Summary:

A woman is pregnant. She is a nurse married to a physician, Jeff, and they have a young son, Willie. The couple is pregnant with their second child. Long before her due date, the woman--author Susan LaScala--begins experiencing signs of premature labor. Because she is a nurse, because she is married to a doctor who takes call, she doesn't want to over-react or bother her obstetrician unnecessarily. But when vague aches turn into cramps, the author enters, as a patient, the world she had known, until then, only as a caregiver.

It is impossible, in a brief annotation, to describe fully the richness of this memoir. Because the author is a nurse, she brings to the story of the premature birth and survival of her daughter, Sarah, a wonderful double vision: LaScala tells this tale not only as a mother and a patient but also as a clinician able to explain, in simple language, the complex technologies used to sustain the life of her one pound nine ounce baby. The author's rendering of the bells and whistles of neonatal medicine, whether describing the process of intubating a preemie (p. 23) or ultrasounding a baby determined to survive (p. 182-3) are precise and haunting.

Equally compelling (and instructive for caregivers) are the author's candid revelations of how it feels to be a patient. She takes to "grading" the doctors and nurses--an "A" for the staff that lets her see her newborn girl (p. 3), and a "C" for a nurse with "No kind words. No warmth" (p.11). She describes her own bodily sensations in language both lovely and informing: the pushing and tugging she feels during her C-Section is a "quiet violence" (p.21); standing beside her daughter during the ventilator weaning process she feels "a witch's brew of fear and panic mixing and growing inside" (p. 225).

In an introduction, physician Barbara Wolk Stechenberg, describes the "gift" that the author has given by writing this memoir. The author has allowed Dr. Stechenberg, who was part of the team that saved Sarah, "a rare glimpse into two worlds" (p. xii). One was the world of intensive care nurses and how "they truly are the primary caregivers" (p. xii). The other world was that of physicians, who "may feel we are empathic and caring, but we really have no idea of the emotional roller coaster many of our parents are riding" (p. xii).

View full annotation

Summary:

Twelve year -old Emaline is riding with her father as he discs their fields, when she sees her beloved dog Prince running dangerously close to the blades. In trying to stop him, she falls off the tractor and her leg is sliced almost completely through. In anger, her father shoots Prince and leaves home. She is rushed to hospital where a series of operations and treatments save her limb, although it is permanently shortened and she walks with a limp.

The fields need seeding. In desperation Emmy’s mother appeals to the local “mental hospital,” and Angus, the crazy man, arrives to help. Emmy is warned to stay clear of him, and neighbours gawk, but she begins to notice his special qualities. He quietly sows the fields with blue flax and yellow mustard rather than the unsellable wheat. He helps fit her with a built up shoe, and he is steadfast though frightened when falsely accused of theft. Yet some neighbours, like Harry Record, cannot adapt to Angus and believe that the family is taking risks. Just as Angus is the object of ridicule, Emmy is mercilessly teased for her deformity by Record’s son, Joey.

One night in a snowstorm both Joey and Angus disappear. Angus has been driven out of town and dumped by Harry Record, but he finds Joey lost in the storm and brings him home. Record refuses to accept his guilt and pleads not guilty. As the book ends Angus is more accepted, but a trial is looming, in which Emmy and Joey will have to give evidence against his father.

View full annotation

Summary:

In his Introduction, editor Thom Schramm puts the themes of this anthology into perspective. He notes that the moods associated with bipolar disorder are familiar to everyone. Moreover, the notion that artistic creativity is associated with psychological instability is widespread; in fact, it is almost a stereotype, ranging in time from Plato's depiction of poets as suffering from "divine madness" to contemporary examples, like Sylvia Plath, Anne Sexton, and Robert Lowell. However, it should be evident that, since we all experience periods of sadness and elation, it is no wonder that poets of all stripes, no matter how "stable" they might be, may evince these moods in their work.

Living in Storms presents an array of contemporary poems grouped to reflect mania and depression from different perspectives. The book has eight sections. In the first three, the poet himself or herself expresses what it is like to be susceptible to mania or depression ("How It Is"), the experience of being there ("In the Mood"), and the experience in retrospect ("Remembering the Episodes"). The next two sections contain poems that approach these moods from more of a distance, either looking at the sufferer from another's perspective, ("Characters") or at the influence of manic-depressive sufferers on those around them ("Family and Friends"). The following section is devoted to poems about artists who suffered from manic-depression ("Artists"). The last two sections contain poems that depict shifts from one mood to the other, either on a daily or general basis ("Daily Shifts") or seasonally ("With the Seasons").

