Summary:

A foreign correspondent accustomed to global calamities now finds himself entangled in a personal disaster. Tom is a middle-aged man with a weakness for cigarettes and women but not much interest in his wife, Barbara, and their young daughter. Tom develops a nagging cough. Night sweats, bloody sputum, and weight loss soon follow. He visits multiple physicians. A chest X-ray demonstrates a suspicious "shadow." Even before further testing is performed, a distinguished pulmonary specialist tells Tom that the diagnosis is lung cancer.

Tom and his wife search the Internet and worry even more when they learn about the harsh side effects of treatment and the dismal prognosis of the disease. Although he has smoked cigarettes since he was a teenager, Tom suddenly has little trouble quitting. He develops a greater appreciation of his wife and fondness for his daughter. If only he could have another chance at life, he would mend his ways and become a new man. The results of Tom's additional tests reveal a different diagnosis - tuberculosis. Tom and Barbara are ecstatic that he can be cured with a combination of five different medications. With the threat of cancer eliminated, Tom resumes all his old habits: smoking cigarettes, ignoring his wife, and flirting with women.

View full annotation

Summary:

In Especially Then David Moolten discovers his poetry in the ordinary, often painful, texture of childhood, adolescence, love, and marriage. Each memory becomes a small story-like poem that looks simple and straightforward at first, until suddenly the poem reveals its hidden truth.  A sense of existential loss pervades these poems, as in “One morning as a man’s wife offers to fill / His empty bowl he feels suddenly desolate / For how plain he has become…” (“Cornflakes,” p. 31)  But Moolten’s melancholy is sweet, rather than bitter; energized, rather than depleted; and cumulatively powerful, as “The tractor / Of memory drags on, churning its femurs, / Its numbers and dates.” (“Verdun,” p. 64)

Especially Then is ripe with traumatic events: A father’s abandonment, “During that proud, petulant year my father left / And I became a punk, nothing could touch me.” (“Achilles,” p. 17). A brother’s death: “in the shallow dark of years since / I buried my brother…” (“Pulled Over on I-95,” p. 23) Divorce, “despite the years between you / And a hard divorce, the unshrived recriminations…” (“Seen and So Believed,” p. 51) And a wife’s death, “As if his wife had always gone / By the name of death he thinks of her / Whenever he sees or hears the word.” (“In Name Only,” p. 49)

These ordinary tragedies play out against a panorama of tragedy, as evidenced in “Photograph of a Liberated Prisoner, Dachau (1945)” and “The War Criminal Gives His Testimony.” Most often, though, the world’s suffering has little impact on the way we live our lives, “Someone at the next table sighs / Over Guatemala, the tragedy / Of having read an article or watched / A TV special…” (“Who You Are,” p. 53) We go on as we always do.

View full annotation

Summary:

Amelia Stern is an academic pediatrician in a large city hospital and mother of a bright, young son. She is deeply involved with her patients, including Darren, born with AIDS, and Sara, the malnourished child of anxious parents, both lawyers. As she struggles to answer to the demands of her work for "other women’s children," she neglects her own child and her marriage begins to fall apart. Her husband’s resentment and her own feelings of guilt come to a crisis when her son falls seriously ill while she is at the hospital.

View full annotation

Summary:

In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

View full annotation

Summary:

Middlemarch is a middle-sized country town typical of rural British life in the early nineteenth century. George Eliot (born Mary Ann Evans) was part of the realist school that dominated Victorian literature. She tried to create a true representation of the real, historical lives of ordinary people.

The novel has a vast number of characters and events but most of the plot centers on two couples: Dorothea and Casaubon (later Will Ladislaw) and Rosamond and Lydgate. Dorothea is an intelligent, vigorous woman, eager to improve the lives of her friends and the poor. She is determined not to marry any of the local, mindless squires but to devote herself to godly work.

Soon, however, she is introduced to Casaubon. Casaubon is an aging, ugly scholar, but Dorothea is attracted by his learning and agrees to marry him in hopes of helping him in his work. Their marriage is unhappy and cold. It is contrasted to Dorothea’s growing relationship with Will Ladislaw, a distant relative of Casaubon. Where Casaubon is cold, Will is passionate. Casaubon senses the kinship between his wife and Will and adds a codicil to his will insisting that if Dorothea and Will marry after his death than Dorothea must give up Casaubon’s house and money.

Shortly thereafter, Casaubon does die, and Dorothea is outraged upon hearing of the codicil. She does not recognize her feelings towards Will as feelings of love. By the end of the novel, however, the two confess their feelings and Dorothea gives up her earthly possesssions to live happily.

The plot developed around Lydgate and Rosamond is of particular medical interest. Lydgate is a new kind of medical practitioner. At the beginning of the nineteenth century, the traditional medical order, consisting of physicians (like modern consultants), surgeons, and apothecaries, was being replaced. New well-schooled general practitioners could perform all these functions.

When Lydgate arrives in Middlemarch with his modern techniques and visions of building a modern hospital for the poor, the medical establishment greet him with jealousy and suspicion. Lydgate’s practice therefore develops very slowly. His marriage to Rosamond, a woman used to a rich lifestyle, quickly depletes his savings.

