Summary:

Filmed at Shands (teaching) Hospital in Florida, this documentary validates the importance of the arts and expressive therapies in all aspects of health care, including medical education. Pediatric oncologist John Graham-Pole and poetry therapist John Fox -often as a team- work with patients of all ages in groups and at the bedside.   Other physicians including a neuroscientist provide rational explanations of the release of endorphins and brain changes resulting from creative activities.  Though the healing process initiated by the reflective act of writing poetry is ostensibly the focus of the film, the documentary is permeated with the transforming effects of dance and art therapies in their ability to lessen physical and emotional pain; the importance of healing environments, not just paintings in lobbies, but in patient created ceiling tiles and wall installations; and especially the warmth, intimacy and humanity generated by exemplary physician communication skills.

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Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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When diagnosed with Amyotrophic Lateral Sclerosis (ALS) at age 36, filmmaker Ben Byer began recording a video diary.  Episodes from his diary create the engaging, coherent narrative of "Indestructible," a documentary that intimately, but unsentimentally invites viewers to witness Byer's and his family's responses to his diagnosis.  Their first impulse is to search for a cure for this degenerative disease, "the grim reaper of neurological diseases," a physician tells him.  They also find themselves seeking ways to understand living with loss, most centrally losing the illusion of control over their lives. 

Over the course of three years Byer and family travel to six countries, including Greece, China, Tibet, and Israel.  During his journey, Byer, an irrepressible extrovert, also seeks the companionship and insights of other ALS patients and families, wishing to create a world-wide bond among people who struggle daily.   A montage of clips from family videos prefaces the film, revealing Byer in the decades before his diagnosis.  The images show a luminous child, who grows into a playful, photogenically handsome teen ager and young man, husband, father, son, and brother.  His exceptional force of personality, incandescent smile, and spontaneous sense of humor fill the screen.  These robust images contrast touchingly with the thinner, clumsier Byer who later struggles to remove a t-shirt.  But they also reveal continuities between Byer's capacity to enjoy his life during seemingly carefree days and his strength of spirit as he becomes increasingly more disabled, disappointed, and introspective.  Although even such strength can't alter his condition, it nonetheless sees him through to the next day and fresh adventure.

The family in the montage and the film emerge as Byer's source of support as well as conflict.  One of the most devastating conflicts arises from his father Steve's restless determination to find treatments to reverse or retard ALS.  After searching the Internet for remedies, Steve turns his garage into an ad hoc distribution center for an herbal concoction he encourages his son to drink.  To advance his son's place on the waiting list of a Chinese neurosurgeon who performs olfactory cell transplantation, he recruits other ALS patients for the procedure.  The results are dubious, in some cases perhaps fatal.  After these strategies fail to reverse Byer's physical decline, and place others at risk, the camera rolls during a family showdown that exposes their fears and desperation as it acknowledges their love.  This memorable scene does so in a way that's consistent with the rest of the film: by letting the camera show, not tell. 

Even the many moments when Byer's family help him with daily activities and his most reflective moments at the end of his film resist sentimentality and easy didacticism.  Byer's equally irrepressible young son John raises a fork wound thick with pasta to his father's mouth and loops his belt through his pants, setting off giggles all around.  The ordinariness and extraordinariness of these acts, the learning of selflessness, the uneasy acceptance of dependency, the inevitability of loss are told through such images or captured in fragments lifted from daily conversations.  Bathing Byer, his brother Josh matter-of-factly says, "You don't have all the time in the world":  a searing acknowledgment of Byer's decline that reminds us of all human fragility.  The closing scenes of the film unobtrusively place Byer's solitary experience in the long history of the search for meaning in human struggle.  They record his wobbly, yet victorious ascent of Masada, supported by Josh, right after we hear a rabbi recount Camus's version of the myth of Sisyphus. 

 

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Spoiler Alert: The ending of this thriller is revealed in the final paragraph of the summary. The threat of terrorism and the moral code of a physician place Dr. Collin Reeves in a very difficult position. The young American doctor is a specialist in parasitology and tropical diseases. He has trained and worked around the world - London, Kuwait, Brazil, and Africa. He presently practices in Mexico City. The U.S. Embassy refers sick American tourists to him. Dr. Reeves is also a CIA operative who enlisted after 9/11 to fight terrorism. After two years as an employee of the U.S. Intelligenge Service, he is disenchanted and wants out. Dr. Reeves is appalled by the brutal handling of terrorist suspects. It is his job to treat them and keep them alive long enough to obtain information or a confession.

