Summary:

The great French actress Sarah Bernhardt (1844-1923) conducted an affair with her doctor, gynecologist Samuel Pozzi (1846-1918) in the decade before he married. They remained friends, and she always called him her Docteur Dieu (doctor god).

The handsome physician was a leading light in French gynecology and in the Paris arts community. Clad in his red dressing gown, Pozzi was the subject of John Singer Sargent's wonderful portrait (1881), which spawned erotic legends about him.

At first happy, Pozzi’s marriage degenerated into coldness, but his wife would not grant him a divorce. He then established a long-standing, public relationship with Emma Fischhof. During the Dreyfus affair, which unmasked the horror of entrenched anti-Semitism in France, physician and actress both fought against the ill treatment of the Jewish officer.

In 1915 and at Sarah’s insistence, Pozzi amputated her painful leg. Three years later, he was shot and killed by a disgruntled and delusional patient who blamed him for a minor illness.

 

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The author was the first blind physician to be licensed in Canada. Her autobiography is also an autopathography.

From her anger over developing severe diabetes as a teenager, through her relentless pursuit of a scientific degree and medical school, through a brief failed marriage – followed by the tragedy of completely losing her sight while still in training, to a rewarding and responsible career as a palliative care physician and educator.

Sustained by her religious faith and by loyal family members and friends, Poulson explains choices, compromises and supports that allowed her to continue studying and working in Montreal and later in Toronto.

Her complications from diabetes were numerous, and included heart disease for which she required surgery. Then she developed breast cancer, which eventually metastasized. In closing her narrative, she knows it will likely take her life.

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In 1904, the 19 year-old Russian Jewish Sabina Spielrein (Keira Knightley) is admitted to Burgholzi clinic under the care of Dr. Carl Jung (Michael Fassbender) who is beginning to adopt the talk-therapy methods of psychoanalysis promoted by Sigmund Freud (Viggo Mortensen). 

She is hysterical and difficult to control, but she is also bright and has been studying to become a doctor. Jung slowly breaks through her resistence using dream interpretation and word association; eventually she reveals that her mental distress has its origin in her relationship with her father. He would punish her physically and she found it sexually exciting. 

The married Jung is obsessed with his patient and seduces her. They conduct a heated affair that entails sessions of bondage and beating, that they pursue almost like a scientific experiment.

On this background, Jung is becoming the protégé and anticipated heir of Freud—but they disagree over whether or not psychotherapy can cure. Spielrein recovers and goes on to become a physician and psychiatrist who develops her own methods of therapy. Freud comes to admire her and Jung is torn by jealousy. 

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With the publication of Stag's Leap, it is very publicly (on the flyleaf) revealed that Olds is writing about the sudden, unexpected death of her 32 year marriage when her husband left to be with another woman. She waited 15 years after the event to publish this book, not wishing her children to have to face the immediate publicity.  Stag's Leap refers both to the favorite wine that she and her husband drank together, and to his leap out of the marriage.

The collection is divided into sections: the year of her husband's revelation and departure, beginning with "While He Told Me"; several years following, divided into seasons; and "Years Later." The poems detail her shock, grief, and eventual acceptance, covering a wide range of emotion, hindsight, and insight. Since the poems were written more or less in the moment, and extend over several years, the reader experiences Olds's evolving inner landscape along with her. The perspective is one of shock - with only the slightest hint of possible trouble ahead: while doing the laundry, she found a picture of the "other woman" in her husband's running shorts ("Tiny Siren," p. 56). But "he smiled at me, / and took my hand, and turned to me,/ and said, it seemed not by rote, / but as if it were a physical law / of the earth, I love you. And we made love, / and I felt so close to him - I had not / known he knew how to lie. . ."
 
Throughout much of the book there is this theme of blissful ignorance torn to shreds and a questioning of how the poet could be so deceived in her assumptions about the relationship - "when I thought he loved me, when I thought / we were joined not just for breath's time, / but for the long continuance" ("Unspeakable," p. 4). The realization of self deception and love lost is both annihilating and shameful: "if I pass a mirror, I turn away, / I do not want to look at her, / and she does not want to be seen  . . . I am so ashamed . . . to be known to be left" ("Known to Be Left," p. 18).

