Summary:

This is a collection of related stories, sketches, poems, and a one-act play by Jean Toomer, a little-known writer of the Harlem Renaissance. The book is divided into three sections. The first part of the book is a series of stories that portray the lives of poor black women in rural Georgia. They deal with such subjects as infanticide ("Karintha"), miscegenation ("Becky"), hysteria ("Carma"), lynching ("Blood-Burning Moon"), and religious mysticism ("Fern" and "Esther"). Taken together, these stories portray an intuitive, violent, spontaneous, and pre-rational culture.

The second part of Cane takes place in Washington, DC, where Toomer depicts the life of urban black Americans in the early 1920's. Here we encounter the conflict between rationalism, as represented by the well-educated "intellectuals," and traditional lifestyle and morality. The best stories in this section include, "Avey," "Theater," and "Box Seat."

The last section is a one-act play ("Kabnis") about two urban black writers attempting to establish a contemporary "Negro identity" in light of the repression and suffering of their people. One is overwhelmed by negativity and a sense of victimization, while the other man believes that the past can be transcended, especially through the power of art.

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For more than fifteen years, Irish-born Grace Marks has been confined for the 1843 murder of housekeeper, Nancy Montgomery, and her employer, Thomas Kinnear, at their home north of Toronto. Her convicted accomplice was hanged, accusing Grace with his last breath, but her sentence was commuted to life in prison at the last minute. Because of her amnesia and outbursts of rage and panic, she was held in the Lunatic Asylum before being sent to the Kingston [Ontario] Penitentiary.

Beautiful, intelligent, and strangely poised, Grace intrigues worthy townsfolk, spiritualists, and some of her jailers, who grant her the privilege of outside work, believe in her innocence, and strive for a pardon. In looking for medical approbation, they consult Dr. Simon Jordan, a young American doctor who is interested in insanity and memory loss. Without explaining his purpose, he brings her vegetables and other familiar objects, hoping to stimulate recollection of her life.

Interspersed with Jordan's own problems, Grace's story unfolds in her own words, from her poverty-stricken childhood in Ireland and the emigration voyage that killed her mother, leaving her and her younger siblings to a neglectful father, through her short life in service, to the dreadful events of autumn 1843. She has suffered many losses, including the death of her mother to ship fever, and that of her friend and fellow servant, Mary Whitney, from an illegally procured abortion. After many weeks, Jordan abandons his project in frustration and ambiguity. The novel ends years later with forty-six year-old Grace's discharge from prison in 1872, nearly thirty years after the crime.

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Note: I try not to reveal too much here. Nevertheless, I urge you to read the book first. I would not want the magic of reading this book to be diminished by too much foreknowledge--no matter when the book is initially opened.

Harry Potter and the Order of the Phoenix is the fifth book in a planned series of seven (see Harry Potter and the Sorcerer's Stone for an introductory summary). Harry is now fifteen years old. The opening chapter, "Dudley Demented," features a return of the Dementors (see Harry Potter and the Prisoner of Azkaban), who had been sent to Harry's neighborhood in Little Whinging to deliver their soul-sucking kiss. In order to repel the Dementors and save himself and his bullying cousin Dudley Dursley from the kiss's death-in-life, Harry uses magic. This transgression from rules on underage wizardry leads to Harry's near expulsion from his school, Hogwarts, and a trial by the full court, the Wizengamot, led by Cornelius Fudge, in the Department of Mysteries of the Ministry of Magic.

Headmaster Albus Dumbledore, concerned with Harry's safety as well as with leading the resistance efforts (The Order of the Phoenix) against the resurgent evil Lord Voldemort, not only prevents Harry's expulsion, but also organizes the guard for Harry's transfer from the Dursley home to the ancient house of Harry's godfather, the wonderfully moody and complex Sirius Black. Sirius, like Harry's parents, would risk anything for his godson, but the relationship is charged by Sirius' goading of Harry to be more cavalier like James Potter--Harry's father and Sirius' best friend--and by Sirius' antipathy towards being imprisoned in his ancestral home, filled with reminders of his pureblood wizard family.

