Summary:

Thin, a documentary film produced, aired and distributed by HBO, is the centerpiece of a multi-faceted project that explores the complex issues of body images and eating disorders in young women. Photographer and journalist Lauren Greenfield began documenting eating disorders in 1997, eventually publishing an article for Time Magazine and a book entitled Girl Culture, as well as producing a traveling photographic exhibit. Returning to one of the facilities featured in the exhibit, Greenfield took up residence at the Renfrew Center, an in-patient facility for eating disorders in Florida, to film the day-to-day suffering of four young women struggling with anorexia over the course of six months.

The youngest is Brittany, a sad and troubled fifteen-year old, whose bulimia and anorexia began when she was only eight (her weight bounced from 185 to 95 pounds in one year) and whose mother has her own very unhealthy relationship to food. Brittany is eventually returned to her weight-obsessed mother because of the loss of insurance. Shelly, a twenty-five year-old, psychiatric nurse, has been anorexic for six years and enters Renfrew at 84 pounds with a surgically-implanted feeding tube. Her identical twin visits to plead with Shelly to refrain from slowly killing herself and ultimately destroying their family. Polly is a twenty-nine year old, charming troublemaker whose health is returning but whose defiance of rules eventually gets her kicked out of the facility. The oldest patient is Alisa, a thirty-year old, divorced mother of two whose eating disorder ostensibly developed at age seven when a pediatrician persuaded her mother to put her plump daughter on a severe diet. Alisa's graphic account of a single day of binging and purging is shocking, and her forced release from Renfrew because of problems with health insurance precipitates a return to this pattern after she tucks her children into bed.

 

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Serving as a summer hospital volunteer, fifteen-year-old Teri d'Angelo meets Valerie Ross, a girl her age who has damaged a nerve in a fall, and lost the use of one leg. Valerie's anguish over her partial paralysis takes the form of anger; she manages to keep most of those who try to help her at a distance. But Teri finds her intriguing, and Valerie's condition evokes a kind of sympathy and interest in her that overcomes even the patient's most strenuous rebuffs. Gradually, and with much caution on Valerie's part, they become friends. Valerie finds herself welcomed into Teri's large, warm Italian-American family. Teri's compassion for Valerie grows as she recognizes her loneliness; Valerie's parents are divorced, her father rarely visits, and her mother keeps up a hectic work schedule.
      
Teri also benefits in ways she didn't expect from the friendship; Valerie's bravery, even when masked with anger, inspires her to speak up more clearly on her own behalf, to ask for what she needs, and even to circulate a petition at school when she feels she has been discriminated against in the judging of a science project.
     
When Valerie is taken to a "sanitarium"-a mental health facility-for depression and apparently psychosomatic involvement of her good leg in the paralysis, Teri visits her patiently, despite Valerie's apparent lack of interest. But finally, when she watches Valerie rejecting the grandmother who traveled from England to see her, she acts in uncharacteristic anger, and in the shock of the moment, Valerie stands up, proving to herself and others that her good leg does, infact, function.  It is a turning point in her healing.

In an interesting twist, the book ends with the girls drifting apart.  They are, indeed, very different. Valerie is planning to attend City College in engineering. Valerie is going to live with her grandmother in England and attend Oxford University, hoping later to become a writer. In a final phone call, two years after Valerie's accident, the girls part with some affection and gratitude on both sides, but also with an acceptance of the fact that their friendship may have been for a season. They gave each other important gifts, and now life is taking them in very different directions. 

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The book opens with a thought "exercise": thirteen short essays, each in a different national voice and beginning "We, the people of a nation . . . " The honest, intelligent "speakers" love their countries and traditions; however, they try to express the ugly truths about their homelands as challenges for the future.

For example, American smugness over its know-how and wealth combines with American failure to recognize the resentment sparked elsewhere by these same attributes. Similarly, the mutual intolerance of Canada's linguistic and religious duality is portrayed as a grotesque irony. The U.S.S.R. has exchanged an old tyranny for a new; Japan must face the issue of controlling its population, if it is to control its impulse to aggression.

Chisholm then returns to his role as a socially committed psychiatrist who hopes to avert a war that could annihilate the human species. World aggression, he writes, is caused by the "anxiety" that emerges from intolerance typifying narrow parental guidance and even narrower systems of education and religion. People must learn to be comfortable with differences in population, race, language, and wealth. The message is simple: "anxiety" leads to "aggression." The book ends with a ideal curriculum for "world citizenship," surprisingly different from any currently in use.

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A saxophone-playing, divorced psychiatrist, Dr. Denis, is baffled by the unexplained arrival of a new patient in his mental hospital. The highly intelligent newcomer, called Rantes, has extraordinary gifts and spends long hours in the yard facing southeast, where he claims to receive communications from his home planet. He is visited by the saintly Beatriz, who works in a church, and Denis asks her questions about Rantes.

The bond between the three people begins to transgress the ordinary boundaries between doctor and patient, and culminates in an excursion to a concert in the park. Charmed by Beethoven's "Song of Joy," Rantes instigates generalized waltzing and takes over from an inexplicably obliging conductor. Back in the asylum, the other patients feel the vibrations emanating from Rantes' concert and engage in a good-humored romp. The doctor is reprimanded for the embarrassing situation, and begins to doubt the integrity of the psychiatric enterprise. A weakened Rantes dies after electroshock therapy and the film ends in ambiguity.

