Summary:

This short novel relates how a catastrophe involving strangers perturbs the lives of people who live in or near the site where the disaster occurs. The event is an airplane crash; the site, the small town of Bounds, Texas. Told as an inner monologue by each person who either witnessed the crash, or became directly involved in its aftermath, the well crafted narrative weaves back and forth among a widowed postmistress into whose field the plane falls; a priest who is questioning his calling and who administers last rites to all of the victims; a skeptical newspaper reporter; a reclusive young man who ghoulishly hunts souvenirs in the wreckage.

The postmistress hovers between dismay at the ruination of her field and curiosity and concern over the far-flung surviving relatives who come to visit the site long afterwards. Her thoughts are filled with memories of her husband and of the evolving relationship with her married son. She ponders that before the crash, ". . . seemed like I'd lived in a fishtank. "Then, "something shattered" and ". . . the whole world poured in."

The priest keeps the church doors open to strangers, including mourners from far away. This runs up the utility bill, drawing criticism from the parish council. So shaken is he by their small-mindedness and by his vocational doubts that he cannot say Mass. The reclusive souvenir hunter, who pocketed a body part, a hand, from the crash site, is haunted by ". . . that hand against my hand . . ." The newspaper reporter feels compelled to re-visit the scene months later.

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This is the first person narrative of Maarten, a seventy-one year old man who is experiencing a rapidly progressive loss of intellectual function. It is a harrowing yet poetic account of mental deterioration, revealed in an on-going chronicle of daily life and disjointed memories. The reader experiences what Maarten experiences, not only through descriptions of what life is like, but through the sequencing of thoughts and actions.

At first Maarten is just aware of being uneasy and anxious, "this feeling of being absent while being fully conscious" and he knows, from the comments of his wife, that he must be behaving absent-mindedly. His hold on familiar certainties becomes shaky--he’s not sure of how the rooms in his house are arranged. His wife, Vera, is his anchor and he realizes that his behavior has become deeply disturbing to her, as well as incomprehensible to himself. As Maarten becomes increasingly forgetful and unable to function, Vera is alternately worried, exasperated, and profoundly understanding.

Finally, Maarten is institutionalized--his thoughts disintegrate--yet we know from his observations of "the utterly moronic community" that he still has some awareness of what is happening. Although he no longer recognizes his wife, he listens to "a woman" whisper that "the spring is almost beginning . . . ."

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James, a dwarf, lives in a dwarf house and has a dwarf girl-friend. His brother, MacDonald, thinks of James as a dwarf first and a person second. MacDonald is really bothered by James wanting to marry--as if marriage and sexual relations were something dwarfs shouldn't do. When MacDonald tells his mother James has other people to talk to in the dwarf house, she says, "Dwarfs, not people. He's hiding from the real world." She too does not see dwarfs as real people, and sees herself as punished by giving birth to a dwarf. Yet at the wedding itself, the bride is genuinely happy, as MacDonald recognizes to his surprise.

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An overweight, young teenager whose mother is having a nervous breakdown, and whose father doesn't know what to do, is invited to spend the summer with her cousin in Mississippi. Through telling lies about her background, she works her way into popularity on her cousin's coattails. Then a boyfriend tells her she should lose weight, and she pretends there is something wrong with her thyroid. Still, she jumps at the challenge of swimming across the lake (five miles) with him, which she accomplishes to great applause, but when she gets back, her parents are there to take her home. Back in Indiana, she tries to keep the glow of the summer dream.

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Twelve contemporary stories set in Rhode Island and New York City. Major themes include the pain of cultural dislocation and cross-cultural experience ("Theng," "Shambalileh," "My German Problem"); human frailty and self-deception ("Sleep," "Juilliard"); and the personal and moral dimensions of medical practice. See the separate annotations for Laundry, The Good Doctor and Ambulance--three stories which are particularly relevant to Literature and Medicine.

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This novel is set on San Pedro Island off the coast of Washington in 1954. Kabuo Miyamoto, a member of the island's Japanese-American community, is on trial for the murder of Carl Heine, a fellow fisherman. Heine's boat was found drifting one morning, with his body entangled in a net. While the death initially appeared accidental, bits of circumstantial evidence accumulate that seem to implicate Miyamoto.

Miyamoto's family was unjustly cheated out of some land by Heine's mother during the time the island's Japanese community was incarcerated in a "relocation camp" in California during the War. The dead man's traumatic head wound appeared suggestive of a Japanese "kendo" blow. Carl Heine's blood type was found on a wooden gaff on Kabuo Miyamoto's boat.

As the trial proceeds, the story of Carl, Kabuo, and what happened that night gradually evolves, as does the tale of Ishmael Chambers, the local newspaper reporter, who had a "charmed love affair" with Kabuo's wife when they were both adolescents, just before the Japanese families were sent away in 1942. It is clear, however, that this is more than a story of one man's guilt or innocence; it is a story of a community's fear and prejudice against the Japanese-Americans in its midst.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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This story is told by Tillie's grandfather. Tillie's parents were killed in a plane crash and she now lives with her paternal grandfather, a man who (in a sense) has never really grown up. "Retirement" has always been his natural lifestyle. He says that he never "amounted to anything." The grandfather enjoys story-telling and fantasy. In his stories for Tillie, he invents the character Joey Moxey, a clown whose life-events just happen to mirror the daily events in Tillie's life.

Joey Moxey always overcomes adversity. His story is full of hairbrained schemes, breathtaking escapes, and the loving support of friends, like Tina the cat, Oogak the jungle boy, and Sadie Donut the policewoman. These stories provide a way for Tillie to understand her own world.

Finally, the grandfather discovers that he has inoperable cancer. Shortly thereafter, Joey Moxey develops a terrible runny nose and "to everyone's disappointment" dies. However, his friends, led by Sadie Donut, gather and agree to continue their friendship and their adventures together.

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Mother is set in the 1930's and deals with a woman's difficult life, low self-esteem, and sense of having inherited tragedy and misfortune from her mother. Even though she finally marries, and unexpectedly conceives long after her husband and she had given up trying, her outcome is destined to be unhappy. She goes into premature labor, and gives birth to a stillborn child.

When she finally wakes up, she is weak, and cannot remember anything about the delivery. Her paternalistic physician, her husband, and the hospital staff withhold from her the news that her child has died. One night, in her frustration and need, and believing that her child is in the nursery "in the basement," she searches the basement corridors for her child. Outside the morgue she begins to hemorrhage and despite the efforts of her physician, she dies.

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This bittersweet and very funny novel tells the tale of Porter Osborn, Jr. from the time he leaves his home in a small Georgia town to attend Willingham University, until he completes college and is about to begin medical school. Even though he has been "raised right" in the Baptist faith, young Porter confronts his new environment with energy, pride, skepticism, and mischievous delight.

This picaresque novel introduces us to Bob Cater, Michael Jurkiedyk, Vashti Clemmons, Clarence Spangler, and a host of other fascinating characters who populate Sambo's (Osborn's nickname) college years. This is the old story of a young man finding himself. "Full of outrageous pranks and ribald humor," as the endnote proclaims, yet "we sense a quiet constant flow toward maturity."

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