Summary:

The Island is a collection of three stories sharing a similar setting (Italy) and populated by several characters who are outcasts. In the title story, the relationship between residents of an island and its medieval monastery, the Certosa, decays over time. When a talented stonemason is accidentally injured, his damaged senses are replaced by pain and suffering. His struggle and sacrifice, however, ultimately result in redemption for all those who inhabit "The Island."

In the eighteenth century, a 20 year old leper is condemned to live the remainder of his life in a tower fittingly known as the Tower of Fright. Although befriended by a stranger, the occupant of "The Tower" must nevertheless endure solitude, and he does so with the patience and grace of a saint. With the backdrop of a plague, "The Second Coming" is a medieval tale that recounts the torture of a doubting priest, an unknown pilgrim’s participation in a miracle, and the death of a pope.

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Leprosy looms large in this story about transformation and loss set in post World War II Japan. A nineteen-year-old pearl diver notices a numb red spot on her forearm. Later on, another blemish appears on her lower back. These two lesions are manifestations of a mild case of leprosy. Her infection will be arrested by medication and never get any worse. The girl is forcibly transported to the Nagashima Leprosarium, an island where she will spend the rest of her life except for a few brief excursions and one extended "escape" at the age of sixty-four.

Despite the introduction of new and effective drugs--Promin (sulphone) and dapsone--authorities still fear allowing the leprous patients to return to society. Inhabitants of the sanatorium are admonished on arrival that their past is erased. Each individual must begin a new life and select a new name. The protagonist chooses the moniker Miss Fuji. She is a kind and sensitive young woman who eventually functions as a nurse and caregiver for the other patients incarcerated in the sanatorium. As a punishment, Miss Fuji is required to attend abortions and dispose of the dead fetuses.

As the decades pass, conditions on the island improve. The number of residents with leprosy still living there dwindles from about two thousand people to six hundred. Even a bridge connecting Nagashima to the mainland is constructed. It no longer matters. Emotional and psychological barriers remain. When Miss Fuji has an opportunity to create a new life for herself away from the sanatorium, she still returns to the place and the people that have been her home and family for so many years.

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John Ames narrates this story in the form of a lengthy letter to his young son. Ames is a 76-year-old minister suffering from angina pectoris and heart failure. He has spent almost all of his life in Gilead, a small town in Iowa. His first wife died during childbirth along with a baby girl. Ames remarried a younger woman who is now 41. They have a son almost 7 years old.

Because Ames believes his death is close at hand, he pens a missive to the boy. Its purpose is to teach his son about all the important things in life Ames may not be around to share with him. During the course of composing the letter, Ames reflects upon his own existence. He recalls the experiences of his father and grandfather who were also ministers.

Reverend Ames likes to think, read, and pray. Born in 1880, he has lived through three wars, the Great Depression, a pandemic of influenza, and droughts. His hope is that his young son will grow into a brave and useful man.

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When oral antibiotics are no longer effective, the narrator grudgingly consents to begin a six-week course of intravenous antibiotic therapy with Rocephin (a powerful, broad-spectrum antibiotic). She has an infection caused by spirochetes. The illness has been festering for as long as ten years but has only recently been diagnosed. It causes joint pain and stiffness. Her daughter has already been successfully treated for the same infection.

Every morning in her kitchen, the narrator performs the same ritual. She cautiously infuses the antibiotic and imagines that the golden fluid is extinguishing the corkscrew-shaped microbes. At first she experiences a drug reaction, but the event only convinces her that the treatment is actually working.

She senses that her husband and her friend are repulsed by the treatment (especially the syringes and IV apparatus). A visiting nurse, Ginger, comes to the house to perform minor maintenance on the intravenous line. She upsets the narrator with grim information about the infection and an account of a patient suffering from the same disease who is currently in awful condition. Dr. Kennicott, the narrator's physician, has not been so forthcoming about the course of the illness or pessimistic about the prognosis. The narrator chastises Ginger. Both women are now distressed. The narrator's immediate goal is to control her emotions and avoid crying.

