Summary:

A physician seeks solace at the South Pole. Her planned one year stay there is cut short when she discovers a lump in her breast. The attempts to care for her at the South Pole (with telecommunicated help from the U.S.) prove insufficient and a plan to rescue her is successful.

There's more than the drama of illness in a remote location in this book, however. Intertwined with this story of illness is the story of the author's troubled marriage (to her physician-husband), the eventual estrangement from her children, the support of her family of origin, and most fascinatingly the daily rhythms of living (and doctoring) at the South Pole. Scattered throughout the memoir are occasional critiques of "corporate" medicine and poems that inspired the author throughout her ordeal.

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Madame Ranevsky returns to her estate after five years in Paris, where she had fled after the accidental death of her young son. In the interim her brother and adopted daughter have been running the estate, which has gone hopelessly into debt, largely because of Madame Ranevsky's improvident life style. As she and her adolescent daughter Anya arrive, friends and retainers have gathered to greet them. Among these are Trofimov, her dead son's tutor and an ineffectual idealist; and Lopahin, a brilliantly successful businessman whose father had once been a serf on the Ranevsky estate.

The family's beloved cherry orchard, along with the house and the rest of the estate, are about to go on the auction block. Lopahin proposes a solution: break up the cherry orchard into building plots and lease them to city folks to build summer villas. This would generate an annual income of 25,000 rubles and, thus, solve all of Madame Ranevsky's financial problems. She refuses to consider cutting down the orchard. Her brother, Gaev, gravitates ineffectually around the problem, suggesting various harebrained schemes to raise money, but in the end he believes there is no solution: "Someone gets sick, you know, and the doctor suggests one thing after another, that means there's no cure . . . " (p. 346)

The auction occurs, and, lo and behold, Lopahin himself has purchased the estate with the intention of developing the property for summer villas. In the last act, as Madame Ranevsky and her family prepare to vacate the house, workmen hover in the background, ready to begin chopping down the orchard. Madame Ranevsky departs for Paris, and Lopahin leaves to pursue his business in the city. A much alluded-to liaison between Lopahin and Varya, the adopted daughter, dies on the vine, apparently because the businessman has neither the time nor inclination for romance. As the house is closed up, Firs, the senile 87-year-old servant, is inadvertently left behind.

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The tale is that of two men who have had some business and a bit of social relationship in the past who are brought together after some long time in the course of the book. Allbee, who has disappeared into the underworld of skid row, submerged in his own alcoholism, suddenly reappears in the life of Leventhal, a fearful, up-tight man who struggles to maintain himself in a middle-class job and apartment. Allbee appears to have lost everything--wife, job, self-esteem, while Leventhal plods along in a respectable, but scarcely enthralling life.

Leventhal doesn't really owe Allbee anything, but he cannot rid himself of a sense of guilt. He is "successful," questionably at the expense of Allbee, and he allows the latter to plague his days and nights. Interwoven among the threads of this strange entanglement are family stresses, including the untimely death of a nephew, dragging at Leventhal's time and patience.

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A retired professor has returned to his estate to live with his beautiful young wife, Yelena. The estate originally belonged to his first wife, now deceased; her mother and brother still live there and manage the farm. For many years the brother (Uncle Vanya) has sent the farm’s proceeds to the professor, while receiving only a small salary himself. Sonya, the professor’s daughter, who is about the same age as his new wife, also lives on the estate. The professor is pompous, vain, and irritable. He calls the doctor (Astrov) to treat his gout, only to send him away without seeing him. Astrov is an experienced physician who performs his job conscientiously, but has lost all idealism and spends much of his time drinking.

The presence of Yelena introduces a bit of sexual tension into the household. Astrov and Uncle Vanya both fall in love with Yelena; she spurns them both. Meanwhile, Sonya is in love with Astrov, who fails even to notice her. Finally, when the professor announces he wants to sell the estate, Vanya, whose admiration for the man died with his sister, tries to kill him. But the professor survives and he and Yelena leave the estate.

