Summary:

Set in 1894 and based on a history of the logging projects among the California sequoias, this is a story of Francie, whose sister died in an accident six years earlier. She chafes under her parents' excessive protectiveness since Carrie's death. She loves the woods, and longs to do something to keep the loggers from cutting down the ancient sequoias, especially the oldest and largest, a tree over 2500 years old. Through a little sleuthing based on her sister's diary, she finds out that the property on which the ancient tree sits actually belongs to an old hermit, not to the logging company.

In an effort to get the company to stop before cutting the oldest tree, she rides the dangerous log flume into town to alert the one journalist she knows will support her cause. They arrive in time to save that tree and some of the others, and, perhaps as importantly to Francie, her mother and father begin to see her not only in terms of their loss of Carrie, but as a young woman independently interesting, daring, and very much alive.

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Fifteen selections--short stories, essays, and memoir--make up this collection. Two stories are notable: The Whistlers' Room and Atrium: October 2001 (see annotations). The title story is a translation and retelling of an obscure German tale published 75 years ago. Set in a military hospital in Germany during World War I, four soldiers share a common wound--throat injuries and laryngeal damage necessitating a tracheostomy for each man. This remarkable quartet of patients forges a fellowship of the maimed.

"Atrium: October 2001" describes the random meeting between a physician and a terminally ill teenager in the hospital atrium. The subject of death dominates their discussion. "Parable" chronicles an elderly doctor's efforts to comfort a dying man, and in the process, ease both their suffering.

Excerpts from Selzer's diary reveal much about the character of the author as well as the characters in his life. He also reminisces about growing up in Troy, New York. Approximately one-quarter of the book is devoted to Selzer's musings on works of art (sculpture and painting). Lighter fare includes a discussion of life behind the podium, a description of his home, and a new ending for A Tale of Two Cities by Charles Dickens.

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Birth Sounds includes 45 short tales of labor and delivery, ranging through a wide swath of the human comedy, but always maintaining focus on the very first scene. In most of these stories, it isn't the delivery that provides the drama, but rather the people. Take the first story, for example. In "Faceless" a Vietnamese husband cautions the obstetrician-narrator, "In our country no man will examine a woman in such an intimate way." The obstetrician never sees the patient's face, which she has covered with a towel. After the delivery, he examines her and speaks carefully, not sure that she understands English. However, from beneath the towel, she thanks him in a perfect American Southern accent. A neat surprise!

In "The Little Devil" (p. 6) a 38-year-old member of a satanic cult announces that she intends to kill the baby if it is a boy. She has been directed to do so by her satanic mentor. When, amid a panoply of lit candles and inverted crucifixes she delivers a boy, the resident contacts the sheriff's office, where the mother's intentions are already known. Sure enough, the SWAT team storms the delivery room and takes the baby.

In "Red Bag" (p. 31) the narrator is serving as a medical expert in a murder trial. The defendant had arrived at the hospital hemorrhaging after delivering a baby at home, evidently into the toilet bowl. The baby had died of head injury. The obstetrician-narrator turns out to be more supportive of the woman and less compliant than the prosecutor had expected; but afterward the doctor receives his financial reward--a check from the state for a full $7.00!

In "Resilience" (p. 259) a woman with a near-term pregnancy asks the obstetrician to examine her breast, which has suddenly developed a red lump. He takes one look and immediately experiences a flashback to another young woman he cared for who had developed breast cancer during pregnancy and died of metastatic disease about a year later. Sure enough, the current patient also has cancer. But in this case the patient delivers, receives treatment, and recovers, apparently cured of her cancer.

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Before and after an appendectomy (done for what seem possibly questionable indications) an adolescent boy just feeling the surges of pubescence receives the appropriate attentions of a nurse. During a follow-up visit, for no clear medical reason that I can fathom, he also experiences the exhilarating good luck, for him, of a sperm test, performed by the physician's "young, good-looking nurse."

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A classic heterosexual triangle between an inordinately selfish young rake, O'Byrne (who helps his equally disgusting brother run a pornography book shop in London--thus the title of the short story) and two women: Lucy, a nurse, and Pauline, a nursing trainee. (The "Sister" used to refer to Lucy is a British term for nurse and does not mean she is a religious. See my review of John Patrick's The Hasty Heart, in this database).

O'Bryne has "the clap" (gonorrhea), yet cavalierly, even maliciously, continues his sexual relationships with both women, who do not (at the beginning of the story) know of each other's existence. When they learn of his affliction, his infidelity and his uncaring infliction of "the clap" on them, they begin to wreak a horrid revenge on him in a perversion of their surgical and nursing skills.

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The practice of medicine in equatorial Africa is both a challenge and an escape for Dr. Koestler. The physician from New Zealand works at a Global Aid mission in Zaire. He has toiled there a long time but is still a loner. His best friend appears to be a pet baboon named George Babbitt. The monkey drinks whiskey and smokes cigarettes. It is a clever creature with a mean streak and is generally despised by everyone except Koestler.

