Summary:

In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.

Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.

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The story, set in small-town Ontario in 1960, takes the form of letters to her ex-fiancé from a young woman who has returned to the home of her father, a widowed physician who lives with his housekeeper, Mrs. Barrie. She recalls growing up with her strict and remote father and realizes now that he had been performing illegal abortions all her life. He will not discuss it, will not allow the word "abortion" to be said in his house, though she tells him she believes abortion should be legalized.

We are led to suspect that she herself has recently been pregnant.

When Mrs. Barrie breaks her arm, the doctor is forced to ask his daughter to assist with one of his "special" patients. She helps the young woman throughout the procedure, and disposes of the aborted fetus afterwards. Later, trapped indoors by a heavy snowfall, she and her father are sitting together at the kitchen table when she tells him about her own pregnancy.

She had carried it to term, giving up the baby for adoption. She had ended the engagement because her fiancé, a theology student, had insisted that she have an abortion before their wedding because he feared the social consequences of rumors that she had been pregnant before marriage. She is about to ask her father about his own work, and about what might happen should the law change and abortion become legal, when she realizes that he is not listening. He has had a massive stroke, and dies later the same day. The daughter turns away the next patient who calls about having an abortion.

She learns from the lawyer that, mysteriously, her father had virtually no money saved. She gives Mrs. Barrie most of the small amount her father had given her, and then realizes that all his money has already been given to Mrs. Barrie, either because she was blackmailing him, or because he loved her. She cannot tell which, but is oddly exhilarated and is now able to say goodbye to her fiancé for good.

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A year in the life of a group of interns in a big city hospital guided by the wise internist (Buddy Ebsen) and the irascible, woman-hating surgeon (Telly Savalas). Contortionist posturing designed to lead to desired residencies is the major theme. The only female intern, and the most brilliant of the lot, wants to be a surgeon, but she is repeatedly belittled by the surgical chief until he realizes--not that she is good--but that she is the sole support of a daughter.

Another intern falls in love with a young Asian patient and at her death resolves to work in her country. A crisis emerges around the overdose of a suicidal patient with syringomyelia; all the interns are held responsible until they rather brutally force a confession from the man's wife. Friends throughout medical school, Lou Worship (James MacArthur) and Sean Otis (Cliff Robertson) plan to become surgeons and open a clinic for the poor. Otis falls for a glamorous model, while Worship is smitten with obstetrics and a student nurse (Stephanie Powers).

Forsaking the original plan, Worship applies to obstetrics, pressures his fiancee to sacrifice her dream of an international career, and tells on Otis when he discovers that he is helping his girlfriend abort her unwanted child. His career ruined, Otis marries the irretrievably pregnant woman and expresses his admiration to Worship for doing the right thing.

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In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer argues that "the traditional western ethic has collapsed" as we enter "a period of transition in our attitude to the sanctity of life" (pp. 1). The book begins with the tale of Trisha Marshall, a twenty-eight year old woman, who in 1993 was seventeen weeks pregnant when a gunshot to her head left her in an intensive care unit, her body warm, her heart beating, a respirator supporting her breathing. However, she was brain dead.

Her boyfriend and her parents wanted the hospital to do everything possible so that the baby would be born. The ethics committee of the hospital supported the decision. For the next 100 days, Trisha Marshall continued to be supported in the ICU until her baby was delivered by cesarean birth. After a blood test showed that the boyfriend was not the father, and after three weeks in the intensive care unit, the baby went to live with Marshall's parents.

Singer uses this introduction to pose the many ethical questions that are raised because of medicine's ability to keep a "brain dead" body warm for an extended period of time. "How should we treat someone whose brain is dead, but whose body is still warm and breathing? Is a fetus the kind of being whose life we should make great efforts to preserve? If so, should these efforts be made irrespective of their cost? Shall we just ignore the other lives that might be saved with the medical resources required?

Should efforts to preserve the fetus be made only when it is clear that the mother would have wanted this? Or when the (presumed?) father or other close relatives ask for the fetus to be saved? Or do we make these efforts because the fetus has a right to life which could only be overridden by the right of the pregnant woman to control her own body--and in this case there is no living pregnant woman whose rights override those of the fetus?" (pp. 17-18).

In the chapters that follow, Singer argues that whether western society will acknowledge it or not, we have, in our actions and decisions, moved to an ethic where "quality of life" distinctions trump "sanctity of life" positions. Yet, many continue to raise the "sanctity of life" position when it is clear that our legal and ethical positions in western society have embraced the "quality of life" stance. For Singer, this paradox results in an incoherent and illogical approach to the ethical challenges presented by modern medicine.

Throughout his book, Singer presents evidence for his argument through ethical and historical analysis of brain death, abortion, physician assisted suicide and euthanasia, organ donation, and the nature of persons. For those uncomfortable with Singer's position on "infanticide," this book allows one to follow Singer's argument and his recommendations in the last chapter for a coherent approach to these "quality of life" decisions.

He closes his book with the recommendation that a new ethic should embrace five new commandments to replace the old "sanctity of life" commandments. His commandments are: 1) Recognize that the worth of human life varies; 2) Take responsibility for the consequences of our decisions (in end of life care); 3) Respect a person's desire to live or die; 4) Bring children into the world only if they are wanted; and 5) Do not discriminate on the basis of species.

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This is the story of the life, loves, wounds, grit, artistic genius, and death of the well-known Mexican artist Frida Kahlo, played by Salma Hayek. At the age of eighteen Kahlo was in a near-fatal bus accident that left her with lifelong injuries to her pelvis, spine, and uterus. (The film does not include the fact that Kahlo had suffered some physical disability since a case of polio at the age of six.)

