Summary:

Richard Kraft is about as burnt-out as a fifth-year resident in pediatric surgery can be. Overwhelmed by his stint in an inner-city, public hospital in Los Angeles, he seeks to hide from the misery of his patients by avoiding any personal connection with them. Then he meets twelve-year-old Joy, an Asian immigrant trying desperately to learn the puzzling ways of her new culture. She speaks words that trigger memories from Kraft's own childhood as the son of a U.S. agent in Joy's country, and he loses his distance.

He performs surgery on a life-threatening cancer in her leg, pulling back at the last minute in an unreasonable fear that he will hurt her if he cuts too deep. The implied result: incomplete excision of the cancer and a death sentence for the child he now tries, unsuccessfully to avoid. His avoidance is repeatedly foiled by Linda Espera, the physical therapist with whom he is falling in love and who will not let him abandon the emotional needs of any of the children in Joy's ward.

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Showalter identifies clusters of syndromes, or mini-epidemics, which she suggests represent late-twentieth century manifestations of the entity which was called hysteria in nineteenth century western culture. Opening with the history of psychiatry's involvement in hysteria in the time of Charcot and Freud, she traces the replacement of hysteria or conversion reaction by modern hysterical analogues such as: chronic fatigue syndrome, recovered memory, Gulf War syndrome, multiple personality syndrome, satanic ritual abuse, and alien abduction.

In separate chapters she examines each of these entities--how it presents, how it fits into her theory of mass hysteria as a cultural response to the millennium, and how it is being handled by health care professionals. Showalter contends that "Redefining hysteria as a universal human response to emotional conflict is a better course than evading, denying, or projecting its realities." (p. 17)

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The narrator of this 37-line poem describes childbirth and its immediate aftermath, when she is recuperating in the hospital with her baby. The first 14 lines focus on the "theatre of pain"--the actual and conceptual space in which the pain of childbirth is experienced. Childbirth is painful, all-absorbing, surreal: " a dream of world . . . wave after wave knocking me down" until, after the anesthetic, "I was on an island where no wind blew . . . ."

Then, suddenly, the poem shifts, when, "with a final push you were born," and we realize that it is the child whom the poet is addressing. As the baby is born, the new mother is no longer alone; she and the baby are part of the same process, "leaving the two of us half drowned and clinging to the shore . . . ." "We would meet," she says, "meet for the first time." While the baby’s birth is "engraved upon the world forever . . . " paradoxically, the outside world is "completely, most completely, unaware of you."

As the narrator/new mother recovers in her hospital room, the day’s routine impinges on this intense experience and she becomes aware once again of her surroundings. Life and death go on around them; the world is oblivious, even as her own life has been altered forever. And yet the nurses too seem to recognize the tremendous implications: "amazed, . . . lifting you high into the air," they cry, "Welcome to the World!"

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John Binkerson ("Binx") Bolling is a young man from a "good" New Orleans family who for some years has devoted himself to money, sex, and watching movies. During Mardi Gras, when the novel begins, he wakes up to the vague feeling that something more is needed in his life.

We meet his Aunt Emily, a Southern noblewoman, and his cousin Kate, who is said to be somewhat unstable since her fiance's death some years earlier; she is currently engaged to the virtually invisible Walter. The action also takes us to the bayous, where Binx visits his remarried (Catholic) mother and her family, including his sickly adolescent stepbrother, Lonnie. (Binx's father died in World War II; Binx, himself, has survived service in the Korean Conflict.)

Subsequently, Binx takes a trip to Chicago with Kate; on the train she offers to have sex with him, but he refuses. Binx and Kate must then respond to Lonnie's unexpected death. In the end Binx decides to give up his business as a bond dealer and go to medical school, and he and Kate decide to marry.

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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 setting is Germany in the late 1920s. Rosalie, the central character, is a "sociable," cheerful 50 year old widow who lives with her adult unmarried daughter and her adolescent son. Her manner is youthful but "her health had been affected by certain critical organic phenomena of her time of life." Rosalie is keenly aware of all that menopause implies: the loss of sexual allure and of a (biologic) purpose in life. She feels "superannuated."

Along comes a young man, well-built, who is the American-born tutor for her son. She is overwhelmed by physical attraction for him, becoming infatuated, much to the disapproval of her repressed, cerebral daughter. She feels young and attractive once more, believing that her heightened state of sensuality has resulted in the resumption of what appears to be menstrual bleeding.

Planning to declare her love to the tutor, Rosalie arranges a family excursion to the Rhine castle where the black swans swim. In the decaying alcoves of the castle, she does so; the pair will rendezvous that night. The rendezvous never takes place; Rosalie has hemorrhaged. She is found to have a large, metastatic uterine tumor.

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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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Slater subtitles her book, A Therapist's Memoir of Madness. Embedded in this definition are two elements: a psychotherapist's composite experiences with a small cadre of patients and the therapist's personal experience with a mental disorder. The author draws the reader into a fascinating series of anecdotes based on therapeutic encounters.

These stories are as much, if not more, about the therapist's deepest responses to her patients than about the patient him or herself. This particular approach adds an element of confession to the work that one does not often find in clinical studies. And, finally, Slater takes the reader backward in time to her own past as a woman with profound emotional pain.

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On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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