Summary:

Send in the Idiots is a witty and moving tale of reunion, part memoir and part journalistic character study. Nazeer, hailing from a Pakistani family that has lived in the United States, Great Britain, Saudi Arabia and Pakistan, returns to the United States, where he had attended a school for autistic children during his early youth. He tracks down some of those who were also at that school with him, in order to find out how they are doing, what they are doing, and how their autism has affected their lives. He locates three people who were in the same class as he was and goes to visit them; he finds the family of a fourth; and finally sits down and has a slice of cheesecake with their former teacher and principal. Now a civil servant in the English government, Nazeer visits Andre, a computer scientist who makes uses of puppets to facilitate communication; Randall, a bike courier in Chicago and poet; and Chris, a speechwriter in Washington, DC. He then stays with the parents of Elizabeth, who had committed suicide a few years before, and through them finds out about her life, and about how parents may cope in the aftermath of such an awful catastrophe. Finally, he meets with Rebecca, who had been one of their teachers, and Ira, the prinicipal of the school, which has since shut down.

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At fourteen, after marginally consensual sex with a boyfriend, Jane has a baby.  She managed to keep her pregnancy a well-camouflaged secret until late in the process; both family and friends are still reeling from her late-breaking news.  Her mother has died; her grandmother has moved from the tribal reservation to live with Jane, her father (a white Canadian), and Jane's two brothers.  Though the school she attends has daycare for students' babies, Jane finds little emotional support, even among former friends, until a new girl, Dawna, takes an active, unpretentious interest in both Jane and the baby.

With Dawna's and her grandmother's help Jane decides to make the rather complicated arrangements required to allow her to audition for the school play and pursue a longstanding dream of singing and dancing on stage.  She meets with fierce and aggressive competition from a much more privileged girl who does her best to discredit Jane's efforts on account of her unfitness as both a Native American who doesn't look the part, and as an unwed mother who, as one faculty member puts it, shouldn't "parade herself" in public.  Nevertheless, Jane's skill and determination and soul-searching pay off; despite the steep learning curve required to care for a baby and the psychological cost of teen motherhood, she succeeds in making the accommodations and compromises necessary to retrieve old dreams on new terms.

            

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Until their father abandoned the family and moved to California, Toby Malone, his older brother, Jake, and his younger brother Eli have a close, easy relationship with each other and their parents.  After his departure, and their move into a small condo, Jake begins to associate with drug users and dealers.  He becomes secretive, his behavior becomes erratic, and Toby, from whose point of view the story is told, is torn between loyalty to Jake and guilt at keeping secrets from his mother, who, coping with her own losses, is preoccupied and somewhat depressed.

For a while Toby runs interference, finding ways to care for his younger brother, mask the trouble from his mother, and cover Jake's tracks.  His own stability is preserved in part by a comfortable, cordial relationship with an older man in whose store he helps, and who helps him find baseball cards he treasures.  Finally, when Jake is apprehended and sentenced to rehab, Toby is relieved of his conflict and able to enter into a more authentic relationship with all his family members.  This new stage includes releasing pointless fantasies about his father's coming back and rescuing the family from their troubles.

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The idea for this anthology of poetry and prose about Alzheimer's disease patients and their caregivers arose from the editor's own experience writing about her mother. Encouraged by Tess Gallagher, Edward Hirsch, and others, Holly Hughes invited writers to contribute poems and short prose pieces that witnessed to the human experience of Alzheimer's disease. The resulting anthology includes about 120 pieces chosen from over 500 submitted. The editor has arranged these in a series of thematic sections, one of which, "Missing Pieces," contains the nine prose contributions to this primarily-poetry anthology. At the end of each work, the author has provided the reader with a brief (two or three sentence) comment on the circumstances that led he or she to write it.  Tess Gallagher's Foreword describes her experience living with, and caring for, her mother who suffered from Alzheimer's disease, two "widows together" (p. xv), during the months and years after Raymond Carver's death (Gallagher was married to Carver).

