Summary:

This unusual collection of contemporary art features full color prints of what might be termed comic doctor archetypes. Entitled by specialty, paintings feature doctors in a variety of incongruous settings that constitute fantastic anachronistic commentary on the situation of the doctor relative to different social groups or social expectations.

"The Internist," for instance, is represented as a modern female doctor in a medieval setting, commenting ironically on the various institutional pressures that come to bear upon women in the medical profession and expectations of the internist in particular. "The Pathologist" is featured getting his comeuppance as the doctor who usually has "the last word" in a confrontation with the figure of death--a skeleton straddling a Jungian snake among a horde of rats on the office floor. Each of the paintings is accompanied on the opposite page by a brief, but informative and insightful commentary by Spence.

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Thirteen-year-old Jessie Keyser likes to accompany her mother, a midwife, to homes where there are births or illnesses. Her father is a blacksmith. She and her five siblings live in a log cabin in a small village. They believe the year is 1840. What Jessie doesn't know is that she lives in a replica of a 19th-century village and that the year is actually 1996.

When local children begin to fall ill of diphtheria, Jessie's mother takes her into the woods, provides her with food, blue jeans and a T-shirt, instructions on how to use a telephone, and amazing stories of the world outside that she and Jessie's father left when they joined the experimental colony. Jessie learns that tourists view them at their daily activities through hidden cameras. Now she is to escape and get needed medicine.

Armed guards surround the village. Safely outside the gates, Jessie wanders disoriented in 1996, looking for someone safe to ask for help. She finally talks to reporters who broadcast the news and send help immediately to the town. Medicines are brought and some children saved, though diphtheria has taken several lives. Jessie enters the present with some ambivalence, realizing there are large tradeoffs to leaving the simplicity of the past.

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Set in a future in which communities are entirely regulated, all life patterns ordered for maximum security, uniformity, painless existence, and pleasant, if uneventful family life, this novel unfolds the story of Jonas, a promising boy who, with all his age peers, will receive his adult assignment from the elders on the yearly day of advancement celebrated for all children going through carefully calibrated developmental stages. Jonas's assignment, however, sets him apart from his peers, and ultimately from the whole community.

He is selected as the next Receiver of Memories, a post that allows him access to knowledge of the past carefully guarded from all but one Receiver in each generation. His lot will be to bear the pain of bearing, not only in his mind and imagination, but in his body, feelings and sensations suppressed in others by lifelong administration of biochemical regulators.

Besides the old Receiver of Memories, whom Jonas calls The Giver, he becomes the only one able to see colors, feel pain, desire, loss, hunger, and to remember a world in which people felt something deeper than superficial stirrings. Among other things, he discovers what it is to feel love. Horrified at the blankness in which his people live, he chooses, with the Giver's blessing, and at great risk, to escape the community, and thus to release into it the memories he will not keep to himself.

Rescuing a child destined for "release" for nonstandard development, Jonas embarks on a journey that leads him to a faraway place where the old life survives, leaving behind him a community that will emerge from their anaesthetized condition into the costly terms on which the gifts of ecstasy, joy, awareness, grief, and pain give life its value.

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Writer Paul Monette's first-person account of living through his lover Roger's last nineteen months with AIDS, from diagnosis to death (1986), told in language that is poetic and highly articulate. The couple faces not only progressive physical degeneration (Monette calls time with AIDS a "minefield") but also the agonizing issues of truthtelling with their families, friends gay and straight, and the world, in "the double closet of the war."

Fact-finding is a constant obsession in this story, not only about who is positive and who knows, but also in the rapidly-changing medical arena, where through Monette's extraordinary efforts Roger becomes the first person west of the Mississippi to be put on the drug, AZT. Monette is so devoted a caregiver that he often loses himself--a problem he solves in part by turning to the subject of AIDS as a writer.

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Set in a future when genetic engineering allows many couples to arrange for perfected babies, Gattaca tells the story of one imperfect man's successful fight against the odds. Born "naturally" with several serious imperfections, Vincent (Ethan Hawke) nevertheless grows up dreaming only of being an astronaut. As a member of the genetic underclass, he is able to work only as a custodian at Gattaca, the future version of NASA.

