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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The author tells the story of two Native-American (Chippewa) families whose lives interweave through several generations during the years 1934-1984. The primary setting is a reservation in North Dakota. The main characters, Marie and Nector Kashpaw and Lulu Lamartine, are colorful, sympathetic people caught in a love triangle that endures for most of their adult lives. "Love medicine" represents an attempt by a Kashpaw grandson to assure once and for all that his aging grandfather will love and be true to his wife and cease "hankering after the Lamartine." The plan ends in disaster when corners are cut and the authentic old Indian customs for preparing the "love medicine" are circumvented.

There is a strong sense of the blending of cultures--religion, medicine, commerce, education all take on the distinctive qualities of an evolving mixed culture. Displacement and disenfranchisement are a fact of life, taken almost for granted, with humor, but not without a response. "They gave you worthless land to start with and then they chopped it out from under your feet. They took your kids away and stuffed the English language in their mouth . . . They sold you booze for furs and then told you not to drink. It was time, high past time, the Indians smartened up and started using the only leverage they had-federal law." (p. 326) So begins an initiative to establish a gambling casino; "gambling fit into the old traditions . . . . "

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A Kiowa Native-American, so obese he looks "like a grand piano in soft sculpture," visits the narrator's office. The Kiowa is a teacher and lover of words, but back home on the reservation, the old sources of inspiration are gone--"the old stories disappear"--and he knows "at the center of himself he is starving." (The obesity comes from this desperate need for feeding!) The narrator, who is probably a writer and teacher herself cannot help him.

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The poem presents a Native-American woman hanging by her fingers from a window ledge 13 floors above the street. As she tries to decide whether or not she'll let go, she thinks of all the reasons that have led her to consider suicide: she feels broken in "several pieces between the two husbands she has had"; here in a crowded Chicago tenement, she is out of her natural native place in the north; she is poor; she suffers from racial discrimination; she hears voices; she cries "for lost beauty." She considers her three young children and remembers her own childhood. The poem ends with the either/or choice still not made--either she will fall to her death or she will climb back in the window and reclaim her life.

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A Mexican-American woman has an appointment for her son Jorge to be seen at the Anglo clinic. She insists on keeping the appointment, even though her relatives think she is crazy. She reflects on events in her life--Jorge's congenital heart disease, the fact that she had a tubal ligation after his birth, and that the heart disease might have been a punishment from God. She reflects upon the fact that often people go for clinic appointments, only to find that the Anglo doctors aren't there and another appointment must be made. She carefully selects Jorge's clothes. She takes the crowded bus.

Finally, at the clinic two doctors enter after a long wait. One is a psychiatrist. In this last scene it becomes evident that Jorge has already died. His mother has brought a bundle of Jorge's clothes to the clinic for "his" appointment, still hoping for a miracle. Referring to the psychiatrist, the woman doctor tells the mother, "He will make you better."

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Tama, a young Maori man who works as a clerk in Wellington, receives word that his father has died. He flies home to northern New Zealand, participates with his mother and siblings in his father's wake and funeral, then returns to Wellington to collect his belongings. As the eldest son, he is now responsible for the family and must return to the family farm. The story begins on the morning that Tama catches the train to Wellington; the events of the preceding week flash back and forward through his consciousness during the long, lonely railroad trip.

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