Summary:

In the early Eocene period, a small horse (Eohippus) accidentally dies in the depths of a lake. Over time, the body of the mare decays. Heat and pressure convert the remains of the animal into oil. Thousands of feet beneath the surface of Utah and millions of years later, that oil is tapped. As it travels through a pipeline, a nearby worker is injured. As a result of the accident, the man loses part of his arm.

The worker, Djamolidine Hasanov, was born in Azerbaijan. Before coming to the United States, he changed his name to Jimmy Nash. As a boy, he loved to bicycle. As an adult in America, his pastimes include drinking beer and writing haiku. After he is injured at work, Jimmy becomes a drifter and lives off his disability benefits.

The oil derived from the matter of the prehistoric horse continues its journey through time and space. It is refined into gasoline and transported to a gas station in Austin, Texas. On June 23, 1975, some of that gasoline is pumped into the tank of a Ford Pinto. One drop of the fuel comes from the once-pumping heart of the ancient equine.

The car is driven by Clarissa Sanders, a college student who is enthralled by biology and genetics. Later that day, she picks up a hitchhiker on a highway leading to San Antonio. The man has an accent and is missing his lower right arm. Jimmy Nash shares some LSD with Clarissa. He even drives her automobile. On the same day, Clarissa inhales some soot particles emitted in the car's exhaust fumes. They contain a carcinogen - benzapyrene. Thirty years later, she is diagnosed with metastatic adenocarcinoma of the lung. Three months after receiving the diagnosis, Clarissa dies.

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Author Jennifer Culkin has been involved, for all of her nursing career, in high stakes, heart stopping, instant-decision-making areas of critical care.  After years working in Neonatal Intensive Care, she became a flight nurse--and giving intensive care to trauma victims while trying to maintain balance and sterile technique in a wind-buffeted helicopter has to be one of the most difficult tasks a nurse might undertake.  Her memoir, A Final Arc of Sky, opens with such a scene.  The patient, Doug, is soon crashing, and the nursing team, Jennifer and her partner, have to make a series of tough decisions (pp. 8-12).  From this scene on, the action rarely wavers.  And although Culkin keeps the pace moving, she is not always, or even most often, telling us about similar traumas.  She deftly weaves her personal narrative--husband and sons and dying parents--in and out of scenes from her nursing career, braiding the plot lines of her life in chapters both moving and compelling. 

In those chapters that deal with the often dangerous helicopter transports Culkin has flown, we learn (and we feel) just what it's like to be a flight nurse crammed in-between patient and helicopter door, juggling instruments that too often slip to the floor and trying to save patients that too often want to die.  In those pages that deal with family, we are privy to Culkin's internal debate about how to separate family from nursing (what she calls "the great neuronal divide between my work and my life" (p.136), and we see that she sometimes doesn't have much energy left at the end of the day to draw close to those she loves.  Part of what makes this memoir difficult to put down is the persona of the narrator herself: Culkin comes across as an honest, often irreverent risk taker, a woman who likes to ride her bike down dangerous hills at breakneck speed and allows her son to do the same (see chapter six, p. 57); a woman who loves the dangerous drama of flight nursing and doesn't worry about crashing (p. 80)--in fact she enjoys strapping herself "into the eye of a maelstrom" (p. 80). 

This memoir entertains, and it provides a glimpse into how some caregivers not only risk their lives to save the lives of others but also shoulder the responsibility of making split second decisions upon which a patient's life might depend.  And there is a surprise in this memoir, one that I can't too fully divulge because to do so would be to rob potential readers of their own discovery.  Suffice it to say that near the end, Culkin reveals something about her own health, an illness she has fought against in every chapter.  When we learn the details of her own illness narrative, we look again, with new understanding, at her fascinating career and her interactions with her loved ones.   

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Mabry Kincaid, a New York art conservator is flying home on September 11, 2001, when news comes to him on the plane of the attacks on the World Trade Center.  Unable to return to his apartment in the city, he decides to visit his aging father, an Episcopal priest, in his boyhood home in North Carolina. There he meets Audrey, an African-American seminary student in her forties, who has moved in to care for his disabled father.  In the ensuing weeks Mabry is led to reflect deeply not only on the fate of the country and of his career, but on how his father's apparently final illness compels him to come to new terms with their constrained relationship. The death of the brother Mabry always believed to be the favorite has left a painful chasm between father and son, made more so by his father's own admission of favoritism.

