Summary:

A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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Gilbert begins her narrative with the event that inspired her to write: her husband's death in 1991 after a routine prostatectomy. "Though he was in robust health apart from the tumor for which he was being treated, Elliot died some six hours after my children and I were told that his surgeon had successfully removed the malignancy. And for the first six months after he died, death suddenly seemed plausible ... "(1).

But whereas her book Wrongful Death (annotated in this database) deals with Elliot Gilbert's death, the present work takes the author through death's door into personal reflection and research across a vast area, including personal, cultural, and literary aspects of death. Larger than a memoir, her work universalizes her personal experience with dying and death. And writing is what she does and what she has to do: "THIS is the curse. Write" (92).

Gilbert divides her material into three main sections, each containing several subsections: 1. Arranging my mourning: five meditations on the psychology of grief; 2. History makes death: how the twentieth century reshaped dying and mourning; and 3. The handbook of heartbreak: contemporary elegy and lamentation. The 27 illustrations she has selected range from the Isenheim Altarpiece by Matthias Grünewald to recent photographs by Dan Jury, to Maya Lin's Vietnam War Memorial. In these symbolic representations, Gilbert finds our universal fear of the process of dying, "If this is what it is, GrŸnewald seems to be telling the viewer, for Our Lord to die the death, what must it be for those of us less staunch, less noble - in short, less divine?" (115).

Traditional elegy, by John Milton and Percy Bysshe Shelley, on the other hand, seeks to comfort the poet and reader with the hope of a life hereafter, but modern secular poets like William Carlos Williams and Samuel Beckett offer no solace at all. The older term "expiration" gives hope that our spirit may survive our death. But "termination," the twentieth-century word for death, describes how humans and animals die, in our post-Darwinian world. Her word for this is nada. The holocaust stands as the ultimate ex-termination, or death by technology.

Seeking to understand Sylvia Plath's disease- and death-filled poetry, Gilbert travels literally to Berck-Plage, France, and figuratively, through the notorious "Daddy," "Lady Lazarus," and "Getting There." As a woman and a writer, Gilbert is fascinated by Plath: "For perhaps more than anyone else - more even than her much-admired Wallace Stevens himself - she really did articulate not just the vision but the 'mythology of modern death' that Stevens tentatively proposed" (310). The author contrasts Plath with nineteenth-century Walt Whitman who said, "... to die is different from what anyone supposed, and luckier" (332). Whitman seems to be ambivalent or even positive towards death; Emily Dickinson, of his same century, finds death terrifying.

Ultimately, modern death is embarrassing; death avoidance prevails, notably among doctors. This despite the fact that the first patient a medical student sees is a cadaver. Death is a doctor's failure and it is easier to blame the patient than to accept the death. Death in an American hospital is a "humanectomy", or physical removal of the individual's humanity as she/he is attached to IVs, monitors, feedings tubes, and other mechanical devices.

Modern hospital death is demeaning, because patients are granted little privacy, their TV sets are set to blaring; all personnel, including doctors, enter their rooms unannounced: "Whereas the patient is emotional - fearful, angry, needy - the doctor is detached, abstract, 'objective' " (189). Clearly, the author still lovingly mourns her dead husband bleeding to death alone in a hospital room. Energized by lost love, she writes and documents and works her way toward death.

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The narrator is visiting a patient in a mental hospital and sits chewing his sandwich. He has also brought a sandwich for the patient (his brother? father? friend?), but the patient just holds his sandwich motionless in front of his mouth. The narrator tries to accept this as ordinary; he keeps chewing. But his "past is sitting in front of" him, trying unsuccessfully "to bring the present to its mouth."

