Summary:

This documentary, narrated alternately by the daughter-filmmaker and mother whose stories it tells, focuses on how two women move apart and together while experiencing, respectively, adolescence and mid-life. The mother has cancer, a mastectomy, and then rheumatoid arthritis, and these experiences intertwine thematically and structurally with the narrative of the mother-daughter relationship.

Another provocative juxtaposition cross-cuts scenes from the daughter's modeling career (and the social and erotic body that context constructs for her) with scenes of the mother's illness, stigmatization, and erotic daydreams. Both women come to a new awareness of the social meaning of mastectomy within heterosexual and same-sex contexts by the documentary's end; they also come to a place of recognition of the mother's personal and social value and the nature of their relationship.

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The narrator is an aging, male gynecologist who works in a small North Carolina town. The National Health Service sends a young doctor, Rachel, to work in the clinic. From Boston, she is unused to the town's racial politics. She learns slowly to understand the motivations and concerns of her patients. As she campaigns for condom distribution, she ends up insulting the white men who run the town by calling them racists.

The narrator protests that they have power in the town only because no blacks ever run for office and that their policies are meant to distribute wealth evenly. He encourages Rachel to be more gentle and womanly. She will get her way more easily if she smiles. But Rachel eventually turns her back on the narrator, too, when in order to get a violent black man out of the clinic's lobby he calls the man "boy" and threatens to call the police. Rachel moves in with a black man. The town has revenge when a hit and run driver kills her lover and Rachel is hounded out of town.

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In the early 1950's, Milan, Georgia is a racially divided town where secrets are plentiful and the meaning of justice is muddled. J. T. Malone, a 40-year-old pharmacist who failed his second year of medical school, is diagnosed with leukemia and told he has only 12-15 months to live. In some ways, Malone's last year of life parallels the declining fortunes of the town's leading citizen, Judge Fox Clane, an overweight and elderly former Congressman who suffers from diabetes and a previous stroke. Judge Clane's wife died of breast cancer, his only son committed suicide, and his daughter-in-law died during childbirth. He raises his grandson, John Jester Clane, and aspires to restore the grandeur of the South in conjunction with redeeming his personal hoard of Confederate currency.

Judge Clane hires Sherman Pew, a "colored boy" and orphan, as his personal assistant, but Sherman eventually resigns from the position when he can no longer tolerate the Judge or his prejudice. Sherman moves into a house located in a white neighborhood. A group of townspeople including the Judge plots to get rid of him. A local man bombs the building and Sherman dies. Shortly after his death, the United States Supreme Court announces its decision supporting school integration.

The Judge is infuriated and goes on the radio station to express his opinion, but he has not prepared a speech. Instead, he begins babbling Lincoln's Gettysburg Address. The radio station cuts him off. Malone has been listening to the Judge on the radio, but his wife turns it off. Integration no longer matters to Malone. Near the end of his life, Malone finds solace in the renewed love for his wife, Martha. He finally appreciates the order and simplicity of life. The pharmacist dies peacefully in his own bed.

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Williams's autobiography recounts his life from his first memory ("being put outdoors after the blizzard of '88") to the composition of "Patterson" and a trip to the American West in 1950. The book's 58 short chapters epitomize the writer's episodic and impressionistic style, presenting a series of scenes and meditations, rather than a narrative life story.

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Nathaniel Lachenmeyer’s memoir is a reconstructed account of his father Charles’s battle with paranoid schizophrenia and Nathaniel’s inability or unwillingness to recognize his father’s need for help. After his father’s death, Nathaniel contacted many of the people who had known his father, both when he was a student and college professor and later when his illness forced him into mental hospitals, squalid apartments, and homeless living on the streets. Nathaniel’s search to understand his father after his death led him to interview the many health care workers, police, street people, restaurant staff, and others who knew Charles when he was very ill.

Charles was delusional, often hearing voices and talking to his mother, who had been dead for years. Typical of people suffering from paranoid schizophrenia, Charles did not see himself as mentally ill. Therefore he did not like to take medications and would refuse treatments when he could, although his health care workers could see substantial changes for the better when he was on medication. He believed he was the victim of a mind control experiment, forced on him by his persecutors. He died out of touch with his family, having suffered almost twenty years on his own with his illness.

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This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.

Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.

Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?

One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).

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The site of the multiple stories interwoven in this novel is a teaching hospital in San Francisco. One of the featured characters is a young single mother who comes in with a swollen arm and finds herself in more medical trouble than she anticipated. She suffers a mild stroke after debatable treatment. Two doctors attend her, but differ markedly in their ideas of how to treat her and their human responses to her. One ends up having a brief affair with her that changes his life.

In addition to these there are stories of a comatose young man and the family that refuses to believe he will not awaken (he does); a volunteer coordinator who observes the politics of hospital life from a privileged margin, and sundry staff people who represent alternative points of view. The single mother recovers, but only after a stay in the hospital has convinced her she may not yet be too old to go to medical school to find a life not in marrying a doctor, but in being one.

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Subtitled "New and Selected Medical Poems," this volume includes poems on illness and healing from Downie's three previous collections, along with several new poems. A longer piece called "Learning Curve Journal" serves as a framework for the book.

Beginning with the desperate voice he hears on his first night as a "suicide line" volunteer, the poet reveals the shape of his own medical learning curve, moving poem by poem from "Orientation" through the realm of "Patient Teaching" and "Teaching Rounds" to "Pronouncing Death." Among the many strong poems in this collection are "Diagnosis: Heart Failure," "Louise," "Sudden Infant Death," "Wishbone," "Living with Cancer," and "Ron and Don."

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This documentary video follows the making of an opera, based on the illness experiences of four Australians who have been diagnosed and treated for cancer. Their feelings about these experiences are translated into music (with lyrics) as they work closely with music therapist/composer, Emma O'Brien. As the three women and one man tell their stories of physical debility and emotional pain, the music therapist asks them to think in terms of color (they choose purple, black) and tones and rhythms that she plays for them on the piano.

When the narratives and their musical representations have evolved sufficiently, trained singers take on the roles "written" for them by the four former patients; the latter continue to be intimately involved in the opera's production, directed by David Kram. At the end of the project, which is also the conclusion of the film, the opera is performed in front of an audience (with musicians playing instruments, singing, and dramatic enactment) and the four people whose illness experience is performed take their bows together with the singers.

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Richard Koslowski, a 32-year-old computer systems supervisor and musician, breaks a tooth when he bites an olive pit. Although the remnant of the damaged tooth is removed during his initial visit to the dentist, Koslowski embarks on a peculiar quest. He longs to find a perfect-fitting dental bridge, to eliminate a mysterious oral pain, and to measure up to the suffering his parents have endured as survivors of concentration camps.

He eventually elicits opinions or treatment from ten different dentists and specialists. Koslowski realizes that he has sustained more than just a cracked tooth. His entire life is now fractured. Koslowski becomes obsessed with his teeth. His girlfriend, Lisa, is a law student who is passionate about women's rights. She travels to Bosnia to interview and assist rape victims. When Lisa returns, she breaks up with Koslowski. His suffering seems so small and his life so insignificant that she can no longer tolerate him.

Koslowski's father is dying of a brain tumor but remains stoic until the end. Koslowski, on the other hand, has a poor pain tolerance. After undergoing multiple dental procedures--tooth extraction, root canals, a series of gum cleanings every week, and finally dental implants--Koslowski ultimately resigns himself to living with the discomfort in his mouth. His "reward" is marriage to a disabled woman, three children, and an ordinary life filled with minor ailments and nuisances.

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