Summary:

In A Step from Death a profusion of memories radiate from a near-fatal accident on Larry Woiwoide's farm in western North Dakota. Woiwode, a novelist and poet of America's heartland, had just finished baling hay when his denim jacket got caught in the tractor's power take-off, "a geared stub at the rear of the tractor that spins at 500 rpm." (p. 9) Caught in the powerful machine with no one around to hear his cries for help, Woiwode could easily have died, but survived by using his pocket knife to free himself from the jacket.

In a sense A Step from Death takes up where the author's previous memoir, What I Think I Did, leaves off. The earlier book focuses on surviving North Dakota's outrageously bitter winter of 1996-97. The current memoir ranges far and wide over nearly 40 years of Woiwode's life as a writer who chooses a difficult but fulfilling life for himself and his family on the land. The memoir is addressed to Woiwode's only son Joseph (the second of four children), with whom he shares his fatherly failures, as well as the strengths of their relationship. The reader soon learns that accidents were no strangers to their life on the northern plains. Woiwode and his wife and older daughter had survived a serious car accident on an icy road in one of their early Dakota winters. Joseph, too, sustained severe injuries as a child when he fell off a horse and again later in a tractor accident. On another occasion, Joseph and his sisters are responsible for accidentally causing a fire that burned down the family barn.

Now, however, Joseph is a married man, a helicopter pilot, with two children of his own. The recollections and wisdom that his father shares with him (and us) flow freely, creating a free associational, rather than linear, narrative. Woiwode explores the deep network of connections that bind him to the land and his family, as well as to the community of creative writers and especially William Maxwell, his long-time editor at The New Yorker, mentor, and father figure. Woiwode explores as well the strong pull of loss in his life-his parents' deaths and eventually that of Maxwell-but A Step from Death is ultimately a celebration of survival.

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Poet Leatha Kendrick is the author of two chapbooks, Science in Your Own Back Yard (see annotation) and Heart Cake. In this full-length collection she continues to examine themes explored in her first titles: love and loss; the fleeting of time; and her personal experience of breast cancer. Second Opinion is divided into three sections: the first two sections have 14 poems each, the final section has 13, perhaps to indicate that for this passionate and articulate poet the the final poem is yet to be written. The first poem in the collection, "A lesson in Love Unleashed," sets the theme for the poems that follow: "yes, I think, even in their distorted flesh, / I still desire what's gone. What I'm leaving" (p. 3). In the first and third sections, the poet writes of marital and familial trials and triumphs, both past and present, and in the second section--for me the most vivid in the collection--she writes about breast cancer and how this experience weaves in and out of her other loves and losses. This weaving is given both visual and emotional expression in the poem "Tonight Weaving" (p. 28)

Throughout the book, Kendrick's poems take varying forms and tones, and yet there is always the assurance of a constant voice--personal, passionate and often humorous. In the second section, the poems become more visually complex and fractured, poetic representation of the "distortion" of the flesh as the narrator considers the diagnosis and treatment of her breast cancer. In this section's opening poem, "The Calculus of a Cracked Cup," the poet writes, "Our position is never certain, only our / velocity" (p. 27), adding the concern of the swift passing of time to the collection's overall theme. In "Second Opinion," the title poem, she notes, "I want to believe in sudden remission, / in some way to avert what we are certainly / headed for" (p. 34). But while time rushes on, the reality of cancer, the loss of a breast becomes a "stopped surface" under which a "lost life" wants "its old course, not subject to IVs or a knife" (p. 35).

It is life--difficult and sweet--that is ultimately celebrated in these poems and that overcomes the losses. The most wry poems are found in the breast cancer section: "Christmas, Adolescence, Yin and Yang" (p. 32) is a sort of ode to "Skeeter and Bite," so named by a first love; now "they'll lift / one out, the eye sewn shut by mastectomy." "Costume. Fakery. The Sell." is a tough, nervy poem that has the narrator claiming acceptance for who she is, post surgery: "Alive! Tender, I'm not hiding" (p. 39). Throughout the book there is a subtle triple play on the word "tender": woman as caregiver; woman as collateral in a society that values cleavage; and woman as injured, post op, and physically vulnerable.

In the collection's final poem, "What You Leave Me," the theme of love and loss balanced against time comes to some resolution as the narrator and her partner join in a "sweet tangle": "the blossoming / hide, this bounded / time against brevity" (p. 64).

