Summary:

The narrator, who has narrowly escaped death, feels as if there were "odd secrets . . . to tell" to the world of the living. She speculates about her next (and last) encounter with death, anticipating it with curiosity, and resigning herself to the "slow tramp [of] the centuries."

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Set in 1665, Journal of the Plague Year is a fictional account of the plague that set upon London that summer. Defoe, one of the first British novelists, walked a thin line between fact and fiction. His book poses as a firsthand account and contains statistical information on the plague, but is primarily fictional.

His novel charts the development of the infection, its spread, and the destruction it left in its wake. He provides gruesome accounts of medical practice in the era, including graphic descriptions of women dying in childbirth and vast burial pits. Doctors tried to stop the spread of the disease by killing 40,000 dogs and 200,000 cats who they assumed carried the disease.

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Sontag argues against the use of illness as metaphor. She states her main point on the first page of this long essay : "The most truthful way of regarding illness--and the healthiest way of being ill--is one most purified of, most resistant to, metaphoric thinking."

Tuberculosis and cancer serve as her two central examples of the human tendency to use metaphoric thinking about illness. In the 19th century, tuberculosis was considered a disease of passion, of "inward burning," of the "consumption" of life force. Sufferers were thought to have superior sensibility; the illness purified them of the dross of everyday life. The romantic image of the TB sufferer became "the first widespread example of that distinctively modern activity, promoting the self as an image" (p. 29). Metaphoric thinking about TB declined in the early part of the 20th century as the disease succumbed to science and public health measures.

Cancer has now become the predominant disease metaphor in our culture. Cancer is considered a disease of repression, or inhibited passion. The cancer sufferer characteristically suppresses emotion, which after many years emerges from the unconscious self as malignant growth. As in Auden’s poem, Miss Gee, reproduced on page 49, (see annotation in this database): "Childless women get it, / And men when they retire . . . . " Sontag uses the 19th century view of insanity as another example of malignant metaphoric thinking, while metaphor related to syphilis was somewhat more benign. She concludes the essay with an eloquent prediction that, as we learn more about the etiology and treatment of cancer, its metaphorical system will die on the vine. (I wonder if Sontag would consider my "die on the vine" an appropriate metaphor here?)

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This book is an autobiographical account of an abrupt and painful injury that completely transforms the author’s life. Berger in 1985 was a healthy woman who enjoyed ice skating and canoeing, a published poet, wife, and mother of a toddler. She bent over one day to pick up her daughter and felt a tearing "within the thickness of flesh, moving in seconds across the base of the spine." No longer able to run, walk, or even sit, she is forced into a life spent lying down.

Hers is now a world of boundaries and barriers--physical, psychological, and societal. The book chronicles her struggle to parent her child (they make gingerbread creatures lying down on the kitchen floor), to relate to her husband (she has to deal with the constant feeling of being the recipient of his care), to live with pain, and to regain her mobility.

Because hers is not a visible injury and because she must frequently lie down in public places or use her carry-along lawn chair, she suffers the stares and scrutiny of people who cannot pigeon-hole her into a tidy handicapped-wheelchair category. After seven years of physical therapy (she calls her therapists "angels of attempted repair ") she is able to walk and drive, though she is still limited in activity and lives in fear of re-injury.

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I used to be able to think. My brain’s circuits were all connected . . . I had a memory and an intuition that I could trust. So begins Floyd Skloot’s memoir of living his life with "a scatter of white spots like bubbles" in his brain, as a result of a viral illness in 1988 that led to chronic fatigue syndrome and persistent brain damage. The first section ("Gray Area") consists of essays that re-create a texture of mistaken words and memory lapses, as well as the author’s creativity in discovering ways to minimize or bypass disability in his daily life. The temporal vector of this section begins with the onset of illness; continues through his marriage to Beverly and their settling on a hilltop in Oregon; and ends with an idyllic stay on Achill Island off the western coast of Ireland.

The second section draws us back in time to "The Family Story," a series of stories about childhood. In "Kismet," which begins section 3, the author returns to a description of his post-illness experience, in this case to his fateful final visit with an older brother, who is dying of diabetes and kidney failure. Later, in "A Measure of Acceptance," he tells of his encounter with a Social Security psychiatrist, whose task is to determine whether Floyd Skloot is "really" sick. The Social Security Administration provides one measure of acceptance; but the author creates a more important measure of acceptance for himself: "I can say that I’ve become adept at being brain damaged. It’s not that my symptoms have gone away: I still try to dice a stalk of celery with a carrot instead of a knife . . . Along the way, though, I’ve learned to manage my encounters with the world." (p. 196)

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The narrator describes his experiences as an after-hours cleaning person in the autopsy room. The macabre nature of the work carried out there during the day by the medical professionals (who appear to take it for granted) is vividly impressed on the narrator when he comes upon "a pale and shapely leg." This evokes his own memories and feelings of sexuality. He is disturbed, no longer "has the strength of ten," and can’t involve himself with his wife when he goes home.

