Summary:

This essay was written ten years after the author's Illness as Metaphor (see this database). Sontag begins by explaining the stimulus for her earlier essay: her own experience as a cancer patient. During that time, she discovered that cultural myths about cancer tended to isolate and estrange cancer patients. They suffered needlessly because of "meaning" attributed to their illness by society. A decade later, Sontag observes that attitudes about cancer have become more open and truthful. However, a new illness (AIDS) has arisen to carry forward the metaphorical banner.

AIDS brings together two powerful metaphors about illness. First, AIDS develops further the theme (seen earlier in cancer) of disease as invader: the enemy invades and destroys you from within. Thus, AIDS strengthens the use of military metaphors in medicine. The war against cancer is reincarnated as a war against AIDS. Secondly, because AIDS is a sexually transmitted disease, it also evokes the theme of plague-as-punishment.

Sontag's project in this essay is more focused than in the earlier book. She acknowledges that the medical and public health response to AIDS explicitly counters these myths. She concludes that "not all metaphors applied to illnesses and their treatment are equally unsavory and distorting" (p. 94). The metaphor she is most anxious to see eliminated is the military metaphor, both on an illness level (illness invades the person) and a societal level (social problems invade society).

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This is a story about storytelling. The narrator--a writer--and her aged, ill father are discussing the narrator's style of story writing. The father wants her to write a story that is simple, "Just recognizable people and then write down what happened to them next." The writer doesn't like telling stories that way because "it takes all hope away. Everyone, real or invented, deserves the open destiny of life."

Because she wants to please her father, the writer narrates a one-paragraph tale about a woman and her teenage son, a drug addict. But this is not what the father had in mind at all. "You misunderstood me on purpose . . . You left everything out." The father asks the writer questions, attempting to fill in details of the story that he believes are important. The writer agrees to tell the story again.

The second version is longer, complicated, unlikely, and, like the first version, has an unhappy conclusion, ending, "The End." The father is discouraged and saddened by this version. How could his daughter, the writer, leave the mother in the story in such an abandoned state? As they discuss the ending the father becomes exasperated with his daughter's bantering: "Tragedy! . . . When will you look it in the face?"

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Stella is the wife of Max Raphael, the deputy superintendent of a maximum security psychiatric hospital near London (based perhaps on Broadmoor, where the author's father was medical superintendent), and mother of a ten-year-old son. She becomes involved in an obsessive sexual affair with one of the institution's patients, Edgar Stark, a schizophrenic sculptor institutionalized after murdering and decapitating his wife.

Stark uses his affair with Stella to escape, and she runs away to London to join him. After a few passionate but squalid weeks in hiding, Edgar's illness resurfaces, evinced both in the violence he shows to a sculpture he's making of Stella's head, and in his paranoid jealousy. She runs away from him and is captured by the police and returned her to her husband, who has been fired because of his wife's role in the escape of so dangerous an inmate.

The family moves to a remote hospital in North Wales, where Max has a minor position, and Stella becomes severely depressed, to the extent that she stands by helplessly as her son dies in an accidental drowning. As a result, she is institutionalized--she returns to the hospital, not as the superintendent's wife, but as a patient. Edgar has meanwhile been recaptured (in North Wales, seeking out Stella either to take her with him or to kill her), but they never meet again, for Stella commits suicide.

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Trudi Montag is a Zwerg, a dwarf. Born to a mentally disturbed woman who dies when Trudi is a small child, the girl reaches adulthood under the loving care of her father, a pay-librarian in a small German town. (A pay-librarian is one who runs a library as a business and charges the patrons to borrow books.) Trudi is angry, deeply resentful of her "differentness," and she uses her unique status in a variety of ways, both helpful and vengeful toward others.

For example, Trudi tells stories, some of which enchant and comfort frightened children during the war, others of which harm the lives and personal security of the townsfolk whom the story teller doesn't like. World War II comes and goes in Burgdorf; Trudi finds and loses romantic love; her father dies; and she begins, at the end of the tale, to reflect on the ways in which she has contributed to her own suffering and that of others.

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In 1984 Handler was a moderately successful 23 year old New York City actor, when he developed acute myelogenous leukemia. Strongly supported by his girlfriend and family, Handler underwent induction and, later, consolidation chemotherapy at Sloan-Kettering Memorial Hospital, where he also began his long experience (the "comedy of terrors" or, perhaps more appropriately, the "tragedy of errors") of a harsh, hostile medical environment populated by arrogant physicians, condescending nurses, and a host of unhelpful minor characters.

Handler carries us briskly through his first remission, the impact of his illness on his family and personal relationships, his experience with nonconventional healing (Simonton Cancer Center), his return to work on Broadway, his relapse, and the agony of a second round of induction chemotherapy at Sloan-Kettering.

Subsequently, he goes to Johns Hopkins Hospital to undergo the rigors of an autologous bone marrow transplant. At Hopkins he discovers to his surprise a medical setting far different from Sloan-Kettering: communicative, compassionate physicians and a patient-centered healing environment. Even the two hospitals' sperm banks reflect this radical difference in approach.

