Summary:

The title refers to a Veteran’s Administration hospital regulation concerning the withholding of full medical benefits if an ailment is not specifically related to military service. In an oftentimes comic battle between the forces of good--physicians and vulnerable patients--and those of evil--the administrators and their minions--the story has currency and direct appeal to viewers.

The Darth-Vader-like administrators are self-serving, inhumane bureaucrats with emotions that run the gamut "from A to B" (Dorothy Parker). Physicians, especially the character played by Ray Liotta, but also his dedicated colleagues, are imaginative and non-rule abiding in their central concerns: the patients. They listen to stories and sympathize; in addition, they turf, lie, steal, and do whatever is necessary to protect, serve, and treat their patients. When the government denies a heart bypass, for example, the docs schedule prostate surgery for the official record and do, instead, the needed heart surgery.

At times, it’s as if the Marx Brothers or the Keystone Cops have donned white coats to sneak around the hospital with patient-centered antics. In the absurd bureaucracy, viewers, perforce, must cheer enthusiastically for the merry band of renegade docs.

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Four doomed characters illustrate the downward course of drug initiation and addiction. Aronofsky's innovative portrayal is arrestingly brutal and compelling; many viewers will be disturbed by penetrating and darkly lucid visual effects guiding the descending spiral--from spring to winter, from life and hope to destruction and death.

One character, Sara Goldfarb, played courageously and brilliantly by Ellen Burstyn, becomes addicted to diet pills prescribed by a despicably careless physician. The other characters--her son, Harry (Jared Leto) and his two friends (played by Marlon Wayon and Jennifer Connelly)--are heroin addicts and dealers. In separate ways all move toward the same abyss.

Although graphic and, at times, extremely difficult to watch, the frightening nightmare of addiction should be required viewing for those who might yet succumb and those who think that just saying "no" works. The grisly and unbearably sad storyline and its explicit horror recalls the 1989 film and novel on which it was based, Last Exit to Brooklyn, also written by Hubert Selby, Jr.

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This unusual story, beautiful and overwhelmingly sad, is set in Sicily on the craggy and barren island of Lampadusa surrounded by the bluest of seas. Everyone in the small fishing and canning village may be related; certainly, this is a place where secrets are not possible. Grazia (Varria Golino) appears to be the loveliest and most loving mother and wife, although her carefree, even childlike behavior is foreboding. The camera loves her and so do viewers who are ravished by her beauty and innocence.

With children positioned on the back of her Vespa, she and they escape to a deserted beach where she swims topless with her children; later, she releases hundreds of howling stray dogs from their inhumane confinement. Not surprisingly, spied-upon actions such as these produce critical response from more conservative neighbors whose norms are less capricious.

When signs of instability and manic depression become apparent, the community joins together to suggest hospitalization to her very supportive and heart-broken husband (Vincenzo Amato). She, like the caged-up dogs, seems to deserve the kind of freedom epitomized by her trips to the beach and will not, we sense, survive medical "imprisonment."

At this juncture, just as her wings are to be clipped, the story’s unexpected turn forces the mourning village to wonder about human frailty and reality. The ending, ultimately unclear and haunting, is a celebration of imaginative madness and ephemeral beauty. Visually stunning.

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The story is based on an actual 1950's trip by two university friends, Ernesto 'Che' Guevara (Gael Garcia Bernal) and Alberto Granado (Rodrigo De la Serna). Guevara is studying medicine, Granado biochemistry. They plan to travel from Buenos Aires across the Andes Mountains to Chile, Peru, and, then, to Venezuela. Before too many miles their derelict 1939 motorcycle fails, and the two young men continue by whatever means is available. The journey intent is one of adventure--drinking, meeting women, seeing the world.

The young men do discover South America's impressive natural beauty but more strikingly, their eyes and sensibilities are directed to abject poverty and shocking injustices. These blatant inequities, as well as an extended period of time in a leper colony, contribute to the reframing of their original happy-go-lucky adventure and explain, in part, the impulses that eventually would shape Guevara's role in the Cuban Revolution.

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Oscar, the narrator of this fresh fictional gem, is ten years old. Because his form of leukemia has not responded to treatment, he has been living in a French hospital for a very long time. His parents, who bring him gifts and surely love him, are uncomfortable during their infrequent visits. Dr. Dusseldorf and the nurses are kind, but indirect and distant in their communications with him. Because no one talks to him about his illness or what is likely to happen, he feels isolated, alone, and miserable.

When Mamie-Rose, a very elderly hospital "pink lady" (hospital volunteer) with an exotic past, enters Oscar's life, she brings honesty, warmth, and comfort to the lost child known as Bald Egg. Guided by this incredible person--a blunt-spoken, irreverent woman who touches him, kisses him, and tells him wondrous stories of her wrestling feats--the boy grows stronger. Who wouldn't under the influence of the Strangler of Languedoc?

