Summary:

Written as an interior monologue, Destiny begins as Chris Burton receives a phone call informing him of his schizophrenic son's suicide. Burton, a British ex-pat journalist in the final stages of writing his chef d'oeuvre--a cultural history on national character--is married to Mara, a provocative, capricious, flamboyant Italian. The vitriolic arguments and hurtful stratagems that characterize their discordant marriage intensify with the crisis of death and its aftermath--the identification, transport and entombment of Marco's body. Family relationships are further complicated by Mara's distrust and estrangement of her adopted daughter, Paola.

Burton reveals the chaos that schizophrenia imposes not only on the patient, but also on the entire family. In order to avoid prison following an attack on his family and home, Marco had been placed in a psychiatric institute, Villa Serena, and it was at this facility that Marco stabbed himself to death with a screwdriver. The onset of disordered thinking and erratic behavior, the search for therapies, the various repercussions of guilt and blame (including recriminations about the intense, border-blurring maternal love lavished on Marco), are re-examined by Burton as he travels from London to Rome, sits vigil by his son's body in the camera ardente, and confronts his wife at her family's tomb.

Burton's physical distress mirrors his mental anguish. Burton has heart disease and obsesses about lacking his anti-coagulant medication. In addition to the worry of clot formation, urinary retention prevents Burton from emptying his bladder. These physical ailments of containment, confinement, obstruction and blockage form resonances throughout the book: the tomb, the strictures of marriage and the leakage of adultery, the oppressive family 'house of ghosts,' the separateness of interior thought from observable behavior, the barriers of language, the herky-jerky redirections of emergency travel.

Furthermore, the will to create permanence, to make one's destiny more than a transient destination, informs Burton's moves. In the midst of his exploding marriage and tormented trek home, Burton agitates over his work, and in particular, his book, which "must serve to transform a respectable career into a monument" (p. 1).

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Dr. Dymov is an earnest and rather boring young physician, who is preoccupied with his patients and his research. Olga, his wife, craves the excitement and gaiety of the artistic life. She discovers a new lease on romance with Ryabovsky, a colorful landscape artist, who takes her on a cruise on the Volga River. As they spoon under the stars, Olga and her lover make light of her bumptious stay-at-home husband.

After she returns from the cruise, Dymov forgives her infidelity, but in Olga's mind, his forgiveness proves to be another strike against the poor slob, since she just can't stand his complaisant devotion. She runs back to Ryabovsky for a while, until he makes it clear that he is bored with her.

Then one day Dymov develops diphtheria, evidently contracted by "sucking up the mucus through a pipette from a boy with diphtheria. And what for? It was stupid . . . just from folly." Dymov soon becomes delirious, and then dies. Suddenly, Olga is overcome with guilt and grief. Too late, Olga realizes that her husband was a hero.

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A district doctor and an examining magistrate are on their way to an inquest. The magistrate tells the story of a young pregnant woman who "foretold her own death" shortly after giving birth. Though she was apparently healthy, she simply closed her eyes and "gave up her soul to God." This tale, the magistrate contends, is an illustration of how inexplicable life can be.

No, the doctor responds, there is no effect without a cause. The woman probably poisoned herself, the doctor explains. Her husband was unfaithful. She wished to commit suicide, but did not want to harm the unborn baby. Thus, she waited until after her confinement. The magistrate is overwhelmed with grief--in fact, the story is that of his own wife. His infidelity may have caused her suicide!

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This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.

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Subtitled "The Story of a Gifted Young Obstetrician's Mistake and the Psychologist Who Helped Her," this is an absorbing account of a young female physician's torment following the difficult delivery of a baby who was soon thereafter diagnosed with cerebral palsy. "Doctor Amelia" seeks counseling after she has taken an indefinite leave of absence from her practice and faculty position. The book intertwines reconstructed counseling sessions in the voice of the doctor-patient, with the therapeutic strategy and personal reflections of her therapist, author Dan Shapiro.

The obstetrician enters therapy because she has lost confidence in her professional abilities. Once deeply engaged in her chosen profession, she has lost her enthusiasm for it and feels "numb." Her marriage is under strain. When asked if she is suicidal, she hesitates and then denies she is. Shapiro thinks there may be trouble ahead, and so does the reader. Gradually, Doctor Amelia reveals the incident that triggered her changed emotional state. She had delayed performing a cesarean section on a patient who was in extended labor and whose baby was showing deceleration of its heartbeat rate. A few weeks later, the baby's pediatrician informed Doctor Amelia that the baby had cerebral palsy and now the baby's parents are filing a lawsuit.

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In 1768 the young, feeble-minded King Christian VII of Denmark sets off on a prolonged tour of European capitals. His "handlers" determine that he needs to have a doctor along to help fend off, and to treat, the King’s frequent bouts of "agitation." Therefore, they appoint Johann Friedrich Struensee, a German physician from Altona, as the Royal Physician. Christian and Struensee develop a close bond; when the trip is over, the Royal Physician stays with the King and becomes a permanent fixture at the Danish court.

