Summary:

Frears presents a stark portrayal of London’s underbelly, a place where everything is for sale--at a price. It is a world in which most people tend to ignore or overlook: prostitution, illegal immigrants struggling to survive, illegal activities, humiliating circumstances, and most centrally, black market organ transplantation. "We are the people you don’t see." Information age technologies mix with greed and desperation to depict an engrossing and sordid narrative about real-life events occurring in places beyond the ordinary purview. This modern day thriller brings audiences to the edge of their seats as they witness harrowing and very believable accounts of marginalized members of society deprived of basic human dignities.

The story is complex but two characters dominate, a doctor from Nigeria (Chiwetel Ejiofor) now reduced by harsh circumstances to several menial jobs including taxi driving and hotel clerking, and an illegal chambermaid from Turkey (Audrey Tautou) whom he befriends and assists. She lives in constant danger of humiliation, exposure, deportation. Their paths cross in a hotel where both work, where "johns" are served by prostitutes, and where illegal and sloppy surgical procedures are employed to harvest kidneys from desperate donors.

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In this first person narrative, Dr. Edward Haggard addresses his story to James, the son of his former lover Fanny Vaughn. Haggard, once a surgical registrar at a major hospital in London, has isolated himself in a coastal town, where he serves as a general practitioner. The "present" of Dr. Haggard’s story is the early stages of World War II, when James Vaughn, a Royal Air Force pilot, lies dying in Edward Haggard’s arms.

The story’s "past" has multiple dimensions. The outermost, framing story recounts the relationship between James and Edward that began several months before the war and a year or so following Fanny Vaughn’s death from kidney disease. James sought out the reclusive Dr. Haggard to discover the "truth" about Haggard’s relationship with his mother.

The inner story consists of Haggard’s description of his reckless and passionate love affair with Fanny, an ultimately hopeless liaison between a young registrar and the wife of the hospital’s senior pathologist. Their few brief months of happiness ended when Dr. Vaughn learned of the affair, and Fanny made the realistic choice to remain with her husband and adolescent son. In a confrontation between the two men, Vaughn knocked Haggard to the floor, causing a leg injury that resulted in chronic pain and permanent disability.

Haggard resigned from the hospital and withdrew to a solitary life, in which "Spike" (the name he gives to his deformed and painful leg) is his only companion. He must constantly "feed" Spike with intravenous morphine to quell the emotional, as well as physical, pain. The situation only worsens when Haggard learns of Fanny’s death from kidney failure.

The obsession worsens further still after James Vaughn shows up at his door. As Haggard treats the young pilot for a minor wound (he has become the local RAF surgeon), he notices that James has a feminized body habitus--gynecomastia, lack of body hair, broad hips, narrow shoulders, and pre-pubertal penis. He interprets this as "a pituitary disorder" and attempts to convince James that he needs treatment. James is repulsed by these advances, which eventually escalate.

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Tolstoy’s short novel is more than a classic portrayal of dying and suffering. While those issues are central in most discussions of this work, an equally important and overlapping theme concerns choices made in life. Ivan, the protagonist, followed a well-traveled road, adhering to "comme il faut" (as is expected) or doing what one was supposed to do in career matters, selection of clothes, choosing a wife, raising children.

There is little to admire about this generally successful but thoughtless and selfish man. Ivan’s inability to invest meaningfully in family, social, or professional relationships leads to frightening consequences when he becomes gravely ill, probably with pancreatic cancer. Five different physicians with attitudes that range from arrogant to dishonest offer little assistance or compassion.

His family soon loses patience with his suffering and tends to blame him for the onset of illness. Only Gerasim, a peasant hired to assist him in his most basic needs, provides the kind of care and understanding required by the dying and increasingly isolated or deserted sufferer. The first chapter is masterful in its presentation of responses to death by friends and family members and prepares readers for the consequences of shallowness in an unlived life.

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This remarkable book takes the reader into a Dutch nursing home where many of the 300 patients are terminally ill. The main protagonist is Anton, a competent, tough, and compassionate physician who tries to discover some meaning in the suffering of his patients, while at the same time disavowing any such meaning. Anton’s colleagues include Jaarsma, a somewhat detached and bureaucratic older physician, and Van Gooyer, a young physician who still believes that science has all the answers.

The first-person narrative consists of short, punchy segments (almost like an endless series of discrete physician-patient interactions) detailing the stories of Anton’s patients and his reactions to them. Many of these persons request assisted suicide or euthanasia. Anton reveals what he feels about these requests, how he goes about judging their validity, and the manner in which he actually carries out assisted deaths. A strong spiritual theme permeates the book; while Anton denies the relevance of God and religion, he seems constantly to be searching for a spirituality that "makes sense" of contemporary life.

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This film traces the shared career and dissolution of Beverly and Elliot Mantle, male identical twins (both played, thanks to seamless special effects, by Jeremy Irons) who are gynecologists, running a successful fertility clinic in Toronto in the 1980’s. They share both work and personal lives; Elliot, the dominant twin, lectures at the hospital, accepts awards, plays the smooth professional--and seduces women. Beverly, the quiet one, sees patients, does research--and sometimes has affairs with women his brother passes on to him.

