Summary:

A night on the town with two friends turns into "an attack of nerves" for Vasilyev, a law student. The three students spend the night drinking and visiting houses of prostitution; Vasilyev is horrified and repulsed by the women, who he thinks are "more like animals than human beings." The social problem of prostitution becomes an obsession; he is so fixated on finding a solution that he is in moral agony. His friends, among whom is a medical student, are concerned only with his health; they take him to a psychiatrist who "cures" Vasilyev with bromide and morphine.

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The author tells the story of two Native-American (Chippewa) families whose lives interweave through several generations during the years 1934-1984. The primary setting is a reservation in North Dakota. The main characters, Marie and Nector Kashpaw and Lulu Lamartine, are colorful, sympathetic people caught in a love triangle that endures for most of their adult lives. "Love medicine" represents an attempt by a Kashpaw grandson to assure once and for all that his aging grandfather will love and be true to his wife and cease "hankering after the Lamartine." The plan ends in disaster when corners are cut and the authentic old Indian customs for preparing the "love medicine" are circumvented.

There is a strong sense of the blending of cultures--religion, medicine, commerce, education all take on the distinctive qualities of an evolving mixed culture. Displacement and disenfranchisement are a fact of life, taken almost for granted, with humor, but not without a response. "They gave you worthless land to start with and then they chopped it out from under your feet. They took your kids away and stuffed the English language in their mouth . . . They sold you booze for furs and then told you not to drink. It was time, high past time, the Indians smartened up and started using the only leverage they had-federal law." (p. 326) So begins an initiative to establish a gambling casino; "gambling fit into the old traditions . . . . "

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This absorbing, sad, humorous evocation of an impoverished Irish Catholic childhood describes the first nineteen years of Frank McCourt’s life--from his birth in Brooklyn, New York; through the family’s emigration four years later to his mother’s roots in the slums of Limerick, Ireland--and ends with McCourt’s return migration to America, a young man on his own. McCourt sets the scene in his first lines: "When I look back on my childhood I wonder how I survived at all. It was, of course, a miserable childhood: the happy childhood is hardly worth your while. . . the poverty; the shiftless loquacious alcoholic father; the pious defeated mother moaning by the fire; pompous priests; bullying schoolmasters . . . . "

Born during the Great Depression, the author leads us in lilting present-tense narrative through the struggle and occasional small joys of daily life with siblings, school friends, and the adults who circumscribe his life. He is an alien in his parental homeland, the oldest child of a father whose background in "the North" engenders continual suspicion, and a mother (Angela of the book’s title) who had never known her father and whose own mother is as miserly with her affections as with offers of economic assistance.

The hardships in Limerick are so profound that starvation is a way of life. "Consumption," pneumonia, and typhoid are rampant; children go to school barefoot or in pieces of flopping rubber; stealing is a necessity. Frank’s tiny sister and twin brothers die. Above all, there is "the drink"--the endemic disease of Irish fathers who spend their weeks’ wages in the pub on Friday night.

Frank leaves school to earn money for the family (his father had joined the war-time wave of work in England, but continued to drink his earnings away), and to save for a return to America. Blessed with verbal skills and stamina, through stealth, charm and struggle he manages to save what is needed to book ship’s passage to America. As the Hudson River flows by en route to Albany, the ship’s Wireless Officer says to Frank, "My God, . . . isn’t this a great country altogether?" Answers Frank in the single phrase comprising the last chapter, " ’T. is."

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The year is 1954, the place a construction camp in the interior of Tasmania. One evening Maria Buloh, a young immigrant from Slovenia, walks out of her home and into the snowy forest, disappearing forever. She leaves behind her husband, Bojan, and Sonja, their three-year-old daughter. Sonja's childhood evolves into a harsh series of foster homes, followed by adolescence taking care of her drunken, abusive father. She escapes at the age of 16. Flash forward to 1989, when Sonja Buloh pays her first visit to Tasmania and to her father in more than 20 years.

What is Sonja looking for? What does she expect to find? She and her father are both damaged people. Their spirits are scarred and deeply hidden--his in alcohol and an obstinate lack of ambition, hers in wariness and distance. We soon learn that Sonja is pregnant and plans to have an abortion as soon as she returns to Sydney. While staying with some old friends, she has an epiphany--she decides to remain in Tasmania and carry the pregnancy to term.

During the months of her pregnancy, Sonja and her father gradually grow closer. Sonja finally learns the truth about what happened to her mother. Father and daughter are transformed. To quote the book's blurb, "the shadows of the past begin to intrude ever more forcefully into the present-- changing forever his living death and her ordered life."

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Doebin is an island reserve for Aborigines off the coast of north Queensland. In 1930 the superintendent goes insane after his wife dies. He sets fire to his house, kills his children, and wounds others in a bloody rampage that ends in his being shot by an Aboriginal man. Interestingly, this superintendent was a benevolent dictator who actually appeared to care for the Aborigines, whom he considered childlike and treated in a strict paternalistic manner. In return, his charges respected him and called him "Uncle Boss."