Dr. Reeves loves Mexico, painting, and living day to day. He hates arrogance, disease, and human misery. His boss, Alex Law, is the chief of the CIA station in Mexico. He and his pal, Butch Nickels, have been in the spy business a very long time. Law is an alcoholic. His wife finds a lump in her breast that proves to be malignant. Dr. Reeves and his father (a surgeon practicing in San Francisco) arrange treatment for the woman in California where she undergoes a double masectomy.

Law has some clues that a group of al Qaeda in Mexico are plannning an attack. He worries they intend to bomb a city in California. Law's intuition is pretty good. A husband (Mohammad) and wife (Fatima) from Baghdad are set on revenge. Their young son was killed by an American bomb in Iraq. The husband, a physician, was mutilated by the same bomb. Unaware of her true background and her mission of destruction, Dr. Reeves falls in love with the beautiful woman who calls herself Dolores Rios. At one point, he kills a policeman and wounds another to rescue the woman. When her husband is bitten by scorpions, Dr. Reeves saves his life.

Members of the al Qaeda cell eventually capture Dr. Reeves and some of his friends. They plan to crash a stolen airplane into a California city. Dolores has a change of heart, but her husband is intent on revenge and becoming a martyr. Dr. Reeves offers to accompany the terrorists in exchange for Dolores being left behind. Still recovering from the effects of the scorpion bites, Mohammad figures it might be wise to have some medical expertise readily available. Shortly after take-off, Dr. Reeves manages to crash the plane but he is killed by gunfire in the process. The terrorist attack is averted. When Alex Law locates Dolores, he allows her to go free and start a new life. The doctor would have wanted it that way and Law allows him that much.

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Pietro Brnwa, nicknamed "The Bearclaw," has embraced change - a new name, a different occupation, and a regenerated outlook. Thanks to the Federal Witness Protection Program, Pietro, who was formerly employed as a hitman by a mafia-connected lawyer, is now Dr. Peter Brown, an intern in the Department of Internal Medicine at Manhattan Catholic Hospital. His career as an assassin was motivated by the desire to avenge the murder of the grandparents who raised him. As a physician, Dr. Brown is paying off a moral debt - doing good deeds to atone for previous acts of violence including killing people.

Unfortunately, life doesn't get any easier for the hit man-turned-physician. Trouble stalks him and finds him. Everyone he loves is lost. In addition to the death of his grandparents, Dr. Brown's girlfriend, Magdalene, is gunned down in a car. His former best friend, "Skinflick" is thrown out of a window of a six-story building, survives, and is later stabbed to death by Dr. Brown.

Life might have been easier if Dr. Brown had not been recognized by a mafia acquaintance named Nicholas LoBrutto who is a patient in Manhattan Catholic Hospital. LoBrutto has stomach cancer and threatens to squeal to Dr. Brown's former crime boss. If Dr. Brown cannot keep LoBrutto alive, the mafia will be notified where to find the physician and he will be eliminated. Dr. Brown assists during LoBrutto's surgery but the mobster experiences ventricular fibrillation postoperatively. Dr. Brown's two medical students mistakenly administer intravenous potassium and LoBrutto dies.

A group of thugs quickly infiltrate the hospital and it appears likely that Dr. Brown will be exterminated. He risks his life to prevent a young woman from having her leg amputated for an erroneous diagnosis. The thugs capture Dr. Brown and detain him in the blood bank freezer. He removes a piece of bone from his own lower leg (an autofibulectomy) to use as a weapon and proceeds to kill the entire gang of murderers. Dr. Brown is sure to be dismissed from Manhattan Catholic Hospital but realizes there is still much he hopes to accomplish as a physician. With some help from friends in the Witness Protection Program (and a likely sequel to this novel on the horizon), it's a good bet that Dr. Brown is not likely to retire his stethoscope (or firearms) anytime soon.

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After reading Tad Friend's article, "Jumpers: The Fatal Grandeur of the Golden Gate Bridge" in an October 2003 issue of The New Yorker, filmmaker Eric Steel became so fascinated by the mystery of the final, dark moments of a human being who makes the long journey across the bridge to his or her death that he finagled $100,000 worth of equipment and moved from New York to San Francisco.  At 5:00 AM on a rainy New Year's Day in 2004, Steel and his ragtag crew set up their cameras, beginning a strange year-long vigil.  Training telephoto lenses on the mid-span of the bridge, they peered intently from dawn to dusk, watching for "suspicious behavior" or a "sense of despair" among the crowds passing back and forth.  During that year of filming, twenty-two people ended their lives, some caught on tape and some not; however, six attempts were thwarted by the film crew who became quite adept at indentifying potential victims and alerting the Bridge Patrol. 

