Summary:

A chronicle of the author's perceptions, thoughts, memories, and personal relationships during the months after he was diagnosed as having AIDS. Brodkey's mind and prose are as sharp as a knife's edge. Beginning with the desperate struggle for breath that signaled pneumonia and, retrospectively, "how my life ended. And my dying began," continuing with the reactions and decisions of himself and his wife, the first half of the essay spins out an observant, introspective, cerebral, even amusing account of his particular experience.

But AIDS is often a disease associated with more emotional baggage than other fatal illnesses, and in Brodkey's case we learn that he traces both his dying and his homosexual experiences to "the major drama of [his] adolescence", daily sexual abuse by his adoptive father, with the implied knowledge and acquiescence of his mother. Writes Brodkey, "I experimented with homosexuality to break my pride, to open myself to the story." "Now I will die disfigured and in pain."

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The Way We Live Now consists entirely of fragments of conversation among friends concerned about a friend with AIDS. They confer on the telephone, over coffee, in the halls of the hospital, about the patient and his illness. They speculate, prognosticate, share anxieties, trade innuendoes of guilt and blame, pool their medical knowledge, and criticize the medical establishment.

The patient never appears, and indeed, we never meet a fully-fledged character, but only hear the orchestra of voices that wryly and accurately reflect the mediated and fragmented character of modern community life. News travels among them like an electric current, carrying shock waves of fear and pain. Their pooling of medical lore results in an eclectic mix of remedies that reach from chicken soup to the patient's favorite jelly beans.

By the end, several of the characters, represented only by voices in the conversation, have had to come to terms not only with the impending loss of their friend, but with their own various and unsettling responses. The disease, clearly AIDS, is never mentioned by name.

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Atul Gawande, a surgical resident at Harvard Medical School, asks in his well written essay, "when you see your patient making a grave mistake, should you simply do what the patient wants?" (p. 86) He answers this question by sharing a number of cases from his training that suggest that the orthodoxy of 'absolute respect for patient autonomy' may interfere with good patient care.

Gawande also gives the reader insight into the difficulties that young residents especially have in developing an artful approach to medical practice. He suggests that part of respecting autonomy is (at appropriate times) allowing patients to cede that autonomy to an authority figure. He argues further that, "patients frequently don't want the freedom that we've given them." (p. 89)

He also shares in his essay a personal experience with his youngest child. She was a premature baby who at eleven days old ended up in the intensive care unit. He was glad to put the ultimate decision(s) of how to care for his daughter in the hands of physicians--"they could live with the consequences, good or bad." (p. 90)

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A chance meeting with her former and most compassionate fertility doctor brought Wendy Wasserstein (at age 48, and after 8 years of effort) back to his fertility clinic. Two weeks later she got the news that she was pregnant, and six months after that, just as she was getting ready to tell her friends "that the twenty pounds I had gained were not the result of bad habits and anxiety," she developed preeclampsia and was hospitalized.

What follows in this ’Annals of Motherhood’ memoir is an account of her hospitalization; her subsequent delivery 16 days later of 1lb., 12oz. daughter, Lucy Jane (Lucy’s waving hand sonogram picture reminded Wasserstein of "Lucy in the Sky With Diamonds"); and her separation from Lucy, who spent two months in the neonatal intensive care unit.

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Subtitled "What happens when patients find out how good their doctors really are," this article starts with an important statement: "Every illness is a story, and Annie Page's began with the kinds of small unexceptional details that mean nothing until seen in hindsight."

This is the introduction to a look at a child with cystic fibrosis and how her family sought the best care for her.

The author, Dr. Atul Gawande, goes on not only to tell their story but also the story of the way in which the understanding of this disorder has increased and the unusual rigor with which centers that specialize in the disease are evaluated.

He also includes stories of other sufferers to emphasize the importance of surveillance of their care.

These stories allow him to generalize about the way physicians' care is evaluated in general by the public and our medical organizations and how difficult it is to be at the high end of the Bell Curve. The author concludes, "When the stakes are our lives and the lives of our children, we expect averageness to be resisted."

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The story begins as a young woman enters the hospital for cancer treatment. She struggles to maintain her identity despite the institutionalized depersonalization typical of the hospital environment. Later, loss of hair from her cancer treatment also threatens her identity, for her appearance is a large part of who she is. Although she is rather proud of the fact that she refuses to buy a wig, preferring scarves instead, she covers all the mirrors in her home. Finally, she learns that even her naked skull can be beautiful, and dares to walk outside bareheaded for the first time after her treatment.

