Summary:

Two individuals share a struggle that is grueling, depressing, and whose outcome is probably preordained. The Mother (divorced, constantly tired, and fearful of sickness) is "not a good choice for the parent of a chronic invalid" (p. 168). The Son (smallish, clever, and born with some kind of tumor) has previously had an organ transplant (most likely kidney).

Their trek through the realm of sickness unfurls in seven scenes - all hospital wards and finally Hospice. First, the Son is an adolescent in a pediatric ward where the Machine (presumably renal dialysis) prevents his death. There he spots a baby that he dubs a "Not-Dead." She has multiple birth defects due to a chromosomal abnormality and is kept alive by technology. He intuits that while not dead, the baby is not "properly alive" either. He muses about his own status. His mother is always bedside, propping up his spirits.

Next he is in the ICU and then transferred to a medical floor. He receives a blood transfusion after disconnecting the Machine in a likely suicide attempt. Sometime later, he is back in the pediatric ward after receiving an organ transplant. The Son gets admitted to the Cardio-Respiratory unit for a severe infection. In and out of hospitals, he enrolls in college but quits. After getting married, he joins a commune of survivors of medical illnesses known as "The Saved." This collective lives on a farm and members avoid any contact with family.

The Son's health further deteriorates. He is hospitalized in terminal condition. By this time, he has his own child, a 14-month-old boy named Jaybird. In the oncology ward, doctors diagnose three tumors in the Son's brain but he refuses any treatment (surgery, radiation, or chemotherapy). He is moved to Hospice. His absent Father comes to visit and comfort him. When the Son dies, it is the Mother who is alone with him. The Son's wife, Father, Jaybird, and members of The Saved commune are all asleep in the Day Room. Only after the Son dies are the names of the Mother and the Son revealed: Julia and Jonathon.

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When nine-year-old Rob Cole, child of poor 11th-century English farmers, loses his mother, he is consigned to the care of a barber-surgeon who takes him around the countryside, teaching him to juggle, sell potions of questionable value, and assist him in basic medical care that ranges from good practical first-aid to useless ritual.  When, eight years later, his mentor dies, Rob takes the wagon, horse, and trappings and embarks on a life-changing journey across Europe to learn real medicine from Avicenna in Persia.  Through a Jewish physician practicing in England, he has learned that Avicenna’s school is the only place to learn real medicine and develop the gift he has come to recognize in himself.  In addition to skill, he discovers in encounters with patients that he has sharp and accurate intuitions about their conditions, but little learning to enable him to heal them.  The journey with a caravan of Jewish merchants involves many trials, including arduous efforts to learn Persian and pass himself off as a Jew, since Christians are treated with hostility in the Muslim lands he is about to enter.  Refused at first at Avicenna’s school, he finally receives help from the Shah and becomes a star student.  His medical education culminates in travel as far as India, and illegal ventures into the body as he dissects the dead under cover of darkness.  Ultimately he marries the daughter of a Scottish merchant he had met but parted with in his outgoing journey, and, fleeing the dangers of war, returns with her and their two sons to the British Isles, where he sets up practice in Scotland.

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In 1816 London, Napoleon has been defeated and troops have returned, including teenaged Will Starling, who survived the wars as assistant to the decent surgeon Alec Comrie. Will now serves Comrie in the city, still in strained circumstances.

Medical science has turned to the utility of anatomy, but material for research and teaching is scarce. Body-snatchers procure subjects from robbing graves—sometimes from murder—but they are not the only bad actors. Flamboyant, privileged Doctor Dionysius Atherton is trying to raise the dead by applying newly harnessed electricity to fresh cadavers.

From this ghoulish world of science and crime, young Will Starling tells his own tale, as your “Wery Umble Narrator.” Vivid scenes of wretched urban poverty, wanton cruelty, and selfless heroism march past to a grim ending.  

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Blow’s account of growing up in rural Louisiana, exposed to negligence, sexual molestation, violence, and loss focuses on a child’s strategies of survival first, and then on sexual confusion, social ambition, and discovery of the gifts that led him to his life as a writer for the New York Times.  A major theme in the memoir is his learning to claim his bisexuality after years of secrecy and shame.  That emergent fact about his identity, along with moving to New York after a life in the rural South required an unusual level of self-reflection and hard, costly choices that challenged norms at every level.  His account of learning to assume a leadership role in a college fraternity and deciding to finally leave it behind offers a particularly vivid example of what it takes to resist perpetuating rites of humiliation and conformity designed to curb individuation.     

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Pale, gaunt children from the backwoods hills of Kentucky bring their stool specimens to school so the visiting physician can check for worms. But these sinewy kids come from a long line of leathery ancestors "bred from one tough root"--and they keep on surviving whether they have worms or not. They "shall inherit" the earth, whether or not physicians treat them.

