Summary:

Through a compilation of journal entries, prose, and poetry, poet and activist Audre Lorde considers her breast cancer and mastectomy. Lorde emphasizes the importance of having a support network of other women. As a lesbian and feminist, she also offers a different perspective on this surgery. Her concern is not attracting or pleasing men despite the loss of a breast.

In one chapter, "Breast Cancer: Power vs. Prosthesis," Lorde considers the political implications of prosthetic breasts, arguing that hiding women’s pain and suffering disguises the widespread nature of the disease and places too much emphasis on "normal" femininity. She also writes about plastic surgeons who perform dangerous reconstructive surgery in the name of "quality of life."

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This is a cluster of seven short poems focusing on the response of husband to the diagnosis, treatment, and prognosis for the future of his beloved wife who has breast cancer. For example, "The Cloud" speaks of the passage of the uncertain weeks and years: "And into this idyllic time breast cancer crept. . . Wonder if it’s coming back. It’s life writ small / You don’t know what’s around that curve. . . ."

"For Rosemarie" is a plea for strength, while "Mommy’s Getting Chemo" contemplates the stance of the couple’s very young son. "Lymphedema Hand" is a loving tribute to the power and competence of the altered body of the woman. In all, the collection is forthright, painfully frank, while sustained by the gentle love that propels it.

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These fourteen sonnets interweave themselves to form a unified work, just as lines are repeated or echoed to interweave in the individual poems, providing an account of the author’s experience of breast cancer, radical mastectomy, and recovery. The medical details appear more prominently in the early sonnets, but gradually, other themes take precedence: suffering and how to compare relative degrees of suffering among individuals and groups; the reaction of oneself and one’s lovers to a disfigured body; and the search for affirmation, for a reason to want to live and be rid of the horror of disease and death.

Note: A relevant Web site about and by artist-model Matuschka, http://www.songster.net/projects/matuschka/, has been annotated in the art section of this database (Matuschka: Matuschka Archive).

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The author, an internist and medical educator with a long-term interest in literature (she recently was awarded a Ph.D. in English literature), describes the literary exercise she uses to develop empathy in students taking her required course in medical interviewing. Charon has her students choose a difficult medical encounter from their own recent training and then write, using the first person, the story of that patient’s life in the day before the difficulty--including being treated by the medical student who is doing the writing. Because much of the story must be imagined, the writer’s intuition is automatically brought into play.

Because it is told from the patient’s point of view, the medical student is forced to see the patient whole and without reference to medical terms. Charon argues that this exercise of the imagination yields a combination of objectivity and empathy that forms the basis for good medical care. She also finds that the exercise helps medical students see themselves as their patients see them--and thus to understand, for instance, the effect on their patients of their youth and nervousness.

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Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Two metaphors permeate this poem about drinking a barium containing liquid prior to fluoroscopy to determine cancer growth and staging. The first metaphor involves the liquid as alcohol and the radiology suite as a rather perverse bar. Hence the patient drinks the proffered liquid which "froths and hisses like volcanic vodka / or martinis by Dr. Hyde." The second metaphor is 'cancer is war.' The body is seen as a battleground in which the "army of metastasizing cells / advances, armed and dangerous." The patient realizes that medical interventions are allies in this fight, but drinks the barium "as Socrates / must have: one eye on the door."

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Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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Anton Chekhov died in 1904. His sister Marya (or "Maria" in this novel) survived the Communist Revolution and two World Wars to die in 1957 at the age of 94. After Anton's death, the unmarried Maria assumed his role as head of the extended Chekhov clan and she devoted the remainder of her life to the protection and advancement of her brother's literary legacy. To do so, she had to plead his case with the Russian authorities and later adapt to the political (and literary) orthodoxy imposed by the Communist regime. Early in the Soviet era, Maria successfully lobbied to have the Chekhov house at Yalta turned into a State museum, thereby insuring that the author's books and papers would be preserved.

The action of this novel takes place during the Great Patriotic War in late 1941 when the Germans occupied Yalta. Maria lives at the Chekhov museum, where she presides as curator. Also living at the house is Peter Kunin, a medical student and would-be writer who is Maria's protégé. In preparation for the Germans' arrival, Maria arranges the house to make it seem that Chekhov was pro-German. For example, she has Kunin dig up an old portrait of Goethe to hang over the mantelpiece.

Despite these machinations, the Germans fully intend to billet soldiers in the museum until a mysterious man named Diskau shows up. Diskau, who works for the German Ministry of Culture, insists that the Chekhov household be spared. In fact, he proposes to win over the local population to the German "liberators" by staging a New Year's Eve production of The Seagull in the abandoned Imperial Theater.

The remainder of the novel traces preparations and rehearsals, culminating in the single catastrophic performance of The Seagull, during which all is revealed.

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In the late 20th century, Britannula, an island near New Zealand, has achieved its independence from Great Britain. Settled by a group of young men some 30 years before the action of this novel, Britannula has developed into a prosperous land governed by a President and a single-house legislative body, the Assembly. They have adopted a great social experiment called the "Fixed Period," by which the society and its citizens will avoid the suffering, decrepitude, and expense of old age. At age 67 each person will be "deposited" into a lovely, carefree "college" (Necropolis) where he or she will spend one delightful year before being euthanized.

The story takes place just as the time approaches for Gabriel Crasweller, a wealthy landowner and good friend of President Neverbend, to be deposited. Crasweller is the first citizen to have lived out his Fixed Period, and the President, whose brainchild the Fixed Period is, experiences a conflict between his love for Crasweller--who inexplicably does not want to die--and his determination to carry out the law. Mounting resistance to the Fixed Period among the older citizens (including his wife) also surprises Neverbend, although the Assembly, composed mostly of young people, reaffirms the law. Just as Crasweller is led off to Necropolis, a British gunship arrives in port to relieve Neverbend of his duties as President and re-establish direct control of Britannula.

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Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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