Summary:

This short story begins with a summary of the tale of Guillermo Blake, who believed that "the five senses obstruct or deform the apprehension of reality." The narrator then relates the tale to his own experience: upon visiting his gerontologist for a check-up, he is informed of a procedure that confers immortality. The "immortals" are reduced to living brains within wooden cubes, their bodies having been replaced by "formica, steel, plastics." The narrator tries not to show his horror, but moves immediately to a different part of the country under an alias.

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The narrator is a patient with advanced cancer who has come home from the hospital after being told that "medicine has no hope." Yet, for one night, he strives to overcome his cancer with drink, his "Basic Life Force," and hope.

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This is a description of the last moments of the narrator's ailing grandmother. She is "wrinkled and nearly blind," and protests cantankerously as the ambulance speeds her towards the hospital. However, in a sudden change of character, her last words express how tired she is of looking at the passing trees; her loss of interest in the view parallels her loss of interest in life.

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In "Fortitude" Dr. Elbert Little, a Vermont family physician, visits the laboratory of Dr. Frankenstein and his trusty assistant, Dr. Tom Swift. Frankenstein has only one patient, Sylvia Lovejoy. His life work has been to keep Lovejoy alive. In 78 operations over the last 36 years, Frankenstein has replaced every one of her organs with prosthetic devices, so that now she consists of a head on a tripod, attached by tubes to various machines.

Frankenstein controls her mood, as he controls all her functions, from a "fantastically complicated" master console. Usually he makes sure that she feels joyful and loving, but last month a transistor went bad in one of the machines and she felt depressed for a while; so depressed, in fact, that she wrote to Dr. Little and asked him to bring her some cyanide.

Lovejoy's only friend is Gloria, the beautician who comes every day to care for her hair. Gloria is horrified over what Sylvia Lovejoy has become; she sees only a "spark" of the real person remaining, but she knows that the "spark" wants to die. After Frankenstein fires Gloria for speaking about death in Sylvia's presence, she sneaks back into the room when Sylvia is sleeping and puts a loaded revolver in her knitting bag.

Later, Sylvia finds the gun and tries to kill herself, but her prosthetic arms have been designed not to allow her to do that. Instead, she shoots Frankenstein, who promptly becomes the second head attached to the machines. (It seems he has designed all the prosthetic organs to be able to serve two "persons," so that he and Sylvia will be able to "live in such perfect harmony . . . that the gods themselves will tear out their hair in envy!")

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Summary:

A man suffers from a disease that "came / from love, or some / such place" (AIDS?). He has come home to his father's house to die. He grows thin, his sores will not heal, family and friends grow distant. While in the kitchen family members discuss how much the illness affects them, the sick man himself is already in hell, "which is / the living room . . . . "

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A short poem in which the speaker enters the X-ray room, braces herself against the cold, lies "suspended in icy silence." She looks at herself from a distance, feeling free, "Even though I'm not, now / Or ever . . . . " She feels the "metal teeth of death bite" but they reject her "One more time" and she returns to the everyday reality of being a sick person lying in a cold X-ray room.

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This splendid poem describes the writer's image of his own death in a very matter-of-fact and conversational style. If he's lucky, he tells us, he'll die in the hospital, surrounded by machines and loved ones. His friends will be there to give him support; he'll be able to tell them how much he loves them. If he's unlucky, however, "as I deserve," he'll just drop dead and not have a chance to say farewell properly. But, whatever happens, he just wants to say "I was happy when I was here . . . . "

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A third year medical student rotates through a gynecology clinic at the university. The attending Dr. Snarr, is supposed to treat his patients' chronic pelvic pain, but only seems to inflict pain himself. The student/narrator wants to comfort the patients, but lacks the knowledge, skills, and authority. The student also feels uncomfortable with issues of sexuality and intimacy with these female patients.

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The narrator recounts the interview with his physician during which he learned the bad news about his lung cancer--although the word "cancer" is never mentioned. But the interview is marked throughout by signs of imperfect communication. At several points, the physician's grave remarks are matched by diffident, sometimes humorous responses.

For example, when asked if he is a religious man or a communer with nature, the narrator responds "I said not yet but I intend to start today." The culminating account of miscommunication is near the end: "he said something else / I didn't catch and not knowing what else to do / and not wanting him to have to repeat it / and me to have to fully digest it / I just looked at him." The final line clinches the oddly blurred nature of the whole exchange: "I may even have thanked him habit being so strong."

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Summary:

Ruth Picardie was a journalist working in London. Shortly after her marriage in 1994 to Matt Seaton, also a journalist, she found a breast lump. After testing, she was told it was benign. Two years later, and a year after giving birth to twins, the lump enlarged and this time she was diagnosed with advanced, inoperable breast cancer. She rapidly developed bone, liver, and brain metastases and died in September 1997, aged 33.

This book consists of a selection of Picardie's e-mail correspondence during the last year of her life, the columns she wrote for the Observer newspaper (a series about dying she called "Before I say goodbye"), readers' letters responding to her column, and an introduction and epilogue by her husband. While not, then, strictly a memoir, this collection of texts constitutes an intimate view of a witty, angry young woman undergoing an intolerable illness.

The expected elements are there: diagnosis, chemotherapy, radiation, hope, the loss of hope. What is unexpected is the way these are presented, and the vividness with which we share the prospect of saying good bye to her children, her gradual detachment from her husband, and, as the brain metastases spread, the loss of coherence and the appalling silencing of her powerful voice.

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