Summary:

Tenderly Lift Me is the latest publication from Kent State University Press in the Literature and Medicine series edited by Martin Kohn and Carol Donley. Not all the 39 caregivers Bryner honors through poetry, biographical sketches and photos are nurses, but all have discharged their caregiving duties as the title indicates: tenderly. The book opens with a preface by Bryner who wants "people to care about nurses the way nurses care about people who are total strangers" (p.xii). A literate and insightful introduction by Suzanne Poirier and Rosemary Field follows.

The book, divided into eight parts, contains biographical sketches and interviews with nurses or tender caregivers, their photographs, and poems by Bryner in which she speaks in the voices of the individual nurses, celebrating but never sentimentalizing their stories.

Some of the nurses are daughters of blue-collar workers: Carol Johnson (p. 77) went on to become a cardiothoracic nurse practitioner, harvesting veins for open heart surgeries. Helen Albert (p. 52), the granddaughter of a slave, became "the first black registered nurse hired in Warren, Ohio." The nurses celebrated are both living and dead; some are aged, this book the only vessel that might hold their histories. All the caregivers, like Father Damien, born in 1840, caretaker to a colony of lepers in Molokai, come alive in Bryner's prose and poems, speaking to us in image and metaphor as well as fact and biography.

There are journal entries from Kate Cumming, who cared for confederate soldiers during the Civil War (p. 151), and comments from contemporary nurses, like Sylvia Engelhardt, one of the first nurses to graduate from an associate degree program and feel the "sting of labels" (p. 69), or Theresa Marcotte Kokrak (p. 46) who remembers traveling though Canada's seventy-below wind-chill to report to duty. Bryner celebrates the nurses' accomplishments as well as the daily events, the doubts and frustrations, the dark moments that these nurses have overcome in order to care for others, nurses who are "human, and sometimes a little heroic, but not from heaven" (P. xii).

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While on an airplane, Carson experiences abdominal pain. He is a divorced man in his fifties and a sales representative for a computer and information technology firm. He spends much of his time traveling and fancies himself "a connoisseur of cities." The increasingly severe stomach pain forces Carson to reschedule his business meeting and retreat to his hotel room.

His suffering mounts and he decides to visit the emergency department of the city hospital. Carson is evaluated by two young male doctors and later a middle-aged female physician. Despite blood tests and X-rays, his diagnosis remains murky and a surgical consultation is obtained. The surgeon suspects appendicitis. He postulates that Carson may have a retrocecal appendix and explains that in such cases the anatomical location of the organ often confounds the diagnosis.

Carson undergoes surgery. His appendix is indeed retrocecal and rupturing. He spends five days convalescing from the operation. During that time he acquires an intimate knowledge of the city from his stay at the hospital. The experience revitalizes him. Carson reasons that the world is miraculous in part because it is so simple yet still spectacular.

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For three weeks the narrator has been working as a clerk in the emergency department. His good friend, Georgie, is a hospital orderly. Both men abuse drugs, and Georgie steals them from the hospital. The ER staff includes Nurse (an overweight woman who shakes) and the Family Service doctor (a physician with limited competence who is not well-liked).

At 3:30 A.M., a man named Terrence Weber arrives at the ER. He has a hunting knife stuck deep in his eye. Ironically, his other eye is artificial. Weber's wife apparently tried to blind him because he ogled the woman next door. The doctor immediately decides the situation is beyond his expertise and calls for an ophthalmologist, neurosurgeon, and anesthesiologist.

Meanwhile Georgie is prepping Weber for surgery. The drugged-up orderly, who cannot even tie his shoe at this point, somehow removes the knife by himself. Weber's vision is fine. Later on, the narrator and Georgie get lost while driving around in a pick-up truck without headlights. The truck runs over a jackrabbit on the road. Intent on making rabbit stew, Georgie cuts the animal open with the hunting knife he had earlier removed from Weber's eye. The rabbit is pregnant with eight miniature bunnies inside her.

Georgie decides to save the babies. Unfortunately the narrator forgets about the rabbits and accidentally squashes them to death. At the end of the story the two men encounter a hitchhiker who has gone AWOL from military service. Georgie promises to take him to Canada.

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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A country doctor, Gregory Ovchinnikov, begins his daily rounds in the hospital. He soon notes that his assistant, Smirnovsky, is drunk. When the assistant refuses to obey an order and snaps back at him, Ovchinnikov hits the man in his face. The angry physician then rushes out of the ward and goes back to his lodgings.

At first, he considers demanding that the town council fire Smirnovsky. Later, after he goes back to work, Orchinnikov begins to wonder about the enormity of his unprofessional act--perhaps the town council will fire him. Strangely, when the assistant comes to apologize, the doctor indicates that it is he--the doctor--who has behaved inexcusably. The assistant is stunned, but decides to complain to the council. Of course, the council demands that the (lower class) Smirnovsky apologize to the (upper class) Ovchinnikov.

