Summary:

Claude Monet (1840--1926) was a French impressionist painter. As he aged, he developed cataracts, but refused to have them surgically removed. In this 46-line free verse poem, Monet, the speaker, tries to make the doctor understand his reasons for refusing the operation.

What the doctor sees as deterioration, an "aberration" and an "affliction," is for the artist the result of a long process of development, a kind of culmination of his life’s work: exploring the way that people (rather than eyes) see. For Monet, removing the cataracts would "restore / my youthful errors" of vision, a world seen according to "fixed notions" of discrete objects rather than as the flux of pure light it has become. Monet wishes the doctor could see what he does: "if only you could see / how heaven pulls earth into its arms . . . ."

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This book describes San Francisco’s Laguna Honda Hospital, where Victoria Sweet worked as a doctor for 20 years. In the tradition of the Hôtel-Dieu in Paris (literally “God’s Hotel”), Laguna Honda cares for the sickest and poorest patients, many staying there indefinitely because there is no alternative for them. Sweet learns from her long experience at Laguna Honda that “Slow Medicine” has benefits, that a holistic or unified view of patients works best, and that the reductionism and specialization of modern medicine has limitations and costs. During these years Sweet becomes fascinated by the medieval abbess Hildegard of Bingen and earns a Ph.D. focusing on medieval medicine. At the same time (and increasingly) various forces—economic, legal, political, bureaucratic—cause many changes at Laguna Honda, mostly contrary to Sweet’s vision of medicine.

            Part history, part memoir, part social criticism, the book is informative, entertaining, and important for its discussion of the care of our least-well-off citizens and for its perspectives on modern, Western medicine.         

            There are three intertwining strands to this engaging book: Sweet’s medical evolution as a physician, the changes in Laguna Honda, and her investigations of Hildegard of Bingen and other spiritual matters.

            Sweet joins up with Laguna Honda initially for only two months, but she finds the hospital and her work there so fascinating that she stays for 20 years. As an almshouse, Laguna Honda takes care of indigent patients, most with complicated medical conditions, including mental illness and dependencies on alcohol and/or drugs. Many of these cases come from the County Hospital with continuing (but not carefully reviewed) drug treatments. Every 15 or 20 pages, Sweet describes the dilemmas of a particular patient, and her medical (and personal) attention to that patient. The cases are vivid and instructive.

   Clearly Laguna Honda is a major figure on the book; we can even consider it (or “her”) a beloved character and a teacher to the young Dr. Sweet, who learns three principles from her work there: hospitality, community, and charity. 

Because Laguna Honda is old-fashioned in many ways, Sweet reads her own X-rays, goes the to lab to see results, and spends large amounts of time with each patient. Laguna Honda has an aviary, a farm with barnyard, and a solarium; such features help to heal the whole person. While respectful of modern medicine, Sweet slowly learns that a careful review of a patient through Slow Medicine is more accurate and more cost-efficient than standard, reductionist, high-tech medicine. She comes to respect approaches from “premodern” medicine, including that of Hippocrates and Hildegard.

  The second strand is the evolution of Laguna Honda itself. Sweet describes a variety of pressures: the recommendations of consulting firms, rulings from the Department of Justice, a lawsuit, financial difficulties (including fiscal mismanagement), administrators focused on a narrow concept of efficiency, a utilization review board, forms and more forms, and a pervasive sense that modern (including Evidence Based Medicine) is always good. All these and more create a “relentless pressure squeezing the hospital’s Old Medicine into the New Health Care” (p. 322). Sweet demonstrates that her Slow Medicine can actually save money in the long run. Confident that her way is better, she proposes an “ecomedicine unit” that she would match against the modern, “efficient” units in a two-year experiment. (For more information on her concept of ecomedicine proposal, see http://www.victoriasweet.com/.)

            As the hospital is “modernized,” many important features of the old place are gone and many “new and improved” aspects don’t work. Somehow there are no rooms for physicians in the new building while there is plenty of space for administrators and managers. A sophisticated computer system doesn’t work. Sweet doesn’t say “I told you so” directly, but we get the picture.

            The third strand is Sweet’s investigations of spirituality and pilgrimage. She is fascinated by Hildegard’s notions of the healing power of nature, the ability of the body to heal itself, and wholeness as an aim for a person and for a community. Sweet attends a Swiss conference on Hildegard. She hikes the pilgrimage route from France to Santiago de Compostela in four installments and considers notions of pilgrimage. She feels called to pursue her ecomedicine project and to write this book.           

            By the end of the book, both Sweet and Laguna Honda have changed and are now headed in different directions. 

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Summary:

When Lia Lee's sister slammed the front door to their Merced, California, apartment, Lia experienced her first in several years of increasingly severe seizures. The Lee family knew that the noise had awakened a dab, an evil spirit who stole Lia's soul. They also knew, in the midst of their grief for their infant daughter, that people suffering from "the spirit catches you and you fall down" often grew up to be healers in their Hmong culture.