View full annotation

Summary:

In this one act play, as a result of a new medication, a middle-aged woman named Deborah wakes up after spending nearly 30 years in a "coma." More precisely, she was in a dream-like state of unawareness or altered awareness that Hornby, her doctor, refers to as "a kind of Alaska."(p. 34) Deborah thinks that she has only been "asleep" for a short while, so she asks about her parents and sister, as if she were still the adolescent she remembers. Hornby assures her that her mind has been suspended all that time, although he has been at her side, fighting to keep her alive: "Some wanted to bury you. I forbade it." (p. 34)

 

Uncertain what to say, Pauline, Deborah's younger sister, now enters the hospital room. Hearing Pauline's news of the family, Deborah tries to comprehend what has happened, but it seems just too bizarre. Then Hornby reveals that Pauline has been his wife for more than 20 years. Deborah experiences the walls of her consciousness closing in, "Let me out. Stop it. Let me out. Stop it. Stop it." (p. 38) Suddenly, she returns to the conversation and summarizes everything she has heard. "I think I have the matter in proportion," she concludes.

View full annotation

Summary:

Fifteen-year-old Webber hits a young girl, seriously injuring her, while taking a little illegal driving practice with his indulgent grandfather. Webber, himself, is injured, and unlikely to return to the track team he has loved. He has trouble remembering the accident during the first weeks of his recovery, especially since his grandfather has determined to take the blame for the accident. But as memory returns, aided by the bitter insinuations of a classmate who babysits the injured girl, Webber is torn between accepting his grandfather's cover for the sake of a clean record and an unencumbered high school career, and confessing. The technical fact that his grandfather was legally responsible for letting him drive complicates the ambiguity of his dilemma. Ultimately, he makes the decision to confess. The book concludes with his telling his grandfather of his intention--a decision that is sure to be relationally as well as legally consequential.

View full annotation

Summary:

The speaker, the "childless woman" of the poem, describes the way infertility has rendered her body aimless and horrible. Her womb, like a dried-out plant, "rattles its pod." Her body is a knot, lines turned back on themselves instead of leading to the future, making it unnatural, "Ungodly as a child’s shriek." All her body can produce is the blood of menstruation, which signifies her own death, and a surreal and horrifying landscape "gleaming with the mouths of corpses." (18 lines)

View full annotation

Summary:

This is another wonderful book from Dr. Sacks. The subtitle, “Tales of Music and the Brain,” is accurate: we have a charming and informative mixture of stories of patients and the neurophysiology that interprets how music is processed and performed. The book is synthetic in combining cases from his practice, other clinical reports, letters from correspondents, references to medical literature, and even Sacks’s own personal experiences with music.

Sacks finds that humans have a “propensity to music,” something “innate” in human nature, perhaps like E. O. Wilson’s biophilia. “Our auditory systems, our nervous systems,” he writes, “are indeed exquisitely tuned for music” (xi). Although humans have been involved with music for millennia, it is only in the last few decades that medical imaging (functional MRI, PET) has shown what areas of the brain are active when music is heard.

While humans routinely enjoy music, the book emphasizes unusual events and neurological patients, in short, departures from the norm. Sacks—himself a lover of music—reports on his own experiences with hallucinatory music and anhedonia (loss of pleasure) in hearing music. He describes going to hear the great baritone Dietrich Fischer-Dieskau but finding that he could not, on that day, perceive the beauty of the music. Another condition “amusia,” or loss of musical ability, can be chronic, acquired, or temporary.

Some patients have had injuries or diseases of the brain that change how music is perceived. A man hit by lightning is suddenly obsessed with piano music. Another man (who survived a brain infection) has amnesia about many things but can still make and conduct music at a professional level. The concert pianist Leon Fleisher visits Sacks to discuss his dystonia, or loss of muscle function in one hand (with implications for the brain). Rolfing and Botox helped him heal and he returned to two-handed performances.

Sacks discusses other phenomena that involve brain structures, for example, perfect pitch; persons with this ability have “exaggerated asymmetry between the volumes of the right and left planum temporale” (128). People who experience synesthesia (perceiving notes as colors) have cross activation of neurons in different areas of the brain. Professional musicians (and patients with Tourette’s) demonstrate cortical plasticity, that is they have expanded areas of the brain for particular uses. Children with Williams syndrome have brains influenced by a microdeletion of genes on one chromosome; they have some cognitive deficits and also a great responsiveness to music. For some conditions, the brain determines all; for others, behavior components are also important.

View full annotation

Summary:

The basis for this autobiographical essay on the experience of having a malignancy are 92 illustrations, all the work of the author; they include 32 ink or woodcut sketches, 24 charcoal drawings, and many acrylic paintings (16 in full colour). Pope's images evoke the dependence, fear, loneliness, pain, and even the mutilation surrounding cancer illness and therapy.

