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George and Rufus (Rue) are born one year apart into grinding poverty of a Nova Scotia community, to a violently abusive father and a frightened well-intentioned mother. They have mixed heritage, part Black, part Mi’kmaq. Battered and hungry, they struggle with learning and abandon school after several attempts at grade three. 

George is stolid, strives to be good, serves briefly (and badly) in the military, and is happiest doing heavy physical work for farms, gardens, and woodlots. But he can never hold a job for long. He marries Blondola and they start a family in Fredericton, New Brunswick. 

Rue is more dashing, calculating, and slippery. He has a self-taught talent for piano and cultivates an odd form of jazz. He falls in love twice and loses both times--first to an accidental death and next to his own imprisonment. Arrested for theft, he serves two years in prison and, upon his release, barges into George’s marginal existence, contributing nothing and menacing the precarious but loving home. 

When Blondola goes into hospital for the birth of her daughter, the doctor refuses to let her leave until his bill is paid. George needs money desperately. Rue convinces him to use a hammer to stun a white man – any white man—and take his money. Together they settle on targeting a taxi driver, but the man who responds to the call is George’s friend. He cannot go through with it, but Rue clobbers the driver, cajoles George into robbing the dying man and dealing with the evidence.

The brutal murder and shockingly clumsy aftermath of their barely disguised deeds results in their arrest. During the police interrogation, George tries to explain his innocence and blames his brother. They are tried within the racially intolerant British-inherited court system that wrongly flatters itself to have avoided American excesses of racism. They are executed on the gallows, hanging side-by-side. 

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In 1902, an unusual structure was erected on South Dakota’s windswept prairies. It was not a silo, farmhouse, or barn—buildings that would be perfectly commonplace in that corner of the state. This conspicuously odd edifice, a “two-story building, with its jasper granite foundations,” was called the Canton Asylum for Insane Indians, a first-of-its-kind and federally managed institution based outside of Canton, South Dakota (Joinson 24). The asylum, which operated from 1902 to 1934, was designed to incarcerate and treat Indigenous peoples deemed ‘mad’ by powerful political authorities, such as reservation superintendents and the Bureau of Indian Affairs. According to the historian and disability studies scholar, Susan Burch, the facility “ultimately held four hundred men, women, and children from seventeen states and nearly fifty tribal nations.”

In Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians, Carla Joinson provides an incisive institutional history of the Canton Asylum, examining the political motivations for its establishment, its different periods of (mis)management, and, ultimately, its demise in the early 1930s due to inspection findings and Indigenous affairs advocacy spurred by John Collier. In writing the book, Joinson seeks to answer her chief research question: “why an institution like this asylum could exist for so many years, and what made it tick as a viable part of the Interior Department” (2). Her research explores the mechanics of institutional longevity, specifically how, despite government inspection reports that revealed appalling evidence of neglect and abuse, the facility remained in operation for over three decades. Joinson’s book also corroborates the staggering fact that many of the asylum’s patients were not, in fact, ‘insane,’ but sent to the institution only so that the federal government could detain and surveil people who may have experienced difficulties with reservation authorities back home. Other Indigenous peoples, such as those with epilepsy and ‘feeblemindedness,’ were also deemed ‘mad’ and in need of medical detention. Many instances of abuse are chronicled: unhygienic conditions, patient restraint, fraudulent diagnoses and misdiagnoses, suicide, and failure to quarantine tubercular patients. Joinson also unearths decades-long dysfunction among the facility’s administration: staff backbiting and high turnover rates, lack of medical treatment, poor medical training and recordkeeping, and refusal to employ translators to communicate with Indigenous patients and understand their different cultures. Vanished in Hiawatha documents that Canton’s patients suffered years of neglect, and those who would have potentially benefitted from psychiatric treatment never received it because the facility was little more than a rural prison for unwanted, troublesome, and chronically ill Indigenous peoples.

