Summary:

This book contains 17 short stories, all set in an in-patient hospice, all exploring the reactions of patients and their caregivers--both family members and professionals--to the last stages of terminal illness. A woman struggles to find the strength to write last letters to her loved ones, nurses are surprised when a seemingly unconscious patient suddenly joins in their conversation; the hospice chaplain becomes a patient; and so on. In the title story, a dying woman's daughter finally manages to answer honestly when her mother asks when death will come: "Soon."

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This is one of the two dozen studies of patients with right-brain disorders that make up Sacks's volume The Man Who Mistook His Wife for a Hat. The nineteen-year-old Rebecca has significant physical and mental defects (her IQ is 60 at best), and by conventional neurological standards she is severely impaired, but Sacks discovers that she has moments of being quite in touch and "together" (her word).

The essay tells of Sacks's discovery of Rebecca's poetic expression and spiritual qualities, and of her self-awareness, in planes unknown to standard neurological and psychiatric categories. Sacks is broadly critical of psychological and neurological testing as constituting a "defectology" that is blind to important human qualities. He warmly recommends music and story-telling, both as modes of understanding and also as narrative therapies that work by ignoring the defects and speaking to the soul.

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Nan Shin was an American woman living as a Zen Buddhist nun in France. She is diagnosed with advanced uterine cancer, undergoes surgery and chemotherapy and, by the end of the book, it appears, is dying. Her account does not, however, take the conventional form of the illness narrative; in fact its form might be called anti-narrative, for its focus is not on the story of Shin's illness and dying, but rather on the "every day living" that is at the center of her Zen beliefs.

The book consists of several strands that recur in alternating sections. One strand describes, in minute detail, the course of a single day's devotions and activities in the life of a Zen nun. Another traces the author's travels in the United States with her sensei, an astonishing man whose perspective on American culture is both detached and hilariously insightful.

A third tells of the author's frequent horseback rides through the French countryside, with beautifully focused and precise descriptions of the natural surroundings. Finally, there is the illness, presented matter-of-factly but conveying powerfully the author's (not always wholly successful) efforts to put into practice, in such trying circumstances, all she has learnt as a practitioner of Zen.

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Malcolm Vaughan, an architect, his wife, Sarah, a biochemist, and their five-year-old son, Harry, are driving home one evening. The driver of the car in front of them is acting strangely. Malcolm goes to investigate and the driver shoots him dead. The novel traces the effects of Malcolm's death from the alternating points of view of his wife and his best friend, Deckard Jones, a black Vietnam vet. Following different and often conflicting trajectories but linked by their love for Harry, both Sarah and Deck begin to move from traumatized shock to the beginnings of recovery.

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Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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Adam and Seth Bede work as carpenters in the little village of Hayslope. Seth proposes to Dinah Morris, a gifted Methodist preacher, but she wants to devote herself to God's work. However, neither Dinah's faith nor her aunt Mrs. Poyser's sharp country truths can deflate the vain fancies of her pretty Hetty Sorrel (Mrs. Poyser's other niece). Although good Adam woos Hetty, she is distracted by the idle attentions of Captain Arthur Donnithorne, and when Adam finds out, he fights Arthur, who leaves town.

But when Hetty realizes she is pregnant, she runs away to see Arthur, only to find, arriving destitute after a difficult journey, that his regiment has been called away. Hetty restrains herself from suicide and gives birth in a lodging-house, then runs off with the infant and buries it in the brush, where it dies. After she is convicted for child-murder, Arthur finally hears the news, and Hetty's commuted sentence (transportation) saves her from the gallows. Two years later, Adam and Dinah realize they love each other, and they marry.

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The novel opens with a man known only as Pilgrim hanging himself in London in 1912. Despite being pronounced dead by two physicians, he somehow lives. Pilgrim has attempted suicide many times before but is seemingly unable to die. He claims to have endured life for thousands of years but has tired of living and only longs for death. He has crossed paths with many historical figures including Leonardo da Vinci, Saint Teresa, Oscar Wilde, and Auguste Rodin.

After his most recent suicide attempt, he is admitted to a psychiatric facility in Zurich as a patient of the famous Swiss psychiatrist, Carl Jung. Pilgrim eventually escapes from the institution and masterminds the successful theft of the Mona Lisa from the Louvre. Next, he sets the cathedral at Chartres on fire. The novel ends with Pilgrim driving a car into a river on the eve of World War I. His body is never found.

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The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

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At the age of 42, Barbara Rosenblum learns, after several misdiagnoses, that she has advanced breast cancer. This book, co-written by Rosenblum, a sociologist, and her lesbian partner, Sandra Butler, a feminist writer and activist, is a record of their lives together from the diagnosis until Rosenblum's death three years later. Early on, Rosenblum decides that her dying will be exemplary and self-conscious, and she and Butler use their writing as a way to create an illuminating examination of their lives over those three years.

The book's title is accurate; the writing takes the form of alternating meditations by two women, on the effects of cancer on their relationship, their work, their families, and their social, political, and spiritual beliefs. Especially significant are the differences between their voices, and the differences between the experience of the person who is dying and that of the person who is going to have to survive and grieve. The writers bravely explore the conflicts between them as well as their profound bonds.

After a mastectomy and eighteen months of chemotherapy, Rosenblum has a very brief respite, followed by liver and lung metastases, and prolonged further chemotherapy. A few months after ending treatment, she dies at home.

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This brief autobiography, written when Schweitzer was mid-50's, summarizes his life and thought up to 1931. He presents illustrative factoids and incidents from his childhood and student years, then briskly covers his development as a minister, philosopher, biblical scholar, musician, and musicologist, all before he reaches Chapter 9 (p. 102), which is entitled, "I Resolve to Become a Jungle Doctor." He greatly enjoyed his life as a scholar, yet was plagued by "the thought that I must not accept this happiness as a matter of course, but must give something in return for it." (p. 103)

He was particularly struck by the fact that so many people in the world were "denied that happiness by their material circumstances or their health." At around this time (1904), Schweitzer came across a publication of the Paris Missionary Society, which described the needs of their Congo mission. This article changed his life. In 1905, at the age of 30, he enrolled in medical school at the University of Strasburg. (Thus, Schweitzer became a forerunner of today's nontraditional applicants who leave other promising careers to enter medicine.)

Schweitzer and his wife began their work at Lambaréné in Gabon, West Africa, in 1913. As a result of the Great War in late 1917, they were sent back to France and detained as enemy aliens until mid-1918. They returned to Lambaréné and rebuilt the hospital in 1924. Between then and 1931 when Out of My Life and Thought was written, Schweitzer devoted most of his time (as he would for the rest of his life) to doctoring at his hospital in Gabon.

This memoir also includes brief intellectual asides describing many of Schweitzer's famous works, such as The Quest of the Historical Jesus (1906), J. S. Bach (1908), On the Edge of the Primeval Forest (1920), Philosophy of Civilization (1923), and The Mysticism of Paul the Apostle (1930).

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