Summary:

This is a dramatic and moving story about a concert pianist who, at 45 years of age, suddenly and inexplicably, has ALS, and also equally about his ex-wife Karina, who takes on his care throughout his slow, inevitable, and lethal decline. As many readers know, ALS (Amyotrophic Lateral Sclerosis). or “Lou Gherig’s disease,” hardens the motor nerves so that, progressively, there is no more control of muscles throughout the body. Not many readers know, however, the difficult path such patients and their families must pursue. This sensitive and detailed novel takes readers powerfully into the world of ALS, a disease for which there is today no cure.                                                                                      

Obsessed with his musical career and international travel, Richard has paid little attention to Karina and their daughter, Grace, and he has had affairs with other women. Karina has deceived him about her inability to bear more children. Because of their move from New York City to Boston, Karina, also a gifted pianist, has lost a possible career in jazz and now gives piano lessons to unpromising students. 

The first several chapters alternate between Richard and Karina. Although divorced from him, she brings him, now an ALS patient, back into the home they once shared. Various nurses, doctors, and other specialists try to explain the difficult future that includes certain loss of body functions, but Richard and Karina are slow to comprehend these. Despite their denial, they are forced to come to terms with Richard’s progressive decline and, finally, death.     
          
Richard loses the ability to use his hands, then his arms. He needs a special machine to breathe at night. Soon he has paid caregivers for parts of the day; these include a cheery and admirable man named Bill. No longer able to eat, Richard has a feeding tube. Later he needs a hospital bed. Also a Head Mouse to work his computer. Also an elaborate wheelchair. With unresolved issues in the past, Richard and Karina are emotionally apart—even with feelings of hate and rage—even while she cares for him.  

Karina’s walking partner Elise, a teacher, helps her stay sane. Karina travels to New Orleans with Elise and her class and finds her interest in jazz reawakened. No longer able to breathe even with assistance, should Richard go on to mechanical ventilation that will require 24-hour care at enormous expense? A choice is made. Richard dies, with various resolutions before and after his death.  

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Fran, an aging but energetic expert on elder housing, drives around the English countryside visiting facilities and also friends and family.  She, herself, is not at all ready to go gentle into the good night so many others are facing.  But everywhere she encounters reminders of mortality--her son's fiancee suddenly dies; an old friend is dying a lingering death of cancer; others in her circle of family and friends are facing their own or others' mortality in various ways, including natural disasters like earthquake and flood.  The episodic story takes place in England and in the Canary Islands; the large cast of characters are linked by intersecting stories and by their mortality, of which they, and the reader, are recurrently reminded.    

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Brother, I come o'er many seas and lands

To the sad rite which pious love ordains, 

To pay thee the last gift that death demands ;

And oft, though vain, invoke thy mute remains : 

Since death has ravish'd half myself in thee,

Oh wretched brother, sadly torn from me ! 

And now ere fate our souls shall re-unite,

To give me back all it hath snatch'd away, 

Receive the gifts, our fathers' ancient rite

To shades departed still was wont to pay ;

Gifts wet with tears of heartfelt grief that tell,

And ever, brother, bless thee, and farewell!

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Summary:

Haunted by grief over the loss of his young daughter, Felix is a gifted director at a theatre festival. He plans an inspired interpretation of The Tempest, but is unfairly ousted from his beloved position by a jealous and inadequate rival.

As his fortunes dwindle, he accepts a position to promote literacy in a local prison—and hits upon the idea of using his newfound but incarcerated protégés to mount his long-planned Tempest. The project encounters financial difficulties that begin to seem insurmountable as his hostile rival assumes an influential government position.  

The result exceeds all expectations, helps to heal his grief, and with its unorthodox staging, provides a delicious revenge.

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This collection of poems is a memoir in verse: it is a lyric and epistolary exploration of what it is to live in the limbo of an emotional and psychological ambiguity whose genesis lies in maternal loss, mourning, depression, and despair.  The poems are arranged in three sections:  “Crossing,” “Asylum Song,” and “Holding.” 

The “Crossing section generally conveys to readers the nature of life in this limbo, even as it discloses some of the familial anguish that has brought about a repressive silence in the poet’s mother, as well as a depression that wreaked its havoc on the poet’s growing up.  The family mysteries and the suffering of the poet prompt her to research the death of her maternal grandmother, and we learn many details of that loss in the poems of the “Asylum Song” section. 

A Czech immigrant, the woman had, in the old country, lost her parents and sister, and she’d apparently abandoned—for reasons unknown—her illegitimate child.  She’d married an older man and moved to the States.  After giving birth to another child, she suffered a postpartum depression, for which she was placed in an asylum, and was heavily and inappropriately medicated.  She died within three weeks, at age 34.  Her daughter, the poet’s mother, grew up in her absence and, in turn, lost her own child—the poet’s sister—in infancy, prior to Baptism. 

According to widely held beliefs of Catholics at the time, the infant would thus be relegated to Limbo for eternity: she would be barred from union with God, this is to say, though kept free from any punishment or any suffering, other than the longing for a bliss she could never attain.  Such a belief would clearly exacerbate the feelings of failure and guilt that a mother might feel in losing her infant.  The poet’s mother’s depression resulted, unsurprisingly, in a bewildering absence of maternal care in the poet’s life: she is stuck in her own “asylum” or Limbo—a state of emotional confinement where she maintains some vision of “beatific” maternal love, but feels it forever beyond her reach to experience.  The poems of the final section, “Holding,” convey the struggle and surprising joy of inhabiting this Limbo.