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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This unique "miscellany" of prose from journals and essays, poems, stories, music, paintings (reproduced in black and white), drawings, and cartoons illustrates countless ways that medicine and the arts, in tandem, "stretch the imagination, deepen the sympathy . . . enrich the perceptions" and give sheer, unadulterated pleasure. Organized by Robin Downie, renowned Professor Emeritus of Moral Philosophy at Glasgow University, the anthology is grouped in eight categories: "The Way We Are," "Disease and Mental Illness," "Doctors and Psychiatrists," "Nurses and Patients," "Healing," "Last Things," "Research," and "Ethics and Purpose."

Excerpts include the classic lore [Charles Lamb’s essay, "The Convalescent"; Florence Nightingale’s diary, "Notes on Nursing"; W. H. Auden’s poem, Musee des Beaux Arts (see this database); Theodore Roethke’s poem, In a Dark Time (see this database); C. S. Lewis’s journal, A Grief Observed (see this database); Sir Luke Fildes’s painting, The Doctor (see this database)] and refreshingly new nuggets from John Wisdom’s radio talk, "What is There in Horse-Racing" ("For a game of croquet is not merely a matter of getting balls through hoops, anymore than a conversation is a matter of getting noises out of a larynx,"); Robert Pirsig’s treatise, "Zen and the Art of Motorcycle Maintenance"; physician Roy Calne’s tender sketches of his own patients; composer Richard Wagner’s letter, "Biscuits as Therapy"; Janice Galloway’s novel, "The Trick is to Keep Breathing"; and expressions by patients and artists who happen to be patients of their particular illness experiences.

Lest "commentary be intrusive," except as brief introduction to each section, Downie deliberately omitted them, placing illustrations and extracts so as to provide commentary on one another. (Readers cannot help but be stimulated, however, to rearrange and create their own juxtapositions.)

The section on "Healing" considers not only the expected operations, spiritual healing, traditional cures, music and art as therapy, but also "spells, hope, and mothers." Richard Asher’s essay on why medical journals are so dull (British Medical Journal 23 Aug. 1958), or on whether or not baldness is psychological, and the comic strips of Posy Simmonds (the double entendres of "Medical Precautions," the "Minor Operation" burlesque on Shakespeare’s "All the Ward’s a Stage,") remind us yet again that birthing, aging, illness and dying are not pathological events or mere medical processes, and that the arts and humanities are bountiful reservoirs of moral discourse, inspiration, and renewal.

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This extraordinary graphic work began its life as a Web comic, posted anonymously, tracing in image and word the story of a son, his sisters and their mother who was diagnosed with a brain tumor, metastatic from her lung.  This comic caught on, and news of it was passed by email and link from reader to reader. About a year later, the author, Brian Fies, was presented the Eisner Award for Best Digital Comic. The entire sequence has now been published in a small, wonderful hardback book that will fit into a lab coat pocket.
 
Fies has managed to capture, in word and graphic panels, the thousand emotions and moments that swirl about a family when cancer changes their lives. He shows us the small, personal gestures and thoughts that we look back upon--how he "didn't lose any sleep" (3) when his mom first fell ill; how his mother both denied the severity of her illness and, at the same time, fell into the abyss of medical examination, radiation, chemotherapy; how he and his sisters assumed various roles in their mother's care and, soon, morphed into "superpowers," each defending his or her own territory (41-44).

Most amazing is how Fies exposes, in honest and poignant visuals, the many points of view of illness--his mother's, his siblings', his own, even the physicians'. His portrayal of how the medical system both confuses, abandons and supports his mother is alone worth the price of the book (39-40). We watch his mother, through his "cartoons," as she moves deeper and deeper into the world of illness, and we see the author's own anger in response to this loss.

He lashes out at smokers (pp 55-56), perfectly portrays the ever-smiling doctor (48-49), captures the odd suspension of a transient ischemic attack (TIA) (68-70), and lets us walk the tightrope of treatment alongside his mother (59-61). He also cleverly interweaves the back-story of his mother's youth, marriage and divorce, his childhood, and a vignette of the sickness and death of a favorite uncle, one whose dying prophesy impacted Fies's life (73-77). The moment when his mother truly understands the severity of her prognosis (94) is stunning.

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These poems offer a rich series of impressions of the speaker's present life, surrounded by family, a garden, and pockets of natural life that evoke memory after memory of a childhood lived in relative poverty with a father whose years as a coal miner damaged his lungs and finally killed him. Allusions to his chronic and worsening illness and his death thread through the poems like a long shadow.

Recurrent images of his blood-stained handkerchief, his coal-smeared face and hands, are echoed in images of the death of an uncle, the deaths of animals, and of a mother strained by poverty and taking frugal measures to preserve small things. The final poem in the collection recalls her in old age, barely able to see, but still "stitching it all together."

The title poem, one of the best, pauses over the famous idea that the flutter of a butterfly's wings might be the source of large effects continents away. Together the collection invites us, without sentimentality, to consider how things are connected over time and come together in memory in compositions one couldn't have anticipated.

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