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This remarkable, absorbing novel is the story of a marriage and of catastrophe. Dan and Laura are a young couple from very different backgrounds who have two children. There is a terrible boating accident, caused by Dan's cavalier carelessness: Laura is severely injured and is rendered quadriplegic. The narrative skillfully weaves back and forth between Dan and Laura's earlier life, the nature of their relationship, and the present shocking realities of daily living; on-going unresolved guilt, anger, withdrawal and despair; and a gradual reconfiguration of the love and attraction that initially brought the pair together.The author pays unflinching attention to the details of physical incapacitation and how they must be dealt with, and the consequences for Dan as husband-caregiver as well as for Laura. At the same time we hear Laura's dream-like, poetic inner thoughts--a mind trapped in a useless body-- yet she seems to use her mind both as sense organ and limbs. "If Dan . . . ever touched me above my breasts where I edge towards feeling like ice thinning out . . . I would feel it everywhere. Memory is a muscle too if you work it."

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A “drive-by mammogram” leads the writer, Barbara, to a biopsy of a suspicious breast lump. She awakes from the fog of anesthesia to hear the surgeon’s bland remark: “Unfortunately, there is a cancer.” Welcome to Cancerland, a place where her identity is displaced by the vast implications of the diagnosis, another operation, and arduous months of chemotherapy. What works for her own peace of mind has little to do with the trappings of pink-ribbon sentimentalism in the survivors groups.

Barbara resorts to her knowledge of cell biology, asks to see her own tumor under the microscope, and contemplates the meaning of visualizing the malignant cells even if she does not believe the exercise can help her. She dissects the rank commercialism and denial in the survivor movement: let me die of “anything but the sticky sentimentalism in that Teddy Bear.” She decries the claims that cancer therapy makes better skin, better hair, and better people, with better bodies, especially when an implant on one side subtends a cosmetic procedure on the other.

Posting these thoughts on a chat line, she discovers that most women berate her attitude and suggest she needs a psychiatrist. But one dying woman agrees with her distress, and writes of having cancer, “IT IS NOT OK.” Admitting feminists can be found in the “survivor” community, Barbara faults its underlying tone for being coercively optimistic, infantilizing, and insulting to the dying and the dead. She is angry. Very angry, and her “purifying rage” spares no one: doctors, support groups, feminists, drug companies, and the Cancer Society. Nevertheless--and in keeping with her earlier work--she credits the women’s movement with helping to rid the world of three medical evils: the radical Halsted mastectomy, the practice of proceeding to mastectomy from biopsy without waking up the patient, and high dose chemotherapy.

Two disturbing ironies bring the essay to a close. The first, is the possibility that mammograms may not be saving or even prolonging lives, even as they detect cancers; they make women dwell in Cancerland for longer and cause too many “unnecessary” biopsies. The mammogram is a ritual, she says. The second irony lies in the role of the pharmaceutical industry which fosters the pink power movement –the ribbons, the teddy bears, the marathons-- while manufacturing the expensive poisons that seem to have anticancer side effects. These same companies, she argues, have also manufactured carcinogenic pesticides that pollute the environment. Having profitably poisoned women into having breast cancers, they continue to profit from poisons of chemotherapy.
She faults both the “cult” of the survivors movement and the American Cancer Society for their “unquestioning faith” in these imperfect instruments of action.

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Matthew McCarthy begins his memoir of medicine internship year at Columbia University with a glimpse into his first rotation, surgery, as a Harvard medical student. He had exhibited a talent for surgery and liked it – an affinity compatible with his dexterity as a minor league baseball player and sense of team spirit. The reader meets some of McCarthy’s memorable mentors, and, although he opts to not pursue surgery as a career, McCarthy’s eye for seeking productive apprenticeships with talented housestaff and faculty allow him to guide the reader through a year of drinking from the firehose, also known as internship. Medical training is full of liminal experiences, and internship is one the most powerful and transformative.  

McCarthy’s eagerness to do well, both by his patients and by his medical colleagues and team, and his candor with revealing his mental and bodily responses to the stress and strain of the responsibilities of internship, make him an adept guide. For example, he has gulped an iced coffee and is churning at the bit to take care of a new admission on his first day of call in the cardiac care unit (CCU). His resident, called Baio in the book, tries to tell McCarthy to take it easy. But McCarthy notes, “Our orientation leaders, a peppy group of second- and third year residents, had instructed us to exude a demented degree of enthusiasm at all times, which wasn’t difficult now that my blood was more caffeine than hemoglobin.” (p 15) The previous chapter had ended with a cliffhanger – a patient life would be placed in danger because neophyte McCarthy misses the importance of a key clinical finding – what and how that plays out will wait until McCarthy guides us through the terror and exhilaration he feels as he begins his CCU rotation.  

