Summary:

This book contains 17 short stories, all set in an in-patient hospice, all exploring the reactions of patients and their caregivers--both family members and professionals--to the last stages of terminal illness. A woman struggles to find the strength to write last letters to her loved ones, nurses are surprised when a seemingly unconscious patient suddenly joins in their conversation; the hospice chaplain becomes a patient; and so on. In the title story, a dying woman's daughter finally manages to answer honestly when her mother asks when death will come: "Soon."

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Dr. Sacks was growing up in London during World War II and had a very traumatic experience when he was sent away from his home for protection from the bombing. He and his brother were sent to a boarding school, where they were beaten and underfed. Sack's home had been filled with a wonderful extended family of physicists, mathematicians, teachers, and chemists, in addition to his parents who were both practicing physicians. Being unusually bright and talented, Sacks responded to a wide variety of stimuli when he returned to this environment.

He became fascinated with the chemistry of metals and with the periodic table of elements. An uncle, for whom the book is named, was a manufacturer of light bulbs with tungsten filaments and encouraged him in setting up his own chemistry laboratory in the family laundry room, to do experiments. The family allowed him a great deal of freedom, which encouraged his creativity.

In writing about these experiences Sacks includes the history of the development of chemistry concepts that fascinated him. It was only much later that his interests moved on to the natural sciences and medicine. He says that his parents had been tolerant and even pleased with his early interests in chemistry but by the time he was fourteen they felt that the time for play was over. He kept a journal from the age of fourteen and took advantage of every opportunity to read broadly and experience nature, music and art.

In retrospect, however, Sacks felt that life was shallower after he left behind his passion for chemistry. He says that he dreams of chemistry at night. This description of such intense interest in the world around him and the people he read about or knew explains a great deal about his great success as a neurologist and as a remarkable story teller.

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The story takes place in the winter at Einfried, a sanatorium directed by Dr. Leander, a physician "whom science has cooled and hardened and filled with silent, forbearing pessimism." A young married woman (Frau Kloterjahn) arrives as a patient. Her husband denies the seriousness of her illness by calling it merely "a problem of the trachea." In reality, Frau Kloterjahn, who had recently given birth to a healthy son, is dying of consumption.

A not-so-sick novelist (Detlev Spinell) also lives in the sanatorium, and he quickly develops a romantic obsession with the new patient. One day most of the residents go for a sleigh ride, but Spinell and Frau Kloterjahn remain indoors. He cajoles her to play the piano for him, which has been forbidden. Picking up a score from "Tristan und Isolde," Frau Kloterjahn plays beautifully until exhausted. When her death becomes imminent, Herr Kloterjahn returns to her bedside. At this point Spinell writes Kloterjahn an excoriating letter, saying (in essence) that the man is an insensitive slob who doesn't understand his own wife.

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The editor, herself a writer and one who has suffered depressive episodes, collects a series of personal essays or illness narratives about experiences with depression. Her contributors are all artists, primarily writers, who generally but not exclusively speak to the relationship between their art and their mood disorders. Some of the essays included have been previously published, but most are original contributions to this collection. The collection is introduced by Kay Redfield Jamison whose academic work has examined the relationship between creativity and depression, including manic-depressive disease.

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Charlie Babbitt (Tom Cruise), a young businessman aggressively pursuing his fortune in collector automobiles, hears that the wealthy father from whom he has been estranged for years, has died. He attends the funeral planning to remain only long enough to hear the will and receive the fortune he believes is coming to him. He is shocked to learn that most of the fortune has been left in trust to someone whose name is not disclosed. Investigations lead him to a home for the mentally handicapped where he discovers he has a brother, Raymond (Dustin Hoffman), an autistic savant, who has been housed there since Charlie's early childhood.

Charlie kidnaps him, planning to keep him "hostage" until the institution delivers the half of Raymond's inheritance he believes rightly to be his. On the road, two things happen: 1) he is baffled, angered, and confused by the paradoxical behavior of this genius with no emotional vocabulary and no social skills and 2) he uncovers early memories of Raymond as the "Rain man" who comforted him when he was very small. He takes Raymond to Las Vegas to exploit his card-counting skills, wins enough at blackjack to get kicked out of the casino, and ends up calling Raymond's guardian out to California, hoping to be entrusted with his guardianship.

He is finally convinced, however, that Raymond is indeed incapable of progressing in relationship much beyond where he is, and that he, Charlie, is not sufficiently equipped to care for him. He sends him back to the institution, committed to maintaining relationship not for the money, but for its own sake. Mystified as he is by the brother whose humanity he can't quite fathom, something like love has been awakened in him in the course of his painful journey in caregiving.

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Summary:

The novel opens with a man known only as Pilgrim hanging himself in London in 1912. Despite being pronounced dead by two physicians, he somehow lives. Pilgrim has attempted suicide many times before but is seemingly unable to die. He claims to have endured life for thousands of years but has tired of living and only longs for death. He has crossed paths with many historical figures including Leonardo da Vinci, Saint Teresa, Oscar Wilde, and Auguste Rodin.

After his most recent suicide attempt, he is admitted to a psychiatric facility in Zurich as a patient of the famous Swiss psychiatrist, Carl Jung. Pilgrim eventually escapes from the institution and masterminds the successful theft of the Mona Lisa from the Louvre. Next, he sets the cathedral at Chartres on fire. The novel ends with Pilgrim driving a car into a river on the eve of World War I. His body is never found.