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The new interns, Roy Basch (Tim Matheson), Chuck (Howard Rollins, Jr.) and Wayne Potts (Michael Sacks), begin their year of internal medicine training in a busy city hospital under construction. After initial introductions led by the vague staff man and vapid chief resident, they become the specific charges of the cynical resident doctor "Fats" (Charles Haid). Fats teaches them attitude and language: how to "buff" (improve) and "turf" (transfer) "gomers" (Get Out of My Emergency Room)--the words used to describe management of incurable, hateful patients who "never die," regardless of the abuse the clumsy housestaff might inflict. But Fats has heart.

Soon, they fall under the command of the militaristic and lonely woman resident, Jo Miller (Lisa Pelikan), who cannot bring herself to withhold treatment, even at a patient's request. She blames underlings for the failings of medicine and nature, as well as herself.

Wayne throws himself from the hospital roof because of a misplaced sense of guilt over a patient's demise. Roy falls in love with the nurse, Molly (Kathryn Dowling), but nearly loses her as he begins to emulate Jo's cold, calculating style. He is "rescued" in the nick of time by his friends, Fats, and the death of a physician patient (Ossie Davis) whom he admires. With recovered equanimity and renewed anger over the suicide of his fellow intern, Roy refuses to go on with his residency.

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This is a new collection of poetry and short prose by nurses, edited by Cortney Davis and Judy Schaefer, whose remarkable first anthology, Between the Heartbeats: Poetry and Prose by Nurses [see annotation in this database], may be the founding document of "nurse writing" as a recognizable genre. In the Foreword, Cortney Davis comments on the process of selection and sketches the similarities and differences between this and the previous volume.

One of the interesting similarities is that nurses write more often about birth than death; one of the differences is the wider range of topics, including nurses who reveal their own experiences as patients (see Amy Haddad, "Conversations with Wendy," pp. 100-102) and others whose fatigue and frustration cause them to step away from nursing (see Pamela Mitchell, "A Nurse's Farewell," pp., 149-151)

As in Between the Heartbeats, the authors of Intensive Care appear in alphabetical order, which favors variety and surprise over categorization. In "Medical Ward," the first poem (pp. 1-2), Krys Ahlman captures many of the themes of the anthology. "I was wearing a thousand tiny failures," Ahlman writes, and concludes: "I held out my hand, I said / I am not afraid to cry."

Intensive Care is full of delights. As advertised, there is much about bringing children into the world and caring for them; for example, Lynn Bernardini's reminiscence, "Does This Day Mean Anything to You?" about having given up her own baby for adoption (pp. 11-16); Celia Brown's poem "Forget-Me-Nots" (pp. 35-36); and the powerful but ambiguous hope of "Neonatal ICU" (Leigh Wilkerson, p.247). There are the painful memories of dying children and adolescents, especially Jeanne Bryner's amazing, "Breathless" (p. 42) and "Car Spotting, " (pp. 173-184), a story by Christine Rahn about a terminally ill adolescent. In "Car Spotting" the head nurse criticizes the young narrator because, "You become too personally involved with the patients . . . Nurses must make decisions based on objective data. Becoming too attached can cloud professional judgment." (p. 175) I found this an interesting statement coming from a nursing instructor--it could well have been made by a professor of medicine to a third year medical student.

Other major themes include the humor of nursing (see "RX for Nurses: Brag!" by Kathleen Walsh Spencer, p. 203; and "What Nurses Do on Their Day Off," Judy Schaefer, p. 188); women's health (see "Every Day, the Pregnant Teenagers," Cortney Davis, p 69; and "Redemption at the Women's Center," Jeanne Lavasseur, pp. 132-133); nursing the elderly (see "Home Visits," Paula Sergi, pp. 195-196); and the wonderful narratives of patient care (see "Sarah's Pumpkin Bread," Terry Evans, pp. 87-90; "Edna's Star," Chris Grant," pp. 95-99; and "That Mystique," Madeline Mysko, pp. 158-167). Finally, Intensive Care looks back thoughtfully in a number of pieces to nursing in military settings.

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Ruth is an orphaned seamstress. One day, while repairing ladies' dresses at a ball, she meets Henry Bellingham, an aristocratic young man who accompanies his proud partner to the seamstress' room. Circumstances throw Henry and Ruth together and the two become close friends; innocent Ruth has no idea of the trouble into which this affair is leading.

