Summary:

Fifteen selections--short stories, essays, and memoir--make up this collection. Two stories are notable: The Whistlers' Room and Atrium: October 2001 (see annotations). The title story is a translation and retelling of an obscure German tale published 75 years ago. Set in a military hospital in Germany during World War I, four soldiers share a common wound--throat injuries and laryngeal damage necessitating a tracheostomy for each man. This remarkable quartet of patients forges a fellowship of the maimed.

"Atrium: October 2001" describes the random meeting between a physician and a terminally ill teenager in the hospital atrium. The subject of death dominates their discussion. "Parable" chronicles an elderly doctor's efforts to comfort a dying man, and in the process, ease both their suffering.

Excerpts from Selzer's diary reveal much about the character of the author as well as the characters in his life. He also reminisces about growing up in Troy, New York. Approximately one-quarter of the book is devoted to Selzer's musings on works of art (sculpture and painting). Lighter fare includes a discussion of life behind the podium, a description of his home, and a new ending for A Tale of Two Cities by Charles Dickens.

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The unnamed narrator of the story is a "dreadfully nervous" character who disputes the allegation that he might be crazy. He contends that his disposition arises from a heightening of the senses: "Above all was the sense of hearing acute" (74). The narrator provides care for a wealthy elderly man. For some inexplicable reason, the narrator becomes obsessed with the diseased eye of the old man. The narrator likens it to a vulture’s eye and is so haunted by the Evil Eye that he decides to murder the old man.

He meticulously plans the murder. After one week of preparation, the narrator charges into the old man’s bedroom after midnight and kills him using the heavy bed the victim had been sleeping in to either crush or suffocate him. Even after the murder, the victim’s heart continues beating for many minutes. The narrator carefully dismembers the body in a tub. He conceals all the pieces under the floor boards.

At four o’clock in the morning, three policemen arrive. A neighbor heard a scream and notified the police. They are here to investigate. The narrator maintains his composure and even entertains the police. After all, he has committed the perfect crime. Suddenly, he hears a repetitive noise like the ticking of a watch. At first soft, the sound grows louder and louder. No one else hears it. What is the cause of the noise--paranoia, his conscience, auditory hallucinations, a supernatural clue, or (most likely) the sound of his own pounding heart? The narrator can no longer tolerate the thumping and confesses to the murder: "I admit the deed!--tear up the planks!--here, here!--it is the beating of his hideous heart!" (78)

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This book interweaves an American love story with the development and repercussions of x-ray technology and atomic energy. It is an intriguing and beautifully written story. The setting is the southeastern United States, where the male protagonist, Fos, meets and marries Opal. Fos is a returning World War I veteran when the story begins; the story ends some years after the atomic bomb is dropped in World War II.

Fos is stationed in France during World War I. His assignment is to produce chemical flares. He shares a trench bunker with "Flash," the regiment photographer. After the war is over, Fos and Flash open up a photography shop in Flash's hometown of Knoxville, Tennessee. Fos is fascinated by natural phenomena such as phosphorescence, radiation, and the application of scientific discoveries for practical use. Flash is a good businessman and has a way with the ladies.

After Fos marries Opal, the three are in business together--Opal has accounting experience and handles the shop's "books." On the side, Fos and Opal have a traveling show that features an "x-ray box" where people can view the skeleton of their own feet. Opal is part of the show, on exhibit to demonstrate how this works as Fos x-rays her feet. A baby comes into their lives--they name him Lightfoot. The novel takes these characters and a few other connected figures through the 1920s into the Depression of the 1930s and formation of the Tennessee Valley Authority, to the work on the atomic bomb at Oak Ridge National Laboratory. Fos is recruited by the government to work at Oak Ridge--to take photographs. To say any more about the plot would spoil the pleasure of reading this absorbing book.

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The narrative of Pilgrim and his psychiatrist, Carl G. Jung, begins with Pilgrim's most recent unsuccessful attempt to kill himself. The surrealistic nature of the tale begins with this mysterious inability of the title character to exit life--a life self-proclaimed to have covered multiple incarnations over millennia each of which he has memory. His friend and his servants take him to Zurich to the renowned psychiatrist's clinic for institutionalization and therapy. Enter Dr. Jung, whose personal and professional life assumes a dominant role in the narrative.

As the story progresses, the reader learns from Pilgrim's journals the interstices of his seemingly endless voyage. While Pilgrim's tale--real or imagined--is progressively revealed, the immediate lives of the Jungs are explored in increasing depth. Layer upon layer of development of plot, past and present, is peeled away until Pilgrim escapes his prison and Jung's emotional chaos is exposed.

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Closed like confessionals, ambulances weave through the city. One of them might come to rest anywhere. When that happens, the onlookers momentarily see "a wild white face that overtops / Red stretcher blankets" as the patient is taken into the ambulance.

Suddenly, just for a moment, they "sense the solving emptiness / That lies just under all we do." The onlookers whisper in distress. But the ambulance moves on, the traffic parts to let it by, and "dulls to distance all we are." [30 lines]

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The story begins soon after the narrator has moved his elderly mother into Cherry Orchard, an "independent living" facility near his home in Providence, Rhode Island. Because of progressive dementia, she was no longer able to maintain her own home in New Jersey, or her relationship with Warren, her boyfriend of 20 years, with whom she spent part of each year in Florida. Thus, the narrator and his sister arranged for her move to an apartment in the exclusive Cherry Orchard, where her symptoms of Alzheimer's disease had to be hidden in order to ensure her eligibility.

