Summary:

In dire financial straits, the physician-researcher, Dr. Malcolm Sayres (Robin Williams), accepts a clinical job for which he is decidedly unsuited: staff physician in a chronic-care hospital. His charges include the severely damaged, rigid, and inarticulate victims of an epidemic of encephalitis lethargica. Sayres makes a connection between their symptoms and Parkinson’s disease. With the hard-won blessing of his skeptical supervisor, he conducts a therapeutic trial using the new anti-Parkinson drug, L-Dopa.

The first patient to "awaken" is Leonard Lowe (Robert De Niro) who, despite being "away" for many years, proves to be a natural leader, with a philosophical mind of his own. Other patients soon display marked improvement and their stories are told in an aura of fund-raising celebration marked by happy excursions.

Gradually, however, problems develop: patients have trouble adapting to the radical changes in themselves and the world; Leonard grows angry with the imperfection of his rehabilitation; the horrifying side effects of L-Dopa appear; and Leonard’s mother (Ruth Nelson), initially happy for her son’s recovery, is later alienated by the concomitant arousal of his individuality, sexuality, and independence. The film ends with "closure of the therapeutic window" and marked regression in some patients, but not before they have awakened clinical commitment and a new ability to express feelings in their shy doctor.

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The aged, black nurse, Eunice Evers (Alfre Woodward), testifies before the 1973 Senate hearings into the Tuskegee study. Through a series of lengthy flashbacks, her testimony evokes the 1932 origin and four-decade course of a research experiment to study but not treat syphilis in the black men of Macon County, Alabama. The federally funded project began with the intent to treat the men, but when funds dried up, the project coordinators decided simply to document the course of the disease to discover if blacks responded to syphilis as did whites.

The nurse was deeply attached to the patients and they, to her; a Dixie band named itself "Miss Evers' Boys." Evers and her doctor supervisor (Joe Morton) hoped that treatment would be restored after a few months, but ten years pass. With the advent of penicillin in 1942, her intelligent lover Caleb (Laurence Fishburne) rebelled, took penicillin, and enlisted in the army; the project, however, continues.

Evers is disbelieving when she realizes that the men will not be treated, but she cannot abandon them. Against the advice of her father, she refuses to leave Alabama with Caleb and continues to participate in the lie that encourages the Tuskegee men to remain untreated into the late 1960s. One by one Miss Evers' Boys die or are disabled by the disease.

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The lives of writer Cathy Crimmins, her lawyer husband Alan Forman, and their seven-year-old daughter were changed forever on July 1, 1996, at a lake near Kingston, Ontario. "Alan’s brain got run over by a speedboat. That last sentence reads like a bad country-western song lyric, but it’s true. It was a silly, horrible, stupid accident." (p. 5). While Alan steered a small boat back to dock at the end of their vacation, a teenager drove a speedboat literally over him, causing major traumatic brain injury (TBI) including seizures, coma, hemorrhage and paralysis.

Crimmins chronicles her husband’s remarkable recovery with a mix of humor, medical information, anger at HMO denial of benefits, and gratitude for the care of physicians, nurses, therapists, EMT, friends and family during this grueling, and in many ways, never-ending ordeal. Although Alan survived -- and is now capable of walking, speaking, reading, loving, working and driving -- he is a different person. The injury to his frontal lobes causes him to be disinhibited, erratic, angry, irrational, petulant, obsessive, devoted yet cruel to his daughter, and prone to severe "cognitive fatigue."

TBI is a bizarre, unpredictable illness. Crimmins notes that the degree of Alan’s recovery is atypical for the force of his trauma. In addition, TBI survivors say and do wacky things: "Where is the mango princess?" was one of Alan’s first utterances after emerging from his coma. Alan’s pre-accident sharp-edged humor was replaced by bland affability and a disturbingly vacant gaze. Yet some of what he says and does is heart wrenching and poignant.

The book clearly documents that the trauma is not limited to the patient. As Crimmins so eloquently and honestly recounts, she, her daughter, and all who knew Alan were traumatized by the accident and its aftermath.

Crimmins is an aggressive caregiver, thrust kicking and fighting into the caregiver role. Her advocacy for her husband, including research into the best rehabilitation facility, day hospital, vocational rehabilitation program, doctors, therapists, etc., was unwavering and crucial to his optimal care and outcome.

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This is the story of a child/young adult who had the misfortune of multiple health problems from the age of three until his death at 19. But even more than Jesse's story, this is the narrative of and by Jesse's father as he recalls the emotional rollercoaster accompanying the abbreviated span of his oldest son's life. The author kept detailed journals of his and his son's experiences with the health care professions, while also collecting the boy's artwork which appears to be Jesse's personal record of his own internal struggle.

Although not chronologically linear, the narrative allows the reader into the soul of the parents' agony, from the time of Jesse's initial diagnosis of hydrocephalus, through management of inflammatory bowel disease, and into the final chronicle of unsuccessful liver transplantations.