The life Kahlo survived to live was artistically enormously productive and successful, but it also had more than the usual share of physical suffering, medical procedures, attempts to self-medicate, and accompanying emotional distress. The film covers these things, as well as what Kahlo called the second disaster in her life, her marriage to the famous Mexican muralist Diego Rivera, played by Alfred Molina.

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This book's title is from a Goethe poem, "The Holy Longing," translated from German in its entirety by Robert Bly: "And so long as you haven't experienced / this: to die and so to grow, / you are only a troubled guest / on the dark earth." Ten intensely personal essays tell of the suffering and everyday presence of pain of a severely disabled writer who has advancing multiple sclerosis, and of how, "in a very real sense, and entirely without design, death has become [her] life's work." (p. 13)

Beginning with her father's sudden death when she was a child, the essays describe her aging mother's expected death and the family's decision to take her off life support; her caretaker husband's diagnosis of metastatic cancer with uncertain prognosis; her own attempted suicide; death of friends, pets, including her beloved dog; and a young pen-pal executed on death row. If that weren't enough, a coda, her foster son's murder and again the decision to remove life-support, provides "[t]he end. For now." (p. 191)

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At the heart of this novel is a simple love story. Dr. Bruno Sachs, a slight, stooped, and somewhat unkempt general practitioner in a French village is dedicated to his work and loved by his patients. Sachs is a solitary, self-effacing man who takes his Hippocratic duties seriously and is especially sensitive to the needs of his patients.

In addition to his private practice, Sachs works part-time at an abortion clinic, where he performs an abortion on a distraught young woman named Pauline Kasser. Soon the doctor and his patient fall in love. She moves in with him and becomes pregnant. An editor by profession, Pauline also encourages and assists Dr. Sachs in completing the book he is writing.

The story has many additional layers and dimensions. The reader views Sachs through the eyes of multiple narrators--his patients, colleagues, friends and acquaintances, all of whom write in the first person and present Bruno Sachs as "you" or "he." Thus, the reader gradually builds up a "connection" (empathy) with Sachs by synthesizing multiple glimpses of his behavior and facets of his character. At the same time, Sachs is trying to find his own voice, his own connection, by becoming a writer. At first he jots down random thoughts, then he keeps a notebook, and eventually he produces a complete manuscript.

The book has innovative structural elements that introduce other layers of meaning. For example, the 112 short chapters are organized into seven sections, corresponding with the components of a complete clinical case history: presentation (as in "chief complaint"), history, clinical examination, further investigations, diagnosis, treatment, and prognosis. Similarly, the narratives delve progressively into Sachs' "illness" and follow the "patient" through his course of "treatment."

Another structural element is the cycle of fertility and gestation. The story takes place from September through June, precisely 40 weeks, a pregnancy of nine months, during which Sachs is re-born.

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It is 1965. Graduate student, Adam Appleby (the name is significant), twenty-five years old and father of three, is terrified that his wife, Barbara, is pregnant again. He loves her and is faithful, but their commitment to Catholicism turns their sex life into a furtive obsession, encumbered with calendars, thermometers, and guilt.

This day in his life, like all others, is spent in the British Museum, researching an interminable thesis on 'the long sentence' in minor English writers. But Adam cannot concentrate for frustration, anxiety (over Barbara's delayed period), and financial despair. When a young descendant of a minor writer tries to seduce him in exchange for a steamy manuscript that could easily make his career, Adam discovers a shocking willingness to compromise on his principles.

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At the height of campus unrest over Vietnam, Brian Tate, the conventional, politically moderate, foreign policy professor at Corinth (clearly Ithaca), has an office affair with his blonde graduate student, Wendy, but only after the vapid flower-child has pursued him relentlessly for months. Brian’s wife, Erica, learns of his infidelity when she reads Wendy’s ungrammatical but explicit letter.

Miserable at home with their two shockingly difficult adolescent children, Erica is unemployed because Brian disapproves of her working. She confronts him; Wendy apologizes to her; Brian lies; Wendy is forced to have an abortion; Brian moves out; Wendy moves in; Erica grows thin and ages prematurely. She takes up with an old friend who has become a wan new-age ’guru,’ but he is often impotent.

Wendy becomes pregnant again, terrifying Brian into believing he must marry her. But she spares him this punishment by moving to a California commune with Ralph, who, unlike Brian, does not care about biological origin of her child. Hoping to return, Brian visits Erica; she is expecting him with wary resignation.

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An American man and "a girl" sit drinking beer in a bar by a train station in northern Spain making self-consciously ironic, brittle small talk. The woman comments that the hills look like white elephants (hence the story's title). Eventually, the two discuss an operation, which the man earnestly reassures her is "awfully simple . . . not really an operation at all . . . all perfectly natural" (726).

The woman is unconvinced, questioning "what will we do afterward," but says she will have the operation because "I don't care about me" (727). A few moments later, however, she avers that they "could" have everything and go anywhere, suddenly as earnest as he had been earlier. When the man agrees that they "can" do these things, however, the woman now says no, they can't, her change in verb tense suggesting that the possible lives they once could have pursued (and produced) are even now, before any firm decision has been spoken, irrevocably out of reach. When the man says that he will go along with whatever she wants, the woman asks him to "please please please please please please please stop talking" or she will scream. The train arrives during this impasse, and once the bags are loaded, the woman, smiling brightly, insists she feels fine.

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