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Michael Pollan is curious about human consciousness and how humans alter it using a variety of molecular compounds. This curiosity took him first to three mind-altering psychedelic drugs: psilocybin, lysergic acid diethylamide (LSD), and 5-MeO-DMT (“The Toad”). He reported his findings and personal experiences in a 2018 book, How to Change Your Mind. His curiosity yet untamed, Pollan expands his project to three mind-altering compounds found in plants: opium, caffeine, and mescaline in his latest book.

Pollan’s investigation is born of his vocation as a gardener “fascinated by our attraction to these powerful plants as well as by the equally powerful taboos and fraught feelings with which we surround them.” He’s further attracted to them for the way in which when “we take these plants into our bodies and let them change our minds, we are engaging with nature in one of the most profound ways possible” (p. 3). The sources he chooses are the opium poppy for opium; coffee and tea for caffeine; and peyote and San Pedro cacti for mescaline. 

Opium, caffeine, and mescaline represent the range of mind-altering properties available from plants of interest to Pollan. In opium he saw a sedative, in caffeine a stimulant, and in mescaline a hallucinogen, or as he characterizes them, the “downer, the upper, and the outer,” respectively (p. 4). Their effects on consciousness do not feature dissolution of the ego, as is the case with psychedelics, and indeed, they can solidify ego. Seemingly most important to his selection, however, was that,

Taken together, these three plant drugs cover much of the spectrum of the human experience of psychoactive substances, from the everyday use of caffeine, the most popular psychoactive drug on the planet; to the ceremonial use of mescaline by Indigenous peoples; to the age-old use of opiates to relieve pain. (p. 4)

The book comprises an introduction and a chapter each covering opium, caffeine, and mescaline. The introduction describes his dual interest in the ancient human drive to fool with consciousness, and in plants that produce mind-altering substances as evolutionary features. Pollan also touches on how civilizations, ancient and current, aid and combat the use of these substances, at times simultaneously. In the chapter on opium, Pollan updates his April, 1997 Harper’s Magazine article about his experience growing opium poppies as the war on drugs peaked in the mid-1990s; in this version he reconstitutes the section he left out for fear of arrest and conviction that has since abated. In the next two chapters, Pollan separately reports on how caffeine and mescaline affected his consciousness. Because he was already a heavy caffeine user, Pollan had to give up coffee and tea if he was to discern its mind-altering effects, but for mescaline’s mind-altering effects, he had to find a source, a setting, and a guide through the maze the Covid-19 pandemic created.

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Described in minute detail by the narrator, the villagers - who have turned over every stone in the woods, dived many times in the river, and ridden to nearby villages to find Carlos - turn to an old man who requests a perfectly flat piece of wood and a stout candle. He then meticulously fastens the candle to the wood and carefully launches this raft of mystical exploration and recovery on the river. Every villager watches this ceremony with rapt attention. It is truly a riveting passage, for the raft travels under its own power from the river bank against the current, meandering slowly towards the bridge where it finally stops, despite the current, under the bridge, the only place no diver has yet looked:

"The board in the meanwhile has wandered farther under the bridge, but always in a right angle to the fifth post. Now it is under the middle of the bridge. From here it sails towards the fourth post, though only for about a foot. And here it stops as if it were nailed to the water. It does not mind the current nor the light breeze that sweeps softly across the surface of the river. The manner in which the board has halted is entirely different from that in which it stopped before. Now and then it trembles slightly, as if something were breathing against it from below. But it no longer whirls. ... The board begins softly to dance as if impatient. It seems that it wants to be relieved of its torture. It wriggles, swings about itself, though it does not move as much as two inches. One might think it is trying to go down to the bottom."