McCarthy has a good sense of the ironic: the huge banner advertising the hospital reads “Amazing Things are Happening Here!” Indeed, not only for patients and families, but also for the many trainees and workers. We watch McCarthy successfully perform his first needle decompression of a pneumothorax; he is allowed to attempt it as he notes that he watched the video of the procedure. But unlike the video, he needs to readjust the needle several times and add on some additional tubing and water trap, which makes the scenario more true-to-life than a fictionalized ‘save.’ The author ends the chapter with congratulations from resident Baio: “Well done… Amazing things are indeed happening here.” (p 244) As McCarthy’s year continues, many things do happen, including an infected needle stick, telling bad news to a new widow, and developing a friendship with a longterm hospital patient waiting for a heart transplant.

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Lament is a twenty-two line dirge in free verse with one rhyme, at the end of the poem, which is almost certainly intentional. The poem represents a mother’s terse lament over the death of the father of the two children whom she is addressing. More of a soliloquy than a dialogue, one receives the distinct impression that the children may not even be present as the mother announces matter-of-factly that their father is dead, that they must soldier on, and describes the manner in which she will distribute the coins and keys in his pocket to them. The final couplet succinctly sums up the poem’s sentiment:


Life must go on,
And the dead be forgotten;
Life must go on,
Though good men die;
Anne, eat your breakfast;
Dan, take your medicine;
Life must go on;
I forget just why.

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Performance poet Bao Phi was born in Saigon; his parents emigrated to Minnesota, where he grew up and still lives. His poetry is rooted in Asian American immigrant experience, especially in Vietnamese American experiences, and speaks of racism, economic hardship, cultural difference, and the legacy of the Vietnam war. The collection is divided into four sections, each preceded by a quote from another (usually Asian American) writer. Four introductory poems set the tone for the poet's project of "refugeography" (from "You Bring Out the Vietnamese in Me", p. 9): recognition and celebration of the variety of Asian American lives, and anger at exploitation - both economic and cultural: "They box our geography / And sell it in bougie boutiques / Our culture quite profitable / But can somebody tell me / How our culture can be hip / And yet our people remain invisible?" ("For Us", p. 1)

In section 2 (The Nguyens) 14 poems highlight the lives of a variety of unrelated individuals and families across the US who have the same family name. "They are one story for every Viet body, one song for every voice that sings or otherwise" (p. 17). Many are angry and bitter. There is the Sacramento girl who grows up, makes good, and wants now to get even with the white boy who pushed her down and called her "gook" in ninth grade: "where is your wheat- haired crown now, / where is your Made- in- America tongue: / a slide of spit to take me back to where I came from / now that I am ready to show you / show you / where I come from" ("Vu Nguyen's Revenge", p. 20). There is the chef who had once worked in the kitchen of a restaurant where the waitstaff was white only: "let me tell you that the white people / can choke to death on their lychee martinis" ("Fusion", p. 24). Others are reflective - such as the soldier in Iraq who meditates, "let me not tear apart a people, a country, causing Iraqi food to / become the nouvelle cuisine in 25 years back home" ("Mercy", p. 29).

Some wrestle with generational misunderstanding: Dotty from Dallas whose mother "hid the food stamps by holding [her] hand out like a fan of shame at the checkout line" and later kicked her out of the family, accusing her of being a "Commie" (p. 45). There is tongue in cheek irony, such as in "The Nguyen Twins Find Adoration in the Poetry World" (p. 40), about two vastly different poets - Joan, who has an Anglo boyfriend, publishes in respected traditional literary journals, includes in her work Vietnamese sentences "she never fails to translate" and who won the "safe ethnic poet award"; and Jesus, whose poems are "system fascist overthrow racism working class" performed on Def Poetry Jam where he mispronounces all three of the only Vietnamese words he uses in his poetry.

Numerous poems in sections 3 and 4 address racism. "Reverse Racism" (p. 59) imagines the tables being turned on whites: schools that teach only Asian-American history and suspend any student who questions it; jobs that "stick white men in middle -management hell, then put them on a pedestal as an example of how whites can be successful", and "when white men form their own groups to protect themselves, I'll accuse them of being separatists and reverse racists". "Dear Senator McCain" (p. 65) begins with a quote from the year 2000 in which the senator (who had been imprisoned and tortured by the North Vietnamese during the Vietnam war) says, "I hate the gooks. I will hate them as long as I live." The poem issues a challenge: "I am that gook waiting in your nightmare jungle / that gook in front of you with 17 items in the 10 items or less lane at the supermarket / that gook born with a grenade in his head / that gook that got a better grade than you in shop class" and ends, "Senator / what's the difference / between an Asian /and a gook / to you".

Another poem ("8 [9]", p. 93) is based on the 2006 killing of a 19-year-old Hmong American by a white policeman in Minneapolis. There is despair ("For Colored Boys in Danger of Sudden Unexplained Nocturnal Death Syndrome and All the Rest for Whom Considering Suicide Is Not Enuf ", p. 82 ). There are also poems of self-awareness, for example, of the dichotomy of an earlier ghetto life and a later "fancy college" experience ("Called [An Open Letter to Myself]", p. 76); intra-ethnic suspicion and misunderstanding ("Everyday People", p. 99); energy and pride ("Yellowbrown Babies for the Revolution", p. 86).

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