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The Glass Castle, a gripping memoir about growing up devastatingly poor in America, opens with this first line: "I was sitting in a taxi, wondering if I had overdressed for the evening, when I looked out the window and saw Mom rooting through a Dumpster." (p. 3) Jeanette Walls slinks down in the taxi's back seat and returns to her Park Avenue apartment. A few days later, she manages to contact her homeless mother and take her out for dinner, offering her help, yet again. But her mother refuses, and when asked what Jeannette is supposed to say about her parents, her mother replies "Just tell the truth...[t]hat's simple enough." (p.5) And with these words, Walls launches into the history of her upbringing, with all the deprivations, suffering, joys, shame, exasperations, tribulations and sorrows - the story of the Rex and Rose Mary Walls' family.

Rex Walls is an alcoholic and dreamer, his wife an artist and egoist; both are psychotically blind to the basic needs of their four children. Yet the parents do feed the children with love and intellectual stimulation, managing to keep the family unit intact while the children figure out how to survive. The reader first meets the child Jeannette at age three when she is on fire, cooking hot dogs on the stove in a trailer park, completely unsupervised. She requires multiple skin grafts but enjoys the regularity of hospital food, until six weeks later her father abducts her from the hospital in the first of a series of "skedaddles" that the reader learns is the way Rex Walls stays ahead of bill collectors and other authorities.

At each miserable turn, the reader wonders if things can get any worse. They do. The family winds up living in a rotting hut without plumbing in the coal mining town of Welch, West Virginia. Rex steals money from his children, Rose Mary buys herself art books instead of food for the family. The kids eat garbage they secretly remove from trash bins at school.

But finally, one by one, the kids do escape, although, like everyone, they carry the past within them. To varying degrees, each is scarred. Nonetheless, Jeannette works her way through Barnard in New York City and becomes a contributor to MSNBC. Ultimately the book is a tribute to the gutsy resilience of some remarkable individuals.

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Cancer Vixen is the graphic narrative of Marisa Acocella Marchetto’s eleven-month cancer experience in 2004. Marchetto, a successful forty-something cartoonist for Glamour magazine and the New Yorker, serialized Cancer Vixen in Glamour while undergoing treatment. As well as the narrative of Marchetto’s diagnosis, treatment, and remission, Cancer Vixen recounts the story of Marchetto’s romance and engagement to restaurateur Silvano Marchetto, a narrative embedded in the graphic novel despite preceding it in actual chronology. The narrative explores fears about the cancer's effect on the relationship and about the loss of the chance to be a biological mother, as well as developing the relationship between the engaged couple and between Marisa and her mother (or "(s)mother," as she calls her).

The culture of cancer is another focus, including the social dynamics of having hair during cancer treatment and thus leaving oneself open to critique for not undertaking a strong enough chemotherapy. While this New York story, full of cuisine, couture (including images of the specific shoes Marchetto wore to each chemo), and cappuccino may recall the episodes of the television show Sex in the City featuring cancer, the brightly colored frames of this “Cancer in the City” tale also engage political issues like environmental causes of cancer and the reduced survival rates of women with cancer and no insurance.

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A woman is pregnant. She is a nurse married to a physician, Jeff, and they have a young son, Willie. The couple is pregnant with their second child. Long before her due date, the woman--author Susan LaScala--begins experiencing signs of premature labor. Because she is a nurse, because she is married to a doctor who takes call, she doesn't want to over-react or bother her obstetrician unnecessarily. But when vague aches turn into cramps, the author enters, as a patient, the world she had known, until then, only as a caregiver.

It is impossible, in a brief annotation, to describe fully the richness of this memoir. Because the author is a nurse, she brings to the story of the premature birth and survival of her daughter, Sarah, a wonderful double vision: LaScala tells this tale not only as a mother and a patient but also as a clinician able to explain, in simple language, the complex technologies used to sustain the life of her one pound nine ounce baby. The author's rendering of the bells and whistles of neonatal medicine, whether describing the process of intubating a preemie (p. 23) or ultrasounding a baby determined to survive (p. 182-3) are precise and haunting.

Equally compelling (and instructive for caregivers) are the author's candid revelations of how it feels to be a patient. She takes to "grading" the doctors and nurses--an "A" for the staff that lets her see her newborn girl (p. 3), and a "C" for a nurse with "No kind words. No warmth" (p.11). She describes her own bodily sensations in language both lovely and informing: the pushing and tugging she feels during her C-Section is a "quiet violence" (p.21); standing beside her daughter during the ventilator weaning process she feels "a witch's brew of fear and panic mixing and growing inside" (p. 225).

In an introduction, physician Barbara Wolk Stechenberg, describes the "gift" that the author has given by writing this memoir. The author has allowed Dr. Stechenberg, who was part of the team that saved Sarah, "a rare glimpse into two worlds" (p. xii). One was the world of intensive care nurses and how "they truly are the primary caregivers" (p. xii). The other world was that of physicians, who "may feel we are empathic and caring, but we really have no idea of the emotional roller coaster many of our parents are riding" (p. xii).

