Summary:

A pediatric intern encounters her first dying child. Her initial response is to care for the child, hold him, and try to comfort him. She is told by her attending physician that this behavior is unprofessional. When she cries in response to her stress and grief, she is told she will never be an effective physician. The narrator then describes how she ultimately came to terms with her impulse to cry at stressful times, and how she interacts with patients in her current practice.

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The thirty-four autobiographical essays were written while Klass was a medical student in the Harvard class of 1986. Many of her short chapters were previously published as columns in magazines, journals and newspapers. The insightful but often funny stories cover a variety of scientific and clinical subjects, lifestyle, eating habits, and relationships with other professionals, including nurses.

Pregnancy and the birth of her son half-way though training makes her experience somewhat unusual. In several other essays, including "Macho" and "Learning the Language," Klass reveals her particular sensitivity to language and the advantages and disadvantages of professional discourse.

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Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.

For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.

An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.

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The Ramsay family are spending the summer in their holiday house on the Isle of Skye. Mr. Ramsay, a mathematician, and his wife, who runs the home, have eight children, including the beautiful Prue, who is likely to be married soon, and James, the youngest, still fiercely attached to his mother. There are also assorted guests, including Charles Tansley, one of Mr. Ramsay's students; Lily Briscoe, a keenly observant painter; and Mr. Carmichael, an opium-addicted poet.

James wants to be taken by boat to visit the lighthouse and his mother encourages him, but his father, enraging James, says it'll be impossible because of the weather. That night Mrs. Ramsay gives a dinner party where she orchestrates the complex dynamics of the family and their guests into a perfect social unit, which is presented as a kind of work of art.

This is followed by a short interlude, "Time Passes," which marks a shift in scale from the human to a wider view, where encroaching darkness and dissolution threaten the house and the lives connected to it. During this period, Mrs. Ramsay dies, Prue marries and then dies in childbirth, and a War takes place in which Andrew, another son, is killed.

All these events are diminished by the universal context of time and change against which Woolf places them. The final part of the novel returns to the human scale. About ten years later, the surviving characters are back at the house and Mrs. Ramsay, though dead, continues to be the central figure, motivating much of what occurs. Mr. Ramsay now takes the still-angry James to the lighthouse, and Lily Briscoe, inspired by her memory of Mrs. Ramsay, is at last able to complete the painting she began years before.

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A strange Irish girl is "away" ever since she lay beside a drowned man. A teacher marries her, providing stability if not sanity, but the 1840s famines begin and the couple flee Ireland with their child Liam. They establish a homestead in a remote part of Ontario where a baby girl, Eileen, is born.

Not long after, the mother disappears and is not seen again for years until she is brought home dead. The son learns that she had been living by a lake immersed in her fantasies of the long dead lover. Eventually, Liam is left to care for his sister alone; they travel to a small port town where he realizes that Eileen has become an attractive young woman with desires of her own. She too goes "away" following a lover, but returns to Liam and his wife to live out her long and lonely life.

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Subtitled, A Memoir of an Alaskan Childhood, this spare, compelling work recalls young Julia's difficult and unusual life in a splintered family living "at the edge of the world." When Julia was born in 1929 the family had just moved to Seattle and entered an economic crisis--"somehow, my father had been bilked out of their money." (17) The marriage went downhill as poverty and the father's serious illness compounded an underlying conjugal incompatibility.

Julia was only seven years old when she and her older sister Lillian found their father dead--a suicide. "Nothing is said about how my father died, or even, in fact, that he is dead." (8) Not long thereafter Julia's mother, Rose, without any explanation or advance warning, left the girls at the Pacific Hebrew Orphan Asylum; there they remained for two years. Rose went to Nome, Alaska to try to find work. "Meanwhile, I strive to be a model orphan. I do all my chores . . . I'm quiet, do well in school, am extremely polite. And most of the time, I'm afraid." (33)

There follows another stay in a different orphanage. Here "I never hear my name . . . No one ever touches me. And, in my memory of that time, that place, I am always alone." (72) Finally, they join their mother again in a remote mining outpost of Alaska where Rose operates a roadhouse. Moving with the seasons back and forth between the outpost and the city of Nome, Julia's life takes on a semblance of normalcy. The environment is strange but interesting, the men who frequent the roadhouse are rough but friendly--there is a sense of camaraderie.

As Julia reaches puberty she becomes subliminally aware of a relationship between her mother and the owner of the Nome liquor store, Cappy. Cappy is married--his family is back in Seattle. There is never any open display of affection between Cappy and Rose, but he eats his meals with them and is almost a surrogate father to Julia and her sister. Suddenly Rose decides to move the family to Fairbanks. Here there is a "secret scenario" that Julia only pieces together many years later. As the events unfold in Fairbanks, Julia knows only that her mother is "distracted, not there." And that a man "carrying a small black satchel" comes to the house and leaves her mother moaning in bed.

Once more, Rose leaves her now teenaged children behind as she returns to Nome. It is wartime and Lillian and Julia find jobs at the military base in Fairbanks. As suddenly as they came to Fairbanks, they are summoned back to Nome--no questions asked, no explanations given. Cappy's son is missing in action. Once again, Julia cannot understand the silence, the absence of grief displayed--"Isn't anybody sad? Isn't anybody upset?" (181) Rose's relationship with Cappy quietly ends.

