Summary:

"My mother danced all night and Roberta’s was sick. That’s why we were taken to St. Bonny’s." Thus begins Twyla’s narrative of her long-term, intermittent relationship with Roberta, another eight-year-old who shares her failing grades and "not real orphan" status at St. Bonaventure’s, the shelter where they live for a few months.

The two girls become fast friends despite the discomfort occasioned by the situation, their problematic mothers (Roberta’s is hyper-religious and unfriendly; Twyla’s is pretty but childlike, an embarrassment to Twyla because of her casual clothing and behavior), and their racial differences (one is white, one African-American). They also share a defining moment, in which they watch bigger girls assault Maggie, a disabled woman who works in the institution’s kitchen.

The girls meet by accident four more times; as young adults in a Howard Johnson’s, where Twyla works and Roberta stops in with two young men on the way to the coast for "an appointment with Hendrix"; in a grocery store in Newburgh, the blue-collar town on the Hudson river where Twyla lives (Roberta lives in white-collar Annandale); at a picket line against a busing plan (Roberta is protesting the busing; Twyla ends up picketing for it); and finally in a diner on Christmas Eve. Each time they meet, they piece together what has happened in their lives, but also return to the defining moment of Maggie, arguing about what really happened and what role they played in the abuse.

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Lenny's development from childhood to adolescence concurs with India's independence from Britain and the partitioning of India into India and Pakistan. The interwoven plots give each other substantial meaning. Partly because Lenny's family are Parsees, a religious and ethnic minority that remained relatively neutral in post-Partition religious conflicts, she has access to people of all ethnicities and religions, both within Lahore and in other locales. More significantly, she has access to a wide variety of viewpoints both pre-and post-Partition through her Ayah, a beautiful woman whose suitors are ethnically and religiously diverse.

Lenny's passionate love of Ayah and the loss of innocence that accompanies their changing relationship through the Partition is an energetic center to the plot. Lenny's relationships with her mother, her powerful godmother, and her sexually invasive cousin are also important to the novel. Lenny's polio forms a significant early narrative thread. Other minor but compelling subplots include Lenny's parents' changing relationship, the murder of a British official, and the child marriage of the much-abused daughter of one of Lenny's family's servants.

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This novel is based on the facts of an actual hantavirus outbreak that took place in the southwestern US in 1993, retelling the events as medical mystery, as ghost story, and as meditation on the relationship between rationalist western medicine and the beliefs of local indigenous cultures.

Dr. Push Foster is part Choctaw and part white, raised in Oklahoma. He returns to Arizona as an Indian Health Services physician at the time an outbreak begins of what is later identified as Hantavirus Pulmonary Syndrome. Western medicine and traditional health beliefs and practices overlap in the investigation and response to the illness as it infects and kills Navajo people.

Querry presents us with a convincing epidemiological investigation into the virus, but also suggests an alternative, or complementary, etiology for the outbreak: an archaeologist has stolen a sacred stone from the Hopi people with the help of a Navajo witch, or shape-shifter, the title's "bad medicine" practitioner. This theft, the novel suggests, is the reason that only Navajo, and one white person (the archaeologist's partner) become ill.

The climax of the story is a showdown between the shape-shifter, a Hopi village headman, and the ghost of a woman killed trying to save her people from the 1805 massacre of Navajo by Spanish troops at Muerto Canyon. (The virus, when first identified, was named Muerto Canyon Virus.) This woman becomes a figure of both vengeance and reconciliation, an uneasy meeting of cultures that echoes and informs the work of Push Foster and his colleague, Sonny Brokeshoulder: both are men of Indian blood with a "white" upbringing and who return to their culture bearing Western medical training, but do not deny the traditional knowledge either.

Unlike most medical thrillers, this book does not offer reductive explanations and answers; instead, we are left with the certainty that traditional and western thinkers must collaborate, not only to care for patients, but to take care of the natural environment on which all our health depends.

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Tessa Quayle, the young wife of a British civil servant in Kenya, is mysteriously murdered. Tessa, a lawyer, had been an outspoken human rights activist, and something of an embarrassment to her husband. But shaken from his marital and political complacency by her death and the rumors that quickly surround it, Justin Quayle sets out to solve the mystery and in doing so inherits her cause.

Tessa had discovered, as Justin now learns, that a new tuberculosis drug was being prematurely tested on Kenyan patients: clinical trials were effectively being carried out on the African population by the drug's giant pharmaceutical producer without the patients' knowledge or consent, but with the support and cover of a global corporation with African interests and of the British High Commission in Kenya. Lethal side effects and deaths were being concealed, the drug retitrated and retested in preparation for its safer and more lucrative release in the west in time for a predicted rise in incidence of multi-resistant strains of TB.

Justin, now a kind of rogue agent, uncovers the layers of sinister plotting to be expected in one of Le Carré's intelligence thrillers, but in the process we are led to consider, vividly, the interlocking roles of international biomedical research, postcolonial political interests, and global capital in determining the fates of impoverished, uneducated, and deeply vulnerable patients in developing countries--as well as the fates of those who try, often against all odds, to offer them the best available care. The novel also gives us, in Justin Quayle's odyssey, a moving study of desire, loss, regret, and, finally, outraged action.

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Frank Eloff, the novel’s narrator, is a white doctor working at a hospital in the former capital of one of South Africa’s now-defunct independent homelands (rural areas set aside by the apartheid government for black "separate development"). The hospital, in its deserted and decaying city, is understaffed and understocked, and there are hardly any patients. Those who do arrive usually need to be taken elsewhere if they need any significant treatment. The homeland’s former leader, the Brigadier, has returned as a criminal gang leader to loot the place, and a white former army commander, now in the employ of the present government, is trying to capture him.