Photographed from multiple perspectives, at all times of day, and in all kinds of weather, the Golden Gate Bridge is the main character of this documentary film.  It is formidable; it is magnificent; it is ominous; it is alluring.  According to the film:  "More people have chosen to end their lives [here] than anywhere else in the world."  The sublime images not only capture the many facets and features of the structure, but they also illustrate the emotions and represent the psychology of the other narratives intertwined in the film:  the stories of seven individuals who jumped from the bridge during the course of that year.

There is thirty-four year-old Gene, a haunting figure dressed all in black whose story begins and ends the documentary.  Like the film crew, we watch him prowl the bridge day after day, his long dark hair whipping in the wind until he makes that final leap, a dramatic backward dive.  There is forty-four year-old Lisa, who has suffered throughout her adult life with schizophrenia and who disappears off the bridge on Easter Sunday afternoon.  And there is twenty-two year-old Philip whose parents relate the history of their son's struggle with mental illness.

In addition to using footage of the bridge being obscured by fog as an evocative image of the progressive suffocation of self, the filmmaker employs long shots of the island of Alcatraz to symbolize the prison of mental illness.  Indeed, Philip's father describes his son's leap from the bridge as a release, "the only way he could get free."

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The unusual title is borrowed from Nathaniel Hawthorne's story, "The Custom House," to suggest a shift in fortune when immigrants "strike their roots into unaccustomed earth."  Set almost entirely in the United States (the unaccustomed earth), eight separate stories are connected most obviously by cultural dissonances affecting characters who are Indian or have Indian parents.  Three of the stories, however, are linked by a strong narrative connection that is unexpected, profound, and unforgettable.

For Indian readers, the narratives describe complexities about migration patterns, cultural issues, alienation, and generational differences. The stories deal with well-educated children of immigrants who become offspring their parents barely recognize.  For other readers, the stories reveal situations about families and customs that are strangely familiar, especially those stories dealing with relationships between parents and children.
 
The forces of globalization have created and accelerated shifts that can seem staggering to all parents intent on preserving cultural patterns and traditions. Whether Indian or not, most parents experience a sense of alienation while watching their children flourish in a world that increasingly appears unfamiliar and foreign.

Not surprisingly, the stories concern strains and challenges affecting mixed relationships and/or mixed marriages and stresses on disapproving and disappointed parents, while others focus on children succumbing to drugs and alcohol(for the latter, see annotation of "Only Goodness").  All deal with some kind of emotional loss, but provide connections to feelings experienced by children and their parents in life's quiet and more kinetic negotiations.
 
The first story is about Ruma, a well-educated woman who lives in Seattle with her work-alcoholic American husband, and child, Akash.  Generational and cultural contrasts are revealed in overt and more subtle ways when her recently widowed father arrives for a short visit. Even though Ruma's complete assimilation into her non-Indian home as well as her on-going worries about her father's loneliness are major considerations, another story thread is spun, one that quietly reveals the father's thoughts about himself and a new relationship made recently during a vacation in Europe. Ruma's assumptions about her father, his loneliness, his possible dependency on her, and the Seattle vacation as a possible signal for relocating to her household turn out to be entirely wrong. 
 
The last three stories follow a boy, Kaushik, and girl, Hema, into adulthood.  In the first story, "Once in a Lifetime," Hema recalls her first memory of Kaushik when he was 9 and she was 6. The occasion was a farewell party for Kaushik's parents who were returning from the United States to live in Calcutta. The mothers, who grew up in Calcutta, but met in Cambridge, Massachusetts had become very close and were saddened by this separation.

Seven years pass before Kaushik‘s parents return to the Boston area and stay with Hema's family. Hema found the now 16-year old young man appealing, but brooding and totally uninterested in her. Even though Hema expected Kaushik to be Indian-like in behavior, he was more Americanized than she was. That the family had flown first-class shocked Hema's conservative family as did their new smoking and moderate drinking habits.

After a long search, and to the relief of Hema's parents, Kaushik's family found a  modern house on the North Shore.  Before they moved to their new home, Kaushik surprised Hema with confidential information-- his family had left India to seek treatment in Boston for his mother's breast cancer.  All medical efforts had been unsuccessful and his mother had only a short time to live.  Hema promised to keep this disclosure secret and grieved for the woman she had come to admire and love.
 
