Summary:

Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

View full annotation

Summary:

In July 1998 the poet Maxine Kumin was thrown from her carriage when her horse bolted during a competition. The type of cervical (C1-C2) fracture that she sustained is fatal before reaching the hospital in 95% of cases, and if survived, usually results in quadriplegia. This book is a memoir written in the form of a journal that begins on the day of the accident. In fact, it was nearly a month after the accident that the poet's daughter brought writing materials to the rehab hospital, and Maxine began to dictate the journal, and the two of them filled in the temporal gaps.

The journal covers her experience in the acute care hospital, the rehab facility, and the following months of convalescence at home. It ends on April 23, 1999, when Maxine climbs a hill (unassisted) near her Vermont home, looks out over the early spring vista, and concludes, "I am letting myself believe I will heal."

The journal describes the poet's physical, emotional, and spiritual experiences as she struggles, first to survive, and then to live with the "halo vest" that for months she had to wear to stabilize her fractured neck bones, and finally to regain her function and equilibrium. Much of the story is about her family--husband, son, and daughters--who mobilize from various points around the world to support her. Comments about her doctors and the medical care she received constitute only a small, at times almost incidental, part of this narrative.

View full annotation

Summary:

Eva McEwen is born in Scotland in 1920. Her mother dies shortly after giving birth to her. At the age of six, Eva is "visited" by two strangers (an older woman and a teenage girl) that only she can see and hear. These mysterious companions steer the course of her life. During World War II, Eva serves as a nurse in a burn unit.

She falls in love with a plastic surgeon but her supernatural attendants have other plans for Eva. She secures a job as a school nurse, marries a teacher, and has a daughter. Sadly, Eva dies at a young age from cancer of the liver and pancreas. Thus the novel ends much like it began, with the tragic death of a young mother who leaves behind a devoted husband and daughter while ghostly visitors are poised to both share and meddle in the youngster's life.

View full annotation

Summary:

The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

View full annotation

Summary:

A young doctor, recently assigned to a country hospital, is fraught with anxiety, especially over his lack of experience with obstetrical problems. One night the midwives call him; a woman is having a difficult labor. The fetus is presenting in a transverse position. The doctor must reach internally and “turn it around by the foot,” as Anna Nikolaevna, the seasoned midwife, reminds him.

The doctor has never performed this procedure. He buys time by going back to his room to consult the textbook (under the pretext of going for cigarettes). Finally, he can't avoid it any longer. He performs the rotation. It works! Both mother and baby are saved.

View full annotation

Summary:

The narrator is visiting a sick loved one in University Hospital, Boston and reflects on the many patients who have stayed in this hospital, most especially the young men from the battlefields of the American Civil War.

View full annotation

Summary:

In the second volume of her trilogy of memoirs (which begins with American Girl and ends with Speaking with Strangers), Mary Cantwell, a former fashion magazine editor and writer, describes her marriage, the birth of her two daughters, her career advancements, and her divorce, with Manhattan in the 1950s as the backdrop.

View full annotation

Summary:

Motivated at first by an attachment to her strict and demanding ballet teacher, as well as frustration and disgust with her own body compared to other dancers', Francesca develops an obsession with weight loss and increasingly ritualized forms of self-discipline in eating and exercise that lead to severe anorexia nervosa. It takes her family several months to see and acknowledge what is happening in front of them, during which she has trained herself to eat less and less, to throw up after meals, and to push herself to the point of exhaustion.

She becomes secretive, isolates herself from friends, and puts up a wall between herself and her parents, who are unable fully to understand the degree to which her behavior has gone beyond her control, but are worried. A compassionate male therapist with clear boundaries and a non-judgmental approach finally succeeds in disengaging Francesca from the mutually destructive downward spiral of family conflict around her illness;

he helps her to envision and desire her own health and to take responsibility for recovery. The story is told in the third person, but from Francesca's point of view.

View full annotation

Summary:

The story begins as an MRI technician assures Baily that "Contrary to popular opinion, . . . this is not a torture device." The test was ordered because her arm suddenly went numb and she suddenly lost most of her vision during algebra class. With no idea what's wrong, Baily speculates about the possibility of a brain tumor, about how disease will change her life, about early death. She is uncomfortable with her mother's cheery reassurances, which consist mostly of simple theories like the possibility that Baily was reacting to missing lunch, but wants them, nonetheless.

Since the pediatric wing is full, she is put in a room with an old woman for observation overnight. The nurse runs her through a series of highly irrelevant questions about her physical health from drug use to dentures. Then her mother is required to leave for the night. In the morning they take her for an EKG before her mother can get there; Baily returns to her room in a state of morbid conviction that she's dying, which is finally overturned when the doctor comes in to explain to her that she had a classic case of severe migraine.

View full annotation

Summary:

This first-person narrative of a runaway girl's short stay in a residential mental health center develops her impressions, resistances, and accommodations from her admission ("I can see right away it's a nuthouse") to her release. These include reluctant interviews with the staff counselor, uncomfortable encounters with nurses, observations of other patients' erratic behavior, and efforts, finally, to communicate with a very detached roommate.

"Stevie" speaks from a place of anger and mistrust. She attempted suicide in the girl's bathroom by slicing her wrists, but regards herself as otherwise quite competent. A turning point comes for her when her silent roommate sings a song she's written which ends with the words, "Don't forget to cry." This moment of vulnerability, which also unveils surprising talent and beauty, moves Stevie from anger toward curiosity and sympathy.

She takes steps toward friendship with her roommate, and finally toward reconciliation with her mother who, she realizes, really wants her home. As she leaves, Zena really addresses her for the first time, reminding her, "Don't forget to cry."

View full annotation