Summary:

Shay, a psychiatrist who specializes in post-traumatic stress disorder (PTSD), juxtaposes the narrated memories of his patients who are Vietnam veterans to the story of Achilles in Homer's Iliad. He finds that the roots of their illness, like that of the ancient hero, lie in betrayal of duty by senior officers who failed to do "what's right," in the repression of grief, and in the social limitations imposed on expressions of love between men.

These stressors lead to guilt, wrongful substitution, and dangerous rage, called the "berserk" state. The mental pathology is fostered by an equally wrongful failure to honor the enemy; return to "normal" is never possible. The book concludes medically with recommendations for prevention.

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A son’s story of his father’s illness, treatment, and resultant destruction by the "psychic-driving" experiments of Dr. Ewen Cameron at Montreal’s Allan Memorial Institute in the 1950’s. The effect of the father’s illness on the family is recounted, as is the son’s gradual realization, only when he is himself about to become a psychiatrist, that something abnormal must have taken place during those long hospitalizations. Weinstein tells other patient stories in some detail as he recounts the legal fight for compensation awarded finally in October, 1988.

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The story of a woman artist's slow decline into dementia and death as told through the eyes, words, and reflections of her philosophy professor son. Through his memories of their 1950s life together, he reconstructs a speculative analysis of her early married life with his soil-scientist, Russian-immigrant father.

The one older brother becomes a neuropathologist who investigates the very disease that slowly strips their mother of herself. Their father tends to her growing needs at the family farm, but he dies suddenly and she must be placed in an institution where one nurse alone seems to respect her dignity.

The brothers' rivalries and misunderstandings are recapitulated in their different responses to their father's death and their mother's illness: the physician retreats to scientific explanations of the "scar tissue" in her brain; the philosopher looks for evidence of personhood and for reassurance that death should not be feared. His obsession with his mother's condition stems from a deeply felt sense of guilt; it destroys his marriage and condemns him to depression, hypochondria, and shame as he creates and diagnoses the same illness in himself, long before it can be detected by doctors.

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In dire financial straits, the physician-researcher, Dr. Malcolm Sayres (Robin Williams), accepts a clinical job for which he is decidedly unsuited: staff physician in a chronic-care hospital. His charges include the severely damaged, rigid, and inarticulate victims of an epidemic of encephalitis lethargica. Sayres makes a connection between their symptoms and Parkinson’s disease. With the hard-won blessing of his skeptical supervisor, he conducts a therapeutic trial using the new anti-Parkinson drug, L-Dopa.

The first patient to "awaken" is Leonard Lowe (Robert De Niro) who, despite being "away" for many years, proves to be a natural leader, with a philosophical mind of his own. Other patients soon display marked improvement and their stories are told in an aura of fund-raising celebration marked by happy excursions.

Gradually, however, problems develop: patients have trouble adapting to the radical changes in themselves and the world; Leonard grows angry with the imperfection of his rehabilitation; the horrifying side effects of L-Dopa appear; and Leonard’s mother (Ruth Nelson), initially happy for her son’s recovery, is later alienated by the concomitant arousal of his individuality, sexuality, and independence. The film ends with "closure of the therapeutic window" and marked regression in some patients, but not before they have awakened clinical commitment and a new ability to express feelings in their shy doctor.

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A series of approximately 175 short fictional monologues or "postcards," each less than a page, in the voice of an alcoholic--the view from "the bottle"--describing the obsession, rationalization, pain, dissolution, and toll that alcoholism takes on career, body, friends and family. Each "postcard" is written in a different voice: sometimes old, sometimes young; male or female; reformed or not. In few words, they capture intense moments that vividly evoke the misery and folly in the rest of alcoholic existence. There is humour and despair.

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On 15 March 1977, the acclaimed Quebec writer, Hubert Aquin (HA) born 1929, blew out his brains on the grounds of Montreal's Villa Maria, a convent girls' school, where his first wife had been educated and only steps from the Westmount home that he shared with his psychiatrist partner, Andrée Yanacopoulu (herself now a writer of medical history) and their nine-year old son, Emmanuel. Yanacopoulo had known of the suicide plan well in advance and, as part of a pact, had agreed not to stop it.

Through a series of interviews with family, ex-family, friends, lovers, colleagues, secretaries, students, and cleaning ladies, mostly between 1977 and 1983, Sheppard conducts an "investigation" to determine why Aquin ended his life at that time and in that way; and why his partner allowed it. Only a single interview seems to have been conducted after 1985. Each chapter is preceded by an extensive citation from one of Aquin's four novels, followed by stage direction notes for music, sound effects, and mood, and comprised of situated testimony written as dialogue for a film script.

Just as many explanations for Aquin's suicide emerge from this inquiry as there are witnesses. The causes range from the political, through the physical, psychological, social, symbolic, and emotional, to the spiritual. For each witness, they are the truth. They include 1. the failure of the recently elected separatist government to declare Quebec to be a sovereign nation; 2. Aquin's much publicized dismissal from a newspaper job, which he had counted on for a prominent editorial opportunity; 3. the failure of one (or several) love affair(s); 4. the collapse of two marriages; 5. estrangement from the two sons of his first marriage; 6. chronic ill health due to alcoholic epilepsy; 7. unresolved conflicts with his parents; 8. the result of his own writing which displayed a longstanding fascination with sex, death, violence, and suicide; 9. the result of writer's block; 10. a "classic" capitulation of a "québécois" male to the tyranny of women, either a "québécoise" mother or--(take your choice)-- a non-québécoise lover; 11. a covenant with 9 year-old boys crossing several generations; 12. the destiny of a man with a death wish, a chronic predisposition to self killing, who, according to one engaging friend (Jacques Languirand), had probably already committed suicide in a previous life as a late Antique Roman, and would likely do again--perhaps already has.