After surviving his transplant and a subsequent round of serious infections, Handler resumes his life. He realizes that most of the time nowadays he is not in touch with the sense of joy and gratitude for each moment that the illness taught him. Yet, these feelings exist below his consciousness; sometimes he steps through "a little doorway near the floor of my consciousness" and experiences his life in a simpler, more profound way.

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As the book opens, Fauchery, a drama critic, is waiting for the hottest play in Paris to open. "The Blonde Venus" has bad music and bad actresses, but a new star, Nana, who appears on stage clad only in a diaphanous wrap brings down the house anyway. Nana is an experienced concubine. She exploits the hysteria caused by her nearly nude performance to win Steiner, a wealthy banker. Steiner buys her a country house where she entertains other lovers to win more gifts. Here she also has a brief affair with the penniless student George.

Steiner soon sets her loose and she takes up with Fontan, an actor. She tries to be domestic and kind, but Fontan beats her, then abandons her and she turns to streetwalking. Threatened by the police, who in order to prevent the spread of syphilis can imprison women and perform mandatory gynecological exams, she quickly searches for a new, wealthy lover. She finds Muffat whom she humiliates, trampling on his uniform and sleeping with whomever she likes. One day, Muffat finds her in the arms of young George and then with his elderly father-in-law. Nana also brings home Stain, a streetwalker, to be her lover and confidant.

Young George finally grows so jealous of Muffat and of his brother, another of Nana's conquests, he kills himself in her bedroom. Her other lovers must step over the bloodstain to approach Nana's bed. Soon after, Nana catches smallpox and dies miserably, the disease ravaging her beauty. She dies in 1870 just as the Franco-Prussian War begins.

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This is a collection of stories and sketches by a practicing neurologist. Most of the material is clinical and autobiographical. In "Mrs. Bachman" a new patient enters the doctor's office, carrying a thick stack of medical records. It all started in 1946 and no doctor has ever found the explanation of her condition. Meanwhile, the doctor is wearing contact lenses for the first time. His eyes begin to tear. Mrs. Bachman thinks that he is crying over her misfortune. She consoles him, "I want you to know that you are the kindest, most sympathetic man I have ever met."

In "Intensive Care" an elderly woman is agitated after a seizure. The staff try unsuccessfully to calm her. Finally, her husband approaches and kisses her. She settles peacefully and they hold hands.

The doctor in "Continuing Medical Education" finally discovers metastatic breast cancer as the cause of a psychotherapist's neck pain, long after he and other physicians had told her again and again that the "driving mechanism" of her chronic pain was "unresolved anger and frustration." In a longer essay, "The Narrow Bridge," the author reflects on the meaning of healing, "Healing helps us find a place in this world for ourselves and for each other."

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This book, which is subtitled "Seven Paradoxical Tales," contains seven of Oliver Sacks' clinical stories of persons whose unusual neurological deficits teach us something about the way the brain (and, therefore, the mind) works. In "The Case of the Colorblind Painter" an artist learns to adapt to a completely black-and-white world after sustaining trauma to his occipital lobe.

"The Last Hippie" portrays a man whose ability to form new memories was destroyed by a massive midline brain tumor; he still "lives" in the 1960's. "A Surgeon's Life" depicts a Canadian surgeon with Gilles de la Tourette Syndrome, showing how he is able to live as a respected member of the community and practice surgery despite this disabling condition. "To See and Not See" tells the tale of a man in his 50's who is suddenly able to see after being blind since early childhood.

In "The Landscape of His Dreams" Sacks introduces a painter who, after a serious illness in the 1960's, apparently developed extraordinary and persistent "waking visions" of Pontito, his hometown in Italy. For many years he has obsessively painted remarkably accurate scenes of Pontito. "Prodogies" and "An Anthropologist on Mars" both deal with autism. The first tells of an autistic boy from England who has remarkable skill in visual memory and drawing; the second is about an autistic woman with a Ph.D. in animal science, who teaches at Colorado State University.

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At the beginning of the Spanish Civil War, while her father fights for the Republicans against Franco's forces which her deceased mother's family supports, fourteen-year-old Matia is forced to leave her elderly nanny and go to live with her maternal grandmother, aunt, and her fifteen-year-old male cousin, Borja. This is the summer the frightened, rebellious, and homesick Matia struggles with her changing body, and the changing relationships and behaviors she must have as a woman in her society. This is the summer Matia learns of social class, politics, sex, and family secrets; of love, honor, and betrayal.

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At some indeterminate point in time and space following World War II, George remembers telling Corinne the story he has told Blum. The discontinuous, contiguous rememberings and tellings--rememberings of tellings, tellings of rememberings--are the labyrinthine elements of George's searches for meanings: to his own life, to his ancestral identity, to the disastrous routing of French troops by German in May 1940, to the human condition. In the course of their textual wanderings, narrator and reader return again and again to specific scenes--trying to make sense of life and death, and the cardinal, corporal points between.

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