Summary:

This is a story of injury in the midst of exuberant good health, followed by a progressively darkening journey. The writer experiences a period of isolation from normal life by his hospitalization, isolation from a part of his body by neurosensory damage to the injured leg, isolation from the security of medical colleagues by their insensitivity to his anguish. Sacks reaches a psychological nadir before beginning his return. He chronicles, retrospectively, the stages of this trip. As in the classical journey myths, the traveler returns with new insight and an altered vision of the meaning of disease.

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Although the title suggests a letter, this prose poem is written more as a dramatic monologue. The speaker speaks to his wound ("my dear") as though it were a jealous lover. Written some 18 months after a diagnosis (which is left unclear), the poem allows the speaker to think back over the time, reflecting on "what a great change has come over us recently", meaning a new kind of maturity, of empathy, brought about by the speaker’s suffering. The "letter" ends with the speaker’s remark to his wound: "The surgeon was dead right. Nothing will ever part us. Good-night and God bless you, my dear. / Better burn this."

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This poem captures the last thoughts and sensations of a person on her death bed. Surrounded by mourners who are bracing themselves for her death, the narrator’s focus as she dies is on the most mundane of living creatures: a buzzing fly. The final ebb of consciousness is depicted as a loss of light and sight: "And then the Windows failed--and then / I could not see to see--."

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The narrator, who has narrowly escaped death, feels as if there were "odd secrets . . . to tell" to the world of the living. She speculates about her next (and last) encounter with death, anticipating it with curiosity, and resigning herself to the "slow tramp [of] the centuries."

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This posthumously published short (132 pp) collection is by a former New York Times book reviewer and essayist who was diagnosed with metastatic prostate cancer in 1989 and who died the following year. Broyard responded to his illness by writing about the experience. The book is comprised of six parts:

Part 1: Intoxicated by My Illness

Part 2: Toward a Literature of Illness

Part 3: The Patient Examines the Doctor

Part 4: A Style for Death: Journal Notes, May-September,1990

Part 5: The Literature of Death

Part 6: What the Cystoscope Said

Parts 1, 2 and 5 appeared in slightly different form in the New York Times between 1981 and 1990.

Parts 2 and 3 are in part from a talk Mr. Broyard gave at the Univ. of Chicago Medical School in April 1990. Part 6 is a short story written by Broyard in 1954 about his father’s death.

Mr. Broyard had long been fascinated with death and dying, before his prostatic cancer, publishing "What the Cystoscope Said" in 1954, some 35 years before his own diagnosis. It is as though he had been preparing for what he knew would be his finest work. Always an engaging essayist and reviewer, Mr. Broyard here offers what he did best--a discursive (in the best sense) soliloquy on disease, suffering, the majesty of the educated, reflective person with illness--all amplified with widely ranging withdrawals from the broad literary bank account one would expect of a professional reader and reviewer: one reads about personal fate vis-à-vis D. H. Lawrence’s Women in Love; one reads, as one can read nowhere else, about illness, dying and sexuality and its relevance to Hemingway’s The Sun Also Rises.

Part 1, Intoxicated By My Illness, is a personal statement about the effect of this illness on Broyard’s attitude and is rich with his own and others’ literary sense of how he should and did react to it. Part 2, written later than Part 5, deals with literature and illness as opposed to the emphasis on death in Part 5. Within Part 2 are references to Susan Sontag, Norman Cousins and Siegel, among other students of this subject. It is interesting to compare the more powerful and personal and moving appeal of the later writings on illness (Part 2) to the more abstract, critical ruminations on death (Part 5) at a time when, in fact, Part 5 was a literary exercise. Part 2 is written with the pen of the heart.

Part 3 is a wonderful account of Broyard’s first meeting with his personal physician. While Broyard analyzes this man, he reflects on what he would like in his ideal doctor. Part 4 is a brief (7 pages) collection of short diary entries reminiscent of Dag Hammarskjöld’s Markings. Part 5 includes essays on death and dying in literature and what these books, e.g., Robert Kastenbaum’s Between Life and Death and David Hendin’s Death as a Fact of Life and Ernest Becker’s Denial of Death, have to offer us.

Part 6 is a short story about his father’s death, the son’s sexual escapades and the relationship between the two. Clearly sex, death and their nexus have long been on Broyard’s mind. This is a welcome reflection and is of interest more as it compares to Broyard’s later writings on the subject, especially in Part 2, than for its intrinsic worth as a short story.

