Summary:

Premiering on November 11, 1985, An Early Frost was the first television film to deal with the subject of AIDS. It tells the story of Michael Pierson (Aidan Quinn), a young and successful Chicago attorney who is gay and who is stricken with AIDS. After being hospitalized, Michael goes home to break the news of both his devastating illness and his sexual orientation to his parents (Gena Rowlands and Ben Gazzara). They must not only come to terms with their son's impending death but also with their own prejudices concerning homosexuality and their own ignorance concerning this disease.

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A man suffers from a disease that "came / from love, or some / such place" (AIDS?). He has come home to his father's house to die. He grows thin, his sores will not heal, family and friends grow distant. While in the kitchen family members discuss how much the illness affects them, the sick man himself is already in hell, "which is / the living room . . . . "

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Ruth Picardie was a journalist working in London. Shortly after her marriage in 1994 to Matt Seaton, also a journalist, she found a breast lump. After testing, she was told it was benign. Two years later, and a year after giving birth to twins, the lump enlarged and this time she was diagnosed with advanced, inoperable breast cancer. She rapidly developed bone, liver, and brain metastases and died in September 1997, aged 33.

This book consists of a selection of Picardie's e-mail correspondence during the last year of her life, the columns she wrote for the Observer newspaper (a series about dying she called "Before I say goodbye"), readers' letters responding to her column, and an introduction and epilogue by her husband. While not, then, strictly a memoir, this collection of texts constitutes an intimate view of a witty, angry young woman undergoing an intolerable illness.

The expected elements are there: diagnosis, chemotherapy, radiation, hope, the loss of hope. What is unexpected is the way these are presented, and the vividness with which we share the prospect of saying good bye to her children, her gradual detachment from her husband, and, as the brain metastases spread, the loss of coherence and the appalling silencing of her powerful voice.

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The first poem in this chapbook ("Sonogram") contains two images of a small, mysterious life (the fetus imagined as a "white boat on whiter water" and as a "tiny orca") in the midst of the coldly technical medical world. This juxtaposition is characteristic of B. A. St. Andrews's poems in this small collection. In most of them, she uses disciplined and sparkling language to explore the interface between modern medicine with its impersonal machinery and the irreducible mystery of life.

Some of the images are simply breathtaking. For example, in "A Dying Art: Room 309," a terminally ill artist lies in bed, surrounded by "plastic bags that hang / like udders dripping pigment / into her." In a love poem called "The Body of Science," the poet confesses, "Each time your voluntary / muscles make contact / my involuntary ones / contract." And at the end of "Alzheimer's," she observes, "She stood at the big bay / window screaming but he never / heard what it was she never said."

The four poems entitled "Your Breast a Unicorn" consider the fate of breasts attacked "at consolation's center" by "one aberrant cell metastasized." These learned, wise, and witty poems are, in my opinion, among the very best of the breast cancer genre.

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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.

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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").

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This is a collection of poems by members of an AIDS workshop run for Gay Men’s Health Crisis in New York by poet Rachel Hadas. The poetry is framed by an introductory essay by Hadas, "The Lights Must Never Go Out," and a long concluding chapter that includes Hadas’s reflections on the poetry collection, her own experiences with illness, and many of her own poems.

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Gabriel Noone, a late-night radio personality ("Noone at Night" on PBS) who reads his semi-autobiographical stories to millions of Americans, has just separated from his lover Jess when a publisher sends him the proofs of a memoir written by a 13-year-old boy with AIDS. Peter, the young author, has suffered heinous sexual abuse from his parents and hoards of strangers; he lives with his adoptive mother Donna, who was his therapist. Gabriel, shaken by the memoir, calls Peter, a conversation (all via phone, almost all at night) that begins a relationship that quickly becomes an intense, father-son-like relationship that grows deeper as it grows more unsettling as Jess and others begin to cast suspicion on the actual existence of Peter.

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In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.

In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.

Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).

He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.

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Summary:

This collection's first section contains eight poems that address AIDS. "Inventory," a listing of the author's acquaintances who have died of AIDS, catalogs a variety of responses to this illness. Other poems are stark portraits of death in progress ("Waste Not," "Photo") as well as evidence of the love and coping skills a diagnosis of AIDS elicits ("Althea," "In Time of Plague," "Sonnet Positive"). "The Review" ironically compares a popular movie about AIDS to its reality: in the movie, family members do not flinch from kissing their infected son.

The second section addresses coming out as a Lesbian ("In the Duchess"), domestic violence ("Beatings"), and Lesbian sexuality and relationships ("Hunger" and "Want"). "My Body" is another effective "list" poem, a catalog of the female body and how its physical dimension becomes the visual history of a life "healed and healed again."

The final eight poems examine the difficult relationship between a daughter and her dying mother. The book comes full circle as the "swift river" (death from AIDS) of the book's opening poem becomes the "cold river" the speaker now swims in, a metaphor for internalizing a mother's "bitter edge" as well as the accumulated deaths of friends and lovers ("Cold River").

"To Spirit," "Journey," and "Here" regard the daughter's deathwatch over her mother. The remaining five poems serve to balance loss and hope, especially "Legacy," in which the narrator accepts how age is transforming her own body into her mother's, "her scared eyes shining in triumph."

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