Frank moved to this place when promised directorship of the hospital (and in flight after his wife left him for his best friend), but the previous director has not left yet, and Frank is in a kind of personal and professional bureaucratic limbo. He has a sexual relationship with a black woman who runs a roadside souvenir stall. It is not quite prostitution, not quite a love affair: she is married, speaks little English, and Frank regularly gives her money.

A new doctor, Laurence Waters, arrives. He is fresh from medical school, sent to the hospital in order to complete the rural community service year required by the government of all new physicians. He and Frank become roommates and begin an uneasy friendship. Laurence is an idealist, planning to make heroic changes, but he misunderstands the complex balance of tolerance, cynicism and patience that characterize survival at the hospital, and his well-intentioned efforts, such as trying to end theft from the hospital and to establish a clinic in a local tribal village, lead to disaster. The novel ends with Frank appointed hospital director at last, and things returning to their depressingly ineffective "normality."

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Vanya and Uncle Nicolai, two orderlies in a morgue, are preparing for funeral the body of Trepov ("Known everywhere simply as Trepov" (63), a hated officer because of whom "more [Russian] people were murdered than absolutely necessary." Trepov is the pawn of "the Little Father" (64); both very well may be cruel administrators of an invading force, not necessarily Russians themselves, although this is not clear.

What is clear is that Vanya, the younger orderly, despises Trepov. After finishing the dressing of the cadaver in military finery, replete with "all those gilt-enameled medals" (64). Vanya suddenly closes the door, to Uncle Nicolai’s bewilderment. Even more surprising is Vanya’s determined slapping of Trepov’s face three times. With tacit approval from Uncle Nicolai, Vanya then kicks Trepov. Finally, Vanya slaps, with all his strength "the corpse’s face again. Now we can go, he stammered, his face flushed with the thrill of it." (65)

Vanya goes to bed thinking about the son his wife is expecting (since there was no ultrasound between 1908 and 1912 when Csáth most likely wrote this story, this detail remains mysterious) and how he will boast to him about "that day’s doings." And then he falls fast asleep, "breathing evenly, deeply, like all healthy people" (65).

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This 15-line poem considers how, through the ages, dwarves have been ridiculed. Something about their appearance makes us, in our "big, proper bodies" laugh at them. We "snicker" at the immensely obese as well, even as we are aware of the danger to their health. Then the narrator takes us one step further: "And imagine the small political base / of a fat dwarf."

In the final stanza, the "we" becomes restricted to the narrator and his friends, who are socializing over dinner and can "hardly contain" themselves. But does that let the rest of us--the complicitous larger audience--off the hook?

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The text explores the experiences of a nurse practitioner in an inner city OB-GYN (Obstetrics & Gynecology) clinic and four of her women patients, from a fifteen-year-old homeless pregnant child to a mature woman struggling with cancer. Another of her patients is pregnant and drug addicted; a fourth suffers from pains that come from buried memories of sexual abuse. The stories of all four patients weave in and out of the narrator's own stories about herself, her own health and illness experiences, her own respectful appreciation of the female body.

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As much about the abusive treatment of women, and the clash of traditional and contemporary mores as it is about the HIV/AIDS pandemic, this beautifully crafted novel tells the story of a nineteen-year-old Mosa (for mosadi--woman) who has already lost two brothers to AIDS. The reader is caught up in the mega-deaths and non-mention of the dreaded acronym, AIDS, as the story unfolds. At their brother’s gravesite Mosa’s one remaining living brother is halted as he shovels in the final loads of earth: "All around him were fresh graves . . . He looked at the not fresh, fresh graves, and noted the dates of birth. Young people who had died prematurely . . . He had known about their long illnesses, their deaths and their funerals." (p. 20)

The author is the first (and only) female judge of the High Court of Botswana and a human rights activist. She is internationally renowned for bringing about the Dow Case, which challenged Botswana nationality laws; she argued successfully for revisions allowing women to pass their nationality on to their children.

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Couser, long interested in autobiography, explores the ethics of representation in biographical writing, and in particular, the ethics of representing vulnerable subjects--for example, the aged or very young, the sick or impaired, or those who are "socially or culturally disadvantaged." He is concerned with representation of people who are intimately connected to the biographer, either as family members, or in some other "trust-based relationship." Couser argues that the relationship between vulnerable subjects and their biographers is analogous to that between patients and their physicians and that therefore principles of bioethics should be applied to such life writing, especially the principles of autonomy, nonmaleficence, and beneficence.

Couser explores life writing and betrayal (Chapter 1), outlines how he will apply the principles of biomedical ethics and ethnographical ethics to life writing (Chapter 2), and applies these principles to examples of collaborative autobiography (Chapter 3). He then critiques in detail Michael Dorris’s memoir about his adopted son, The Broken Cord (Chapter 4); the work of Oliver Sacks (Chapter 6); memoirs of euthanasia (Couser calls these "euthanographies"), Saying Goodbye to Daniel: When Death Is the Best Choice, by Julia Cassutto Rothman; Rescuing Jeffrey, by Richard Galli, and But What If She Wants to Die, by George DeLury (Chapter 7). Finally, in the last chapter, Couser considers how investigation of the human genome might influence the "scripts" of our lives and hence life writing, and also how life writing might be a counter discursive force against genomic essentialism.

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