Summary:

Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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The poet conjures up the image of the doctor who delivered him and his siblings ("All of us came in Doctor Kerlin's bag"), the doctor who arrived at the house in his fur-lined coat and ascended to his mother's bedroom, and later came down and arranged the instruments in his bag (a "plump ark"), which by that point was otherwise empty. In the boy's fantasy, Doctor Kerlin's small eyes were "peepholes into a locked room," in which were strung "the little pendant infant parts / . . . neatly from a line up near the ceiling-- / a toe, a foot and shin, an arm, a cock."

On a visit to the ruined temple of Asclepius, the god of healing, the poet finds himself remembering Doctor Kerlin, and also the incident when, as an altar boy, he fainted during a procession at the healing shrine of Lourdes in 1956. Now many years later, he pulls up some tufts of grass from around the temple and sends them to friends suffering from cancer. He remembers entering the bedroom after Doctor Kerlin left, his mother on the bed asking, "And what do you think / Of the new wee baby the doctor brought for us all / When I was asleep?" [94 lines]

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Dedicated to the poet's mother, Naomi Ginsberg, the poem is a narration and a lament arising from Ginsberg's memories, three years after Naomi's death, of her life and of his life with her. This long poem is subdivided into 5 sections that address the dead woman directly.

The highly poetic Part I is a reflection on death, life ["all the accumulations of life, that wear us out" (p. 11)], mortality, the link between the dead and the living, the great unknown that lies beyond death--not in the abstract, but in the signs and symbols of Naomi's life/death and in the issues that remain for her son: "Now I've got to cut through--to talk to you / --as I didn't when you had a mouth." (p. 11)

Part II is a long narration of Naomi's life story, especially the history of her mental illness and of the role it imposed on Ginsberg himself. Ginsberg "was only 12" when he brought his mother to what was intended as a rest cure; instead, she became psychotic and was hospitalized, leaving Ginsberg with an everlasting sense of guilt. Separated from her husband, Naomi spent years of paranoia in chaos and institutionalization; son Allen vacillated between pity, disgust, escape in travel, and (homo)sexual exploration.

At the last meeting with his mother, in a mental hospital, she didn't recognize him. While living in San Francisco, two days after Naomi died, he received a letter from her: "Strange Prophesies anew! She wrote--'The key is in / the window, the key is in the sunlight at the window--I have / the key--Get married Allen don't take drugs . . . .' " (p. 31)

These passages give a vivid sense of mental disease and its impact on the family. Ginsberg is not self-pitying or self-indulgent in his description of the illness that laid siege to his mother's life and which so strongly influenced his own life for years. Modestly, he inserts: "I was in bughouse that year 8 months--my own visions unmentioned in this here Lament--" (p. 25)

The brief "Hymnn," is a blessing: "Blessed be you Naomi in Hospitals! Blessed be you Naomi in solitude! Blest be your triumph! . . . Blest be your last year's loneliness!" Part III (one page long) is a short recapitulation of Naomi's life, and uses her own cryptic words to try to make sense out of her life as well as of all life and death: "But that the key should be left behind--at the window . . . to the living . . . that can . . . look back see / Creation glistening backwards to the same grave . . . ." (p. 33)

Part IV, a chant, reaches beyond the personal to social history: "O mother / what have I left out"; (p. 34) "with your eyes of shock / with your eyes of lobotomy; " "farewell / with Communist party and a broken stocking"; "with your eyes of Czechoslovakia attacked by robots . . . ." (p. 35) Ending with the short part V, Ginsberg cries out to the shrieking crows circling in the sky above His mother's grave, "Lord Lord O Grinder of giant Beyonds my voice in a boundless / field in Sheol" (p.36) [Sheol is a Hebrew word meaning "the abode of death."]

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In this sonnet Hopkins reflects on the long illness and death of Felix Randal, the farrier. The poet watched this "big-boned and hardy-handsome" man decline, until he was broken by "some / fatal four disorders" and his "reason rambled . . . . " At first Randal had railed against his fate, but later, anointed by the poet-priest, he developed a "heavenlier heart" and "sweet reprieve."

The poet reflects on his role as a spiritual healer: "This seeing the sick endears them to us, us too it endears." While the priestly tongue and touch refreshed Felix Randal in his illness, Randal's tears also touched the priest's heart, and so he is left with a sense of loss and mourning when the man dies.

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By the author's own admission, this memoir is a collection of fragments taken from her memory of bits and pieces of her four year experience as a nurse in an evacuation hospital unit following the front lines up and down the European theatre during World War I. The work is fragmented because this experience was fragmented.