The works address an array of closely related themes in a wonderful variety of voices. A major focus is the Alzheimer's patient's slipping away, withdrawing, changing, whether it be toward dissolution, or into a different country. Sometimes the change reveals "your true life: / the bright unruffled water, / a sudden lift of wings," as in Linda Alexander's "Your True Life" (p. 23). Sometimes life has fled elsewhere, as in "No Destination" by Penny Harter (p. 67), or gradually dissolved ("Verbal Charms" by Melanie Martin, p. 41). Other poems evoke the unexpected and sometimes humorous antics of the demented. Witness, for example, Len Roberts' "My Uncle Chauncey Drove My Aunt Eleanor" (p. 36) and "Early Alzheimer's" by Sheryl L. Neims (p. 55). Another theme is the loving commitment of spouses who are taking care of a demented partner so many years after saying "I do" "This is what you signed on for / in such bodily earnest before the distractible / justice of the peace 64 runaway years ago" (E. A. Axelberg, p. 79). Parent-child relationships also take on new meaning, as in the touching poems "Bath" by Holly Hughes (p. 119) and "Pacific Sunset" by Arthur Ginsberg (p. 127). Finally, the inevitable themes of death and mourning pervade the anthology's last section entitled, appropriately, "Still Life."

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Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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Thirteen-year-old Matilda lives on a south Pacific island with copper mines. Rebels and other more official warriors are tearing the place apart. A blockade has made resources scarce and communication impossible; fathers are absent at distant work. Along with everything else, the local school collapses. 

Mr. Watts, the only island white man, offers to take over the education of the children, but he has no experience, few materials and just one book: his treasured copy of Charles Dickens’s Great Expectations. He begins reading a few pages every day. Captivated by the story, the children repeat it to their mothers when they go home each night.  

Matilda believes that she loves Mr. Dickens more than anyone else and she is both bemused and irritated by her stern mother's suspicion of the strange, possibly godless, white man and her feigned disinterest in Pip. Parents are invited to the school to pass on their own expectations about learning. Students accept these moments with pride and embarrassment.

The political chaos deepens, homes are destroyed, and the book vanishes. But Watts (nicknamed Mr. Pip) turns the loss to advantage by helping the students to recover fragments in a lengthy effort of collective recollection.

The ever menacing warriors return. Little more than frightened children in an incomprehensible conflict, they indulge in senseless brutality and killing. With courage absorbed from her mother, Matilda escapes, rediscovers her father, and finds a scholarly future—a life she embraces because of Mr. Dickens and Mr. Pip.

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This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Desmond Bates is a retired professor of linguistics who lives with his second wife, "Fred," in a "northern" British town. He is becoming increasingly deaf, and, although he wears hearing aids (except when he doesn't), his social interactions--even those with Fred--are fraught with difficulty and occasional hilarious misunderstandings. His deafness is at the center of the novel, providing the title of this work of fiction, but also serving as an extended, often funny, but ultimately serious impetus to riff on aging, disability, and mortality. "Deafness is a kind of pre-death, a drawn-out introduction to the long silence into which we will all eventually lapse" (19).

Bates is at loose ends. His wife is busy with her successful interior decorating business, his adult children live elsewhere. He considers himself a "house husband" and does not really enjoy it. His aged, widowed father insists on living alone in London although he cannot be trusted to take care of himself without endangering his life (such as starting a fire in the kitchen during meal preparation). Bates visits him dutifully once a month with a mixture of dread, obligation, and guilty relief when it is over.

Desmond's hearing difficulty and boredom set him up for an encounter with a female graduate student and its unexpected complications. She is working on a thesis about suicide. Their interaction is threaded throughout the book and drives the "plot," but the details of life with hearing impairment, loss of professional involvement and purpose, and coping with an old, stubborn parent who is slipping into dementia are the main events of this clever, well-written, entertaining novel. And along the way are witty commentaries on contemporary life. The link between the narrator's profession of linguistics and his difficulty hearing the spoken word are also significant.

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Kaplan Publishing has recently released several anthologies aimed at a nursing audience or perhaps at a reading audience that wants to know more about what nurses think and feel about their professions.  This anthology, a collection of poetry and essays, looks at the various reasons these authors went into nursing in the first place, how nursing changed them, and why they either stayed the course or went on to other pursuits.  As the editors say in the Introduction, "nursing abounds with experiences that can either reinforce our vocational commitment or cause us to reconsider it" (p. xi).

In the first section, "The Calling," poems and essays examine "the idealistic reflections of those aglow with nursing's promise of intimacy and connection" (xii).  Here we meet student nurses with a true calling who are "living, breathing and sleeping nursing" (p.5), and students who are sure they are going "to murder someone" (p. 6).  Like most professionals, nurses often have mentors, and those mentors--"brisk, frank, fast, sometimes sharp" (p. 30)---are honored in this section as well.  Readers, upon completing this section, will be moved and cheered by the poems and essays that reflect the romance of nursing and the intense drive that many nurses have to give of themselves to others. 

