Summary:

The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

View full annotation

Summary:

The action of this stream-of-consciousness novel takes place over one day--the Day of the Dead--1938, in a remote village in Mexico. The novel opens with a conversation between two who reminisce about the Consul who died one year ago. Thence the work takes the reader back to the preceding year and the principals about whom the story evolves. The Consul (Geoffrey), his former wife Yvonne, his half brother Hugh, and a smattering of characters resonating in the Consul's past come together with some dream or fantasy about reconstructing a life that has been cast asunder by the Consul's alcoholism.

Flashback by flashback, the reader is apprised of the former lives of the central characters as they move together through a surrealistic day in search of some anchor to which they may attach their ill-fated, but obsessively conjoined, lives. Much of the day is mired in the Consul's alcoholic hallucinosis and the reader is challenged to sort the reality from the fantasy as the day ends in tragedy for two of the three primary characters.

View full annotation

Summary:

This memoir begins in Africa, where Dr. Grim is with Médecins sans Frontières managing a meningitis outbreak in Nigeria. Conditions are appalling, but she has come here because of burnout: "so I won't be back home and in the ER" (11). Later in the book, she describes her other "escapes" from the Emergency Room, caring for war refugees in the Balkans.

The book centers, however, on life in an American emergency department, as Grim remembers it from the vantage point of Africa (where she does eventually become nostalgic for well-stocked supply cupboards and a more comprehensible chaos). She organizes her stories into a series of "Lessons in Emergency Medicine," in which she addresses the reader directly. After going through a step-by-step account of death in the ER, illustrated with several moving and alarming cases, she concludes: "Congratulations: you have successfully declared someone dead. Now, as an encore . . . you'll get to do it all over again" (28).

The ironic, even bitter, tone warns us of the difficulty of working in such perpetually crisis-ridden circumstances, but it does not conceal a vulnerability that seems necessary to doing the job well, such as when Grim has to tell a family that the father has died of the heart attack he had at his daughter's wedding: "you just stood there," she says, "looking at the corsage, the tuxedo and the pearls . . . You had no idea what to say and you don't really remember what you finally came out with" (26).

The stories are organized around several lessons: "How to deliver a baby," "How to crack a chest," "How to write a prescription" (which includes a discussion of addiction to prescription medication and a withering account of the doctor who overprescribes), and, as if it's as inevitable as the rest, "How to burn out."

By the book's final chapter, emergency medicine has merged, along with the vaccination of refugee children and the impossibility of treating tetanus in Nigeria, into the story of almost unreasonable determination in the face of endless frustration--but this, Grim shows in her final chapter, "Why I do what I do," is the point. Against this backdrop her final story, about the rescue of a child, makes its point: the feeling of saving a life explains all the rest.

View full annotation

Summary:

In the first section of the book ("Rejected Prayers"), Liveson proves that the prayers were not rejected; rather, they resulted in a group of thoughtful and moving poems. These poems speak eloquently of suffering patients, especially the elderly and neurologically compromised; for example, "Jenna," wearing her "diapered dress" (p. 16), "Sonnet to Sarah," who "lets her fingers trace the pattern on the wall," (p. 20), and the patient in "Praxis," whose "smile was rare but even" (p. 21).

These poems also speak passionately of social and historical pain, and of injustice writ large. Some of the most powerful are in the section called "Before the Plaster Sets," with which the book ends: "My First Death" (p. 63), "Holocaust Torah" (p. 66), and "Yom Kippur, 5760--Musaf" (p. 68).

The latter poem is a kind of contemporary re-envisioning of Allen Ginsburg’s 1956 poem "America." Jay Liveson writes, "Yom Kippur, this is serious. We sit here / hoping to somehow tune the engine / or at least check the map." Is tuning the engine enough? Perhaps we are fooling ourselves; much more needs to be done. How can we be content to sit and tune the engine in this unjust world? Perhaps the poem that speaks this theme most eloquently is "Statistical Causes of Traumatic Shock Syndrome in Gaza--Chart VII" (p. 72).

View full annotation

Summary:

In mid-19th century England, a small group of religious women called the Household of Hidden Stars follow Muley Moloch, an itinerant prophet, across the world to establish a life for themselves in New South Wales. Catherine, Moloch's wife, gives her account of their story many years later in 1898.

Moloch is an illiterate shoemaker-turned-prophet who claims to perform miracles. His goal is to prepare the way for the Second Coming of Christ. To accomplish this, he and his group of 8 or 9 women set out to lead exemplary lives in the wilderness, yet they do not attempt to make converts.