The first few chapters are dream-like descriptions of the men marching into battle and crawling back, or being carried back. The second collection of short vignettes dips--just a wee bit--into some of the individual soldiers' immediate stories. The latter segment of the book deals in more detail with the operations of the field hospital, some of its personnel, and some of the patients. Finally, the author treats the reader to a handful of poems, perhaps unnecessary, since the entire memoir is like one giant poem.

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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.

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The first-person narrative of Catherine who is desperate for her seemingly indifferent mother’s love. Raised from infancy by grandparents following her parents’ divorce, Catherine seeks her indifferent but devout mother’s affection by emulating her saintly namesake. She mortifies her flesh in the pursuit of thinness based on an ideal of purity as self-denial and on her mother’s esthetic expectations.

The obsessive behavior extends from anorexia to willful insomnia and severe illness. At college she recovers by discovery of a happier, more direct faith. The essay begins and ends in the narrator’s later life, as she contemplates her own revulsion and pain in caring for her mother who lies dying of breast cancer.

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In July of 1986, author Andre Dubus was assisting some stranded highway motorists when he was struck by a car. After two painful months of hospitalization, one leg had to be amputated at the knee; the other leg, damaged and immobilized in a cast for many months, became virtually useless, but still painful. Dubus was forced to "accept life in a wheelchair." (106)

In meditating on events and people in his life before and after the accident, Dubus leads us to the interior space of his suffering, fear, moodiness, stoicism, and religious faith. Like the Hemingway character he describes in "A Hemingway Story," he has both gotten over and not gotten over the consequences of his accident.

"Sacraments" interweaves the receiving of religious sacraments with the concentration, care, and love associated with making sandwiches for his two young daughters, the emotional pain of carrying on a love relationship by telephone because of his limited mobility, the received sacraments of learning how to drive his specially equipped car, and of getting a bargain from a swimming pool contractor--"the money itself was sacramental: my being alive to receive it and give it for good work." (95) Concluding with the recollection of his father's death; Dubus notes that "I had not lived enough and lost enough" to recognize the grace that accompanied past pain.

Pain and grace continue to compete for his attention: "The memory of having legs that held me upright at this counter and the image of simply turning from the counter and stepping to the drawer are the demons I must keep at bay . . . So I must try to know the spiritual essence of what I am doing." (89) Similarly, mourning--for what he can no longer do-- and gratitude--for what he once was able to do-- go hand in hand as Dubus remembers the joy of running for miles in the countryside (" A Country Road Song").

The body's memory and the losses suffered figure importantly also in "Liv UIlman in Spring." In this powerful piece, Dubus describes his meeting with the actress, how he was moved to tell her "everything," how, bent low, "her eyes looking at mine" she said, 'You cannot compensate.' " (130) For her honesty and understanding Dubus was enormously grateful.

"Witness" relates the uncanny experience of meeting a woman who had witnessed his accident. Wonderment, fear, depression, inspiration, and writing about this incident were the result. As always, Dubus wrote in order to be led to some further understanding. The essay ends, "Today the light came: I'm here."

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The action takes place in a mental hospital where Pythagoras is a patient. According to the medical authorities, Pythagoras is a small-time show-biz magician. The patient, however, believes that he is the REAL Pythagoras, the ancient Greek philosopher, mathematician, and mystic. It certainly SEEMS that Pythagoras may have magical powers: when he points to the telephone, it rings; when he raises his hand to the sky, thunder claps.

Dr. Aquillus, the superintendent, has no sympathy with these pranks. The patients believe in his power, but even they sometimes question Pythagoras. For example, in response to the Greek's boast that "I was philosopher, mathematician and magician," one patient says, "You shoulda specialized, buster. You won't get anywhere unless you specialize." At this point Pythagoras responds that it is "difficult to wear both the white coat of science and the magician's purple one. You have to be--very great!" In the end Pythagoras is reduced to Tony Smith and the truth is revealed. Or is it?

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Ann Blake is a lonely, divorced, childless English teacher whose ninth grade class includes Karen, a girl who is dying of cancer ( probably lymphoma). As an adjunct to the medical treatment and prayer/faith healing that the child receives, Ann hopes that she might instill in Karen a purpose to live for, through her creative writing

The Infinite Dark refers to a story the students read during that school year, and the teacher ponders on what this phrase really means. She has assumed it means death, but, as Karen regains her health and moves on to another grade and forgets about Ann Blake, Ann realizes that for herself the infinite dark means being unconnected from others, being alone, not making an impact that is permanent--a sort of death in life. As the teacher tries to facilitate healing in the student she ironically realizes that she herself has known little about living her own life.

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