure, of relations], we open up the possibility of new routes, new treatments: in and between art, medicine, philosophy, and politics" (166).

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In this collection, twenty-two medical students and young physicians across the United States eloquently recount the process of medical education for those who do not believe they fit standard measures of student demographics. The editors, Takakuwa, an emergency medicine resident physician; Rubashkin, a medical student; and Herzig, who holds a doctorate in health psychology, group the essays into three sections: Life and Family Histories, Shifting Identities, and Confronted.

Each section is prefaced by an essay explicating the essay selection process, the history of medical school admissions policies and requirements, the basic progression of medical education and the reasons for this collection, such as "putting a human face" (p. xx) on the changing characteristics of admitted medical students: "With their diversity and through their self-reflections, we hope that these students will bring new gifts and insights to the practice of medicine and that they might one day play an important role in transforming American medical education into a fairer and more responsive system." (p. 141)

Additionally, a foreword by former Surgeon General Joycelyn Elders outlines her experience as a black woman entering medical school in 1956, including eating in the segregated cafeteria. The book concludes with recommendations for further reading and improvements to the medical education process as well as with brief biographies of the contributors and editors.

The range of essays is impressive: diversity itself is given a new meaning by the variety of narrative voices in this volume. Contributors include people from impoverished backgrounds, both immigrant (Vietnamese, Mexican) and not. One student, marginalized by his academic difficulties, began a homeless existence during his first clinical year. Others were made to feel different because of being African or Native American.

In two essays, mothers defy labels placed on them (pregnant black teen; lesbian) and describe the trials and triumphs of their situations. Students write of being subjected to ridicule, ignorance and prejudice due to their gender, interest in complementary medicine, political and advocacy views, or religious beliefs. Due to pressures to conform, even students from what might be considered more mainstream in American culture (e.g., growing up in a small town, or being Christian) can experience the effects of being "different" when in medical school.

A number of essays communicate the difficulties of illness, disability and bodily differences. Issues include recovered alcoholism (rather tellingly, this is the only essay that is anonymous), obsessive compulsive disorder, sickle cell anemia, Tourette Disorder, attention deficit hyperactivity disorder, chronic pain, and obesity. The authors balance their narratives of hardship with insights into how their struggles improve their opportunities for empathy, perspective and fulfillment as physicians.

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In this poem, a young male patient receives stitches in an emergency room for a face wound from an alleyway knife fight. It seems the violence involved drugs, as a "broken syringe" is involved in the fight. However, more telling is the label that the ER doctor uses to describe the patient. The narrator of the poem, apparently an exhausted physician-in-training, is told by the ER doctor to quickly "Stitch up the faggot in bed 6."

The narrator meticulously sews his patient's wound, empathizing completely with him: "Each suture thrown reminded me I would never be safe / in that town." He too, could be ripped open "to see the dirty faggot inside." Furthermore, he ruminates that when the perpetrators of such violence themselves become victims, he would also stitch their wounds--silently, carefully, passively, "like an old woman."

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Memoirs of Hadrian is a historical novel in the form of a long letter written by the Roman Emperor Hadrian to his young friend and eventual successor, Marcus Aurelius. Alas, Hadrian is "growing old, and is about to die of a dropsical heart." The Emperor begins by describing his recent visit with his physician Hermogenes, who "was alarmed, in spite of himself, at the rapid progress of the disease" (3). In light of his physical deterioration, Hadrian begins to reflect on his life and work, and to share his wisdom with his young correspondent.

Hadrian tells of his early life as the protégé of the Emperor Trajan, his military and political victories, and his eventual adoption by Trajan, a move that guaranteed the succession when his adoptive father died. While Trajan, whose victories brought the Roman Empire to its greatest size, was a military man to the core, Hadrian considers himself essentially peace loving--his personal life devoted to simplicity and harmony; and his public life to prosperity and justice. Nonetheless, he has always recognized that, in order to govern effectively, ruthless action is sometimes required.

Hadrian's marriage to the Empress Sabina was simply a matter of convenience. The love of his life was a beautiful young man named Antinous. The two men were deeply committed to one another, but at the same time the middle-aged emperor had "a certain dread of bondage" ( 177) that kept him from fully giving himself to Antinous with the abandon of youth. They were visiting Alexandria when the despondent Antinous committed suicide in a way that mimicked a religious ritual, essentially sacrificing himself to the deified Emperor.

Hadrian was crushed with grief and descended into a long period of depression. However, he eventually overcame his depression through his love of literature and ideas, as well as his sense of duty to the Empire (no SSRIs being available at the time), although not before attempting to enlist his physician in assisted suicide. Unable to refuse his emperor's request, the physician himself commits suicide rather than violating his Hippocratic Oath.

