Summary:

In Gain, Richard Powers interweaves two narratives. One is the story of Laura Bodey, a forty-two-year-old divorced realtor with two adolescent children, who lives in the midwestern U.S. town of Lacewood. Sometime in the late 1990s, Laura is diagnosed with ovarian cancer. The account of her illness, treatment, and eventual death is set against the story of the Clare Soap and Chemical corporation, whose headquarters are in Lacewood, from its inception as a trading company at the beginning of the nineteenth century.

The Clare corporation is implicated in Laura's death: pollutants from its Lacewood plant have been associated, not quite unquestionably, with abnormally high cancer rates in the area. A class-action suit against the company succeeds, but Clare, globally powerful and massively differentiated, is ultimately immune: no matter how much we might sympathize with individual members of the Clare company (and Powers ensures that we do), the corporation has become a kind of monster beyond human control.

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As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.

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Rachel is married to passive Leon who is utterly dependent on her care and organizational skills. They live in a vast, blanc-mange of a suburb where Rachel constantly looses her way while driving home from work. One night, she seeks direction from Wilkes. A strange recluse, he is obsessed with his teenage memory of the lost "girl on the bus" and leads a support group for agoraphobics.

Through contact with Wilkes, Leon gradually grows more independent and finds himself a job. Rachel becomes obsessed with the search for the meaning of "Harry," a mystery man who recurs in her husband's dreams and begins to take over her thoughts. She consults a psychologist, Alex Silver, who soon has Rachel enrolled in a study with two other women. Silver uses dream-deprivation with the goal of enhancing insight about her marriage, her life, and her friends.

Cameo appearances of three depressive, mid-life siblings, Dick, Jane, and Sally, with their dog, Spot, and cat, Puff, emphasize that life in modern suburbia can be a pathology in itself. In Jane, Wilkes finds his lost girl on the bus. Rachel dumps Leon and finds happiness with the agoraphobic developer of the aptly named "Arcadia Centre," where expense, space, light, greenery, and intimacy are employed unstintingly to create a non-pathogenic space for human collectivity.

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Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.

Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)

Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.

However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.

She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)

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The austere and homesick Breton doctor, René T.H. Laennec (1781-1826) (Pierre Blanchar) and his religious friend, G.L. Bayle (1774-1816) are caring for the hundreds of patients dying of epidemic tuberculosis in the Necker Hospital of Paris. They conduct autopsies on the dead, but cannot predict the findings before the patients' demise, nor can they offer any treatment.

Laennec's sister, Marie-Anne, arrives from Brittany with news of their brother's death from tuberculosis. He confesses his despair over this devastating scourge to his friend, but quickly realizes that Bayle too is doomed. A distant cousin, the widow Jacquemine Guichard Argou, becomes Laennec's housekeeper and companion in philanthropic work for the sick after he is able to reassure her about her health; she engages the widow of Bayle in the same enterprise.

One day in 1816, Laennec is invited by urchins to hear to the scratching of a pin transmitted through the length of a wooden beam. He is thereby inspired to fashion a paper tube to listen to the chests of his patients. With Jacquemine at his side, he joyously announces that he can hear sounds from inside the chest. Feverish research ensues as he links the chests sounds of the dying to the findings at autopsy.

He turns his wooden, cylindrical stethoscopes on a lathe in his apartment, publishes his findings, and marries Argou. Fame and notoriety follow, as Laennec is able to distinguish fatal disease from minor illness and to predict the need for operations; however, he is ridiculed by jealous colleagues. Suffering now himself, Laennec consults his friend Pierre Louis, who tells him that he has tuberculosis. In the final scene, he returns to his native Brittany only to collapse on the stairs of his beloved home and die.

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A pediatric intern encounters her first dying child. Her initial response is to care for the child, hold him, and try to comfort him. She is told by her attending physician that this behavior is unprofessional. When she cries in response to her stress and grief, she is told she will never be an effective physician. The narrator then describes how she ultimately came to terms with her impulse to cry at stressful times, and how she interacts with patients in her current practice.

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The poem is divided into six stanzas, each titled by a successive day. The subject of the poem is a woman's reaction to mammography and the unexpected "spot" that is discovered. The woman is shown the spot on the mammogram, and the agony begins: does she have breast cancer? The exam occurs on Thursday; she must wait until the following Tuesday to find out.