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This chapbook of 26 poems traces the author's interactions with her mother, a woman lost in the morass of Alzheimer's disease. In the first poem, "The Loss" (1), the author takes us into her mother's home--a disorganized mess of stained thrift shop clothes folded and refolded into piles. The daughter tricks her mother into moving in with her "for a trial" which becomes permanent.

In the last poem, "At Least This" (26), the poet stoops "to pull the diaper / up around my mother's / waist, my temple / near her breasts." As the daughter leans into this task, the mother caresses her hair, embraces her. This hug, beautifully and simply portrayed, is the poet's fragile reward for all the struggles, mercies and difficult moments examined in the poems between.

These poems are both beautiful and unfailingly honest, addressing with humor and charity the difficulties of caring for a parent with this disease. In one poem, "The Battle" (5), the mother slathers herself with Vaseline. In another poem, "The Bath" (7), the mother lies in the bathtub, her flaccid skin smoothed by water's illusion, her body suddenly as lovely as Bonnard's painting of a woman bathing. "This is the mother I battled / when young: the mother / who beat my defiance; / the one I hit back," the poet writes in "A Late Blessing" (6), and in another poem, "Intellectual Opiate" (10), she speaks of her mother's love for words she no longer understands.

But these poems are more than poignant narratives about a daughter's relationship with a once-difficult, now dependent mother. They address the "seeds of her disease" (11), exposing the flaws of this relationship without dishonor or blame. In these poems, Slatkin's mother appears vibrant and whole, not ravaged by disease. Rarely have the difficulties and possibilities of Alzheimer's disease been presented in poetry with such insight and respect.

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In four parts this book uses a wide variety of images--caricatures in newspapers, comic books, advertisements, and photojournalism of Life magazine--to explore attitudes to physicians and medical progress in the mass media from the late nineteenth century to the mid-twentieth century. Each section centers on a specific type of image and the analysis addresses change in perception of doctors and their achievements by privileging crucial moments of newsworthy events and discoveries.

Early in this history, the media portrayed doctors as frock-coat wearing fops.  Medical metaphors used in a political context proclaimed these attitudes well. The story of four little boys, bitten by a dog in 1885 and sent to Pasteur in Paris for the newly invented rabies vaccination, is used as a pivot point for a transition in perceptions of medicine: from a clumsy, suspicious craft to a useful, progressive science.

The third section is devoted to the public fascination with the history of medicine in the period from 1920 to 1950, Films, newspaper articles, and comic books chart the insatiable taste for scientific success and medical progress. The last section studies images of progress in Life and other magazines through a meticulous analysis of health-related articles. In this section, Hansen shows how the media participated in educating the public to a definition of science that enjoyed an enthusiastically optimistic spin.

An appendix lists American radio dramas about medical history from 1935 to 1953. A wealth of sources are documented in the notes and the whole is completed with an intelligent index.

 

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Kaplan Publishing has recently released several anthologies aimed at a nursing audience or perhaps at a reading audience that wants to know more about what nurses think and feel about their professions.  This anthology, a collection of poetry and essays, looks at the various reasons these authors went into nursing in the first place, how nursing changed them, and why they either stayed the course or went on to other pursuits.  As the editors say in the Introduction, "nursing abounds with experiences that can either reinforce our vocational commitment or cause us to reconsider it" (p. xi).

In the first section, "The Calling," poems and essays examine "the idealistic reflections of those aglow with nursing's promise of intimacy and connection" (xii).  Here we meet student nurses with a true calling who are "living, breathing and sleeping nursing" (p.5), and students who are sure they are going "to murder someone" (p. 6).  Like most professionals, nurses often have mentors, and those mentors--"brisk, frank, fast, sometimes sharp" (p. 30)---are honored in this section as well.  Readers, upon completing this section, will be moved and cheered by the poems and essays that reflect the romance of nursing and the intense drive that many nurses have to give of themselves to others. 

The editors, however, are no Polyannas.  They know that a student's illusions and dreams will run right smack into reality.  While the rewards will certainly be many, the discouragements will be present as well.  The fact that both experiences---the highs and the lows---can occur within a single day is reflected in the collection's second section, "The Reckoning."  Here the realities of death, exhaustion, burnout and doubt are faced full on.  Some of the works in this section are by nurses who have chosen to leave the profession:  "Brazil, the new hospital.  We have no water.  Doctors protest poor facilities by refusing to see patients and sitting in their cars outside in the parking lot" (p. 81), writes Veneta Masson as she traces her career from 1958 to 1998 when she decides to leave nursing and "use my hands to write and to bless" (p. 84).  While some have chosen to leave, other nurses have found ways to survive: "Nursing allowed me to help my mother die; my music has helped me live" (p. 88) writes Colleen O'Brien, and Fr. Robert J. Kus writes about his dual roles, priest and nurse, how they balance and enhance one another (pp. 102-110).  The works in this section remind readers of the sacrifices caregivers must make every day.  As Jo Ann Papich writes, "Please appreciate your nurse while you still have one" (p. 99).

