Summary:

This impactful memoir recounts the events of the summer of 1996 when Greenberg's fifteen-year old daughter Sally "was struck mad," as he puts it (3).   Greenberg's portrayal of Sally's behavior as her illness erupts -seemingly from nowhere-- is staggeringly vivid and trustworthy, as is his description of the series of reactions that belong to him, the father who cannot protect, cannot even reach his daughter, although she sits beside him.   

A then-struggling writer, Greenberg unfolds the story, set in a ramshackle, five-story walk-up apartment in the Greenwich Village where he and his second wife (Sally's step-mother) reside.  Among the many rewards of this story is a colorful slice of a New York city life, around the block and in the locked ward.

Greenberg takes us through Sally's initial onset, her sleeplessness, grandiosity, delusions, and frantic drive to communicate, "a pile-up of words without sequence" (17).  The portrayal of his and his wife's initial shock; the diagnosis, "fulminating mania" with indicators for bipolar disorder; Sally's eventful hospitalization, and her return home in a medicated state that Greenberg finds almost as unsettling a transformation as the onset of the mania.  He details building a rapport with Sally's intriguing psychiatrist, as he observes Sally's efforts to do the same. Greenberg tells us about the day he decided to take Sally's medication -for a variety of understandable and also desperate reasons.  This sequence is brilliantly funny and poignant. And he gives us glimpses of the cost to his marriage of these events, bringing the stresses to light with astounding compassion for all concerned.

This memoir moves with exceptional grace between unfolding events and Greenberg's beautifully informed reflections on them.  Observations about the mental illness of James Joyce's daughter, Lucia, are woven through the text, as are insights and characterizations from other writers and doctors, like that of Eugen Bleuler who, Greenberg informs us, coined the word schizophrenia in 1911, when he observed that "in the end his patients were stranger to him than the birds in his garden.  But if they're strangers to us," Greenberg adds, "what are we to them? (24)" Perhaps the most gorgeous and unforgettable feature of the book is Greenberg's way with words, and his attentiveness to Sally's altered relation to words: "Afraid.  Frayed.  Why are you so a-frayed? She keeps asking" (25).

The story of this hard summer draws in a cast of compelling characters, including Michael's mother who arrives, it seems, from another world -of material comfort and propriety-bringing surprising sources of comfort to her adult son and to her granddaughter.  We also get to know Steve, Greenberg's older brother who, also suffering from mental illness, lives the life of a shut-in only blocks away from Michael, who brings him groceries and looks after him, at times a challenging job.

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Each poem in this collection is preceded by brief comments both by the author/patient and by her psychiatrist.  Together the poems chronicle incidents in the interior life of a woman who has lived with schizophrenia for 35 years, been hospitalized, changed doctors and medication, undergone intense feelings of isolation, and also has experienced remarkable support and love from a twin sister and a few loyal friends.  The poems range in tone from matter-of-fact tellings of psychotic episodes to reflections on relationships, both personal and professional, that have been important in the course of treatment.  The book is organized as a chronology that traces the trajectory of diagnosis, illness, treatment and recovery; the final section is entitled "Beginning Again."  Read in sequence, they give a rich sense of the writer's life, struggles, resilience, and unusual self-awareness.  

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This scholarly study examines "what it meant to ’talk of diseases’ in the second half of the nineteenth century" (2) and how discourses of health and illness were a vehicle for exploring individual and social identities, including gendered, racialized, and national identities. Narratives of physical illness are not simply artifacts of Victorian medical culture, Vrettos argues, but offer examples of the pervasive "master narratives" that shaped Victorian middle-class culture.

Individual chapters focus on the ill female body as an expressive text with variable legibility (and on nurses as privileged readers of ill bodies); "nervous illness" and the role of narrative in reconstructing the self; "neuromimesis" or neurotic imitation of disease; and the "politics of fitness and its relation to imperialist ideology." Vrettos discusses fictional works by Louisa May Alcott, (Hospital Sketches; see this database) Charlotte Bronte, George Eliot (Middlemarch; see this database), H. Rider Haggard, Henry James, Bram Stoker, and Harriet Beecher Stowe.