They usually draw the line at patients, not because of ethics, but because "it’s not safe." Their dealings with women have to be carefully compartmentalized, for the ambiguous intimacy of the gynecological doctor-patient relationship is difficult and dangerous for the twins, who form a psychologically unstable and deeply interdependent relationship on their own, likening themselves to the original Siamese twins, Eng and Chang, whose names they eventually take on, too.

Their symbiotic system is disrupted when a television actress, Claire Niveau (Genevieve Bujold), consults them about her infertility. She has a trifurcate uterus--the twins call her a "mutation"--and will never have children. Elliot, fascinated, seduces her, and then gives her to Beverly, who falls in love, with disastrous consequences. When Claire discovers that they’ve deceived her and temporarily leaves, Beverly becomes addicted to the amphetamines and sleeping pills that Claire habitually abuses.

The drugs impair his work, he begins to hurt patients, is hospitalized, and after a calamitous breakdown in the operating room (where Beverly attempts to use the monstrously beautiful surgical instruments he designed himself

"for operating on mutant women") both brothers keep their hospital privileges only on condition that they don’t use them. Elliot tries to rehabilitate Beverly, but realizes that the need to do so comes from their absolute interdependence--they might as well be physically joined. So Elliot begins taking drugs as well, and when Claire returns and Beverly goes back to her, Elliot breaks down completely.

The rest of the film traces Beverly’s failed attempt to become a separate individual. The instruments he invented are now, he says, "for separating Siamese twins," and, in a terrifying surgery scene, the drugged Beverly "operates" on his conscious though equally drugged brother, apparently disemboweling him. Next morning, Beverly leaves the apartment where his dead brother lies and calls the woman he loves, but he cannot talk to her. He goes back, his bid for independent identity a failure, and the film ends on a shot of the two, dead, in an embrace echoing the Renaissance anatomical illustrations of in utero twins which illuminate the film’s opening credits.

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A man dying of pancreatic cancer has reached the point where the pain is no longer controlled by morphine. In the hospital he begs for death. The surgeon tells his wife, "To give him any more would kill him." "Then do it," she says.

He returns with three syringes of morphine and finally injects them, but the man will not die. How easy it would be to suffocate him! But the surgeon rejects this thought and leaves the room, having failed to provide euthanasia.

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Three novellas by a master storyteller. For the title story, see the separate entry in this database (Epiphany). "Harmony Ain't Easy" is a tale in which Dr. and Mrs. Sams (he retains his own name here) get stranded when their car is disabled on a country road, thanks to Dr. Sams's bull-headedness. After a warmly humorous series of reverses, they are finally saved.

In the last story, "Relative and Absolute," aged Mr. McEachern is approached by three high school students who want to interview him for their oral history project. They ask him questions about living conditions and race relations in their county when he was young. During the series of interviews, as he tells them anecdote after anecdote heavy with homey wisdom, the old man and the adolescents learn to like and respect each other.

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The story consists of a series of Dr. Mark Goddard's dictated office notes regarding the care of his patient Gregry McHune, interspersed with the narrator's description of these physician-patient interactions. McHune first presents as a standard case of high blood pressure; however, in subsequent visits the man tells his harrowing story.

Goddard learns that his patient was unjustly jailed for killing a black man in self-defense. McHune tells him about racism in the penitentiary and his fight for survival, both in prison and later. Eventually McHune and his family are hounded out of town by the son of the man he killed.

Through all these losses, McHune maintains his sense of humor and easy-going integrity. Meanwhile, the elderly Dr. Goddard is repeatedly harrangued by the clinic administrator (a vacuous young man) for including extraneous details and poetic language in his dictations. As time goes on, and he is transformed by his relationship with McHune, Goddard includes more and more poetry in his office notes.

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Dr. Thomas Stockmann, a public-minded doctor in a small town famous for its public baths, discovers that the water supply for the baths is contaminated and has probably been the cause of some illness among the tourists who are the town's economic lifeblood. In his effort to clean up the water supply, Dr. Stockmann runs into political cowards, sold-out journalists, shortsighted armchair economists, and a benighted citizenry. His own principled idealism exacerbates the conflict. The well-meaning doctor is publicly labeled an enemy of the people, and he and his family are all but driven out of the town he was trying to save.

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This is the last of Cooper’s Leatherstocking tales, in which his hero, Natty Bumpo, is on the frontier as an old man living and reliving his experiences in the developing West. As the reader follows Leatherstocking in his final venture, he/she repeatedly encounters an interesting character, Obed Bat (or Battius, as he is sometimes called because of his propensity for imposing Latinate terms on everything he sees).

Dr. Bat claims to be a medical practitioner who has chosen to study the natural world, the flora and fauna of the prairie. In a novel that is replete with unintentional comedy, Dr. Bat invites apparent, intentional and pointed ridicule. He chronically mistakes his own donkey for new species of wild animal; his vapid attempts at providing any kind of serious medical advice to the various travelers he encounters remind the reader of the tenuous position of the medical practitioner in the early to mid nineteenth century.

Although this adventure is the last trip for Natty, Dr. Bat’s presence is a major portion of the old-fashioned charm of Cooper’s novels. The unlikely collection of characters in this novel keep meeting, even though they are independently trekking across the vast land between the Mississippi and the Platte. There are, of course, buffalo and Sioux--friendly and otherwise--who must be tamed or overcome.

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