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Pym’s novels depict ordinary life among middle class Englishmen and women with compassion, humor, and irony. The quartet denoted in this title consists of two men and two women in their sixties, the autumn of their lives. These characters hold menial jobs at the same office in London during the nineteen-seventies; two live in rented rooms, and two own their own small houses. Pym’s opening chapter catches them going to the library, because it is free. She clues us in to their personalities by describing their hair: Edwin’s hair is “thin, graying and bald on top”; Norman’s hair is “difficult”, as he is; Letty wears her faded brown hair too long and soft and wispy. Marcia’s hair is “short, stiff, lifeless” and home dyed. (1-2)

Only Letty visits the library because she likes to read; the others take advantage of the shelter it offers. Edwin frequents the local churches when there are masses or holiday celebrations with sherry and perhaps free food. Pym depicts their office routines, conversations, and uneventful lives. When Letty and Marcia retire, the (acting) deputy assistant director wonders what they have done during their working life: ”The activities of their department seemed to be shrouded in mystery – something to do with records or filing, it was thought, nobody knew for certain, but it was evidently ‘women’s work’, the kind of thing that could easily be replaced by a computer.” (101)

Letty moves in with another woman, and Marcia, alone in her house, wears her old clothes and forgets to eat. She resists the well-meaning social worker knocking on her door. Letty begins thinking of her failures: she did not marry, and she has no children or grandchildren. After some time, Edwin arranges a reunion at a restaurant; Letty tries to be upbeat: ”She must never give the slightest hint of loneliness or boredom, the sense of time hanging heavy.” (134) Marcia complains about the social worker and brags about her “major operation”, a mastectomy. She takes the bus to her surgeon’s, Mr. Strong’s, house to spy on him, and her encounters with him are her happiest moments. After Marcia’s decline into dementia and lonely death, the three office mates meet at her house, which Marcia has willed to Norman. Here they divide up the contents of her cupboards: the tins of sardines, butter beans, and macaroni cheese. They find an unopened bottle of sherry and toast each other as they remember their deceased friend.

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Having remarried after a long and partly happy life with a woman who bore him three sons, novelist Campbell Armstrong lives in rural Ireland with his second wife. He learns that his first wife, who works in Phoenix, has advanced lung cancer and, with his second wife’s blessing, goes to spend time with her and their grown sons. In the course of that trip, he reflects on their life together, their romance, his alcoholism and its effect on their family, their move to the U.S., their losses, and the remarkably enduring affection between them and, surprisingly, between the first wife and the second.

Completely surprising all of them, a daughter his first wife gave up for adoption, who has searched for years for her birth mother, shows up in the months before Eileen’s death and makes the trip to Phoenix to meet her birth mother. Her appearance turns out to be a gift to the whole family. She assuages decades of sorrow and longing in both her and her mother’s hearts. She herself has cancer, not as advanced as her mothers. Both she and her mother work in health care professions. Much psychological and spiritual healing is accomplished between them in the short time they have before Eileen’s death several months later.

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At seven months, Remy, daughter and second child of Heather and Lon Davis, is hospitalized with a seizure that, after several days of agonizing uncertainty, is traced to a brain tumor. This narrative of her diagnosis and treatment, told by her mother and very much from her mother’s perspective, is not only a chronicle of a medical event, but, perhaps more centrally, of a spiritual awakening in the mother’s life. From a person uncertain about and largely indifferent to prayer, faith, and spirituality, Ms. Davis becomes, over the course of her daughter’s treatment, convinced of the presence of God, the power of prayer, and the availability of grace in precisely those circumstances that threaten life and lifestyle and bring individuals face to face with their deepest fears and deepest needs.

A series of “coincidences” makes her more and more aware of how little she controls in the grueling process, and how much of comfort, relief, and unexpected aid comes as unsolicited gift from un expected places. The child recovers, unlike several others the mother encounters during her weeks of witnessing hospital life. The mother emerges profoundly different for the experience, and clearer in her purposes as a writer and, eventually, a teacher.

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This is the first full-length collection by pediatrician and international health physician Roy Jacobstein. These 40 poems engage a wide range of topics, settings, and tones, but all demonstrate the same fine craftsmanship and strong voice.

