Summary:

The diagnosis is delivered in the opening sentence: "a bad heart." Anton Rosicky is an immigrant to the United States from Czechoslovakia. The 65 year old man and his wife, Mary, own a farm in Nebraska. They have five sons and a daughter. Rosicky is an ordinary fellow with one remarkable quality--a genuine love for people. He is attached to his family, the land, and hard work. His physician, Doctor Ed Burleigh, writes a prescription for Rosicky and instructs him to avoid strenuous activities.

The young doctor is quite fond of Mr. and Mrs. Rosicky and speculates that tender and generous people like this couple are more interested in relishing life than getting ahead in it. Although he knows better, one day Rosicky overexerts himself raking thistles and bringing some horses into the barn. He experiences chest pain accompanied by shortness of breath. His daughter-in-law, Polly, helps him into bed and applies moist hot towels to his chest.

Unfortunately, Dr. Ed is out of town--his first vacation in seven years. Rosicky appears to recover from the episode but the following day after enjoying breakfast with his family, the chest pain recurs and he dies at home. When Dr. Ed returns from his trip, he stops at the graveyard near the farm. He realizes that the natural beauty and serenity of the landscape make a fitting final resting place for a farmer like Rosicky and a man whose life was not only rich with love but deeply fulfilling.

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Tenderly Lift Me is the latest publication from Kent State University Press in the Literature and Medicine series edited by Martin Kohn and Carol Donley. Not all the 39 caregivers Bryner honors through poetry, biographical sketches and photos are nurses, but all have discharged their caregiving duties as the title indicates: tenderly. The book opens with a preface by Bryner who wants "people to care about nurses the way nurses care about people who are total strangers" (p.xii). A literate and insightful introduction by Suzanne Poirier and Rosemary Field follows.

The book, divided into eight parts, contains biographical sketches and interviews with nurses or tender caregivers, their photographs, and poems by Bryner in which she speaks in the voices of the individual nurses, celebrating but never sentimentalizing their stories.

Some of the nurses are daughters of blue-collar workers: Carol Johnson (p. 77) went on to become a cardiothoracic nurse practitioner, harvesting veins for open heart surgeries. Helen Albert (p. 52), the granddaughter of a slave, became "the first black registered nurse hired in Warren, Ohio." The nurses celebrated are both living and dead; some are aged, this book the only vessel that might hold their histories. All the caregivers, like Father Damien, born in 1840, caretaker to a colony of lepers in Molokai, come alive in Bryner's prose and poems, speaking to us in image and metaphor as well as fact and biography.

There are journal entries from Kate Cumming, who cared for confederate soldiers during the Civil War (p. 151), and comments from contemporary nurses, like Sylvia Engelhardt, one of the first nurses to graduate from an associate degree program and feel the "sting of labels" (p. 69), or Theresa Marcotte Kokrak (p. 46) who remembers traveling though Canada's seventy-below wind-chill to report to duty. Bryner celebrates the nurses' accomplishments as well as the daily events, the doubts and frustrations, the dark moments that these nurses have overcome in order to care for others, nurses who are "human, and sometimes a little heroic, but not from heaven" (P. xii).

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While on an airplane, Carson experiences abdominal pain. He is a divorced man in his fifties and a sales representative for a computer and information technology firm. He spends much of his time traveling and fancies himself "a connoisseur of cities." The increasingly severe stomach pain forces Carson to reschedule his business meeting and retreat to his hotel room.

His suffering mounts and he decides to visit the emergency department of the city hospital. Carson is evaluated by two young male doctors and later a middle-aged female physician. Despite blood tests and X-rays, his diagnosis remains murky and a surgical consultation is obtained. The surgeon suspects appendicitis. He postulates that Carson may have a retrocecal appendix and explains that in such cases the anatomical location of the organ often confounds the diagnosis.

Carson undergoes surgery. His appendix is indeed retrocecal and rupturing. He spends five days convalescing from the operation. During that time he acquires an intimate knowledge of the city from his stay at the hospital. The experience revitalizes him. Carson reasons that the world is miraculous in part because it is so simple yet still spectacular.

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Written as an interior monologue, Destiny begins as Chris Burton receives a phone call informing him of his schizophrenic son's suicide. Burton, a British ex-pat journalist in the final stages of writing his chef d'oeuvre--a cultural history on national character--is married to Mara, a provocative, capricious, flamboyant Italian. The vitriolic arguments and hurtful stratagems that characterize their discordant marriage intensify with the crisis of death and its aftermath--the identification, transport and entombment of Marco's body. Family relationships are further complicated by Mara's distrust and estrangement of her adopted daughter, Paola.

Burton reveals the chaos that schizophrenia imposes not only on the patient, but also on the entire family. In order to avoid prison following an attack on his family and home, Marco had been placed in a psychiatric institute, Villa Serena, and it was at this facility that Marco stabbed himself to death with a screwdriver. The onset of disordered thinking and erratic behavior, the search for therapies, the various repercussions of guilt and blame (including recriminations about the intense, border-blurring maternal love lavished on Marco), are re-examined by Burton as he travels from London to Rome, sits vigil by his son's body in the camera ardente, and confronts his wife at her family's tomb.

Burton's physical distress mirrors his mental anguish. Burton has heart disease and obsesses about lacking his anti-coagulant medication. In addition to the worry of clot formation, urinary retention prevents Burton from emptying his bladder. These physical ailments of containment, confinement, obstruction and blockage form resonances throughout the book: the tomb, the strictures of marriage and the leakage of adultery, the oppressive family 'house of ghosts,' the separateness of interior thought from observable behavior, the barriers of language, the herky-jerky redirections of emergency travel.

