Summary:

This book chronicles a tortured parenthood during the birth and brief life of a severely brain-damaged female infant, Silvie. Doctors predict that the child will live only a few days but instead she survives for seven months. The story is told in first person by the mother, beginning with her arduous labor during a home delivery in the presence of an experienced midwife and the family physician. The baby does not cry when she is born and turns blue even with oxygen that the doctor administers. An ambulance is summoned; "a bigger, better oxygen machine" restores the baby's color and she is brought to a hospital neonatal intensive care unit where she is artificially ventilated and fed.

In the hospital Silvie "fails" all the tests of normalcy. The doctors recommend removing artificial ventilation. "I feared, even more than I feared her death I think (and harder to admit), that they would remove the oxygen pump and the baby would live on and on and never be able to do anything at all" (14). Yet when the child does in fact breathe independently, "I took the fact that she could sustain her own breathing to mean that the baby wanted to live. It was all right to love her" (15). A few days later, however, the medical team concludes that there is nothing further they can do for the baby, that the parents should take the child home, where she will likely die within a couple of days. Upon being prodded, one physician suggests the parents give her an overdose of phenobarbital, which she is receiving for continual epileptic seizures.

At home, the parents feed Silvie by tube, medicate her, change her diapers, hold her, and learn from a friend how to swaddle her. The child never cries, does not focus her eyes on anything, rarely responds to sound or touch, and gains no weight. Whatever random responsiveness there seems to be gives the author a sense of motherhood: "I was able to survive because of my faith in these intermittent chance meetings, believing that Silvie did know when I was here and that I was holding her close in a way that meant love" (37). The parents brace themselves for Silvie's death. The husband's sister visits and councils them to actively put an end to Silvie's life, which they refuse to do. But they do not plan to take extra measures (CPR) if Silvie seems to be dying at home and when they articulate this to a social worker whom they consult to obtain respite care, it becomes clear that she would report them to Child Protective Services.

The husband quits his job as a residential counselor of emotionally disturbed teenagers to do part-time carpentry work -- he is too preoccupied to care about other people's problems. When a friend accidentally breaks the phenobarbital bottle, the parents together with the family physician decide to see how Silvie will get along without the drug. To their amazement, the baby appears slightly more alert and is able to suck from a bottle -- no more feeding tube required. But the husband reminds his wife, "The doctors warned us she might do this. This is the one and only thing she can ever learn. They said when this happened to other parents they started to believe that the baby was getting better" (59).

The parents live in limbo, attempt to live a "normal" life. When Silvie starts to lose weight at age 4 months, the doctor advises to resume tube feeding; they don't see the point, but when hospital physicians use the word, "murder," and threaten to "take over" Silvie's care, the parents relent. The baby lives but "it was the sameness of Silvie that drove you crazy . . . She slept and woke, but was awake that much different? She did not change, she did not change. Her sameness was a stone I wore, an emblem of failure, failed life" (96).

The final act for Silvie begins when the author's mother-in-law is dying of cancer in New York and a decision is made to leave the baby at home in California for several days in the care of a retired nurse. The nurse has been shown how to do the tube feeding, but while the parents are in New York she experiments with spoon feeding, then discontinues tube feeding for three days before the parents return. The parents see that Silvie has deteriorated in their absence and resume tube feeding. For the remaining couple of months the parents wait, investigate institutionalizing Silvie, and finally determine that "the way we loved Silvie meant we loved her enough to let her die" at home, with "a certain amount of fluid and nourishment for comfort, but a gradual withdrawal of excessive food. Replaced with a lot of touching and holding, stroking and whispering" (122). Silvie dies and the author is four months pregnant with the baby she and her husband have decided not to abort.

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Summary:

This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

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Summary:

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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Dr. Flaherty, a practicing neurologist, sets out to explore the act of writing and, more broadly, creativity, in the context of both neuroscience and emotion. She begins by describing several brain conditions that seem to enhance the need to write, even to the extent of obsessive hypergraphia. Next she turns to the opposite state, writer's block, looking at both psychological and neuroscientific perspectives.

Using some of the recent studies of the relationships between certain brain centers and language related phenomena, Flaherty further clarifies some of the cognitive bases for creating literature. Finally, the study turns specifically to the temporal lobe as the possible organic site of the perceived voice of the muse in religious and creative inspiration.

