Summary:

Ten months after being burned over 68% of his body, Dax Cowart was interviewed on videotape at the University of Texas Medical Branch in Galveston by Dr. Robert B. White. Blind, disfigured and helpless, Dax had consistently asserted his right to refuse medical treatment, including further corrective surgery on his hands (useless, unsightly stumps) as well as the daily, excruciatingly painful baths in the Hubbard tank.

At the time of his admission to UTMB, he had become adamant that he be allowed to leave the hospital and return home to die--a certain outcome since only daily tankings would prevent overwhelming infection. Dr. White had been called in as a psychiatric consultant, and much of the twenty-nine minute documentary is a conversation between patient and psychiatrist.

Calm and coherent, Dax states his wishes clearly and presents his case compellingly. He does not "want to go through the pain"; he does not "want to go on as a blind and a crippled person"; and he does not understand or accept any physician’s "right to keep alive a patient who wants to die."

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This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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Life on the Line relates the experience of 228 writers who express in their work the deep connection between healing and words. Walker and Roffman have organized their anthology into eight topical chapters: Abuse, Death and Dying, Illness, Relationships, Memory, Rituals and Remedies, White Flags From Silent Camps, and a chapter of poems about the nuclear accident at Chernobyl. This hefty volume contains a very broad selection of contemporary poems, stories, and essays by both well-known and relatively unknown writers on the experience of illness and healing.

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This is a harrowing story, told in the first person, of an obsession with food and body image. "One day I will be thin enough", says Josie, the 25 year old anorectic woman who has been hospitalized for life-threatening self-starvation. "Just the bones, . . . the pure, clear shape of me." "One day I will be pure consciousness." The narration spins out in painful detail the pattern of compulsive behavior which pervades Josie’s existence. Her pitifully barren emotional life is revealed as well.

How did it all begin? Flashbacks of significant events invade Josie’s attempts to stop thinking. A shy, awkward adolescent, overly sensitive to casual comments about excess flesh, decides to diet. Josie stumbles non-communicatively through a teen-age sexual initiation to a later affair with her married professor, retreating ever further from her bewildered family.

But why do events take such an extreme turn? The mystery of anorexia nervosa remains. In the hospital, a nurse who has seen everything seems to strike some responsive cord, and Josie begins eating to gain weight. At the end of the novel she’ll soon be released , under supervision, but the outcome is in doubt. "Can I learn to be so present? Can I learn to be so full?" ". . . if I were a body, what would I be?"

 

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In "Life Support," a mother must make a difficult decision: whether or not to consent to heart surgery without anesthesia for her critically ill newborn who is on a ventilator. Her instincts and reason contradict each other, and she isn’t sure which to believe. She wants to let the child die naturally in her arms, but this will not be allowed in this particular institution. She feels distant from her husband and from the doctors, and believes that her sudden transformation into the guardian of this child presumes far more knowledge and ability than she possesses.

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This posthumously published short (132 pp) collection is by a former New York Times book reviewer and essayist who was diagnosed with metastatic prostate cancer in 1989 and who died the following year. Broyard responded to his illness by writing about the experience. The book is comprised of six parts:

Part 1: Intoxicated by My Illness

Part 2: Toward a Literature of Illness

Part 3: The Patient Examines the Doctor

Part 4: A Style for Death: Journal Notes, May-September,1990

Part 5: The Literature of Death

Part 6: What the Cystoscope Said

Parts 1, 2 and 5 appeared in slightly different form in the New York Times between 1981 and 1990.

Parts 2 and 3 are in part from a talk Mr. Broyard gave at the Univ. of Chicago Medical School in April 1990. Part 6 is a short story written by Broyard in 1954 about his father’s death.

Mr. Broyard had long been fascinated with death and dying, before his prostatic cancer, publishing "What the Cystoscope Said" in 1954, some 35 years before his own diagnosis. It is as though he had been preparing for what he knew would be his finest work. Always an engaging essayist and reviewer, Mr. Broyard here offers what he did best--a discursive (in the best sense) soliloquy on disease, suffering, the majesty of the educated, reflective person with illness--all amplified with widely ranging withdrawals from the broad literary bank account one would expect of a professional reader and reviewer: one reads about personal fate vis-à-vis D. H. Lawrence’s Women in Love; one reads, as one can read nowhere else, about illness, dying and sexuality and its relevance to Hemingway’s The Sun Also Rises.

Part 1, Intoxicated By My Illness, is a personal statement about the effect of this illness on Broyard’s attitude and is rich with his own and others’ literary sense of how he should and did react to it. Part 2, written later than Part 5, deals with literature and illness as opposed to the emphasis on death in Part 5. Within Part 2 are references to Susan Sontag, Norman Cousins and Siegel, among other students of this subject. It is interesting to compare the more powerful and personal and moving appeal of the later writings on illness (Part 2) to the more abstract, critical ruminations on death (Part 5) at a time when, in fact, Part 5 was a literary exercise. Part 2 is written with the pen of the heart.