The mother and son have never been close, especially after the boy's father died during his early adolescence. She was a pleasant, but distant parent, more interested in her own social and cultural affairs than in taking care of her children. The narrator is 34 years old now, married, with his own son. He has little emotional attachment to this woman who is slowing losing her mind, yet now he feels duty-bound to visit her at least weekly at Cherry Orchard.

The mother has almost entirely lost her short-term memory, yet at first blush seems surprisingly intact because of her ability to cover-up with social skills. She writes notes to herself. The texture of her life unravels. She begins to wander. Other residents complain. Occasionally a glimmer of insight appears, but quickly dies. Fighting his inclinations every step of the way, the narrator provides ever increasing physical and emotional support, while at the same time gaining a deeper understanding of how his mother was (and is). In the end nothing is changed--the mother spirals slowly downward. But in another sense everything has changed. The narrator concludes, "I had taken her in so that I could understand why I had agreed to take her. I would do it again."

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Boyle drives out to the cottage to visit Joady, who is dying of cancer. Dinny and Joady are two elderly brothers who live together. "In all his years Joady had never slept away from the cottage," until recently when he went to the hospital and had an operation. Boyle and Dinny speak about how, a week earlier, they had been stopped by police in a helicopter as they were driving to the hospital to visit Joady--this was the day after an IRA bombing in which five people lost their lives. When they reached the hospital, they spoke to the surgeon who told them that Joady was terminal. By this time (back at the cottage), Joady knows that he is dying. However, he follows his normal routine, apparently unchanged, while Dinny is sullen, distracted, and complaining.

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The narrator, a schoolteacher substituting in a "stagnant, godforsaken little place" in the west of Ireland, meets an old woman that everyone in town calls "The Creature." She decides to visit The Creature and listens to her story, eventually becoming a regular weekly visitor at her hut.

The Creature is a widow who has two children: a daughter who lives in Canada and a married son who lives a few miles away on a farm The Creature used to own. Her husband had been killed, a victim of The Troubles two years after they were married. Thus, she had to raise the children alone.

Originally her farm was relatively prosperous, but the animals had all developed hoof-and-mouth disease and died. Nonetheless, she managed to keep body and soul together and to send the children away to school. Her son returned from the city after marrying a woman who despised The Creature. He and his wife had moved into the farm, but the young couple argued every night about money and the mother's presence, so The Creature signed the farm over to her son and moved away. That was 17 years ago; he had never visited her since.

The narrator goes to the farm, meets the son (by this time a passive and depressed middle aged man), and arranges for him to visit his mother. He does this, but the visit goes poorly. The narrator finally realizes that she has actually removed the last little glimmer of hope the old woman had; before seeing her son again, she could always hope that someday the two would be reunited, but after he visits, she realizes that he doesn't care about her and will probably never come back.

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"Spell Check for a Malformed Fetus" (p. 1) sets the stage for some of the important themes in this collection by poet-psychiatrist, Ronald Pies. First, the lack of honest language to express life’s "mistakes" and disappointments. Our attempt to disguise the pain by using easy, but inaccurate, words. And finally, an expression of hope, even if only in the world of imagination: "if only / in your first fission / some godly processor / had blessed / your blighted genes."

Some of these poems emerge from relationships with patients, notably "Consultation Request" (p. 35), "Three Patients" (pp. 37-39), "Prolapse of the Uterus" (p.76), and "Congestive Heart Failure" (p. 85). "Smoke, Lilac, Lemon" (p. 45) evokes a fascinating test apparently used by some clinicians to distinguish depression from Alzheimer’s disease on the basis of olfactory function. The four "Alzheimer Sonnets" (pp. 87-88) tackle the difficult task of expressing the experience of dementia from the patient’s point of view.

Many of the other poems deal with love, memory, loss, and pain in the context of family and intimate relationships. Among the best of these are: the title poem (p.3), "Sitting Shivah" (pp. 14-15), "Riding Down Dark" (p. 16), "Visitant" (pp. 41-43), and "Migrations" (pp. 64-69).

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Birth Sounds includes 45 short tales of labor and delivery, ranging through a wide swath of the human comedy, but always maintaining focus on the very first scene. In most of these stories, it isn't the delivery that provides the drama, but rather the people. Take the first story, for example. In "Faceless" a Vietnamese husband cautions the obstetrician-narrator, "In our country no man will examine a woman in such an intimate way." The obstetrician never sees the patient's face, which she has covered with a towel. After the delivery, he examines her and speaks carefully, not sure that she understands English. However, from beneath the towel, she thanks him in a perfect American Southern accent. A neat surprise!

In "The Little Devil" (p. 6) a 38-year-old member of a satanic cult announces that she intends to kill the baby if it is a boy. She has been directed to do so by her satanic mentor. When, amid a panoply of lit candles and inverted crucifixes she delivers a boy, the resident contacts the sheriff's office, where the mother's intentions are already known. Sure enough, the SWAT team storms the delivery room and takes the baby.

In "Red Bag" (p. 31) the narrator is serving as a medical expert in a murder trial. The defendant had arrived at the hospital hemorrhaging after delivering a baby at home, evidently into the toilet bowl. The baby had died of head injury. The obstetrician-narrator turns out to be more supportive of the woman and less compliant than the prosecutor had expected; but afterward the doctor receives his financial reward--a check from the state for a full $7.00!

In "Resilience" (p. 259) a woman with a near-term pregnancy asks the obstetrician to examine her breast, which has suddenly developed a red lump. He takes one look and immediately experiences a flashback to another young woman he cared for who had developed breast cancer during pregnancy and died of metastatic disease about a year later. Sure enough, the current patient also has cancer. But in this case the patient delivers, receives treatment, and recovers, apparently cured of her cancer.

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