At the same time Mabry is coming to terms with his own diagnosis of multiple sclerosis and with the grief he continues to process since his wife's death from cancer.  Audrey and her son bring a new dimension to the life of the household and a widened sense of family to the two men as they struggle to lay the past to rest and to accept the radical uncertainties of the personal and national future. One interesting subplot involves Mabry's discovery of what is reputed to be a minor, uncatalogued Van Gogh painting, covered by the work of another artist, that he has brought home for his employer, now dead, and his musings about what to do with this undocumented treasure.  The question remains open for symbolic reflection as he leaves it behind in North Carolina and returns to New York for a very different kind of life than the one he left. 

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In this candid chronicle of what many would call a prolonged depression occasioned in part by her husband's illness and death, Norris, a popular memoirist and essayist, seeks carefully to distinguish the psychological or psycho-medical category of "depression" from the spiritual state of "acedia" or, more bluntly, "sloth," in its oldest and most precise sense.  In doing so she raises important questions about widespread and often imprecise use of categories derived from clinical psychology, an imprecision that may muddy the distinction between spiritual and psychopathological experience.

"Acedia" she defines as a failure of will, signifying a need for spiritual guidance and prayer, whereas "depression" requires medical treatment.  Going beyond the confessional, Norris suggests that acedia may be an endemic condition among middle-class Americans, over-busy but spiritually slothful.  The book is loosely organized, often characteristically lyrical, and more invitational than diagnostic.  Her purpose, finally, seems to be to inspire readers to embrace simple life-giving spiritual disciplines like reading the Psalms as a stay against excessive self-preoccupation and actual depression as well as spiritual depletion.  

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Testifying to its author's "fascination with death" (324), this scholarly and abundantly illustrated work focuses on the history of the American idea of the Good Death as this concept took shape during the Civil War. Frederic Law Olmstead used the phrase "republic of suffering" to describe the many wounded and dying soldiers being treated at Union hospital ships on the Virginia Peninsula. Faust argues that the task of dealing with more than half a million dead during the War motivated Americans in the North and South to discover cultural and physical measures of interpreting and coping with the suffering and loss that occurred in thousands of families.

The scale of this War was unprecedented due to rifles and railroads; however, Gilpin Faust reminds us that twice as many soldiers died of disease as died of wounds suffered in the conflict. The illnesses were epidemics of measles, mumps and smallpox, then diarrhea and dysentery, typhoid and malaria. Medical care was inadequate; consequently, soldiers and their families turned to spiritual consolation. The Good Death was identified as sacrificing your life for the cause; many  believed in the Christian idea of resurrection and the afterlife. Killing became work,  as African American soldiers fought for "God, race and country" (53), where  Southerners fought to preserve the status quo, including slavery.

Because of the War, public cemeteries and ceremonies, and government's identifying and counting the dead are now taken for granted. Because of the Civil War, bodies of the dead military are today brought back from foreign lands and honored with decent burial: "We still seek to use our deaths to create meaning where we are not sure any exists" (271).

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Filmed at Shands (teaching) Hospital in Florida, this documentary validates the importance of the arts and expressive therapies in all aspects of health care, including medical education. Pediatric oncologist John Graham-Pole and poetry therapist John Fox -often as a team- work with patients of all ages in groups and at the bedside.   Other physicians including a neuroscientist provide rational explanations of the release of endorphins and brain changes resulting from creative activities.  Though the healing process initiated by the reflective act of writing poetry is ostensibly the focus of the film, the documentary is permeated with the transforming effects of dance and art therapies in their ability to lessen physical and emotional pain; the importance of healing environments, not just paintings in lobbies, but in patient created ceiling tiles and wall installations; and especially the warmth, intimacy and humanity generated by exemplary physician communication skills.

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Body Language, a beautifully crafted and expansive memoir by retired nurse Constance Studer, spans a range of issues within the narrative of the author's life: a childhood marred by a medical procedure--a hasty frontal lobotomy that left her father incarcerated in a mental institute-- and, in later years, by her own illness, one caused by the Hepatitis B vaccine.  These two events are the bookends that frame Body Language, a memoir that examines family life, nursing, medicine, medical ethics, personal survival and illness in language that is poetic and compelling.  Studer, a writer as well as a nurse, intersperses her own story--which is novel-like in its intensity--with literary allusions, research material and knowledge culled from her years as a nurse in Intensive Care.  In her memoir, she writes not only with the authority of one who has been on both sides of the bed, as professional caregiver and as suffering patient, but also as a family member who has witnessed how unwise and unchallenged medical decisions might affect generations. 

