Summary:

In language of the street and of the heart, Belle Waring has put together another wonderful (her second) collection of poems (see annotation of Refuge, her first collection). She writes of relationships starting and ending; her work experience as a nurse--the powerful "It Was My First Nursing Job," "From the Diary of a Clinic Nurse, Poland, 1945," and "Twenty-Four Week Preemie, Change of Shift"; and other miraculous everyday events of living with eyes wide open as exemplified in "The Brothers on the Trash Truck and my Near-Death Experience" and "Fever, Mood, and Crows."

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This is a collection of 111 poems, all about women who are old. As the editor says in her introduction, it is not a book about becoming old, but about being old, and the book bears the pointed reminder that an old woman is still a woman, as well as being old (vii). The poems are arranged in ten sections, from portraits of old women (usually grandmothers, here) as seen by the young, through explorations of their work and wisdom, their relationships and sexuality, the vivid and sometimes shocking realities of their bodies, their illnesses and weaknesses, institutionalization and nursing homes, and finally, their confrontations with death and the sense of loss in those they leave behind.

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The speaker, the "barren woman" of the poem, describes her state as empty. She likens herself to a deserted space, a "museum without statues," at its center a fountain which, rather than issuing life, recycles its water, which "sinks back into itself." She imagines herself as a mother, but recognizes that "nothing can happen." The only one who pays attention is the moon, silently but ineffectually trying to soothe her. (10 lines)

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This is a short bittersweet story of a father's (eventually) successful efforts to teach his seven year old son about the "evils" of smoking. The father, a prosperous and recently widowed prosecutor, begins his "lesson" by first trying to explain the nature of property (his son had taken his tobacco); in the voice of "the nursery" he tries to compel his son not to smoke again.

Then, trying to recapture the teachable moment after this first attempt fails, the father reminds himself that the modern teacher must stand on logic in order to help the child form the necessary principles. Learning should be based neither on fear nor on desire for rewards he tells himself--but he fails again.

Finally the father realizes that he must enter his son's world in order for his son to understand him. This he does through an improvised story wherein a young prince "abandons" his aging father through an early death due to smoking. The connection is made and the young son swears to not smoke again. The father then reflects on the power of story in the lives not only of children, but of us all.

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This collection of vignettes follows the growth and development of one internist as he reflects on some of the critical experiences that shaped him as physician. The common thread of the work is the celebration of the relationship that can, and perhaps should, be built between the physician and his or her patient in the course of caring: this relationship is the sacred space of the title.

The author accomplishes his self-imposed task of describing this space by presenting situations in his practice life that illustrate the concept. The chronological structure of the collection enables the reader to study the maturation of the author as a self-reflective practitioner over the many decades of his professional life. Many of the stories are very funny; others are wrenching; all are gently told.

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Laurence "Tubby" Passmore is a successful scriptwriter for a television sitcom, in his mid-fifties, married and the father of two grown children. He is indecisive and inexplicably depressed, unhappy with himself, his fat body, bald head, wonky knee, and impending impotence. At least, he is confident in his marriage to Sally, an attractive, self-made academic who enjoys sex; on weekly jaunts to London, he maintains a supportive but platonic relationship with the earthy Amy.

Seeking to alleviate his woes, he dabbles in acupuncture and aromatherapy and regularly attends a blind physiotherapist and a woman psychiatrist; the latter counsels him to write a journal. His wife suddenly announces her wish for a divorce and the television network invokes a contractual obligation to make unwelcome demands on his skills. These events shatter his unappreciated but complacent "angst" and deepen his identity crisis.

Laurence scrambles to rediscover himself. He reads the gloomy, Kierkegaard--because he identified with the titles--and he travels to the existentialist's Copenhagen. He pushes the boundaries of his relationship with Amy in a maudlin trip to Tenerife. He befriends a philosophic squatter, called "Grahame" (with an "e" no doubt to distinguish him from Graham Green whose "writing is a form of therapy" is an epigraph to this book). He flies wildly off to Los Angeles hoping to rekindle a one-night stand "manqué." Finally he recalls and tracks the Irish Catholic, Maureen, his first girlfriend from forty years before. Maureen has suffered too--the death of her son and breast cancer; he finds her on the Road to Compostella.

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Canadian artist, Robert Pope (d.1992), devoted the last years of his short life to documenting his decade-long experience as a patient with Hodgkin's Disease. Shortly after his diagnosis he was influenced by the 1945 autobiographical novel of Elizabeth Smart, By Grand Central Station I Sat Down and Wept. Pope's early work explored the interconnectedness and pain of individuals bound by an imperfect love, in Smart's case for a married man. After his disease went into remission, he began to paint the patient's perspective on illness, hospitals, visitors, family, and health-care providers in a series of images that suggest the lighting of de la Tour, the photographic immediacy of Doisneau, and the menacing surrealism of de Chirico. His book, Illness and Healing: Images of Cancer (1991), became a bestseller.

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An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.

At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.

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A surgical intern has participated in 86 year old Mrs. Byrnes's abdominal surgery, where extensive metastases from ovarian cancer are found. The surgeons take biopsies, confirm the diagnosis, and close her abdomen, knowing that her case is not treatable. Later that day, it falls to the intern to inform Mrs. Byrne of what they found.

The author describes how he avoided the task, finding other chores to do, appealing to the attending physician to not make him talk to the patient. The attending insists, and the author finally finds the nerve to talk with his patient. Much to his surprise, she has already suspected that she has cancer, tells him not to be upset, and assures him he did his best. The author discovered that learning to be a doctor meant being open to learning from his patients.

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Summary:

The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.

He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.

Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."

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