Summary:

This book chronicles a tortured parenthood during the birth and brief life of a severely brain-damaged female infant, Silvie. Doctors predict that the child will live only a few days but instead she survives for seven months. The story is told in first person by the mother, beginning with her arduous labor during a home delivery in the presence of an experienced midwife and the family physician. The baby does not cry when she is born and turns blue even with oxygen that the doctor administers. An ambulance is summoned; "a bigger, better oxygen machine" restores the baby's color and she is brought to a hospital neonatal intensive care unit where she is artificially ventilated and fed.

In the hospital Silvie "fails" all the tests of normalcy. The doctors recommend removing artificial ventilation. "I feared, even more than I feared her death I think (and harder to admit), that they would remove the oxygen pump and the baby would live on and on and never be able to do anything at all" (14). Yet when the child does in fact breathe independently, "I took the fact that she could sustain her own breathing to mean that the baby wanted to live. It was all right to love her" (15). A few days later, however, the medical team concludes that there is nothing further they can do for the baby, that the parents should take the child home, where she will likely die within a couple of days. Upon being prodded, one physician suggests the parents give her an overdose of phenobarbital, which she is receiving for continual epileptic seizures.

At home, the parents feed Silvie by tube, medicate her, change her diapers, hold her, and learn from a friend how to swaddle her. The child never cries, does not focus her eyes on anything, rarely responds to sound or touch, and gains no weight. Whatever random responsiveness there seems to be gives the author a sense of motherhood: "I was able to survive because of my faith in these intermittent chance meetings, believing that Silvie did know when I was here and that I was holding her close in a way that meant love" (37). The parents brace themselves for Silvie's death. The husband's sister visits and councils them to actively put an end to Silvie's life, which they refuse to do. But they do not plan to take extra measures (CPR) if Silvie seems to be dying at home and when they articulate this to a social worker whom they consult to obtain respite care, it becomes clear that she would report them to Child Protective Services.

The husband quits his job as a residential counselor of emotionally disturbed teenagers to do part-time carpentry work -- he is too preoccupied to care about other people's problems. When a friend accidentally breaks the phenobarbital bottle, the parents together with the family physician decide to see how Silvie will get along without the drug. To their amazement, the baby appears slightly more alert and is able to suck from a bottle -- no more feeding tube required. But the husband reminds his wife, "The doctors warned us she might do this. This is the one and only thing she can ever learn. They said when this happened to other parents they started to believe that the baby was getting better" (59).

The parents live in limbo, attempt to live a "normal" life. When Silvie starts to lose weight at age 4 months, the doctor advises to resume tube feeding; they don't see the point, but when hospital physicians use the word, "murder," and threaten to "take over" Silvie's care, the parents relent. The baby lives but "it was the sameness of Silvie that drove you crazy . . . She slept and woke, but was awake that much different? She did not change, she did not change. Her sameness was a stone I wore, an emblem of failure, failed life" (96).

The final act for Silvie begins when the author's mother-in-law is dying of cancer in New York and a decision is made to leave the baby at home in California for several days in the care of a retired nurse. The nurse has been shown how to do the tube feeding, but while the parents are in New York she experiments with spoon feeding, then discontinues tube feeding for three days before the parents return. The parents see that Silvie has deteriorated in their absence and resume tube feeding. For the remaining couple of months the parents wait, investigate institutionalizing Silvie, and finally determine that "the way we loved Silvie meant we loved her enough to let her die" at home, with "a certain amount of fluid and nourishment for comfort, but a gradual withdrawal of excessive food. Replaced with a lot of touching and holding, stroking and whispering" (122). Silvie dies and the author is four months pregnant with the baby she and her husband have decided not to abort.

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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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Dora Rare, the only girl child born in multiple generations of her family is encouraged by her mother to establish a bond with Miss Babineau, an odd isolated midwife, whose wisdom on health matters is much sought after by the local women in their small Nova Scotia community. Gripping and intimate encounters with her neighbours as birthing mothers and as women seeking control over their fertility lead Dora to accept a role as Marie’s successor. When arrogant, young Dr Gilbert Thomas comes to town with his strong ideas about science and birth, he is appalled at the practices of the local women; he also resents the competition. Dora embarks on a difficult marriage herself and seeks temporary refuge in the United States where she witnesses a new kind of independence.

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In his Introduction, editor Thom Schramm puts the themes of this anthology into perspective. He notes that the moods associated with bipolar disorder are familiar to everyone. Moreover, the notion that artistic creativity is associated with psychological instability is widespread; in fact, it is almost a stereotype, ranging in time from Plato's depiction of poets as suffering from "divine madness" to contemporary examples, like Sylvia Plath, Anne Sexton, and Robert Lowell. However, it should be evident that, since we all experience periods of sadness and elation, it is no wonder that poets of all stripes, no matter how "stable" they might be, may evince these moods in their work.

Living in Storms presents an array of contemporary poems grouped to reflect mania and depression from different perspectives. The book has eight sections. In the first three, the poet himself or herself expresses what it is like to be susceptible to mania or depression ("How It Is"), the experience of being there ("In the Mood"), and the experience in retrospect ("Remembering the Episodes"). The next two sections contain poems that approach these moods from more of a distance, either looking at the sufferer from another's perspective, ("Characters") or at the influence of manic-depressive sufferers on those around them ("Family and Friends"). The following section is devoted to poems about artists who suffered from manic-depression ("Artists"). The last two sections contain poems that depict shifts from one mood to the other, either on a daily or general basis ("Daily Shifts") or seasonally ("With the Seasons").