Among the most engaging of Jacobstein’s poems are those dealing with memories of childhood and adolescence. Consider, for example: “Mr. Gardner in 10th grade told us there was no purpose / to mitochondria, only function.” (“Atomic Numbers,” p. 5). Or, “What transgression made fat Mr. Handler / drop his towel, his gloves, everything… to chase you from one end / of Fullerton to the other?” (“The Lesson,” p. 30) The poet displays a delightful sense of humor in pieces like “Bypass” (p. 36) and “Squid’s Sex Life Revealed in USA Today” (p. 59). Poems with explicit medical themes include “Pre-Med” (p. 6), “Admissions” (p. 8), and “What It Was” (p.11).

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The 25-year-old narrator returns to his hometown after a five-year absence. He accompanies his 14-year-old cousin to the hospital. The cousin's right ear is damaged, and his hearing is ruined. Although previous treatments have been unsuccessful, a new ear specialist is going to perform a procedure on the boy's ear.

The narrator recalls another trip he took to a hospital eight years earlier. At that time, he and a high school friend visited a girl who was having an operation on her rib. The girl had composed a poem based on a dream she had. She told the story to her two visitors and illustrated it by drawing a picture on a napkin. Her tale involved miniscule flies that crept into a woman's ear causing her to fall asleep. While she slept, the insects eventually devoured her flesh. A man attempted to awake (and save) her, but it was too late. The narrator remembers that his high school friend died not long afterwards.

The cousin's appointment with the ear doctor ends with a sack of medication and little likelihood that the day's treatment will restore his hearing. The narrator and his cousin eat in the hospital cafeteria. The boy asks the narrator to gaze inside his ears, and the narrator marvels at the structure and mystery of the human ear. He decides his cousin's ear appears normal. Soon, the narrator's mind once again drifts back to a summer eight years ago and memories of his lost friend.

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Summary:

Daniel has plenty of problems. He is already divorced. He loses his job. He is stalked by a mysterious group of well-dressed men (maybe federal agents) for an unknown reason. They follow him around in a blue Toyota SUV and show up at his ex-wife's house asking questions. On his way to an interview for an assistant manager's job at Dunkin' Donuts, Daniel drives through a medical district containing six hospitals. His mother died in one of these buildings. When he spots the blue SUV trailing him, he takes evasive action. After parking his car in a hospital lot, he wanders into the hallway outside the intensive care unit.

Eventually he settles into the ICU waiting room where he meets many family members of critically ill patients. Michael, a former Russian KGB agent whose elderly mother is a patient in the ICU, befriends him. Daniel remains in the medical complex for one month visiting the intensive care area of a different hospital each day. He sits with the relatives of ICU patients, and even though they are strangers, he listens to their tales of woe and empathizes with them.

Daniel becomes addicted to the humanity of the waiting room. Even when his car is finally towed from the parking lot, the threatening men in suits still wait for him outside the hospital. Daniel never learns the nature of his offense. Although he has nowhere to safely go, Daniel finds himself strangely comforted and at home in the ICU waiting room.

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Except for her canary and cat, Martha (Sheila Florance) lives alone in an apartment containing fragments and memorabilia of the past which speak to a rich and complex life comprised of various relationships and wartime horrors. Many of the fragments are further referenced in flashback scenes. Three current relationships--with her caretaker, her son, and her dependent and declining neighbor, Billy (Norman Kaye)--are central to this moment in time and provide an illuminating portrayal of Martha’s struggle for independence and undiminished zest for life. While her kind caretaker, Anna (Gosia Dobrowolska), respects the old woman’s fierce need for autonomy, her son, concerned about her frailty and safety, is intent on relocation to a nursing home where she can be supervised. Martha, on the other hand, provides gentle and kind care for Billy, who has been abandoned by his family; during the night, when he is unable to find the bathroom, Martha provides gentle and unobtrusive assistance. Martha’s strength comes from character and spirit, remarkable traits which leave an indelible impression about our tendencies to conventionalize aging.

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