Summary:

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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According to the U.S. Department of Health and Human Services, nearly thirty-one percent of the American public is obese; obesity accounts for 300,000 deaths a year, making it the second-most common preventable cause of death after cigarette smoking; individuals who are obese have a fifty to one-hundred percent increased risk of premature death from all causes.  On the opposite end of the scale, so to speak, is anorexia, which, as one of the deadliest of psychiatric diseases, claims up to fifteen percent of its sufferers who either die of suicide or complications related to starvation; about one-third spend their lives dominated by their obsession with food, and almost half never marry. 

How can we ever understand the psychological, physical, emotional, cultural and spiritual complexity of eating disorders, whether they result in morbid obesity or in a starving body digesting itself?  Ann Pai's memoir opens a window to reveal the inner world of a food obsession, her own, and holds up a mirror to reflect the outer experience of a dying, five hundred fifty pound woman, her sister.

The narrative weaves together three strands:  the sweet but unsentimental history of two sisters growing up in the midwest--Joyce, the elder of the two, and Ann, younger by almost five years; the detailed and horrific account of Joyce's sudden hospitalization on September 11, 2001, and her inexorable decline through multiple, undiagnosable and fatal illnesses as the result of her obesity; and the stream-of-conscious and raw monologue of Ann's own struggle to manage a compulsive eating disorder.

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This absorbing, sad, humorous evocation of an impoverished Irish Catholic childhood describes the first nineteen years of Frank McCourt’s life--from his birth in Brooklyn, New York; through the family’s emigration four years later to his mother’s roots in the slums of Limerick, Ireland--and ends with McCourt’s return migration to America, a young man on his own. McCourt sets the scene in his first lines: "When I look back on my childhood I wonder how I survived at all. It was, of course, a miserable childhood: the happy childhood is hardly worth your while. . . the poverty; the shiftless loquacious alcoholic father; the pious defeated mother moaning by the fire; pompous priests; bullying schoolmasters . . . . "

Born during the Great Depression, the author leads us in lilting present-tense narrative through the struggle and occasional small joys of daily life with siblings, school friends, and the adults who circumscribe his life. He is an alien in his parental homeland, the oldest child of a father whose background in "the North" engenders continual suspicion, and a mother (Angela of the book’s title) who had never known her father and whose own mother is as miserly with her affections as with offers of economic assistance.

The hardships in Limerick are so profound that starvation is a way of life. "Consumption," pneumonia, and typhoid are rampant; children go to school barefoot or in pieces of flopping rubber; stealing is a necessity. Frank’s tiny sister and twin brothers die. Above all, there is "the drink"--the endemic disease of Irish fathers who spend their weeks’ wages in the pub on Friday night.

Frank leaves school to earn money for the family (his father had joined the war-time wave of work in England, but continued to drink his earnings away), and to save for a return to America. Blessed with verbal skills and stamina, through stealth, charm and struggle he manages to save what is needed to book ship’s passage to America. As the Hudson River flows by en route to Albany, the ship’s Wireless Officer says to Frank, "My God, . . . isn’t this a great country altogether?" Answers Frank in the single phrase comprising the last chapter, " ’T. is."

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The text explores the experiences of a nurse practitioner in an inner city OB-GYN (Obstetrics & Gynecology) clinic and four of her women patients, from a fifteen-year-old homeless pregnant child to a mature woman struggling with cancer. Another of her patients is pregnant and drug addicted; a fourth suffers from pains that come from buried memories of sexual abuse. The stories of all four patients weave in and out of the narrator's own stories about herself, her own health and illness experiences, her own respectful appreciation of the female body.

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Couser, long interested in autobiography, explores the ethics of representation in biographical writing, and in particular, the ethics of representing vulnerable subjects--for example, the aged or very young, the sick or impaired, or those who are "socially or culturally disadvantaged." He is concerned with representation of people who are intimately connected to the biographer, either as family members, or in some other "trust-based relationship." Couser argues that the relationship between vulnerable subjects and their biographers is analogous to that between patients and their physicians and that therefore principles of bioethics should be applied to such life writing, especially the principles of autonomy, nonmaleficence, and beneficence.