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The basis for this autobiographical essay on the experience of having a malignancy are 92 illustrations, all the work of the author; they include 32 ink or woodcut sketches, 24 charcoal drawings, and many acrylic paintings (16 in full colour). Pope's images evoke the dependence, fear, loneliness, pain, and even the mutilation surrounding cancer illness and therapy.

He describes in plain language the course of his own illness, diagnosis, and treatment; he also relates the experiences of a few fellow patients. Most intriguing is his ready description of the stories behind his pictures: who posed, how he painted them, and what exactly he was trying to convey. When the book was published, Pope was in a hard-won remission from Hodgkin's Disease, but he died the following year of treatment-induced bone marrow failure.

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Summary:

The basis for this autobiographical essay on the experience of having a malignancy are 92 illustrations, all the work of the author; they include 32 ink or woodcut sketches, 24 charcoal drawings, and many acrylic paintings (16 in full colour). Pope's images evoke the dependence, fear, loneliness, pain, and even the mutilation surrounding cancer illness and therapy.

He describes in plain language the course of his own illness, diagnosis, and treatment; he also relates the experiences of a few fellow patients. Most intriguing is his ready description of the stories behind his pictures: who posed, how he painted them, and what exactly he was trying to convey. When the book was published, Pope was in a hard-won remission from Hodgkin's Disease, but he died the following year of treatment-induced bone marrow failure.

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A beautiful elderly couple are forced to confront Fiona’s (Julie Christie) problems with memory. Always stylish and active, she begins to neglect her appearance and do odd things. She loses her way while cross-country skiing in a familiar terrain; at nightfall, Grant (Gordon Pinsent) finds her frightened and frozen. She decides that she must go into a nursing home, but Grant is horrified to learn that, in order for her to adapt, he may not visit for an entire month. When he finally returns, bearing a bouquet of flowers and hoping for her warm affection, he is stunned to find Fiona pleasant but indifferent to his presence. Instead, she is preoccupied, even infatuated with Aubrey (Michael Murphy), who silently occupies a wheelchair. Fiona is able to interpret Aubrey’s moods and desires.

At first, Grant is hurt and jealous, but gradually he accepts Fiona’s need to be important for someone. Haunted by guilt over an affair with a student years ago, Grant wonders if Fiona is somehow retaliating. When Aubrey’s wife Marian (Olympia Dukakis) brings Aubrey home because she cannot afford the care, Fiona is despondent. He approaches Marian about returning Aubrey to the center. Thrown together by their absent yet present spouses, Marian and Grant indulge in a half-hearted affair. By the time, Aubrey returns, Fiona may have forgotten him, but she still knows Grant and appears to recall his distant infidelity though so much else is lost. But he still loves her and together they can find reasons to laugh.

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Madame Raquin, a widowed haberdasher, lives with her son, Camille, who has a history of poor health and is weak and uneducated, and her niece, Thérèse, conceived in Algeria by Madame’s soldier brother and a “native woman,” both of whom are now dead. Raised by her aunt as companion to the invalid Camille, Thérèse is a model of repression. When Thérèse turns twenty-one, she and Camille marry, and the three move from the country to Paris. One day Camille brings home an old friend, Laurent. He and Thérèse become lovers and decide to murder Camille so they can marry. On an outing they go boating and Laurent drowns Camille.

The murder replaces their mutual passion with guilt, remorse, and evenutally, hatred. The two must wait before they can marry without arousing suspicion; they are both increasingly haunted by memories of Camille and visions of his corpse. When the aging and still-bereft Madame Raquin actually helps arrange for them to marry (to ensure that they will take care of her), they torture each other with their proximity, and they torture Madame Raquin, now immobilized and silenced by a stroke, by allowing her to learn that her trusted caregivers killed her son. The three live in torment until, finally, Thérèse and Laurent kill each other.

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Within the first few pages of this novel, the reader is thrust into the midst of a family--their past history, their present tragedy, and their future healing.  Kitty Duvall, a middle-aged woman living in Baltimore, Maryland, receives a phone call informing her that her son, soldier Vincent Duvall, has been injured in Viet Nam and now lies, severely burned, in the Intensive Care Unit of Brooke Army Medical Center.  Kitty packs her bags and rushes to his bedside.  Thus begins this straight forward and yet complex story, one that weaves between past and present, one that examines the lives of caregivers, especially nurses; the lives of patients, particularly those young men and women sacrificed to war; and the lives of the parents who must, as Kitty does, find their places alongside their dying or healing children, always wondering how best to help them. 

Although this book is a novel, it reads like a memoir.  Indeed, the events of the novel seem so right and so accurate because the author served as a lieutenant in the Army Nurse Corps at Brooke Army Medical Center during the Vietnam War.  Her own experience as a nurse, her own memories of the burned and wounded men, inform this novel and bring to it an accuracy and an urgency that takes the reader behind the scenes into unforgettable images of war and recovery.  Although set in the Vietnam era, this story is especially relevant today, when once again soldiers and their families must deal with the physical and emotional wages of battle.

 

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