When Catherine becomes pregnant, she and the others think her pregnancy is a miracle. (In reality, Moloch has had sex with her while she was desperately ill and unaware of what was going on.) They name the child Immanuel and believe that he is the Second Coming of Christ.

Muloch considers the local Aboriginal people to be demons and treats them as such. One day he sees Immanuel talking to a "demon" and shoots the man dead. Immanuel, already fed up with all the craziness, runs away. At this point the women finally seize control of their own lives and tell Moloch that he must leave. As the years progress, the women remain together. One by one they die of consumption, until only Catherine and Louisa are left.

View full annotation

Summary:

In this extensive review of her experiences in public health and rural and urban medicine, Eva Salber, MD, explores the commonalities and the differences in medical practice among three environments: pre-World War II South Africa, urban America, and the hills of North Carolina. Trained in South Africa, where she and her husband practiced for many years, Salber came to the US during a very difficult political period for whites in Cape Town.

In Boston, she pursued her passion for the plight of the poor and their health issues by studying further public health and running a ghetto clinic. Later, as a member of the Duke University faculty, she established rural health clinics in North Carolina. She describes, in this memoir, the contrasts among the cultures as well as her own difficulty in obtaining the funding and support she needed to carry out her work in each setting.

View full annotation

Summary:

In 371 E. C. (Efican Calendar) a woman named Felicity Smith gives birth to Tristan, a child with such severe congenital defects that the doctors advise her to let him die. Felicity is an actress and the head of a theater troupe in Chemin Rouge, the capital of a small fictional country called Efica. Instead of getting rid of her son, Felicity takes him to live in the tower of her theater.

The boy actually has three fathers (Bill, Wally, and Vincent), each of whom in his own way accepts responsibility for the horribly deformed child. The boy grows up with the ambition to become an actor, even though he is only three and a half feet tall, his speech is almost unintelligible, and he inspires revulsion in almost everyone that he meets for the first time. Nonetheless, he thrives in the close-knit theatrical community.

When Tristan is eleven, agents from Voorstand murder his mother, who has entered politics and become a "persona non grata" in Voorstand. Tristan also fears for his life, but nonetheless avenges his mother's death by writing subversive pamphlets. Many years later, at the ripe old age of 23, Tristan and Wally (one of his fathers) travel illegally to Voorstand where they encounter many adventures before the novel comes to a satisfactory conclusion.

View full annotation

Summary:

Joe and Mary Wilson live an isolated life in the outback of New South Wales. Their infant son Jim begins to "take convulsions." Jim turns into a sickly child who appears to be "too old fashioned" to survive in this word. After the three-year-old boy has spent a month with his mother's sister, he and Joe begin the two-day trek home. The boy becomes ill while they are camping overnight, and Joe, terrified that his son is going to die, carries him to "Brighten's sister-in-law," who lives in the only homestead in the area. She nurses the boy, who survives.

View full annotation

Summary:

Joe and Mary Wilson move from the little outback town of Gulong to the bush at Lahey's Creek. Mary becomes depressed over the drudgery and isolation of the place. The closest neighbors are the Spicers, dirt poor folks with a whole passel of children.

Mr. Spicer is usually on the road. Mrs. Spicer tries to maintain some beauty in her life by growing geraniums in the desert. At first she visits the Wilsons frequently, but soon she becomes reluctant to visit because she gets melancholic when she goes home. She tells Mary that the land has broken her--she is "past caring." At the end she dies in her bed. The last thing she tells her daughter to do is to water the geraniums.

View full annotation

Summary:

The story takes place in the course of one night during the 1820's in the Australian outback. Carney, an Irish convict-turned-revolutionary, is scheduled for execution in the morning. Two soldiers guard him at the lonely outpost. An officer named Adair arrives to interrogate Carney, in the hope that he might betray his surviving comrades, especially Dolan, the leader of the insurrection.

The officer and the prisoner keep a vigil through the long cold night. Carney tells about his impoverished life in Ireland and his goal of achieving freedom for himself and his countrymen. Adair, too, is Irish. He remembers his own, more privileged life in Dublin.

The uneducated Carney asks, "Why is there so much injustice in the world?" Adair has no answer. At dawn Carney asks permission to wash in the stream before he is executed. The officer allows him to do so, and the convict presumably jumps on a horse and successfully flees. It is clear that Adair has permitted his charge to escape.

View full annotation