Summary:

Matt leaves a swim meet, happy with his performance, to drive home on a snowy road with his mother and sister.  On the way their car is hit by a drunk driver who swerves out of his lane.  His mother is killed instantly, his sister badly injured.  When he has received treatment in the hospital for an injured shoulder, his best friend’s family comes to pick him up.  He isn’t allowed to see his sister for days, and when he finally does, she looks lifeless and unfamiliar, tubed up in the ICU.  At home with his friend Jamie, he remembers a time when he and his sister rescued a robin, only to see it die.  The story traces the days and weeks following Matt’s loss—his mother’s funeral, his friend’s family’s decision to adopt him, and eventually his sister’s death.  Despite his struggle with grief, anger, and bewilderment, Matt also has times of hope and pleasure in his new relationship to a family he already loved.  Readjusting to school is one of the many challenges he faces.  When he does return to school, he finds himself and his perspective changed, and realizes loss has grown him up in unexpected ways.

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The writer opens the volume by discussing the ways in which the poetry created by the affected person differs from the narrative form of describing the experience of illness—the classic “pathography.”  The essays in the collection demonstrate, by using examples, some of the unique qualities of the poem as an alternative to a prose narrative progression as well as the ambiguities introduced by the language of poetry. The discussions of the poetry presented provide the reader with guidance to the acceptance of poems in their “own terms” in order to understand the poet’s internal sense of the meaning of illness.  By allowing new and different information to become available for consideration the careful reader may gain new insights into the lives of those who are ill or disabled.

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Centered on an 85 year-old widower named Mo, the play brings to life many of the issues around end-of-life choices. Mo talks with his late wife, Dolores, through her picture and lets her know of his plans to come back to her. but his plans are interrupted--first by a neighbor and later by his nephew. Each interaction illuminates some aspect of the issues facing Mo: risk factors (loss of his spouse, other friends, work); warning signs (insomnia, giving things away) and protective factors (strong relationship with his nephew). The play shines a light on these themes while always keeping the characters honest and real. Yet the play isn't morbid. The audience frequently shifts from tears to laughter as the play weaves in light moments. In one particularly funny scene, Mo's best friend appears handing out condoms and promoting "Safe Sex 'till Rigor Mortis."

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With the publication of Stag's Leap, it is very publicly (on the flyleaf) revealed that Olds is writing about the sudden, unexpected death of her 32 year marriage when her husband left to be with another woman. She waited 15 years after the event to publish this book, not wishing her children to have to face the immediate publicity.  Stag's Leap refers both to the favorite wine that she and her husband drank together, and to his leap out of the marriage.

The collection is divided into sections: the year of her husband's revelation and departure, beginning with "While He Told Me"; several years following, divided into seasons; and "Years Later." The poems detail her shock, grief, and eventual acceptance, covering a wide range of emotion, hindsight, and insight. Since the poems were written more or less in the moment, and extend over several years, the reader experiences Olds's evolving inner landscape along with her. The perspective is one of shock - with only the slightest hint of possible trouble ahead: while doing the laundry, she found a picture of the "other woman" in her husband's running shorts ("Tiny Siren," p. 56). But "he smiled at me, / and took my hand, and turned to me,/ and said, it seemed not by rote, / but as if it were a physical law / of the earth, I love you. And we made love, / and I felt so close to him - I had not / known he knew how to lie. . ."
 
Throughout much of the book there is this theme of blissful ignorance torn to shreds and a questioning of how the poet could be so deceived in her assumptions about the relationship - "when I thought he loved me, when I thought / we were joined not just for breath's time, / but for the long continuance" ("Unspeakable," p. 4). The realization of self deception and love lost is both annihilating and shameful: "if I pass a mirror, I turn away, / I do not want to look at her, / and she does not want to be seen  . . . I am so ashamed . . . to be known to be left" ("Known to Be Left," p. 18).