(page 110-1)

A villager dives and retrieves Carlos and hands his body to his mother:

"With an indescribable nobility and solemnity, and in his eyes that pitiful sad look which only animals and primitive people possess, he steps slowly forward. And Perez, the man whose daily task it is to fell the hard trees of the jungle and convert them into charcoal, lays that little water-soaked body in the outstretched arms of the mother with a tenderness that makes one think of glass so thin and fragile that a single soft breath could break it."
(page 113)

The villagers, in a procession that is tragicomic, take Carlos' body to the graveyard where a well respected teacher, now drunk from all the mescal others have offered him, gives an eulogy that suggests Christ's Sermon on the Mount. However, with inverted symbolism, this sermon is for, not by, Jesus and is delivered by a drunken priest-figure who is so drunk he falls into the open grave. To Traven's credit he introduces this farcical moment to emphasize how none of the villagers, much less the author, and, consequently, the reader, laughs at a decent man trying his best to honor Carlos. It is truly a most moving finale to a most moving book.

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Volck’s memoir describes his medical practice and learning in a variety of settings (Cleveland, Baltimore, Cincinnati), but, more importantly, in non-metropolitan places, such as Tuba City on the Navajo Reservation in Arizona and rural clinics in Honduras. He suggests that his knowledge of medicine has largely come as he has practiced it and not from his formal education. Further, he believes that best medical practice is not primarily high-tech, urban, or industrial. Each of the 15 chapters has a title—a topic, a person, or a theme—but also one or more locations specified. For example, we have “Chapter One, A Wedding, Navajo Nation, Northern Arizona,” suggesting the importance of culture and locale. Further, the chapters include personal associations from several realms beyond the topic and place as Volck seeks to understand medicine, healthcare, and how we live in the world.           

Of the first seven chapters, five are set in Navajo land, where Volck is an outsider by his cultural heritage and his profession, a doctor with a pediatrics specialty. From time to time he reflects on his training, the English verb “to attend,” and specific patients, such as two-year-old Alice in Tuba City and eight-year-old Brian in Cleveland. Both children died while in his care. Working on the front-line of medicine, he considers the weaknesses of our modern attitudes toward death and our wishes for control. He also wrestles with personal lifestyle issues of balancing medicine, family, and an urge to write.
             
Other chapters describe restlessness in his profession, the growth of his family (including the adoption of a Guatemalan baby girl), hiking in the Grand Canyon, camping in the rain, and a retreat with Benedictine monks. Chapter 11 “Embodying the Word” discusses literature and medicine, lectio divina (a Benedictine reading practice), and the need to listen carefully to patients’ stories.            
The final chapter returns to Cincinnati, Honduras, and Tuba City. Volck has found more projects in the Navajo Nation, including a youth service project from his church. With permission, he conducts interviews and plans a book on the Navajo, “drawing on cultural history, anthropology, history, medicine, and politics” (p. 201).

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Frank Drum, 13, and his younger brother Jake are catapulted into adulthood the summer of 1961 in their small Minnesota town as they become involved in investigation of a series of violent deaths.  Their father, a Methodist minister, and their mother, a singer and musician, can’t protect them from knowing more than children perhaps should know about suicide, mental illness, and unprovoked violence.  The story is Frank’s retrospective, 40 years later, on that summer and its lasting impact on their family, including what he and his brother learned about the complicated ways people are driven to violence and the equally complicated range of ways people respond to violence and loss—grief, anger, depression, and sometimes slow and discerning forgiveness.  

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This memoir of a life in medicine takes the writer from St. Louis to a Navajo reservation to Central America to the east coast and from urban hospitals to ill-equipped rural clinics. It offers a wide range of reflections on encounters with patients that widen and deepen his sense of calling and  understanding of what it means to do healing work.  He learns to listen to tribal elders, to what children communicate without words, to worried parents, and to his own intuition while calling on all the skills he acquired in a rigorous medical education.  Always drawn to writing, Volck takes his writing work (and play) as seriously as his medical practice, and muses on the role of writing in the medical life as he goes along.

