Summary:

In typically terse poetic structure, utilizing fresh new images, Holub visualizes removal and replacement of a human heart during a transplant procedure. He describes the throb of the extracorporeal circulation mechanics as an "inaudible New World Symphony" as he elevates the imagery of the hole in the chest where once resided the "king of Blood" transiently into the cosmos. With the arrival of the "new heart," the imagery again becomes earth bound: the structure is sewn in place, the beats resume and the "curves jump like / synthetic sheep" as the EKG rhythm resumes.

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Dr. Papper, a revered figure in the field of anesthesiology, questioned why it took so long for anesthesia to be "discovered": after all, pain and suffering existed long before the mid-nineteenth century. This book is a result of Papper’s graduate studies in literature and history and explains his thesis that "societal concern with pain and suffering, and the subsequent development of surgical anesthesia in the Romantic era . . . are outgrowths of Romantic subjectivity."

The book provides biographies of scientists, physicians and poets, such as Humphry Davy, Thomas Beddoes, Sr., Samuel Taylor Coleridge and Percy Bysshe Shelley, along with analyses of Romantic poetry as related to pain and suffering. Papper theorizes that the exchange of ideas amongst these intellectuals and the political upheavals of the time paved the way for society to recognize that the pursuit of happiness could include the relief of pain.

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For forty years, James Langstaff (1825-1889) practiced medicine in a small town near Toronto. He witnessed the advent of anesthesia, antisepsis, new drug remedies, germ theory, and public health. Chapters are devoted to his management of surgery, obstetrics, and diseases, especially in women and children, his finances, and his role and that of his suffragist wife in the political and social fabric of their community. A reformer and temperance advocate, Langstaff was quick to adopt medical innovations, but slow to abandon familiar practices.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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Like Paul Muldoon's Sonogram (see this bibliography), this poem was occasioned by the poet's wife's ultrasound of their first child, Tobias. (See pgs. 258-259 of the anthology for a description of the poet and his comments on this poem.) "Sonogram" is alternately lyrical and bright ("through succulences of conducting gel") and dark (" . . . or sinuses of thought / like Siracusa's limestone quarries, where / an army of seven thousand starved to death.") The language is highly poetic (and successfully so) in conjoining the worlds of medical technology and poetry ("or alveolus in a narthex rose") and playful ("God's image lies couched safe in blood and matter" punning on "vouchsafed").

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It is sometime in the future of genetic engineering, at the point at which, for a high enough price, one can buy physical and intellectual characteristics for one's fetus. This is the story of a young American couple of average means who have one "normal" son and are negotiating a supernorm status for their female fetus. The action centers around the stresses placed on the young family by the financial sacrifices required to engineer a daughter who would be able to compete in the growing population of engineered people. Husband and wife disagree increasingly, and ultimately the family breaks up over the wife's obsession with having a perfectly engineered child.

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In this story, Earth's inhabitants have moved below terra firma where their every need is met and every act controlled by "the machine." A young rebel protesting against the loss of authenticity and the reverence for abstraction seeks to communicate with his mother about his need to go to the surface of the earth. This act of direct experience terrifies his mother who is sure that her son will be sentenced to "homelessness." The son does experience the beauty of the earth and returns to prophesize the end of the machine and the "civilization" it created.

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In this little poem the narrator gives the reader permission to observe an appeal to a higher order for help in deciding how best to care for a ventilator-dependent patient. The narrator seems to be addressing Emma's creator to hear his concerns.

Emma now "lives as a swollen eggplant on its stem" although she was formerly strong and healthy. The poet develops the theme of organicity as the narrator makes his final case for guidance: "I must tend the leaf as best I can / and, anticipating other seasons, / turn the soil."

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This remarkable poem notes the contrast between the mechanical, technologically manipulated heart today (without faith or spirit) and the mysterious, spirit-creating heart of Riverius. In the days of Riverius, the heart created spirit which "descended like dew" into the body and "ascended like steam" into the head--"how souls and bodies blended!" But now all mystery and spirit are gone. Cadaver-cutting scientists made an ox of the heart which pumps "the blood in dispirited circles" (note the wonderful use of "dispirited").

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The speaker in this poem provides a vivid portrayal of the recovery room experience from the perspective of an articulate patient. Where he had been warned about the room's brightness, he was unprepared for the keening woman in the adjacent bed and the "false and stark balm delivered to her crumpled ear" by the nurse. He and other "freshly filleted" and "drug-docile" visitors to this room wait in the anesthetized setting of otherness or in-between for release. The patient feels like a "diver serving time against the bends" or like one of eight piano keys parallely parked. While waiting for the return of sensation in his lower body, he imagines that he is like a "truculent champagne" loosening off "petulant bubbles," a few at a time.

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