These poems are an intense self-examination and an attempt to understand what happened. "I was vain of his / faithfulness, as if it was / a compliment, rather than a state / of partial sleep" ("Stag's Leap," p. 16). "I think he had come, in private, to / feel he was dying, with me" ("Pain I Did Not," p. 26). "maybe what he had for me / was unconditional, temporary / affection and trust, without romance" and "what precision of action / it had taken, for the bodies to hurtle through / the sky for so long without harming each other." ("Crazy," p. 65 ). There is a recognition that their two worlds were vastly different - he a physician, she a poet - and that their personalities were vastly different - he taciturn, she verbal and open. Olds speculates that even her writing about family and marriage could have been a factor in the divorce: "And he did not give / his secrets to his patients, but I gave my secrets / to you, dear strangers, and his, too . . Uneven, uneven, our scales / of contentment went slowly askew" ("Left-Wife Bop," p. 83).

Still, Olds finds something redeeming: "I saw again, how blessed my life has been, / first, to have been able to love, / then, to have the parting now behind me  . . and not to have lost him when he loved me, and not to have / lost someone who could have loved me for life" ("Last Look," p. 14). "What Left?," the last poem in the collection, presents the marriage and its aftermath as a movement: "we did not hold still, we moved, we are moving / still - we made, with each other, a moving / like a kind of music: duet; then solo, / solo." (p. 89)

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At five years old, Willow O’Keefe has lived a life rich in love and exceptional learning; she reads beyond her years and has memorized a startling compendium of unusual facts.  She has also sustained over 50 broken bones, two of them in utero.  She has osteogenesis imperfecta, a congenital defect in the body’s production of type 1 collagen that leaves bones very brittle.  People with the disease generally suffer many fractures and often other conditions—exceptionally small stature, hearing loss, and bowed limbs.  Willow’s parents and older sister have organized their lives for five years around protecting her from damage and helping her heal from her many broken bones.  Though Amelia, her older sister, loves Willow, her parents’, Charlotte and Sean’s, intense focus on Willow’s condition often leaves her jealous and disgruntled.  Things go from bad to worse when their mother learns that a lawsuit for “wrongful birth” is legal in New Hampshire, and could bring them the money they need to cover Willow’s many medical expenses.  Such a step, however, means losing a best friend, since the obstetrician who oversaw Charlotte’s pregnancy and Willow’s birth, and who ostensibly overlooked signs of the disease and failed to warn the parents, has been Charlotte’s best friend for years.  A “wrongful birth” suit is based on the claim that medical information about a congenital defect was withheld that might have been grounds for a decision to abort the pregnancy.  Though Charlotte insists this drastic step is the best thing they can do to insure a secure future for Willow, Sean finds it repugnant enough finally to leave home.  It is clear that even a win will be a pyrrhic victory, and indeed, the outcome is ambiguous, costly, and life-changing for everyone concerned.

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Summary:

This collection of 16 short stories focuses on doctors and patients in San Francisco, where a wide variety of wealth and culture impact the delivery of medical care.  Further, there are many restrictions—financial, bureaucratic, ethical, and legal —that limit what doctors can do, especially in cases of patients near death.

The author, Louise Aronson, is a geriatrician who knows this terrain very well, having trained in San Francisco and worked as a physician there. A skilled writer and close observer, she has created dramatic and often funny stories that reveal social and bioethical complexity. About half the stories describe end-of-life issues for the aged and the dilemmas for their physicians and families.

In ‘The Promise,” Dr. Westphall orders comfort care only for an elderly patient who has suffered a massive stroke, but a hospital gives full treatment because there was no advance directive and the daughter told the attending to do “what he thought best.”

When Dr. Westphall sees this barely functioning patient in a skilled nursing facility seven months later, he tenderly washes her face and hair—although the text teases us that he might have been prepared to kill her.

In “Giving Good Death,” a doctor is in jail charged with murder; he has fulfilled the request of Consuela, a Parkinson’s patient, to help her die. When it appears that she may have died for other reasons, he is released, his life “ruined.” He leaves San Francisco, and, we surmise, medicine. In three other stories, doctors also leave the profession: the cumulative stresses of work and family and/or a sense that it’s not the right path bring them to that choice.

On the other hand, one of the longer pieces “Becoming a Doctor” celebrates the profession, despite all the rigors of training including sexism against women. 

The stories bring multicultural insights; we read of people from China, Cambodia, Latin America, India, Russia, and the Philippines. Some are African-American; some Jewish, some gay. These different backgrounds color notions of health, death, and medical care. There are also pervasive issues of poverty and, at another extreme, professionalism that is hyper-rational and heartless.

Indeed, a recurring theme is care and love for people, no matter their background or current health status. A surgeon realizes (regrettably too late) that the secret of medical care is “caring for the patient—for anyone—just a little. Enough, but not too much” (p. 135). 