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Carol Levine's anthology of stories and poems about the intimate caregiving that takes place within families and among friends and lovers reminds us that the experience of illness reaches beyond clinicians and patients. It can also touch, enrich, and exasperate the lives of those who travel with patients into what Levine calls the land of limbo. This land oddly resembles the place where some Christian theologians believe lost souls wander indefinitely between heaven and hell. For Levine the limbo of familial caregiving is an unmapped territory. In it caregivers perform seemingly endless medical, social, and psychological labors without professional training and with feelings of isolation and uncertainty. Caregiving in this modern limbo, created by contemporary medicine's capacity to extend the lives of those with chronic conditions and terminal illnesses, has become, according to Levine, "a normative experience" (1).

By compiling this useful selection of well known and less familiar stories and poems, Levine increases the visibility of the experience of familial caregiving among works of literature about medicine. While illness literature is typically classified by disease or disability, Levine focuses instead on the relationships between caregivers and those being cared for. Her collection organizes the literature into five parts: Children of Aging Parents; Husbands and Wives; Parents and Sick Children; Relatives, Lovers, and Friends; and Paid Caregivers who assist families. The literature in each section tends nonetheless to represent particular conditions: dementias, including Alzheimer's disease, cancer, and frailty in the first two sections; childhood cancer, hyperactivity, and mental illness in the third; AIDS in the fourth. 

Probably the most familiar and powerful works include Rick Moody's "Whosoever: The Language of Mothers and Sons," Ethan Canin's "We Are Nighttime Travelers," Alice Munro's "The Bear Came over the Mountain" (the source for the film "Away from Her"), Lorrie Moore's "People Like That Are the Only People Here," and several poems: Mark Doty's "Atlantis" and selections by Donald Hall, Jane Kenyon, James Dickey, and Raymond Carver.

These and the less familiar works offer disparate responses from both caregivers and those they care for. The narrator of Tereze Gluck's "Oceanic Hotel, Nice" thinks "what a bad person I was to not even want to touch his feet. . . it made me shudder" (220). The wife in Ann Harleman's "Thoreau's Laundry" cannot place her husband with Multiple Sclerosis in a nursing home because "his presence, however diminished, was as necessary to her as breathing" (116). The caregiver in "Starter" by Amy Hanridge "didn't want to be the person people feel bad about" (180).  Several stories explore the limits of obligation. As is often the case, the son in Eugenia Collier's "The Caregiver" is sick himself, failing to schedule his own doctor's appointments and dying before his mother. Marjorie Kemper's witty, exuberant "God's Goodness" plays out an unexpected relationship between a dying teenage boy and his Chinese immigrant aide, while his parents remain in the background.

Carol Levine's brief introduction to the collection explains that she excluded excerpts from memoirs and selected only very recent literature, almost all from the past three decades. A Resources section at the end includes some introductory medical humanities resources and practical resources for caregivers.

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The third novel in the series of Zol Szabo, who is a public-health doctor for the Hamilton Ontario region. He is also a single parent to ten year-old, Max, because his unstable wife, Francine, could not deal with Max’s mild physical disability. His partner in life and work is now Colleen, an attractive woman detective whom he met in the first novel and who looks "like Cameron Diaz in a ponytail” (p. 140).

Teenagers at a private religious school begin to sicken and some die of a mysterious liver ailment. School authorities categorically deny any use of drugs, tobacco, or alcohol—but Szabo’s team quickly discovers that not only do the kids smoke, they prefer a cheaper form of cigarette that is manufactured and sold at cut rates by the local native community.

In the background of this stressful situation, Zol’s mother is dying of cancer, his ex-wife is threatening to visit, and Zol is caught up in a violent break-in at a Toronto museum that resulted in the theft of a precious native artifact.

The team unravels a series of epidemiological clues that point to the interaction of pesticide-tainted tobacco reacting with liver cells to produce the dangerous disease. He must then convince the unscrupulous cigarette manufacturer to stop production before the problem spreads widely. Their methods are unorthodox because they lack support from the bosses who are afraid of public and political opinion. Using clandestine photography they prove that the owner has been lying about his distribution methods.

The investigation helps to solve the older murder of a native woman scientist who had uncovered the problem and been brutally silenced.

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