Of course Oscar is going to die. In addition to her generous companionship and her introductions of him to other children in the hospital, Mamie-Rose suggests letters to God as a way of feeling less lonely. "So God, on the occasion of this first letter I've shown you a little of what my life in the hospital is like here, where they now see me as an obstacle to medicine, and I'd like to ask you for clarification on one point: Am I going to get better? Just answer yes or no. It's not very complicated. Yes or no. All you have to do is cross out the wrong answer. More tomorrow, kisses. P.S. I don't have your address: what do I do" (65).

With Mamie-Rose treating him like a real kid, "move your but . . . we're not ambling along like snails" and Oscar scripting very candid letters to God, the first-person story about loneliness, love, and compassion is presented with spirited imagination. Oscar's story is quite extraordinary--and unforgettable.

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This story details several months in the life of a thirteen-year-old with incurable kidney disease and of her extended family--the policeman father who has cared for her since her mother ran off, the mother who reappears in time to learn she is the most likely donor, two sets of grandparents and several of the father's close friends. Two women in the father's life find their romantic attachments to him complicated by his role as his daughter's caretaker.

As Mary Grace's health deteriorates, her maturing accelerates. Each of the principal characters has to come to terms not only with impending loss, but with how this crisis reconfigures old patterns of family conflict and dependency. The story continues after her death as focus shifts to the father's grief, mourning, and new empathy with victims of accident and loss.

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In December 1995, at the age of 43, the author suffered a sudden and severe stroke in the brain stem and emerged from a coma several weeks later to find himself in a rare condition called "locked-in syndrome" (LIS). Although his mind was intact, he had lost virtually all physical control, able to move only his left eyelid. There was no hope of significant recovery. This memoir, composed and dictated the following summer, consists of Bauby's brief and poignant reflections on his condition and excursions into the realms of his memory, imagination, and dreams.

The composition of this book was an extraordinary feat in itself. Unable to write or speak, Bauby composed each passage mentally and then dictated it, letter by letter, to an amanuensis who painstakingly recited a frequency-ordered alphabet until Bauby chose a letter by blinking his left eyelid once to signify "yes." In what was likely another heroic act of will, Bauby survived just long enough to see his memoir published in the spring of 1997.

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At the age of 72, Lily Maynard finds herself suddenly famous for a memoir she has published about the disintegration of her marriage years before at the height of the civil rights movement, the women's movements, and the religious shifts of the 1960's. The book brings two young women into her life: one a journalist who wants to do a story on her, the other an African-American historian who takes an interest in the connections between her personal history and the pressures of the civil rights conflicts.

Simultaneous with her cresting notoriety is an exacerbation of the Parkinson's disease which makes it necessary for Lily to move in temporarily with her son and his wife while awaiting a place in a retirement home. Half her face is paralyzed; she has difficulty feeding herself; and her extreme fatigue makes it hard to conduct interviews without dissolving into a fog of incommunicable feeling.

Each of the younger people involved in her life is driven to come to terms with his or her own life in new ways, especially her son, who finds complex feelings surfacing after years of emotional estrangement. Ultimately, her story told, Lily quietly exits the family before relocation to a home by committing suicide with an overdose of medication. In the aftermath Alan's grief gives him a new understanding of his mother's life and his own.

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Like her earlier collection, Words Like Fate and Pain (see this database), the thread of connection among these exquisite poems is the experience of chronic suffering. However the poems vary widely in focus and content, including those that touch on the intimacies of love found and lost, family relationships, musings on the road, political events, philosophical ideas, and qualities of words themselves. All open doors to an inner life deeply examined and thoughtfully lived. The poems deal frankly not only with the experiences of various kinds of pain, but with pain remembered and feared, with the mental detachment that enables one in pain not only to endure, but even at times to be playful about the business of living life in spite of ongoing suffering.

One is aware of the speaker in these poems as not only a patient, but as a writer who loves words, a woman who enters wholeheartedly into the relationships life puts in her path, and an observer with a wry wit and sharp sense of irony. Poem titles include "Cripple Time," "Trauerarbeit," "Phantom Life," "The Mind, That Ocean," "Pain as Metaphor," "Sleeping in My Notebook," "One, With Egg Roll," and "Waltzing the Gorilla."

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This anthology is part of an emerging literature of HIV/AIDS in Africa. It offers individual stories about the impact of HIV/AIDS in Africa as a means of countering the mind-numbing statistics on infections and deaths. As the literature of the AIDS crisis in the United States in the 1980s and 90s brought to the general public the subjective experience of HIV/AIDS and thus strengthened the socio-political will to combat the virus, so this emerging literature of AIDS in Africa will deepen awareness about the crisis, engender sympathy for the individuals who suffer from it, and ideally help to shape an effective response to alleviate the devastation being wreaked by this epidemic.

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