Summary:

Dr. Lois Ramondetta was a fellow in gynecologic oncology at M. D. Anderson Hospital in 1998 when she met Deborah Rose Sills, a professor of comparative religion, who had undergone surgery for ovarian cancer the year before and was re-admitted for small bowel obstruction. Ramondetta and Sills "clicked," and their relationship developed over several years from doctor-and-patient to close friendship and eventually co-authorship of this memoir. The women tell separate stories (Sills's are in italics), which interact more and more as the relationship progresses. Ramondetta writes about marriage to a medical classmate, its rapid unraveling under the stresses of residency, her infant daughter, and the complexities of her life as a single mother. Sills' sections tell of a highly regarded professor accepting a life with cancer, but struggling against reinterpreting herself as sick. Some of their interactions take place at MD Anderson Hospital, as Sills returns for a bone marrow transplant and later for management of recurrences and complications.

Their friendship also blossoms at their respective homes in Houston and Santa Barbara. Among the stories they share is that of Ramondetta's courtship and marriage to a local disk jockey, and the rock-solid support of Sills's family.  In addition, they begin to collaborate, first on a lecture and then on an academic paper about spirituality and ovarian cancer. This dialogue eventually leads to the book itself, completed only after Sills's death in 2006.

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After several years as a firefighter, Paul Austin decided to return to school and become a doctor.  Both his training as firefighter and a somewhat late start at medical school gave him an unusual perspective on his selected specialty-emergency medicine.  The book chronicles a wide variety of surprises, learning moments, and challenges from his years in the emergency room.  These are interspersed with vignettes about the interrupted home life of an emergency physician rotating into night duty three to four times a month.  The pace is lively and the stories confessional in the best sense-rich with reflection on what he has learned, often at great cost to his resilient wife and three children, one with Down syndrome.  A strong theme in the book is the importance of developing strategies for sustaining humanity and compassion even under intense pressure to be quick, clinical, and detached. 

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Julian Schnabel’s film version of Jean-Dominque Bauby’s memoir, The Diving Bell and the Butterfly (see annotation), is a re-imagining of the book that offers new approaches to teaching, even while it misses some of the aspects of the book that are so critical to educating medical and nursing students about the experiences of patients. Like Bauby’s book, Schnabel’s movie tells the story of a high-level editor at French Elle who has a stroke and is paralyzed except for the ability to blink one eye and to move his head slightly. Bauby (Mathieu Amalric) awakens from a coma to find himself in a hospital and unable to move or, at least at first, to communicate.

A speech therapist (Marie- Josée Croze) teaches him how to blink in response to letters as she reads through the alphabet, so that letter by letter Bauby can communicate. Friends and family learn this method, and eventually Bauby decides to write a memoir of his experiences using this technique. His publisher finds an amanuensis to transcribe the portions of the book that he first memorizes and then communicates to her painstakingly. The film portrays the process of writing the book, Bauby’s experiences in the hospital with health care professionals, family, and friends, and also some past experiences, such as caring for his aging father and taking a trip with a girlfriend to Lourdes.

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A Place Called Canterbury by social historian Dudley Clendinen, former New York Times national correspondent and editorial writer, provides readers with an intimate and revealing account of aging in a particular place at a particular time--Canterbury Tower in Tampa, Florida. The story about the author's mother, Bobbie--and so many others--begins in 1994, a few years after the death of James Clendinen, Bobbie's husband of 48 years, and known to the community as the progressive editor of the Tampa Tribune. Although she had been "falling apart, a piece here, a piece there...collapsing vertebrae...bent, frail, and crooked...subject to spells and little strokes...." (p. xii),

Bobbie Clendinen was in reasonably good health. Nevertheless, her grown son and daughter did what most children their age do--they worried. When she finally agreed to move from the home where she had lived for twenty-nine years to Canterbury Towers, room 502, two bedrooms, two baths ($88,000 in cash, $1505 each month), Clendinen and his sister were relieved. She would be cared for and safe in "the small, cream colored, obsessively well-run geriatric apartment tower and nursing wing...across a broad boulevard from an arm of Tampa Bay" (see book cover).  And, so many of her old friends were already established residents!

Clendinen was fascinated by his mother's new circumstance and by what he came to regard as the new old age. As a writer, he could not resist the opportunity before him. Although he lived in Baltimore, he could come and go, but over the twelve-year period of his mother's residence--three in the Towers and nine years in the hospital wing--he spent more than 400 days as a live-in visitor, observer, listener, interpreter. This unusual arrangement provided Clendinen with a close-up view of a 21st Century phenomenon, the comings and goings of aging people in the final setting of their lives.