Section Three, "Reincarnation," tells of the "informed commitment that arises after sustained trial" (p. 165).  Here nurse-writers talk about survival and the oddly comfortable balance between stress and transcendence that comes, at last, after many years in nursing.  In "Why I Like Dead People," Sallie Tisdale takes a wry look at death, nursing homes and their "cockeyed logic" (p. 175).  Anne Webster, in "Slow Night in the E.R." talks about doing what you must do to help others even when you "can't do it," when you "stand outside the curtain, shaking" until the patient asks, "Are you there?" (p. 186-7).  Kathryn Gahl, in "The Reason Nurses Write Mostly Poetry" says it's because nurses "convert heart sounds // and hard words into art before the next patient / arrives, hemorrhaging, counting on that nurse / to flow like a pen, bleed for both of them" (p. 195).  And in the book's final essay, "I'm Staying," Shirley Stephenson offers a series of lovely statements about why she, and others, might continue in the frustrating, tiring, challenging and miraculous profession of nursing.  "Because I have been in the bed, and beside the bed. Because I have waited. Because I believe any one of us could face the circumstances of those for whom we provide care, and we're much more similar than different. Because this is where the rhythm is loudest---yes this yes this yes this yes this" (p. 246).

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Author Jennifer Culkin has been involved, for all of her nursing career, in high stakes, heart stopping, instant-decision-making areas of critical care.  After years working in Neonatal Intensive Care, she became a flight nurse--and giving intensive care to trauma victims while trying to maintain balance and sterile technique in a wind-buffeted helicopter has to be one of the most difficult tasks a nurse might undertake.  Her memoir, A Final Arc of Sky, opens with such a scene.  The patient, Doug, is soon crashing, and the nursing team, Jennifer and her partner, have to make a series of tough decisions (pp. 8-12).  From this scene on, the action rarely wavers.  And although Culkin keeps the pace moving, she is not always, or even most often, telling us about similar traumas.  She deftly weaves her personal narrative--husband and sons and dying parents--in and out of scenes from her nursing career, braiding the plot lines of her life in chapters both moving and compelling. 

In those chapters that deal with the often dangerous helicopter transports Culkin has flown, we learn (and we feel) just what it's like to be a flight nurse crammed in-between patient and helicopter door, juggling instruments that too often slip to the floor and trying to save patients that too often want to die.  In those pages that deal with family, we are privy to Culkin's internal debate about how to separate family from nursing (what she calls "the great neuronal divide between my work and my life" (p.136), and we see that she sometimes doesn't have much energy left at the end of the day to draw close to those she loves.  Part of what makes this memoir difficult to put down is the persona of the narrator herself: Culkin comes across as an honest, often irreverent risk taker, a woman who likes to ride her bike down dangerous hills at breakneck speed and allows her son to do the same (see chapter six, p. 57); a woman who loves the dangerous drama of flight nursing and doesn't worry about crashing (p. 80)--in fact she enjoys strapping herself "into the eye of a maelstrom" (p. 80). 

This memoir entertains, and it provides a glimpse into how some caregivers not only risk their lives to save the lives of others but also shoulder the responsibility of making split second decisions upon which a patient's life might depend.  And there is a surprise in this memoir, one that I can't too fully divulge because to do so would be to rob potential readers of their own discovery.  Suffice it to say that near the end, Culkin reveals something about her own health, an illness she has fought against in every chapter.  When we learn the details of her own illness narrative, we look again, with new understanding, at her fascinating career and her interactions with her loved ones.   

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Body Language, a beautifully crafted and expansive memoir by retired nurse Constance Studer, spans a range of issues within the narrative of the author's life: a childhood marred by a medical procedure--a hasty frontal lobotomy that left her father incarcerated in a mental institute-- and, in later years, by her own illness, one caused by the Hepatitis B vaccine.  These two events are the bookends that frame Body Language, a memoir that examines family life, nursing, medicine, medical ethics, personal survival and illness in language that is poetic and compelling.  Studer, a writer as well as a nurse, intersperses her own story--which is novel-like in its intensity--with literary allusions, research material and knowledge culled from her years as a nurse in Intensive Care.  In her memoir, she writes not only with the authority of one who has been on both sides of the bed, as professional caregiver and as suffering patient, but also as a family member who has witnessed how unwise and unchallenged medical decisions might affect generations. 

What I especially admire about this memoir is that it is not simply a "telling about."  Instead Studer brings us into the action of the narrative, for example giving us imagery and dialogue as her father prepares for the surgery that he doesn't know will deprive him of memory and sense ("Holy Socks" p. 21).  She also intertwines many narrative strands, giving us the fullness of her family history and her professional adventures, so that when we reach the narrative of her own illness we have a sense of a life, a full life, that has been forever altered.

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Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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