Summary:

A young woman observes the slow decline of her grandmother into dementia and her grandfather’s reaction to the situation. Issues of denial, anger, autonomy, and intimacy rise to the surface—and expose the formerly private dimensions of their marriage. The illness also stresses her own relationship and invites the idea that someday she and her partner could be projected into a future with the same vulnerability.

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This absorbing, sad, humorous evocation of an impoverished Irish Catholic childhood describes the first nineteen years of Frank McCourt’s life--from his birth in Brooklyn, New York; through the family’s emigration four years later to his mother’s roots in the slums of Limerick, Ireland--and ends with McCourt’s return migration to America, a young man on his own. McCourt sets the scene in his first lines: "When I look back on my childhood I wonder how I survived at all. It was, of course, a miserable childhood: the happy childhood is hardly worth your while. . . the poverty; the shiftless loquacious alcoholic father; the pious defeated mother moaning by the fire; pompous priests; bullying schoolmasters . . . . "

Born during the Great Depression, the author leads us in lilting present-tense narrative through the struggle and occasional small joys of daily life with siblings, school friends, and the adults who circumscribe his life. He is an alien in his parental homeland, the oldest child of a father whose background in "the North" engenders continual suspicion, and a mother (Angela of the book’s title) who had never known her father and whose own mother is as miserly with her affections as with offers of economic assistance.

The hardships in Limerick are so profound that starvation is a way of life. "Consumption," pneumonia, and typhoid are rampant; children go to school barefoot or in pieces of flopping rubber; stealing is a necessity. Frank’s tiny sister and twin brothers die. Above all, there is "the drink"--the endemic disease of Irish fathers who spend their weeks’ wages in the pub on Friday night.

Frank leaves school to earn money for the family (his father had joined the war-time wave of work in England, but continued to drink his earnings away), and to save for a return to America. Blessed with verbal skills and stamina, through stealth, charm and struggle he manages to save what is needed to book ship’s passage to America. As the Hudson River flows by en route to Albany, the ship’s Wireless Officer says to Frank, "My God, . . . isn’t this a great country altogether?" Answers Frank in the single phrase comprising the last chapter, " ’T. is."

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As much about the abusive treatment of women, and the clash of traditional and contemporary mores as it is about the HIV/AIDS pandemic, this beautifully crafted novel tells the story of a nineteen-year-old Mosa (for mosadi--woman) who has already lost two brothers to AIDS. The reader is caught up in the mega-deaths and non-mention of the dreaded acronym, AIDS, as the story unfolds. At their brother’s gravesite Mosa’s one remaining living brother is halted as he shovels in the final loads of earth: "All around him were fresh graves . . . He looked at the not fresh, fresh graves, and noted the dates of birth. Young people who had died prematurely . . . He had known about their long illnesses, their deaths and their funerals." (p. 20)

The author is the first (and only) female judge of the High Court of Botswana and a human rights activist. She is internationally renowned for bringing about the Dow Case, which challenged Botswana nationality laws; she argued successfully for revisions allowing women to pass their nationality on to their children.

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Couser, long interested in autobiography, explores the ethics of representation in biographical writing, and in particular, the ethics of representing vulnerable subjects--for example, the aged or very young, the sick or impaired, or those who are "socially or culturally disadvantaged." He is concerned with representation of people who are intimately connected to the biographer, either as family members, or in some other "trust-based relationship." Couser argues that the relationship between vulnerable subjects and their biographers is analogous to that between patients and their physicians and that therefore principles of bioethics should be applied to such life writing, especially the principles of autonomy, nonmaleficence, and beneficence.

Couser explores life writing and betrayal (Chapter 1), outlines how he will apply the principles of biomedical ethics and ethnographical ethics to life writing (Chapter 2), and applies these principles to examples of collaborative autobiography (Chapter 3). He then critiques in detail Michael Dorris’s memoir about his adopted son, The Broken Cord (Chapter 4); the work of Oliver Sacks (Chapter 6); memoirs of euthanasia (Couser calls these "euthanographies"), Saying Goodbye to Daniel: When Death Is the Best Choice, by Julia Cassutto Rothman; Rescuing Jeffrey, by Richard Galli, and But What If She Wants to Die, by George DeLury (Chapter 7). Finally, in the last chapter, Couser considers how investigation of the human genome might influence the "scripts" of our lives and hence life writing, and also how life writing might be a counter discursive force against genomic essentialism.

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A Mexican-American woman has an appointment for her son Jorge to be seen at the Anglo clinic. She insists on keeping the appointment, even though her relatives think she is crazy. She reflects on events in her life--Jorge's congenital heart disease, the fact that she had a tubal ligation after his birth, and that the heart disease might have been a punishment from God. She reflects upon the fact that often people go for clinic appointments, only to find that the Anglo doctors aren't there and another appointment must be made. She carefully selects Jorge's clothes. She takes the crowded bus.

Finally, at the clinic two doctors enter after a long wait. One is a psychiatrist. In this last scene it becomes evident that Jorge has already died. His mother has brought a bundle of Jorge's clothes to the clinic for "his" appointment, still hoping for a miracle. Referring to the psychiatrist, the woman doctor tells the mother, "He will make you better."