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Because he can't reach the hospital in a winter snowstorm, Dr. David Henry ends up assisting his own wife in the birth of their twin children at his clinic with the help of his nurse, Caroline. The boy is fine; the girl has Down symdrome. While his wife is as yet unaware, he gives the girl baby to Caroline to take to an institution. Norah, his wife, remains unaware that she give birth to two children, yet is haunted by some sense of loss she can't name. Caroline, unable to leave the baby in an unappealing institutional setting, makes a snap decision to keep her. She leaves town, renewing communication later with the baby's father, and raises her as a single mother until she meets a man who is willing to marry her and love Phoebe as a daughter.

Only after Dr. Henry dies suddenly does his wife discover the existence of her daughter, through photographs sent to him over the years by Caroline, and then a visit from Caroline and Phoebe. Sadly, but with a will to choose life on strange and demanding terms, Norah and her son, Phoebe's brother, choose to enlarge their circle of family to include a loving relationship with Phoebe, clearly her own person, and the woman and man who have cared for her.

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A brooding book that sounds the death knell for optimistic views on humanity's progress through civilization, Civilization and its Discontents begins with a recapitulation of Freud's disdainful views on religion as a psychological salve and then goes on to challenge enduring platitudes about human society: that civilization has emerged as a simple marker of progress of mankind over nature, protects us against suffering, and guards our liberties and happinesses. Comparing the development of civilization to the development of individual psychologies, he sees in both an essential conflict between eros and thanatos, between the desire to be with other people and the violence committed (or wished upon) other people.

Given that civilization is a process of negotiating and structuring communities, it must also be a way of controlling and repressing both violent and libidinous instincts; it does so not only through its laws but by infiltrating our own psychologies, which Freud discusses through the filter of his structural theory (where the instinctual, unconscious drives of the id are reined in by the ego under the fierce supervision of the inwardly aggressive superego). Freud's psychological perspective is to try to make sense of individual guilt, conscience, and remorse in the broadest social context as the products of this compromise between eros and thanatos, between the individual and the group, and between satisfying one's own instinctual drives and a broader community's needs. While some of his views are redolent of turn-of-the-century anthropology, his focus on guilt, aggression, and the murderous instincts towards extermination are very much prescient, charting the next decade and a half's fall into civilization's darkest hour.

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This novel begins as it ends - as an interior monologue, a soliloquy only the reader hears. Paula Hook, married 25 years to her husband Mike, who is asleep beside her throughout the entire novel, is reflecting on the discussion she and her husband have decided to have with their fraternal twins on their sixteenth birthday (June 10, 1995), which is the "Tomorrow" of the title. Although the book begins with "tomorrow" yet to come, it ends on "today" around dawn. The twins, Nick and Kate, have no idea that this revelation--that they are the products of artifical insemination (AI), i.e., that Mike is not their biological father--is forthcoming.

Paula Campbell and Mike Hook met casually but experienced love at first sight, despite Mike's making the sexual rounds of Paula's friends and roommates. Mike was initially a biologist but becomes a publisher of popular biological publications. Paula is a director in an art gallery in London. Both gradually become more successful and prosperous, have infertility problems and undergo AI. The discussion with the twins never takes place in the novel, which ends at dawn.

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Sandeep Jauhar, M.D., Ph.D. is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York. Thus, one can assume that he is an accomplished cardiologist and administrator. It was not always so. This memoir flashes back to 10-15 years earlier when the author was casting about for a career, finally settling on medicine almost by default; it follows him to medical school (at Washington University in St. Louis) and then centers on his first year of residency training at Cornell's New York Hospital in Manhattan -- the internship year.

We learn in the introduction to the book that the author will speak freely of self-doubt about career choice, constant anxiety and feelings of inadequacy, exhaustion, and disillusionment. Which indeed he does. But Jauhar first discusses his family background: born in India and emigrating with his family to the USA at age 8; father holding a Ph.D. in plant genetics, now writing academic textbooks and still regretting that he had not been able to afford his dream of becoming a doctor; mother helping to support the family as a lab technician; older brother, Rajiv, a mentor and competitor, charming, self-assured, and unquestioningly headed for a medical career; sister, Suneeta. Sandeep (the author) undertakes graduate work in theoretical physics but as he nears completion of his doctoral degree, realizes that he probably does not have what it takes to be successful in the field. When his girlfriend, Lisa, becomes seriously ill, he begins to (re)consider medicine as a career. Against the advice of his parents who are now convinced he is a dilettante, he applies to medical school and is accepted.

