Summary:

Rachel is married to passive Leon who is utterly dependent on her care and organizational skills. They live in a vast, blanc-mange of a suburb where Rachel constantly looses her way while driving home from work. One night, she seeks direction from Wilkes. A strange recluse, he is obsessed with his teenage memory of the lost "girl on the bus" and leads a support group for agoraphobics.

Through contact with Wilkes, Leon gradually grows more independent and finds himself a job. Rachel becomes obsessed with the search for the meaning of "Harry," a mystery man who recurs in her husband's dreams and begins to take over her thoughts. She consults a psychologist, Alex Silver, who soon has Rachel enrolled in a study with two other women. Silver uses dream-deprivation with the goal of enhancing insight about her marriage, her life, and her friends.

Cameo appearances of three depressive, mid-life siblings, Dick, Jane, and Sally, with their dog, Spot, and cat, Puff, emphasize that life in modern suburbia can be a pathology in itself. In Jane, Wilkes finds his lost girl on the bus. Rachel dumps Leon and finds happiness with the agoraphobic developer of the aptly named "Arcadia Centre," where expense, space, light, greenery, and intimacy are employed unstintingly to create a non-pathogenic space for human collectivity.

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Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.

Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)

Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.

However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.

She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)

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The narrator describes his chronic illness of two or more years duration. He likens his former good health to "an island / going out of sight behind you." His days are filled with visits to the doctor, medicine, and a loss of interest in "wanting to make love . . . . " He describes going through stages: feelings of being punished, which generate "an enormous effort to be good"; anger; fear of death; "a lake of grief"; "neurotic vigilance"; and finally, "only a desire to be done." In the end, he is still en route.

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This 22-line poem lacking any punctuation is a breathless narration of an urgent need to escape from the hospital environment. The narrator runs past the bodies "crumpled on every bed" and "the lead apron / of hospital drapes" to emerge outside into the rain. She is immensely relieved to experience the cold wetness of the rain and to feel the pavement against her feet as she runs to her car.

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This book is a sequence of poems about Frank Goldin, a middle-aged biochemist who is admitted to a mental hospital, Elmhurst, with the chief complaint, "I hear a thousand voices and must respond to each." In the first poem Goldin confesses his sins, but simple confession doesn't get to the root of his dilemma, the existential ambiguity that plagues him.

During Goldin's dark night of the soul, his scientific self struggles with the mysterious longing within. Dr. Hudspeth, the Elmhurst psychiatrist, directs his support to the part of Goldin that says, "I am the restless biochemical cycle / that pours out glutathione in buckets." In essence, just straighten out the chemicals and you'll get better.

Throughout the book Goldin waits for his wife Helen to visit Elmhurst, but she never appears. He ruminates over the matter of confessing that he had an affair with a woman named Da-ling during a professional meeting in Osaka. If he confesses, if Helen comes, Goldin hopes that things will return to the way the way they used to be.

However, the mysterious side of Goldin is looking for something else. He has visions of the ancient Rabbi Yehuda of Smyrna, who asks, "Why do we not even know how to ask a question properly?" After several weeks Goldin leaves Elmhurst with the feeling that he has made progress, but not in any discernible direction. Goldin concludes that he should be grateful, but he asks, "to whom?"

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Anne Finger, a writer and disabled activist whose childhood polio left her with a disability, tells the story of her pregnancy, her birth experience at home and in the hospital, and the serious health problems her newborn son experienced.

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This poem describes the ineffable experience of

having a barium enema to answer the question, "has time betrayed you yet?" While it is summer outside, inside the room "numbers flee across / banked screens." The narrator tries not to be there, but he is. Soon he will "pass a gallon, / more or less, of latex enamel, / as blooms of cramp go on and on." He sees the barium as it moves through the compartments of his large intestine, and he reflects that "life is so common"--but not his life.

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This is a tight, short poem that takes its central metaphor from the uncredited quote, ". . . a madman attacked Michelangelo's Pietà with a hammer." The speaker is presumably a physician who, with a pathology report on his desk, contemplates the task before him. He likens himself, as bearer of grim news, to an avenging creature about to assault his patient, the Pietà, with a catalogue of cutting and pounding tools as images for the effect of such news on the recipient. The speaker also reflects on his own anger, the anger he feels about his patient's bad fortune, yet ". . . not wanting to judge / the cracked face of God."

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The austere and homesick Breton doctor, René T.H. Laennec (1781-1826) (Pierre Blanchar) and his religious friend, G.L. Bayle (1774-1816) are caring for the hundreds of patients dying of epidemic tuberculosis in the Necker Hospital of Paris. They conduct autopsies on the dead, but cannot predict the findings before the patients' demise, nor can they offer any treatment.

Laennec's sister, Marie-Anne, arrives from Brittany with news of their brother's death from tuberculosis. He confesses his despair over this devastating scourge to his friend, but quickly realizes that Bayle too is doomed. A distant cousin, the widow Jacquemine Guichard Argou, becomes Laennec's housekeeper and companion in philanthropic work for the sick after he is able to reassure her about her health; she engages the widow of Bayle in the same enterprise.

One day in 1816, Laennec is invited by urchins to hear to the scratching of a pin transmitted through the length of a wooden beam. He is thereby inspired to fashion a paper tube to listen to the chests of his patients. With Jacquemine at his side, he joyously announces that he can hear sounds from inside the chest. Feverish research ensues as he links the chests sounds of the dying to the findings at autopsy.

He turns his wooden, cylindrical stethoscopes on a lathe in his apartment, publishes his findings, and marries Argou. Fame and notoriety follow, as Laennec is able to distinguish fatal disease from minor illness and to predict the need for operations; however, he is ridiculed by jealous colleagues. Suffering now himself, Laennec consults his friend Pierre Louis, who tells him that he has tuberculosis. In the final scene, he returns to his native Brittany only to collapse on the stairs of his beloved home and die.

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Grégoire Ponceludon de Malavoy (Charles Berling) travels to the court of Louis XVI at Versailles seeking support for his plan to drain a marsh in order to relieve his poverty-stricken community from the scourge of malarial fever. Naive in the ways of court, he is robbed and left on the road for dead. A kindly doctor and would-be courtier (Bernard Girardeau) finds Grégoire and nurses him back to health with the help of his beautiful and highly intelligent daughter, Mathilde (Judith Godréche).

Grégoire accompanies the doctor to court where he quickly excels in the fine arts of repartee, ridicule, and sang-froid. Seeing this practice as a route to the king, Grégoire plays the game well and begins to have fun, in spite of himself. He attracts the attention of the influential Comtesse de Blayac (Fanny Ardent) with whom he sleeps, despite his love for Mathilde.

A peasant child's death at home inflames his obsession over the marsh. At the moment he is finally about to have the king's attention, he duels with an officer over a matter of honor; he wins the duel but loses his regal audience for having shot a royal soldier. The film ends in the Revolution: Grégoire and Mathilde are well launched in their drainage project and the doctor is an émigré on the English coast learning the fine arts of British humor.

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