Couser explores life writing and betrayal (Chapter 1), outlines how he will apply the principles of biomedical ethics and ethnographical ethics to life writing (Chapter 2), and applies these principles to examples of collaborative autobiography (Chapter 3). He then critiques in detail Michael Dorris’s memoir about his adopted son, The Broken Cord (Chapter 4); the work of Oliver Sacks (Chapter 6); memoirs of euthanasia (Couser calls these "euthanographies"), Saying Goodbye to Daniel: When Death Is the Best Choice, by Julia Cassutto Rothman; Rescuing Jeffrey, by Richard Galli, and But What If She Wants to Die, by George DeLury (Chapter 7). Finally, in the last chapter, Couser considers how investigation of the human genome might influence the "scripts" of our lives and hence life writing, and also how life writing might be a counter discursive force against genomic essentialism.

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In this book Sacks takes the reader into the world of the prelingually deaf, a world in which spoken language is incomprehensible. He describes the visual language, Sign, and considers the development and culture of American Sign Language. Sacks evokes the conflict between those who seek to teach the deaf to communicate via voice and lip-reading and those who affirm Sign, the native culture of the deaf.

In the latter part of the book, Sacks re-creates the student rebellion at Gallaudet University in 1988 when a "hearing" president was chosen from among three finalists, two of whom were deaf. The back cover summarizes this book as "a provocative meditation on communication, biology, and culture."

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In this collection, Judith Arcana brings together her long-standing feminist activism, especially for reproductive health and abortion rights, and her gifts as a poet. Although Arcana's activism dates back to the early seventies, most of the poems in the book were written between 1998 and 2004. They draw from "the lives of women and girls I know or have simply encountered" (xi).

The collection is divided into four sections: "Separating argument from fact," "Information rarely offered," "Don't tell me you didn't know this," and "Here, in the heart of the country." Spoken in first, second, or third person, these poems evoke the myriad individual situations in which women of childbearing age become pregnant, and the trajectories their lives may take as a result.

The title of the collection derives from one of its poems ("What if your mother") and the related, immediately preceding poem, "My father tells me something, 1973" (6-7). Arguing back to those who confront her with, "What if your mother had an abortion? . . . they mean me," the speaker/poet answers, "then I say she did . . . . "What if, what if. / What's the point of asking this phony question?"

From the preceding poem, the reader has learned, along with the speaker listening to her father in 1973, that the poet's mother had an abortion in the Depression era, early in marriage. With this juxtaposition of poems we are introduced early in the book to the complexity of the issues surrounding pregnancy, parenthood, and abortion and to the timeline of a continuing national and personal debate. This complexity is the subject of the collection.

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Belle Yang has created a beautiful and lyrical tribute to her father (Baba) and to her Chinese heritage. She has illustrated the folktales and life of her father with her own brilliantly colored paintings, which complement her vivid and colorful prose. Several stories concern doctors and healing in early to mid 20th century China. For example, in the chapter titled "Secret Family Recipes," the tale of Daye reveals the intricate world of family relations, social structure based on wealth and family position, and country versus city prejudices.

Daye is a poor relation but a hard-worker. After he and his wife take an old traveling doctor, "jangling the healer’s trademark ring-shaped rattle," into their humble home, the old doctor teaches Daye how to heal and gave him his "family recipes" for healing. However, Daye’s troubles are not ended, as the townspeople call him a charlatan and quack. Daye does, though, possess the power to heal.

When a wealthy magnate is injured, Daye stakes his life that he can save the man’s leg, even though all the important doctors of Western medicine advise amputation. Daye saves the magnate’s leg, is catapulted to become the head of herbal medicine at the medical institute and passes on the "family recipes" to his daughter, "a short, squat, swarthy woman with bulbous eyes and yellow, ratlike teeth that sprouted between her normal adult ones, leaning every which way like disrupted roof tiles."

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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