Henry invites her one Sunday to walk with him out of town to her old family home. She is blissfully happy during the trip, but on their return, they are overtaken by Ruth's employer who jumps to conclusions about the couple and fires Ruth on the spot. Pressed by circumstances, Ruth accepts Henry's offer of help. She travels with him to Scotland and the two become lovers. While in Scotland, Henry becomes ill. His mother is called and as soon as her son is well he returns to London with her, leaving the disgraced Ruth behind.

Ruth is ready to kill herself but is stopped by Thurston Benson, an invalid who pities Ruth and finds her a place to stay as she falls ill in her despair. When Thurston and his sister Faith find out that Ruth is pregnant, they have her move in with them, presenting her to their friends as a widow. Ruth bears a son and everything goes well for many years. Ruth's piety and goodness win the respect of her very traditional neighbors.

About this time, Henry Bellingham is campaigning to represent the district in which Ruth lives. He recognizes Ruth and tries to win her again, even offering marriage, but she will not listen to him. Soon after, a jealous woman in the town discovers Ruth's secret. Ruth is fired from her position as governess and despised by the townspeople. All her goodness stands for nothing in the face of her early mistake.

Ruth struggles on for her child's sake, even helping in the hospital during a typhus epidemic. She learns that Bellingham is nearby, deathly ill from typhus. She helps cure him, but leaves his bedside before he can recognize her. She, however, contracts the disease and dies. Bellingham comes to see her body.

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In the first of this poem's three stanzas, the narrator is looking out the window, presumably on or near his fiftieth birthday. He watches as a baby possum is snatched up by a fox while the possum's mother stands dumbly by. Seeing this, the narrator notes that it is one more thing he "couldn't do anything about." In fact, he sees the drama dispassionately. He says that instead of "feeling very much" he had the sense of "something dull / like a small door being shut, / a door to someone else's house."

In the next stanza, later that night, the narrator is flipping through the TV channels but stops when he is captivated by a nurse who "had a beautiful smile / while she spoke about triage and death." Again he observes death from afar as the nurse talks about her experiences in Viet Nam and how a dying soldier asked her to bend closer so he could smell her hair.

In the final stanza, the narrator's wife comes home, tired. The narrator, however, is somehow energized; he wants to talk about the possum, the fox, and the young man who "wanted one last chaste sense / of a woman." The wife wants a drink, some music, everything "normal." But the narrator, transformed by the nurse's smile, its "pretty hint of pain / the other expressions it concealed," is no longer just an observer.

He now has "something to say," something almost inexpressible about life and death, the death that he is moving closer to but was, at the poem's beginning, unable to face. The nurse's experience--her proximity to death, her ability not only to observe but to acknowledge and honor it--has somehow transformed him.

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Summary:

Poet and writer Jeanne Bryner has assembled 24 short stories to give us Eclipse, a wise and tender collection that reflects her blue-collar roots in Appalachia and industrial Ohio, and also her work as a registered nurse. These stories are about real human beings, flawed and graced, who, for the most part, care for one another, whether family or stranger, with compassion and the kind of acceptance that comes from living a hard life. Bryner's writing skills move these characters beyond easy stereotype and turn their actions--their anger over the death of a loved one or the cooking of a Sunday supper--into transformative metaphors that illuminate the sorrows and joys of everyday life.

The following stories might be of particular interest to those teaching or studying literature and medicine: "Sara's Daughters," in which a woman undergoes artificial insemination and, through her thoughts and her conversations with the nurse, perfectly reveals an infertile woman's humiliation, longing, and hope; "The Jaws of Life," in which a young woman takes her Aunt Mavis to visit Uncle Webster in a nursing home and there observes the poignant interactions of the well and the dying, the young and the old, moments infused with both charity and dread.

In addition: "Turn the Radio to a Gospel Station," in which two cleaning ladies in a hospital ER observe and philosophize about what goes on around them, the deaths and near-deaths, the kindness or mutinies of nurses, the doctors' mechanical repetition of questions, the lovers hiding in the linen closet; "The Gemini Sisters," in which a group of weight-watching women meet to shed pounds and talk about life; "Foxglove Canyon," in which a registered nurse with forty year's experience relates memories of her work, her family, and how things change when a writer comes to teach the staff and the patients about poetry, "the flower you stumble across growing near the barn, a purple bloom that nobody planted."

"Red Corvette" examines the intimacy that develops between family members, particularly when one is caregiver to the other. In this story a woman comes to visit her post-op sister and remembers, while watching her sister suffer in pain, their childhood, those moments of freedom and health she yearns for her sister to regain.

"The Feel of Flannel" is about a woman who, like her mother and grandmother, has breast cancer. She refuses to participate in a research project but instead barrels ahead into her uncertain future, planning to wear her nightgown to the grocery store and tattoo her husband's name "right here when this port comes out."

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