These include a portrait of his raging, hate-filled, deceased mother and a malevolent house elf, Kreacher. Communication between Harry and Sirius is a key theme in the book, as Harry looks to Sirius for guidance on the tribulations of adolescence and to satiate Harry's continued craving for information about his father. Harry's emotional tether is short in this novel, and runs the gamut from frustration and envy that his two best friends, Ron and Hermione, were made prefects of Gryffindor House, to despising two teachers (potions teacher Snape, of course, and the new venomous, officious Defense of the Dark Arts teacher, Dolores Umbridge) and finally to absolute fear and hatred of Voldemort, his mortal, yet intimate, enemy.

Harry's scar pains him almost continuously now that Voldemort has returned in the flesh, and also now that Harry has dreams and visions of Voldemort's actions. With this ability, Harry envisions himself as a snake and witnesses the wounding of Ron's father, Arthur Weasley. This episode leads to two visits to the wizard hospital: St. Mungo's Hospital for Magical Maladies and Injuries. The reader is deliciously informed that the personnel in green robes are not doctors ("those Muggle nutters that cut people up" p. 484), but rather Healers: wizards and witches who passed a large battery of tests in a range of subjects to qualify for such training.

The hospital is a mix of the mundane (the irritable receptionist) and the arcane (patients suffering from bizarre spell damage). Mr. Weasley's recovery from the nearly lethal snake bite suffers a minor setback when Trainee Healer Pye (not the Healer-in-Charge, Hippocrates Smethwyck) tries some "complementary medicine . . .

[an] old Muggle remed[y] . . .

called stitches . . . " (pp. 306-7). The loving Mrs. Weasley, whose temper is notorious and hence humorous, shouts at her husband that even he "wouldn't be that stupid" as to allow his skin to be sewn together. (p. 307)

While in the hospital, Harry and his friends encounter schoolmate Neville Longbottom visiting his parents, who suffer dementia caused by dark magic performed by one of Voldemort's Death Eater followers. Mental illnesses prove far more difficult to remedy than bodily injuries and maladies. Indeed, late in the book, Madam Pomfrey, the Healer at Hogwarts, wisely advises that "thoughts could leave deeper scarring than almost anything else." (p. 847) As Dumbledore, the embodiment of sagacity, states, memories of old hurts, slights and abuses, make "some wounds run too deep for . . .

healing." (p. 833)

Other medically related items include the Skivving Snackboxes--an assortment of magical treats and their antidotes concocted to fake various illnesses in order to skip classes, and Umbridge's detention punishment which results in the painful etching of the required written phrases on the back of the hand of the miscreant student.

Professor Snape is charged with teaching Harry the subtleties of mind-reading (Legilimency) and its prevention (Occlumency), in an effort to prevent Voldemort's use of Harry's mind. "The mind is a complex and many-layered thing," says Snape, and hence the mind cannot be read like a book. (p. 530) Harry's failure at these lessons leads to the denouement of the book and ultimately to the loss of someone very dear to him. After the inevitable confrontation between Voldemort and Harry, Dumbledore gently coaches Harry through his guilt and anger to teach him about destiny, love and death.

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In 1869, national and medical attention was focused on a poor family in Wales. The daughter, twelve year-old Sarah Jacob, was bedridden with a strange ailment characterized by paralysis, staring fits, and anorexia. Yet she did not waste away. On the contrary, she seemed to survive comfortably with only few drops of water daily. Credulous folk came to visit, knowing that such abstinence had been the practice of many Christian saints; they would leave a few coins as an offering, although the family protested that money had never been requested. Others claimed it was a hoax.

Eventually the doctors and vicars became curious. An initial investigation upheld the family’s position that the girl did not eat. A more rigorous second investigation was designed by medical professors from Guy’s Hospital in London and carried out by trained nurses who sat knitting at the bedside. It resulted in the girl’s death.