Two young American doctors arrive at the mission to assist Koestler. While the three physicians and the bush pilot drink whiskey and smoke marijuana, Koestler instructs the new doctors on some of the laws of jungle medicine: Use only disposable needles and then destroy them. Never transfuse a patient unless they require at least 3 units of blood (since all blood will likely be contaminated by Hepatitis B or HIV). Safe sex means no sex. Speed matters. Avoid getting involved because feelings will inevitably obstruct your work.

Although a leopard is roaming outside the confines of the mission, Koestler ventures into the darkness of the jungle to search for George Babbitt who has run off with a bottle of whiskey. In a locale teeming with life, the physician remains essentially alone--by choice.

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Four soldiers with a similar wound--laryngeal damage after being shot in the throat--share a room in a German military hospital during World War I. Each of them has a tracheostomy tube, and they can only speak by covering the opening of the tube with a finger. Because every breath or laugh generates the sound of a little whistle, these men are dubbed "whistlers" and their hospital room is named after them. The injured soldiers are Pointner, Kollin, Benjamin, and an 18-year-old English prisoner of war, Harry Flint. They undergo a series of painful surgeries (without anesthesia) to dilate the narrowed and scarred air passage.

The surgeon, Dr. Quint, is a compassionate man with incredible physical strength. He holds the "whistlers" in high regard. They in turn venerate the devoted surgeon. Pointner and Kollin die. Surgery on Benjamin and Harry is successful and their tracheostomy tubes are removed. They can now breathe normally and soon discover their new voices.

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While eating lunch in the hospital atrium, the retired doctor who narrates this story notices a boy in a wheelchair looking at him. The elderly physician and the youngster begin a conversation. The fourteen-year-old boy is terminally ill with cancer. The doctor quickly determines that the lad only has time left for honesty. The boy lies, however, about his name. He calls himself Thomas Fogarty but his real name is Tony. "What will you do on your last day on earth?" the moribund boy asks the narrator.

The doctor shares with Tony his own fantasy about dying. He envisions a former student who is now a great surgeon transporting him to an ancient forest. There he becomes part of the woods and keenly aware of the mystery of life. Soon his mind breaks with his body. Death is just "a painless transition."

Tony dies the next morning. He had dictated an unfinished letter to the doctor, and Tony's nurse delivers it to him. As a retired physician, the narrator has performed a valuable service by helping prepare the boy for death. As a writer, the narrator still hopes to save him. He has immortalized Tony by converting him into an enduring story.

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A young art student falls off a ladder and literally lands into the arms of a middle-aged doctor. Daisy Whimple is a poor, homeless woman with multiple body piercings. She has volunteered to decorate the Gynae Ward of the hospital where she had once been a patient undergoing surgery for a complicated abortion.

Dr. Damian Becket is an obstetrician and gynecologist. He is a lapsed Catholic who is separated from his wife. Becket is interested in modern art and attracted to an art historian, Martha Sharpin. The hospital has a collection of medical antiquities in need of cataloging. Some of the pieces are treasures but others are horrible relics. Martha is in charge of organizing the collection, and Daisy is paid to assist her.

Because she has nowhere to live, Becket invites Daisy to stay at his apartment. They make love every night for one week until she leaves. While attending an art exhibit, Becket and Martha spot a sculpture of the goddess Kali. The figure is comprised of artifacts "borrowed" from the hospital's collection including prosthetic arms, antiquated instruments, and body parts. It is designed by Daisy.

The sculpture is not the only unexpected thing created by Daisy. She is pregnant by Becket. Daisy requests an abortion but he insists that she have the baby. The pregnancy is almost miraculous given the damage done to Daisy's fallopian tubes from her previous abortion. It turns out to be a difficult delivery and Becket must perform it since he is the most qualified obstetrician at the hospital. The baby is a healthy girl. The newborn child radically changes the lives of Daisy, Becket, and Martha, yet the three of them have no clue what to do next.

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Just as the new plague that will eventually become known as AIDS begins to exact its toll on the gay community, William and Terry slide somewhat unintentionally into a committed relationship, complete with a dog. Terry has issues with the modest size of his penis; being "married" absolves him from performance anxiety.

Almost equally furtive, William has inherited polycystic kidney disease from his mother and is on dialysis, with the severe dietary restrictions and merciless thirst that it entails. William professes to Terry that size doesn't matter, but he indulges in elaborate fantasies about Peter Hunter, a well-endowed star of porn magazines; he becomes an obsessive collector of Hunter's work.

Terry and William are insulated by their singular bond from the havoc of AIDS, but William finds himself compelled to hunt the stigmata of that disease in photos of the exposed and hidden portions of Hunter's anatomy. When he realizes that motorbike riders are prone to becoming organ donors, he cultivates a fascination with their behavior and their machines, following them in his car and tracking statistics. Finally, a matched biker kidney is found for William, but the immunosuppressive drugs, which are given to help him tolerate the transplant, make him very ill. He is admitted with opportunistic pneumonia, ironically, to an AIDS ward.

More than once William says, "I went to sleep next to someone I knew and I woke side by side with a stranger," The book closes with a surreal dream-like sequence, as William takes leave of his lover. It could be continued life, readjusted by this brush with mortality toward a bold new freedom. On the other hand, it could be death itself, and the story suddenly becomes the memoir of a ghost.

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