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Subtitled "Tuberculosis and the Social Experience of Illness in American History," the book chronicles the medical and societal treatment of tuberculosis in the United States from the perspective of individuals who suffered from the disease. The author includes illness narratives derived from letters and diaries of the afflicted; her analysis spans the period in American history from the nineteenth through the first half of the twentieth century.

The book is divided into four sections. Part I, "The Invalid Experience: New England Men, 1810-60" and Part II, "The Female Invalid: The Narrative of Deborah Vinal Fiske, 1806-44" reveal an interesting contrast in the medical/societal treatment of tubercular men and women, and the resulting differences in their lives as "consumptives." Whereas men were expected to seek a cure by embarking on sea voyages and other travel, women remained at home and sought to control the disease by adjustments in domestic life. For men this meant major disruption and even change of career along with a sometimes exhilarating change of scene; for women it meant relentless anxiety and elaborate coping strategies.

Part III, "Health Seekers in the West, 1840-90" describes the role of cure-seekers in the westward migration and demonstrates how the culture of the time, an optimistic faith in nature and in the economic promise of the newly settled western territories, was reflected in the treatment regimen for tuberculosis. Interestingly, much of the promotional effort to bring "consumptives" west was initiated by physicians who were themselves tubercular.

The final section, "Becoming a Patient, 1882-1940," moves into the modern era with the discovery of the tubercle bacillus, public health measures, and the illness narratives of people who were confined in sanatoriums. Rothman points out that this period marked a transition away from the patient’s ability to understand and determine his/her treatment to one more like the current one in which the medical establishment is the authoritarian "expert."

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A Doctor's Story of Friendship and Loss, this book is, in a sense, a sequel to Verghese's earlier memoir, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (see this database). The Tennis Partner tells the parallel stories of Verghese's disintegrating marriage as he establishes new roots in El Paso, Texas and of his new deep friendship with a (male) medical student who shares his passion for tennis. Both men are struggling to re-establish order in their personal lives: Verghese, in easing himself out of a dying marriage while trying to maintain a close relationship with his two sons; David (the tennis partner), in remaining drug-free and successfully completing medical training, which had been interrupted by his addiction.

Verghese, an experienced physician trained in infectious disease and an expert on AIDS treatment, relishes his role as David's mentor; David, a former tennis "pro," enjoys teaching Verghese how to play better. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other, seeking solace in a difficult time. Through it "we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost." (339)

While the reader suspects that David must have a drug problem because the Prologue to the book, narrated in the third person, describes a "young doctor from El Paso" in drug treatment, Verghese the biographer has no inkling of the problem until one-third into his first person narrative. He is shocked, but in some ways the bonds of their friendship are strengthened. Each has only the other as a confidant.

David, however, has another addiction: women. The friendship becomes increasingly complicated as Verghese tries to remain both supportive and objective. Eventually David resumes "using" and Verghese must decide how to respond, both professionally and on a personal level. The turmoil in both lives ends tragically for David and causes profound grief in Verghese.

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Before Jamie Weisman went to medical school and became a physician she wanted to be a writer. As she struggled to make a career out of writing, she was forced to acknowledge that the obscure, life-threatening condition that had plagued her since adolescence could not be factored out of her plans. Writers don't have easy access to affordable health insurance and her monthly intravenous infusions of antibodies and interferon were very expensive. Yet they were essential to fend off infection, for she had an immune system malfunction.

Of course, finances were not the only reason that Weisman decided to go into medicine. As is often the case, her own experience of illness was an important motivating factor, as was the fact that her father, of whom she is very fond, was a physician. This memoir describes significant stages of Weisman's illness, her interaction with the physicians she consulted, and the issues she grapples with as she pursues her life as a physician, wife, and mother (she graduated from Emory University's school of medicine in 1998 and practices dermatology).

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Poet and essayist Floyd Skloot gives us his third memoir; each of the three concerns a somewhat different facet of his attempt to recover from and live with mental and physical damage resulting from a viral illness that struck him in 1988. This book, written approximately 15 years after the initial insult, "is a memoir of the reassembled life" (ix). Life for Skloot is different than before, but a kind of order--Skloot calls it "harmony"--has been constructed out of memory loss, mental disorder and incoherence: "I have learned to savor the fragments themselves, and to live in the moment" (xi). A World of Light is perhaps more a collection of essays than a memoir.

