Summary:

Life on the Line relates the experience of 228 writers who express in their work the deep connection between healing and words. Walker and Roffman have organized their anthology into eight topical chapters: Abuse, Death and Dying, Illness, Relationships, Memory, Rituals and Remedies, White Flags From Silent Camps, and a chapter of poems about the nuclear accident at Chernobyl. This hefty volume contains a very broad selection of contemporary poems, stories, and essays by both well-known and relatively unknown writers on the experience of illness and healing.

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This posthumously published short (132 pp) collection is by a former New York Times book reviewer and essayist who was diagnosed with metastatic prostate cancer in 1989 and who died the following year. Broyard responded to his illness by writing about the experience. The book is comprised of six parts:

Part 1: Intoxicated by My Illness

Part 2: Toward a Literature of Illness

Part 3: The Patient Examines the Doctor

Part 4: A Style for Death: Journal Notes, May-September,1990

Part 5: The Literature of Death

Part 6: What the Cystoscope Said

Parts 1, 2 and 5 appeared in slightly different form in the New York Times between 1981 and 1990.

Parts 2 and 3 are in part from a talk Mr. Broyard gave at the Univ. of Chicago Medical School in April 1990. Part 6 is a short story written by Broyard in 1954 about his father’s death.

Mr. Broyard had long been fascinated with death and dying, before his prostatic cancer, publishing "What the Cystoscope Said" in 1954, some 35 years before his own diagnosis. It is as though he had been preparing for what he knew would be his finest work. Always an engaging essayist and reviewer, Mr. Broyard here offers what he did best--a discursive (in the best sense) soliloquy on disease, suffering, the majesty of the educated, reflective person with illness--all amplified with widely ranging withdrawals from the broad literary bank account one would expect of a professional reader and reviewer: one reads about personal fate vis-à-vis D. H. Lawrence’s Women in Love; one reads, as one can read nowhere else, about illness, dying and sexuality and its relevance to Hemingway’s The Sun Also Rises.

Part 1, Intoxicated By My Illness, is a personal statement about the effect of this illness on Broyard’s attitude and is rich with his own and others’ literary sense of how he should and did react to it. Part 2, written later than Part 5, deals with literature and illness as opposed to the emphasis on death in Part 5. Within Part 2 are references to Susan Sontag, Norman Cousins and Siegel, among other students of this subject. It is interesting to compare the more powerful and personal and moving appeal of the later writings on illness (Part 2) to the more abstract, critical ruminations on death (Part 5) at a time when, in fact, Part 5 was a literary exercise. Part 2 is written with the pen of the heart.

Part 3 is a wonderful account of Broyard’s first meeting with his personal physician. While Broyard analyzes this man, he reflects on what he would like in his ideal doctor. Part 4 is a brief (7 pages) collection of short diary entries reminiscent of Dag Hammarskjöld’s Markings. Part 5 includes essays on death and dying in literature and what these books, e.g., Robert Kastenbaum’s Between Life and Death and David Hendin’s Death as a Fact of Life and Ernest Becker’s Denial of Death, have to offer us.

Part 6 is a short story about his father’s death, the son’s sexual escapades and the relationship between the two. Clearly sex, death and their nexus have long been on Broyard’s mind. This is a welcome reflection and is of interest more as it compares to Broyard’s later writings on the subject, especially in Part 2, than for its intrinsic worth as a short story.

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A pregnant woman stands in profile to the viewer, with her head bowed down toward her belly and bared breasts. The woman’s eyes are closed and one hand, its fingers curled, is raised so that the palm faces away from her. Perhaps she is praying. A streak of grey angles up behind her head, possibly an abstract halo or wing.

The woman wears a colorful shawl, although her breasts are exposed. The shawl is intricately patterned with swirls and circles evocative of sperm and ova, respectively. A grey skull-cum-death’s head peers out from behind her belly. Beneath the woman and partially enshrouded by her shawl are three women who assume the same position of bent head, closed eyes, and raised hand(s).

All the activity in the image is compacted into a long pillar of sorts, the right side of which forms a fairly straight edge, and the left side of which curves outwards. Behind, a speckled golden-brown makes for a solid background with no perspective.

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An epigraph preceding this 28-line poem, apparently from notes by the physician-writer’s physician-father, sets the action of the poem in Wales in 1938. In the operating room, the surgeon attempts to locate the brain tumor of a patient who was under only local anesthesia because of his blood pressure. In those days in that place, finding the tumor was a "somewhat hit and miss" procedure that seems to have involved looking for it with one’s fingers.

A grotesque image, but all goes well until the patient, in a "gramophone" or "ventriloquist" voice not his own, cries out, "Leave my soul alone, leave my soul alone!" The doctor withdraws from the brain, but the patient then dies, after which the mood in the operating room is shocked and speechless, as "silence matched the silence under snow."

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This work is an adaptation and abridgment of a classic work of Chekhov scholarship by Vladimir Kataev published in Russia in 1979 and presented here in English for the first time. Professor Kataev is concerned primarily with Chekhov’s perspective and methodology, the manner in which Chekhov looks at the world and, hence, the kinds of stories he tells and the methods by which he tells them.

The characteristic Chekhovian perspective first appears in recognizable form in stories that Chekhov wrote in his breakthrough years of the mid-1880s, yet it continued to develop and deepen throughout his writing career. Thus, If Only We Could Know is arranged chronologically. In each chapter the author discusses one or more stories or plays, using them as grist for his topical mill, beginning with "Kashanka" (1887) and ending with The Bishop (1902) and The Cherry Orchard(1903).