The editors, however, are no Polyannas.  They know that a student's illusions and dreams will run right smack into reality.  While the rewards will certainly be many, the discouragements will be present as well.  The fact that both experiences---the highs and the lows---can occur within a single day is reflected in the collection's second section, "The Reckoning."  Here the realities of death, exhaustion, burnout and doubt are faced full on.  Some of the works in this section are by nurses who have chosen to leave the profession:  "Brazil, the new hospital.  We have no water.  Doctors protest poor facilities by refusing to see patients and sitting in their cars outside in the parking lot" (p. 81), writes Veneta Masson as she traces her career from 1958 to 1998 when she decides to leave nursing and "use my hands to write and to bless" (p. 84).  While some have chosen to leave, other nurses have found ways to survive: "Nursing allowed me to help my mother die; my music has helped me live" (p. 88) writes Colleen O'Brien, and Fr. Robert J. Kus writes about his dual roles, priest and nurse, how they balance and enhance one another (pp. 102-110).  The works in this section remind readers of the sacrifices caregivers must make every day.  As Jo Ann Papich writes, "Please appreciate your nurse while you still have one" (p. 99).

Section Three, "Reincarnation," tells of the "informed commitment that arises after sustained trial" (p. 165).  Here nurse-writers talk about survival and the oddly comfortable balance between stress and transcendence that comes, at last, after many years in nursing.  In "Why I Like Dead People," Sallie Tisdale takes a wry look at death, nursing homes and their "cockeyed logic" (p. 175).  Anne Webster, in "Slow Night in the E.R." talks about doing what you must do to help others even when you "can't do it," when you "stand outside the curtain, shaking" until the patient asks, "Are you there?" (p. 186-7).  Kathryn Gahl, in "The Reason Nurses Write Mostly Poetry" says it's because nurses "convert heart sounds // and hard words into art before the next patient / arrives, hemorrhaging, counting on that nurse / to flow like a pen, bleed for both of them" (p. 195).  And in the book's final essay, "I'm Staying," Shirley Stephenson offers a series of lovely statements about why she, and others, might continue in the frustrating, tiring, challenging and miraculous profession of nursing.  "Because I have been in the bed, and beside the bed. Because I have waited. Because I believe any one of us could face the circumstances of those for whom we provide care, and we're much more similar than different. Because this is where the rhythm is loudest---yes this yes this yes this yes this" (p. 246).

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Author Jennifer Culkin has been involved, for all of her nursing career, in high stakes, heart stopping, instant-decision-making areas of critical care.  After years working in Neonatal Intensive Care, she became a flight nurse--and giving intensive care to trauma victims while trying to maintain balance and sterile technique in a wind-buffeted helicopter has to be one of the most difficult tasks a nurse might undertake.  Her memoir, A Final Arc of Sky, opens with such a scene.  The patient, Doug, is soon crashing, and the nursing team, Jennifer and her partner, have to make a series of tough decisions (pp. 8-12).  From this scene on, the action rarely wavers.  And although Culkin keeps the pace moving, she is not always, or even most often, telling us about similar traumas.  She deftly weaves her personal narrative--husband and sons and dying parents--in and out of scenes from her nursing career, braiding the plot lines of her life in chapters both moving and compelling. 

In those chapters that deal with the often dangerous helicopter transports Culkin has flown, we learn (and we feel) just what it's like to be a flight nurse crammed in-between patient and helicopter door, juggling instruments that too often slip to the floor and trying to save patients that too often want to die.  In those pages that deal with family, we are privy to Culkin's internal debate about how to separate family from nursing (what she calls "the great neuronal divide between my work and my life" (p.136), and we see that she sometimes doesn't have much energy left at the end of the day to draw close to those she loves.  Part of what makes this memoir difficult to put down is the persona of the narrator herself: Culkin comes across as an honest, often irreverent risk taker, a woman who likes to ride her bike down dangerous hills at breakneck speed and allows her son to do the same (see chapter six, p. 57); a woman who loves the dangerous drama of flight nursing and doesn't worry about crashing (p. 80)--in fact she enjoys strapping herself "into the eye of a maelstrom" (p. 80). 

This memoir entertains, and it provides a glimpse into how some caregivers not only risk their lives to save the lives of others but also shoulder the responsibility of making split second decisions upon which a patient's life might depend.  And there is a surprise in this memoir, one that I can't too fully divulge because to do so would be to rob potential readers of their own discovery.  Suffice it to say that near the end, Culkin reveals something about her own health, an illness she has fought against in every chapter.  When we learn the details of her own illness narrative, we look again, with new understanding, at her fascinating career and her interactions with her loved ones.   

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