Summary:

This three-part collection of poems offers powerful images and vignettes from the life of a family practitioner living and working among the urban poor. The first section is the most explicitly medical in theme, including poems that pay painful tribute to a mother after stillbirth, a hydrocephalic child, an addict covered with boils, a young man murdered at eighteen, an old man with a failing heart.

The second section weaves images from the writer's personal story together with those from his life as physician, and the third focuses primarily on life lived as a gay man among the sick and dying, patients to be treated and friends to be mourned while life remains to be claimed and savored.

Despite the pain and grief attested to in many of the poems, a lively voice of clarity, compassion, and consent to the goodness of life even on hard terms gives the collection a defining note of celebration. Pereira's lines about a bereaved Cambodian seamstress suggest something true about his own work: ". . . she joins the circle / of other Khmer women to sew. / Punctuating the fabric / with yellow thread, finding her remnants / into a piece that will hold." ("What is Lost")

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The story of Avram Halevi of Toledo, a late 14th-century Jewish doctor forced to convert to Christianity at the age of ten. He becomes a physician and surgeon in Montpellier and returns to the poor Jewish sector of his native city to live a dangerous professional life, serving the Christian rich. His relationship with the beautiful, ambitious Gabriela founders as his people are scattered in yet another attack by misguided Christian zealots.

His cousin, Antonio, is cruelly tortured and Halevi euthanizes him in prison. Escaping Toledo, he returns to Montpellier where he finds friends, a wife, a family, and eventually a professorship--but religious rivalry again intervenes through the brutality of a worldly cardinal. Try as he might to remain above the fray of religious and political struggles, Halevi is stripped of all he holds dear and dragged into controversy again because he senses what is morally right.

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Leland Fowler, a small-town Vermont attorney, is raising his small daughter alone two years after his wife's death in a car accident when he meets Carissa Lake, a homeopath, and falls in love. He originally seeks her services because of low-grade cold symptoms that won't go away. She attempts to keep their relationship purely professional, but finally advises him to see another homeopath so they can pursue a more intimate relationship.

She starts him on a regimen of highly dilute arsenic solution that helps him immediately. In the meantime another patient of Carissa's, a young family man suffering from severe athsma and allergies, has gone into a coma as a result of eating cashews to which he is violently allergic. The man's wife brings legal action against Carissa since it was under her care that Richard, the patient, started taking a homeopathic solution derived from cashews and apparently was motivated to try the cashews themselves by dint of misunderstanding the "law of similars"--that "like cures like"--that is a central homeopathic principle.

Leland's law firm prosecutes after Richard dies, and Leland is forced to keep his relationship to Carissa secret while he himself struggles with his own doubts about homeopathy. To protect Carissa, because he believes her innocent, he helps her doctor her casenotes. Eventually the case is dropped; Carissa leaves town; and Leland is left to ponder the forces that drive medical, legal, and personal decisions.

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This story of love and marriage under the shadow of AIDS travels a couple's unlikely journey from meeting to courtship to disclosure of the male partner's AIDS, through a subsequent breakup, then a decision to marry, and four years of almost inexplicably happy marriage dogged from the beginning by the specter of death.

Over this time the couple has a chance to explore their respective understandings of the life of the spirit and for Hyung Goo to entertain and reject a number of avenues of comfort before joining his wife, a Presbyterian theologian and seminary professor, in her faith. Much of their short life together is lived in the context of intersecting circles of medical people and church community, in both of which they are active participants whose challenging marriage becomes a mirror and a lamp to their cohort.

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Pook, Dante, and Wyatt inhabit the social margins of an inner-city school in Oakland. Pook's family has disintegrated from drug trade, Dante needs a heart operation he can't afford as a result of his now-dead mother's addiction to crack cocaine, Wyatt, slowed and ostracized by obesity, provides a frequent refuge for the other two at his mother's rundown dockside café. The three of them are no strangers to the violence of drug-infested neighborhoods, Wyatt manages to smuggle a gun into the schoolyard despite metal detectors, but none of the boys is eager to use weapons. They are "homies," committed to each other's survival, and intensely loyal.

Radgi, a younger, smaller homeless kid, follows them for occasional handouts and eventually is taken into Dante's apartment where his father, a dock worker, is frequently absent. All are threatened repeatedly by "Air Touch," a leader in the local drug trade who deals with smugglers and rich white patrons. Another occasional friend is Kelly, a Korean boy whose father runs a convenience store in the "hood."

The plot follows the fortunes of the boys after they witness the police beating Air Torch, see him toss his gun and briefcase away before being apprehended, and pick up both as they run for home. In the briefcase is a load of cocaine ready for sale. They have to decide whether to sell it to get the money for Dante's operation or pour it down the toilet. They sell the gun with the help of Kelly who, discovered by Air Torch, is killed, along with his father.

Eventually, after some hair-raising close calls, the boys get rid of the drugs, assemble in Dante's apartment, and discover that the petite Radgi, who they thought was bloated from starvation, is a girl, about to have a baby as a result of rape. Pook, who longs to be a doctor and has read a medical book sequestered among his few possessions, helps deliver the child, a "little brutha."

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This unusual collection of contemporary art features full color prints of what might be termed comic doctor archetypes. Entitled by specialty, paintings feature doctors in a variety of incongruous settings that constitute fantastic anachronistic commentary on the situation of the doctor relative to different social groups or social expectations.

