Summary:

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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Sea Creatures is Dr. Vernon Rowe's first collection and contains forty-eight poems divided into two sections: "Creatures of the Inland Seas" and "Out Far and In Deep." The poems are succinct and focused. Much of the imagery is derived from nature, as in the title poem, where the poet-neurologist-helicopter pilot likens his descent through the sky to a dive into a deep and ancient ocean. Poems in the first section are directly related to the poet's life as a physician; works such as "Paralyzed" "Brahms' First, First Movement" and "Wasted" are empathic portrayals of patients.

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A wonderful poem about an old, dying man recognizing he is dying before any one else in the family will admit it. He wants them to help him die--a kind of family consensus on euthanasia, which he seems to control. After much family discussion, they agree to help him by giving him enough pills to "put him to sleep." He jokes with his family as they assist his dying: "On the day it would happen, the old man would be funny again: wolfing down handfuls of pills, 'I know this'll upset my stomach,' he'd say."

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This is another of Hemingway's dense vignettes, filled with nuance but spare in style. The anecdote revolves around the difference between a clean, bright cafe and a dark, not-so-clean, bar as a place for lonely men to spend the long, sleepless nights. Two waiters discuss a lingering patron in a cafe who overstays his welcome as the night wears on. The old man gets quietly drunk each night; just last week he tried to kill himself, but was rescued.

Tonight he tries to pass the night in a clean, well-lighted place. The young waiter, impatient, to get home to his wife, does not comprehend the importance of this place to this old man's survival. The older waiter, who does understand, walks into the night himself, unable to find his own clean, well-lighted place in which to pass a lonely and sleepless night.

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Tomorrow, as soon as it dawns, I will go to visit your grave, Papa, Adriana, in the long abandoned family home, reflects on her life before her father’s death when she was fifteen. She remembers their closeness and similarities, but also their distance and differences. Wedded by their physical resemblance, temperament and interests, they are also separated--by silence and sorrow, desires and disillusionments.

One night the adolescent tries to discuss her father’s torment, but both become angry. It is their last conversation. In the hours that follow, her beloved father takes his life with a single bullet.

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The initial chapter in this novel, Of Mist, and Grass, and Sand (annotated separately), sets the stage for the quest of the young healer/heroine, "Snake," to find a replacement for the snake she had carelessly allowed to come to harm, in the course of caring for a seriously ill child. The remainder of this coming-of-age novel chronicles Snake's journey during her "proving year" (aka/residency training).

Over the course of this year, Snake continues to minister to the sick and encounters, among others, a patient who demands assistance in suicide, a patient who refuses treatment for a gangrenous leg, and a young girl who has been sexually abused (whom Snake eventually adopts and begins to apprentice). There are, as well, myriad lessons in humility, rigidity of thought, and ethnocentrism.

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Condemned to death, Socrates, strong, calm and at peace, discusses the immortality of the soul. Surrounded by Crito, his grieving friends and students, he is teaching, philosophizing, and in fact, thanking the God of Health, Asclepius, for the hemlock brew which will insure a peaceful death. His last words are "a cock for Asclepius!"

The wife of Socrates can be seen grieving alone outside the chamber, dismissed for her weakness. Plato (not present when Socrates died) is depicted as an old man seated at the end of the bed. The pompous "medical celebrity"--as Tolstoy might describe him, were he one of Ivan Ilyich's five consults (The Death of Ivan Ilyich, see this database)--is pontificating on his rounds about the pharmacological details of the medication.

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Agnes Higgins envies her husband Harold's ability to have brilliant and captivating dreams, nightly exotic dreams which he can recount to her in vivid detail. Agnes's dreams, when she has them, are ugly and frightening. Harold begins to coach Agnes in techniques for achieving perfect dreams. Agnes practices. She becomes progressively preoccupied with learning how to dream, but is unable to achieve a satisfying result. She becomes depressed, insomniac, and finally takes a fatal dose of sleeping pills. Harold finds Agnes "with her tranquil features set in a slight, secret smile of triumph . . . ."

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Susan and Matthew Rawlings marry in their late twenties and raise four children. When the youngest child goes off to school Susan, who quit her job to mother, does not experience the sense of freedom that she expected. She feels simultaneously as if she has nothing to do worth doing and never has a spare moment to herself. Her day is taken up in waiting for the children to come home, consulting with the maid or worrying about dinner. She becomes anxious and distant, pulling away from her husband, who begins to have affairs.

Finally, in order to get some time alone, she rents a hotel room every afternoon where she just sits and thinks. Her husband assumes she is having an affair and tracks her down. Knowing that his rational world will not recognize her "irrational" feelings she tells him that she is indeed having an affair. The next day, she returns to the room and kills herself.

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The story begins with Dr. Frank Rapallo's son recalling his father's funeral and then progresses with a series of vignettes that show us who Dr. Rapallo was and how he died. Rapallo was an old time doctor who loved his work and whose patients told him "everything."

The boy was only seven when his father had radiation treatment for a cancer of his shoulder; subsequently, he had surgery to try to save the arm, but this left a hole "big enough to fit my hand." The hole never healed. He lost the arm anyway, but continued to perform operations with the assistance of Matthew, his young Japanese partner. The son reflects on his father's experiences in World War II--he was profoundly moved by the destruction in Japan and by the courage of Japanese physicians.

A strong, dedicated doctor, Rapallo was painstakingly honest, both with his patients and himself. In the end, he developed an incurable infection in his incurable wound. With characteristic dignity, Dr. Rapallo set about doing his last things--seeing patients for a few hours, visiting with his old friend Finch--and then in the evening took the contents of the vial he had prepared, and died.

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