Summary:

When Dan Shapiro was 20 years old and a junior in college, he was diagnosed with "nodular sclerosing Hodgkin's disease." Thus began a five-year ordeal of chemotherapy, radiation treatments, and a bone marrow transplant that failed. But this memoir, which recounts diagnosis, treatment, and two relapses, is more than a narrative of illness. Woven in and out of the subjective experience of physical and emotional trauma is the author's life as an adolescent, a family member, a young man who falls in love with the woman who eventually becomes his wife, a graduate student learning to be a clinical psychologist.

Sequences of ordinary life are carefully juxtaposed with sections on illness and treatment, emphasizing the author's determination to incorporate his illness into his life, all part of one continuous fabric. Even though disease was enormously disruptive, "[l]ife doesn't stop when something horrible happens" (158). Part of that life was a mother who decided to grow marijuana plants in her backyard ("Mom's Marijuana") so that her son would have an antidote for the terrible nausea that accompanied his chemotherapy. It is Mom who learns in a waiting room conversation that it might be advisable for Dan to bank his sperm for the future-- and who then proceeds to make the arrangements. As the memoir ends, Dan's mother finally disposes of the dry marijuana leaves that have been hanging in her attic for several years.

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This long poem in 20 sections seeks to explore, dissect, and create a language for the experience of hemophilia. "Blood pools in a joint / The limb locks . . . " The poet first dissects words like "trans / fusion" and "hema / toma," and showers the reader with images (like splatters of blood?).

In section 5 he states his purpose in the familiar jargon of educational objectives and later, in section 10, he utilizes spacing and line breaks to convert standard admonitions into poetry; for example, "These child- / ren should / not / be / punished, and / their / play with / other / children / should / be super- / vised . . . " Isolated phrases and sentences appear--some from the hospital and some from the "outside" world.

In some phrases the worlds of outside and inside mix, as in "Arterial sunrise, capillary dusk." Section 13 consists of laboratory reports. The poem breathes in and out, between syllables and long lines, between prosaic statements and poetic images. Finally, the poet finds words for the endless rhythm of hemophilia, "Gratitude and / fear--Your relentless / rhythm--I move to / it still . . . "

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St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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Summary:

The first part of this novel presents a detailed picture of the Jewish Californian Cooper family, centering on the sixty-year-old Louise, who is dying of breast cancer. Her husband, Nat, is unfaithful, and, she suspects, only loves her when she is at her weakest and most sick. Her daughter, April, is a lesbian folk singer who becomes pregnant with the help of a gay male friend and a turkey baster. Danny, the son, is also gay, living in New York with Walter, his lover, who is becoming increasingly detached and obsessed with internet sex groups.

Louise considers herself lucky, though, compared with her younger sister Eleanor, partially disabled by childhood polio, disorganized and ill-groomed and married to Sid, whom Louise finds deeply unattractive. Eleanor's son is a sociopathic drug addict, and her daughter has ovarian cancer caused by Eleanor's taking DES (diethylstilbesterol) in pregnancy. She sends Louise newspaper cuttings about the causes of homosexuality and the dangers of AIDS.

The first part having established the complex dynamics and histories of the family's relationships, the second brings the entire family together in the crisis of Louise's final illness and death (a reaction to chemotherapy drugs causes severe chemical burns and she dies in a burn unit in a San Francisco hospital). After her death, the new dynamics of the family are established, and Louise's son and daughter conclude that their mother had "a terrible life" (p. 261).

The short third part shows that no such conclusion is possible, that even those closest to us remain terribly but fascinatingly unknowable. A flashback to a point just before Louise's final illness describes her attempt to convert to Catholicism and a brief moment in which she experiences a marvelous sense of complete harmony.

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Summary:

Note: I try not to reveal too much here. Nevertheless, I urge you to read the book first. I would not want the magic of reading this book to be diminished by too much foreknowledge--no matter when the book is initially opened.

Harry Potter and the Order of the Phoenix is the fifth book in a planned series of seven (see Harry Potter and the Sorcerer's Stone for an introductory summary). Harry is now fifteen years old. The opening chapter, "Dudley Demented," features a return of the Dementors (see Harry Potter and the Prisoner of Azkaban), who had been sent to Harry's neighborhood in Little Whinging to deliver their soul-sucking kiss. In order to repel the Dementors and save himself and his bullying cousin Dudley Dursley from the kiss's death-in-life, Harry uses magic. This transgression from rules on underage wizardry leads to Harry's near expulsion from his school, Hogwarts, and a trial by the full court, the Wizengamot, led by Cornelius Fudge, in the Department of Mysteries of the Ministry of Magic.

