Summary:

This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?

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In four lengthy chapters, the biographies of Haydn, Mozart, Beethoven, and Schubert are carefully presented. Special attention is given to health, both physical and psychological, throughout life and at its end. Autopsy information is included. In particular, the author emphasizes the impact of illness on the composers' relationships with family members and doctors, and on their musical composition.

Evidence is derived from a wealth of primary sources, often with long citations from letters, poetry, musical scores, prescriptions, diaries, the remarkable "chat books" of Beethoven. Neumayr also takes on the host of other medical biographers who have preceded him in trying to retrospectively 'diagnose' these immortal dead.

Late eighteenth- and early nineteenth-century Vienna emerges as a remarkable city of musical innovation and clinical medicine. The composers' encounters with each other link these biographies. Similarly, many patrons, be they aristocrats or physicians, appear in more than one chapter, such as the Esterhazy family and Dr Anton Mesmer.

The disease concepts of the era, prevalent infections, and preferred therapies are treated with respect. Rigid public health rules in Vienna concerning burial practices meant that ceremonies could not take place in cemeteries and may explain why some unusual information is available and why other seemingly simple facts are lost.

Biographical information about the treating physicians is also given, together with a bibliography of secondary sources, and an index of specific works of music cited.

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Film clips of Cary Grant as the consummate anatomy professor in 0100 (see this database) are interspersed with comments from contemporary gross anatomy students, two medical school faculty intimately connected with dissection and the body donation tradition, and a live body donor. In what ways "yes" and "no" could both be proper responses to the statement, "A cadaver in the classroom is not a dead human being" is the key premise, beautifully presented in the cut-aways, organization, and editing of this piece.

The structure of the film is an as-if dialogue between young dissectors and soon-to-be cadaver (the body donor). Interviews heighten and explore the relationship between the living and the dead--and not just medical students and body donors. The medical students do not speak directly with the future donor, though we see him shaking hands with them, visiting (and speculating on) the spot where his remains will eventually be deposited. The video concludes with a moving annual ritual, the disposition of body donors' cremated remains at sea.

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Margaret returns one afternoon from tennis to discover that Lewis, her husband, has committed suicide by taking an overdose of pain medication. Lewis had been bedridden from amyotrophic lateral sclerosis (ALS). They had thoroughly discussed his plan to kill himself before he was unable to do so, but Margaret is surprised when it happens because she expected Lewis to leave her a message. There is none.

As Margaret prepares for her husband’s cremation, she recalls the circumstances under which he left his teaching job--not because of the ALS, but because he used to teach human evolution in his high school biology class, without giving "equal weight" to creationism.

Because this upset many of his students’ parents and local clergy, the principal several times suggested that Lewis might at least give a nod to creationism. However, Lewis, an outspoken opponent of religion, was insulted by this proposal and quit his job.

The undertaker encourages Margaret to hold a wake--to comfort her and their many friends--but she insists that Lewis wanted no wake and no service. The next day the undertaker brings her Lewis’ ashes; she goes out into the country at night and disperses them.

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This beautifully illustrated (by Teddy Kristiansen) semi-autobiographical graphic novel captures the struggle of the author to take on the assignment as the newest chronicler of the adventures of Superman. This once-in-a lifetime opportunity evokes the memory of his first encounter with the man of steel--as a young boy reading his Superman comic book in a hospital waiting room as his grandmother lies dying of Huntington's disease.

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While driving away from a dangerous city in an area of north Afghanistan ravaged by war, three men must journey by foot when their car is damaged in an accident. Donk is an American combat photographer. Hassan is a young Afghan translator. Graves is a British journalist suffering from a severe case of malaria and in desperate need of medication.

They arrive at a remote village ruled by a warlord, General Ismail Mohammed. Medication is unavailable there and transportation to a larger city is not possible for at least another day. The local doctor recommends an herbal remedy for the treatment of malaria, and General Mohammed attests to its effectiveness. The medicinal grass grows only in a nearby mountain valley. Two soldiers escort Donk and Hassan to the vale. They encounter a convoy of transport vehicles that have been incinerated by a bomb blast.

When the grass is finally in sight, Donk and Hassan race towards it even as the two soldiers shout at them. Too late! Donk steps on a bomblet and the device detonates. Badly injured (and maybe even mortally wounded), Donk and Hassan lie on their backs and gaze at the sky. They are surrounded by the thick grass they hoped might save the life of their companion, Graves.

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A stern, old doctor (Victor Sjostrom) is preparing to travel by car to Lund to receive an honorary degree. He has a disquieting dream in which he perceives his own death as the frightening, lonely end to a hollow existence. In the morning, his gruff demeanor is considerably altered by the intimations of mortality. His daughter-in-law (Ingrid Thulin), who has inexplicably been visiting, decides to accompany him to Lund. En route they encounter a trio of mirthful teenagers, a bickering married couple, and grateful patients. They also visit the doctor's mother.