These poems are an intense self-examination and an attempt to understand what happened. "I was vain of his / faithfulness, as if it was / a compliment, rather than a state / of partial sleep" ("Stag's Leap," p. 16). "I think he had come, in private, to / feel he was dying, with me" ("Pain I Did Not," p. 26). "maybe what he had for me / was unconditional, temporary / affection and trust, without romance" and "what precision of action / it had taken, for the bodies to hurtle through / the sky for so long without harming each other." ("Crazy," p. 65 ). There is a recognition that their two worlds were vastly different - he a physician, she a poet - and that their personalities were vastly different - he taciturn, she verbal and open. Olds speculates that even her writing about family and marriage could have been a factor in the divorce: "And he did not give / his secrets to his patients, but I gave my secrets / to you, dear strangers, and his, too . . Uneven, uneven, our scales / of contentment went slowly askew" ("Left-Wife Bop," p. 83).

Still, Olds finds something redeeming: "I saw again, how blessed my life has been, / first, to have been able to love, / then, to have the parting now behind me  . . and not to have lost him when he loved me, and not to have / lost someone who could have loved me for life" ("Last Look," p. 14). "What Left?," the last poem in the collection, presents the marriage and its aftermath as a movement: "we did not hold still, we moved, we are moving / still - we made, with each other, a moving / like a kind of music: duet; then solo, / solo." (p. 89)

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In her reflections on the vocation of nursing Robinson explores many myths and archetypes that give shape and energy to the identity of the nurse as it has evolved in Western culture, including the stories of Hygeia, Baubo, Hermes, Hecate, Cassandra, and the Dionysian Maenad.  The ancient stories of each of these figures and others articulate particular constraints, conventions, and conflicts involved in caregiving, especially in the ways women assume the role of caregiver.  She explains at the outset that she deals particularly with women in nursing, though now many men are nurses, since traditionally it has been a profession deeply shaped by cultural notions of female roles.  Another layer of this exploration is a chapter on the nurse in popular culture that considers ways in which the figure of the nurse has been both elevated and debased, made comic or tragic, sidelined or sexualized.  The multidimensionality of the nursing vocation and, consequently, the challenge it poses to women who enter it, is strongly emphasized throughout the six chapters, which together depict the work of nursing as a soul journey. This journey challenges nurses in new ways to work within institutions that suppress important aspects of their power to do healing work at a level of intimacy generally not accessed by doctors.

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At five years old, Willow O’Keefe has lived a life rich in love and exceptional learning; she reads beyond her years and has memorized a startling compendium of unusual facts.  She has also sustained over 50 broken bones, two of them in utero.  She has osteogenesis imperfecta, a congenital defect in the body’s production of type 1 collagen that leaves bones very brittle.  People with the disease generally suffer many fractures and often other conditions—exceptionally small stature, hearing loss, and bowed limbs.  Willow’s parents and older sister have organized their lives for five years around protecting her from damage and helping her heal from her many broken bones.  Though Amelia, her older sister, loves Willow, her parents’, Charlotte and Sean’s, intense focus on Willow’s condition often leaves her jealous and disgruntled.  Things go from bad to worse when their mother learns that a lawsuit for “wrongful birth” is legal in New Hampshire, and could bring them the money they need to cover Willow’s many medical expenses.  Such a step, however, means losing a best friend, since the obstetrician who oversaw Charlotte’s pregnancy and Willow’s birth, and who ostensibly overlooked signs of the disease and failed to warn the parents, has been Charlotte’s best friend for years.  A “wrongful birth” suit is based on the claim that medical information about a congenital defect was withheld that might have been grounds for a decision to abort the pregnancy.  Though Charlotte insists this drastic step is the best thing they can do to insure a secure future for Willow, Sean finds it repugnant enough finally to leave home.  It is clear that even a win will be a pyrrhic victory, and indeed, the outcome is ambiguous, costly, and life-changing for everyone concerned.

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This collection of 16 short stories focuses on doctors and patients in San Francisco, where a wide variety of wealth and culture impact the delivery of medical care.  Further, there are many restrictions—financial, bureaucratic, ethical, and legal —that limit what doctors can do, especially in cases of patients near death.

The author, Louise Aronson, is a geriatrician who knows this terrain very well, having trained in San Francisco and worked as a physician there. A skilled writer and close observer, she has created dramatic and often funny stories that reveal social and bioethical complexity. About half the stories describe end-of-life issues for the aged and the dilemmas for their physicians and families.

