Summary:

While driving away from a dangerous city in an area of north Afghanistan ravaged by war, three men must journey by foot when their car is damaged in an accident. Donk is an American combat photographer. Hassan is a young Afghan translator. Graves is a British journalist suffering from a severe case of malaria and in desperate need of medication.

They arrive at a remote village ruled by a warlord, General Ismail Mohammed. Medication is unavailable there and transportation to a larger city is not possible for at least another day. The local doctor recommends an herbal remedy for the treatment of malaria, and General Mohammed attests to its effectiveness. The medicinal grass grows only in a nearby mountain valley. Two soldiers escort Donk and Hassan to the vale. They encounter a convoy of transport vehicles that have been incinerated by a bomb blast.

When the grass is finally in sight, Donk and Hassan race towards it even as the two soldiers shout at them. Too late! Donk steps on a bomblet and the device detonates. Badly injured (and maybe even mortally wounded), Donk and Hassan lie on their backs and gaze at the sky. They are surrounded by the thick grass they hoped might save the life of their companion, Graves.

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This film by Danish filmmakers focuses on two Scots, Wilbur (Jamie Sives) and his older, considerate brother Harbour (Adrian Rawlins), who own a family buy-and-sell bookshop, North Books, in Glasgow. The opening movie credits intersperse with Wilbur's suicide attempt by pills and gassing himself. Wilbur's attempt is thwarted first by the fact that he has to put more coins into the apartment gas meter, and then by his brother, whom Wilbur had telephoned just before losing consciousness. Wilbur continues suicide attempts throughout much of the movie, with methods that range from the absurd to the disturbingly tragic.

The brothers' father had recently died and several scenes occur at a hillside cemetery. Surrounded by imposing stone monuments, the brothers' parents are buried without markers, but with a view, if you cock your head and imagine, of the bookshop. The tragedy of the mother's death when Wilbur was only 5 years old, is invoked to explain much of Wilbur's disturbance.

Early in the movie, Alice (Shirley Henderson), a waif-like single mother who cleans the operating and trauma theatres and sells books she finds at the hospital to the bookshop, is introduced, along with her soon to be 9 year old daughter, Mary (Lisa McKinlay). Alice and Harbour wed, and Mary presciently plunks a penguin eraser she has just received atop the wedding cake next to the bride and groom: "That's Wilbur," she says.

Two hospital workers feature prominently in the film. Horst (Mads Mikkelsen) is a Danish ex-pat physician and "senior psychologist." He chain smokes, distances himself from the group therapy he supposedly supervises, and yet deftly discusses bad news with Harbour in several scenes. The psychiatric nurse, Moira (Julia Davis), however, who, with ever-changing hairstyles and inappropriate nurse-patient interactions, acts primarily as comic relief, delivers the same bad news with unthinking, devastating directness.

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As Bertman says in her introduction, this book "is meant to refuel therapists, counselors, social workers, physicians, nurses, clergy and all others who are committed to providing support to those in grief." While the caregivers' focus is on those in grief, they also have to give some attention to their own bodies, minds and spirits. This collection of essays, poems and stories, illustrated with drawings and photographs, examines grief from several perspectives.

The opening section looks at professional roles in experiencing and understanding suffering and empathy. Section two provides several descriptions of how caregivers use the arts for themselves and for those they companion. Section three is devoted to lessons from old and new cultures. The final section explores basic needs of grieving people.

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The author of this bold collection is a registered nurse who relates, through her poems, patient and caregiver experiences culled from her own years of working in Intensive Care-Coronary Care. There are 24 poems here, most running two to three pages and most written in short lines, a point of craft that adds to their power. There is not one moment of easy sentimentality in these poems. Instead, the author plunges into the grittier side of nursing and illness--and yet, in aggregate, these poems celebrate the embodied and holy work of healing.

In the opening poem, "The-Trickle-Down-Theory-Of-Health," Adam, in the Garden of Eden, is surprised by "The knife" that "separates his ribs." By poem's end, we see health slip "like a ring / from earth's finger" (2), and with this simile we are introduced to the book's underlying metaphor and also to the poet's technique: dense and sometimes near-extreme imagery that ranges, in this poem alone, from encyclopedias to acid rain to barefoot children to librarians to a patient in the dark, "her arteries and shelves / of bone in a ruby gloom" (2). This accumulation of unrelenting, unusual images recreates the world of a patient's pain and suffering and the fierce determination and occasional despair of a caregiver.

"Coma" is written from a comatose woman's point of view, and yet we also see her from the nurse's vantage. In a lovely and surprising twist, the coma becomes, for the patient, a sort of liberation as "Slowly she sloughs, / cell by cell, / the old thorn" (15). This patient is not Sleeping Beauty, who in some fairy tale might be wakened by a kiss. "On the Fireline" becomes a wonderful metaphor for the daily confrontation of illness, for the way the nurse, returning daily to tend her patients, also "coalesces into fire" (16).

The 5-page poem "Intensive Care" perfectly renders the physical sense of being alternately caregiver, patient, and family member within the rarified atmosphere of the ICU (24-28). A patient's blood "pulls against/ the moon, his breath / this tide going out" (26) and, as she comforts a waiting family member, a nurse's eyes "beyond clarity, / unfold a silken language / all their own" (28).

Other not-to-be-missed poems are "The Holy O" (36), "Prayer to a Purple God" (38), "Pieta" (44), "A Riot of Flowers" (52), "What the Body Remembers" (57), and one of my very favorites, "Anesthesia" (59). In "Anesthesia" the caregiver lets an anesthetized patient float like "an embryo / tethered on the end of IV tubing, / floated like an astronaut / in cold stratosphere, / a naked thing / alone / in the universe" (60). But since these poems are finally loving, involved, experienced and hopeful, the patient is told to hush; he is watched over; he is protected. When danger is past, he is reclaimed: "She will hold you / within white-curved wings. / She will reel you back in / when you are healed" (60).

