Summary:

Written as an interior monologue, Destiny begins as Chris Burton receives a phone call informing him of his schizophrenic son's suicide. Burton, a British ex-pat journalist in the final stages of writing his chef d'oeuvre--a cultural history on national character--is married to Mara, a provocative, capricious, flamboyant Italian. The vitriolic arguments and hurtful stratagems that characterize their discordant marriage intensify with the crisis of death and its aftermath--the identification, transport and entombment of Marco's body. Family relationships are further complicated by Mara's distrust and estrangement of her adopted daughter, Paola.

Burton reveals the chaos that schizophrenia imposes not only on the patient, but also on the entire family. In order to avoid prison following an attack on his family and home, Marco had been placed in a psychiatric institute, Villa Serena, and it was at this facility that Marco stabbed himself to death with a screwdriver. The onset of disordered thinking and erratic behavior, the search for therapies, the various repercussions of guilt and blame (including recriminations about the intense, border-blurring maternal love lavished on Marco), are re-examined by Burton as he travels from London to Rome, sits vigil by his son's body in the camera ardente, and confronts his wife at her family's tomb.

Burton's physical distress mirrors his mental anguish. Burton has heart disease and obsesses about lacking his anti-coagulant medication. In addition to the worry of clot formation, urinary retention prevents Burton from emptying his bladder. These physical ailments of containment, confinement, obstruction and blockage form resonances throughout the book: the tomb, the strictures of marriage and the leakage of adultery, the oppressive family 'house of ghosts,' the separateness of interior thought from observable behavior, the barriers of language, the herky-jerky redirections of emergency travel.

Furthermore, the will to create permanence, to make one's destiny more than a transient destination, informs Burton's moves. In the midst of his exploding marriage and tormented trek home, Burton agitates over his work, and in particular, his book, which "must serve to transform a respectable career into a monument" (p. 1).

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Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.

Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.

The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.

Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.

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Summary:

This story of one exceptionally accomplished family's discovery of their past and future relationships with Huntington's Disease (HD) is also the story of how the Wexler family changed the cultural narrative of HD for other families at risk for this genetically-transmitted and currently incurable disease. The HD diagnosis of Leonore Wexler (the author's mother) inspires Milton Wexler, a psychologist, to create a major foundation for HD research, which develops critical mass and influence as Leonore Wexler's condition deteriorates, and after her death. The book interweaves the story of the Wexlers' emotional and other negotiations with HD and the story of their efforts to create an HD community comprised of those with active symptoms of HD, family members, advocates, and researchers.

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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Summary:

Dr. Dymov is an earnest and rather boring young physician, who is preoccupied with his patients and his research. Olga, his wife, craves the excitement and gaiety of the artistic life. She discovers a new lease on romance with Ryabovsky, a colorful landscape artist, who takes her on a cruise on the Volga River. As they spoon under the stars, Olga and her lover make light of her bumptious stay-at-home husband.

After she returns from the cruise, Dymov forgives her infidelity, but in Olga's mind, his forgiveness proves to be another strike against the poor slob, since she just can't stand his complaisant devotion. She runs back to Ryabovsky for a while, until he makes it clear that he is bored with her.

Then one day Dymov develops diphtheria, evidently contracted by "sucking up the mucus through a pipette from a boy with diphtheria. And what for? It was stupid . . . just from folly." Dymov soon becomes delirious, and then dies. Suddenly, Olga is overcome with guilt and grief. Too late, Olga realizes that her husband was a hero.

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Summary:

The physician Tsvyetkov visits a child who is dying of a brain tumor, and the boy's mother. There is no hope, nothing to be done. Tsvyetkov has had one romantic fling in his life; when he was younger, he had an affair with the boy's mother. She has always told him that Misha was his son. Yet she also had affairs with other men around the same time; one of them might be the father. Tsvyetkov suspects that she insists that he is the father just so he will continue to make payments to support them, which he has always done. As he leaves, he asks the boy's mother one last time, "It can make no difference now. Is the boy mine?" She hesitates for a moment, but answers, "Yes. he is your son."

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Summary:

A district doctor and an examining magistrate are on their way to an inquest. The magistrate tells the story of a young pregnant woman who "foretold her own death" shortly after giving birth. Though she was apparently healthy, she simply closed her eyes and "gave up her soul to God." This tale, the magistrate contends, is an illustration of how inexplicable life can be.

No, the doctor responds, there is no effect without a cause. The woman probably poisoned herself, the doctor explains. Her husband was unfaithful. She wished to commit suicide, but did not want to harm the unborn baby. Thus, she waited until after her confinement. The magistrate is overwhelmed with grief--in fact, the story is that of his own wife. His infidelity may have caused her suicide!

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Summary:

This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.

The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."

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When we view photographs of war-torn bodies, piled-up corpses, or starving children, are we changed? How about the photographer, whether a professional or an amateur, who takes such pictures? Do these photographs teach us about suffering--or do they numb us over time and simply cause us to turn away? In this slim book Sontag re-visits her ideas in "On Photography," published 25 years ago.

Her aim, it seems, is not so much to answer the above questions but to provoke us by her statements, urging us at least to THINK about what happens when suffering is viewed third hand; because after all, she reminds us, we see only what the photographer wanted us to see. When scenes of violence are as close as our morning papers or our TV screens, Sontag's is an important debate.

She also gives a brief history of photo-journalism, from the Crimean and Civil Wars to the almost instantaneous transmission of images from Operation Iraqi Freedom. In chapters that sometimes seem to disagree with one another, she plays the devil's advocate and views the IDEA of photographs of suffering from all directions. Can gruesome photos be artistic? Should they be? And if a war photo is posed--a corpse moved for a better shot or a battle scene restaged to make it more dramatic--is the effect enhanced or decreased? She considers the impact of candid photos versus those technologically manipulated; she discusses how photos, and their impact on us, change when the names of the victims are revealed.

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Summary:

Patrimony relates the final illness and death of Philip Roth's father, Herman Roth. It begins as a misdiagnosis of Bell's palsy, which is eventually diagnosed as a brain tumor. Further tests reveal that it is cancer, operable only with great effort and little promise of cure or even significant palliation. The family (including Herman) decides against surgery and remains in close contact with him until his death.

Roth recounts his father's increasing weakness and helplessness, his own emergency quintuple bypass surgery, and his dreams of his father speaking to him from beyond the grave. Writing this book, he concludes, is the natural and necessary process in bearing witness to his father's life and death.

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