Summary:

This is a story of a day in the life of 12-year-old Albert Abrams in Brownsville, Brooklyn, during the Depression summer of 1934. Albert’s father is an irascible middle-aged general practitioner whose practice is getting smaller and smaller. Most of his patients can’t pay; and many have left Dr. Abrams to go to younger doctors, or to specialists. Albert’s mother is a refined literary-type lady who never complains about their life in the deteriorating neighborhood, even though all of their middle-class friends have moved elsewhere.

Albert is a brilliant young man ("the highest IQ in the school"), but his greatest desire is to be "one of the boys." He is small, skinny, and poor at sports. The other kids make fun of him because of his "rich" father. The novel describes a long day of verbal and physical harassment; its highlights are a critical punchball game between the white kids, mostly Jewish, and black kids of Longview Avenue, and a fistfight in which Albert actually "beats" one of his perennial nemeses. In the evening there is a fire in which Yussel Melnick, an old Talmudic scholar, is burned to death.

Peeking out from behind his son’s story is the image of Dr. Abrams, a man who once was the star of his medical school class, but whose career long ago failed to "take off" because of his bluntness, bad-temper, and general difficulty getting along with other professionals. He is portrayed as a man truly committed to his patients, but also prone to yelling at them and hounding them for payment. As the day progresses, it becomes evident that Dr. Abrams has been losing his grip; he has episodes of confusion and appears to be on the verge of a nervous breakdown. In the end, stimulated by love for his son, he rouses himself from suicidal ruminations.

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In this verse for children, Silverstein plays with the idea of malingering: the protagonist, "little Peggy Ann McKay" invokes all kinds of alarming ailments from the common to the bizarre ("My hip hurts when I move my chin") in order to stay home from school. The poem swings with a couplet rhyme scheme until the dramatic turn, when little Peggy discovers it's Saturday. She is miraculously freed of all symptoms and one can imagine her puckishly skipping out the door to play.

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To whom shall I tell my grief? Grief must be shared. The son of Iona Potapov, an old cabman, has died. He sits lost in his thoughts, mourning his son. He tries to share his feelings (or at least to tell his story) with each of the people who engage his cab. Iona says to each of them, "My son died last week."

The first passenger responds by asking, "What did he die of?" Iona tells a second group of passengers, "This week my son died." They give him a flip response, "We shall all die." Again, this trivializes his story and his feelings. No one listens. No one is willing to make contact with him. When he tells one of his colleagues at the yard, "but my son is dead," the person doesn't even bother to answer.

Iona "thirsts for speech." He needs to occupy his mind, to share his anguish, to avoid the silence in which he imagines his son. "To talk about him with someone is possible, but to think of him and picture him is insufferable anguish . . ." In the end Iona is reduced to experiencing some relief in the warm, animal companionship of his horse. As he tells his sad story to the mare, she "breathes on her master's hands."

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This quiet little story has two parts. In the first section, the narrator remembers an incident that occurred when he was a high school boy. He was traveling with his grandfather in the Ukraine and they stopped to rest at the home of an Armenian family. The boy was virtually struck dumb by the beauty of the young woman who served them tea. While his grandfather slept, he stood outside in the yard and watched the exquisite young woman do her chores.

In the second section, he remembers an incident from somewhat later, when he was a university student. His train was stopped at a station, and he had gone out to stretch his legs on the platform. He noticed a carelessly dressed young woman, who was standing outside a train window, speaking to one of the passengers.

Once again, he was "suddenly overwhelmed by the feeling I had once experienced in the Armenian village." The narrator also notices the battered and ugly telegraph operator staring at the girl with "a look of tenderness and of the deepest sadness, as though in that girl he saw happiness, his own youth, soberness, purity, wife, children . . . " A bell rang, and the train moved off.

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This story is in the voice of a young boy whose father is unemployed and reduced to begging. Father and son stand on the street outside a restaurant, which sports a placard that says, "Oysters." While the father screws up his courage to ask some passersby for money, the son asks him, "Papa, what does 'oysters' mean?" He answers vaguely, "It is an animal that lives in the sea." But the son asks progressively more specific questions about oysters, ultimately envisioning the creature as a frog with large jaws that lives between two shells.