Canterbury is a well-run camp and life there is a soap opera. Between his exchanges with the witty rabbi and the former jitterbug champs, the enthusiasm generated by a nudity calendar proposal (declined) and the geriatric bib enterprise (thriving), the inhabitants provided Clendinen with an abundance of riches. Whether at lunch in the dining room overlooking the Bay, over daily drinks at 5pm, or in bed in the health center, everyone of this Greatest Generation had a story to tell. This ethnographic page-turner, with its cohort of named characters--the Southern Belle, the Rabbi who escaped the Holocaust, Emyfish, the ageless New Yorker, Lucile, the warm-hearted Fundamentalist, the raunchy Atheist, the crusty Yankee, the horny widower, and the maddeningly muddled Wilber--reads like fiction. Whether rich or poor, married or widowed, Clendinen listened as they spoke and in doing so became a trusted friend and chronicler of small and great events in their collective lives: childhood, Depression, World War II, medical advancements, healthcare costs, 9/11. Because Bobbie Clendinen spent so many years in the hospital wing, much of the story describes the kind of care and staff standards that we would hope for all--including ourselves. Mrs. Clendinen died at age 91.

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Lenny Savage (Philip Bosco) lives in the Sun City retirement community in Arizona with Doris, his companion of 20 years. When Doris dies, her children sell their home and Lenny's son and daughter, both in their late 30's, become responsible for his care. Wendy (Laura Linney) is a playwright in New York City. Jon (Philip Seymour Hoffman) is a theater professor in Buffalo. Niether has seen Lenny for many years. He had been an abusive and violent father. The mother is absent, apparently having abandoned the family when the children were young. Both Wendy and Jon seem lost. Wendy is having an unsatisfying affair with a married man and Jon's partner, Kasia, is about to return to Poland because her visa has expired and he is not ready to marry her. Reaquainting themselves with their father forces them to confront the danger of letting unhappy childhood haunt them, and makes them recognize their difficulties being adult (they have Peter Pan names).

Lenny has dementia, probably Parkinson's. Wendy and Jon find him in restraints in a hospital bed. He is hostile from the outset. They take him from the bright light in Arizona to dark sleet in upstate New York, and they put him in a nursing home. Wendy stays with Jon as their father "settles in." She feels guilty but does all the wrong things in trying to make up, while Jon is pragmatic and resentful. Brother and sister get to know each other better. As they bicker, their father seems to watch from a distance with an opacity that is also a kind of dignity. His condition deteriorates and he dies in the nursing home. Wendy returns to New York.

Six months later, Wendy's play about their childhood ("Wake Me up when it's Over") is being produced in New York, and Jon is on his way to give a conference paper ("No Laughing Matter: Dark Comedy in the Plays of Brecht") in Poland where he plans to be reunited with Kasia.

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George Hall has recently retired when he discovers a lesion on his hip which he takes to be skin cancer. Even though his doctor tells him that it is simply eczema, George is not reassured for long. His worry gradually becomes panic. He learns that his wife, Jean, is having an affair with an old friend of his, that his daughter, divorced single mother Katie, is going to marry a man he disapproves of, and that his son, Jamie, intends to bring his gay lover to the wedding. At this point his hypochondria becomes distinctly pathological. He attempts to excise the lesion himself with kitchen scissors and ends up in hospital.

With the help of antidepressants and psychotherapy, he begins to recover, and then, finding other marks on his skin, relapses. Things come to a climax at Katie's chaotic and (for the reader) very funny wedding, where George, on a risky mixture of valium and alcohol, makes an overly confessional speech and then physically attacks his wife's lover. Order is restored with the help of Jamie and Ray, the groom, who turns out to be heroically kind and efficient (and whose working-class status is then forgiven by George and Jean), and the novel ends with happy reconcilations. George's health anxiety has not, though, entirely disappeared and the novel ends with a clear sense of the mental effort required, especially as we age, not to give in to our fears of disease and death.

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In A Step from Death a profusion of memories radiate from a near-fatal accident on Larry Woiwoide's farm in western North Dakota. Woiwode, a novelist and poet of America's heartland, had just finished baling hay when his denim jacket got caught in the tractor's power take-off, "a geared stub at the rear of the tractor that spins at 500 rpm." (p. 9) Caught in the powerful machine with no one around to hear his cries for help, Woiwode could easily have died, but survived by using his pocket knife to free himself from the jacket.

