Summary:

Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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Anton Chekhov died in 1904. His sister Marya (or "Maria" in this novel) survived the Communist Revolution and two World Wars to die in 1957 at the age of 94. After Anton's death, the unmarried Maria assumed his role as head of the extended Chekhov clan and she devoted the remainder of her life to the protection and advancement of her brother's literary legacy. To do so, she had to plead his case with the Russian authorities and later adapt to the political (and literary) orthodoxy imposed by the Communist regime. Early in the Soviet era, Maria successfully lobbied to have the Chekhov house at Yalta turned into a State museum, thereby insuring that the author's books and papers would be preserved.

The action of this novel takes place during the Great Patriotic War in late 1941 when the Germans occupied Yalta. Maria lives at the Chekhov museum, where she presides as curator. Also living at the house is Peter Kunin, a medical student and would-be writer who is Maria's protégé. In preparation for the Germans' arrival, Maria arranges the house to make it seem that Chekhov was pro-German. For example, she has Kunin dig up an old portrait of Goethe to hang over the mantelpiece.

Despite these machinations, the Germans fully intend to billet soldiers in the museum until a mysterious man named Diskau shows up. Diskau, who works for the German Ministry of Culture, insists that the Chekhov household be spared. In fact, he proposes to win over the local population to the German "liberators" by staging a New Year's Eve production of The Seagull in the abandoned Imperial Theater.

The remainder of the novel traces preparations and rehearsals, culminating in the single catastrophic performance of The Seagull, during which all is revealed.

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This autobiography by Janet Frame, a preeminent New Zealand writer, was originally published in three volumes in 1982, 1984, and 1985. The first volume is titled To the Is-land. In it the author tells the story of her early life "with its mixture of fact and truths and memories of truths." She describes her mother as a rememberer and a talker, partly exiled from her family through a marriage outside the family's faith and her father as having a strong sense of formal behavior that did not allow him the luxury of reminiscence. Her siblings (4 sisters and 1 brother) are described in equally perceptive language. The brother suffered from epilepsy which was poorly controlled and this had a strong influence on family dynamics.

Frame's writing is so descriptive and personal that it is easy to envision oneself as a family member. She was very early attracted to words and became a voracious reader. The family was poor and moved often but there was a firm family kinship. One older and one younger sister drowned when swimming which had a large impact and drew Janet much closer to the remaining younger sister. Janet was a good student and won many prizes; she writes that she "identified most easily with the stoical, solitary heroine suffering in silence."

The second volume, An Angel at My Table, concerns itself with Janet's experience as a student at Dunedin (Teacher)Training College and her subsequent breakdown and commitment to mental institutions. She was very lonely in college and retreated more and more into her own world of literature. At the end of her year of probationary teaching she walked out of the room during the visit of the school's inspector and disappeared.

After a suicide attempt she was eventually committed to Seacliff, a mental hospital. Her stay there, she writes, and later in another facility which eventually lasted most of seven years, was in a world she'd never known among people whose existences she never thought possible. She describes it as an intensive course in the horrors of insanity. She received multiple electric shock treatments and was scheduled for a lobotomy when it was learned that she had won a prestigious award for a book she had written.

Frame was discharged on probation and lived for a while in a small cottage owned by a well known writer who befriended her. After her book of prose and poems was accepted for publication she was awarded a grant that allowed her to travel abroad.

The third volume, The Envoy from Mirror City, is quite mystical and concerns itself with her life as a writer in England, Spain, and New Zealand after her return. She describes Mirror City as the saving world which sustains writers. She has continued writing and eventually learned that the diagnosis of schizophrenia, with which she had been burdened, was incorrect. With some life experience and wise psychotherapy she was able to write about her life in the mental institutions, among other things.

In all she has published eleven novels, four collections of short stories, a volume of poetry and a children's book.

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The action of this stream-of-consciousness novel takes place over one day--the Day of the Dead--1938, in a remote village in Mexico. The novel opens with a conversation between two who reminisce about the Consul who died one year ago. Thence the work takes the reader back to the preceding year and the principals about whom the story evolves. The Consul (Geoffrey), his former wife Yvonne, his half brother Hugh, and a smattering of characters resonating in the Consul's past come together with some dream or fantasy about reconstructing a life that has been cast asunder by the Consul's alcoholism.