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Written while Carruth was approaching or had reached the age of 80 years, this collection understandably reflects the recognition of aging, loss, and of a changing world. Also, there are memories--of jazz and jazz players, relatives, pets, youth. And there is life in the present--with grown children, old friends, the Vermont countryside, writing, remembering, coping, not coping. Throughout, Carruth has a no-nonsense style; a mixture of straight talk, irony, irreverence, contemplation--and wonderful craft.

Carruth's adult daughter, Martha, died miserably of cancer in the late 1990s; in Part II, "Martha," Carruth describes himself as "blocked and almost silent / for two years. Titled "Dearest M --", this is a 15-page elegy that accomplishes "a release of some dire kind" (46) for Carruth, but he can't take pleasure in the release, feeling shame instead ("how shaming, how / offensive!"). Even in his mourning, Carruth raises questions about the ethics of writing such poems, and questions whom he is addressing ("not Martha. The absence / is like a hollow in my mind" [48]).

Section IV, "Faxes to William," is a series of 54 short poems addressed in "faxes" to a mysterious William: "William, do you know why / I like writing these faxes / to you? Because you / don't have a fax machine" (75). The poems instruct William about writing poetry ("some poets write blurbs, William, / and some do not. And it is by / a law of nature that the former / envy the latter desperately . . . They have unmade / their beds and they must schlepp in them" [67]); and life ("William, for the things / life didn't give us / we have no / compensation. None." [7]); and pose conversational questions ("You say I shouldn't write / so much about old age?) that have their own answers (I always / told my students to write / about what they know" [86]).

Section V, "Basho," is in dialogue with a 17th-century Japanese poet who is considered to be the best haiku poet during the time this form was being developed. Carruth's haiku-like poems in this section blend reflections on aging with reflections on writing poetry.

The final section, "Second Scrapbook," continues to explore memories ("Memory," in which Carruth learns of a former wife's death and can remember her--fondly--only as she was years ago. "My dear, / How could you have let this happen to you?" [116]); growing old ("Senility": "week after week, the mist gathering" [120]); representation ("Something for the Trade": Please note well, all you writers, editors, directors / out there: when a phone call is terminated / by the other person you do not, NOT, hear / a dial tone" [121]).

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Two men who are not very fond of one another and opposites in almost every way are brought together by their affection for the same woman. Isabel is the 30-year-old wife of Maurice Pervin and the longtime friend of Bertie Reid. While fighting in Flanders during World War I, Maurice is blinded and sustains a disfiguring facial scar. He also has episodes of major depression. Maurice and Isabel have become socially isolated since his injury. Although their first child died in infancy, Isabel is pregnant again and due to deliver soon.

Bertie, a bachelor and barrister, pays a visit. The three of them enjoy dinner together. Afterwards, Maurice becomes restless and leaves the house. When Bertie goes out to check on him, he finds Maurice in the barn. The blind man asks Bertie for permission to touch him. With one hand, Maurice examines Bertie's skull, face, and arm.

He then asks Bertie to touch his useless eyes and awful scar. Without warning, Maurice places his hand on top of Bertie's fingers, which still rest upon the maimed face. The experience is a revelation for both men. Maurice suddenly understands the splendor of friendship while Bertie realizes how much he fears intimacy.

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Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

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Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.

Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.

Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."

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The narrator is an inexperienced and overworked doctor in a remote region of Russia. Although accustomed to seeing as many as a hundred or more patients in a day, a blizzard brings him unexpected relief. Only two patients show up in the clinic. He welcomes the prospect of a leisurely day but soon receives a summons for help from a physician in a nearby district.

A bride-to-be has fallen out of a sleigh and is unconscious. The narrator travels more than 2 hours to lend his help, but she is already dying. He later realizes the young woman had a fracture at the base of the skull. Ignoring advice to stay the night, the doctor insists on returning home. Four hours after departing in a sleigh, the doctor and driver are lost and trapped in the snow. With great effort, the two men free the sleigh and horses from the drifts.

As their journey resumes, wolves chase the sleigh until the doctor fires his pistol. Finally, he sees the lights of his hospital in the distance. Once safe in his house, the doctor picks up a manual containing information about skull fractures but decides instead to go to sleep.

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In the Foreword to this collection, poet John Graham-Pole writes, "Children have uncovered for me the last and greatest lesson: souls thriving on failing at bigger and bigger things" (xvii). The heroes of these poems are just such children, transformed by serious illness. For example, Dominic in "Waiting" who "rests on his airbubble cot / awaiting life’s flight from its earthly beat" (10); Ruby in "Ruby Red": "And so poor Ruby meets her final test, in gentle hemolysis rolled to res" (35); the lovely young woman in "Elegy": "You’re newly dead, sans wig, / seventeen year old virgin whom / I’d loved." (57).

"I try through writing poems to lay a finger on the purpose of illness, on its pulse .  . Poems turn denial and withdrawal into compassion--feeling with. They turn fear into mercy--thank you" (xvii). The poet’s eye remains dispassionate, even though his heart may be breaking, as in "Last Rites" (32), in which a dead toddler’s father and his companion "sluice down the flooring with their hoses. After the vomit and blood the water runs clear." He understands the limits of communication about loss, but recognizes, too, that we must make the attempt; and the attempt has meaning in itself: "Afterward the circles of our talk / snap . . . - Within, we write our / separate texts of it. Between, the tension / stands: this no talk could break." ("Circles," p. 87)

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