Summary:

Moller is a sociologist who takes us into the world of the urban poor; he focuses on half a dozen individuals, giving intimate and moving portraits of them. An opening character is called Cowboy (a pseudonym); he lives under a bridge with his dog Cowgirl and dies a slow death of lung cancer. In an Epilogue (pp. 163-184) Moller calls him "an urban Thoreau." This respect for the dying poor pervades the book.

Besides descriptions of the characters, there is much dialogue, including extended quotations, but also some 100 small photographs, usually close-ups, inserted into the text. One photo shows a man in his coffin. Clearly Moller gets close to his characters, and so does the reader.

Moller argues that the dominant society--to its shame--neither supplies adequate care for this sector of society nor even recognition that such people exist. He calls the dying poor "an invisible world." It's a disturbing world, with the pain and neglect, but also an inspiring one, because of the caregivers such as social workers and nurses and the heroism and dignity of the patients presented.

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This is a collection of two dozen case studies, written for non-medical readers, of patients with right-brain disorders. The chapters are divided into four groups: "Losses," dealing with loss of memory, cognition, and proprioceptive sense; "Excesses," with tics and other cases of overabundance; "Transports," with seizures and various "dreamy states," and "The World of the Simple," concerning mental retardation. In every case, Sacks focuses on the interior or existential world of the patient as the foundation of diagnosis and treatment. Sacks argues that this approach is appropriate for the right hemisphere, which compared to the left is less dedicated to specific skills and more dedicated to a "neurology of identity."

Sacks openly proposes these studies as a corrective to the field of neurology, which has tended to focus on the left hemisphere and therefore, he argues, has wound up treating patients solely in terms of specific deficits, often to their detriment. In "the higher reaches of neurology," and in psychology, Sacks argues, disease and identity must be studied together, and thus he recommends that neurologists "restore the human subject at the centre" of the case study. Sacks warmly recommends music, story-telling, and prayer as therapies that work by ignoring physiological defects and speaking to the patient's spirit or soul.

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This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?

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In four lengthy chapters, the biographies of Haydn, Mozart, Beethoven, and Schubert are carefully presented. Special attention is given to health, both physical and psychological, throughout life and at its end. Autopsy information is included. In particular, the author emphasizes the impact of illness on the composers' relationships with family members and doctors, and on their musical composition.

Evidence is derived from a wealth of primary sources, often with long citations from letters, poetry, musical scores, prescriptions, diaries, the remarkable "chat books" of Beethoven. Neumayr also takes on the host of other medical biographers who have preceded him in trying to retrospectively 'diagnose' these immortal dead.

Late eighteenth- and early nineteenth-century Vienna emerges as a remarkable city of musical innovation and clinical medicine. The composers' encounters with each other link these biographies. Similarly, many patrons, be they aristocrats or physicians, appear in more than one chapter, such as the Esterhazy family and Dr Anton Mesmer.

The disease concepts of the era, prevalent infections, and preferred therapies are treated with respect. Rigid public health rules in Vienna concerning burial practices meant that ceremonies could not take place in cemeteries and may explain why some unusual information is available and why other seemingly simple facts are lost.

Biographical information about the treating physicians is also given, together with a bibliography of secondary sources, and an index of specific works of music cited.

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An automobile accident left Mary Swander nearly paralyzed and coping with chronic pain. After several incorrect diagnoses, she saw a neurosurgeon who told her that a disk in her neck ruptured "at C6 and punched a hole in the spinal cord. The flu virus went into the cord and infected it." She had central cord syndrome (which can paralyze arms) and myelitis (which can paralyze legs).

Other than traction, the doctors said they could not do anything more for her. She went to New Mexico where herbal medicines of a curandera and spiritual healing by a Russian Orthodox monk helped her. She now walks without a cane.

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Margaret returns one afternoon from tennis to discover that Lewis, her husband, has committed suicide by taking an overdose of pain medication. Lewis had been bedridden from amyotrophic lateral sclerosis (ALS). They had thoroughly discussed his plan to kill himself before he was unable to do so, but Margaret is surprised when it happens because she expected Lewis to leave her a message. There is none.

As Margaret prepares for her husband’s cremation, she recalls the circumstances under which he left his teaching job--not because of the ALS, but because he used to teach human evolution in his high school biology class, without giving "equal weight" to creationism.

Because this upset many of his students’ parents and local clergy, the principal several times suggested that Lewis might at least give a nod to creationism. However, Lewis, an outspoken opponent of religion, was insulted by this proposal and quit his job.

