Summary:

The speaker was treated for cancer but afterwards "the kidneys / refused to continue. / they closed their thousand eyes." Now she is in the dialysis unit, a patient once again, with other patients. She thinks her body rebelled against the cancer surgery by refusing to lose "even the poisons" that the kidney eliminates.

She thought that when the cancer was treated she would be well, but instead, there was more illness--a chronic disease. She knows that she is expected to take the situation in stride ("we are not / supposed to hate the universe") but she is "furious"--all her gratitude for being saved from cancer has been nullified.

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Contrary to what the title might suggest, this is not a memoir of drug addiction. Writer and poet Tom Andrews has hemophilia, and codeine is the analgesic he requires during excruciatingly painful internal bleeding episodes. In this diary, begun while recovering from a leg injury, Andrews reflects on his particular experience of life and hemophilia. He makes clear that " . . . hemophilia is only one of the stories my life tells me . . . " (p. 29)

The memoir interweaves the author's physical, emotional, and existential journey through the convalescent period with flashbacks of childhood and his relationship with his ailing brother, now dead, to whose memory the book is dedicated. Brother John's fatal illness with kidney disease shaped--and continues to shape--Tom's life as much as did the hemophilia.

On the one hand their parents' concern for John took Tom out of the spotlight and allowed him to pursue his own interests. These extended to motorcycle racing, playing in a punk band, and setting a record for continuous hand clapping--at age 11--that was recorded in the Guinness Book of World Records. On the other hand, Tom's guilt over surviving John's early death may account for an almost reckless disregard of his own precarious physical condition. A constant subtext is the deep grief and abiding love of the living brother for the dead one.

But this is not a mournful book. It is an engaging memoir that provides unusual access and insight into the world of hemophilia, especially with regard to the painful "bleeds." It is the sense of exile and separation from others that is most disturbing for Andrews when in the throes of unrelieved pain. He takes us through the mental concentration required to endure this pain and the liberating relief to mind and spirit provided by codeine. Memory, perception, and writing provide the additional resources he needs to re-connect with the world.

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In 1977 Marion Cohen's physicist husband, Jeffrey, was diagnosed with multiple sclerosis. He was 36 years old. Cohen, a mathematician and poet and mother of four, became his chief caregiver. As her husband's illness progressed, the caregiving role became increasingly absorbing, demanding, all-encompassing. Eventually daytime attendants were hired but sometimes they didn't show up. This collection of 77 poems is a kind of journal, primarily from late 1989 through January, 1991, that chronicles Marion's ambivalent caregiving, despair, resignation, "temper tantrums," love, and compassion.

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Shay, a psychiatrist who specializes in post-traumatic stress disorder (PTSD), juxtaposes the narrated memories of his patients who are Vietnam veterans to the story of Achilles in Homer's Iliad. He finds that the roots of their illness, like that of the ancient hero, lie in betrayal of duty by senior officers who failed to do "what's right," in the repression of grief, and in the social limitations imposed on expressions of love between men.

These stressors lead to guilt, wrongful substitution, and dangerous rage, called the "berserk" state. The mental pathology is fostered by an equally wrongful failure to honor the enemy; return to "normal" is never possible. The book concludes medically with recommendations for prevention.

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In dire financial straits, the physician-researcher, Dr. Malcolm Sayres (Robin Williams), accepts a clinical job for which he is decidedly unsuited: staff physician in a chronic-care hospital. His charges include the severely damaged, rigid, and inarticulate victims of an epidemic of encephalitis lethargica. Sayres makes a connection between their symptoms and Parkinson’s disease. With the hard-won blessing of his skeptical supervisor, he conducts a therapeutic trial using the new anti-Parkinson drug, L-Dopa.

The first patient to "awaken" is Leonard Lowe (Robert De Niro) who, despite being "away" for many years, proves to be a natural leader, with a philosophical mind of his own. Other patients soon display marked improvement and their stories are told in an aura of fund-raising celebration marked by happy excursions.

Gradually, however, problems develop: patients have trouble adapting to the radical changes in themselves and the world; Leonard grows angry with the imperfection of his rehabilitation; the horrifying side effects of L-Dopa appear; and Leonard’s mother (Ruth Nelson), initially happy for her son’s recovery, is later alienated by the concomitant arousal of his individuality, sexuality, and independence. The film ends with "closure of the therapeutic window" and marked regression in some patients, but not before they have awakened clinical commitment and a new ability to express feelings in their shy doctor.

