Summary:

To whom shall I tell my grief? Grief must be shared. The son of Iona Potapov, an old cabman, has died. He sits lost in his thoughts, mourning his son. He tries to share his feelings (or at least to tell his story) with each of the people who engage his cab. Iona says to each of them, "My son died last week."

The first passenger responds by asking, "What did he die of?" Iona tells a second group of passengers, "This week my son died." They give him a flip response, "We shall all die." Again, this trivializes his story and his feelings. No one listens. No one is willing to make contact with him. When he tells one of his colleagues at the yard, "but my son is dead," the person doesn't even bother to answer.

Iona "thirsts for speech." He needs to occupy his mind, to share his anguish, to avoid the silence in which he imagines his son. "To talk about him with someone is possible, but to think of him and picture him is insufferable anguish . . ." In the end Iona is reduced to experiencing some relief in the warm, animal companionship of his horse. As he tells his sad story to the mare, she "breathes on her master's hands."

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Penny (Michele Hicks), working as a prostitute, is called to a room in a seedy hotel where she finds her client is a pair of adult conjoined twins, Blake and Francis Falls (played by identical but not conjoined twins, Mark and Michael Polish, who also co-wrote the screenplay). Shocked, she flees but later returns and, when she learns that one of the twins is ill, calls a doctor friend of hers to examine them. She cares for the twins and they become friends. At Halloween, "the only night of the year they [can pass for] normal," she takes them to a party and then back to her apartment where she and Blake almost make love while Francis, evidently the weaker twin, is sleeping.

She tells her lawyer/pimp about the twins, and he tries to persuade them to sell him their story (which he imagines in terms of separation: "The greatest divorce of all time: not who gets the kid but who gets the kidney . . . "). Offended by her betrayal, they return to their hotel room, and, apparently for the first time, the twins fight. Blake wants to get away from his brother.

The next morning Francis is ill once more, and the twins are hospitalized. Michele visits them and learns that they are dying. Francis's heart is becoming weaker, straining Blake's, and the only way to save Blake will be by separating them. Francis cannot survive separation. Penny tracks down their mother (Lesley Ann Warren), who gave them up for adoption at birth. She visits them in hospital. It emerges that Penny herself has a "retarded" child who is being raised by others. Francis's heart fails, and the twins are taken to the operating room.

Later, Penny tracks Blake down where he is now living alone in the trailer where the twins had lived before, as circus performers. The film ends with Blake, now a man with one arm and one functioning leg, telling Penny that the "story of me is over," but also that stories continue after sad endings. What makes an ending sad, he tells her, is the knowledge that the storyteller is continuing without you.

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Mickey, widowed but one year, and his young son, Duncan, drive East from their home in Wyoming, to vacation with Mickey's family on the Jersey shore. As the story develops, the reader learns that Carol, who died from ovarian cancer, was a westerner, and that Mickey is being tempted to return to the east coast with Duncan and reestablish life there.

The two arrive at the vacation cottage very early in the morning; Mickey needs to be with the ocean and what it means to him; Duncan, who has never seen an ocean, rushes to the experience. The child becomes fearful, as he looks at the vast expanse, calls up the idea of sharks, asks if his Mom waits at the "topic" of Cancer for them. The tension develops when Mickey chooses to swim to assuage his own grief, not realizing that his venture terrifies Duncan. The reunion of father and son points to a new understanding of what it means and will mean to each to go forward without Carol.

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Told from the perspective of a thirteen-year-old girl, this story about a single mother with two daughters who moves, marries, and dies of breast cancer handles a variety of difficult issues with sensitivity and spunk. A list of those issues--absent father, new stepfather, a thousand-mile move to a new social environment, first menstruation, sibling rivalry, an uncle with incestuous impulses, family secrets, sexual experimentation, cancer, and death--might make it sound like a catalogue of the trials of contemporary suburban young adulthood, but in fact the point of view of Tilden, the main character, keeps the story grounded in very believable, sometimes amusing, often poignant, recognizable truth about what it is to come into awareness of the hard terms of adult life.

The mother's cancer is narrated largely in terms of Tilden's experience of it: secrecy, eventual disclosure, partial information, losses of intimacy, feelings of betrayal, confusion about caregivers' roles, and in the midst of it all, the ordinary preoccupations of early adolescence. The generous and understanding stepfather and neighbors with limited but ready sympathies lighten some of the novel's darker themes.

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The poet contemplates the realities of life in the mining --now ghost--towns of Western America by exploring an old graveyard. "Eighty-nine was bad. At least a hundred / children died," the writer muses while walking among the grave markers. The reader recognizes that this settlement is no longer viable: "The last one buried here: 1938."

After describing the arrangement of the markers and the crude fence that defines the burial ground, he ponders why the graveyard is situated so far from the townsite. In an ironic reflection on the mothers' needs to get on with life after the frequent loss of young ones yet still striving to protect the little graves from greedy excavation, the poet says, " . . . a casual glance / would tell you there could be no silver here."

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When literature and cultural studies professor Michael Bérubé's son James was born in 1991, he was diagnosed with Down Syndrome. Negotiating various medical, social, and educational environments and the identities each assigns their son, Bérubé and Janet Lyon (his wife, a literature professor and former cardiac-ICU nurse), become effective advocates for Jamie and embark on a course of questions about the social systems that produce disabled identities and administer to those human differences termed significant ones. Bérubé engages these questions with a mixture of family experience (his own, and that of other families with disabilities), historical research, critical theory, and sophisticated critical analysis.

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This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.

The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.

Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."

This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.

Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.

Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).

These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.

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Giovanni (Nanni Moretti) is a psychoanalyst. He has a beautiful wife, Paola (Laura Morante), and an adolescent son and daughter, Andrea and Irene. One Sunday morning, Giovanni gets a call from one of his patients, newly diagnosed with cancer and frantic. Instead of spending the day with his family, Giovanni attends to his patient. Andrea goes diving with friends, there is an accident, and he is killed.

The rest of the film examines the family’s bereavement. Giovanni finds his work increasingly difficult, and by the end of the film he has decided that he can no longer be a psychotherapist.

A love letter addressed to Andrea arrives from a girl called Arianna: it turns out Andrea had a secret girlfriend. Both parents become obsessed, in different ways, with contacting Arianna. Eventually she visits them, while hitchhiking with her new boyfriend, and the family drive all night along the Mediterranean coast, taking Arianna and the boy to France. Next morning, on the beach at Nice, in saying goodbye to Arianna, they seem to have made progress in continuing their life as a family without their lost son.

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This history play narrates the rise to power through treachery and murder of Richard Plantaganet, Duke of Gloucester and last king of the House of York. Set in England during the Wars of the Roses (1455-1485), the play opens after the Lancastrian King Henry VI and his son Edward have been killed and Richard’s brother has been crowned Edward IV.

In the course of the play, Richard woos and wins Prince Edward’s widow Anne Neville and engineers the murders of his other brother (George, Duke of Clarence), his nephews, his closest advisor, possibly his wife, and other members of the court. He is crowned king but later dies a violent death in the Battle of Bosworth, defeated by Henry Tudor, Duke of Richmond, who will become the first Tudor King Henry VII.

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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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