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This book is an autobiographical account of an abrupt and painful injury that completely transforms the author’s life. Berger in 1985 was a healthy woman who enjoyed ice skating and canoeing, a published poet, wife, and mother of a toddler. She bent over one day to pick up her daughter and felt a tearing "within the thickness of flesh, moving in seconds across the base of the spine." No longer able to run, walk, or even sit, she is forced into a life spent lying down.

Hers is now a world of boundaries and barriers--physical, psychological, and societal. The book chronicles her struggle to parent her child (they make gingerbread creatures lying down on the kitchen floor), to relate to her husband (she has to deal with the constant feeling of being the recipient of his care), to live with pain, and to regain her mobility.

Because hers is not a visible injury and because she must frequently lie down in public places or use her carry-along lawn chair, she suffers the stares and scrutiny of people who cannot pigeon-hole her into a tidy handicapped-wheelchair category. After seven years of physical therapy (she calls her therapists "angels of attempted repair ") she is able to walk and drive, though she is still limited in activity and lives in fear of re-injury.

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A pregnant woman stands in profile to the viewer, with her head bowed down toward her belly and bared breasts. The woman’s eyes are closed and one hand, its fingers curled, is raised so that the palm faces away from her. Perhaps she is praying. A streak of grey angles up behind her head, possibly an abstract halo or wing.

The woman wears a colorful shawl, although her breasts are exposed. The shawl is intricately patterned with swirls and circles evocative of sperm and ova, respectively. A grey skull-cum-death’s head peers out from behind her belly. Beneath the woman and partially enshrouded by her shawl are three women who assume the same position of bent head, closed eyes, and raised hand(s).

All the activity in the image is compacted into a long pillar of sorts, the right side of which forms a fairly straight edge, and the left side of which curves outwards. Behind, a speckled golden-brown makes for a solid background with no perspective.

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A mystery, set in the seventeenth century and told by four different eye-witnesses, all men. Two are the views of fictitious characters, two are imputed to be real figures from the past. Beautiful, but poverty-stricken Sarah Blundy is accused of having killed a professor, only remotely connected to her. Each of the observers reasons his way to a position on her guilt or innocence based on their skewed observation of the events, and on their own assumptions about women, religion, and justice. Post-Cromwellian tensions between Catholics, Protestants, and Quakers are explored.

A manuscript by the Italian, Dr. Cola, constitutes the first account. In the thrall of medical science and the great Robert Boyle, Cola is cast as the true "inventor" of transfusion which is "stolen" by the real and vibrant Richard Lower, generally credited by historians with its first use in England. Cola attends Sarah’s ailing mother gratis and transfuses her with modest success.

The other three writers react to his version of the tale which they read in manuscript. The mad Jack Prescott is intent on exonerating his probably inexonerable father for misdeeds in the Civil War, while the uncharitable cryptographer, John Wallis, is intent on divining nothing but evil in the cryptic forms of women, Catholics, and foreigners. Their versions are wondrously convoluted attempts to keep the impossible within the realm of the plausible. Pears puts the truth (such as it is) in the words of the real antiquarian, Anthony Wood, who explains that a fingerpost--like a pathognomonic sign--points to the only solution possible.

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I used to be able to think. My brain’s circuits were all connected . . . I had a memory and an intuition that I could trust. So begins Floyd Skloot’s memoir of living his life with "a scatter of white spots like bubbles" in his brain, as a result of a viral illness in 1988 that led to chronic fatigue syndrome and persistent brain damage. The first section ("Gray Area") consists of essays that re-create a texture of mistaken words and memory lapses, as well as the author’s creativity in discovering ways to minimize or bypass disability in his daily life. The temporal vector of this section begins with the onset of illness; continues through his marriage to Beverly and their settling on a hilltop in Oregon; and ends with an idyllic stay on Achill Island off the western coast of Ireland.

The second section draws us back in time to "The Family Story," a series of stories about childhood. In "Kismet," which begins section 3, the author returns to a description of his post-illness experience, in this case to his fateful final visit with an older brother, who is dying of diabetes and kidney failure. Later, in "A Measure of Acceptance," he tells of his encounter with a Social Security psychiatrist, whose task is to determine whether Floyd Skloot is "really" sick. The Social Security Administration provides one measure of acceptance; but the author creates a more important measure of acceptance for himself: "I can say that I’ve become adept at being brain damaged. It’s not that my symptoms have gone away: I still try to dice a stalk of celery with a carrot instead of a knife . . . Along the way, though, I’ve learned to manage my encounters with the world." (p. 196)

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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