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The first person narrator of this debut novel is a young pathologist, a woman who relates the story of her family over the course of the book. The story is bleak: a young German woman marries an Austrian soldier in WWII, moves to Austria with him and has three children - two sons (one of whom dies as a youth following abdominal surgery) and the narrator-daughter. In a running commentary, almost hallucinatory at times,  the narrator offers brief descriptions of  a traditional preliminary internship year during which she acts as a pathologist, cares for in-patients, and even makes a futile ambulance call to a fatally injured man in a freight yard.  Yet, virtually the entire novel revolves around her family:her father (whose tuberculosis is briefly described),  a factory worker with dreams of  inventing an electronic security relay (never realized); intermittent holidays of evanescent family happiness; and a long threnody about her father's eventual death at the end of the book from a hopeless and domestically abusive alcoholism. Her detailed description of his death traumatizes everyone around her and leads to a rupture in the family.

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Emily Bauer, mother of two small children, psychotherapist and teacher, social, smart, athletic, and strong-willed, finds, after a curious series of falls and other accidents, that she has ALS, "Lou Gehrig's Disease," a disease that involves slow atrophy of all muscular control, leading to complete paralysis and then death.  The disease is relentless, and treatments palliative at best. 

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Eric Calhoune is known to his classmates as "Moby" because of the extra weight he has carried since grade school.  Though his mother is young and athletic, he has inherited the body type of the father he's never known.  Now, in high school, the fat is turning to muscle under the discipline of hard swim team workouts.  But that transformation has been slow in coming, since for some time Eric has taken on a private commitment to "stay fat for Sarah Byrnes."  Sarah, whose name is a painful pun, was severely burned as a small child not, as we are given to believe early on, because of an accident, but because of a cruel and crazy father who stuck her face and hands into a woodstove in a moment of rage.  She has lived with him and his threats for some time; that and her disfiguring scars have made her tough, smart, and self-protective.  Eric and she became friends as social outcasts.  Well-matched intellectually and in their subversive wit, they write an underground newspaper together.  Sarah, however, lands suddenly in the hospital, speaking to no one, making eye contact with no one.  Eric faithfully visits her and, per nurses' instructions, keeps up a running one-sided conversation as if she could hear him.  As it turns out, she can.  She is faking catatonia because the hospital is a safe place, and she has chosen this as an escape route from her father.  Eric and a sympathetic coach/teacher go to great lengths to find Sarah's mother-who, it turns out, can't bring herself to be involved in her daughter's life because of her own overwhelming shame.  Ultimately the father is apprehended, and Sarah, nearly eighteen, is taken into the coach's home and adopted for what remains of the childhood she bypassed long before.  In the course of this main plot, other kids enter the story and in various ways come to terms with serious issues in their own lives, some of which are aired in a "Contemporary American Thought" course where no controversy is taboo.

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The Hawaiian lawyer Matt King (George Clooney) has two big dilemmas. His large, extended family is thinking of selling their inherited 25,000 acres to a developer—and he must help the consortium decide what to do for the benefit of all. Worse, his wife Elizabeth is in a coma on life support following a severe injury from water skiing. He is trying to parent their two daughters, aged 10 and 17, but the girls are unruly and sulky. He thinks that they are acting out because of their mother’s absence.

The doctors tell Matt that Elizabeth will never recover. According to her living will, she does not want to be left on a machine; they must pull the plug. Matt confides in the older daughter who then informs him that Elizabeth had been having an affair. Her sullenness is sublimated anger with her mother for—among other things—how Matt had been treated. Other family friends know of the infidelity and identify the lover as Brian Speer (Matthew Lillard) a real estate agent living on Kaua’i.

Amazed by his wife’s secret, Matt overcomes his sense of betrayal and resolves to respect her feelings, find the lover and give him a chance to say goodbye. The little family flies to Kaua’i looking for Brian and to deal with the sale of the family estate.  Matt meets Brian’s beautiful wife Julie– who is sympathetic to his situation, not knowing of the connection with her husband. When Matt confronts Brian, he is surprised that Brian has no interest in saying good-bye to Elizabeth. What, for Elizabeth, had been a life-changing relationship, for Brian, was a fling that “just happened” and which he wants to forget. He is terrified that Julie will discover his infidelity and leave him.

Matt contends that “things do not just happen.” Everything happens for a reason. Wondering what his own role had been in Elizabeth’s reasons for taking part in the affair, Matt goes home for her death. But he also decides not to sell the family estate and keep it as a nature preserve over the opposition of many cousins.  Brian never appears, but Julie has learned of his infidelity and she comes to the hospital out of duty and horror. It is not clear if her marriage will survive.

In the final scene, Matt and his daughters are in a little boat off Waikiki where they spread Elizabeth’s ashes.

 

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