Headmaster Albus Dumbledore, concerned with Harry's safety as well as with leading the resistance efforts (The Order of the Phoenix) against the resurgent evil Lord Voldemort, not only prevents Harry's expulsion, but also organizes the guard for Harry's transfer from the Dursley home to the ancient house of Harry's godfather, the wonderfully moody and complex Sirius Black. Sirius, like Harry's parents, would risk anything for his godson, but the relationship is charged by Sirius' goading of Harry to be more cavalier like James Potter--Harry's father and Sirius' best friend--and by Sirius' antipathy towards being imprisoned in his ancestral home, filled with reminders of his pureblood wizard family.

These include a portrait of his raging, hate-filled, deceased mother and a malevolent house elf, Kreacher. Communication between Harry and Sirius is a key theme in the book, as Harry looks to Sirius for guidance on the tribulations of adolescence and to satiate Harry's continued craving for information about his father. Harry's emotional tether is short in this novel, and runs the gamut from frustration and envy that his two best friends, Ron and Hermione, were made prefects of Gryffindor House, to despising two teachers (potions teacher Snape, of course, and the new venomous, officious Defense of the Dark Arts teacher, Dolores Umbridge) and finally to absolute fear and hatred of Voldemort, his mortal, yet intimate, enemy.

Harry's scar pains him almost continuously now that Voldemort has returned in the flesh, and also now that Harry has dreams and visions of Voldemort's actions. With this ability, Harry envisions himself as a snake and witnesses the wounding of Ron's father, Arthur Weasley. This episode leads to two visits to the wizard hospital: St. Mungo's Hospital for Magical Maladies and Injuries. The reader is deliciously informed that the personnel in green robes are not doctors ("those Muggle nutters that cut people up" p. 484), but rather Healers: wizards and witches who passed a large battery of tests in a range of subjects to qualify for such training.

The hospital is a mix of the mundane (the irritable receptionist) and the arcane (patients suffering from bizarre spell damage). Mr. Weasley's recovery from the nearly lethal snake bite suffers a minor setback when Trainee Healer Pye (not the Healer-in-Charge, Hippocrates Smethwyck) tries some "complementary medicine . . .

[an] old Muggle remed[y] . . .

called stitches . . . " (pp. 306-7). The loving Mrs. Weasley, whose temper is notorious and hence humorous, shouts at her husband that even he "wouldn't be that stupid" as to allow his skin to be sewn together. (p. 307)

While in the hospital, Harry and his friends encounter schoolmate Neville Longbottom visiting his parents, who suffer dementia caused by dark magic performed by one of Voldemort's Death Eater followers. Mental illnesses prove far more difficult to remedy than bodily injuries and maladies. Indeed, late in the book, Madam Pomfrey, the Healer at Hogwarts, wisely advises that "thoughts could leave deeper scarring than almost anything else." (p. 847) As Dumbledore, the embodiment of sagacity, states, memories of old hurts, slights and abuses, make "some wounds run too deep for . . .

healing." (p. 833)

Other medically related items include the Skivving Snackboxes--an assortment of magical treats and their antidotes concocted to fake various illnesses in order to skip classes, and Umbridge's detention punishment which results in the painful etching of the required written phrases on the back of the hand of the miscreant student.

Professor Snape is charged with teaching Harry the subtleties of mind-reading (Legilimency) and its prevention (Occlumency), in an effort to prevent Voldemort's use of Harry's mind. "The mind is a complex and many-layered thing," says Snape, and hence the mind cannot be read like a book. (p. 530) Harry's failure at these lessons leads to the denouement of the book and ultimately to the loss of someone very dear to him. After the inevitable confrontation between Voldemort and Harry, Dumbledore gently coaches Harry through his guilt and anger to teach him about destiny, love and death.

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Emiko a child survivor of Hiroshima, is now a documentary filmmaker. She has horrific memories of August 1945 when she lost her parents and little brother, and of the years of painful operations and homesickness in America where she was sent to restore her mutilated face. She is hoping to interview Anton Böll, a scientist who had fled Germany to work on the Manhattan project.

Böll contends that he had been unaware of human rights abuses; he left Europe because the Nazi regime had cramped his scientific style. As a consequence, his mother was imprisoned and killed. During the war, he met his Austrian-born Jewish wife, Sophie, at a displaced persons camp in Canada. Sophie had lost her whole family, but she does not speak of them and he does not ask.