Disillusionment began during the first two years of medical school: "In graduate school I had never learned to memorize . . . But now I couldn't rely on logic and reasoning; I had to commit huge swaths of material to memory" (32). He considered quitting to become a journalist, a profession that had always intrigued him, but which had been discouraged: "my father made it clear that journalism and writing were never to be considered career options because they offered no security" (33). Yet, amazingly, he was awarded a summer fellowship just before starting medical school that placed him in the Washington, DC office of Time magazine; the contacts he made then allowed him to work as a student reporter for the St. Louis Post-Dispatch during medical school and led ultimately to his ongoing and current position as a contributing medical essayist for the New York Times.

Internship for Jauhar unfolds as a series of anxiety-provoking encounters with patients and humiliating encounters with his physician superiors. Feeling inept and inadequate, he stumbles along and worries that he is harming patients. There is too much to keep track of, too many "little things that I find burdensome" (91). "Having so much to do was bad enough, but not knowing why you were doing what you were doing was terrifying . . . Patients were needy, their demands overwhelming . . . Everyone seemed to know how the place worked except me . . . The ecology on the wards was hostile; interactions were hard-bitten, fast paced" (112-113). He is in constant doubt and conflict about his career choice. Even his private life is affected -- his girlfriend Sonia, still a medical student, comes from a medical family, is strongly motivated and secure in her career choice, which aggravates his own sense of insecurity. (Reader, he married her.)

Midway through internship Jauhar suffers a herniated disk. He tries to tough it out without taking time off but his stint as "night float" at Memorial Sloan-Kettering hospital, which specializes in treating cancer patients, proves too difficult-- up all night trying to tend to the severely ill and "taking care of patients about whom you knew next to nothing" (154). He takes a brief leave followed by a reduced schedule. He recognizes that his problems are emotional as well as physical -- he is depressed. But gradually, as his neck problem improves, as he recognizes that medical professionals are actually able to help patients feel better -- his neurologist and physical therapist had "provided hope and comfort to me at a vulnerable time" (181)--, as he makes a house call to a dying patient, as his essays are published in the New York Times, and as the season moves to Spring, his depression lifts and he looks forward to his work.

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The author's mission is to investigate, understand, explain, describe, and puzzle over the nature of phobias -- his own, and that of other sufferers. Allen Shawn is a composer, pianist, and teacher, and is a member of a gifted family: his brother, Wallace Shawn, is a playwright and actor; his father was William Shawn, for many years editor of the New Yorker Magazine. As a musician and academic, Allen Shawn is "successful." And yet, his life is severely limited by agoraphobia, "a restriction of activities brought about by a fear of having panic symptoms in situations in which one is far from help or escape is perceived to be difficult" (13). The author interweaves sections that summarize his extensive readings on the fight-flight reaction, evolution, brain and mind, Freud's theories on phobia--with his personal history, especially as he believes it relates to his phobia.

Shawn's descriptions of how he experiences agoraphobia are vivid and informative, detailing the situations that trigger his physiologic symptoms of panic and disconnectedness: driving on unfamiliar roads, any kind of travel that is unfamiliar, walking across or on the edge of open spaces, traveling across long bridges, being in enclosed spaces (claustrophobia). The agoraphobe, he writes, "feels at risk, as if at risk of sudden death or madness" (14). Shawn tells about what he must do in order to strike out on unfamiliar trips, that is, when he gathers up the courage to take them. He must venture up to the point where panic sets in, turn back, then on another occasion repeat the process but attempt to go further, pushing through the panic, until, one day, he can make the entire journey without turning back. Sometimes he never makes it to the desired goal.

The author points to several different factors that seem to predispose people to phobias: heredity, unconscious imitation of a phobic parent, upbringing. In his own case, in retrospect, his father showed symptoms of agoraphobia. Shawn discusses the underlying repression that was pervasive in his household -- his father carried on a long-term relationship with a woman while remaining married. Shawn's mother knew about the relationship from early on but any discussion of it was forbidden, even after it became common knowledge.

Perhaps more important in Allen Shawn's perception of repression is what happened to his twin sister, Mary, who was born with what is now considered to be autism, and mental retardation. Allen felt close to this girl, even though her behavior was unpredictable and baffling. When he was about eight years old, his parents sent her away to a special boarding school without warning Allen, or offering explanations. From then on he rarely saw her; 10 years later she was institutionalized. The family did not speak much about her and her "'exile' . . . added yet another layer of mystification to an already really mystifying atmosphere. It turned out that even in our temperate environment something extremely violent could occur" (177). Not long after that, Allen began to experience severe anxiety in certain situations.

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