Summary:

The poem is divided into six stanzas, each titled by a successive day. The subject of the poem is a woman's reaction to mammography and the unexpected "spot" that is discovered. The woman is shown the spot on the mammogram, and the agony begins: does she have breast cancer? The exam occurs on Thursday; she must wait until the following Tuesday to find out.

Meanwhile, life and relationships take on new meanings and tenderness. For instance, at a large family reunion, she is determined to laugh with the family about childhood reminiscences, even though her laughter is now bittersweet (she keeps her torment private from all but her lover).

Other days are filled with worry and nightmare. At long last, during a perfunctory call from her physician, she finds out that the spot is merely a protein deposit. Relieved, she thanks the physician, who remains uninformed of the depth of her patient's recent torment.

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Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.

For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.

An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.

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This is the narrative of an old doctor. Once greatly admired, he is now ridiculed by young doctors who find his techniques outdated and his lectures boring. His specialty is microbiology; his lab works on AIDS. His daughter asks him to support a group demanding that researchers release without so much delay the preventive drugs they are developing for AIDS patients. The doctor refuses on the grounds that the drugs need more testing. Later he finds out that his son is dying of AIDS.

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A woman medical student finds herself in a hierarchical dilemma while rotating through her internal medicine clerkship. She is helping to take care of a middle-aged man who has been hospitalized for a diagnostic work-up. As a consequence of invasive procedures ordered by his physicians to determine the cause of his symptoms, the patient has suffered serious complications and is moribund. The doctors are evasive with the patient and his family, who beseech the medical student for an explanation. Even though she has been instructed by the physicians to refer all issues back to them, she follows her own convictions and tells the truth: "Your father is dying."

As a result of this "insubordination," she is called in to see the head of the department, a man of "legendary diagnostic skill" with a long tenure at the hospital. He says that he will have her dismissed, and launches into a long diatribe, making the case for a paternalistic medicine in which the patient needs to believe that the physician is omniscient and possesses quasi-magical healing powers. "Miracle, mystery, and authority," he says, are at the heart of what physicians can do for their patients and to undermine these is to do harm to the vast majority of the sick. Having made his point, he terminates the interview but reinstates the student, who, it is suggested, is so grateful (for his advice or for not being dismissed?) that she kisses him.

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The urgent voice in this poem tells the patient to "Be still." The patient is about to undergo a brain scan (CT or MRI?) and the poem consists of a series of instructions. Don't worry about the discomfort or the side effects of the dye, the poem demands, "forget that your cradled head / may reveal a hard secret soon," the only thing that matters is "the subtle / shading of mass, some new darkness afloat / in the brindled brain sea." [16 lines]

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Chris Cooper (Kevin McDonald) is a shy researcher working for a huge pharmaceutical firm with a team of sympathetic, but unusual personalities. He discovers a substance that makes people (and the company executives) very happy. Promoted as "Gleemonex," the new "brain candy" rapidly begins to make money, and Chris becomes a hero; however, the team soon realize that their wonder drug can render its users comatose.

Their "good" efforts to stop their own creation are opposed by their employer, especially the "bad" chief executive (Mark McKinney) and his cloying "yes-man" (Dave Foley), who relentlessly pursue sales to a craving market. After many tragicomic and slapstick escapades, good mostly prevails in the end.

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A journalistic account of the CIA-funded experiments in "psychic-driving" of Dr. Ewen Cameron at Montreal's Allan Memorial Institute in the 1950's and early 1960's. Cameron investigated "treatment" for various forms of depression, consisting of high-dose electroshock (Page-Russell variant), heavy sedation, and the repetetive playing of patient's or the doctor's recorded voice.

Many patients did not respond; some were destroyed by the technique. Particularly moving is the story of Mary Morrow (Chapter 9), a physician-patient whose career was damaged by her experiences. Cameron held the most prominent positions in professional psychiatry; he died unscathed by his questionable research and in pursuit of yet another goal, a mountain peak.

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The poet undergoes a breast biopsy under local anesthesia: "I had thought my skin was a permanent seal. / Now I watch this layer of myself / . . . sprout red flowers . . . . " She observes the (male) surgeon closely, imagines her tissue on its journey to the pathology laboratory, and listens carefully to the surgeon's first words: "this man / who went beyond my skin / as no one else has . . . / as he made me for the first time, his."

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Dr. Papper, a revered figure in the field of anesthesiology, questioned why it took so long for anesthesia to be "discovered": after all, pain and suffering existed long before the mid-nineteenth century. This book is a result of Papper’s graduate studies in literature and history and explains his thesis that "societal concern with pain and suffering, and the subsequent development of surgical anesthesia in the Romantic era . . . are outgrowths of Romantic subjectivity."

The book provides biographies of scientists, physicians and poets, such as Humphry Davy, Thomas Beddoes, Sr., Samuel Taylor Coleridge and Percy Bysshe Shelley, along with analyses of Romantic poetry as related to pain and suffering. Papper theorizes that the exchange of ideas amongst these intellectuals and the political upheavals of the time paved the way for society to recognize that the pursuit of happiness could include the relief of pain.

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Like Paul Muldoon's Sonogram (see this bibliography), this poem was occasioned by the poet's wife's ultrasound of their first child, Tobias. (See pgs. 258-259 of the anthology for a description of the poet and his comments on this poem.) "Sonogram" is alternately lyrical and bright ("through succulences of conducting gel") and dark (" . . . or sinuses of thought / like Siracusa's limestone quarries, where / an army of seven thousand starved to death.") The language is highly poetic (and successfully so) in conjoining the worlds of medical technology and poetry ("or alveolus in a narthex rose") and playful ("God's image lies couched safe in blood and matter" punning on "vouchsafed").

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