"The Internist," for instance, is represented as a modern female doctor in a medieval setting, commenting ironically on the various institutional pressures that come to bear upon women in the medical profession and expectations of the internist in particular. "The Pathologist" is featured getting his comeuppance as the doctor who usually has "the last word" in a confrontation with the figure of death--a skeleton straddling a Jungian snake among a horde of rats on the office floor. Each of the paintings is accompanied on the opposite page by a brief, but informative and insightful commentary by Spence.

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Lara Ardeche, a glamorous sixteen-year-old, is elected homecoming queen at her Nashville high school, as her mother was years before. She works out daily on gym equipment supplied by her wealthy grandfather. She thinks her family is perfect: her mother and father are youthful and attractive, her younger brother is cute and smart, and she is popular, beautiful, and her father's "princess." Her best friend, Molly, is one of the few offbeat characters in her life; other friends call Molly "the Mouth." Molly is frank, funny, a little fat, and indifferent to the unsubtle slurs of the in-crowd.

Weeks after homecoming, Lara, who has never had a weight problem, begins to gain weight rapidly and inexplicably. Within months her weight soars to 200+ pounds. She is diagnosed with a rare "Axell-Crowne" syndrome, a severe metabolic disorder with no sure cure. Most of her friends abandon her, though Molly stays faithful and Jett, Lara's boyfriend, tries to maintain a relationship.

The family begins to fall apart. The father, it turns out, has been having an affair. They move to Michigan to get a "new start." But the affair continues, kids at the new high school are cruel, and Lara is miserable until she is introduced to a new, motley group of people through her piano teacher who shares her love of music and is about her size.

In a cross-generational, racially mixed jazz club she begins to think differently about who she is and on what basis real relationships survive. By the time her weight begins slowly to fall, she has come to terms with herself and the dysfunctions in her family in a whole new way, and at great cost. She still hopes to be thin again, but not because she any longer kids herself that a fashionably thin body is a key to happiness.

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Set in an indefinite time and place that suggest pre-industrial Ireland, this story follows the fortunes of Marnie, eldest sister of a large family of tenant farmers. When the landowner's son takes an interest in her, though she is not drawn to him, she accepts his offer of marriage to help her family and travels with him to his dead grandmother's run-down cottage by the sea, which he claims is worth the whole of the rest of his family's estate.

Only a few days into their marriage, the bridegroom dies from a fall while thatching the roof. Marnie is left to fend for herself in a village of suspicious and superstitious locals where only the priest befriends her. The one other person with whom she has contact is a young boy called "The Raver" by the villagers who believe he is mad.

Gradually she comes to believe he is not mad, but deaf. She devises hand signs and wins first his trust, then his devotion as she opens a world of communication to one who has been isolated and ostracized his whole life, though the priest has taken care of him. However, upon seeing her effect on the mad boy (whose name Marnie has changed to "Raven") the locals decide that Marnie must be a witch.

They put her to a test for witchcraft, which the priest helps her endure and pass. After that they leave her alone. Eventually the priest, now like a father to both Marnie and Raven, marries them, and they leave with an heirloom ring found in the cottage to begin life again among people who might be able to receive the young couple with their strange hand-speech more open-mindedly.

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This fine collection of short memoirs and stories by doctors offers a variety of narratives about memorable moments in medical education and practice that raise and explore practical and ethical issues in medicine. An explicit aim of the editors was to focus on some of the rewards in medical life as well as the struggles it entails--those often being inseparable.

Starting with a section on medicine and poetry which includes memories of William Carlos Williams by two of his well-known students, Robert Coles and John Stone, and a reflection on illness in poetry by Rafael Campo, the collection is then divided into two major sections: "Grand Perspectives" and "Intimate Experiences." The former includes narratives that show the development of practices, conflicts, or learning over time spent in hospitals and clinics, observing the careers of elders in the profession or the parade of patients whose expectations and needs stretch the physician's creative resources. Several, including Perri Klass and David Hilfiker write about particular patients whose cases became personal landmarks.

In the latter section, stories focus on single cases or incidents in the lives of doctors, some humorous, some tragic, some bemusing, all attesting to the chronic ambiguities of the work of healing and to the very human tensions that arise in institutions that both enable and inhibit the compassion all good doctors want to exercise.

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This searing play takes place in California's central valley where Mexican immigrants are employed at survival wages to work in fields poisoned by pesticides. Their ramshackle government homes are built over dumps where toxic waste poisons the water. The community has suffered a high incidence of cancer--especially in children--, birth defects, and other illnesses related to long-term intake of toxic substances.

One of the main characters, Cerezita, has only half a body, and often occupies center stage encased in an altar-like contraption where only her head shows. She turns pages, points, and performs other basic functions with tongue and teeth. She is a prophetic figure, willing to see and speak, because seeing and speaking are all she can do, and to name the evils that others prefer to call the will of God.

She seeks and finds intellectual companionship in the local priest who is struggling to find an appropriate way to minister to a parish divided among disillusioned cynics turned alcoholic, pious women who want nothing to do with politics, and the angry young, including one young homosexual who feels driven to leave a loving but uncomprehending family, and reveals to the priest that he has AIDS.

The community has been involved in recent protests that consist of hanging the bodies of recently deceased children on crosses in the fields. This dramatic protest has caused public outrage and attracted media attention. The play culminates in a protest in which Cerezita and the priest are shot down and the young man with AIDS cries out for the community to burn the fields. The curtain falls on burning vineyards.

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