In a sense A Step from Death takes up where the author's previous memoir, What I Think I Did, leaves off. The earlier book focuses on surviving North Dakota's outrageously bitter winter of 1996-97. The current memoir ranges far and wide over nearly 40 years of Woiwode's life as a writer who chooses a difficult but fulfilling life for himself and his family on the land. The memoir is addressed to Woiwode's only son Joseph (the second of four children), with whom he shares his fatherly failures, as well as the strengths of their relationship. The reader soon learns that accidents were no strangers to their life on the northern plains. Woiwode and his wife and older daughter had survived a serious car accident on an icy road in one of their early Dakota winters. Joseph, too, sustained severe injuries as a child when he fell off a horse and again later in a tractor accident. On another occasion, Joseph and his sisters are responsible for accidentally causing a fire that burned down the family barn.

Now, however, Joseph is a married man, a helicopter pilot, with two children of his own. The recollections and wisdom that his father shares with him (and us) flow freely, creating a free associational, rather than linear, narrative. Woiwode explores the deep network of connections that bind him to the land and his family, as well as to the community of creative writers and especially William Maxwell, his long-time editor at The New Yorker, mentor, and father figure. Woiwode explores as well the strong pull of loss in his life-his parents' deaths and eventually that of Maxwell-but A Step from Death is ultimately a celebration of survival.

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Poet Leatha Kendrick is the author of two chapbooks, Science in Your Own Back Yard (see annotation) and Heart Cake. In this full-length collection she continues to examine themes explored in her first titles: love and loss; the fleeting of time; and her personal experience of breast cancer. Second Opinion is divided into three sections: the first two sections have 14 poems each, the final section has 13, perhaps to indicate that for this passionate and articulate poet the the final poem is yet to be written. The first poem in the collection, "A lesson in Love Unleashed," sets the theme for the poems that follow: "yes, I think, even in their distorted flesh, / I still desire what's gone. What I'm leaving" (p. 3). In the first and third sections, the poet writes of marital and familial trials and triumphs, both past and present, and in the second section--for me the most vivid in the collection--she writes about breast cancer and how this experience weaves in and out of her other loves and losses. This weaving is given both visual and emotional expression in the poem "Tonight Weaving" (p. 28)

Throughout the book, Kendrick's poems take varying forms and tones, and yet there is always the assurance of a constant voice--personal, passionate and often humorous. In the second section, the poems become more visually complex and fractured, poetic representation of the "distortion" of the flesh as the narrator considers the diagnosis and treatment of her breast cancer. In this section's opening poem, "The Calculus of a Cracked Cup," the poet writes, "Our position is never certain, only our / velocity" (p. 27), adding the concern of the swift passing of time to the collection's overall theme. In "Second Opinion," the title poem, she notes, "I want to believe in sudden remission, / in some way to avert what we are certainly / headed for" (p. 34). But while time rushes on, the reality of cancer, the loss of a breast becomes a "stopped surface" under which a "lost life" wants "its old course, not subject to IVs or a knife" (p. 35).

It is life--difficult and sweet--that is ultimately celebrated in these poems and that overcomes the losses. The most wry poems are found in the breast cancer section: "Christmas, Adolescence, Yin and Yang" (p. 32) is a sort of ode to "Skeeter and Bite," so named by a first love; now "they'll lift / one out, the eye sewn shut by mastectomy." "Costume. Fakery. The Sell." is a tough, nervy poem that has the narrator claiming acceptance for who she is, post surgery: "Alive! Tender, I'm not hiding" (p. 39). Throughout the book there is a subtle triple play on the word "tender": woman as caregiver; woman as collateral in a society that values cleavage; and woman as injured, post op, and physically vulnerable.

In the collection's final poem, "What You Leave Me," the theme of love and loss balanced against time comes to some resolution as the narrator and her partner join in a "sweet tangle": "the blossoming / hide, this bounded / time against brevity" (p. 64).

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This book consists of a series of "found poems" abstracted from transcripts of interviews that Loreen Herwaldt conducted with 24 writers who had previously published accounts of their illnesses. Dr. Herwaldt, an infectious disease specialist at the University of Iowa, began her investigation into the personal experience of illness after having read Mary Swander's Out of this World: A Journey of Healing and Reynolds Price's A Whole New Life, both of which revealed a negative dimension of medical care. These books initiated an "unexpected turn" (p. 1) in Dr. Herwaldt's life, culminating in a sabbatical year during which she interviewed a wide array of writers, intending to investigate the texture and dynamics of their experience of medical care by textual analysis of interview transcripts.