In ‘The Promise,” Dr. Westphall orders comfort care only for an elderly patient who has suffered a massive stroke, but a hospital gives full treatment because there was no advance directive and the daughter told the attending to do “what he thought best.”

When Dr. Westphall sees this barely functioning patient in a skilled nursing facility seven months later, he tenderly washes her face and hair—although the text teases us that he might have been prepared to kill her.

In “Giving Good Death,” a doctor is in jail charged with murder; he has fulfilled the request of Consuela, a Parkinson’s patient, to help her die. When it appears that she may have died for other reasons, he is released, his life “ruined.” He leaves San Francisco, and, we surmise, medicine. In three other stories, doctors also leave the profession: the cumulative stresses of work and family and/or a sense that it’s not the right path bring them to that choice.

On the other hand, one of the longer pieces “Becoming a Doctor” celebrates the profession, despite all the rigors of training including sexism against women. 

The stories bring multicultural insights; we read of people from China, Cambodia, Latin America, India, Russia, and the Philippines. Some are African-American; some Jewish, some gay. These different backgrounds color notions of health, death, and medical care. There are also pervasive issues of poverty and, at another extreme, professionalism that is hyper-rational and heartless.

Indeed, a recurring theme is care and love for people, no matter their background or current health status. A surgeon realizes (regrettably too late) that the secret of medical care is “caring for the patient—for anyone—just a little. Enough, but not too much” (p. 135). 

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Emily Bauer, mother of two small children, psychotherapist and teacher, social, smart, athletic, and strong-willed, finds, after a curious series of falls and other accidents, that she has ALS, "Lou Gehrig's Disease," a disease that involves slow atrophy of all muscular control, leading to complete paralysis and then death.  The disease is relentless, and treatments palliative at best. 

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Tora lived happily on a mountain farm in Norway until her beloved mother's death  and her own subsequent diagnosis with leprosy, an illness common in early 19^th-century Norway and one that drove her mother to suicide.  Upon diagnosis (at the age of 13) she is taken to the leprosarium in Bergen, from which very few emerge.  Most are left there by families whose fear of the disease leads them to abandon even much-loved children, parents, and spouses.  There, despite the misery of living among many who consider themselves the living dead, she finds a friend in Marthe, the chief cook and general caregiver, a woman of almost boundless kindness; and the "Benefactor," a pastor who is remarkably unafraid of the disease from which most flee, and who befriends Tora as she grows into an unpromising early adulthood.  Another unlikely friend is a noblewoman who has languished, embittered, behind a closed door with a trunk full of her old gowns and several cherished books, including the Bible, The Divine Comedy, Gulliver's Travels, and a popular Norwegian epic about the adventures of Niels Klim at the center of the earth.  She gradually softens toward Tora, who cares for her tenderly as the older woman teaches her to read.  Reading becomes not only Tora's consolation, but that of many of her fellow inmates.  Near the end of her own short, but surprisingly rich life, Tora's father shows up after years of neglect.  Forgiving him, almost against her will, she reaches a new level of acceptance of her own mysterious fate.  The book includes a short afterword about the actual leprosarium in which the story is situated and about Gerhard Armauer Hansen who in 1873 discovered the bacillus responsible for leprosy, the first bacterium proved to be the cause of a chronic human disease.

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Where many writers about illness have raised questions about the widespread and often unexamined appropriation of military metaphors to describe how doctors and patients have "struggled with," "combatted," "fought," or "defeated" illness, Dreuilhe embraces it and plays it out to the far reaches of its logic.  Part of the brilliance of this AIDS narrative lies in the way it brings new dimensions of meaning to a metaphor that has become so conventional as to be cliché or so imbedded in the language of illness and treatment, it simply fails to be recognized as metaphor.  Beginning with the "simple skirmishes at the frontier garrisons," Dreuilhe chronicles the progression of his own illness with the sharp eye of a good war reporter who sees through the chaos of the battlefield to the strategies being played out.  "Whenever I take an experimental drug," Dreulhe writes, "—and people fight desperately to be among those privileged to risk their lives—I feel as though I belong to a unit of shock troops parachuted behind enemy lines: already written off as a casualty, I'm entrusted with the task of spearheading the advance."

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