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Protagonist Mary Lennox, "as tyrannical and selfish a little pig as ever lived," is nine years old when she wakes one morning in India to an empty house, forgotten by all in the chaos of a cholera epidemic that has killed her pretty young mother, British army captain father, and most of their servants. The novel charts Mary’s removal to England and her physical, psychological, and moral development on the Yorkshire estate of her widowed uncle Archibald Craven, a reputed "hunchback." As part of her own maturation, Mary catalyzes growth and healing in (and between) her mildly spinally disfigured uncle and his "invalid" son Colin.

The secret garden of the title is Mary’s aunt Lilias’s creation. It has been virtually abandoned since the accident that resulted in Colin’s premature birth and Lilias’s death. Colin himself, while overprotected by the servants, is ignored by his depressed father and hidden in the estate. Mary discovers and rehabilitates both the secret garden and her secret cousin with the help of the working-class Sowerby family, including the servant Martha, her brother Dickon (a boy in tune with nature), and their mother Susan. Archibald, travelling across Europe to escape his sadness, is called back to the garden by a dream of his dead wife and returns to find Colin healthy and walking.

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When Mary Lennox (Margaret O’Brien)’s parents die in a cholera epidemic, she is sent from India to live with her uncle, Archibald Craven (Herbert Marshall) at Misslethwaite Manor, his large and lonely estate on the Yorkshire moors. A neglected, lonely, and disagreeable child, Mary changes through encounters with the gregarious maid Martha (Elsa Lanchester), an elderly gardener as irritable as she is, and Martha’s brother Dickon, a boy at home with nature who helps her rejuvenate the walled, neglected garden she finds on the estate.

Mary also unravels the mysteries associated with Misselthwaite Manor and her uncle’s family. A dramatically unhappy man, Lord Craven is a widower with a spinal deformity who fears he is losing his mind. He has locked the garden after his wife’s death, and similarly hidden away their son Colin, whom he thinks has inherited his bodily and psychiatric illnesses. When Mary discovers her cousin by following the sound of crying in the middle of the night, the two become friends. Whereas the domestic staff indulge Colin for fear of his temper, his reputed invalidism, and his father’s displeasure, Mary rebukes Colin, seeing her own former imperiousness in his bad behavior. She and Dickon bring Colin into the garden, where he grows strong and healthy, defying doctors’ orders and surprising his father—who has come home to sell the estate--by walking into his arms.

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While riding on a commuter train, Bill Chalmers suddenly forgets who he is and where he is headed. His amnesia is accompanied first by a numbness of his hands and then later his legs. Eventually he is confined to a wheelchair and dependent on his family and a home nurse to care for him. Despite extensive testing and consultations with a variety of doctors, no one can make a definitive diagnosis of his illness.

Chalmers is subjected to many empirical treatments including antidepressants, steroids, plasmaphoresis, and psychotherapy, but his health continues to deteriorate and he loses his job. His wife and son become victims of his predicament. By the end of the story, Chalmers gains insight into his life and discovers that only his dignity still remains in his control.

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This anthology culls 1,500 excerpts from approximately 600 works of literature primarily written in the past two centuries and representing all major genres--the novel, drama, poetry, and essay. These brief selections highlight how literature portrays the medical profession and also provide ample evidence of many recurrent themes about the doctor-patient relationship and the personal lives of physicians present in the pages of fiction.

The book is organized into eleven chapters devoted to the following subjects: the doctor's fee, time, bedside manner, the medical history and physical examination, communication and truth, treatment, detachment, resentment of the medical profession, hospital rounds, social status, and the doctor in court. Many well-known authors including Anton P. Chekhov, Sir Arthur Conan Doyle, Ernest Hemingway, Thomas Mann, W. (William) Somerset Maugham, Leo Tolstoy, Tennessee Williams, and William Carlos Williams are featured in this anthology but less notable writers are also introduced. A twenty-three-page bibliography of primary and secondary sources is a useful element of the book.

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After five unproductive meandering sessions, Mr. Trexler, the patient, turns the tables on his psychiatrist, batting back to him the question he has just been pitched: "What do you want?" The doctor's pathetically shallow and concise answer, "I want a wing on the small house I own in Westport. I want more money and leisure to do the things I want to do"(101), propel Mr. Trexler towards compassion for the doctor, and a feeling that he himself had regained his own quirky hold on the world.

After leaving the "poor, scared, overworked" doctor, Trexler thought again about what he wanted: "'I want the second tree from the corner, just as it stands,' he said, answering an imaginary question from an imaginary physician. And he felt a slow pride in realizing that what he wanted none could bestow, and that what he had none could take away. He felt content to be sick, unembarrassed at being afraid; and in the jungle of his fear he glimpsed (as he had so often glimpsed them before)the flashy tail feathers of the bird courage"(102-3).

