Summary:

Gary, now in seventh grade, has lived with his mother since early childhood when his dad left. His uncle, Rob, has always lived nearby and loved and attended to him like a dad. Gary counts on Rob for basketball coaching, good advice about girls, and understanding about things he can't talk with his mom about. Gary notices one day that Rob looks pale and sick. The sickness doesn't seem to go away. Finally he learns that Rob has AIDS.

For a time he manages to convince himself it was a mistake at the lab and couldn't be true. Ultimately he has to come to terms with it when his uncle is taken to the hospital. With Rob's illness he finds a new kind of maturity in himself, and with Rob's encouragement he initiates a friendship with a girl he's been too shy to approach. After Rob dies, he is surprised at the kind of support he gets from friends, and finds ways to recognize and claim something of Rob in himself.

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This novel is a fictionalized version of a true story. In 1973 John Cappelletti from Penn State won the Heisman trophy, given to the outstanding college football player each year. When he received the award, he publicly "awarded" it to his little brother, Joey, then suffering from leukemia.

The story covers the two years prior to that event, a period when the relationship between the brothers deepened as John moved upward to fame and Joey's illness ran its slow course toward his eventual death in 1976. It provides many scenes from family life that show the range of ways a loving family of five children and a daughter-in-law collaborate in supporting Joey through hospital visits, remissions, a near-fatal coma, and increasing bouts of severe pain.

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The wealthy 49-year-old Paul Dorrance, concerned about his health, summons his doctor and a cancer specialist for an examination. They pronounce him healthy, though in need of a rest from work, and Paul begins to ponder a life of renewed vigor, perhaps in marriage with a younger woman who would bear him children. Then he discovers on the floor a piece of paper containing the diagnosis of cancer.

He believes the doctors have deceived him, and his elation turns to self-pity and gloom. In that mood he decides to propose to Eleanor, his mistress of fifteen years whom he had previously decided not to marry, for companionship in the difficult time ahead. He proposes to her the same day as the consultation, without telling her of the diagnosis (even though she knows he saw the doctors).

She accepts his proposal, and she is not deterred when he reveals the harsh prognosis. Several years later Eleanor dies of a heart attack, and Paul soon discovers that on the fatal day of the consultation she . . . had done a certain thing [which readers will want to discover for themselves] that trumps Paul's egotism and manipulativeness in the relationship.

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Like the train images in the last two stanzas, this poem is a train of thoughts about medicine, doctors, and patients' relationships to doctors, medicine and illness. The poem begins with the narrator's (presumably the poet's) Chinese doctor writing a prescription in Chinese. The poet begins daydreaming about the characters, and this leads to a soliloquy about daydreaming and illness and the slower pace of the ill, hanging "suspended in the wallpaper" of waiting rooms.

A recollection of the poet's "lady doctor" and his infatuation with her leads to a revelation of his desire to have illness and suffering, just to be with her. He philosophizes "suffering itself is medicine / and to endure enough will cure you / of anything." He decides he'd like to suffer like his mother, who seemed to not only accept, but also relish, the sick role of the weak, dependent state.

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Magda Danvers, the brilliant English professor and scholar of Blake, is dying of cancer, "the Great Uncouth . . . my final teacher." The novel tracks the course of her illness and her husband, Francis's (who is a former Roman Catholic seminarian) untiring care of her until the end. In addition, the deteriorating marriage of Alice (who has just suffered a miscarriage) and the novelist Hugo Henry is examined alongside of Magda's and Francis's as Alice befriends Magda and Francis throughout the final course of Magda's illness.

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This essay is told from the perspective of an ophthalmologist who was consulted about a patient who had blurry vision. She is told by his internist that he has cancer but the family does not want him to know it. She plays along with the deception and does not inform the patient that his vision problems are from brain metastases. By serendipity she later learns that the patient knows his diagnosis but is playing along with the deception so as not to hurt his family. She is relieved to finally talk with him openly about his disease and his prognosis.

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The Changes is set in the deep South during the depression. A fifteen year old girl, whose main ambition is to finish school and go to college, witnesses her mother’s intentional starvation. The family attributes their mother’s irrational behavior to menopause, believing that all women going through "the change" become crazy.

The young daughter not only fears that her mother’s insanity is hereditary, but also that it may be partly her fault. The reader suspects that the mother may have intended to die in order that her daughter could afford to go school. The family seems to feel that the daughter’s presence in the household somehow drove her mother to insanity.

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A physician recounts the experience of caring for a small child with an incurable disease. The father brings in a bright stuffed dinosaur for the child and despite all expectations, the child opens one eye and reaches for the toy, then lapses back into a coma. The family and physicians cry together. A week later the child dies. The narrator uses this example to argue that it is the intensity of a physician's experiences and the privilege of being a part of them, rather than whether or not the experience is happy, that gives medicine its meaning and satisfaction.

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A mother reflects on her life in the country and on her son who has a seizure disorder. She is nervous about allowing him outside to play because it is hunting season, and because she is worried he may have another seizure and get hurt. She seeks to balance her need to protect her son from harm with his need to grow up as normally as possible.

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The wife of a man dying of cancer takes him to Yosemite for one last visit before his death. During this trip she thinks about how her life has been changed, both by marriage and by her husband's illness. Yosemite represented a tradition for them where they vacationed with their children each year. As the narrator reflects on how her life will change after her husband's death, and on the needs she has suppressed over the years, Yosemite begins to represent a new kind of tradition for her which will give her nurturance in the future.

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