Summary:

While on an airplane, Carson experiences abdominal pain. He is a divorced man in his fifties and a sales representative for a computer and information technology firm. He spends much of his time traveling and fancies himself "a connoisseur of cities." The increasingly severe stomach pain forces Carson to reschedule his business meeting and retreat to his hotel room.

His suffering mounts and he decides to visit the emergency department of the city hospital. Carson is evaluated by two young male doctors and later a middle-aged female physician. Despite blood tests and X-rays, his diagnosis remains murky and a surgical consultation is obtained. The surgeon suspects appendicitis. He postulates that Carson may have a retrocecal appendix and explains that in such cases the anatomical location of the organ often confounds the diagnosis.

Carson undergoes surgery. His appendix is indeed retrocecal and rupturing. He spends five days convalescing from the operation. During that time he acquires an intimate knowledge of the city from his stay at the hospital. The experience revitalizes him. Carson reasons that the world is miraculous in part because it is so simple yet still spectacular.

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Written as an interior monologue, Destiny begins as Chris Burton receives a phone call informing him of his schizophrenic son's suicide. Burton, a British ex-pat journalist in the final stages of writing his chef d'oeuvre--a cultural history on national character--is married to Mara, a provocative, capricious, flamboyant Italian. The vitriolic arguments and hurtful stratagems that characterize their discordant marriage intensify with the crisis of death and its aftermath--the identification, transport and entombment of Marco's body. Family relationships are further complicated by Mara's distrust and estrangement of her adopted daughter, Paola.

Burton reveals the chaos that schizophrenia imposes not only on the patient, but also on the entire family. In order to avoid prison following an attack on his family and home, Marco had been placed in a psychiatric institute, Villa Serena, and it was at this facility that Marco stabbed himself to death with a screwdriver. The onset of disordered thinking and erratic behavior, the search for therapies, the various repercussions of guilt and blame (including recriminations about the intense, border-blurring maternal love lavished on Marco), are re-examined by Burton as he travels from London to Rome, sits vigil by his son's body in the camera ardente, and confronts his wife at her family's tomb.

Burton's physical distress mirrors his mental anguish. Burton has heart disease and obsesses about lacking his anti-coagulant medication. In addition to the worry of clot formation, urinary retention prevents Burton from emptying his bladder. These physical ailments of containment, confinement, obstruction and blockage form resonances throughout the book: the tomb, the strictures of marriage and the leakage of adultery, the oppressive family 'house of ghosts,' the separateness of interior thought from observable behavior, the barriers of language, the herky-jerky redirections of emergency travel.

Furthermore, the will to create permanence, to make one's destiny more than a transient destination, informs Burton's moves. In the midst of his exploding marriage and tormented trek home, Burton agitates over his work, and in particular, his book, which "must serve to transform a respectable career into a monument" (p. 1).

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This story of one exceptionally accomplished family's discovery of their past and future relationships with Huntington's Disease (HD) is also the story of how the Wexler family changed the cultural narrative of HD for other families at risk for this genetically-transmitted and currently incurable disease. The HD diagnosis of Leonore Wexler (the author's mother) inspires Milton Wexler, a psychologist, to create a major foundation for HD research, which develops critical mass and influence as Leonore Wexler's condition deteriorates, and after her death. The book interweaves the story of the Wexlers' emotional and other negotiations with HD and the story of their efforts to create an HD community comprised of those with active symptoms of HD, family members, advocates, and researchers.

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The narrator, Rick, is let out of rehab to live with his older brother, Philip, who is a doctor in Detroit. He will work at a mundane job in Philip's lab. The awkwardness of their encounter slowly evaporates and Rick begins to enjoy life with his family, especially his two young nephews. But he is concerned about Philip's weary appearance, so reminiscent of their father.

It emerges, quickly and to Rick's surprise, that Philip runs an abortion clinic. The clinic is subject to constant harassment by a persistent group of religious, "right-to-lifers," who taunt the doctors, the workers, the patients, and their families at home. Rick struggles to control--even avoid--his feelings; and he tries (unsuccessfully) to suppress the desire to befriend patients.

Eventually, he is reconciled to his new task through an unwelcome fixation on one patient. But angry urges to protect her and his brother well up. After weeks of pent-up rage and fear, he hides a gun, loses control, and begins shooting aggressive protestors. The murder is "nothing"; it's "just like killing babies."

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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Save me / from love affairs / with the pale-green neutral cast of money. / Give me the hue and cry / of words! ("Lime Green") In these poems Ron Charach's love affairs with words are warm, poignant, witty, and wise--none of them have that "neutral cast of money." The poet's topics range from childhood and adolescent experiences to poetry readings, and from "Freud's Face" to "Prostates Growing."

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Dr. Dymov is an earnest and rather boring young physician, who is preoccupied with his patients and his research. Olga, his wife, craves the excitement and gaiety of the artistic life. She discovers a new lease on romance with Ryabovsky, a colorful landscape artist, who takes her on a cruise on the Volga River. As they spoon under the stars, Olga and her lover make light of her bumptious stay-at-home husband.

After she returns from the cruise, Dymov forgives her infidelity, but in Olga's mind, his forgiveness proves to be another strike against the poor slob, since she just can't stand his complaisant devotion. She runs back to Ryabovsky for a while, until he makes it clear that he is bored with her.

Then one day Dymov develops diphtheria, evidently contracted by "sucking up the mucus through a pipette from a boy with diphtheria. And what for? It was stupid . . . just from folly." Dymov soon becomes delirious, and then dies. Suddenly, Olga is overcome with guilt and grief. Too late, Olga realizes that her husband was a hero.

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The physician Tsvyetkov visits a child who is dying of a brain tumor, and the boy's mother. There is no hope, nothing to be done. Tsvyetkov has had one romantic fling in his life; when he was younger, he had an affair with the boy's mother. She has always told him that Misha was his son. Yet she also had affairs with other men around the same time; one of them might be the father. Tsvyetkov suspects that she insists that he is the father just so he will continue to make payments to support them, which he has always done. As he leaves, he asks the boy's mother one last time, "It can make no difference now. Is the boy mine?" She hesitates for a moment, but answers, "Yes. he is your son."

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Vladimir Semyonich Liadovsky fancies himself a literary man; he writes book reviews. His sister, Vera Semyonovna, is a young widowed physician who doesn't practice. She lives with Vladimir and does nothing but lie around and wonder, "What is the meaning of non-resistance to evil?" As she becomes more obsessed with this question, her relationship with her brother worsens.

Finally, she abruptly announces that she is leaving--she will go into the provinces to do vaccination work. Vladimir doesn't regret her leaving. He continues to write his articles, falls ill, and dies. The narrator doesn't know what happened to Vera.

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This is a selection of very early Chekhov tales, dating from his years in medical school (1879-1884). These nine examples of the work Chekhov churned out during those years to support himself and his family have never previously been published in English. They are all quite short. Of most interest are "How I Came to Be Lawfully Wed," "A Hypnotic Seance," "Intrigues," "In Autumn," and "At the Pharmacy."

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