Hadrian's final military engagements involve crushing Jewish insurgents in Palestine, completing the destruction of Jerusalem, and founding a new Roman city on its site. The aged Emperor reflects frequently on his tolerance for all religions, except for politically disruptive fanatics like the followers of a Jewish prophet called Christ. As to the Jews in Palestine, he cannot understand why they continue to engage in self-destructive rebellion, most recently with Bar Kokhba and Rabbi Akiva as their leaders.

In his final years Hadrian adopts Lucius, one of his former lovers (in this account), as his son and heir, but Lucius soon dies, presumably from tuberculosis. Eventually, the Emperor adopts Antinous Pius as his heir and further arranges for Marcus Aurelius to succeed Antinous Pius. At the end of his letter, Hadrian writes, "I could now return to Tibur, going back to that retreat which is called illness, to experiment with my suffering, to taste fully what delights are left to me, and to resume in peace my interrupted dialogue with a shade." [i.e. Antinous, his lost love (271)].

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This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

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Sixteen-year-old Angelina Rossini tells the story of the year her father died. A lively, opinionated, attractive sixty-nine-year-old Italian happily married to a forty-two-year-old English woman, he has hardly been an inconspicuous presence in the small town of Blodgett, Vermont with a population of 854. Angelina, the only child of this second marriage, loves her father dearly, though she rolls her eyes at his eccentricities, and knows herself to be fortunate in both parents, though they're older, and her mother somewhat less expressive, than she would choose. Her best friend, Jax, belongs to a very different family, large, blue-collar, partly French Canadian. Though she and Jax have been friends since kindergarten, and though she has known for some time that he is gay, her love for him sometimes spills over into desire. They talk about this, as they do about everything else, though this subject is a little tenderer than most. When a girl who has been aggressive and unfriendly suddenly reveals her own same-sex desires, Angelina is able to handle her awkward revelation with compassion.

When Angelina's father has a stroke, all the rhythms of family life are disrupted. Her half sister, whom she's never liked much, comes for an extended visit. Her mother is preoccupied, first at the hospital, then with home care. And she herself has to learn aspects of caregiving for a partly paralyzed father who has lost his speech. The process is, of course, emotionally complex, sometimes comical, often heartbreaking. But when she speaks at his funeral, after a heart attack takes his life, it is with a widened appreciation of the kind of man he was, and of what value his life had even in the months he was severely incapacitated. After his death, she explores, in a few final chapters, the ambiguities of grief, and the process of forging a new relationship with her mother, who has lost her own best friend and companion.

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West coast dancer John Henry made his life the subject of his final performance. Choreographer Bromberg and film maker Rosenberg collaborate with Henry in the creation of a work for the theatre based on his desire to leave an autobiographic legacy. Filmed during the last few years of Henry's life with HIV/AIDS, the documentary examines the image of self as one individual prepares to separate from body and personhood, and continues after his death.

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Gilbert and George's work over the past three decades has largely consisted of grid-like photomontages - note, they consider their work to be "sculpture". These often massive works are at once easily identifiable as part of Gilbert and George's oeuvre (in part because they often have Gilbert and George in them) and unflinchingly referential: to the manufactured sheen and unnaturally bright neons of Warhol, to the confrontational exposure of Mapplethorpe's photography, and, of course, to cathedral stained glass. They draw upon these same influences in their creative self-creation, their transgressive aesthetics, and their repetition and reworking of religious and secular motifs intertwined with abstractions. Gilbert and George are insistently doubles: original and derivative, repetitive and evolving, reactionary and visionary.

The Fundamental Pictures consists of a series of some 39 scultptures, most involving juxtapositions of bodily execretia - sputum, tears, urine, semen, feces - in monumental close-up; the tears, urine and semen are captured through a microscope, dessicated and crystalized. The sensational titles of the individual works, such as 'Piss Faith' and 'Spit on Shit', are fairly accurate in describing the central themes of each work. In some of the montages, Gilbert and George appear, pink and naked, against a kaleidoscopic backdrop of bright, magnified bodily fluids; in others, they are dressed in their familiar suits. They were exhibited at the Lehmann Maupin Gallery, New York, in 1997.

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One of Gilbert and George's very few specific portraits, this is a collage of images culled from their photographs of their friend David Robilliard. Its title, "A.D.", can be taken to mean "Anno Domini" or "After David" or, as the artists suggest, "AIDS David". It is at first an extraordinarily ugly piece, even by Gilbert and George's standards: the uniform flesh tone with pearly globules of moisture (sweat, semen), broken up by the black of shadows, the black bristles of stubble, and the black grid. The image looks like it emerged from one of William S. Burrough's novels, a nightmarish combination of mouth, orifices, bodily cavities.

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