Summary:

Aminata Diallo, called Meena, is born in mid-eighteenth-century Africa and leads a happy life with her Muslim parents. Her mother is a midwife and is teaching Meena her skills. But ruthless white men appear, killing her parents and imprisoning her. The eleven year-old girl is forced to march miles and miles to the sea. During the journey she makes friends with Chekura, a slightly older boy who seems to be employed by the white captors, but like Meena, has also been captured. They are kept at a fort, then herded on to ships and taken on an agonizing journey across the ocean.

Meena and Chekura are sold as slaves. They lose sight of each other and live on plantations in privation and squalor never knowing if they will be treated with kindness or cruelty. Meena is raped by an owner. She learns how to read and write English quickly (although her skill must be kept secret), and she is fascinated by maps, constantly plotting to return to Africa.

Meena and Chekura find each other and marry secretly - but soon they are separated. She has a baby girl. Her literary and midwifery skills are her salvation, and eventually she is sold to a Jewish duty inspector. He and his wife treat her well, and she and her child live in comfort, but the revolutionary war disrupts their world. Meena returns home one day to find that the Jewish couple have fled on ship to England, taking her daughter with them..."for her own good."

Meena moves to New York City, taking a room in a hotel and still intent on finding a way back to Africa. She writes the names and ages of the people clamoring to go to Nova Scotia as a reward for serving the British in the Revolutionary War: the original "book of negroes." The settlers arrive with hope and optimism, but they encounter more oppressions. Later she is lured by the attractive plan to build "Freetown" in Sierra Leone; again however, the promised resources never materialize and the fledgling community degenerates into crime and misery. Even Meena's attempt to find her original home is thwarted.

In 1802 London, as a frail elderly woman, the abolitionists treat Meena with reverence and curiosity. They encourage her to write her story, and there she finds her daughter again.

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Haunted by his past actions and wartime experiences, the narrator empties his soul to a silent stranger - a woman sitting and drinking with him at a bar in Lisbon. He tells her about his participation in the colonial war between Portugal and Angola in the early 1970's. He admits to the conflict that still rages inside him. Six years earlier, as a physician in his twenties, he was drafted and shipped 6,000 kilometers from home for a slightly more than two year stint as an army doctor. He left behind a pregnant wife.

While in Africa, he witnessed the waging of a crazy war and was called upon to patch up its many casualties. He describes the maiming, inhumanity, and death that he observed. Questions about political power and morality trouble him. In the midst of this horror, he becomes increasingly cynical and skeptical. On his return home, the narrator acknowledges that he has lost part of himself in Africa. He gets divorced, feels hopeless, and is incapable of shrugging off loneliness.

He and the woman leave the bar and go to his apartment where they have a sexual encounter. She has been an adept listener. The narrator's lengthy confession may have been therapeutic for him. But like everything else in this doctor's post-military service life, any solace is brief. The war has polluted him, and he struggles to clean up the mess.

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The author takes us on a highly colorful autobiographical tour of his medical career - his personal life never enters this account - from a classical medical education in Paris as a young expatriate Swede (he remains expatriate the entire book) to his internal medicine practice in France, including a tour of Naples as a volunteer during the cholera epidemic of 1881 and his finally settling in Italy. There are also anecdotes - many of them side-splitting and told with uncommon skill - about conducting a corpse back to Sweden, a truly thrilling journey to Lapland,  encounters with the legendary Charcot, his return to San Michele whence the book begins with a mythopoetic retelling of his first visit there, and his last years at San Michele as patron of a community (both local and international) and as collector and explorer of the nearby Mediterranean.        

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Sherwin Nuland has had a distinguished career as a surgeon on the faculty at Yale University and as an author with interests in history of medicine, medical ethics, and medical humanism. In this memoir we become acquainted with a different side of Nuland, that of son to a widowed, immigrant father with whom the author had a complex and difficult relationship.

We learn also that Nuland has suffered from depression on and off since he was preadolescent, experiencing a major breakdown in midlife. This book attempts to make sense out of the family dynamics and the depression. At the same time, it describes the insular world of Russian Jewish immigrants living in New York City's Lower East Side and Bronx in the first half of the 20th century.

