Summary:

An older woman is diagnosed as having cancer. The story is of the progression of her symptoms and the effects of her illness and eventual death on her husband and grown children. The years of silent compliance with the expectations of children and spouse begin to erode as the woman becomes sicker. The relationship between the aging couple, and the place of the ill mother in the priorities of her children clarify. The tale ends with the death, and a tiny glimpse of resolution of decades of strife and unexpressed rage between man and wife.

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The summer before her senior year of high school Julie Weiczynkowski qualifies for the Olympic developmental program's regional soccer team. She has every reason to believe she will be recruited by coaches from the best college teams in the country. But her elation is short-lived; the very day she returns home from soccer camp, she learns that her father has untreatable pancreatic cancer.

The story of that summer, told in Julie's journal entries, gives us a close-up look at her own stages of accommodation, and at the skills and strategies she develops to cope with her own grief, to support her mother, and to help care for her father. Each person in the family--mother, grandmother, siblings, and uncles--has a different perspective on and reaction to the crisis. Julie finds herself looking at the rest of her life as if through the wrong end of a telescope, and finds herself alienated from the boy who has been her best friend and support in high school.

The hospice workers who come to help her parents, though she finds their presence invasive, teach her a good deal about what dying looks like and how to bear with the one who is suffering. She travels a painful learning curve to arrive at a place of acceptance, claiming her life after her father's death, and reclaiming a friendship that matters to her on new terms.

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The diagnosis is delivered in the opening sentence: "a bad heart." Anton Rosicky is an immigrant to the United States from Czechoslovakia. The 65 year old man and his wife, Mary, own a farm in Nebraska. They have five sons and a daughter. Rosicky is an ordinary fellow with one remarkable quality--a genuine love for people. He is attached to his family, the land, and hard work. His physician, Doctor Ed Burleigh, writes a prescription for Rosicky and instructs him to avoid strenuous activities.

The young doctor is quite fond of Mr. and Mrs. Rosicky and speculates that tender and generous people like this couple are more interested in relishing life than getting ahead in it. Although he knows better, one day Rosicky overexerts himself raking thistles and bringing some horses into the barn. He experiences chest pain accompanied by shortness of breath. His daughter-in-law, Polly, helps him into bed and applies moist hot towels to his chest.

Unfortunately, Dr. Ed is out of town--his first vacation in seven years. Rosicky appears to recover from the episode but the following day after enjoying breakfast with his family, the chest pain recurs and he dies at home. When Dr. Ed returns from his trip, he stops at the graveyard near the farm. He realizes that the natural beauty and serenity of the landscape make a fitting final resting place for a farmer like Rosicky and a man whose life was not only rich with love but deeply fulfilling.

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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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Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.

Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.

The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.

Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.

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This story of one exceptionally accomplished family's discovery of their past and future relationships with Huntington's Disease (HD) is also the story of how the Wexler family changed the cultural narrative of HD for other families at risk for this genetically-transmitted and currently incurable disease. The HD diagnosis of Leonore Wexler (the author's mother) inspires Milton Wexler, a psychologist, to create a major foundation for HD research, which develops critical mass and influence as Leonore Wexler's condition deteriorates, and after her death. The book interweaves the story of the Wexlers' emotional and other negotiations with HD and the story of their efforts to create an HD community comprised of those with active symptoms of HD, family members, advocates, and researchers.

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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The haunting eyes of a beautiful young woman stare directly at us as we witness the final moment of her plummet from a New York skyscraper to the sidewalk, a stage-like platform in the lower foreground. Her barefoot body and its shadow protrude into the inscription panel where blood-red lettering records the facts: "In the city of New York on the 21st day of the month of October, 1938, at six o'clock in the morning, Mrs. Dorothy Hale committed suicide by throwing herself out of a very high window of the Hampshire House building. In her memory [words apparently painted out] this 'retablo,' executed by Frida Kahlo." Though her blood flows from her morbidly erotic body and seeps through the canvas into the painted wood frame, the bright yellow corsage of tiny roses pinned to the black velvet dress on her intact, virtually undamaged body and face eerily insinuate vitality and sensuality.

Two stages of her fall from the window of her apartment building, as in a multiple-exposure freeze-frame photograph, are surrealistically softened by swirling blue, white and gray cloud-like sky coloring which covers the entire background and the rest of the wooden frame. Barely visible, in the top of the frame is the suggestion of an angel holding a banner on which [now erased or whited-over] was proclaimed "The suicide of Dorothy Hale, painted at the request of Clare Boothe Luce, for the mother of Dorothy."

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When we view photographs of war-torn bodies, piled-up corpses, or starving children, are we changed? How about the photographer, whether a professional or an amateur, who takes such pictures? Do these photographs teach us about suffering--or do they numb us over time and simply cause us to turn away? In this slim book Sontag re-visits her ideas in "On Photography," published 25 years ago.

Her aim, it seems, is not so much to answer the above questions but to provoke us by her statements, urging us at least to THINK about what happens when suffering is viewed third hand; because after all, she reminds us, we see only what the photographer wanted us to see. When scenes of violence are as close as our morning papers or our TV screens, Sontag's is an important debate.

She also gives a brief history of photo-journalism, from the Crimean and Civil Wars to the almost instantaneous transmission of images from Operation Iraqi Freedom. In chapters that sometimes seem to disagree with one another, she plays the devil's advocate and views the IDEA of photographs of suffering from all directions. Can gruesome photos be artistic? Should they be? And if a war photo is posed--a corpse moved for a better shot or a battle scene restaged to make it more dramatic--is the effect enhanced or decreased? She considers the impact of candid photos versus those technologically manipulated; she discusses how photos, and their impact on us, change when the names of the victims are revealed.

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The new interns, Roy Basch (Tim Matheson), Chuck (Howard Rollins, Jr.) and Wayne Potts (Michael Sacks), begin their year of internal medicine training in a busy city hospital under construction. After initial introductions led by the vague staff man and vapid chief resident, they become the specific charges of the cynical resident doctor "Fats" (Charles Haid). Fats teaches them attitude and language: how to "buff" (improve) and "turf" (transfer) "gomers" (Get Out of My Emergency Room)--the words used to describe management of incurable, hateful patients who "never die," regardless of the abuse the clumsy housestaff might inflict. But Fats has heart.

Soon, they fall under the command of the militaristic and lonely woman resident, Jo Miller (Lisa Pelikan), who cannot bring herself to withhold treatment, even at a patient's request. She blames underlings for the failings of medicine and nature, as well as herself.

Wayne throws himself from the hospital roof because of a misplaced sense of guilt over a patient's demise. Roy falls in love with the nurse, Molly (Kathryn Dowling), but nearly loses her as he begins to emulate Jo's cold, calculating style. He is "rescued" in the nick of time by his friends, Fats, and the death of a physician patient (Ossie Davis) whom he admires. With recovered equanimity and renewed anger over the suicide of his fellow intern, Roy refuses to go on with his residency.

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