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In this novel the narrator travels by train from the present into the past and back again. The narrator boards a train in Soviet Moscow; travels to Leningrad in a compartment with some not too friendly people; stays overnight in a relative's run-down, crowded apartment; and rambles through the streets of Leningrad, stopping to visit Dostoyevsky's last place of residence, which is now a museum.

However, this framing story occupies very little of the book. During the train ride, the narrator re-imagines a much earlier trip in April 1867, as Fyodor Dostoyevsky and his young wife, Anna Grigoryevna, travel by train to Baden-Baden in Germany. They will remain abroad for four years, as Dostoyevsky indulges in his passion (and later obsession) for gambling.

In Baden-Baden he loses all their money; he pawns their belongings and loses; he begs and borrows money from friends and publishers, and loses. Each time he loses, he comes home to their rented apartment and throws himself at Anna's feet. He protests his love, berates himself, and promises to do better in the future; and Anna forgives him.

In this dream-like story, repentance and forgiveness, memory and desire, hope and despair revolve like electrons around Dostoevsky's addiction to gambling. Fyodor and Anna recall earlier events in their lives; for example, Anna remembers herself as a hesitant young secretary arriving for the first time to take dictation from the famous man; and Fyodor, the former convict, Slavophile author of Crime and Punishment, remembers being scornfully dismissed by the smooth and sophisticated Turgenev.

Within the 1867 framework, the story seems to be stuck, unable to move forward, although we know from our late 20th century perspective--as Tsypkin recalls (and invents) the events while on his train trip to Leningrad--they are part of a larger story which moves inexorably forward through time and ends at the Dostoevsky house in Leningrad (St. Petersburg), with the moving scene of Fyodor's last days. And the two stories converge as Tsypkin visits the Dostoevsky museum where those last days took place.

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Summary:

This autobiography by Janet Frame, a preeminent New Zealand writer, was originally published in three volumes in 1982, 1984, and 1985. The first volume is titled To the Is-land. In it the author tells the story of her early life "with its mixture of fact and truths and memories of truths." She describes her mother as a rememberer and a talker, partly exiled from her family through a marriage outside the family's faith and her father as having a strong sense of formal behavior that did not allow him the luxury of reminiscence. Her siblings (4 sisters and 1 brother) are described in equally perceptive language. The brother suffered from epilepsy which was poorly controlled and this had a strong influence on family dynamics.

Frame's writing is so descriptive and personal that it is easy to envision oneself as a family member. She was very early attracted to words and became a voracious reader. The family was poor and moved often but there was a firm family kinship. One older and one younger sister drowned when swimming which had a large impact and drew Janet much closer to the remaining younger sister. Janet was a good student and won many prizes; she writes that she "identified most easily with the stoical, solitary heroine suffering in silence."

The second volume, An Angel at My Table, concerns itself with Janet's experience as a student at Dunedin (Teacher)Training College and her subsequent breakdown and commitment to mental institutions. She was very lonely in college and retreated more and more into her own world of literature. At the end of her year of probationary teaching she walked out of the room during the visit of the school's inspector and disappeared.

After a suicide attempt she was eventually committed to Seacliff, a mental hospital. Her stay there, she writes, and later in another facility which eventually lasted most of seven years, was in a world she'd never known among people whose existences she never thought possible. She describes it as an intensive course in the horrors of insanity. She received multiple electric shock treatments and was scheduled for a lobotomy when it was learned that she had won a prestigious award for a book she had written.

Frame was discharged on probation and lived for a while in a small cottage owned by a well known writer who befriended her. After her book of prose and poems was accepted for publication she was awarded a grant that allowed her to travel abroad.

The third volume, The Envoy from Mirror City, is quite mystical and concerns itself with her life as a writer in England, Spain, and New Zealand after her return. She describes Mirror City as the saving world which sustains writers. She has continued writing and eventually learned that the diagnosis of schizophrenia, with which she had been burdened, was incorrect. With some life experience and wise psychotherapy she was able to write about her life in the mental institutions, among other things.

In all she has published eleven novels, four collections of short stories, a volume of poetry and a children's book.