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During the opening credits, the camera slowly pans over the myriad medications for Marvin (Hume Cronyn), the elderly, bedridden invalid cared for round-the-clock by his daughter, Bessie (Diane Keaton). The film opens with Bessie visiting Dr. Wally (Robert DeNiro), a pathologist cum primary care physician, for diagnostic tests which show that she has leukemia.

Bessie also takes care of her Aunt Ruth, whose electric unit for pain relief and penchant for soap operas provide comic relief in this bittersweet drama about families and responsibilities. Because Bessie's best chance for survival is a bone marrow transplant, she contacts her sister, Lee (Meryl Streep), estranged since their father's first stroke and Lee's decision not to help care for him.

Lee's oldest son, Hank (Leonardo DiCaprio), is a troubled seventeen-year-old who sets fire to their home and is hospitalized in a mental institution. Released for this special trip to visit his Aunt Bessie, Hank continues his rebellion by refusing to be tested as a possible donor. Lee is a dysfunctional mother: she does not respond to her son's apology regarding the arson, she has her younger son light cigarettes, and she confuses discipline with control.

The family unites in and around Marvin's room. Reunions are never as smooth as planned, and tensions, stored bitterness, and anger erupt. The sisters confront each other in their failures as sisters--Bessie had never contacted her nephews in any way and Lee had never looked back. But through it all, love and caring emerge: the sisters come to a new understanding, Bessie's reaching out to rebellious Hank is reciprocated, and Lee even learns to communicate caring to her son.

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In Dirty Details, Marion Deutsche Cohen writes about the unrelenting labor entailed in caring for her husband Jeffrey at home as multiple sclerosis turns his symptoms from "mere inconveniences" (11) to extraordinary demands, which can disturb her sleep as frequently as twenty times a night.  The premise of her unsparing narrative is that "we have got to spill the dirty details" (26) of such arrangements before the endurance-draining responsibilities of home care such as hers can be understood and redressed.  In a culture that favors narratives of seemingly heroic individual effort, Cohen's brutally forthright descriptions of the effects of Jeff's needs on her life can be mistaken for a self-pitying complaint, rather than an urgent, revelatory, political call to action.  Like her husband, a well-published physicist at the University of Pennsylvania when diagnosed with MS at age 36 in 1977, Cohen is an accomplished professional.  With a PhD in mathematics, Cohen teaches college students as well as publishes poetry and prose.  She and her husband also shared, with increasing asymmetry, the parenting of their four children.                 

Cohen captures the wearying routine of her days in her narrative's echoing refrain, "nights, lifting, and toilet."   The nights refer to Cohen's dangerously disrupted sleep.  Her husband's respirator can sound every half hour or so, inciting her to worry "about the psychological effects of seldom being allowed to finish my dreams" (23).  (When she asks if the machine can be fixed, she's told that it's supposed to behave that way.  By implication, so is she, despite the toll on her well-being.)  Yet she daily rallies the strength to lift her husband on and off the toilet, a feat, among others, that sometimes defied the powers of several hospital nurses working together.   Toilet also means responding to Jeffrey's regular calls to her to drop what she's doing, run upstairs, and bring him a jar.  The jar at least relieves her from lifting.  She experiences only intermittent relief, however, from finding and keeping home health aides who are able to show up reliably and behave civilly during the few hours per day they can be funded.  What results from these tests of human stamina, Cohen tells us, is not "ordinary stress" that some optimistically believe can be managed by taking stress reduction workshops, but rather "dire straits."  "Calling dire straits stress," she corrects, "undermines well spouses and makes us feel alienated and confused about where we stand" (32). 

