Summary:

Ruth Picardie was a journalist working in London. Shortly after her marriage in 1994 to Matt Seaton, also a journalist, she found a breast lump. After testing, she was told it was benign. Two years later, and a year after giving birth to twins, the lump enlarged and this time she was diagnosed with advanced, inoperable breast cancer. She rapidly developed bone, liver, and brain metastases and died in September 1997, aged 33.

This book consists of a selection of Picardie's e-mail correspondence during the last year of her life, the columns she wrote for the Observer newspaper (a series about dying she called "Before I say goodbye"), readers' letters responding to her column, and an introduction and epilogue by her husband. While not, then, strictly a memoir, this collection of texts constitutes an intimate view of a witty, angry young woman undergoing an intolerable illness.

The expected elements are there: diagnosis, chemotherapy, radiation, hope, the loss of hope. What is unexpected is the way these are presented, and the vividness with which we share the prospect of saying good bye to her children, her gradual detachment from her husband, and, as the brain metastases spread, the loss of coherence and the appalling silencing of her powerful voice.

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The Physician in Literature is an anthology edited and introduced by Norman Cousins that aims to illustrate the multiple ways in which doctors are portrayed in world literature. Literary selections are organized into 12 categories including Research and Serendipity, The Role of the Physician, Gods and Demons, Quacks and Clowns, Clinical Descriptions in Literature, Doctors and Students, The Practice, Women and Healing, Madness, Dying, The Patient, and An Enduring Tradition.

Some of the notable authors represented in this collection include Leo Tolstoy, Herman Melville, Albert Camus, William Shakespeare, Charles Dickens, George Bernard Shaw, Anton P. Chekhov, Orwell, Fyodor Mikhailovich Dostoevski, Ernest Hemingway, Thomas Mann, Gustave Flaubert, and Sir Arthur Conan Doyle. A healthy dose of William Carlos Williams makes for some of the most enjoyable reading ("The Use of Force" and excerpts from his Autobiography).

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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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Malcolm Vaughan, an architect, his wife, Sarah, a biochemist, and their five-year-old son, Harry, are driving home one evening. The driver of the car in front of them is acting strangely. Malcolm goes to investigate and the driver shoots him dead. The novel traces the effects of Malcolm's death from the alternating points of view of his wife and his best friend, Deckard Jones, a black Vietnam vet. Following different and often conflicting trajectories but linked by their love for Harry, both Sarah and Deck begin to move from traumatized shock to the beginnings of recovery.

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Through a compilation of journal entries, prose, and poetry, poet and activist Audre Lorde considers her breast cancer and mastectomy. Lorde emphasizes the importance of having a support network of other women. As a lesbian and feminist, she also offers a different perspective on this surgery. Her concern is not attracting or pleasing men despite the loss of a breast.

In one chapter, "Breast Cancer: Power vs. Prosthesis," Lorde considers the political implications of prosthetic breasts, arguing that hiding women’s pain and suffering disguises the widespread nature of the disease and places too much emphasis on "normal" femininity. She also writes about plastic surgeons who perform dangerous reconstructive surgery in the name of "quality of life."

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These fourteen sonnets interweave themselves to form a unified work, just as lines are repeated or echoed to interweave in the individual poems, providing an account of the author’s experience of breast cancer, radical mastectomy, and recovery. The medical details appear more prominently in the early sonnets, but gradually, other themes take precedence: suffering and how to compare relative degrees of suffering among individuals and groups; the reaction of oneself and one’s lovers to a disfigured body; and the search for affirmation, for a reason to want to live and be rid of the horror of disease and death.

Note: A relevant Web site about and by artist-model Matuschka, http://www.songster.net/projects/matuschka/, has been annotated in the art section of this database (Matuschka: Matuschka Archive).

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Art Myers is not only an art photographer but also a physician who specializes in preventive medicine and public health. Having experienced breast cancer in members of his own family, including his wife, he began to see the disease in a new light and undertook this photographic project to show that for a woman, the loss of part or all of her breast need not be a threat to her being.