The undertaker encourages Margaret to hold a wake--to comfort her and their many friends--but she insists that Lewis wanted no wake and no service. The next day the undertaker brings her Lewis’ ashes; she goes out into the country at night and disperses them.

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As Bertman says in her introduction, this book "is meant to refuel therapists, counselors, social workers, physicians, nurses, clergy and all others who are committed to providing support to those in grief." While the caregivers' focus is on those in grief, they also have to give some attention to their own bodies, minds and spirits. This collection of essays, poems and stories, illustrated with drawings and photographs, examines grief from several perspectives.

The opening section looks at professional roles in experiencing and understanding suffering and empathy. Section two provides several descriptions of how caregivers use the arts for themselves and for those they companion. Section three is devoted to lessons from old and new cultures. The final section explores basic needs of grieving people.

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Beginning with the words, "They are and suffer, that is all they do," this poem describes the experience of those who are recovering from surgery and their treatment at the hands of impersonal doctors ("The treatment that the instruments are giving"). Suffering and pain narrow the patient's world and isolate patients who "lie apart like epochs from each other" and for whom "truth" is "how much they can bear."

The speaker also describes how difficult it is to imagine pain when one does not have it ("we stand elsewhere / For who when healthy can become a foot?"). Finally, the speaker refers to "the common world of the uninjured" where we "cannot / Imagine isolation," but share happiness, anger and "the idea of love."

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The author of this bold collection is a registered nurse who relates, through her poems, patient and caregiver experiences culled from her own years of working in Intensive Care-Coronary Care. There are 24 poems here, most running two to three pages and most written in short lines, a point of craft that adds to their power. There is not one moment of easy sentimentality in these poems. Instead, the author plunges into the grittier side of nursing and illness--and yet, in aggregate, these poems celebrate the embodied and holy work of healing.

In the opening poem, "The-Trickle-Down-Theory-Of-Health," Adam, in the Garden of Eden, is surprised by "The knife" that "separates his ribs." By poem's end, we see health slip "like a ring / from earth's finger" (2), and with this simile we are introduced to the book's underlying metaphor and also to the poet's technique: dense and sometimes near-extreme imagery that ranges, in this poem alone, from encyclopedias to acid rain to barefoot children to librarians to a patient in the dark, "her arteries and shelves / of bone in a ruby gloom" (2). This accumulation of unrelenting, unusual images recreates the world of a patient's pain and suffering and the fierce determination and occasional despair of a caregiver.

"Coma" is written from a comatose woman's point of view, and yet we also see her from the nurse's vantage. In a lovely and surprising twist, the coma becomes, for the patient, a sort of liberation as "Slowly she sloughs, / cell by cell, / the old thorn" (15). This patient is not Sleeping Beauty, who in some fairy tale might be wakened by a kiss. "On the Fireline" becomes a wonderful metaphor for the daily confrontation of illness, for the way the nurse, returning daily to tend her patients, also "coalesces into fire" (16).

The 5-page poem "Intensive Care" perfectly renders the physical sense of being alternately caregiver, patient, and family member within the rarified atmosphere of the ICU (24-28). A patient's blood "pulls against/ the moon, his breath / this tide going out" (26) and, as she comforts a waiting family member, a nurse's eyes "beyond clarity, / unfold a silken language / all their own" (28).

Other not-to-be-missed poems are "The Holy O" (36), "Prayer to a Purple God" (38), "Pieta" (44), "A Riot of Flowers" (52), "What the Body Remembers" (57), and one of my very favorites, "Anesthesia" (59). In "Anesthesia" the caregiver lets an anesthetized patient float like "an embryo / tethered on the end of IV tubing, / floated like an astronaut / in cold stratosphere, / a naked thing / alone / in the universe" (60). But since these poems are finally loving, involved, experienced and hopeful, the patient is told to hush; he is watched over; he is protected. When danger is past, he is reclaimed: "She will hold you / within white-curved wings. / She will reel you back in / when you are healed" (60).

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Physician-scientist Lewis Thomas turns to pressing, threatening issues in this collection of 24 essays, many of which have been published in Discover magazine. The book opens and closes with meditations on nuclear warfare--the atom bombs of World War II and the escalation of worldwide tensions and technology that can combine to destroy the human race. In between, other essays, such as "On Medicine and the Bomb" and "Science and 'Science,'" also focus on these issues.

Less apocalyptic essays concern Thomas's experience with requiring a pacemaker, the state of psychiatry, lie detectors as evidence for essential human morality, and his abiding interest in language and scientific research.

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