Summary:

Beginning in 1992, Mark Duxbury and Dean McClellan are high-flying salesmen for Johnson and Johnson, Ortho branch – happily promoting the drug Procrit, (or Epogen -- erythropoietin), for anemia. The drug stimulates the bone marrow to produce more red blood cells. Developed by fledging company Amgen, it was licensed to Ortho for specific uses. Their careers take off, and they earn bonuses and stature, peaking in 1993. Soon, however, Duxbury realizes that he is being encouraged to promote the drug for off-label uses and in higher doses that will enhance sales and profits through kickbacks. He soon realizes that the drug is not safe when used in these situations. People are dying because their unnaturally thickened blood results in strokes and heart attacks.

He raises objections with his employer. For voicing concerns he is ostracized and then fired in 1998. Along with the stresses of his work, the financial difficulties and emotional turmoil, Duxbury’s home life is in tatters; his marriage falls apart and he worries about his daughter Sojourner (Sojie). He develops multiple health problems, including sleep apnea and dependency on drugs and alcohol.

Enlisting the help of the famous lawyer Jan Schlictmann (A Civil Action), whistleblower Duxbury launches a qui tam lawsuit in 2002 against his former employer. This is a civil action under the False Claims Act, which can offer cost recovery should the charges prove warranted. The lengthy process is still going. The last ruling issued in August 2009 allowed the case to proceed. But Duxbury soon after died of a heart attack in October 2009 at age 49.

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In 1894 France, Madeleine Karno hopes to follow in her father’s footsteps as a pathologist. She is passionate about medicine and especially about science and how it can help the dead 'speak.' When a young girl is found lifeless outside her own home, the autopsy can find no evidence of murder; however, the discovery of tiny mites in her nostrils leads Madeleine and her father on a lengthy investigation involving the girl’s family, a priest, abused children, and a convent school that has a three-hundred year tradition of keeping wolves.

By the end, the story is littered with corpses, each needing careful pathological inspection. Madeleine is chillingly threatened, but she lives and justice prevails.  

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In this young adult novel, Kristin Lattimer is a high school senior who seems to have everything – good looks, two best friends Vee and Faith, excellent athleticism especially in hurdles, a scholarship to State University, and a hunk of a boyfriend. She and her boyfriend are even voted Prom Queen and King. Kristin’s dad is a single parent, as her mother died of cervical cancer when Kristin was in 6th grade. Hence Kristin’s primary sources of knowledge of adolescent changes are her Aunt Carla and her peers, and she is able, at age 18 to chalk up her lack, not only of menstruation, but also of menarche to her running practice. But when she experiences painful and incomplete intercourse, she seeks the advice of a friend’s gynecologist.

 Dr. Johnson quickly diagnoses “androgen insensitivity syndrome” and explains that AIS is “a unique genetic syndrome that causes an intersex state – where a person looks outwardly like a female, but has some of the internal characteristics of a male.” (p. 37) The gynecologist then stumbles through further explanations and concludes, “Miss Lattimer, I think that you might be what some people call a hermaphrodite.” (p. 38) To the now stunned teen, the physician further explains karyotypes, hormone levels and the “better term” intersex. Since Kristin has undescended testes, the discussion includes possible cancer risk, and Kristin’s dad is called into the doctor’s office as well.

 The reader follows Kristin’s journey of discovery – meeting a ‘specialist,’ urologist Dr. Cheng, who provides the definitive diagnosis of AIS and explains that “chromosomal sex, gender identity, and sexual orientation are all separate concepts.” (p. 59) Issues of privacy, friendship, betrayal, sexuality, community, ostracism, social media, athletic rules vis-à-vis gender, and support groups are woven into the story and Kristin learns to cope with her new diagnosis and self-awareness.

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This story centers on Lena, an immigrant teen from Ukraine, whose entire family has been traumatized and uprooted by family deaths during a violent pogrom.  Relocated to Chicago, in a tiny apartment on Bittersweet Place, the family struggles to survive in the years prior to World War I. Wineberg’s tale of disrupted life and resettlement is weighted by formidable issues that stretch beyond the ordinary range of family experiences. 

Lena, the intelligent, highly observant and resilient adolescent, narrates an unvarnished tale of survival for the extended family clustered together in this strange new world, but especially for herself.  While the family’s economic and financial circumstances are difficult, her own life is made worse by an unkind teacher, mean-spirited classmates, and hormonal impulses.  Her uncle touches her inappropriately, a favorite uncle goes mad, a cousin dies, and her mother, who is unfamiliar with the new world setting and mores, drives her crazy. 

Nevertheless, Lena is a clear-eyed survivor exhibiting a surprising toughness of character and determination. For example, her introduction to sex is far more direct than might occur with most girls of that time.  In addition, when her teacher fails cruelly to support her artistic talents, she shows amazing defiance.   When she discovers that her father has a beautiful female friend, undoubtedly a lover, her consideration of this circumstance does not render the crushing blow that might be expected.  In retrospect she is more adult, more mature than most young women might be in each of these situations.  She is a remarkable young woman with a spirited edge.