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Sam and her partner are getting ready to go out. She is due to have a baby soon, and they need to acquire just a few more items to complete the nursery and baby wardrobe. Sam wants a Forever Baby duvet, but realizes that it may be difficult because duvets are large and hard to conceal. Slowly it emerges that her trendy baby supplies are stolen.

Sam stops by the clinic where an assistant makes the mistake of asking if this is her first pregnancy. The glance from a colleague silences her, but Sam notices. She has no baby now but she remembers her little girl who "ought to have kept out of his way" although she was hiding in her duvet.

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The film covers a brief period in the life of a working-class English family: Mum (Tilda Swinton), Dad (Ray Winstone), their 18-year-old daughter, Jessie (Lara Belmont), and 15-year-old Tom (Freddie Cunliffe). They have recently moved from London to an isolated cottage on the Dorset coast. Mum gives birth to a baby girl, Alice. Tom discovers that Dad is sexually abusing Jessie. When the baby is hospitalized with an unexplained injury, apparently genital, Tom tells Mum about the incest, and when Dad confronts him and denies it, Tom stabs him.

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In a village of Reybuzh lives an elderly tyrant who has two sons, one of whom works in a factory in the city, while his ailing wife lives in the village with her in-laws. The other son, a disabled alcoholic, has remained at home; his wife is "a handsome young woman, smart and buxom." The two wives are essentially no more than servants in their father-in-law's house. One day a traveler stops overnight in the village. Before going to bed, he relates the sad tale of Kuzka, his adopted son. The boy's mother was beaten by her husband. She subsequently poisoned him and, after being convicted of murder, died in prison.

Later that night, one of the young wives (Varvara) returns home from a toss in the hay with the priest's son. The other (Sofya) accosts her, and they discuss the traveler's story as they ruminate on their own terrible lives. Varvara suggests that they could poison her drunken husband and their father-in-law. Sofya is tempted, but frightened of being caught, and of God's punishment. The next morning the traveler settles his account, and he and the young boy leave.

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This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.

The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.

Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."

This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.

Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.

Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).

These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.

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This book's title is from a Goethe poem, "The Holy Longing," translated from German in its entirety by Robert Bly: "And so long as you haven't experienced / this: to die and so to grow, / you are only a troubled guest / on the dark earth." Ten intensely personal essays tell of the suffering and everyday presence of pain of a severely disabled writer who has advancing multiple sclerosis, and of how, "in a very real sense, and entirely without design, death has become [her] life's work." (p. 13)

Beginning with her father's sudden death when she was a child, the essays describe her aging mother's expected death and the family's decision to take her off life support; her caretaker husband's diagnosis of metastatic cancer with uncertain prognosis; her own attempted suicide; death of friends, pets, including her beloved dog; and a young pen-pal executed on death row. If that weren't enough, a coda, her foster son's murder and again the decision to remove life-support, provides "[t]he end. For now." (p. 191)

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When Gerald is three, his mother, a drug addict, leaves him alone one time too often and he accidentally sets the apartment on fire. His mother is imprisoned for negligence, he goes to the hospital, and thereafter lives with "Aunt Queen," a great-aunt who exercises considerable authority from her wheelchair, and gives him all the love his mother hasn't.

When he is 9, however, his mother returns with a new sister and a man who claims to be the sister's father. They want to take him "home"; Gerald wants to stay with Aunt Queen. The matter is settled unhappily when Aunt Queen dies of a heart attack.

Gerald soon learns to despise his stepfather for his violence and, eventually, for the abuse of his half sister, which she hides out of fear until she's driven to confess it to Gerald in hope of his protection. Their mother remains in denial about that problem as well as her own and her husband's addictions to alcohol and drugs.

Caring for his sister, however, keeps love in Gerald's life. In defending her one last time, the apartment catches fire and his stepfather is killed. As he, his sister, and his mother ride away in the ambulance, a flicker of hope survives in the darkness for another new chapter in family life, this time without violence.

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