Part 3 is a wonderful account of Broyard’s first meeting with his personal physician. While Broyard analyzes this man, he reflects on what he would like in his ideal doctor. Part 4 is a brief (7 pages) collection of short diary entries reminiscent of Dag Hammarskjöld’s Markings. Part 5 includes essays on death and dying in literature and what these books, e.g., Robert Kastenbaum’s Between Life and Death and David Hendin’s Death as a Fact of Life and Ernest Becker’s Denial of Death, have to offer us.

Part 6 is a short story about his father’s death, the son’s sexual escapades and the relationship between the two. Clearly sex, death and their nexus have long been on Broyard’s mind. This is a welcome reflection and is of interest more as it compares to Broyard’s later writings on the subject, especially in Part 2, than for its intrinsic worth as a short story.

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Invincible Summer introduces illness and death into what might otherwise be a standard teen love story. Here, first love is also a last look at life, and the rites of passage into romance, sexuality, and intimacy are intensified and thrust into profound paradox by approaching death. Robin and Rick meet in the hospital where she has come for a battery of tests, and he for chemotherapy. Both have acute lymphocytic leukemia. He’s been sick for two years. She’s just finding out about her own condition.

Robin lives with her father, who can hardly bear to be around her illness, and her grandmother, who, since her mother died years ago in a car accident, is the primary caretaker. The father’s love has to be understood and accepted in light of his emotional limitations. The book thoughtfully explores how sickness rearranges family systems as well as treating familiar young adult themes of separation from friends, wanting sex, embarrassment about physical appearance, uncertainty of remission, and how to talk about the future.

After Rick’s death, at which Robin is present, Robin recalls a game her mother used to play, called "The Worst Thing." "What’s there to be afraid of? What’s the worst thing that could happen?" The aim of the game is to look at the worst case until it seems manageable, because for every worst thing, there is some way through to remedy or acceptance. The game, reproduced as internal dialogue, drives to ultimate questions, ending with something like Pascal’s wager--a version of intellectual comfort that will do in the absence of positive faith in the promise of afterlife.

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The narrator carries hothouse orchids as a gift to a friend in the hospital. When he gets there, he feels out of place, not having expected "barricades / against infection, the doors’ / pneumatic psshh . . . . " He regrets that his gift flowers are tame, when "the room / cried out for wildness." The place is sleek, efficient, and antiseptic. His friend--who is not described in the poem--"would never rise / from the motored bed." Who could blame the narrator for looking away? Or for wishing that he could have brought a gift of wilder, more glorious flowers? (40 lines).

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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Written in 1944 and first staged on January 3, 1945 with Richard Basehart and Anne Burr and Earl Jones as Basuto, The Hasty Heart grew out of the playwright’s experiences in an ambulance unit on the Burma front in World War II. The play was made into a movie in 1949 (with Richard Todd and Ronald Reagan) and was revived on Broadway in 1984.

The Hasty Heart concerns, initially, six characters in a British General Hospital in the rear of the Assam-Burma front: a nurse (Sister Margaret--"Sister" is a British term for a nurse; she is not a religious--and five Allied patients: Kiwi (a New Zealander), Tommy (a Brit), Digger (an Australian), Yank (an American), and Blossom (an indigenous Basuto) who understands and speaks no English, an important fact for later developments in the play.

Patrick introduces us to Sister Margaret and the five original patients who are, for all their good-natured bickering and nationally directed gibes, clearly a cohesive unit characterized by the camaraderie of an in-patient ward with residential patients. For instance, Tommy, who is chronically kidded about his obesity, claims to be proud of it and accuses Digger of being jealous about Sister Margaret’s giving Tommy therapeutic back rubs.

Enter Colonel "Cobwebs," the medical officer. He solicits the group’s help and cooperation in keeping a new patient "contented." It seems the Colonel has just successfully removed a patient’s kidney damaged by shrapnel only to discover that the soldier’s remaining kidney is "defective." The wounded soldier, Lachie, a Scottish Sergeant, will therefore die in only six weeks of uremic poisoning. The Colonel has "decided against telling him" since "[W]orry won’t help him."

The Colonel tells the men and Sister Margaret that "The only help anyone can give him now, [sic] will come from you." When Yank asks, "And he thinks he’s well, sir?" the Colonel replies, "In a sense--he is. But it would be criminal to release him just to collapse up forward. Do what you can to keep him contented--and happy."

With the arrival of Lachie, an incredibly difficult, abrasive and unfriendly Scot with pathological chips on both shoulders, the scene is set for "an archetypal story about friendship under fire." [Mell Gussow as quoted in a 1984 NY Times review in the obituary above, op. cit.] Despite all their earnest attempts at striking up a friendship, the other patients find themselves rebuffed, often quite rudely, by Lachie. Eventually, at the insistent urging of Sister Margaret, they are successful. A birthday gift of a complete Scottish highlander outfit touches Lachie who admits that he’s never had friends and is, to no reader’s deep surprise, a truly lonely man.

Near the end of the play, the Colonel, following orders, tells Lachie his diagnosis and prognosis, and his superiors’ desire for Lachie to return home, despite his wishes to remain with his friends, in order to become a military hero to be honored before his death. Lachie understandably retreats into a shell of resentment, blaming the men for treating him with pity instead of friendship. Eventually things right themselves and the play ends happily.

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