In addition to the artistic nude photographs of thirteen different women from a variety of backgrounds there are meaningful personal vignettes and beautiful poetry by Maria Marrocchino. Some of the photographs show women with significant others. The women present their bodies and themselves with humor, sadness, vulnerability and honesty.

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At the age of 37, artist/photographer (and former model), Matuschka, was diagnosed with breast cancer. While her most famous response to the disease was her startling photograph on the cover of The New York Times Magazine revealing the results of mastectomy, her political activism surrounding breast cancer took many forms. (The photograph can be viewed at a Web site, Matuschka Archives )

Not only did she have a disease to confront, she felt she had the responsibility to "take on the establishment." She wrote, "My extensive research and understanding of how cancer works and how breast cancer therapies don’t--in addition to my medical nightmare with my doctor (I was first underdiagnosed, then overtreated)--I felt I had other messages to convey."

Thus, her essay describes her ongoing project: not hiding or concealing the condition, but becoming sexy and strong as a result; and reaching middle America with her images to promote breast cancer awareness, education, treatment, and prevention. Artistically and politically, she was determined to project images of women after surgery as whole people with a scar, not the decapitated torsos of medical illustration and other media that give "too much weight to the ’deformity’ that accompanies breast cancer surgery."

The essay chronicles the difficulties she had in finding sites for publication of her work, including her photo/biography, Beauty Out of Damage, and the continuing harsh criticism that she receives, much of it from "mastectomy women." In turn, she continues her harsh criticism against what she calls "backlash in the breast cancer movement," such as mixing political action with consumerism (e.g. Ralph Lauren’s "Target Breast Cancer" t-shirts that put targets on women), or mixing modeling with breast cancer activism (Cindy Crawford modeling the t-shirt rather than women who have had breast cancer modeling the shirt), among many other examples.

Her closing lines summarize the intent of her activism: "to inspire others to become involved in revolutionizing the medical profession, particularly in regard to women’s cancers. After seeing the film of my mastectomy operation, my only reply was, ’No one should ever have to go through this.’"

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In fourteenth century France, a 15 year old virgin, Blanche, levitates in church and nine months later gives birth to a daughter named Bonne. When Bonne is only 12 years old, Blanche is burned alive along with other "sinners" in a church. Bonne becomes a professional breast-feeder or "wet nurse." Her breast milk never stops flowing and seems to have restorative powers.

She finds herself catapulted from outcast to saint despite a series of catastrophes. When her town of Villeneuve is under siege and starving, she breast feeds not just children but many of the townspeople as well, asking only to listen to the individual's life story in exchange for her milk. Bonne's fate becomes deeply entangled with the lives of three friends: Godfridus (a chaste sculptor who goes mad), Hercules Legrand (a dwarf), and Radegonde Putemonnoie (a wealthy pregnant widow who hires Bonne).

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In July 1998 the poet Maxine Kumin was thrown from her carriage when her horse bolted during a competition. The type of cervical (C1-C2) fracture that she sustained is fatal before reaching the hospital in 95% of cases, and if survived, usually results in quadriplegia. This book is a memoir written in the form of a journal that begins on the day of the accident. In fact, it was nearly a month after the accident that the poet's daughter brought writing materials to the rehab hospital, and Maxine began to dictate the journal, and the two of them filled in the temporal gaps.

The journal covers her experience in the acute care hospital, the rehab facility, and the following months of convalescence at home. It ends on April 23, 1999, when Maxine climbs a hill (unassisted) near her Vermont home, looks out over the early spring vista, and concludes, "I am letting myself believe I will heal."

The journal describes the poet's physical, emotional, and spiritual experiences as she struggles, first to survive, and then to live with the "halo vest" that for months she had to wear to stabilize her fractured neck bones, and finally to regain her function and equilibrium. Much of the story is about her family--husband, son, and daughters--who mobilize from various points around the world to support her. Comments about her doctors and the medical care she received constitute only a small, at times almost incidental, part of this narrative.

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