Summary:

This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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Jack Coulehan’s fourth poetry collection brings together new and previously published poems in a well-organized and handsome volume. As a reader who has long followed this author’s career, I found some of my favorite poems here (Irene, "Lima Beans," "For Oysters Only," "Six Prescriptions," "Sir William Osler Remembers His Call on Walt Whitman," "Cholera," and Medicine Stone) as well as compelling newer work: "The Shoe," "Work Rounds: On Lines by Tomas Transtromer," "Definitions," and "Decatur in Winter."

The collection is divided into three sections: the first presents poems about "doctoring" and, a Coulehan trademark, poems from a patient’s point of view; the second is a remarkable assembly of Coulehan’s poetic commentaries on Chekhov’s life and writing; the third features poems about a variety of personal relationships.

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This is a harrowing story, told in the first person, of an obsession with food and body image. "One day I will be thin enough", says Josie, the 25 year old anorectic woman who has been hospitalized for life-threatening self-starvation. "Just the bones, . . . the pure, clear shape of me." "One day I will be pure consciousness." The narration spins out in painful detail the pattern of compulsive behavior which pervades Josie’s existence. Her pitifully barren emotional life is revealed as well.

How did it all begin? Flashbacks of significant events invade Josie’s attempts to stop thinking. A shy, awkward adolescent, overly sensitive to casual comments about excess flesh, decides to diet. Josie stumbles non-communicatively through a teen-age sexual initiation to a later affair with her married professor, retreating ever further from her bewildered family.

But why do events take such an extreme turn? The mystery of anorexia nervosa remains. In the hospital, a nurse who has seen everything seems to strike some responsive cord, and Josie begins eating to gain weight. At the end of the novel she’ll soon be released , under supervision, but the outcome is in doubt. "Can I learn to be so present? Can I learn to be so full?" ". . . if I were a body, what would I be?"

 

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In "Life Support," a mother must make a difficult decision: whether or not to consent to heart surgery without anesthesia for her critically ill newborn who is on a ventilator. Her instincts and reason contradict each other, and she isn’t sure which to believe. She wants to let the child die naturally in her arms, but this will not be allowed in this particular institution. She feels distant from her husband and from the doctors, and believes that her sudden transformation into the guardian of this child presumes far more knowledge and ability than she possesses.

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Losing Julia is narrated by Patrick Delaney, age 81, a World War I veteran, who lives, somewhat independently, in Great Oaks, an assisted living facility. Still able to go into town to get new clothes, books, etc. and enchanted with the kindness and loveliness of Sarah and other female staff members, the well-educated and quick-witted protagonist offers a fresh perspective on "institutional" care.

Much of Patrick’s story, however, concerns Daniel, a war-time buddy, and other soldiers in his embattled unit prior to and during the hellacious Battle of Verdun. Several soldiers are carefully and memorably drawn by the stories they tell about life at home and their aspirations. Daniel stands out as Patrick’s closest friend in the trenches, a young man who is courageous, rational, fearful, and in love with Julia.

Like his peers, Patrick listens to Daniel’s lyrical recollection of the woman others can only imagine. Patrick realizes that he has fallen in love with Julia’s image. Most of the men, including Daniel, are killed brutally in one of the war’s most savage battles. When Patrick’s post-war efforts to find the elusive Julia fail, he marries, works as an accountant, and has two children. Like the war, Julia remains, however, a constant shadow throughout his life.

When a war monument is constructed ten years later on the site of the last atrocious battle, Patrick, his wife, his toddler son, and his sister-in-law journey to Paris. With his family happily detained in Paris, Patrick goes to Verdun alone for the monument’s unveiling ceremonies with many other veterans and grieving family members. It is here that Julia appears and the two become lovers during the time at Verdun and then for a short time in Paris.

The story, non-sequential in its presentation, weaves the various elements of aging, memory, war, love, and loss together for readers to untangle and follow.

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Kay, a 7th grader, lives with her mother, grandmother, and great-grandmother. She is particularly attached to her grandmother, who is diagnosed with breast cancer. Kay’s subsequent waves of response to Grandma Margie’s illness include denial, fear, withdrawal from friends, discovery of a new friend whose mother, it turns out, died of cancer, and discovery of new kinds of intimacy with her mother and great-grandmother. During the illness her grandmother teaches her to knit--one last gift before she dies. After her grandmother’s death, she finds herself a little more grown up, recognizing in herself some of her grandmother’s features and habits, and reclaiming her own life on new terms.

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Invincible Summer introduces illness and death into what might otherwise be a standard teen love story. Here, first love is also a last look at life, and the rites of passage into romance, sexuality, and intimacy are intensified and thrust into profound paradox by approaching death. Robin and Rick meet in the hospital where she has come for a battery of tests, and he for chemotherapy. Both have acute lymphocytic leukemia. He’s been sick for two years. She’s just finding out about her own condition.

Robin lives with her father, who can hardly bear to be around her illness, and her grandmother, who, since her mother died years ago in a car accident, is the primary caretaker. The father’s love has to be understood and accepted in light of his emotional limitations. The book thoughtfully explores how sickness rearranges family systems as well as treating familiar young adult themes of separation from friends, wanting sex, embarrassment about physical appearance, uncertainty of remission, and how to talk about the future.

After Rick’s death, at which Robin is present, Robin recalls a game her mother used to play, called "The Worst Thing." "What’s there to be afraid of? What’s the worst thing that could happen?" The aim of the game is to look at the worst case until it seems manageable, because for every worst thing, there is some way through to remedy or acceptance. The game, reproduced as internal dialogue, drives to ultimate questions, ending with something like Pascal’s wager--a version of intellectual comfort that will do in the absence of positive faith in the promise of afterlife.

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This book is an autobiographical account of an abrupt and painful injury that completely transforms the author’s life. Berger in 1985 was a healthy woman who enjoyed ice skating and canoeing, a published poet, wife, and mother of a toddler. She bent over one day to pick up her daughter and felt a tearing "within the thickness of flesh, moving in seconds across the base of the spine." No longer able to run, walk, or even sit, she is forced into a life spent lying down.

Hers is now a world of boundaries and barriers--physical, psychological, and societal. The book chronicles her struggle to parent her child (they make gingerbread creatures lying down on the kitchen floor), to relate to her husband (she has to deal with the constant feeling of being the recipient of his care), to live with pain, and to regain her mobility.

Because hers is not a visible injury and because she must frequently lie down in public places or use her carry-along lawn chair, she suffers the stares and scrutiny of people who cannot pigeon-hole her into a tidy handicapped-wheelchair category. After seven years of physical therapy (she calls her therapists "angels of attempted repair ") she is able to walk and drive, though she is still limited in activity and lives in fear of re-injury.

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A pregnant woman stands in profile to the viewer, with her head bowed down toward her belly and bared breasts. The woman’s eyes are closed and one hand, its fingers curled, is raised so that the palm faces away from her. Perhaps she is praying. A streak of grey angles up behind her head, possibly an abstract halo or wing.

The woman wears a colorful shawl, although her breasts are exposed. The shawl is intricately patterned with swirls and circles evocative of sperm and ova, respectively. A grey skull-cum-death’s head peers out from behind her belly. Beneath the woman and partially enshrouded by her shawl are three women who assume the same position of bent head, closed eyes, and raised hand(s).

All the activity in the image is compacted into a long pillar of sorts, the right side of which forms a fairly straight edge, and the left side of which curves outwards. Behind, a speckled golden-brown makes for a solid background with no perspective.

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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