Summary:

Slater subtitles her book, A Therapist's Memoir of Madness. Embedded in this definition are two elements: a psychotherapist's composite experiences with a small cadre of patients and the therapist's personal experience with a mental disorder. The author draws the reader into a fascinating series of anecdotes based on therapeutic encounters.

These stories are as much, if not more, about the therapist's deepest responses to her patients than about the patient him or herself. This particular approach adds an element of confession to the work that one does not often find in clinical studies. And, finally, Slater takes the reader backward in time to her own past as a woman with profound emotional pain.

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In this collection of poems, the author details her descent into the hell of bipolar disorder and the re-integration of her life, thanks to lithium therapy. In "Other Lives" she describes herself as "mother of none, good friend to all, / who for no apparent reason, / tries to kill herself, twice." She writes angrily to the psychiatrist who misdiagnosed her and prescribed the wrong medication: "Your first mistake was to see me at all. / Your second, prescribing the Elavil." (in "Shocking Treatment") While she misses the productivity and "rush" of her hypomanic episodes, she realizes this is the price she has to pay to avoid another "two years of pain or nothing, numbness."

As the author's health improves, she cares for friends who are dying of AIDS and for the dying father of a friend: "I'm learning, as I nurse / my father that the worst / would be protection from / death's reality." (in "For Jean") The collection is interlaced with a series of poems called "Black Stones" in which the author encounters very directly the reality of death. In the last of these, she cries out the words of her friend Matthew who has just died: "Rika, dear friend, live and live and live!"

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This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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Terry Tempest Williams, a thirty-four year old Mormon woman and naturalist based in Salt Lake City, Utah, considers herself part of "The Clan of One-Breasted Women." Ten women of her family, including Williams, have been treated or have died from breast cancer. Is this just an example of the randomness of nature, or is it related to the fact that Williams and her family were residing in the "virtually uninhabited" plains downwind of the atomic bomb testing grounds from 1951 to 1962?

When her book begins, Williams' mother has just been diagnosed with ovarian cancer, and the book follows the next five years of her life and death. At the same time, the Great Salt Lake is rising to record heights, flooding the Bear River Migratory Bird Refuge and scattering the birds and animals with whom Williams has lived her life. The interplay of the uncontrollable elements of nature and the inevitability of life and death make this book an elegant study of "renewal and spiritual grace," and an excellent and unusual telling of a daughter learning how to grieve for her mother.

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De Quincey was a well-known 19th century English journalist and essayist. He was orphaned at a young age and sent away to school, where he was successful but bored and soon ran away. He then spent several years living as a vagrant in Wales, then London. In London, he was reunited with an old family friend who supported him financially and sent him to study at Oxford.

At age 28, De Quincey began to use opium (mixed with alcohol in the form of laudanum) regularly to treat his severe stomach pains. Though his intake was moderate at first, he soon became addicted. At first he rationalized the use of the drug. Later, he experienced opium-induced stupors in which he could not distinguish dream from reality nor note the passage of time.

He also developed memory loss and long periods of depression. He resolved to wean himself from the drug and did so, although in the final version (1856) of this memoir he admits to having slipped back into addiction a number of times.

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