Summary:

This is a handsome and unusual volume of self-published poetry by a chaplain who is part of a multidisciplinary team in a geriatric outpatient clinic in Iowa City, Iowa. The poems articulate the struggles of older individuals, their families, and their caregivers to make sense of changes in later life. The 30 "poem portraits" are told from varying points of view. Three of the more compelling works are "Constance," "Remembering the Trees," and "House Dreaming."

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This book's title is from a Goethe poem, "The Holy Longing," translated from German in its entirety by Robert Bly: "And so long as you haven't experienced / this: to die and so to grow, / you are only a troubled guest / on the dark earth." Ten intensely personal essays tell of the suffering and everyday presence of pain of a severely disabled writer who has advancing multiple sclerosis, and of how, "in a very real sense, and entirely without design, death has become [her] life's work." (p. 13)

Beginning with her father's sudden death when she was a child, the essays describe her aging mother's expected death and the family's decision to take her off life support; her caretaker husband's diagnosis of metastatic cancer with uncertain prognosis; her own attempted suicide; death of friends, pets, including her beloved dog; and a young pen-pal executed on death row. If that weren't enough, a coda, her foster son's murder and again the decision to remove life-support, provides "[t]he end. For now." (p. 191)

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Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.

Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.

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David Slavitt has written his own response [Part I, "Meditation" (pp. 1-58)] to the five poems (chapters) that comprise the Old Testament's "Book of Lamentations," which he has translated here from the Hebrew [Part II, "Lamentations" (pp. 59-85)]. The poems appear in Hebrew and in English, on opposite pages. In addition there is a "Note on Translation" (pp. xiii-xiv) and a "Bibliographical Note" (pp. 87-88).

Five poems--The Book of Lamentations--express Israel's brokenness, bewilderment before God, and sorrow at the catastrophes that have beset the Jewish people through the ages. Slavitt's meditation and notes on translation prepare the reader for far more than a prosaic historical account of the destruction and biblical plights of the Jews. "A translator wants to be faithful to the original work but then discovers how fidelity to the word can mean a betrayal of the sentence." (p. xiii)

"As a boy, I knew next to nothing of Tish'a b'Av," begins the author's meditation. We learn, as he did, about "[this] worst day of the year"(p. 6)--the day in 587 B.C. that the Temple in Jerusalem was destroyed, and six centuries later on the same day, when the second temple was destroyed. Annually Tish'a b'Av is devoted to grieving "every terrible thing that happened in this world "(p. 6): Zion, Jerusalem, the Holocaust. Except for The Book of Job (see annotation in this database) and Lamentations, reading even the Torah, the most sacred text in all Judaism, is forbidden on this solemn day.

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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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An anthology of poetry and prose by doctors, nurses, patients, and other authors, A Life in Medicine is divided into four sections: "Physicians Must Be Altruistic"; "Physicians Must Be Knowledgeable"; "Physicians Must Be Skillful"; and "Physicians Must Be Dutiful." Each section begins with the Association of American Medical Colleges' (AAMC) definition of the physician trait examined in that section, and short "explications" precede each individual poem and prose piece, linking them to the section's overall theme.

The anthology has a preface outlining the editors' goals and Robert Coles's introduction, "The Moral Education of Medical Students." These organizational touches make the anthology a classroom-ready text for medical students. The anthology's poems and prose--many of which are stunning--were taken from previously published works and exclude many well-known and often-used pieces. But those selections are readily available elsewhere, and the editors do readers a greater service by introducing many lesser-known, but equally important, poems and essays.

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Abba Kovner wrote these poems during and after his hospitalization at Sloan Kettering for throat cancer. His exile into the world of illness begins as he enters the hospital. "He fell asleep under strange skies" (p. 7) and in the hospital "the silence astounds on all / its many floors."(p. 11) [Throughout the book, Kovner refers to himself in the 3rd person.] He tries to pray: "Is there a prayer for one who prays like him / seething . . . " (p. 15) He decries "the infuriating confidence of the doctors." (p. 21) He celebrates the beauty and magnificence of New York. But then the bad news arrives: "When they told him they were going to cut away his vocal cords / entirely it was merely / a confirmation of what he already knew."(p. 31)

To the brisk, young hospital staff, he is just another patient, nothing but an "ancient shard”: "They could not imagine that this was a man / who had fought the world."(p. 36) Only Norma, the Puerto Rican night nurse, connects with him at a different, more human level. "He blushes / when Norma says: What a lovely / head of hair you have, sir!" (p. 88) As he prepares for the laryngectomy, images from the past invade his consciousness--Christmas Eve, 1941; the Vilna ghetto, where "the lice / got under your skin" (p. 68); and "a shoemaker, his name forgotten" (p. 74). The Holy Guests--the souls of Abraham, Isaac, Jacob, Joseph, Moses, Aaron, and David--also visit the sick room.

After the surgery, the conspiracy of optimism brings him along, carries him forward: "What a healthy recovery, / they said. And patted him on the shoulder / with admiration: You’re doing fine. Wow!" (p. 85) But this is at best a voiceless recovery: "From the wreckage of his voice / there arose a bubble / a tiny bubble . . . " (p. 101) Eventually, the patient leaves the hospital, leaves New York, and arrives home: "Fearful from the moment of arrival: he / watches the landing that cannot / be avoided, into / the arms / of people who love him . . . " (p. 111) He settles into a routine, lives his life as if there is nothing new, but ends at "An Ending, Unfinished" (p. 126), back at Sloan Kettering. "Where now? He asked himself . . . " What next?

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A lonely neurosurgical resident becomes involved with a comatose patient. Susan, a dying woman with an inoperable brain tumor, is the subject of a research study. Scientists are attempting to discern her thoughts with the aid of computers. The resident serendipitously stumbles onto a program that successfully translates the electrical activity of Susan's brain into speech. He labels the computer program a failure (but saves a copy for himself) so that others are unable to eavesdrop on her dreams.

He spends nights listening to her thoughts and soon begins communicating with Susan, sharing his own secrets with her. When the resident learns that the research project is about to be terminated, he decides that Susan is in desperate need of human contact. He kisses her and presumably has sexual intercourse with the comatose woman. The next morning he is found asleep beside her and is dismissed from the hospital.

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This poem--"not graveyard roses"--is the poet's gift to her dead friend Bulgakov. He was defiant and steadfast in the face of all the tragedies of his "high, stricken life." While others may not raise their voices to praise Bulgakov (because of the danger of doing so in Stalinist Russia), "one voice at least / Must break that silence, like a flute." The poet remarks how amazing it is that she who has lost so much in her life should now be eulogizing "one so full of energy / And will" who "only yesterday" was "hiding the illness crucifying him." [20 lines]

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A son beseeches his elderly father to fight, rather than accept, death: "Do not go gentle into that good night." He gives examples of how "wise men," "good men," "wild men," and "grave men" "rage against the dying of the light," and begs his father to do the same.

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