Nuland explores, frankly and openly, his ambivalent relationship with his father, Meyer Nudelman, and contrasting adoration of his mother, who died when Nuland was 11. The young Sherwin (Sheppy) Nudelman lived in fear of his father's strict rules and unpredictable anger. Further, Sheppy was required to assist his father whenever he went out of the house because Meyer Nudelman had an unsteady gait that made walking difficult and that became increasingly severe. Although the boy initially enjoyed these neighborhood jaunts with his father, he was increasingly resentful of them as his father's condition deteriorated and as his own interests focused more on people and activities outside the home. His father's strong Yiddish accent, strange gait, and sloppy appearance were a major embarrassment.

The last third of Lost in America--chronologically the era of World War II, the Nazi atrocities, and after--concern Nuland's maturation and his path toward the profession of medicine. As he and his brother, Harvey, were contemplating a future in the world of Gentiles, they decided to change their last name from Nudelman to Nuland. Sherwin Nuland was accepted to medical school at "Waspy" Yale and chose to enroll there, deliberately distancing himself (on the surface) from his father and his culture.

In medical school Nuland realized that Meyer Nudelman's physical symptoms were caused by late stage syphilis. The initial shock and disbelief of that discovery dissipated; Meyer's growing helplessness and tremendous pride in the accomplishment of his son allowed for a measure of understanding and affection between the two.

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This memoir spins out in detail the despair and violence that emerges from a childhood of poverty and parental absence. When Dubus was preadolescent, his writer father of the same name (see Andre Dubus), took up with a student of his, and the parents divorced. Andre's mother became a social worker, working full-time with no support system, exhausted. Although Andre's father lived nearby and paid child support, it was never enough to keep the four children and their mother out of poverty. They moved frequently, always to the rough sections of depressed Massachusetts towns on or near the Merrimack River. The memoir describes vividly the smells of the polluted river; garbage strewn lawns; smoky, raucous bars; afternoons and evenings spent aimlessly watching television and, in adolescence, neighborhood kids and punks doing drugs and sex in Andre's home - before his mother arrived back from work each evening  .

At school, in bars, and around the neighborhood, kids and adults beat each other up - violence was a constant. Andre was slight and fearful but also drawn to watch the frequent fights. He avoided direct involvement when he could, was beaten up when he couldn't, and loathed himself in either case. He felt like a non-person: "There was the non-feeling that I had no body, that I had no name, no past and no future, that I simply was not. I was not here" (78). Finally, after being unable to help his brother during a fight, Andre resolved to build himself up physically--lifting barbells, bench pressing, and eventually taking boxing lessons.

Now when there was the threat of a fight, he plunged in quickly, inflicting damage. He could defend himself and those he cared about. But always there was the need for vigilance and the need - frequently actualized - to explode in rage. Later, he came to realize that being quick to jump into fights was a way "to get out what was inside him. Like pus from a wound, it was how [I] expressed what had to be expressed" (191). Gradually Andre came to think there might be other ways "to express a wound."

In the second part of the memoir, Dubus writes of how that other way evolved into creative writing. Training for physical prowess had imposed some discipline in his life, which meant being able to concentrate in school, do homework, and read. There were stints in and out of college (eventually he graduated from the University of Texas in Austin), making ends meet as a gas station attendant, construction worker, fast food manager, bartender, and later-- halfway house counselor. At the local Massachusetts college he attended for a while, he overheard himself being called a "townie." He navigated at the interface of the old neighborhood where he still lived and the life of the more privileged. He became more self-aware, more interior, and at the same time, more interested in the larger world. Threaded throughout this period is a developing relationship with his father, whose writing he admired and whose approval he craved.

In spite of the author's ambivalence toward his father - "where were you when I needed you?" (333)--one probably cannot overestimate the role that the senior Dubus played as a writer model for his son. Dubus read and admired his father's stories. He saw the discipline required to write, even though Dubus senior's weekends were often spent unwinding in bars (sometimes with the younger Dubus). Andre met his father's academic colleagues, met other writers, met writers who had stable relationships with a spouse.

He even learned that a writer can be a sports fan (Boston Red Sox), and avid sports participant (jogger). One of the most moving chapters in the book describes the first baseball game Dubus ever attended or watched - at age 13 - (with two tickets from his father), to see the Red Sox play the Yankees in Boston. Dubus went with a friend who explained the game to him as it unfolded. Dubus was stunned: "Every time one of them walked up to home plate with his bat, hundreds of men and boys would yell insults at him I couldn't quite make out, just the tone, which I knew well, but it wasn't directed at me or anyone I would have to try to protect, and I felt relieved of everything, part of something far larger than I was, just one of thousands and thousands of people united in wanting the same thing, for those men from our team to beat the men from the other team, and how strange that they did this by playing, that one beat the other by playing a game" (161-162).