It's that standing in the broadest sense of the word that Cohen's book most searingly addresses.  While Dirty Details contains one woman's account of caring for a disabled husband at home, the book's wider purpose is to make the labor of family caregivers visible with all its strains, conflicts, messiness, failures, anger, and, at times, humor.   As the straights become increasingly dire, though, Cohen writes about what happens to love as she moves from sustaining tenderness, candor, and their physical intimacy to diminishing her compassion for Jeff and saving herself:  a "pure survival instinct" (87).   After sixteen years in his family's care, Jeff at first reluctantly enters Inglis House, a residence that provides as much independence as possible for those who cannot live independently, where he continues to write and publish.  Cohen's professional life, social life, and beloved parenting once again flourish.  The story she is freed to write (illustrated with photographs by Anna Moon taken with Jeff's consent) lead readers away from her particular circumstances toward a comprehensive interrogation of social and medical systems that operate by leaving the most chronically ill and disabled citizens in their families' care by default.   And leave the families in dire straits.

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Skunk Hour is the penultimate poem in Lowell’s 1959 volume of poetry, Life Studies. It is composed of 8 sestets with an internal rhyming scheme in each sestet that can only be called irregular from sestet to sestet. The poem moves slowly, beginning with a descriptive tone that is somber ("she buys up all / the eyesores facing her shore, / and lets them fall."), progresses to frankly pessimistic ("the season’s ill") and ultimately becomes confessional and egoistically relational ("I watched for love-cars. Lights turned down, / they lay together, hull to hull, / where the graveyard shelves on the town. . . . / My mind’s not right.")

The poem opens with a series of portraits of people and phenomena that comprise the poet’s current landscape: "Nautilus Island’s hermit heiress" who is "in her dotage"; the "summer millionaire" whose nine-knot yawl / was auctioned off to lobstermen"; the decorator who brightens his shop but appears as hopeless as the narrator, who draws yet another contrast between appearance and reality, remarking that the decorator knows "there is no money in his work, / he’d rather marry."

The fifth sestet marks a turning point and, to signal it, Lowell takes as his first line the famous "Una noche oscura" of St. John of the Cross, another dour poet/mystic: "One dark night". (In a collection of essays cited on the Internet (reference 1) Lowell writes, "Then all comes alive in stanzas V and VI. This is the dark night. I hoped my readers would remember St. John of the Cross’s poem. My night is not gracious, but secular, puritan, and agnostical. An Existentialist night.") This line begins the first of two consecutive sestets that are concerned with corporal love, bracketing a middle line that announces, to no reader’s surprise, "My mind’s not right."

The second of these sestets moves from a maudlin song refrain to a frankly depressive, almost suicidal pose: "I hear / my ill-spirit sob in each blood cell, / as if my hand were at its throat. . . ." and ends with "I myself am hell; / nobody’s here --", which, as James E. B. Breslin reminds us, is a quotation from Satan in Book IV of Paradise Lost. (ref.1)

Enter the titular skunks: as a parenthetical predicate to the final line of the preceding sestet ("nobody’s here --"), the poet corrects the apparently psychological meaning of "nobody’s here --" to refer to physical presence, noting that in fact there is someone here, namely a family of skunks.

The final two sestets are among the most visually powerful images in poetry with the paradoxically high drama one would not expect from skunks. The hungry skunks "march on their soles up Main Street" in search of food with fiery red eyes as the poet, in response to their upward march, stands "on top / of our back steps" and takes a deep breath of the "rich air", watching the mother skunk jab her head into a cup of sour cream--a mother skunk who, in a fitting yet curiously ambiguous final line, "will not scare."

reference 1. http://www.english.uiuc.edu/maps/poets/g_l/lowell/skunk.htm accessed January 5, 2005.

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Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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Not quite the familiar home-for-the-holidays genre of a dysfunctional family, this one has a twist.   April is a late-teen "problem" daughter who has run away to New York City where she lives with her boyfriend, Bobby (Derek Luke).  April, played by a grungy, pigtailed, and probably tattooed Katie Holmes, has invited her parents, siblings, and grandmother to Thanksgiving dinner.  This reunion, we gather, is the first since April left home.  The family is coming to her lower East Side tenement, a situation that bristles with possibilities.  

Moving back and forth from April's low rent apartment to tension in the crowded car as it moves from a scenic suburb to cityscape, viewers are able to watch both April's unskilled efforts as she struggles with the slippery turkey, a can of cranberry sauce, crepe paper decorations, a broken oven, etc. and an inexplicable drama slowly unfolding in the crowded car.  In spite of crisis situations in both settings, the separate family members do get together for a dinner that neither could have planned. 

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