Summary:

Elizabeth Carpenter is preparing for her fiftieth wedding anniversary and hoping that her children will come home for the event. She nurses her irritable, invalid husband, a retired teacher, who has been a rigid father and is now bedridden with a chronic illness. He is too proud to ask for the things he needs or wants, and spends his vacant hours comparing what he perceives as the dull, dutiful Elizabeth to the "other woman" he loved long ago.

Their oldest child, Victoria, once a fragile beauty full of promise, is institutionalized for a chronic mental illness characterized by irrational fears and self-doubt. The middle child, Jason, is a psychiatrist who has been unable to establish trusting relationships and seeks affirmation through multiple sexual adventures. The youngest child is Emily, a concert violinist whose way of achieving peace is to live abroad, avoiding commitments and her family from whom she is hiding the fact of her own son, Adam. But the reunion leads them to revisit relationships and events in the past and results in some surprises for their present and future.

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Slater subtitles her book, A Therapist's Memoir of Madness. Embedded in this definition are two elements: a psychotherapist's composite experiences with a small cadre of patients and the therapist's personal experience with a mental disorder. The author draws the reader into a fascinating series of anecdotes based on therapeutic encounters.

These stories are as much, if not more, about the therapist's deepest responses to her patients than about the patient him or herself. This particular approach adds an element of confession to the work that one does not often find in clinical studies. And, finally, Slater takes the reader backward in time to her own past as a woman with profound emotional pain.

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In this collection of poems, the author details her descent into the hell of bipolar disorder and the re-integration of her life, thanks to lithium therapy. In "Other Lives" she describes herself as "mother of none, good friend to all, / who for no apparent reason, / tries to kill herself, twice." She writes angrily to the psychiatrist who misdiagnosed her and prescribed the wrong medication: "Your first mistake was to see me at all. / Your second, prescribing the Elavil." (in "Shocking Treatment") While she misses the productivity and "rush" of her hypomanic episodes, she realizes this is the price she has to pay to avoid another "two years of pain or nothing, numbness."

As the author's health improves, she cares for friends who are dying of AIDS and for the dying father of a friend: "I'm learning, as I nurse / my father that the worst / would be protection from / death's reality." (in "For Jean") The collection is interlaced with a series of poems called "Black Stones" in which the author encounters very directly the reality of death. In the last of these, she cries out the words of her friend Matthew who has just died: "Rika, dear friend, live and live and live!"

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William Osler served as one of Walt Whitman’s physicians from 1884, when he moved to Philadelphia to become Professor of Medicine at the University of Pennsylvania, until 1889, when he left Philadelphia for Baltimore. Osler was introduced to Whitman by a mutual friend, Dr. Richard Maurice Bucke, Whitman’s avid disciple and biographer. After his stroke of 1873, Whitman suffered from recurrent episodes of illness (perhaps small strokes?). Osler first paid a call to Whitman’s home in Camden at Bucke’s request and subsequently visited him on numerous occasions.

Published in this book for the first time is Osler’s unfinished 1919 manuscript for a lecture recounting his relationship with Whitman. Much of the book is a gloss on this short manuscript. The book actually deals as much (or more) with the remarkable figure of Richard Maurice Bucke, Whitman’s spokesman and the developer of a theory of "cosmic consciousness," as it does with the two title characters. In sum, Whitman respected Osler, but did not particularly like his sunny, optimistic bedside manner. Osler respected Whitman, but for the most part did not like his poetry. (Leon, however, discovered some handwritten notes on Osler’s copy of Leaves of Grass that suggest Osler grew in his later years to appreciate Whitman’s poetry.)

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On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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A woman admitted to a hospital for cancer treatment describes her progressive loss of identity, from the trading of clothes for a hospital gown to her gradual hair loss. Feelings about the loss of hair (shame, embarrassment, nonchalance) reflect how she confronts the illness; in time, she is ready to face the world again.

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As you are now, so once was I; Prepare for death and follow me. The novel's advisory epigram prepares readers for the realities of aging and death which affect both narrator and reader. Following surgery, Caro Spencer is delivered to Twin Elms, a nursing home in a rural New England setting. While this intelligent woman requires only short-term care, she is deposited, permanently, in an understaffed, sub-standard care facility by relatives unwilling to add her minor but time-consuming difficulties to their own.

It is not a pretty setting. The staff is overworked and demeaning, especially to the new resident who is well-educated and accustomed to better circumstances. The nursing home routine is careless of individual differences and needs, and set up to strip away autonomy and dignity through petty and cruel indignations.

Caro is able to survive by keeping a secret diary for observations, reflections, and interpretations; ultimately, this alone sustains her. While the voice is that of an elderly woman (as we are now), the journal is for us, those still able to manage their lives, but unable to predict or control end-of-life events.

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Mother is set in the 1930's and deals with a woman's difficult life, low self-esteem, and sense of having inherited tragedy and misfortune from her mother. Even though she finally marries, and unexpectedly conceives long after her husband and she had given up trying, her outcome is destined to be unhappy. She goes into premature labor, and gives birth to a stillborn child.

When she finally wakes up, she is weak, and cannot remember anything about the delivery. Her paternalistic physician, her husband, and the hospital staff withhold from her the news that her child has died. One night, in her frustration and need, and believing that her child is in the nursery "in the basement," she searches the basement corridors for her child. Outside the morgue she begins to hemorrhage and despite the efforts of her physician, she dies.

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A hapless country doctor describes with breathless urgency a night-time summons to attend a young patient. Events soon take on a surreal aspect as "unearthly horses" transport him instantaneously to the bedside. The doctor, preoccupied with personal distractions and grievances against those he is employed to care for, fails to find what is revealed to be a vile, fatal wound (symbolizing the Crucifixion?). He is humiliated by the villagers, who are "always expecting the impossible from the doctor," and doomed to an endless return trip, losing everything.

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