Meanwhile, life and relationships take on new meanings and tenderness. For instance, at a large family reunion, she is determined to laugh with the family about childhood reminiscences, even though her laughter is now bittersweet (she keeps her torment private from all but her lover).

Other days are filled with worry and nightmare. At long last, during a perfunctory call from her physician, she finds out that the spot is merely a protein deposit. Relieved, she thanks the physician, who remains uninformed of the depth of her patient's recent torment.

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Dr. Tom More, from Love in the Ruins (see this database), now middle-aged, returns to Feliciana after spending two years in prison for selling prescriptions of Dalmane and Desoxyn at a truckstop. On his return to his psychiatric practice, More observes that two of his former patients are acting strangely. In his own words: "In each there has occurred a sloughing away of the old terrors, worries, rages, a shedding of guilt like last year's snakeskin, and in its place is a mild fond vacancy, a species of unfocused animal good spirits." (21)

More observes that his wife Ellen and his children have also undergone some mysterious personality change. More, the scientist-physician, with the help of his cousin Dr. Lucy Lipscomb, launches a search for the cause of these and other observations. More and Lucy discover that John Van Dorn, head of the computer division of the nearby Grand Mer nuclear power plant and Dr. Bob Comeaux, director of the Quality-of-Life Division of the Federal Complex overseeing euthanasia programs, are involved in social engineering, releasing Heavy Sodium into the water supply to "improve" the social welfare.

Throughout the novel, Dr. Tom More returns several times to evaluate and talk with Father Rinaldo Smith, a parish priest who has exiled himself to a firetower overlooking the vast pine forest of Feliciana. More has been asked by Comeaux, who sits on the probationary board overseeing More's return to practice, to declare Father Smith crazy, so that Comeaux can take over Father Smith's hospice and put it to better use. The conversations between More and Father Smith contain the philosophic and moral themes that support the plot and action of the novel.

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Eleanor Lightbody (Bridget Fonda) and her husband Will (Matthew Broderick) travel to the Battle Creek Sanitarium for the cure. On the train, they meet Charlie Ossining (John Cusak) who hopes to make his fortune in the booming breakfast food industry. The san is run on strict rules of vegetarianism and sexual abstinence by John Harvey Kellogg (Anthony Hopkins), inventor of the corn flake. Regular enemas, exercises, outings and baths are prescribed, but Will repeatedly breaks the rules and is lured into liaisons with a chlorotic fellow patient and his nurse.

Eventually, he and Eleanor turn to other unconventional treatments, which are not sanctioned by Kellogg, including nudism and sexual stimulation. Meanwhile Charlie joins up with George Kellogg (Dana Carvey), the Doctor's adopted but estranged son, who taunts his father when he is not extorting money from him. George sets the san on fire, but is reconciled with Kellogg during the conflagration when he sobs "Daddy give us a cuddle." The Lightbodys go home to a moderate pursuit of health.

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Summary:

In the fall of 1907, Will and Eleanor Lightbody, a wealthy, neurotic couple from Peterskill, New York travel to Battle Creek, Michigan to immerse themselves in the routine of the famous sanitarium run by corn-flake inventor, Dr. John Harvey Kellogg. They meet Charlie Ossining who is seeking his fortune in the fickle market of Battle Creek's breakfast food industry. The Lightbodys have just lost their infant daughter and Eleanor is taking Will to the "san" for the cure. An inveterate meat-eater with a sexual appetite, Will was addicted, first to alcohol, and then, to opium, after his wife spiked his coffee with an off-the-shelf-remedy for drink.

At the sanitarium, they must occupy separate rooms, refrain from sex, and piously eat inflexible non-meat diets. Therapies include five daily enemas, exercises, "radiated" water, and an electrical "sinusoidal bath," which accidentally fries one of the residents. Kellogg is gravely disappointed in Will's inability to toe the "physiologic" line, but he is more deeply disturbed by his adopted son, George, whose chosen life on the street is a perpetual embarrassment.

Worried about his sexual prowess and deprived of his wife, Will becomes obsessed with his beautiful nurse and opts for the stimulation of an electrical belt; equally frustrated and bent on self-starvation, his wife turns to the quack "Dr Spitzvogel" who specializes in nudism and "manipulation of the womb." Brought to their senses by humiliation, Will and Eleanor go home.

Meanwhile, Charlie has joined with George Kellogg and borrowed from Will to keep his business afloat, but he realizes that he has been swindled. He only narrowly escapes jail, during a fiery commotion created by George who is then murdered by his adoptive father.

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