Sheppard dedicates his book to more than one hundred suicides from Sappho to Kurt Cobain. He shapes the responses of his subjects by his pointed questions and the juxtaposition of their answers to advance his overriding theory that Aquin's suicide was his finest work of art. All the varying explanations co-exist peacefully within Aquin's immortality, which resides in the minds of those who remember and grieve for him. No single interpretation is more plausible than another. Sheppard explicitly links these multiple "truths" to the early film work of Kurosawa; we are also reminded of Iain Pears's An Instance of the Fingerpost and The Dream of Scipio (see this database).

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In September 1796, 32-year-old Mary Lamb (1764-1847), stabbed her mother to death with a carving knife during an incoherent frenzy. Almost immediately, she became calm and was sent to a madhouse, remaining away from home for months until her grieving and unforgiving father had died. Mary was released into the care of her much younger brother, Charles (1775-1834), soon to be known for his poetry and essays. She never went to prison, but would return to the madhouse many times over the next fifty years. As a result, this life is an interesting exploration of chronic mental disturbance in the early nineteenth century.

Neither Charles nor Mary ever married; they always lived together and professed to be each other's dearest friend. Obliged to eke out a middle class income--she (until her crime) at dressmaking, he in an office--they turned to writing, often together. The Lambs' famous Tales from Shakespear [sic] was written mostly by Mary, but their friend William Godwin under Charles's name as sole author first published it. Mary's other books, edifying texts for young female readers, were published anonymously.

Letters to their many friends reveal Mary's vexation with Charles's drinking and smoking and his concerns over her multiple relapses, which were triggered by being obliged to move house. Charles predeceased his older sister by ten years and she spent the rest of her life in chronic care of a private couple, visiting his grave almost every day.

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Worlds Apart is a set of four documentary videos designed to stimulate thought and discussion about the effects of culture on communication and medical decision-making. Each video encapsulates the story of a real patient and his or her interactions with physicians and family.

The four videos are: (1) Kochi Story--an Afghan man, diagnosed with stomach cancer, decides about chemotherapy amidst miscommunication due to translation issues and religious convictions; (2) Chitsena Story--the mother of a four-year-old girl from Laos is caught between physicians who tell her that her daughter needs surgery to correct an atrial septal defect, and her mother who upholds the traditional Khmu beliefs that scars, including surgical scars, are injurious to a person in future lives; (3) Phillips Story--an African-American man on dialysis discusses the prejudices against black people in the health care system, particularly the decreased chances for receiving a renal transplant; (4) Mercado Story--a 60-year-old Puerto Rican woman who lives in Hell's Kitchen, New York City, explains the complex social situation which affects her ability to take care of her chronic health problems, such as diabetes and hypertension.

The films depict the patients and families in various settings--in doctors' offices, at other health care facilities, at home or work, during religious ceremonies. Phillips Story is different in that only the patient speaks during the film--in the other three stories we hear family members, translators, and physicians. The pitfalls of translation by a family member or friend are discussed, as well as the need for the physician to elicit information from patients about the social contexts that may affect their health and decisions.

For example, Mr. Kochi's religious beliefs contravene the use of continuous infusion chemotherapy, but not other regimens--this distinction is not elucidated for many months. Hence cultural competency in health care requires that the provider not assume reasons for patients' behaviors and decisions but rather emphasizes communication to understand the particulars of the situation.

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It was during a trip to Paris in 1985 to accept a prestigious writing award that William Styron first realized that the melancholy which had been descending upon him for months was part of the onset of a crippling depression. In this brief book, Styron describes his own experience and eventual recovery, and touches upon the history and clinical aspects of depression as he talks about the many writers who have also been afflicted with this disease.

Styron gives both a retrospective account of the beginnings of his illness, and details his own theories (his abrupt intolerance for alcohol, a possible family history, characters in his early writings in whom he described symptoms strikingly similar to those he would develop himself years later) about the origins of his depression.

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This slim chapbook contains eleven poems that tell the story of a mother and her alcoholic son--how she suspects and then discovers his addiction, how she vacillates between fear and denial, despair and hope. The place in between these extremes of emotion is the Hurricane Zone, and these poems--written by "Anonymous" to protect the son's identity--are hard-edged, starkly moving, and ultimately redeeming.

In "Birthday," the narrator looks back thirty-eight years to her son's arrival, "his mashed, chinless face / dented forehead /breaking its way out of me." The next several poems ("Foreshadowing," "Denial," "Shikker," "Postcard") address denial, how a parent can suspect their child is slipping into the abyss of alcohol or drugs and still wish to create a different story from the available details.

Finding help in Alanon, the narrator begins to work her program. In "Late Lilies" and "Detachment," she finds where a mother and son's boundaries begin and end: "he isn't me, / he isn't mine." In "Give Us This Day" (referring to the group's recitation of The Lord's Prayer at meeting's end) the mother, "lone Jew, lone atheist," learns detachment, that "cloud shadows of startling darkness / moving over the water are not the water."

"Ferryboat" and "Hope" reveal the narrator's painful longing to protect her son as well as her own obsession: a series of affairs early in her marriage when this son was a teenager. That memory, one both cherished and regretted, offers a thin moment of hope: "Anyone who wants to can change." But even when the son is good--able to work on a second novel--there is uncertainty and near-miss communication.

In "Hurricane Zone," the final poem, there is no easy resolution. The victory comes in addressing the topic of alcoholism straight on and making these poems available for others who may be struggling along the same journey.

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