The second story in the link, "Year's End," is narrated by Kaushik.  With the opening line, "I did not attend my father's wedding," readers know that Kaushik‘s mother has died.  His father, in Calcutta for a visit, had married Chitra, a woman with two young daughters, and all would be returning to the North Shore house to live. Most of the chapter recounts the ordeal of the mother‘s dying, Kaushik‘s tremendous sense of loss, and the loneliness experienced by him at Swarthmore College.  No mention is made of Hema by the desolate narrator except to remember he had hated every day spent under her parents' roof, but later had come to think of that time with nostalgia.  

"Going Ashore" brings Hema and Kaushik together in Rome where she has a study grant and a visiting lectureship and he is on vacation from his work as an award-winning photo journalist.  Hema's parents have arranged for her to marry Navin in Calcutta.  Navin has accepted a teaching position at MIT. Until her unexpected reunion with Kaushik and the intense love affair that follows, neither had experienced any real connection with another person.  The story about them in Rome seems to represent an independence from the cultural forces that have shaped their lives, but this independence is short lived.  Ultimately, she is unable to set aside the expectations imposed by her parents.  The consequences of their final separation are more than any reader might imagine.

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Job, a prosperous but god-fearing man, is stricken with a series of misfortunes, losing his goods, his sons, and his health all as a result of a wager between God and Satan about whether or not a "perfect and upright" man will remain thus under relentless misfortune (1:1). As he sits in ashes, covered with boils, a group of friends come to mourn with and comfort him, sitting beside him for seven days and nights in complete silence "for they saw that his grief was great" (3:13).

Job proves a good bet by never following his wife's advice to "curse God and die," but he does deliver a series of lamentations and questions about his condition, countering his friends' theories about the possible causes (unacknowledged sin, primarily) for his troubles and finally asserting his desire to speak directly to God and ask Him the reason that a good man has been burdened with a host of sorrows (2:9). Job's friends, including a fourth speaker, Elihu, who was probably added into the text by a later writer, reprove him angrily.

God appears suddenly and speaks to Job from within a whirlwind, ending Job's complaints with his chastening response. Rather than offering a rationale for Job's suffering, God reminds him of the limitations of a human perspective. Ultimately God rewards Job and reprimands Job's friends.

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Dr. Lois Ramondetta was a fellow in gynecologic oncology at M. D. Anderson Hospital in 1998 when she met Deborah Rose Sills, a professor of comparative religion, who had undergone surgery for ovarian cancer the year before and was re-admitted for small bowel obstruction. Ramondetta and Sills "clicked," and their relationship developed over several years from doctor-and-patient to close friendship and eventually co-authorship of this memoir. The women tell separate stories (Sills's are in italics), which interact more and more as the relationship progresses. Ramondetta writes about marriage to a medical classmate, its rapid unraveling under the stresses of residency, her infant daughter, and the complexities of her life as a single mother. Sills' sections tell of a highly regarded professor accepting a life with cancer, but struggling against reinterpreting herself as sick. Some of their interactions take place at MD Anderson Hospital, as Sills returns for a bone marrow transplant and later for management of recurrences and complications.

Their friendship also blossoms at their respective homes in Houston and Santa Barbara. Among the stories they share is that of Ramondetta's courtship and marriage to a local disk jockey, and the rock-solid support of Sills's family.  In addition, they begin to collaborate, first on a lecture and then on an academic paper about spirituality and ovarian cancer. This dialogue eventually leads to the book itself, completed only after Sills's death in 2006.

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This self-portrait includes two images of the artist. The first lies with her back toward us on a hospital gurney, her head to the left, apparently anesthetized. She is wrapped in a white sheet except for her lower back, which is exposed to show two large surgical cuts dripping blood. The second figure sits facing us in a chair in front of the right side of the gurney.

The sitting figure is essentially the familiar Frida Kahlo of many self-portraits--erect, beautifully dressed in colorful Mexican style, and her face composed in spite of the tear on her right cheek. The difference here is the presence of medical paraphernalia. The upright Kahlo holds in her lap a large back brace, and she seems to be simultaneously wearing the same device under her dress. In her right hand she holds a small flag with a Spanish inscription that could be translated: "Tree of hope, stay firm."

The two figures float in space just above a lifeless and deeply eroded desert landscape. In front of them, at the very bottom of the painting, is the suggestion of an abyss. The painting is divided laterally, the left side ruled over by a sun and the darker right side (the figure’s left) ruled by the moon.

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