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Annie Howard is beginning high school in Tacoma, Washington in 1950, four years after her father returned from World War II, having been blinded in combat.  Her mother has opened her own beauty salon as a way of coping with her husband’s disability and the loss of earning power it has meant.  Annie loves her father, and maintains a close relationship with him, but is dismayed by his recurrent depressions and his steady refusal to get a guide dog, go out into the world, and respond to invitations to volunteer with an organization that helps other veterans similarly afflicted.  As the school year begins she meets two new friends, a Dutch brother and sister—refugees whose parents were killed in the war and who now live with an aunt and uncle.  Through them, and ultimately through her father, Annie learns some hard truths about the lasting effects of trauma, about the role of acceptance in healing, and about how a more grown-up love involves willingness to accompany others through some of the darker dimensions of suffering.

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The author is a practicing neurosurgeon, one of only two hundred or so women in this specialty which numbers about 4,500. She was the first woman to be admitted to her neurosurgery residency program. Her father was a surgeon and she was definitely influenced by him and says that, as the oldest of four children, it was always expected that she would become a doctor; but she didn't decide for sure until partway through her second year of college.

Once in medical school her decision for neurosurgery as her specialty came very easily. Oliver Sacks's writing had a significant influence on her decision. She was also influenced by her college sweetheart who became her husband and who also chose to train as a neurosurgeon. He is not practicing now and they do not have children.

Her description of her long years of training are interestingly related with many individual patient stories and also many descriptions of her teachers and peers. She takes time to describe how she views the specialty itself and its power structure and all that entails. Among the interesting chapters are two about her research years, one at the center for cognitive brain imaging at Carnegie-Mellon and one as a fellow in Epilepsy Surgery. The author was fascinated with the complexity of brain function and its relation to anatomical structure with which she was much more familiar.

Firlik found that she loved "life on the learning curve" and that her curiosity was broad. About her last year as Chief Resident she said "I have had my hand in saving lives and I have had my hand in helping to end them: I'm not talking about murder, of course. I am talking about helping people die" (227). She was able to write this book because she kept a journal during her training.

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Marie Commeford, daughter of Irish Catholic immigrants who grows up in Brooklyn, narrates her life story in episodes rich with reflection on the losses, failed fantasies, illnesses, and disappointments of a life at the edge of poverty, which is also rich with love and poetry and humor and the stuff of which wisdom is made.  The story unfolds as memory unfolds, in flashbacks and reconstructions shaped by a present vantage point from which it all assumes a certain mantle of grace.   From the opening story in which a neighbor girl slips on the steps to a basement apartment and is killed, to repeated glimpses of a blind veteran who umpires the neighborhood boys' street games, to the bereaved families Marie meets when she works for the local undertaker, to her gradual discovery of her brother's closeted homosexuality, and to her aging mother's death, the story keeps reminding us of how much of life is coming to terms with the "ills that flesh is heir to," and also how resilience grows in the midst of loss.  Because much of the story represents the vantage point of a child only partially protected from hard things, it invites us to reflect on how children absorb large and hard truths and learn to cope with them. 

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The author of this long, compassionate and often startling treatise on identity interviewed over three hundred families to elicit stories about raising exceptional children, stories that also come from these exceptional children ('exceptional' is the term chosen to describe the children in the author's material about the book).

'Far From The Tree' explores the challenges children face in being raised in families where one prominent feature in their identity is forged by something out of their parents' control and generally not part of the family's experience until then. These identities are not 'vertical' (passed down from generations of parents to their children), but 'horizontal', springing up between those who share in that identity at any one time. Solomon begins by wondering about his own relationship with his parents when he was a child discovering his sexuality and ends with his own role as a father, 'the terrifying joy of unbearable responsibility' (702); between the two poles of his own experience, he meets parents and children who have experienced deafness, dwarfism, autism, schizophrenia, severe physical disabilities and diverse gender identities, prodigies, children who were concieved by rape and children who became criminal.  

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Tish brings a knife to the breakfast table and threatens to use it on her stepfather if he tries to come into her room again.  Her mother, working at the sink, does her best to ignore the conversation, in which the stepfather moves from mockery to threats.  Tish carries the knife in her boots to school.  When her gym teacher insists on her removing her boots she begins to scream uncontrollably, is sent to the principal, and, unable to tell her secret, runs away.  She finally makes her way to a friend's father, a lawyer, who listens to her story and assures her of legal protection, though as the story ends, Tish has a lot of decisions left to make, and a long way to go before she feels safe and healed.

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In 1877, the widowed Sarah Bell writes to the New York Children’s Aid Society to explain that poverty has driven her to leave her daughter Lily May in its care. Mr Bassett writes to the same office that he and his wife would like to adopt a little girl. They are given Lily May and change the baby’s name to Mabel.

Over the years, Sarah keeps writing to ask for news of her child; when she remarries she begs to have her daughter back. With evident alarm, the Bassetts tell of the good care they have given the girl; they love her and will not relinquish her. Lily/Mabel has no idea that she is adopted and will never be told.

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