Briefly they knew happiness, but soon Böll left for work on the bomb and on to Hiroshima in its aftermath. Their marriage would never be the same. For the rest of his life, Böll justified his involvement as a "dream" turned "nightmare" emerging from the imperative demands of a virtuous science. When Emiko approaches him, he hesitates. He does not want to risk blame. But his dying wife knows that absolution for unacknowledged guilt is what he craves.

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This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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This memoir reconstructs event by event the hospitalization of the author’s husband, Elliot Gilbert, for prostate surgery, his death in the recovery room, and the efforts of his wife and family to find out why he died. The account of those efforts over the ensuing months, which involved friends and lawyers, raises numerous legal, social, and medical questions about how medical mistakes occur; how the medical establishment may seek to protect itself; patients’ and families’ rights to information about norms and procedures; and the vulnerability of both patients and doctors in a litigious environment. The book also reflects on the process of mourning, and begins with an acknowledgment that the writing of it has constituted part of that process.

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The sculptor Ken Harrison (Richard Dreyfuss) is badly injured in a car accident and finds himself in the middle of life permanently paralyzed below the neck and dependent on others for his care and survival. Ken is a strong-minded, passionate man totally dedicated to his art, and he decides he does not want to go on with the compromised, highly dependent life that his doctors, his girlfriend Pat (Janet Eilber), and others urge on him. He breaks up with Pat and fights to be released from the hospital, to gain control of his life in order to stop the care that keeps him alive and unhappy.

His antagonist is the hospital's medical director Dr. Emerson (John Cassavetes), who believes in preserving life no matter what, and so tries to get Ken committed as clinically depressed. Ken's attending physician, Dr. Scott (Christine Lahti), begins with the establishment but gradually moves toward Ken's position.

The film ends with the judge at a legal hearing deciding that Ken is not clinically depressed and that he thus has the right to refuse treatment and be discharged. In the last scene, Ken lies in a hospital bed framed by his own sculptural realization of the forearm and hand of God from Michelangelo's Creation of Man.

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In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer argues that "the traditional western ethic has collapsed" as we enter "a period of transition in our attitude to the sanctity of life" (pp. 1). The book begins with the tale of Trisha Marshall, a twenty-eight year old woman, who in 1993 was seventeen weeks pregnant when a gunshot to her head left her in an intensive care unit, her body warm, her heart beating, a respirator supporting her breathing. However, she was brain dead.

Her boyfriend and her parents wanted the hospital to do everything possible so that the baby would be born. The ethics committee of the hospital supported the decision. For the next 100 days, Trisha Marshall continued to be supported in the ICU until her baby was delivered by cesarean birth. After a blood test showed that the boyfriend was not the father, and after three weeks in the intensive care unit, the baby went to live with Marshall's parents.

Singer uses this introduction to pose the many ethical questions that are raised because of medicine's ability to keep a "brain dead" body warm for an extended period of time. "How should we treat someone whose brain is dead, but whose body is still warm and breathing? Is a fetus the kind of being whose life we should make great efforts to preserve? If so, should these efforts be made irrespective of their cost? Shall we just ignore the other lives that might be saved with the medical resources required?

Should efforts to preserve the fetus be made only when it is clear that the mother would have wanted this? Or when the (presumed?) father or other close relatives ask for the fetus to be saved? Or do we make these efforts because the fetus has a right to life which could only be overridden by the right of the pregnant woman to control her own body--and in this case there is no living pregnant woman whose rights override those of the fetus?" (pp. 17-18).

In the chapters that follow, Singer argues that whether western society will acknowledge it or not, we have, in our actions and decisions, moved to an ethic where "quality of life" distinctions trump "sanctity of life" positions. Yet, many continue to raise the "sanctity of life" position when it is clear that our legal and ethical positions in western society have embraced the "quality of life" stance. For Singer, this paradox results in an incoherent and illogical approach to the ethical challenges presented by modern medicine.

Throughout his book, Singer presents evidence for his argument through ethical and historical analysis of brain death, abortion, physician assisted suicide and euthanasia, organ donation, and the nature of persons. For those uncomfortable with Singer's position on "infanticide," this book allows one to follow Singer's argument and his recommendations in the last chapter for a coherent approach to these "quality of life" decisions.

He closes his book with the recommendation that a new ethic should embrace five new commandments to replace the old "sanctity of life" commandments. His commandments are: 1) Recognize that the worth of human life varies; 2) Take responsibility for the consequences of our decisions (in end of life care); 3) Respect a person's desire to live or die; 4) Bring children into the world only if they are wanted; and 5) Do not discriminate on the basis of species.

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