Summary:

A woman who works at a rehabilitation center for the blind reflects on the deaths of the people around her, clients as well as patients. She recounts the reaction of the staff to the death of a well-loved employee of the center whose name the narrator doesn't recognize. As she assists the blind clients at the funeral home, she suddenly realizes she did know the dead woman, but never had known her name. The narrator reflects on how a sight-impaired friend of hers, Vange, approaches life with supreme attentiveness, and never misses any details. The colleague's funeral reminds the narrator that living means being more like Vange.

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This is the third volume of poetry by Ron Charach, who is a psychiatrist in Toronto, Canada. Charach's poems evoke a wide array of experiences and topics, ranging from surreal dream poems to images of family vacations, from an adolescent biker ("White Laces") to medical imaging techniques ("MRI" and "The Use of Contrast to Study the Spine"). Charach's tone is generally light, frequently insightful, and often surprising.

While "healing" poems are scattered throughout the book, one section ("The Calling") focuses on images of Charach's medical specialty, psychiatry. In "Psychiatrists on the Subway" the poet imagines an off-duty psychiatrist who "sets his ears / on the night table / and prays for a night of long silence / from a God who prefers / to listen." In "Newton" he invites the reader to glimpse the professional life--but with a grain of salt--as he muses about a colleague who "gave so much Electro-Convulsive therapy / he wore wooden cufflinks and rubber-soled Wallabies."

"The Naked Physician" presents an image of a kind and gentle doctor whose failure to be a good husband and father "will be recorded in the final light." Other outstanding poems in this collection include "She Will No Longer Take Her Food," "Equipoise," "Someone Else's Fire," "Labour and Delivery," and "Past Wildflowers."

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The narrator recalls a boyhood encounter with Rab, a majestic dog. Rab causes the lad to make friends with his master, James Noble, a simple horse-cart driver. Six years later, James brings his beautiful old wife, Ailie, to the hospital where the narrator is now a medical student. She has breast cancer and the surgeon tells her that it must be operated the following day. James and the dog are allowed to remain nearby.

Ailie endures the operation in brave silence, commanding silent respect from a lively group of students. James nurses her tenderly, but she develops a fever and dies a few days later. Shortly after her burial, he too falls ill and dies. Rab refuses to eat, becomes hostile, and is killed by the new driver.

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Canadian artist, Robert Pope (d.1992), devoted the last years of his short life to documenting his decade-long experience as a patient with Hodgkin's Disease. Shortly after his diagnosis he was influenced by the 1945 autobiographical novel of Elizabeth Smart, By Grand Central Station I Sat Down and Wept. Pope's early work explored the interconnectedness and pain of individuals bound by an imperfect love, in Smart's case for a married man. After his disease went into remission, he began to paint the patient's perspective on illness, hospitals, visitors, family, and health-care providers in a series of images that suggest the lighting of de la Tour, the photographic immediacy of Doisneau, and the menacing surrealism of de Chirico. His book, Illness and Healing: Images of Cancer (1991), became a bestseller.

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An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.

At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.

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Goya has painted his own portrait as he was during an illness in his old age. The ailing artist sits upright in an olive-green dressing gown; his face is pale and is hands clutch at the sheet against which the carmine blanket glows as the most vivid color element in the painting. He is surrounded and supported by his physician who offers him medicine in a clear glass. The background is both dark and dense, revealing two shadowy figures behind Dr. Arrieta's elbow.

An inscription runs along the bottom border of the canvas, forming a kind of ledge or barrier. It reads in translation: "Goya thankful, to his friend Arrieta: for the skill and care with which he saved his life during his short and dangerous illness, endured at the end of 1819, at seventy-three years of age. He painted it in 1820."

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The author is a fourth year medical student dealing simultaneously with the rigors of medical training and the difficulties of living with diabetes. She has discovered that when she tries to interact with patients she over-identifies with them. When she reads about diabetes in medical textbooks, which present a rigid equation for balancing diet, exercise, and insulin need, she tries to adopt this approach to her personal diabetes management, convincing herself that emotions, fatigue, stress and other factors have no effect on her diabetes control. When this biomedical approach fails, she feels deep shame and frustration.

Only over time does she develop the confidence to realize that it is not shameful to admit one's personal needs even in medical training, that disease is a part of all humans and is not an enemy, that she need not be defined solely by her disease (or her profession), and that blurred boundaries between doctors and patients are not as dangerous as she was first led to believe.

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The physician author is puzzled about what he can do to help a young woman who comes to him for treatment of her chronic abdominal pain. She has had every test, seen every specialist, and has no clear diagnosis. Only on the third visit, which she has initiated, does he discover that she was sexually assaulted at age 14. He is the only person she has told.

He immediately feels out of his element, and asks her to see a psychiatrist. She refuses, and insists he handle her care. He sets up open-ended visits to allow her time to talk, and looks for help in the medical literature and from a psychiatrist colleague.

Over time, as they explore her feelings and experiences, his patient gains self esteem and transforms herself into a confident, beautiful woman, planning on travel, school, and career. After her last visit with him, he realizes, "I had been chosen to receive a gift of trust, and of all the gifts I had ever received, none seemed as precious."

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A nephrologist is named in a lawsuit after serving as a consulting physician in a diabetes case. The diabetic patient had had a serious infection and later his leg was amputated; he apparently felt the doctors neglected the seriousness of his condition. When the dialysis unit treating this patient requests to transfer his care to the author, whose unit is in the patient's home town, the author is uncertain what to do.

The author is angry about the law suit, and his colleagues counsel him to refuse to take this patient. But after realizing that the lawsuit was merely a reflection of the patient's suffering, and that he needs the same compassion and care as any other human being, the author agrees to accept the patient. The author discovers that his patient is a meek, gentle man; over time, he helps him come to terms with his illness, his disability, and his approaching death. Eventually the patient drops his malpractice suit.

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In the introduction to Harvesting the Dew, Judy Schaefer poses the question, "Are nurses mere observers?" She goes on to reply, "in my view the nurse has a vantage point of not only observer but inflicter." This book is a collection of 60 poems arranged in three sections ("Day Shift," "Evening Shift," and "Night Shift") that correspond with three different nursing milieus and moods.

The book also includes an explanatory essay, "A Literary Nurse Bearing Witness to Pain," which concludes "literary nurses then are no longer anticipatory handmaidens but are a profession of men and women with their own highly valued language and structure for observation . . . Literary nurses will further define the caring that is crucial to the nursing profession."

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