Summary:

The diagnosis is delivered in the opening sentence: "a bad heart." Anton Rosicky is an immigrant to the United States from Czechoslovakia. The 65 year old man and his wife, Mary, own a farm in Nebraska. They have five sons and a daughter. Rosicky is an ordinary fellow with one remarkable quality--a genuine love for people. He is attached to his family, the land, and hard work. His physician, Doctor Ed Burleigh, writes a prescription for Rosicky and instructs him to avoid strenuous activities.

The young doctor is quite fond of Mr. and Mrs. Rosicky and speculates that tender and generous people like this couple are more interested in relishing life than getting ahead in it. Although he knows better, one day Rosicky overexerts himself raking thistles and bringing some horses into the barn. He experiences chest pain accompanied by shortness of breath. His daughter-in-law, Polly, helps him into bed and applies moist hot towels to his chest.

Unfortunately, Dr. Ed is out of town--his first vacation in seven years. Rosicky appears to recover from the episode but the following day after enjoying breakfast with his family, the chest pain recurs and he dies at home. When Dr. Ed returns from his trip, he stops at the graveyard near the farm. He realizes that the natural beauty and serenity of the landscape make a fitting final resting place for a farmer like Rosicky and a man whose life was not only rich with love but deeply fulfilling.

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Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.

Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.

The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.

Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.

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This story of one exceptionally accomplished family's discovery of their past and future relationships with Huntington's Disease (HD) is also the story of how the Wexler family changed the cultural narrative of HD for other families at risk for this genetically-transmitted and currently incurable disease. The HD diagnosis of Leonore Wexler (the author's mother) inspires Milton Wexler, a psychologist, to create a major foundation for HD research, which develops critical mass and influence as Leonore Wexler's condition deteriorates, and after her death. The book interweaves the story of the Wexlers' emotional and other negotiations with HD and the story of their efforts to create an HD community comprised of those with active symptoms of HD, family members, advocates, and researchers.

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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Summary:

Patrimony relates the final illness and death of Philip Roth's father, Herman Roth. It begins as a misdiagnosis of Bell's palsy, which is eventually diagnosed as a brain tumor. Further tests reveal that it is cancer, operable only with great effort and little promise of cure or even significant palliation. The family (including Herman) decides against surgery and remains in close contact with him until his death.

Roth recounts his father's increasing weakness and helplessness, his own emergency quintuple bypass surgery, and his dreams of his father speaking to him from beyond the grave. Writing this book, he concludes, is the natural and necessary process in bearing witness to his father's life and death.

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High-school freshman Barry Wilson enrolls in Bay Area Social Concerns and must visit 83-year-old Miss Pierce at Cherry Garden Convalescent Hospital. Barry, short, shy, and miserable at his first visit, thinks of pictures of mummies he's seen in National Geographic; Miss Pierce thinks he's somebody named Willie.

But as Miss Pierce talks about her brother Willie and her childhood as a cripple, Barry gets interested. The story isn't a happy one, and Barry, himself adopted, identifies with Willie's abandoned child and becomes angry with the world until he comes to realize how important he is to his parents.

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Physician, poet, artist, parent, astute observer of his environment, Dr. Schneiderman gives us a wide vision of the things that inform his personal world. This collection of poems and pen and ink sketches spans almost four decades of its creator's life and life experiences. The author has collated his work around nine key foci, roughly but not totally, temporal in sequence. Through his eyes we meet his history related to New York City, his profound love for and attachment to his beloved wife and son, his humbleness before the labors of his chosen profession and the persons he meets in this context, and, finally, his tributes to the bravery of the men and women who responded to the horrendous assault of 9/11/01 upon his birthplace, the Great City.

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This book represents collaboration between neurologist-poet Jerome Freeman and potter Richard Bresnahan. Thirty-seven black-and-white photographs of ceramic pieces by Bresnahan from the Minneapolis Institute of Arts are interspersed with 56 of Freeman’s short poems. In his introduction Freeman writes, "Richard’s pottery (champions) both our environment and the need to nourish our humanity through cooperation and caring." Likewise, Freeman notes that much of his own poetry "attempts to focus upon caring." As he also points out, "the economy and simplicity of pottery can resemble the spare verbiage and subtlety of successful poetry."