However, as a result of a further (and fortunate) insight, the author decided to abstract and arrange these texts into "found poems" that have "a concentrated emotional power that the unedited stories did not." (p. 5) Among the authors whose stories of illness appear in these poems are Arthur Frank (see The Wounded Storyteller ), Nancy Mairs (A Troubled Guest: Life and Death Stories), Richard Selzer (Raising the Dead), Oliver Sacks (A Leg to Stand On), Mary Swandler (The Desert Pilgrim: En Route to Mysticism and Miracles), and Christina Middlebrook (Seeing the Crab: A Memoir of Dying). In most cases Dr. Herwaldt has crafted two or more poems giving voice to different aspects of the subject's experience. For example, Richard McCann (pp. 82-90) speaks about loving his primary care physician, why patients can't talk to doctors, what he needs from a doctor, and being labeled as a patient with hepatitis C (cf. "The Resurrectionist").

The author includes a section on "How to Use This Book" (pp.9-20) that summarizes her experience utilizing these poems in medical education settings and provides helpful hints for teaching them.

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This book chronicles a tortured parenthood during the birth and brief life of a severely brain-damaged female infant, Silvie. Doctors predict that the child will live only a few days but instead she survives for seven months. The story is told in first person by the mother, beginning with her arduous labor during a home delivery in the presence of an experienced midwife and the family physician. The baby does not cry when she is born and turns blue even with oxygen that the doctor administers. An ambulance is summoned; "a bigger, better oxygen machine" restores the baby's color and she is brought to a hospital neonatal intensive care unit where she is artificially ventilated and fed.

In the hospital Silvie "fails" all the tests of normalcy. The doctors recommend removing artificial ventilation. "I feared, even more than I feared her death I think (and harder to admit), that they would remove the oxygen pump and the baby would live on and on and never be able to do anything at all" (14). Yet when the child does in fact breathe independently, "I took the fact that she could sustain her own breathing to mean that the baby wanted to live. It was all right to love her" (15). A few days later, however, the medical team concludes that there is nothing further they can do for the baby, that the parents should take the child home, where she will likely die within a couple of days. Upon being prodded, one physician suggests the parents give her an overdose of phenobarbital, which she is receiving for continual epileptic seizures.

At home, the parents feed Silvie by tube, medicate her, change her diapers, hold her, and learn from a friend how to swaddle her. The child never cries, does not focus her eyes on anything, rarely responds to sound or touch, and gains no weight. Whatever random responsiveness there seems to be gives the author a sense of motherhood: "I was able to survive because of my faith in these intermittent chance meetings, believing that Silvie did know when I was here and that I was holding her close in a way that meant love" (37). The parents brace themselves for Silvie's death. The husband's sister visits and councils them to actively put an end to Silvie's life, which they refuse to do. But they do not plan to take extra measures (CPR) if Silvie seems to be dying at home and when they articulate this to a social worker whom they consult to obtain respite care, it becomes clear that she would report them to Child Protective Services.

The husband quits his job as a residential counselor of emotionally disturbed teenagers to do part-time carpentry work -- he is too preoccupied to care about other people's problems. When a friend accidentally breaks the phenobarbital bottle, the parents together with the family physician decide to see how Silvie will get along without the drug. To their amazement, the baby appears slightly more alert and is able to suck from a bottle -- no more feeding tube required. But the husband reminds his wife, "The doctors warned us she might do this. This is the one and only thing she can ever learn. They said when this happened to other parents they started to believe that the baby was getting better" (59).

The parents live in limbo, attempt to live a "normal" life. When Silvie starts to lose weight at age 4 months, the doctor advises to resume tube feeding; they don't see the point, but when hospital physicians use the word, "murder," and threaten to "take over" Silvie's care, the parents relent. The baby lives but "it was the sameness of Silvie that drove you crazy . . . She slept and woke, but was awake that much different? She did not change, she did not change. Her sameness was a stone I wore, an emblem of failure, failed life" (96).

The final act for Silvie begins when the author's mother-in-law is dying of cancer in New York and a decision is made to leave the baby at home in California for several days in the care of a retired nurse. The nurse has been shown how to do the tube feeding, but while the parents are in New York she experiments with spoon feeding, then discontinues tube feeding for three days before the parents return. The parents see that Silvie has deteriorated in their absence and resume tube feeding. For the remaining couple of months the parents wait, investigate institutionalizing Silvie, and finally determine that "the way we loved Silvie meant we loved her enough to let her die" at home, with "a certain amount of fluid and nourishment for comfort, but a gradual withdrawal of excessive food. Replaced with a lot of touching and holding, stroking and whispering" (122). Silvie dies and the author is four months pregnant with the baby she and her husband have decided not to abort.

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