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Aerobics of the Spirit is a collaborative permanent online exhibition of art by Mary Anne Bartley and poetry by Emanuel E. Garcia, M.D., featuring twenty-nine images and five poems that reflect on sickness. The actual art represented on line consists of acrylic polymer emulsion color canvases and originated at Villanova University, where Bartley is Artist-in-Residence.

The first display (the homepage) includes an Artist's Statement outlining the two artists' tenets that art has a great medical value in the healing process, and that the utilization of one's inner creativity is a powerful treatment in stress reduction. Bartley suffered as a young girl from acute rheumatic heart disease and later became a pioneer in the field of Art in Medicine. Dr. Garcia is a psychoanalyst and psychiatrist who specializes in the treatment of creative and performing artists.

The first display (image 1) also includes artwork, "Lamentations"-- three sliced off faces in profile on a background of mottled blue-green-yellow-brown. Underneath the faces are outstretched arms with reaching fingers, seeking small heart shaped objects that float nearby.

The third and fourth displays (images 2 through 8, plus un-numbered kite drawings), "A Flotilla of Healing Kites," is meant to evoke feelings including freedom of spirit and place, deliverance from ailment, and childhood wonder. Bartley and Garcia include a song by psychotherapist Bruce Lackie, PhD, recognizing "the importance of the arts in healing the spirit." Reminiscent of Jackson Pollack's work, Bartley's kites possess a vibrant energy that, in contrast to what many would find macabre subject matter--sickness and death--elicits hope and joy from the viewer. Other works exhibited later in the online exhibition are non-representational images, often portraits, which make use of color and unconventional painting techniques to convey similar emotions.

The fifth and sixth displays (images 9 through 12), "Collaboration of Poet and Artist," is a joint project begun at The College of Physicians of Philadelphia, Section on Medicine and the Arts. Here, Garcia and Bartley dialogue with one another's work in a "Responsorial Psalm." This section includes the text of two poems by Garcia and a reading by him of one of them.

The seventh and eighth displays (images 13 through 24), "Portraits of Our Self and Others: Intimate Conversations We Have with Our Self," focuses on the power of facial depiction in bringing "new meaning to the past," and to "help rescue [an artist] from the depth of mourning." Included are the text and a reading by Garcia of his poem, "Portraiture."

The ninth display, "Vers la Flamme," pairs a three-part poem ("The Consultation," "The Stay," "The Cure") with three paintings-- the kite shaped drawing, "Behind the Dancer's Mask," and images 25 and 26.

The tenth display (image 27), "Homage to Wilma Bulkin Siegel, MD", pays pictorial tribute to Dr. Siegel, a "pioneer in the hospice movement"

The eleventh and twelfth displays (image 28), "Homage to Healers: John Y. Templeton, III, MD," features a painting of surgeons' hands covering an abstract human heart and a corresponding poem and reading. Mary Anne Bartley explains in text following the image Dr. Templeton's role in saving her life during her teenage years, and again "salute[s] this gentle healer:" "I carry the fingerprints of this great man in my own heart."

Dr. Garcia's poem, "Homage," expounds on Bartley's pictorial sentiment with words: "Darkened to nil . . . / to surrender to a surgeon's tryst, / Hands on my heart to cut and to caress / Deeper than any lover any lover ever would." The display also includes photographs of Bartley as a young patient in 1967 at the time of her surgery, of Dr. Templeton, and of all three--Garcia, Bartley, and Templeton--at an exhibition.

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In 1917, the poet Siegfried Sassoon protests the war in a London newspaper. He is saved from court martial by a military friend who argues successfully for his transfer to the Craiglockhart War Hospital where he comes under the care of psychiatrist, William Rivers. Sassoon is not sick, but he and his doctor both know that the line between sanity and insanity is blurred, especially for a homosexual and in a time of war.

The other patients, however, are gravely wounded in spirit if not body; sometimes they are tormented by uncomprehending parents and wives. Rivers’ efforts to unravel their nightmares, revulsions, mutism, stammering, paralysis, and anorexia begin to shake his own psychic strength and lead him to doubt the rationality--if not the possibility--of restoring them to service. He yearns for his pre-war research in nerve regeneration, the quixotic enterprise that serves as a metaphor for his clinical work.

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