As Julia finishes high school she fantasizes about leaving Nome, going to college, becoming a journalist--fantasies inspired by Rosalind Russell's role in the film, His Girl Friday, and by Sinclair Lewis's critique of small town life in the novel, Main Street. "I begin to discern, vaguely, tentatively, that somewhere there exists a world where the accepted language is the one that Sinclair Lewis speaks--a language of ideas and, even, of feelings." (212) Indeed, as the book jacket notes, the author graduated from Stanford and became a magazine editor; she lives in Manhattan.

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This is the most detailed and comprehensive biography of Anton P. Chekhov written to date. Rayfield is a Chekhov scholar who published an earlier biography of the writer in 1975. There are numerous biographies of Chekhov available. In the Preface to this book, Rayfield explains why he wrote it. Chekhov's life is documented by a vast amount of archival material, much of which was unavailable to Western scholars in the past. Russian scholars have studied these sources extensively, but the studies they have published use only a small part of the material. Rayfield's own study convinced him that by drawing liberally from these archives he could write a new biography that would increase our understanding of Chekhov's life and character.

Rayfield's approach is strictly chronological. The book consists of 84 short chapters, each one named and subtitled with the period covered (e.g. July - August 1894). Rayfield sticks closely to the texts, developing a rather staccato style that is heavy on factual statements and light on his own interpretations. He also chooses not to discuss Chekhov's writings as such, except to present brief summaries of the plays and some of the more important stories, and to indicate relationships between Chekhov's life and his art.

The new material gives us a much better view of the day-to-day texture of Chekhov's life, his interactions with family and friends, and his interesting and enigmatic relationships with women. The book also includes a helpful diagram of the Chekhov family tree, two maps of Chekhov's country, and many photographs.

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This first published work of fiction by Gertrude Stein includes two stories, "The Good Anna" (71 pp.) and "The Gentle Lena" (40 pp.); and a novella, "Melanctha" (151 pp.) Each one is a psychological portrait of the named protagonist. All three are members of the lower socioeconomic stratum of the fictional town of Bridgepoint.

"The Good Anna" tells the story of a German immigrant who kept house for Miss Mathilda. Anna was honest, steadfast, and loyal as the day is long, but she was also stern and difficult to deal with. Anna's special friend was Mrs. Lehntman, the romance of her life. After Miss Mathilda moved to a far country, Anna took in boarders for a living, didn't make much money, and after a while died. "The Gentle Lena" is the story of another German servant girl who married unhappily and died shortly after the birth of her fourth child.

"Melanctha" is an extended portrait of Melanctha Herbert, a mulatto woman, and her unhappy love affair with Dr. Jeff Campbell, the doctor who took care of Melanctha's mother during her final illness. Much of the novella consists of protracted conversations between Melanctha and Jeff and extensive descriptions of their respective mental states.

Eventually the two lovers drifted apart. Melanctha took up with Jem Richards, "who always had to know what it was to have true wisdom." But that relationship didn't work out either. Melanctha became depressed and considered suicide. After she recovered from depression, she developed consumption and died.

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Alice Jones divides The Knot into three sections. The first is a series of poems evoking the poet's painful and tender relationship with Peter, a former lover who is dying of AIDS. We encounter him first on a rainy day in his hospital bed at St. Vincent's ("The Umbrella"), and then through flash-backs to their earlier lives ("In the Pine Woods," "Painting," "Communal Living"). In the long poem "Blood Clot" the author creates and sustains a dynamism between detachment and engagement, objectivity and subjectivity, medical and personal knowledge: from "This time it's his heart. He has / a tumor" to "The glacier that / freezes us in place for centuries, / the same old separateness, only / this time it's called death. / How dare you do it to me / one more time."

The second, and most intensely personal, section imagines the poet's relationship with her mother. The title poem is the centerpiece here. In it, the knot has two faces: the tie that binds us together and an obstacle to be overcome. While loss is real, she writes, "I refuse to be alone. // There is only one / of us. Loss does not / exist in our vocabulary." ("The Lie") The last section consists of poems on a variety of topics, including a long poem about gross anatomy as an initiatory experience ("The Cadaver").

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In this remarkable book of essays, Rafael Campo explores his coming-of-age as a gay Cuban-American physician. He presents us with a series of stories illuminating his childhood and college experience, skillfully interweaving them with narratives from his life as a young physician, especially his interactions with patients dying of AIDS. We follow the author from Amherst College, through Harvard Medical School, to his medical residency in San Francisco. At each step Campo is a close observer of human character and motivation--his own and others. At each step he asks, "Who am I? Who am I becoming?"

He discovers his identity as a gay man, an Hispanic man, a poet, and, finally, as a healer--not four identities, but one. He discovers, too, the healing power of connecting with patients, the "poetry of healing," something far different from the orthodox image of the physician-as-detached-or-distanced from his patients. Though Campo rejects the concept that physicians are agents for social change ("naive," he calls it), he brings sensitivity and poetry to bear on his continued search for "some way to give."

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