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In the eighteenth century, Europe began to take stock of the horrific infant mortality in foundling homes and hospitals. Infant feeding and care became a major preoccupation for charities and philanthropic doctors. Some organized systems of wet nurses in the communities and institutions to provide for motherless children. 

At the same time, syphilis was becoming a serious problem in newborns. The sexually transmitted disease, which swept the continent following the voyages of Columbus, was known to affect babies born to infected mothers. Since the early sixteenth century, doctors had been convinced that mercury was of benefit.

Founded in 1724, the Vaugirard Hospital of Paris was the city’s home for orphans. By 1780 it had made room for mothers with syphilis and their children.  Sometimes the mothers died, or well-off families would abandon their sick children. Healthy wet nurses were engaged to feed these babies.

Eventually, the wet nurses were viewed as a technology—a vehicle--for administering mercury to the babies through their milk. Many of these healthy women fell ill, either from the mercury or by infection from their charges. Nevertheless, the practice continued into the nineteenth century. The wet nurses did not know (or were not told) that the children were infected. The physicians in charge of this experiment also attempted unsuccessfully to vaccinate the wet nurses against syphilis. That experiment also spread the disease.

Remarkably, some wet nurses brought suits against the doctors or the birth families. Occasionally they won damages, and finally the law was changed to offer greater protection.

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In 1951 when Henrietta Lacks was dying of cancer in the colored ward of Johns Hopkins, cancer cells taken from her without her knowledge "became the first immortal human cells grown in a laboratory"(4).  Known as HeLa cells, they are still reproducing today and are used world wide in research for cancer, cloning, genetics, Parkinsons, and many technologies. Henrietta's family did not know she was the source of these immortal cells until scientists began testing the family members too.  Poor and black, they were very angry to find the white establishment had made fortunes using HeLa cells while the family got nothing for it and couldn't even get good health care. In her thorough and careful investigation, Rebecca Skloot interviewed the Lacks family; scientists, doctors, and others who worked with HeLa cells; historians; journalists; ethicists. This book traces the complex stages of her search for the truth about what happened to Henrietta Lacks, her HeLa cells, and her family.

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This suggestively titled collection of poems provides a lyric record of a physician’s way of seeing.  The situations to which the poems bear witness are not only medical, though many are.  Some are cityscapes into which are woven surprisingly astute observations of homeless people or hitchhikers or ducks in the park.  Some explore the geography of a body where memories are held in “neuron chains.”  Some articulate bits of personal history from the point of view of a woman who has spent years in medicine, caring for the elderly, seeing bodies with the double vision of a clinician and a person whose spirituality clearly informs all she sees.

Titles like “ER Alphabet of Hurt” or “Looking for God On the Radio” or “Hippocrates Voyeur” or simply “Scars” may give some sense of the range of focus.  Her vision and voice are strongly local; those who know Marin County, north of San Francisco, will recognize the places that become the poet’s personal geography.  Those who don’t will still see in these poems a sensibility shaped and refined by the knowledge that comes from deep habitation.  

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Mary Anning was born in Lyme Regis in 1799 on the southern coast of England. With her father, she learned to hunt for fossils that have become popular curiosities among tourists. But the science of paleontology was still in its infancy. Her father died in 1810 leaving his small family in precarious circumstances. The following year, at the age of twelve, Mary unearthed the full skeleton of the world’s first ichthyosaur--more than 30 years before Richard Owen would propose the term, dinosauria (terrible lizards) to describe the class of these extinct creatures.

For the rest of her life she was driven to scour the cliffs day in, day out. Wearing odd, bulky clothing to protect her from the elements, she found many important fossils, including the first Plesiosaur and the first representative of a certain kind of pterodactyl.  She sold them to scholars. Although isolated and poor, she kept up with the new discoveries through the literature, and was skilled at reading the landscape and the unique bones.

Mary never prospered from her work, but received all visitors with generosity, flattered and proud of the small attention they gave her. Lacking privilege and a husband, her discoveries were taken over by male scientists who used them to build the new science and their reputations. Religious concerns over the age of the objects is a backdrop for the discoveries; however, Mary appears to have been convinced that her fossils challenged the standard interpretations and yet unshaken in her faith. She died of breast cancer at age 48.

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