What I especially admire about this memoir is that it is not simply a "telling about."  Instead Studer brings us into the action of the narrative, for example giving us imagery and dialogue as her father prepares for the surgery that he doesn't know will deprive him of memory and sense ("Holy Socks" p. 21).  She also intertwines many narrative strands, giving us the fullness of her family history and her professional adventures, so that when we reach the narrative of her own illness we have a sense of a life, a full life, that has been forever altered.

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Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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Intended to "spark a philosophical dialogue among readers and in classrooms, clarifying, refining, and challenging the ethical positions people hold on a great many bioethical topics"(1), Bioethics at the Movies contains 21 essays discussing bioethical issues, from abortion and cloning to disability narratives and end-of-life care, in relation to various films. The two dozen authors come from the United States, Spain, Australia, Israel and the United Kingdom, and the majority have their academic homes in Departments of Philosophy. For the most part, the essays use one particular film as a springboard to discuss a bioethical topic, such as terminating pregnancies (The Cider House Rules), marketing organs (Dirty Pretty Things), and memory deletion (Eternal Sunshine of the Spotless Mind). Two films get a pair of essays (Gattaca and Million Dollar Baby), and several authors cover more than one film. In addition to the aforementioned films, Wit, Citizen Ruth, Bicentennial Man, I, Robot, Babe, Multiplicity, Star Trek: Nemesis, Ghost in the Shell, Dad, Critical Care, Big Fish, Soylent Green, Extreme Measures, Talk to Her, and Ikiru are closely covered.

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When diagnosed with Amyotrophic Lateral Sclerosis (ALS) at age 36, filmmaker Ben Byer began recording a video diary.  Episodes from his diary create the engaging, coherent narrative of "Indestructible," a documentary that intimately, but unsentimentally invites viewers to witness Byer's and his family's responses to his diagnosis.  Their first impulse is to search for a cure for this degenerative disease, "the grim reaper of neurological diseases," a physician tells him.  They also find themselves seeking ways to understand living with loss, most centrally losing the illusion of control over their lives. 

Over the course of three years Byer and family travel to six countries, including Greece, China, Tibet, and Israel.  During his journey, Byer, an irrepressible extrovert, also seeks the companionship and insights of other ALS patients and families, wishing to create a world-wide bond among people who struggle daily.   A montage of clips from family videos prefaces the film, revealing Byer in the decades before his diagnosis.  The images show a luminous child, who grows into a playful, photogenically handsome teen ager and young man, husband, father, son, and brother.  His exceptional force of personality, incandescent smile, and spontaneous sense of humor fill the screen.  These robust images contrast touchingly with the thinner, clumsier Byer who later struggles to remove a t-shirt.  But they also reveal continuities between Byer's capacity to enjoy his life during seemingly carefree days and his strength of spirit as he becomes increasingly more disabled, disappointed, and introspective.  Although even such strength can't alter his condition, it nonetheless sees him through to the next day and fresh adventure.

The family in the montage and the film emerge as Byer's source of support as well as conflict.  One of the most devastating conflicts arises from his father Steve's restless determination to find treatments to reverse or retard ALS.  After searching the Internet for remedies, Steve turns his garage into an ad hoc distribution center for an herbal concoction he encourages his son to drink.  To advance his son's place on the waiting list of a Chinese neurosurgeon who performs olfactory cell transplantation, he recruits other ALS patients for the procedure.  The results are dubious, in some cases perhaps fatal.  After these strategies fail to reverse Byer's physical decline, and place others at risk, the camera rolls during a family showdown that exposes their fears and desperation as it acknowledges their love.  This memorable scene does so in a way that's consistent with the rest of the film: by letting the camera show, not tell. 

Even the many moments when Byer's family help him with daily activities and his most reflective moments at the end of his film resist sentimentality and easy didacticism.  Byer's equally irrepressible young son John raises a fork wound thick with pasta to his father's mouth and loops his belt through his pants, setting off giggles all around.  The ordinariness and extraordinariness of these acts, the learning of selflessness, the uneasy acceptance of dependency, the inevitability of loss are told through such images or captured in fragments lifted from daily conversations.  Bathing Byer, his brother Josh matter-of-factly says, "You don't have all the time in the world":  a searing acknowledgment of Byer's decline that reminds us of all human fragility.  The closing scenes of the film unobtrusively place Byer's solitary experience in the long history of the search for meaning in human struggle.  They record his wobbly, yet victorious ascent of Masada, supported by Josh, right after we hear a rabbi recount Camus's version of the myth of Sisyphus. 

 

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