Summary:

Aurelio Escovar is introduced as a poor dentist without a degree. He is busy polishing false teeth early one morning when the mayor arrives to see him. At first he refuses to see this would-be patient, until the mayor, who has been suffering severe toothache for five days and is desperate, threatens to shoot him. Eventually the dentist lets him in, examines him, and then removes the infected wisdom tooth, without anesthesia.

We realize that the dentist has deliberately made the mayor suffer all this time, and he gives the reason as he pulls out the tooth, saying "Now you’ll pay for our twenty dead men." When the mayor has recovered and wiped his tears, he leaves, telling the dentist to send the bill. When Escovar asks whether to send the bill "To you or the town?," the mayor replies, "It’s the same damn thing."

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In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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This lively volume of medical history chronicles the forms of suffering, illness, injury, and treatment endured by the members of the Lewis and Clark expedition of 1805. Beginning with three chapters of political and medical history to set the context, the story follows the adventures of the extraordinarily fortunate "Corps of Discovery" among whom Lewis was the most trained in the medicine of the time (having studied in preparation for the trip under Dr. Benjamin Rush of Philadelphia), and he only an amateur. Even professional medicine of the time was approximate and largely ineffectual, limited mostly to purgatives, opiates and laudanum for pain relief, bleeding, and topical applications of various compounds or herbal substances.

The story chronicles the main events of the trip based on the extensive journals of Lewis and Clark as well as other historical account, maintaining focus in each chapter on the medical incidents including gastrointestinal distress from parasites and contaminated water; effects of overexposure like hypothermia and exhaustion; infections from wounds and scratches; syphilis; dislocations; muscular spasms; mosquitoes and other insect bites; snakebites and other animal attacks.

Along the way Peck pauses to explain the rather rudimentary medical theories upon which treatments were based, the effects of particular known treatments, and what Lewis and others likely knew, guessed at, or didn’t understand about lead, mercury, opium, and certain herbal substances they used. He speculates about the contexts of their medical decisions and offers occasional contemporary analogies to help readers imagine the circumstances and tradeoffs the explorers faced.

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Editor Chip Spann created this anthology as part of his Ph.D. dissertation in creative writing. The poems were selected because Spann hopes they "can be a comfort to the sick and a rabble-rouser for those who work at getting well" (5). The book’s 234 poems have been organized into seven sections, each section named with a phrase from one of the poems contained therein. Each section is prefaced by an introduction that focuses on Spann’s own journey from a difficult childhood and unanchored young adulthood to his current life in which he is able to combine a love of reading and writing poetry with his background of working with patients in a variety of settings -- he leads a writing group of patients, caregivers, and health professionals at Sutter Medical Center in Sacramento, California.

The seven sections concern: the body; illness and life’s journey as quest; "feelings that are screaming to get out"; looking inward at dark truths; reflecting on "early wounds"; finding creative inspiration from unexpected and small things; and "perspectives on death and aging." I counted approximately 80 poets who are represented in this anthology; those with the greatest representation (number of poems) are Raymond Carver, Lucille Clifton, Emily Dickinson, Grace Paley, Muriel Rukeyser, Mowlana Jalaluddin Rumi, May Sarton, William Stafford, and May Swenson.

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The unrequited love of the narrator is compared to a devastating fever. Reason, "the physician," is ignored and cannot abate the disease. Without reason, madness (fever) reigns; and the poet renounces his beloved as "black as hell, as dark as night."

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A small-town doctor’s son is saved by a black man from a burning house. In gratitude, the doctor takes it upon himself to salvage the life of the badly burned and disfigured hero. Others warn him that he is doing no service to the patient, but the physician cannot let go of one whom he owes such a profound debt. The town begins to fear the newly created "monster." The burned man’s life becomes a nightmare of rejection; the physician and his family are progressively rejected by the community.

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A daughter and her mother play out a psychological drama that is the culmination of a lifetime of poor communication and limited understanding. Laced with humor and a bit of the macabre, the scenes in this short, two-act play work inexorably toward the climax--suicide of the daughter and incomplete resolution of the mother’s confusion.

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This strange little tale, set in western Europe, revolves around the shifting relationships among an Irish doctor, a would-be Austrian baron, a circus performer, and the American woman, Robin, who is to become the nemesis of them all. The plot is unfolded in a long series of conversations, many convoluted by their stream-of-consciousness style, rather than in observed action.

The physician (it is never clearly stated that he is a fully trained physician but the point is probably moot, since he assumes the role), the most consistently present and verbal character, is a study in contradictions. He is essentially never portrayed in a classic physician role, but much is made of his profession. This may be explained by the fact that it is his profession that justifies his central position--he knows and is in the confidence of all other characters. The reader follows, by means of the long and complex dialogues, Robin’s systematic destruction of a chain of male and female lovers in what appears to be an obsessive desire for self-destruction.

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This troubling narrative opens with, "They say you see your whole life pass in review the instant before you die. How would they know? If you die after the instant replay, you aren’t around to tell anyone anything" (120). The narrator, a newborn girl on her way down the garbage chute from the 10th floor of an apartment building, reflects on what might have been had she lived long enough to have experienced life.

The structure of the piece moves the reader from floors ten, nine, into the game of chance played with dice, to "The Floor of Facts." At this juncture, the newspaper account of the newborn dead in the trash is iterated in its cold truths. The narrator laments, "As grateful as I am to have my story made public you should be able to understand why I feel cheated, why the newspaper account is not enough, why I want my voice to be part of the record" (123). The narrator shifts gears and begins to explore what her life might have been had she lived beyond these few hours.

She enters a "Floor of Opinions," where her own beliefs must be voiced and for which there must be room on the "Floor of Facts." She speculates, based on the experiences of her socioeconomic--and possibly racial--situation, whether her death will serve any purpose. On the "Floor Of Wishes" she imagines things she would have likely loved, such as Christmas. From this point, the narrative, in quick and painful anecdotes, draws the reality of the powerlessness, the limitations of love, and the brutality suffered by those in the clutches of urban poverty. Then the narrator enters the garbage compactor at the bottom of the chute, inviting us all to join her "where the heart stops."

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In their introduction to this anthology, the editors write that their goal is "to illustrate and to illuminate the many ways in which medicine and culture combine to shape our values and traditions." Using selections from important literary, philosophical, religious, and medical texts, as well as illustrations, they explore, from a historical perspective, the interactions between medicine and culture. The book is arranged in nine major topical areas: the human form divine, the body secularized, anatomy and destiny, psyche and soma, characteristics of healers, the contaminated and the pure, medical research, the social role of hospitals, and the cultural construction of pain, suffering, and death.

Within each section, a cluster of well-chosen (and often provocative) texts and drawings illuminate the topic. Specifically, literary selections include poems by W. D. Snodgrass ("An Envoi, Post-TURP"), William Wordsworth ("Goody Blake and Harry Gill: A True Story"), and Philip Larkin ("Aubade"); and prose or prose excerpts by Robert Burton ("The Anatomy of Melancholy"), Zora Neale Hurston (My Most Humiliating Jim Crow Experience), Sara Lawrence Lightfoot ("Balm in Gilead: Journey of a Healer"), William Styron (Darkness Visible: A Memoir of Madness), George Orwell ("How the Poor Die"), Ernest Hemingway (Indian Camp), and Paul Monette (Borrowed Time: An AIDS Memoir). (The full texts of the pieces by Hurston, Styron, Hemingway, and Monette have been annotated in this database.)

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