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In his first chapbook of poems, Richard Berlin, a psychiatrist, writes about his current work with patients ("What a Psychiatrist Remembers," "Rough Air," "Berlin Wall," "Jumpology"), about his experiences on medical wards and as a student ("Anatomy Lab," "Sleight of Hand," "Alzheimer's Unit," "Obstetrics Ward, County Hospital"), about love and family and how medicine sometimes infiltrates even these sanctuaries ("How JFK Killed My Father," "Tools," "Our Medical Marriage") and, most effectively, about the complexities inherent in the role of physician and healer ("What to Call Me," "After Watching Chicago Hope," "Code Blue," "What I Love"). In other poems, he observes the human condition through the veil of medicine ("Hospital Food," "PTSD").

The lure of these poems is Berlin's facility with metaphor; he has a talent for spinning a particular image or observation into revelation. He is also willing to allow puzzlement, doubt, and fear into his poems, effectively conveying both the virtuosity of the teacher and the wonder of the student. Reading this collection, I felt as if the poet was a presence both within the poems and outside of them, like the psychiatrist who must enter the mind of the patient and, at the same time, step back and become a safe guide. It is this double vision that sets his poetry apart.

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Water is a metaphor for the life cycle as the poet chronicles the role played by water in his life, in all our lives--"the sac of water we live in." The poet evokes the sound of water as he moves through life stages: swaying trees register the sound of the water from which we emerge at birth, "the sound of sighing" denotes the sound made as he washes his dying father’s feet, whispering rain "outlives us."

The poem is replete with images of water that conjure up family relationships over time. In the ocean of his childhood, his athletic brother cannot swim while his crippled sister swims like a "glimmering fish." Water is a visible symptom of the congestive heart failure suffered by his father--"swollen, heavy . . . bloated"-- whose "respirator mask makes him look like a diver."

As the poet tends to his father, testing the wash water "with my wrist" like a parent, there is a powerful recollection of the father’s earlier ordeal as a political prisoner. Finally, there is water that liberated the family, bringing them from Indonesia to America, juxtaposed against the water that is now drowning the father.

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The speaker recalls his need to call forth a "slender memory" of his father. This memory from childhood is both "painful" and "sweet." In contrast to his father, who, as a political prisoner had devised complex mnemonics, the speaker has a haphazard memory. But is it his memory, or what he recalls that is "illogical"? "My father loved me. So he spanked me. / It hurt him to do so. He did it daily." The speaker remembers, also, how his father protectively wrapped him in his own sweater to shield him from cold. Years later, the speaker wears the sweater.

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A succinct poem [29 lines] that captures the essence of the position in which one finds oneself after a parent, or both parents, have died. Full of evocative phrases, this poem is less about grief than it is about awareness of adult responsibility and one's own future demise: "there is nobody / left standing between you / and the world . . . ."

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This study of the anatomy of alcoholism, its spectrum and individual manifestations, is set in a skid row bar/hotel in 1912. The bar is peopled by a collection of society's failures: drifters, pimps, police informers, former anarchists, failed con-artists, ex-soldiers, and prostitutes. The patrons, in various stages of inebriation, await the annual arrival of the big-spending, happy-go-lucky salesman binge drinker, Hickey, whom the pipe-dreaming losers anticipate will treat them to hours of merriment and free-flowing liquor on the occasion of his birthday.

Hickey does, in fact, arrive, a bit late and very sober. He claims to have seen the light and to desire to help his old drinking buddies dump their pipe-dreams and return to productive lives. The reaction of the folks, the results of their attempts to buy into Hickey's sales-pitch, and an unanticipated homicide and surprise suicide, round out the drama.

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Motivated at first by an attachment to her strict and demanding ballet teacher, as well as frustration and disgust with her own body compared to other dancers', Francesca develops an obsession with weight loss and increasingly ritualized forms of self-discipline in eating and exercise that lead to severe anorexia nervosa. It takes her family several months to see and acknowledge what is happening in front of them, during which she has trained herself to eat less and less, to throw up after meals, and to push herself to the point of exhaustion.

She becomes secretive, isolates herself from friends, and puts up a wall between herself and her parents, who are unable fully to understand the degree to which her behavior has gone beyond her control, but are worried. A compassionate male therapist with clear boundaries and a non-judgmental approach finally succeeds in disengaging Francesca from the mutually destructive downward spiral of family conflict around her illness;

he helps her to envision and desire her own health and to take responsibility for recovery. The story is told in the third person, but from Francesca's point of view.

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