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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Brown, anthropologist and Professor of Anthropology of Religion at Drew University, describes the life, religion and healing practices of Marie Therese Alourdes Macena Margaux Kowalski, also known as Alourdes or Moma Lola, a priestess of Voodou, who emigrated to the U.S. from Port-au-Prince in Haiti at the age of 24. What began as an ethnographic research project on immigrant Haitians, turned into a deep personal friendship between Moma Lola and Brown, and a privileged look at the practices and patients of a priestess, and at the socio-cultural lifeworlds of the Haitian community in Brooklyn and in Haiti between 1978 and 1986.

The book presents an intimate description of an alternative healing tradition through a number of perspectives. Brown alternates between a personal, an analytical, and a descriptive narrative of Moma Lola’s own history and her encounters with patients. In some chapters, Brown fictionally reconstructs the patient’s stories, so that the book is part traditional ethnography, and part fiction.

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This collection of nonfiction writings by fiction author Amy Tan includes multiple genres: essay, email, responses to journalist's questions, eulogy, love poem, university presentations, travel journal entries, and a commencement speech. Hence Tan terms the work "musings." Consonant with the multiple genres are multiple topics, ranging from memoirs of childhood and young adulthood, writing tips, fun portraying a dominatrix in a writers' rock-n-roll band, work on the film version of The Joy Luck Club, and past and present tragedies and struggles.

Much of the book, however, centers on medically-related themes. Prominent themes are: her diagnosis of neuroborreliosis--a form of late-stage Lyme disease--detailed in the final essay entitled "The Opposite of Fate"; her traumas such as the torture and murder of her best friend; the death of her father and brother from brain tumors; a car and a skiing accident; the cancer death of her editor and, woven throughout, the complicated psyche of her mother, Daisy Tan.

Daisy's extreme emotions ruled the family, and her behaviors, such as threatening not only suicide but also murder (she held a knife to Amy's throat), caused profound responses in her daughter. Probably one of the most adaptive responses was Amy Tan's use of their complex relationship in developing the nuanced mother-daughter relationships that characterize her fiction. Daisy's decline and death from Alzheimer's disease are also detailed here.

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The young Beatrice Cenci (1577-1599) is kept with her stepmother, Lucretia, in the appalling isolation and darkness of a forbidding castle outside the Papal States by her cruel father, Francesco, whose enormous debts and misdeeds make him unable, as well as unwilling, to support his offspring. He wants to prevent Beatrice from marrying to avoid paying a dowry. She has suitors, among them a “smooth” prelate, but is unhappily resigned to her lot until her father rapes her.

With the support of her brother, Giacomo, she commands two servants--Olimpio and Marzio--to kill her father, but they waver in their resolve. She taunts them and they return to strangle the man, tossing his body below a balcony as if he had fallen. She rewards them with a bag of coins.

Suspicions about the death are raised almost within the moment of its discovery because of the wounds on the body, bloody evidence in the bedchamber, and the apparent lack of grief in the family. Confessions are extracted by torture.

The defense argued sexual abuse of Beatrice as a mitigating circumstance, but failed to convince the court. Beatrice, her stepmother, Lucretia, and Giacomo are to be executed while a younger brother is forced to watch. In the doleful final scene, the family accepts their fate with tenderness and courage.

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The young and beautiful Beatrice Cenci (1577-1599) is kept with her stepmother, Lucretia, in appalling isolation and darkness in a forbidding castle by her cruel father, Francesco, whose enormous debts and misdeeds make him unable as well as unwilling to support his offspring. He wants to keep Beatrice from marrying to avoid paying a dowry.

He suffers from a horrifying skin disease, possibly syphilis, that covers his lower body in itchy painful sores. He requires Beatrice to rub him nightly with a rough towel, and he is careless to the point of exhibitionism about his sexual and eliminatory functions.

Beatrice decides that he must be killed if her lot is to improve. She begins an affair with Olimpio the married seneschal of the castle—giving herself to obtain his allegiance; soon she is pregnant. She appeals to her brother in Rome for help. He sends poison, but Beatrice cannot use it, because Cenci has her sample all his food and drink.

Angry and impatient with her situation and fearing her father’s wrath when he discovers the affair with an underling, she insists that Olimpio kill Francesco immediately. With the help of the peasant, Marzio, Olimpio smashes the sleeping man’s skull with a hammer and together they stuff his body through a hole in the balcony to make the crime look like an accident.

Suspicions about the death are raised almost within the moment of its discovery because of the wounds on the body, blood in the bedchamber, and the apparent lack of grief in the family. Time passes. Beatrice and Lucretia go back to the family mansion in Rome. Olimpio leaves his own wife to be with Beatrice, and he blackmails the Cenci family into treating him as an equal. Her brother, Giacomo, barely tolerates him.

Beatrice gives birth and the child is handed to the nuns for care. Eventually charges are laid and confessions are extracted by torture on the wheel. Marzio dies in prison of his wounds. Olimpio roams freely but is himself murdered for a ransom.

The lawyer for the defense argued that the father’s sexual abuse of Beatrice was a mitigating circumstance, but he failed to convince the court. Beatrice is beheaded along with her stepmother, while her brother is tortured, drawn and quartered. Because the killig of a parent is the most odious of crimes, the executions are staged as a public spectacle in front of Hadrian’s tomb. Beatrice’s corpse is escorted by a vast crowd to its final resting place near the altar of San Pietro Montorio by Rome’s Gianicolo garden.

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