The dream and the journey unleash a recurring flood of memories of youthful summers at the family home among the wild strawberries and of his unrequited love for a beautiful cousin. He learns that his daughter-in-law is pregnant, but his only son is about to repeat his mistakes by rejecting an emotional bond with his wife and his future child in the empty pursuit of professional achievement. The pregnancy is the reason she left her husband to visit his father. At the end, the doctor establishes a small but real rapport with his son and achieves a degree of understanding about his own life.

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As Bertman says in her introduction, this book "is meant to refuel therapists, counselors, social workers, physicians, nurses, clergy and all others who are committed to providing support to those in grief." While the caregivers' focus is on those in grief, they also have to give some attention to their own bodies, minds and spirits. This collection of essays, poems and stories, illustrated with drawings and photographs, examines grief from several perspectives.

The opening section looks at professional roles in experiencing and understanding suffering and empathy. Section two provides several descriptions of how caregivers use the arts for themselves and for those they companion. Section three is devoted to lessons from old and new cultures. The final section explores basic needs of grieving people.

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The author of this bold collection is a registered nurse who relates, through her poems, patient and caregiver experiences culled from her own years of working in Intensive Care-Coronary Care. There are 24 poems here, most running two to three pages and most written in short lines, a point of craft that adds to their power. There is not one moment of easy sentimentality in these poems. Instead, the author plunges into the grittier side of nursing and illness--and yet, in aggregate, these poems celebrate the embodied and holy work of healing.

In the opening poem, "The-Trickle-Down-Theory-Of-Health," Adam, in the Garden of Eden, is surprised by "The knife" that "separates his ribs." By poem's end, we see health slip "like a ring / from earth's finger" (2), and with this simile we are introduced to the book's underlying metaphor and also to the poet's technique: dense and sometimes near-extreme imagery that ranges, in this poem alone, from encyclopedias to acid rain to barefoot children to librarians to a patient in the dark, "her arteries and shelves / of bone in a ruby gloom" (2). This accumulation of unrelenting, unusual images recreates the world of a patient's pain and suffering and the fierce determination and occasional despair of a caregiver.

"Coma" is written from a comatose woman's point of view, and yet we also see her from the nurse's vantage. In a lovely and surprising twist, the coma becomes, for the patient, a sort of liberation as "Slowly she sloughs, / cell by cell, / the old thorn" (15). This patient is not Sleeping Beauty, who in some fairy tale might be wakened by a kiss. "On the Fireline" becomes a wonderful metaphor for the daily confrontation of illness, for the way the nurse, returning daily to tend her patients, also "coalesces into fire" (16).

The 5-page poem "Intensive Care" perfectly renders the physical sense of being alternately caregiver, patient, and family member within the rarified atmosphere of the ICU (24-28). A patient's blood "pulls against/ the moon, his breath / this tide going out" (26) and, as she comforts a waiting family member, a nurse's eyes "beyond clarity, / unfold a silken language / all their own" (28).

Other not-to-be-missed poems are "The Holy O" (36), "Prayer to a Purple God" (38), "Pieta" (44), "A Riot of Flowers" (52), "What the Body Remembers" (57), and one of my very favorites, "Anesthesia" (59). In "Anesthesia" the caregiver lets an anesthetized patient float like "an embryo / tethered on the end of IV tubing, / floated like an astronaut / in cold stratosphere, / a naked thing / alone / in the universe" (60). But since these poems are finally loving, involved, experienced and hopeful, the patient is told to hush; he is watched over; he is protected. When danger is past, he is reclaimed: "She will hold you / within white-curved wings. / She will reel you back in / when you are healed" (60).

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The front cover of this collection shows the outline of Africa completely filled with the names of patients ("Tyra Lynette Deja Nya Rovert Marqui Fatima Terry Alexia Michon Ty . . . ") On the last page, poem #120 consists of an outline of the United States of America, also completely filled with the names of patients, also African. The poems in this collection constitute a journey through these Dark Continents, both of which lie within.

Kelley Jean White stakes out her territory very clearly: "I suppose I embarrassed you / at all those mainline / plastic surgery parties / talking Quaker and poor and idealism" (3). There are no elegant parties, nor plastic surgeons, after page 3. Instead, persons like Shawanda live here: "At seventeen, Shawanda has never spoken. / Her brother easily carries her frail body / into the exam room--37 pounds" (36). And the nine year old girl who delivers her baby by C-section: "The nurses said it was the worst thing / they’d ever seen . . . She took her to her grandmother’s home / to raise. / The man did time / for assault." ("Freedom," 55)

But the poet hasn’t lost hope at all. She is filled with love and humor and imagination: "I dream I’m marrying this guy I used to work with who spent a lot of money on his hair" (73). "I musta been looking pretty down / when I left you today . . . " because the legless man pulling his wheelchair to his favorite begging spot said, "love, you gotta be always looking up . . . I just smiled and looked at / my too big shoe feet" (118).

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