Christian is unstable and childlike. He enjoys playing games, but is totally uninterested in his beautiful young English wife, Caroline Mathilde. She becomes pregnant the first time he visits her, but he never sleeps with her again. Meanwhile, the King’s ministers actually run the government, even though he is theoretically an absolute monarch.

When Struensee, who is an Enlightenment intellectual, enters this ménage, he decides to reform the State by getting King Christian to agree to a series of enlightened new laws. Having won the King’s ear, the Royal Physician proceeds to rule Denmark for several years and to institute many of the reforms proposed by Voltaire and the other Enlightenment philosophers. Struensee also begins a tender, prolonged, and obvious love affair with the queen, who subsequently bears him a daughter.

The end of this story is not difficult to predict. Aggrieved members of the aristocracy manipulate the king to strip Dr. Struensee of his power and have him executed for adultery with Queen Caroline. She and the baby girl are shipped back to her home in England. The new Prime Minister retracts all of the reforms enacted by Struensee. And the demented king lives on in the fiction of his absolute power.

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Henry Moss is a medical geneticist specializing in Hickman syndrome, a fictitious disease resembling progeria. Children with Hickman syndrome experience premature aging and invariably die before the age of twenty. The physician meets Thomas Benhamouda, a teenager who genetically has Hickman syndrome but astonishingly has no physical manifestations of the disease. Dr. Moss identifies a protein that "corrects" Hickman syndrome in the blood of Thomas and proceeds to synthesize it.

Dr. Moss violates medical ethics by administering the experimental enzyme to his favorite Hickman patient, William Durbin, a dying 14-year-old boy. It is a last-ditch effort to save William's life even though the substance has not been tested for safety or efficacy in human beings. Dr. Moss also injects himself with the enzyme. He realizes the tremendous potential the drug has not only in curing Hickman syndrome but also in extending longevity in normal individuals. He is well aware of the great financial rewards he might reap from his discovery.

After a series of injections, William's deteriorating health stabilizes and even improves but he dies in his home. Dr. Moss has failed to save the doomed boy but in the process of breaking the rules and risking his career has learned how to understand and appreciate his own life as well as reconnect with his family.

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This is psychiatrist Ron Charach's seventh collection of poems. It begins with the narrator going through security in order to board an airplane--a metaphor for contemporary society: we structure more and more "security" into our lives, but the uncertainty seems to increase, rather than decrease. The theme of the book is safe passage: our attempts to achieve it, our failures, and our companions along the way. In the last poem ("The Night After"), Charach tells us, "all the talk in the world cannot dampen my fear / of a world bereft of holiness." The quest is unsuccessful, yet somehow saved by a few fleeting moments of contact with something else; perhaps, it is the sacred.

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In 1822, a young Canadian paddler named Guillaume Roleau is near death after suffering a gunshot wound to the stomach. His recovery is dramatic and scientifically important. The injury has resulted in a traumatic fistula--a porthole between the outside world and Guillaume's abdominal cavity and organs. The treating physician, Dr. William Barber, immediately recognizes the incredible opportunity for medical research and conducts a lengthy series of experiments on the process of human digestion.

Guillaume--patient, research subject, and guest in the doctor's cabin--is rowdy and frequently uncooperative. He continues to participate in the grisly experiments at least partially out of affection for the physician's wife, Julia, who helps nurse him back to health as well as providing emotional sustenance.

Julia ultimately makes a large, uncredited contribution to Dr. Barber's research. At her husband's request, she has sexual relations with Guillaume so that the unreliable man will remain with the doctor until the experiments are all completed. The efforts of this tragic trio result in a landmark textbook on gastrointestinal physiology authored by Dr. Barber and Julia's illegitimate son, Jacob, sired by Guillaume Roleau.

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The first part of this novel presents a detailed picture of the Jewish Californian Cooper family, centering on the sixty-year-old Louise, who is dying of breast cancer. Her husband, Nat, is unfaithful, and, she suspects, only loves her when she is at her weakest and most sick. Her daughter, April, is a lesbian folk singer who becomes pregnant with the help of a gay male friend and a turkey baster. Danny, the son, is also gay, living in New York with Walter, his lover, who is becoming increasingly detached and obsessed with internet sex groups.

Louise considers herself lucky, though, compared with her younger sister Eleanor, partially disabled by childhood polio, disorganized and ill-groomed and married to Sid, whom Louise finds deeply unattractive. Eleanor's son is a sociopathic drug addict, and her daughter has ovarian cancer caused by Eleanor's taking DES (diethylstilbesterol) in pregnancy. She sends Louise newspaper cuttings about the causes of homosexuality and the dangers of AIDS.

The first part having established the complex dynamics and histories of the family's relationships, the second brings the entire family together in the crisis of Louise's final illness and death (a reaction to chemotherapy drugs causes severe chemical burns and she dies in a burn unit in a San Francisco hospital). After her death, the new dynamics of the family are established, and Louise's son and daughter conclude that their mother had "a terrible life" (p. 261).

The short third part shows that no such conclusion is possible, that even those closest to us remain terribly but fascinatingly unknowable. A flashback to a point just before Louise's final illness describes her attempt to convert to Catholicism and a brief moment in which she experiences a marvelous sense of complete harmony.

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