Indeed, Freeman’s poems are simple, direct, and evocative. Many of them, such as "Carrying On" (p. 3), "Ten Year Old with Rheumatoid Arthritis" (p. 17), and "DTs" (p. 49), create images of patients. (However, the 88-year-old arthritis sufferer in "Carrying On" by no means considers himself a patient!) Others evoke more general human responses to severe illness ("Apocalypse," pp. 6-7), or to the threat of illness ("In Defense of the Hypochondriac," p. 15). In the former, Freeman writes of a comatose ICU patient, "All about keep mostly / thinking there’s a mistake / here somewhere." In the latter poem, Freeman concludes, "The worst might / happen. Keep crossing / bridges before you come / to them."

These poems also evoke the landscape and flora and fauna of the Great Plains: "Lake Superior in February" (p. 29), "The Prairie Gentian" (p. 79), and "When Wild Turkeys Come Out of the Woods" (p. 87). But the outside and inside worlds are closely connected. In "Coma Vigil" (p. 59), a poem about a woman in a persistent vegetative state, he begins, "Dawn’s bounty spills over / the rim of sky to spread / across darkened / prairie." Does the woman want to be kept alive in her "coma vigil"? The poem ends, "The time has / come. / Shadows still conceal / easy ways of letting / go."

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Henry Moss is a medical geneticist specializing in Hickman syndrome, a fictitious disease resembling progeria. Children with Hickman syndrome experience premature aging and invariably die before the age of twenty. The physician meets Thomas Benhamouda, a teenager who genetically has Hickman syndrome but astonishingly has no physical manifestations of the disease. Dr. Moss identifies a protein that "corrects" Hickman syndrome in the blood of Thomas and proceeds to synthesize it.

Dr. Moss violates medical ethics by administering the experimental enzyme to his favorite Hickman patient, William Durbin, a dying 14-year-old boy. It is a last-ditch effort to save William's life even though the substance has not been tested for safety or efficacy in human beings. Dr. Moss also injects himself with the enzyme. He realizes the tremendous potential the drug has not only in curing Hickman syndrome but also in extending longevity in normal individuals. He is well aware of the great financial rewards he might reap from his discovery.

After a series of injections, William's deteriorating health stabilizes and even improves but he dies in his home. Dr. Moss has failed to save the doomed boy but in the process of breaking the rules and risking his career has learned how to understand and appreciate his own life as well as reconnect with his family.

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In the first of this poem's three stanzas, the narrator is looking out the window, presumably on or near his fiftieth birthday. He watches as a baby possum is snatched up by a fox while the possum's mother stands dumbly by. Seeing this, the narrator notes that it is one more thing he "couldn't do anything about." In fact, he sees the drama dispassionately. He says that instead of "feeling very much" he had the sense of "something dull / like a small door being shut, / a door to someone else's house."

In the next stanza, later that night, the narrator is flipping through the TV channels but stops when he is captivated by a nurse who "had a beautiful smile / while she spoke about triage and death." Again he observes death from afar as the nurse talks about her experiences in Viet Nam and how a dying soldier asked her to bend closer so he could smell her hair.

In the final stanza, the narrator's wife comes home, tired. The narrator, however, is somehow energized; he wants to talk about the possum, the fox, and the young man who "wanted one last chaste sense / of a woman." The wife wants a drink, some music, everything "normal." But the narrator, transformed by the nurse's smile, its "pretty hint of pain / the other expressions it concealed," is no longer just an observer.

He now has "something to say," something almost inexpressible about life and death, the death that he is moving closer to but was, at the poem's beginning, unable to face. The nurse's experience--her proximity to death, her ability not only to observe but to acknowledge and honor it--has somehow transformed him.

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