Most of part one and some sections of parts two (Ch. 5, "1957") and three (Ch. 15, "Taking Stock") concern Skloot's interaction with his aged mother as she slides further and further into dementia. Anyone who wants an idea of what it is like to interact with a person who has Alzheimer's disease should read these sections. Skloot masterfully reproduces the often bizarre conversations that occur--the sometimes maddening repetition of comments during attempts at conversation.

Skloot's mother admires his wife, Beverly, and repeatedly instructs them to marry each other, no matter how often they assure her they are already married. She forgets their previous visits to her in the nursing home, although they visit regularly, and becomes anxious when they leave, even though she isn't certain who they are. Skloot writes about how receptive his mother is to music, which delights her, and how she sings snatches of old songs triggered by the words of any offhand comment--phenomena that have been noted in some other descriptions of Alzheimer's patients.

The essays in part two look back on Skloot's childhood, his family's background, and on his development as a writer. Part three centers on his current life with his wife, Beverly, whose home in rural Oregon provides a refuge for them both (although they are now in the market for different surroundings).

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Bessie, who has been caring for her invalid aunt and her father who is helpless after suffering a stroke, discovers she has leukemia. While this does not seem like a subject for comedy, this warm-hearted play really has some funny moments. Laughter is good medicine in this caregiving household. Bessie’s sister, Lee, who has been out-of-touch for years, arrives with her two sons in the hopes that one of them might be a bone-marrow match for Bessie. For Lee the idea of devoting her life to caring for helpless aging relatives would be wasting it.

One reason Lee doesn’t want to take over the caregiving for her father is that she has plenty of trouble trying to be a mother to her two sons, particularly Hank who has been committed to a mental hospital because he burned down the family home. She tells the hospital psychiatrist "Hank is something I cannot control, so what is the point of my visiting?" While Bessie will not find a cure for her leukemia, an important start on healing does occur in the play as Bessie helps both Hank and Lee to care for each other.

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This great literate novel is the tale of Hans Castorp, the "delicate child of life" whom we first meet at age 23, ambivalently embarking on a career as a ship-building engineer in his home city of Hamburg, Germany. Before beginning his professional work, however, he journeys on what is intended to be a vacation and a pro forma visit to see his tubercular cousin, Joachim Ziemssen, at a sanatorium in the mountain town of Davos, Switzerland. Yet as the train pursues its course through the alpine scenery, Hans and the reader become aware that this is no ordinary journey. The impressionable Hans is transported away from the life and obligations he has known, to the rarefied mountain environment and insular community of the sanatorium.

At first uneasy, he soon becomes fascinated with and drawn to the routine established for the "consumptives" and to the social scene which flourishes there. Ordinary life seems increasingly unreal to him; his perceptions are heightened and he becomes aware of his physical, spiritual, and emotional vulnerability, as well as of his own sexuality. He is greatly attracted to one of the patients, a married woman of Slavic background, Madame Clavdia Chauchat. She reminds him of a schoolboy to whom he had been strangely drawn as a child. The turmoil brought on by this romantic obsession seems even to be reflected in his physical state, which is unstable and feverish.

As his intended stay of three weeks nears its close, the director of the sanatorium advises Hans to stay on to recuperate from a heavy cold, which appears to reveal an underlying case of tuberculosis. Hans is almost relieved at this news, for it provides him with a reason for remaining near Madame Chauchat as well as the opportunity to continue intriguing, profound discussions and cogitation about illness, life, time, death, religion and world view initiated by another patient, Herr Settembrini.

Settembrini is an Italian man of letters and humanist who believes that reason and the intellect must and will prevail, in daily life as well as in world affairs. He is contemptuous of the foolish flirtations and empty talk in which most of the sanatorium inhabitants indulge, and warns Hans repeatedly of the dangers inherent in cutting off all ties to real life and responsibility.

Nevertheless, Hans remains at the sanatorium for seven years, freeing himself from the constraints and conventions of life "in the flatlands" and instead engaging in a prolonged "questioning of the universe." This questioning includes a critical flirtation with death, stunningly described in the chapter, "Snow." Hans does not return home until the outbreak of World War I, in which he fights and survives.

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