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Summary:

Warren here supposedly presents the papers of a late friend, detailing the interesting cases he had encountered as a physician. In fact, the "cases" are sensational short stories, presented as a novel due to the framing chapter introducing the narrator's "Early Struggles" to make a living as a physician. Other stories investigate typically Gothic themes like ghosts, duels, graverobbing, elopements, and broken hearts, with other scandalous problems like gambling, dissipation, murder, domestic abuse, and suicide. Medical topics include mental illness, epilepsy, hysterical paralysis ("catalepsy"), cancer, toothache, consumption, syphilis, heart disease, alcoholism, disease of the spine, gout, amaurosis (blindness), puerperal hemorrhage, measles, and stroke ("apoplexy").

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Summary:

The first chapter of this memoir consists of two words: "I exaggerate." The narrator then tells us the story of her childhood and early adult experiences as an epileptic. After having her first seizure, at the age of ten, she spends a month at a special Catholic school in Topeka, Kansas, where the nuns teach epileptic children to fall without hurting themselves. This falling may or may not be literal; it is certainly symbolically apt.

During adolescence, Lauren begins lying, stealing, and faking seizures to get attention. She reveals that she has developed Munchausen's Syndrome, whose sufferers are "makers of myths that are still somehow true, the illness a conduit to convey real pain" (88). A neurologist, Dr. Neu, performs surgery severing Lauren's corpus callosum, effectively dividing her brain in half and markedly alleviating the seizure disorder.

Later she attends a writer's workshop where she begins an affair with a married man, a writer much older than she. After it ends badly, she starts going to Alcoholics Anonymous (although she does not drink) and tells her story with such authenticity that when she later confesses that she is NOT an alcoholic, no-one believes her, dismissing her true story as denial. The memoir ends both with her recognition of the value of narrating and with a silent fall to the snowy ground, as the nuns taught her to do, in the knowledge that the sense of falling (rather than the material certainty of landing) is all that is finally, reliably, real.

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Summary:

Sister John of the Cross is a Carmelite nun who has lived in a California monastery for 28 years. She writes poetry and essays. In some ways, writing is nearly equivalent to prayer for her. Sister John is revered for her spirituality and visions. What she has long assumed to be special blessings from God turn out to be manifestations of temporal lobe epilepsy due to a small meningioma.

The nun is forced to confront the scientific explanation that her headaches, altered perception, and hypergraphia are secondary to a seizure disorder and not a gift of divine favor and spiritual ecstasy. Sister John agrees to undergo surgery to remove the tumor aware of the likelihood that a surgical cure will also eliminate her unique visions and insight. Postoperatively, she admits that life without epilepsy seems dull but realizes that "only in complete darkness do we learn that faith gives off light." [p. 178]

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Summary:

By most accounts Dr. Sam Abelman is a failure in life, an irascible old general practitioner who lives in the same grimy Brooklyn neighborhood he has always lived in. He is truculent and tactless, an easy mark for the young specialists who steal his patients. One night a bunch of hoodlums drop a battered young woman on his doorstep. Abelman's nephew, a reporter, publishes a news item about the incident, "Doctor Saves Raped Girl."

Meanwhile, Woody Thrasher, vice president of an advertising agency, is looking for a new type of television show to sell to one of his clients. He comes up with Americans USA, a candid look at "ordinary" Americans who are just doing their jobs, but in an extraordinary way. He decides that Sam Abelman would be the ideal first subject.

Thrasher, a young, high-powered executive, meets Abelman, the last angry man, who summarizes his view on life by saying, "The bastards just won't let you live." The doctor's practice is declining, he can't afford to retire or move away, and the local people certainly don't seem to love him. They don't show gratitude for his services. They don't pay their bills. Many of them consider him a racist, and incompetent to boot. Abelman is clearly not a good candidate for "doctor of the year."

Yet, Thrasher soon finds himself intrigued. Abelman spends hours working in his miniature vegetable garden and reading Henry David Thoreau. He is a brilliant diagnostician, a devoted husband, and an endless campaigner against the "galoots" who think the world owes them a living. Abelman takes aim at "galoots" wherever he finds them, and he finds them everywhere.

The novel interweaves these two men's developing relationship, as Abelman agrees to do the show and Thrasher works to sell it to his bosses, with incidents from Abelman's earlier life. When it turns out that Americans USA will award its subjects their "heart's desire" (in Sam Abelman's case a new house), the doctor declines to go on, refusing to accept "charity" and claiming that Thrasher "tried to crap me up." In the end he agrees to do the show, but suffers a massive heart attack and dies.

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