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This first-person narrative of a runaway girl's short stay in a residential mental health center develops her impressions, resistances, and accommodations from her admission ("I can see right away it's a nuthouse") to her release. These include reluctant interviews with the staff counselor, uncomfortable encounters with nurses, observations of other patients' erratic behavior, and efforts, finally, to communicate with a very detached roommate.

"Stevie" speaks from a place of anger and mistrust. She attempted suicide in the girl's bathroom by slicing her wrists, but regards herself as otherwise quite competent. A turning point comes for her when her silent roommate sings a song she's written which ends with the words, "Don't forget to cry." This moment of vulnerability, which also unveils surprising talent and beauty, moves Stevie from anger toward curiosity and sympathy.

She takes steps toward friendship with her roommate, and finally toward reconciliation with her mother who, she realizes, really wants her home. As she leaves, Zena really addresses her for the first time, reminding her, "Don't forget to cry."

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Dedicated to the poet's mother, Naomi Ginsberg, the poem is a narration and a lament arising from Ginsberg's memories, three years after Naomi's death, of her life and of his life with her. This long poem is subdivided into 5 sections that address the dead woman directly.

The highly poetic Part I is a reflection on death, life ["all the accumulations of life, that wear us out" (p. 11)], mortality, the link between the dead and the living, the great unknown that lies beyond death--not in the abstract, but in the signs and symbols of Naomi's life/death and in the issues that remain for her son: "Now I've got to cut through--to talk to you / --as I didn't when you had a mouth." (p. 11)

Part II is a long narration of Naomi's life story, especially the history of her mental illness and of the role it imposed on Ginsberg himself. Ginsberg "was only 12" when he brought his mother to what was intended as a rest cure; instead, she became psychotic and was hospitalized, leaving Ginsberg with an everlasting sense of guilt. Separated from her husband, Naomi spent years of paranoia in chaos and institutionalization; son Allen vacillated between pity, disgust, escape in travel, and (homo)sexual exploration.

At the last meeting with his mother, in a mental hospital, she didn't recognize him. While living in San Francisco, two days after Naomi died, he received a letter from her: "Strange Prophesies anew! She wrote--'The key is in / the window, the key is in the sunlight at the window--I have / the key--Get married Allen don't take drugs . . . .' " (p. 31)

These passages give a vivid sense of mental disease and its impact on the family. Ginsberg is not self-pitying or self-indulgent in his description of the illness that laid siege to his mother's life and which so strongly influenced his own life for years. Modestly, he inserts: "I was in bughouse that year 8 months--my own visions unmentioned in this here Lament--" (p. 25)

The brief "Hymnn," is a blessing: "Blessed be you Naomi in Hospitals! Blessed be you Naomi in solitude! Blest be your triumph! . . . Blest be your last year's loneliness!" Part III (one page long) is a short recapitulation of Naomi's life, and uses her own cryptic words to try to make sense out of her life as well as of all life and death: "But that the key should be left behind--at the window . . . to the living . . . that can . . . look back see / Creation glistening backwards to the same grave . . . ." (p. 33)

Part IV, a chant, reaches beyond the personal to social history: "O mother / what have I left out"; (p. 34) "with your eyes of shock / with your eyes of lobotomy; " "farewell / with Communist party and a broken stocking"; "with your eyes of Czechoslovakia attacked by robots . . . ." (p. 35) Ending with the short part V, Ginsberg cries out to the shrieking crows circling in the sky above His mother's grave, "Lord Lord O Grinder of giant Beyonds my voice in a boundless / field in Sheol" (p.36) [Sheol is a Hebrew word meaning "the abode of death."]

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Warren here supposedly presents the papers of a late friend, detailing the interesting cases he had encountered as a physician. In fact, the "cases" are sensational short stories, presented as a novel due to the framing chapter introducing the narrator's "Early Struggles" to make a living as a physician. Other stories investigate typically Gothic themes like ghosts, duels, graverobbing, elopements, and broken hearts, with other scandalous problems like gambling, dissipation, murder, domestic abuse, and suicide. Medical topics include mental illness, epilepsy, hysterical paralysis ("catalepsy"), cancer, toothache, consumption, syphilis, heart disease, alcoholism, disease of the spine, gout, amaurosis (blindness), puerperal hemorrhage, measles, and stroke ("apoplexy").

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A sudden epidemic of blindness spreads throughout an unidentified country. When those who have lost their sight are examined, however, no evidence of pathology or damage can be found. The afflicted all describe "seeing" not darkness but rather a dense, impenetrable whiteness.

Because the government believes the disease is contagious, those people initially affected are quickly quarantined in a former mental hospital that is guarded by soldiers. There, the blind are treated like lepers and live like animals. Enigmatically, the wife of a sightless ophthalmologist has been spared from going blind. She functions as both protector and caregiver of a small group of blind people. They escape their imprisonment only when their captors (and presumably everyone except the ophthalmologist's wife) lose their sight.

Life is reduced to a constant search for food. As the situation grows even more grisly, vision is not only abruptly restored but perhaps with a clarity greater than ever before. When crowds of people rejoice "I can see," the reader wonders whether their earlier loss of sight was genuine or maybe some form of psychic blindness or spiritual malaise.

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