According to Kataev, the key to understanding Chekhov is to understand his epistemology or philosophy of knowledge. Basically, in Chekhov’s world the characters do not have access to a privileged perspective or to ultimate truth. "The relative, conditional nature of ideas and opinions, and of stereotyped ways of thinking and behaving; the refusal to regard an individual solution as absolute; and the baselessness of various claims to possession of ’real truth’: these are constants in Chekhov’s world." (p. 164) Thus, the characters communicate poorly and often end up inadvertently causing pain, or sabotaging their own life projects.

Nonetheless, Chekhov’s vision is not pessimistic. Chapter 16, "Chekhov’s General Conclusions," summarizes Kataev’s analysis of the author’s overall approach. Chekhov’s conclusions "may be negative {no one knows the real truth), or affirmative (seeking the truth is an inalienable part of human nature), or they may take the form of indicating the criteria and conditions necessary for establishing real truth." (p. 168) Thus, Kataev expresses here, as well as in his analyses of individual works, the dialectical (my term--JC) relationship between the facts of Chekhov’s stories (i.e. failed beliefs, failed communication, missed opportunities) and his compassion for human nature that searches endlessly for love and meaning in life.

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The book is based on a series of conversations between Edith Heal and William Carlos Williams that took place over a five-month period in the mid 1950s. Williams had published more than 40 books (some of them mere pamphlets) between 1909 and 1957, the span of time covered in these conversations. The interviewer asked him to make biographical comments related to each book--what he was doing at the time, how the book came about, and how this particular work related to his development as a writer.

Thus, after Williams makes some introductory comments about becoming a poet, the book is arranged chronologically, with one to several pages devoted to each book from the privately printed "Poems" in 1909 to "The Lost Poems of William Carlos Williams" (New Directions) and "The Selected Letters of William Carlos Williams" (McDowell, Obolensky, Inc.), both published in 1957.

In many cases, especially for some of the early pamphlets and, later, the "selected" and "collected" volumes, Williams’s comments are short and avuncular. However, his reminiscences about the major books are interesting and insightful, although, of course, they put us in touch with the persona that their author wished to reveal, and not necessarily with the "real" William Carlos Williams.

Typical comments include this, about "Spring and All" (1923), in which so many of Williams’s most famous poems were originally collected: "Nobody ever saw it--it had no circulation at all--but I had a lot of fun with it." (p. 36) Regarding The Knife of the Times and Other Stories (1932), he comments: "This is the first book of short stories . . . I felt furious at the country for its lack of progressive ideas . . . These people didn’t know anything about poetry, about literature. They were not interested in me as a writer, but as a man and a physician." (pp. 49-50)

Williams’s first Collected Poems appeared in 1934, "Needless to say, it didn’t sell at all." (Only 500 copies were made.) Williams finally broke into the world of commercial publishing with New Directions and his 1937 novel, White Mule (see annotation in this database). [At the time he was 54 years old!] New Directions subsequently published two other novels in The White Mule trilogy, along with short stories (Life Along the Passaic River) and his later volumes of poems.

Williams has a lot to say about his massive poetic project, Patterson, which was very well received in its first installment (1946), but became progressively less entrancing to the critics in Books 2 through 5. In Book 2 of Patterson (1948) he mentions first using his famous triadic variable foot, which he later developed fully in The Desert Music and Other Poems (1954) and Pictures from Brueghel (1962): "From the time I hit on this I knew what I was going to have to do . . . My two leading forces were trying to know life and trying to find a technique of verse. Now I had it--a sea change." (pp. 82-83)

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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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Gaudeamus Igitur was read by Stone as a graduation address for the class of 1982 at Emory University School of Medicine. The poem begins with "For this is the day of joy," and ends with, "Therefore, let us rejoice." Between these two lines, Stone (both poet and physician) piles image after image, detail on detail, paradox on paradox: "there may be no answer," he writes, "For you will not be Solomon / but you will be asked the question nevertheless." He writes about the sorrows ("For whole days will move in the direction of rain") and difficulties ("For the trivia will trap you and the important escape you") of medicine, as well as about the joys of medicine ("For there will be elevators of elation").

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A physician is called to visit a sick baby in an apartment in the poorer part of town. When he arrives, the baby is being cared for by a "lank haired girl of about fifteen," the child’s sister. The parents are out. The doctor is intrigued by the young girl’s forthrightness, the "complete lack of the rotten smell of a liar." He notices that she has a rash on her legs. She asks for some medicine to help her acne.

The doctor returns later when the mother is home. She speaks little English. Evidently the child had been in the hospital, but they had brought her home because she was getting worse with hospital-acquired diarrhea. The doctor examines the baby, discovering that she has a congenital heart defect, which is probably responsible for her failure to thrive. The doctor gives advice about feeding and prescribes some cream for the fifteen year old’s acne.

Later, the doctor’s wife and his colleagues comment on the baby’s family: they’re no good, they’re crooks, he’ll never get paid. In the end he does go back to the apartment. The baby looks a little better and the girl’s face is a little clearer.

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The subtitle of this photographic essay is "The Story of a Country Doctor." Berger and Mohr give the reader an imaginative portrait of Dr. John Sassall, an English general practitioner who lives and practices in a remote rural community. The book begins with several stories of Sassall’s work with patients, gradually introducing the man himself and revealing his thoughts about his profession, his life, and the nature of healing.

Berger explores what people in the community think about this unusual doctor who has given up his chance to "get ahead" in the world in order to remain with them. They are sure he is a "good doctor," but what does that mean? How does one judge "goodness" in a physician? Berger comments in an impressionistic way on the nature of Sassall’s relationships with patients--a complex mixture of authority, fraternity, and intimacy.

The latter part of the essay expands its focus to the community as a whole and the nature of contemporary medicine. Throughout the book, Jean Mohr’s photographs serve as indispensable features of the story.

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