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This anthology of "healing poems" is designed, according to the editors, "to find readers who might not usually read poetry." They say it should also be read "by those sitting in waiting rooms in surgeries and outpatients' clinics." These are definitely large tasks to expect this small collection of poems to accomplish, but in a different world (for example, a world in which people believed in the power of poetry to heal), this particular anthology would have a good shot at becoming a standard waiting room fixture.

The therapeutic intervention is well thought out. The editors have arranged the book into eight sections, each containing poems that exemplify a different theme, or situation, or style of treatment. The sections include: Admissions, Poems to Make You Feel Better, What It Feels Like, For Those We Love, The Language of Pain, Healing Rhythms, Body Parts, and Talking to the Dead. There is considerable overlap among these categories, because good poems speak several languages and can't be pinned down to a single feature. However, the classification does serve a heuristic purpose. It is another way to hook the reader, by choosing a topic he or she likes; once inside the covers, the reader may explore at will without regard to categories.

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Doctors Everett and Mimi Menlo are psychiatrists living in Toronto. The married couple sleeps in separate beds. They vow never to work as a team or in the same medical facility. Each doctor is deeply troubled by a patient who refuses to communicate. For Mimi, it is Brian Bassett, an eight-year-old boy with autism who eventually dies under her care. For Everett, it is Kenneth Albright, a hospitalized patient with severe paranoid schizophrenia who has attempted suicide four times.

Kenneth's dreams were once complex and intriguing but lately they lack detail and variety. One morning, he is found covered with blood but has no signs of injury. Despite a thorough investigation, it remains a mystery as to whose blood it really is. Following that strange occurrence, Everett experiences insomnia, but he is reluctant to admit the cause to Mimi. She worries that he might be having a nervous breakdown.

In truth, he fears dreaming. He has recurrent nightmares of a bloody Kenneth kneeling next to the bodies of strangers. Everett suspects that Kenneth has placed these corpses in his dreams. Everett finally tells Mimi about his nightmares. He shocks her with the revelation that Kenneth Albright has genuine bloodstains on his clothing and hands every day even though he is still confined to the psychiatric ward. There is only one spot Kenneth can escape to--dreams. After their conversation, Mimi falls asleep and dreams of Brian Bassett. She wakes up and finds Everett in the bathtub. His pajamas are saturated with blood. Mimi promises Everett, "I'm waiting here . . . until we both wake up" (596).

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An overthrown Latin American ruler, Mr. President, is exiled to Martinique. The 73-year-old man develops a peculiar pain in his ribs, lower abdomen, and groin. He travels to Geneva, Switzerland in search of a diagnosis. After extensive medical testing, he is informed that the problem resides in his spine. A risky operation is recommended to relieve the pain.

The President meets a fellow countryman, Homero Rey, who works as an ambulance driver at the hospital. Homero schemes to sell an insurance plan and funeral package to the sick man, but the President is no longer wealthy and lives frugally. He is reduced to selling his dead wife's jewelry and other trinkets to pay the cost of his medical expenses and operation.

Homero and his wife, Lázara, grow fond of Mr. President. They provide financial assistance and care for him after he is discharged from the hospital. The President returns to Martinique. His pain is unimproved but no worse either. He resumes many of his bad habits and considers going back to the country he once ruled, only this time as the head of a reform group.

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This is the house of Bedlam. So begins the strong poem by Elizabeth Bishop, the woman who wrote of that wretched old man who lived in the house of Bedlam. "This is the man / that lies in the house of Bedlam." So go the two lines of the following stanza of the 1950 poem about the cranky old man who was kept for his crimes in the house of Bedlam. "This is the time / of the tragic man" begins the three lines of the following stanza of the nursery rhyme poem by the consummate poet who wrote of "the Jew in a newspaper hat / that dances joyfully down the ward" and the brilliantly cruel and crazy man who lived in the house of Bedlam.

"This is the soldier home from the war. These are the years and the walls and the door." So starts the 12th and last stanza of the metrical rhyming repetitive poem by one of the finest American poets about Ezra Pound, an American poet, who found himself at the end of the war "walking the plank of a coffin board" and because of his treason becoming the man--the tragic, talkative, wretched and tedious man--who lived in the house of Bedlam. [79 lines]

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