When two men walk by, the father begs, "Help us, gentlemen!" Simultaneously, the boy cries out "Oysters!" The gentlemen think this is hilarious. They promptly take the man and his son into the restaurant and buy the boy some oysters to eat. Later that night, the boy develops heartburn, while his father regrets that he was afraid to ask the men, who squandered 10 rubles on buying the oysters, for some money.

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Mickey, widowed but one year, and his young son, Duncan, drive East from their home in Wyoming, to vacation with Mickey's family on the Jersey shore. As the story develops, the reader learns that Carol, who died from ovarian cancer, was a westerner, and that Mickey is being tempted to return to the east coast with Duncan and reestablish life there.

The two arrive at the vacation cottage very early in the morning; Mickey needs to be with the ocean and what it means to him; Duncan, who has never seen an ocean, rushes to the experience. The child becomes fearful, as he looks at the vast expanse, calls up the idea of sharks, asks if his Mom waits at the "topic" of Cancer for them. The tension develops when Mickey chooses to swim to assuage his own grief, not realizing that his venture terrifies Duncan. The reunion of father and son points to a new understanding of what it means and will mean to each to go forward without Carol.

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Told from the perspective of a thirteen-year-old girl, this story about a single mother with two daughters who moves, marries, and dies of breast cancer handles a variety of difficult issues with sensitivity and spunk. A list of those issues--absent father, new stepfather, a thousand-mile move to a new social environment, first menstruation, sibling rivalry, an uncle with incestuous impulses, family secrets, sexual experimentation, cancer, and death--might make it sound like a catalogue of the trials of contemporary suburban young adulthood, but in fact the point of view of Tilden, the main character, keeps the story grounded in very believable, sometimes amusing, often poignant, recognizable truth about what it is to come into awareness of the hard terms of adult life.

The mother's cancer is narrated largely in terms of Tilden's experience of it: secrecy, eventual disclosure, partial information, losses of intimacy, feelings of betrayal, confusion about caregivers' roles, and in the midst of it all, the ordinary preoccupations of early adolescence. The generous and understanding stepfather and neighbors with limited but ready sympathies lighten some of the novel's darker themes.

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This historical novel for young adults details the horrors of the Philadelphia Yellow Fever epidemic in 1793 from the point of view of a fourteen-year-old, Mattie, who runs a coffeehouse with her widowed mother and grandfather. In the course of the story, her mother is taken ill, she herself falls ill on the way to the safety of the countryside, and her grandfather dies of heart failure after nursing her. Separated from her mother who is also removed from the city, Mattie finds herself scrabbling for survival in a mostly deserted town after the death of her grandfather, but relocates the free black woman, Eliza, who had worked for her family and who essentially becomes part of her family.

Eventually the mother returns, an invalid but alive, and Eliza and Mattie undertake to run the reopened coffeehouse together and care for Eliza's nephews and an orphaned child Mattie has rescued. Hope reappears with the first frost in the forms of a reopened farmers' market, the return of George Washington to the town, and the reappearance from enforced isolation of Nathaniel Benson, a young painter who gives Mattie a vision of a future life with friendship and love.

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Beginning with an informative introduction on the form of lyric poetry known as elegy, this comprehensive anthology of English-language poems from the late middle ages to the present represents both what endures and what varies in modes of lamentation. The first section (pp. 35-147) is divided into four parts: watching the dying, viewing the dead, ceremonies of separation, and imagining the afterlife. The second, and much longer section (pp. 151-444), is composed of subsections lamenting the gamut of specific losses: dead family members, children, spouses and lovers, friends, those dead by violence, the great and beautiful, poets mourning other poets, self-elegies, and meditations on mortality.

Within each section poems are chronologically arranged "to show how historical and cultural differences have produced aesthetic changes" and to illuminate "the often strikingly transformed procedures for mourning devised by so many poets in our own era of mounting theological and social confusion." (p. 26) An index listing authors, poem titles, and first lines is another way of navigating this voluminous collection.

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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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