Not surprisingly, the physicians and other health professionals who worked with Lia and her parents over the next seven-plus years did not share this diagnosis--most of them did not even know about it. Fadiman melds her story of Lia, the Lees, the family's physicians and social workers, and countless other people who enter the Lees' life (usually uninvited and unwelcome) with the long history of the Hmong people, their religion and culture, and their more recent lives as refugees from war in Laos and Cambodia (and the troubled history of their relationship to the U.S. military system).

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In Illness as Narrative, Ann Jurecic thoughtfully examines the unruly questions that personal accounts of illness pose to literary studies: What is the role of criticism in responding to literature about suffering?  Does the shared vulnerability of living in a body, which stories of illness intimately expose, justify empathic readings?   What is the place of skepticism in responding to stories of suffering?  Does whether or how we read illness narratives matter?  Jurecic's questions entice discussion at an interesting cultural moment.  The numbers of memoirs and essays about illness—and their inclusion in medical school and other humanities courses—multiplied from the later decades of the 20^th century to the present.   However, their increase, and their potential to encourage empathic readings, coincided with dominant literary theories that advocated vigorously skeptical, error-seeking responses to texts and their authors.  Jurecic reminds us that Paul Ricoeur called such responses "the hermeneutics of suspicion" (3). 

Jurecic's astutely researched, nuanced answers to those questions propose a corrective to the extreme skepticism of "disembodied criticism." Such criticism, she claims, dismisses testimonial writing from "a position of distance and privilege."  But her answers also affirm that intellectually "rigorous" responses to texts are central to the critical humanities (15).  To further her position, she offers attentive readings of accounts of illness by Virginia Woolf, Reynolds Price, and Jean-Dominique Bauby, as well as the theoretical writing of literary and other scholars.  For instance, Jurecic speculates that the condition of a reader's body aligns with his or her responses to texts.  In a chapter called "Theory's Aging Body," she observes that as skeptical scholarly readers age—Stephen Greenblatt, Michel Foucault, Judith Butler—they have turned their attention to "illness, vulnerability, and mortality" (93).  Jurecic also suggests that a function of criticism is to uncover the cultural conditions that memoirs and essays about illness respond to.  Living "at risk" is a recent one.  In stories of living with the risk of experiencing a particular illness in the future, potential patients create narratives of uncertainty to discover the "personal meaning of the impersonal statistics" that medical research now regularly delivers (18). 

 Jurecic also reflects on the ways theorists have understood the possibilities of representing and responding to pain in the varied approaches of philosophers Elaine Scarry, Martha Nussbaum, and Richard Rorty and of anthropologists Jean E. Jackson, Byron Good, and Veena Das.  In an exceptionally comprehensive and nuanced reading of Susan Sontag's theoretical, fictional, and journal writing about suffering, Jurecic uncovers Sontag's inconsistent, yet revelatory positions on the human capacity for responding to representations of pain.  The chapter on Sontag is enriched by Jurecic's reading of Annie Lebovitz's and David Reiff's responses to Sontag's suffering: in Lebovitz's controversial photographs of Sontag's final days (included in A Photographer's Life: 1990-2005) and Reiff's memoir about his mother's illnesses (Swimming in a Sea of Death). 

Illness as Narrative closes with examples of what Jurecic calls reparative writing and reading practices.  In the first instance, ill writers such as Jean-Dominique Bauby (The Diving Bell and the Butterfly) both recreate "a more coherent sense of themselves" and dislodge "fixed ideas and narratives" about illness (109).  In the second instance, Jurecic outlines the limits of two competing readings of Anne Fadiman's The Spirit Catches You and You Fall Down.  One assumes that readers will by nature empathically imagine those who are culturally different from themselves.  The other looks skeptically at the assumption that what medical educators call cultural competence can be acquired by reading a book.  Jurecic suggests that strategies for reading and teaching informed by Janelle S. Taylor, Eve Kosofsky Sedgwick, and Rita Felski can encourage more complex habits of response, such as Taylor's "'empathic curiosity'" (quoted 122).

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This documentary film follows the professional and private lives of the 2004 U.S. Wheelchair Rugby team. Murderball is a highly engaging, informative look at the lives of a group of quadriplegic men who are also elite athletes. The sport of "murderball" combines basketball, hockey, and rugby. It is played in custom-built wheelchairs with angled, shield-like metal side plates that make the chairs look like chariots, encouraging the term "gladiators" that is often applied to the players. Invented in Canada in the 1970s, murderball was renamed "wheelchair rugby" or "quad rugby" to make it less offensive to corporate sponsors, but retains its toughness with any name. The sport is played without helmets, and its players tackle each other through chair-to-chair collisions as they try to move the ball to the end zones.

The documentary begins with the 2002 World Wheelchair Rugby Championships in Sweden, includes team tryouts and competitions with arch-rival Canada, and closes with the Paralympic Games (held two weeks after the traditional Olympic Games end) in Athens, Greece. The film is a fast-paced sports documentary with abundant chair-level footage of action on the court, but also focuses on many aspects of the personal lives of key players, including psychological conflicts and sexuality. While the documentary is focused on the entire team, not individuals, three distinct subplots include the emotional journey of team captain Mark Zupan, including his relationship with the friend whose actions precipitated Zupan's disabling accident over ten years earlier; the passion and resentment of the Canadian team coach Joe Soares, who was cut from the U.S. Team and whose obsession with murderball leaves little space for Soares to appreciate his musically gifted teenage son until his own heart attack; and the experiences of newly disabled athlete Keith Cavill.