He describes in plain language the course of his own illness, diagnosis, and treatment; he also relates the experiences of a few fellow patients. Most intriguing is his ready description of the stories behind his pictures: who posed, how he painted them, and what exactly he was trying to convey. When the book was published, Pope was in a hard-won remission from Hodgkin's Disease, but he died the following year of treatment-induced bone marrow failure.

View full annotation

Summary:

The basis for this autobiographical essay on the experience of having a malignancy are 92 illustrations, all the work of the author; they include 32 ink or woodcut sketches, 24 charcoal drawings, and many acrylic paintings (16 in full colour). Pope's images evoke the dependence, fear, loneliness, pain, and even the mutilation surrounding cancer illness and therapy.

He describes in plain language the course of his own illness, diagnosis, and treatment; he also relates the experiences of a few fellow patients. Most intriguing is his ready description of the stories behind his pictures: who posed, how he painted them, and what exactly he was trying to convey. When the book was published, Pope was in a hard-won remission from Hodgkin's Disease, but he died the following year of treatment-induced bone marrow failure.

View full annotation

Summary:

Janis Caldwell, who practiced emergency medicine for five years before getting her Ph.D. in English, examines the philosophy and practice of nineteenth-century British literature and medicine in this book. In an erudite introduction, she explains what she means by the "double vision" of "Romantic materialism," "Romantic because [physicians and authors] were concerned with consciousness and self-expression, and materialist because they placed a particularly high value on what natural philosophy was telling them about the material world" (1). These writers' intellectual context, influenced by natural theology, was dualist, including both the Book of Scripture and the Book of Nature. Their methodology "tacked back and forth between physical evidence and inner, imaginative understanding" (1), giving rise to the two-part "history and physical exam" familiar to physicians today.

The book examines this dual hermeneutic in six influential sites over the course of the century. In Chapter Two, Caldwell reads early-nineteenth-century debates over vitalism in the context of Mary Shelley's Frankenstein, arguing against the materialist-spiritualist divide so often cited in that period. She also brings readings of the novel into line with contemporary theories of physiologic sympathy. Next, she turns to the enormously influential sage Thomas Carlyle, arguing that he broadens the body/soul model to include both natural and supernatural aspects of the world. Again rejecting the notion of a philosophical dualism that prohibits mixing differing approaches, she argues, both Carlyle and the anatomist Richard Owen enthusiastically endorse a more heterodox vision of the world, in which we learn from both natural and spiritual enquiry.

The fourth chapter reads Emily Brontë's Wuthering Heights in the context of contemporary popular treatises on children's health and child-rearing. Caldwell argues that Brontë's image of the Romantic child, as emblematized in Cathy and Heathcliff, and characterized as "a more social, empirical, physical, literal version of childhood," derives in part from the "domestic medical texts which function as a sort of secular scripture in the Brontë household" (74). She suggests that the dualist language of natural theology, which combined spiritual and natural interpretation, and which was well-known in the Bronte household, influenced Emily's mixture of religious and medical concepts in her portrait of Romantic childhood.

Chapter Five contrasts Emily Brontë's version of childhood to that of her sister, Charlotte Bronte, in Jane Eyre and Villette. Charlotte Brontë, argues Caldwell, inclines more to the professional version of medicine, less suspicious of physician authority and more likely to experiment (in her fiction) with alternative medical theories such as phrenology. In an extended discussion of theories of literalization and metaphor, using Ricoeur to argue that the literalization of a metaphor returns us to the fact but also reinvigorates the metaphor through its dissonance with the fact. Caldwell proposes that the supposed "coarseness" of Brontë's novels is linked to her use of literalization.

A chapter on Darwin posits that "Darwin's thought arises directly out of ... Romantic materialism" (117). Although by the end of his life Darwin had renounced literary reading, the "dialectic of Romantic materialism" (shaped by Romantic literature as well as science) appears in "Darwin's preferred scientific method," in his rhetoric, and in the narrative structure of his scientific autobiography (123-24).

Caldwell's final chapter provides a significant new reading of the genre of the medical case history, by studying George Eliot's Middlemarch in the light of the bipartite structure of "the patient's narrative and the physical exam" (143). Emphasizing the negotiations between doctors and patients in the mid-nineteenth century, and calling for similar negotiations today, Caldwell navigates the differing critical positions on George Eliot's novel, weighing whether the narrator "participates in the systematic, totalizing knowledge of the pathologist" or undercuts that knowledge (156). Caldwell concludes that the narrator of Middlemarch practices a "hermeneutic circling" that shuttles back and forth between incommensurate perspectives, part and whole, nature and spirit, seeking "a partial and provisional, rather than absolute or positive, knowledge" (160). The book ends with a call to return the term "clinical" to its full meaning, not just of detachment, but of engaged practice.

View full annotation