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In "Mandatory Evacuation Zone," Felice Aull has gathered 63 beautifully crafted poems in which she examines the intricacies of language and loss, of grief and healing.  Each of the book's five sections considers these themes in slightly different ways, always in language that is understated, vivid, and exact.  In Section I, we read poems that focus on the author's complicated family history and her early loss of homeland.  In "Tracings" (page 15), an unknown relative (thanks to online genealogy searches) reaches the narrator and wants to meet her.  She, however, only wishes to learn ". . . how my parents / and my infant self / made our tortuous way out . . . . " Brought in infancy from Germany to America, the author suffers the loss of both native homeland and native language ("Notes from an Alpine Vacation" page 16).  She searches photos of her mother and ponders museum note cards illustrated by Holocaust survivors ("Museum Notecards" page 18), imagining what she can't quite know and yet can't quite forget.  

Section II finds the narrator as a young woman in American, awakening to sexuality ("Gay Blades," "Camp Counselors Make Out,"  "On the Staircase" pages 29-31), becoming a wife and mother, and then a grandmother.  A grandchild's birth is both joyful and yet another "slipping toward / the edge of separation" ("Daughter in her Eighth Month" page 37). 

In Section III, the author turns her gaze to observations of the world around her, around us, aware of how many come to loss and death.  "Be prepare to mourn," she tells us in "Disaster in October" (page 49), and in the moving poem, "I Saw the Smoke," re-visions September 11th in words stripped of sentimentality and therefore made more powerful. 

Sections IV and V confront bodily loss through aging and illness, noting how, in so many ways, we try both to capture and to let go: "You snap photo upon photo / hoping to grasp and preserve / what cannot be grasped" (Capturing Alaska" page 66).  We learn of the most personal losses in poems of biopsies, surgeries, and chemotherapy.  When facing the unknown, every event might seem to hold a prediction.  In "Stunning Blows," a doorman stuns a mouse, claims that it's dead.  But the narrator, aware of the wages of time, writes, "But I still see it, like death, / moving toward me" (page 81).  At the book's end, we return to language, how it too can leave us ("Forget That" page 90).  Yet in the collection's final, gentle poems, the poet is "able, finally / to walk past the park's redbud tree / without weeping" ("Immunity" page 96).

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Dr. Monika Renz’s work with dying patients is unusual if not unique in the way she appropriates and applies insights from Jungian depth psychology, practices available in patients’ faith traditions, and musically guided meditation to invite and support the spiritual experiences that so often come, bidden or unbidden, near the end of life.  An experienced oncologist, Dr. Renz offers carefully amassed data to support her advocacy of focused practices of spiritual care as a dimension of palliative care, but is also quite comfortable with the fact that “neither the frequency nor the visible effects of experiences of the transcendent prove that such experience is an expression of grace” because “unverifiability is intrinsic to grace.”  Still, her long experience leads her to assert not only that “grace” can be a useful, practical, operative word for what professional caregivers may witness and mediate but also that affirmation and support of patients’ spiritual, religious, or transcendent experiences in the course of dying can amplify and multiply moments of grace, which manifest as sudden, deep peace in the very midst of pain, profound acceptance, openness to reconciliations, or significant awakenings from torpor that allow needed moments of closure with loved ones.  Describing herself as “an open-minded religious person and a practicing Christian,” she reminds readers that God is a loanword, whose basic form in Germanic was gaudam, a neutral participle.  Depending on the Indo-Germanic root, the word means “the called upon” or “the one sacrificed to . . . .”  Openness to the divine in both patients and caregivers, Dr. Renz argues, can and does make end-of-life care a shared journey of discovery and offer everyone involved a valuable reminder that medicine is practiced, always, at the threshold of mystery.

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These poems are not a cancer chronicle, but the experience of living with cancer is threaded through them in a way that illustrates beautifully how awareness of illness may permeate daily life, but is foregrounded and backgrounded, reshaped and revisited in shifting ways as it takes its course.  They encompass moments in family life, moments in the hospital, moments of spiritual longing and awareness of loss.  Together they offer a record of accommodation, acclimation, and complex acceptance.

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In this follow-up to his masterful memoir Do No Harm, British neurosurgeon Henry Marsh must deal with old age and retirement after nearly four decades as a doctor. Stepping down engenders mixed feelings, and he confesses to "longing to retire, to escape all the human misery that I have had to witness for so many years, and yet dreading my departure as well" (p17).

Marsh keeps busy by spending time in Nepal training young doctors and operating. He also makes visits to the Ukraine to perform surgery and teach. He has a fondness for creating things and purchases a fixer upper cottage that he struggles to repair. Marsh recounts previous neurosurgical cases, mostly patients with brain tumors. He remembers the distress at being sued by patients. He reveals his own admission to a psychiatric hospital as a young man. Regrets, both personal and professional, are confessed.

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This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians.   Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few. 

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334).   The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185)  The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor. 
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field.  Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul".  Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151) 

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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