The book tells this story from the perspectives of several different characters and reveals how the events of 1930 influenced their lives and bound them together in mysterious ways. We learn of the influence these events had on the subsequent lives of the island's little community: doctor, matron, schoolteacher, boarding house operator, priest, and Manny Cooktown, the man who shot and killed the madman, Captain Brodie.

Time moves on, things change. World War II comes and goes. On Doebin Island, however, Aboriginal people continue to be treated like prisoners. Benign paternalism is replaced by out-and-out hatred during the reigns of a succession of superintendents, who treat their Aboriginal charges as if they were animals.

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Jimmie Blacksmith is the son of a white man and an Aboriginal woman in late 19th century New South Wales. A Methodist minister teaches him Christian ideals and Western ambition. Thus, he sets out to make a life for himself in the cash economy and to marry a white woman, who he believes is carrying his child.

For a long time Jimmie quietly overcomes one barrier after another, and calmly accepts the continuous taunting and humiliation of Christian whites, who believe that Aboriginal people are dirt. However, he finally snaps. Exploited by his boss and betrayed by his wife, he simply cannot take it anymore. Jimmie then goes on a killing spree that seems to confirm the whites' worst fears.

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The title of this collection of poems recalls the formulaic statement by which a physician introduces a patient's medical problem or chief complaint. For example, "The patient presents with a history of fever, abdominal cramps and diarrhea for the last 24 hours." Or, "The patient presents with a long history of hypertension and diabetes." In this case, though, Dr. White's patients' presentations are poems, rather than chunks of sanitized medical jargon; and, while the patient remains a key character in most of these works, they also present the doctor's story.

Domestic violence, child abuse, and sexual abuse figure prominently in these poems. In "365" (p. 1) a five year old girl presents with "a foul smelling vaginal discharge"; she was a victim of rape. Baby "John Brown" (p. 9) has 47 fractured bones and was "dipped in boiling water" for soiling himself. In "Ironing" (p. 18) a first grade girl has the impression of an iron burned into her thigh. And the two-year-old girl in "Peek" (p. 49) is admitted to the Intensive Care Unit (ICU) with cigarette burns and a liver fracture.

Dr. White also writes of babies left behind by their mothers ("Autumn Angels," p. 3), homeless mothers and children ("Numbers," p. 42), and complex multigenerational family pathology ("Riddle," p. 50). All in all, these stories carry the reader very close to "Looking at the Gates of Hell" (p. 32).

Yet, a still, small voice of calm, maybe even of salvation, can appear in the most unlikely places. In "Belly" (p. 4) the physician lays her face against a baby's belly and "the warm brown skin calms my forehead. / All stiffness melts." In "Maplewood & Greene" (p. 36) she revels in seeing "three little girls on roller skates." And in the Whitmanesque poem called "Oh" (p. 45), she gloriously affirms, "Oh to laughter, oh to sorrow / Oh to a better day, oh tomorrow."

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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Having remarried after a long and partly happy life with a woman who bore him three sons, novelist Campbell Armstrong lives in rural Ireland with his second wife. He learns that his first wife, who works in Phoenix, has advanced lung cancer and, with his second wife’s blessing, goes to spend time with her and their grown sons. In the course of that trip, he reflects on their life together, their romance, his alcoholism and its effect on their family, their move to the U.S., their losses, and the remarkably enduring affection between them and, surprisingly, between the first wife and the second.

Completely surprising all of them, a daughter his first wife gave up for adoption, who has searched for years for her birth mother, shows up in the months before Eileen’s death and makes the trip to Phoenix to meet her birth mother. Her appearance turns out to be a gift to the whole family. She assuages decades of sorrow and longing in both her and her mother’s hearts. She herself has cancer, not as advanced as her mothers. Both she and her mother work in health care professions. Much psychological and spiritual healing is accomplished between them in the short time they have before Eileen’s death several months later.

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Anne Lamott, a writer, recovered alcoholic, former addict and impassioned Republican-hater, finds herself pregnant in her mid-thirties, and decides to have the baby. This journal is a chronicle of her son Sam’s first year. She is fiercely self-deprecatory and funny and unafraid to talk about the dark side of parenting an infant: the fear, exhaustion, anger, emotional swings; that 4 a.m. inability to cope with the crying neediness of the baby.

She is a single parent barely able to pay the bills, but she has a tremendous support network of family, friends, and the people of her church--all of whom clearly love Sam and love her. And then, when Sam is 7 months old, crawling "like a Komodo dragon," the author’s best friend Pammy is diagnosed with metastatic breast cancer. The author, who discovers the depth and resonance of love because of the gift of Sam, must now learn loss. She questions her faith, which she cannot justify on a cerebral level, but still hopes that God loves and guides her the way a parent loves and guides a child.

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