Facing bankruptcy and the loss of his disappointed wife, Lydgate receives an unexpected loan from Bulstrode, a wealthy landowner. Soon after, Bulstrode is charged with murder and Lydgate is accused of having a hand in it; Middlemarch sees the loan as a payoff. Disgraced, Lydgate cannot fight back. He becomes a doctor who toadies to the wealthy and abandons his revolutionary dreams. He dies at 50.

View full annotation

Summary:

This tale is subtitled, "A Provincial’s Story." The narrator is Misail Poloznev, who lives in a provincial town with his father, an uninspired architect, and his sister, Cleopatra. Misail has no interest in the standard, clerical-type employment of gentlemen, but wishes to earn his living by manual labor. This is outrageous! It is totally immoral for a gentleman to cross the line and act like a common workman. When Misail goes to work for Radish the painter and contractor, his father first has the local governor warn the young man that he had better shape up or the genteel community will make him an outcast; when Misail persists, his father disowns him.

Misail’s friend, Dr. Blagovo, is a physician who articulates the beliefs of many of Russian intellectuals: "In this land of ours cultural life hasn’t even begun. There’s that same savagery that existed five hundred years ago." Through Dr. Blagovo, Misail meets Masha Dolzhikov, the engineer’s daughter. By falling in love with the idea of working the land and helping the peasants, she falls in love with and marries Misail, who embodies her ideal. They move to the country and try to farm, but the peasants cheat them. Masha tries to start a school for peasant children, but the peasants sabotage her plan. Finally, she gives up and moves to Petersburg, eventually asking Misail for a divorce.

Meanwhile, Cleopatra has fallen in love with Dr. Blagovo, who gets her pregnant and leaves. The outcast brother and sister then live together, until Cleopatra dies of tuberculosis after having the baby. Years later, Misail continues his principled career as a workman and cares for his orphaned niece.

View full annotation

Summary:

In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.

It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.

The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.

View full annotation

Summary:

After working with the Parisian physiologist, François Magendie, Dr. John Leggate returns to England to practice in the town of Middlethorpe in the late 1840s. He is obsessed with making a research discovery that will help humanity and establish his name. He falls in love with the intelligent and gifted Marian Brooks who aspires to a career as a concert pianist after study in Leipzig with Felix Mendelsohn. They marry and find happiness at first, but she is troubled by discovery of his past affair in France, and he is troubled by her abandoning music simply to be the type of wife he never wanted.

Leggate has a theory about the origins of cholera, but his painstaking work shows him two things: 1. his original idea is mistaken, and 2. the disease is spread by water. He does not publish, though he announces his intentions to do so. Intimidated by skeptical colleagues, he is unable to write, and the problem is exacerbated by a newspapermen who makes unwarranted accusations because he holds a grudge against Leggate’s wife.

Marian wants to help him, but he rejects her offers and retreats into himself. Their marriage is threatened. Just as cholera returns and the town learns from Leggate’s insights, John Snow publishes his famous observations on cholera. Leggate is scooped. He and Marian migrate to Canada where he is accepted for his skills and desire to be of service and she establishes a conservatory of music. Their marriage is restored.

View full annotation

Summary:

A lieutenant named Alexander Grigoryvitch Sokolsky arrives at the home of Susanna Moiseyevna Rothstein, a Jewess and owner of a vodka distillery. Sokolsky has come to collect the 2300 rubles that Rothstein owes his married cousin. In fact, his cousin doesn’t actually need the money, but Sokolsky is helping his cousin get his debts paid so that he can then borrow the 5000 rubles that he needs to marry his fiancée.

Susanna, a luscious, free-spirited young woman, receives the lieutenant and offers him supper. She entices the IOUs from him, but then refuses to pay up. The next morning Sokolsky returns to his cousin’s house without the money, but presumably sexually satisfied. Kryukov, the cousin, rants and raves. What an outrage! He determines to visit the Jewess himself and demand payment. He does so and, likewise, only returns the next morning, penniless.

After a week, Sokolsky borrows the money from his cousin and leaves. After another week, Kryukov gets an uncontrollable itch to visit the Jewess again. When he arrives at her mansion, there are many men around, including Sokolsky, who evidently has hung around Susanna’s house for a week, having completely forgotten about his fiancée. Krykov’s final words are: "How can I judge him since I’m here myself?"

View full annotation

Summary:

A doctor is riding through the desolate steppe at twilight and loses his way. He comes to a hut along the new railroad where two men, an engineer and his young assistant, are spending the night. After they all have a few drinks, the engineer marvels over the beauty of lights in the distance, while the young man says the lights remind him "of something long dead, that lived thousands of years ago." (p. 607) He sees no point in human love or accomplishment because, after all, we all have the same fate--death. This encourages the old engineer to tell a tale of his youth.

Once, when visiting his hometown on business, he had come across a childhood friend, a woman who was unhappily married. He looked forward to having a brief affair with her, but she considered him her savior. She desperately wanted him to take her away. The engineer agreed, but then callously abandoned her.

Later, he realized that "I had committed a crime as bad as murder." (p. 635) He went back and "besought Kisotchka’s forgiveness like a naughty boy and wept with her . . . " (p. 639) At the end of "Lights," the doctor rides off at sunrise toward home. All around him nature seems to be saying, "Yes, there’s no understanding anything in the world!"

View full annotation