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Winter surveys the rise and fall of mesmerism in Victorian Britain, from animal magnetism to hypnotism, including electrobiology (a form of group hysteria), table-turning, and other fads. The book offers rich detail about the different stages of the use of mesmerism in medicine: its initial appearance in staged experiments; its uncertain status and the struggle to locate the boundary demarcating alternative medicines; its performance by professional medical men as well as travelers and quacks; its importance in the development of anesthesia; and its role in prompting skeptical scientists to consider the possibility of mental reflexes as one way to explain away mesmeric phenomena.

Winter argues that mesmerism was not "illegitimate" so much as it brought "legitimacy" itself - of medical authority, of evidence, of knowledge -- into question. Thus, she argues, mesmerism crucially inspired many of the considerable changes in nineteenth-century medicine as well as the reorganization of science and the educational reforms of the later nineteenth century. The book also discusses mesmerism as a form of religion, as a conduit for spiritualism and communication with the dead, as a catalyst in orchestral conducting, and as a model for liberal political consensus.

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Fraser’s subtitle is accurate; this book tells about a middle-aged woman rediscovering her difficult past of incest from her father and abuse, as a child, from another man. She tells her life story of growing up in a working-class neighborhood in Hamilton, Ontario, Canada, going to university, marrying, and becoming a journalist. All the while, anger and rage fuel her, but it is only after surgery (for fibroids) and psychotherapy that she can recall the abuse and has it corroborated by others. Fraser understands that her personality split into three personae; she uses her dreams, her writing (including six novels), and her childhood drawings to understand what happened to her. Finally she is able to forgive her father (although after his death) and continue with her successful career as a writer.

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A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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Witty Ticcy Ray tells the story of Dr. Sacks’s treatment of a 24-year-old man with disabling Tourette’s syndrome. The first half of the essay is mainly medical-historical, with some technical language. When Sacks first tries treating Ray with a minute dose of Haldol, Ray finds that even that low dose too effective. It breaks up the rhythms that have determined his life since the age of 4, and he doesn’t like it. Later, a second trial using the same dose succeeds, Sacks believes, because Ray had by that time accommodated mentally to a change in self-image.

Still, over time Ray missed his old wildness and speed, and he and Sacks agree on a compromise: During the week, Ray takes Haldol and is the "sober citizen, the calm deliberator." On weekends, he is again "’witty ticcy Ray,’ frenetic, frivolous, inspired"--and a talented jazz drummer. This, according to Ray, offers Touretters an acceptable artificial version of normals’ balance between freedom and constraint.

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This video depicts Robert Coles, noted author, psychiatrist, documentator and humanist, teaching his popular undergraduate course, "The Literature of Social Reflection," at Harvard University in 1990. The film begins with a bell tolling in a steeple and students entering the lecture hall. Excerpts from his lectures are presented in 4 parts: I: Ruby; II: Seeing--The Paintings of Edward Hopper and The Stories of Raymond Carver; III: Praying; and IV: Potato Chips and Tolstoy.

Some additional documentary clips are shown, such as footage of six-year-old Ruby Bridges being escorted into a previously all-white New Orleans school amidst a screaming mob during forced integration of schools. In between segments, brief interviews of Coles’ students let the viewer know that his message is getting through: it matters how you live your life--it matters a great deal.

Coles teaches with stories and these stories are riveting. In 1960, while in the Air Force and assigned to a psychiatric detail, he befriends young Ruby after he witnesses her courage in entering the school building. He comes to know her family and teacher.

Several months later, during the morning escort, Ruby stops in front of the school and says something which makes the mob even more frenzied. Coles is asked by the teacher to tell Ruby not to do that again. Upon gentle questioning, it turns out that Ruby was not talking to the mob, but to God: "Please God, try to forgive those people because they don’t know what they’re doing."

It was a prayer she said every morning, usually a couple of blocks away from the school, but that morning she had forgotten to do it earlier. Coles discusses the remarkable gift of forgiveness instilled in this brave child by her parents, who despite poverty and lack of opportunity to advance in life, were able to love and teach their children values and grace.

In Part II, Coles uses paintings by Edward Hopper, a poem by Raymond Carver ("What the Doctor Said" (annotated by Felice Aull and Irene Chen, also annotated by James Terry) and Carver short story (Cathedral) to illustrate how difficult it can be to truly communicate with and know another person. And how magical the moments are when we do.

In Part III, Coles shows some of the children’s drawings that he has collected during his documentary work. Coles delights in describing what the children said about their drawings at the time they created them. He clearly respects them and their ideas.

The last part ends with the story of the death of Coles’s mother at Massachusetts General Hospital. In her dying days she befriended an African-American woman, whose job was at the bottom of the hierarchy of the hospital: an orderly. After Coles’s mother died, it was this woman--not any doctor or nurse--who taught Coles how to take the time and be with his mother, rather than rush off as he was preparing to do. Coles asks, "Who was the doctor, the healer, the wise person?"

He notes that these twists are characteristic of many stories, such as those by Flannery O’Connor. He then concludes before a standing ovation: "Let us be good to one another, live on behalf of one another . . . . We are lucky to have these writers . . . and to have the lives that can include them."

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In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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