Flashback by flashback, the reader is apprised of the former lives of the central characters as they move together through a surrealistic day in search of some anchor to which they may attach their ill-fated, but obsessively conjoined, lives. Much of the day is mired in the Consul's alcoholic hallucinosis and the reader is challenged to sort the reality from the fantasy as the day ends in tragedy for two of the three primary characters.

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A tiny figure slowly emerges from a vast expanse of snow, and a succession of short essays recreate moments in the life of the brilliant Canadian pianist, Glenn Gould (Colm Feore). From his unusual Ontario childhood to his musical debuts on the international stage, to his eccentric living, performing, dressing, driving, waking, and sleeping habits, this film offers insights into his loneliness, hypochondria, polypharmacy, and tragic death from a stroke at age 50 in 1982. The artistic vignettes are enriched by a tender humour, the intimate recollections of real-life friends, the abstract beauty of piano keys in motion, and above all, Gould's immortal playing.

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Warren here supposedly presents the papers of a late friend, detailing the interesting cases he had encountered as a physician. In fact, the "cases" are sensational short stories, presented as a novel due to the framing chapter introducing the narrator's "Early Struggles" to make a living as a physician. Other stories investigate typically Gothic themes like ghosts, duels, graverobbing, elopements, and broken hearts, with other scandalous problems like gambling, dissipation, murder, domestic abuse, and suicide. Medical topics include mental illness, epilepsy, hysterical paralysis ("catalepsy"), cancer, toothache, consumption, syphilis, heart disease, alcoholism, disease of the spine, gout, amaurosis (blindness), puerperal hemorrhage, measles, and stroke ("apoplexy").

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Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.

Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).

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The narrator, a writer, prides himself on his astute review of Hugh Vereker's latest novel. Vereker dismisses his efforts, explaining that all critics have "missed my little point," "the particular thing I've written my books most for," "the thing for the critic to find," "my secret," "like a complex figure in a Persian carpet." The narrator racks his brains and, in desperation, tells his friend Corvick of the puzzle. Corvick and his novelist fiancée, Gwendolyn, pursue "the trick" without success until Corvick, traveling alone in India, wires Gwendolyn and the narrator "Eureka! Immense."

He refuses, however, to divulge the secret to Gwendolyn until after they are married, and then dies in a car crash. Since Gwendolyn refuses to share her knowledge, the narrator speculates, "the figure in the carpet [was] traceable or describable only for husbands and wives--for lovers supremely united." She marries Drayton Deane, and after her death, the narrator approaches Deane to discover the secret. But Deane is surprised and humiliated by the news of his wife's great "secret," and he and the narrator conclude by sharing the same throbbing curiosity.

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The life cycle of a townspeople and of one ignored couple, lyrically rendered in nine short stanzas. To stunning effect, Cummings employs reversed word order, almost-but-not-quite-nonsense sentences, play on words, and repetition. We get the coming and going of the seasons; the leading of lives, circumscribed, sometimes small-minded, monotonous.

But there is also yearning and dreaming, marriage, children, joy and hope. It may take several readings to realize that woven into the description of the townsfolk is the tale of a man and a woman, "anyone" and "noone", ignored or even reviled by everyone else. Only "children guessed" that they were falling in love--that "anyone’s any was all to her . . . . " Time passes, they die, they are buried next to each other, they become part of the earth and of the cosmos, "all by all and deep by deep . . . Wish by spirit and if by yes."

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The first chapter of this memoir consists of two words: "I exaggerate." The narrator then tells us the story of her childhood and early adult experiences as an epileptic. After having her first seizure, at the age of ten, she spends a month at a special Catholic school in Topeka, Kansas, where the nuns teach epileptic children to fall without hurting themselves. This falling may or may not be literal; it is certainly symbolically apt.

During adolescence, Lauren begins lying, stealing, and faking seizures to get attention. She reveals that she has developed Munchausen's Syndrome, whose sufferers are "makers of myths that are still somehow true, the illness a conduit to convey real pain" (88). A neurologist, Dr. Neu, performs surgery severing Lauren's corpus callosum, effectively dividing her brain in half and markedly alleviating the seizure disorder.

Later she attends a writer's workshop where she begins an affair with a married man, a writer much older than she. After it ends badly, she starts going to Alcoholics Anonymous (although she does not drink) and tells her story with such authenticity that when she later confesses that she is NOT an alcoholic, no-one believes her, dismissing her true story as denial. The memoir ends both with her recognition of the value of narrating and with a silent fall to the snowy ground, as the nuns taught her to do, in the knowledge that the sense of falling (rather than the material certainty of landing) is all that is finally, reliably, real.

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