Vincent's frustration drives him to engage a sort of identity broker who arranges for him to appear to change his physical identity with Jerome (Jude Law), a member of the elite who has been paralyzed in an accident. Through this complex deception Vincent finally succeeds in being selected as an astronaut for an upcoming mission to a moon of Saturn. A large part of this future thriller consists of Vincent's heroic attempts to continue to pass as Jerome through a series of genetic checks.

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Sarah (Whoopi Goldberg) is an African-American woman who runs a bookstore, the "African Queen," in San Francisco. She has an adolescent daughter, Zora (Nia Long), conceived with donor sperm after the death of Sarah's husband, Charlie. Zora believes she is Charlie's daughter until she discovers a discrepancy while learning about blood types in biology class. Sarah tells Zora about her conception and Zora, determined to find out the identity of her "real father," breaks into the computer records of the California Cryobank.

She discovers the name of the sperm donor, Halbert Jackson, and tracks him down, discovering that he is a white truck salesman (Ted Danson). She and Sarah are both horrified (Sarah had requested the sperm of a black man), as is Hal, but after some comic conflict, Sarah and Hal fall in love and Zora begins to think of Hal as her father. They then learn that there was a mix up in the records and Hal is NOT after all Zora's genetic father, but by this point they have nonetheless become a family.

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In this book Sacks takes the reader into the world of the prelingually deaf, a world in which spoken language is incomprehensible. He describes the visual language, Sign, and considers the development and culture of American Sign Language. Sacks evokes the conflict between those who seek to teach the deaf to communicate via voice and lip-reading and those who affirm Sign, the native culture of the deaf.

In the latter part of the book, Sacks re-creates the student rebellion at Gallaudet University in 1988 when a "hearing" president was chosen from among three finalists, two of whom were deaf. The back cover summarizes this book as "a provocative meditation on communication, biology, and culture."

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Imago is set in the future, after a nuclear war has decimated most of the earth. A foreign species, the Oankali, has made Earth a colony. The Oankali are male and female but also have a third sex, the Ooloi. Ooloi are necessary to Oankali reproduction; they lie between partners, gather and recombine genetic material, and inseminate the female to produce offspring. The main Ooloi organ, the yashi, contains genetic information about every living thing. Ooloi can cure anything with a single touch. Also, of course, an evil Ooloi could start diseases no one has ever seen before.

The Ooloi and Oankali breed with earthlings who are willing and cure them of the tumors, infertility and other effects of the war. Unwilling humans are also repaired and sent to a colony on Mars where they can live autonomously. The Oankali have little hope for these humans, as their biological aggression will eventually cause another war. The Oankali do learn one thing from the humans, cancer. While for humans the fast reproduction of cells is a dreaded disease, the Ooloi control it and use it to recreate lost limbs and repair other damage.

Imago focuses on one particular Ooloi, Judahs. He is an anomaly because he has human parents. Judahs searches for human mates, finally finding two rebels. This pair tell him of a hidden community of humans unknown to the invaders. This area too becomes a colony, but with a more human aspect.

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A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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The first sentence of the introduction indicates the author's intention to talk about "how we do it--and how we could do it". Ending life, she says, is an issue under sustained debate in the United States and in much of the developed world. The argument over physician-assisted suicide is the central framework. The described debates on euthanasia and suicide include two pro and three con arguments in American and international contexts. This collection includes essays, practical notes, historical explorations, policy analyses, fiction, and creative non-fiction written by the author.

The author describes the role of fiction and creative non-fiction as offering a recognition of narrative as a respected form of investigation of social issues. Included are two selections that are in this genre and they are very powerful. The essay on the ethics of self-sacrifice is timely and well written. The author's final conclusion is that Stoic and Christian thinking are still in active collision in much of our consideration of these issues and that this means that advance personal policy making remains in the fullest sense an exercise for each individual.

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