Furthermore, the will to create permanence, to make one's destiny more than a transient destination, informs Burton's moves. In the midst of his exploding marriage and tormented trek home, Burton agitates over his work, and in particular, his book, which "must serve to transform a respectable career into a monument" (p. 1).

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For three weeks the narrator has been working as a clerk in the emergency department. His good friend, Georgie, is a hospital orderly. Both men abuse drugs, and Georgie steals them from the hospital. The ER staff includes Nurse (an overweight woman who shakes) and the Family Service doctor (a physician with limited competence who is not well-liked).

At 3:30 A.M., a man named Terrence Weber arrives at the ER. He has a hunting knife stuck deep in his eye. Ironically, his other eye is artificial. Weber's wife apparently tried to blind him because he ogled the woman next door. The doctor immediately decides the situation is beyond his expertise and calls for an ophthalmologist, neurosurgeon, and anesthesiologist.

Meanwhile Georgie is prepping Weber for surgery. The drugged-up orderly, who cannot even tie his shoe at this point, somehow removes the knife by himself. Weber's vision is fine. Later on, the narrator and Georgie get lost while driving around in a pick-up truck without headlights. The truck runs over a jackrabbit on the road. Intent on making rabbit stew, Georgie cuts the animal open with the hunting knife he had earlier removed from Weber's eye. The rabbit is pregnant with eight miniature bunnies inside her.

Georgie decides to save the babies. Unfortunately the narrator forgets about the rabbits and accidentally squashes them to death. At the end of the story the two men encounter a hitchhiker who has gone AWOL from military service. Georgie promises to take him to Canada.

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Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.

Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.

The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.

Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.

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This story of one exceptionally accomplished family's discovery of their past and future relationships with Huntington's Disease (HD) is also the story of how the Wexler family changed the cultural narrative of HD for other families at risk for this genetically-transmitted and currently incurable disease. The HD diagnosis of Leonore Wexler (the author's mother) inspires Milton Wexler, a psychologist, to create a major foundation for HD research, which develops critical mass and influence as Leonore Wexler's condition deteriorates, and after her death. The book interweaves the story of the Wexlers' emotional and other negotiations with HD and the story of their efforts to create an HD community comprised of those with active symptoms of HD, family members, advocates, and researchers.

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The narrator, Rick, is let out of rehab to live with his older brother, Philip, who is a doctor in Detroit. He will work at a mundane job in Philip's lab. The awkwardness of their encounter slowly evaporates and Rick begins to enjoy life with his family, especially his two young nephews. But he is concerned about Philip's weary appearance, so reminiscent of their father.

It emerges, quickly and to Rick's surprise, that Philip runs an abortion clinic. The clinic is subject to constant harassment by a persistent group of religious, "right-to-lifers," who taunt the doctors, the workers, the patients, and their families at home. Rick struggles to control--even avoid--his feelings; and he tries (unsuccessfully) to suppress the desire to befriend patients.

Eventually, he is reconciled to his new task through an unwelcome fixation on one patient. But angry urges to protect her and his brother well up. After weeks of pent-up rage and fear, he hides a gun, loses control, and begins shooting aggressive protestors. The murder is "nothing"; it's "just like killing babies."

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A child dies in the hospital shortly after the infectious disease consultant, Dr. Michael Grant, evaluates her. The 35-year-old physician has cause to be troubled by the patient's death. He failed to perform a careful examination, did not check the results of her most recent lab tests, and held off on ordering antibiotics. Although an autopsy was not performed, it is believed she died of sepsis.

Divorced and recently relocated to North Carolina, Dr. Grant is already depressed. Now he must worry about the possibility of a malpractice lawsuit. Jonas Williams, the father of the dead child, is also ill. He complains of fatigue, visual disturbances, confusion, night sweats, and fever. Jonas has developed unusual lesions in his throat and retina--white threads in a serpentine pattern. A biopsy of his oral lesion demonstrates the presence of osteoblasts and new bone formation. Dr. Grant becomes convinced he has stumbled onto a completely new infectious illness even though he cannot identify the causative organism.

Jonas experiences gastrointestinal bleeding as a result of a low platelet count. He dies in a trailer that has caught on fire. Dr. Grant soon develops the same symptoms as his patient. He remembers coming into contact with some of Jonas's blood. He is admitted to the hospital with massive gastrointestinal bleeding. His physician attributes the bleeding to ulcers, gastritis, and thrombocytopenia. Dr. Grant, however, believes the bleeding is due to the same mysterious disease that Jonas had.

The body of Jonas's daughter is exhumed, and there is anatomic evidence of the same bizarre changes that occurred in her father. Dr. Grant visits a cabin in the woods where Jonas had lived. He is looking for clues to the puzzling new illness. What he finds, however, is not an answer. Instead, it is a renewed appreciation for his life as well as the world around him.

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At a flower sale on Count N.'s estate, the head gardener tells the story of Thomson, a doctor who lived in a certain village and who was such a good man that no one could conceive of wishing him harm. Even the bandits held him in such high esteem that they wouldn't rob him.

One day Thomson was found dead in a ravine. Even though it looked like murder--he was stabbed--the people thought he must have died in a strange accident because no one would be evil enough to kill the doctor. Later, a vagrant was caught trying to sell Thomson's snuffbox. The police found the doctor's bloody shirt under his bed.

Thus, the vagrant was put on trial for the doctor's murder. At the last minute, however, the judge acquitted him because, "I cannot admit the thought that there exists a man who would dare to murder our friend the doctor."

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