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Summary:

A collection of poetry written by a family doctor  who practices in New Zealand. They are grouped around themes: patients (20 poems), diseases (10 poems), spells (9 poems), a doctor (9 poems), and end with “Playing God,” which is a collection in 10 parts about clinical practice. 

Miracles and wonders are found in the physiological workings of the body. Myths and spells are identified in the rituals of practice guidelines. 

The poet loves medicine even as he realizes some of the unpleasant challenges and distortions it brings to his life and behavior.

 

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A nurse clothed in white and holding a baby stands in the center of a hospital ward. Surrounding her sit adults colored brown and grey. Naked babies lie mostly unattended on white beds. Most of the newborns share the same posture--their arms are splayed and their legs are raised towards the ceiling. A handful of adults in the room attend to the children. Their blurred faces and pallid coloring assign them a baleful monstrousness.

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In 1964, newly minted doctor, Barry Laverty, begins practice as the young assistant of crusty, seasoned, Dr. Fingal O’Reilly, in the small, Northern Irish village of Ballybucklebo. At first he thinks his new boss is fierce and unprofessional. But soon, Barry uncovers the sadness in the older doctor’s past and realizes that O’Reilly has excellent, clinical acumen. If he bends the rules, it is usually for the best.

Over the course of a month they face the ordinary struggles of general practice with Barry slowly learning the ropes: appendicitis in a child, a rushed delivery, pneumonia combined with heart failure, hypothyroidism, unwanted pregnancy, and stroke. And of course, the more minor staples of headache, cuts, and scrapes.

Not everything turns out well. Barry misses a diagnosis and cannot stop blaming himself, but his admission of the error to the patient’s wife is an important step in his education. The patients, however, leave the practice.

Social factors such as poverty, discrimination, and corruption of local officials pervade each vignette.

Barry also meets the beautiful Patricia—a survivor of polio—whose desire to pursue a career in civil engineering seems to pose an obstacle until all is happily resolved in the end.

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Helga Crane is a beautiful young teacher in Naxos, a southern American boarding school for black students. She is half Danish on her mother’s side, half African-American on her father’s side. Her only family is an aunt and uncle in Denmark.

Dr. Anderson, a distinguished black teacher professes love for her, but she feels stifled by him and the vision of their life ahead. She quits her job and flees to New York and the exciting cultural life of Harlem.

She thrives in that environment and men flock to her. There she meets James Vayle whom she likes and the Reverend Pleasant Green whom she does not—but once again, when Vayle proposes permanence, she flees to Copenhagen.

There, she spends an extended visit with her Aunt Katrina and Uncle Poul. At first the Danish couple are startled by her blackness, but they quickly adapt and enjoy the elevated status conveyed by having this intelligent, beautiful black woman in their world. Upon receiving another offer of marriage, Helga grows suspicious of her family’s use of her and flees once again.

She returns to America where she marries the Reverend Pleasant Green, although she doesn’t love him.  As babies come in succession, Helga develops severe post-partum depression. 

 

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Aminata Diallo, called Meena, is born in mid-eighteenth-century Africa and leads a happy life with her Muslim parents. Her mother is a midwife and is teaching Meena her skills. But ruthless white men appear, killing her parents and imprisoning her. The eleven year-old girl is forced to march miles and miles to the sea. During the journey she makes friends with Chekura, a slightly older boy who seems to be employed by the white captors, but like Meena, has also been captured. They are kept at a fort, then herded on to ships and taken on an agonizing journey across the ocean.

Meena and Chekura are sold as slaves. They lose sight of each other and live on plantations in privation and squalor never knowing if they will be treated with kindness or cruelty. Meena is raped by an owner. She learns how to read and write English quickly (although her skill must be kept secret), and she is fascinated by maps, constantly plotting to return to Africa.

Meena and Chekura find each other and marry secretly - but soon they are separated. She has a baby girl. Her literary and midwifery skills are her salvation, and eventually she is sold to a Jewish duty inspector. He and his wife treat her well, and she and her child live in comfort, but the revolutionary war disrupts their world. Meena returns home one day to find that the Jewish couple have fled on ship to England, taking her daughter with them..."for her own good."

Meena moves to New York City, taking a room in a hotel and still intent on finding a way back to Africa. She writes the names and ages of the people clamoring to go to Nova Scotia as a reward for serving the British in the Revolutionary War: the original "book of negroes." The settlers arrive with hope and optimism, but they encounter more oppressions. Later she is lured by the attractive plan to build "Freetown" in Sierra Leone; again however, the promised resources never materialize and the fledgling community degenerates into crime and misery. Even Meena's attempt to find her original home is thwarted.

In 1802 London, as a frail elderly woman, the abolitionists treat Meena with reverence and curiosity. They encourage her to write her story, and there she finds her daughter again.

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