Summary:

This book contains 17 short stories, all set in an in-patient hospice, all exploring the reactions of patients and their caregivers--both family members and professionals--to the last stages of terminal illness. A woman struggles to find the strength to write last letters to her loved ones, nurses are surprised when a seemingly unconscious patient suddenly joins in their conversation; the hospice chaplain becomes a patient; and so on. In the title story, a dying woman's daughter finally manages to answer honestly when her mother asks when death will come: "Soon."

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Marat, a leader of the French Revolution of 1789, is portrayed just after being stabbed to death in his bath by a fervent revolutionist, Charlotte Corday. The faked letter of introduction with which she fraudulently entered his home is still held in the dead man's hand. Three quarters of the gray-brown bathtub is covered by a wooden board. The background, shades of gray, is entirely bare.

Warm yellow light further softens the horror of the scene. Both dagger on the floor and wound in the breast are barely visible in the shadow. In fact, emerging from a gray-white turban, the dead man's face--eyes closed, mouth partly smiling--appears calm, as in a gentle sleep. The inscription on the side of a wooden block makeshift desk reads "À Marat/David."

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Carol White (Julianne Moore), an upper-middle-class Los Angeles housewife, is stricken with a mysterious illness that her doctor cannot diagnose or explain. He believes her illness to be psychosomatic, but Carol, through contact with a support group, realizes she has "environmental illness," an immune disorder that causes her to physically overreact to common chemicals, fumes, and environmental pollutants. The film follows her journey to a clinic in New Mexico in search of relief from her increasingly debilitating symptoms.

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A young man (Alexander Anaishnov) has come to take care of his mother (Gudrin Geyer) who lives alone in rural Russia. She is dying. He watches her sleep, takes her for a walk (or rather carries her), reads to her, gives her medicine, and, when she falls asleep, goes for a walk alone. He breaks down and weeps, then returns to his mother, who may still be sleeping or may now be dead.

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Andy Safian (Bill Pullman), an English professor, and his wife Tracy (Nicole Kidman), recently married, have bought a new house. Short of money, they take in a lodger, Dr. Jed Hill (Alec Baldwin), a surgeon who went to high school with Andy. Tracy suffers from mysterious abdominal pains and then has to have emergency surgery when an ovarian cyst ruptures. Jed Hill performs the surgery. He finds that her other ovary appears necrotic and removes it. It later turns out to have been healthy.

Tracy sues for malpractice and receives a huge settlement. She then leaves her husband, who gradually realizes that she and the surgeon had been lovers and that he has been the victim of their complex con game: she has sacrificed her fertility and Dr. Hill his career in exchange for the millions of dollars paid out by the hospital's insurance company. Andy sets about seeking revenge.

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Berger writes shortly after the death of his mother. He remembers how as a child he had a morbid fear that his parents would die in the middle of the night. But his mother has lived for a long time. Now Berger reflects on his mother's secrets. She was forever stoic and had an air of mystery that Berger thinks caused him to become a writer--he had to try to fathom the mystery. On her death bed, he learns her secret-- she has had a happy life.

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In 1871 the Polaris, a rebuilt tugboat commissioned by the U.S. Navy, set sail with a dual mission: planting the stars and stripes on the North Pole and providing scientific data and specimens for the Smithsonian Institution. A number of poor decisions were made early on in the planning and initiation of the expedition, including an inadequately structured vessel, a vague power distribution lacking a clear absolute authority, and a sailing captain with a significant alcohol problem.

The power struggles begin early. By the third month of the voyage the ship is in physical trouble and the designated expedition head (Charles Francis Hall) has died suddenly of an unexplained illness. There is no leader and the struggle for control erupts between the German scientist/physician who is responsible for the scientific mission and the drunken whaleboat captain who is responsible for keeping his ship and crew safe.

Bad weather, terrible luck, and lack of discipline result in the loss of the Polaris, the splitting of the crew onto separate ice floes, and several months of harrowing experience trying to survive the Arctic winter and hope for rescue. The good news is that everyone except Mr. Hall miraculously survives the ordeal. The subsequent Naval inquiry into the failed endeavor ends without resolution as to the cause of Hall’s death despite hints from crew members that it was not natural. In 1968, long after all crew members had expired, Hall’s grave was located and forensic samples proved that he had died of arsenic poisoning.

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Annie, about to finish high school, is still struggling with the long-term grief and confusion that has changed her family life since her sister, Mog, was killed by a car thief just before her own high school graduation two years ago. Annie wants to talk about Mog, but her mother remains in insistent denial and turns away from any mention of her; her father is protective of her mother and keeps his own long silences; and her brother, eager to get on with life, is willing, but unable to sustain much of the kind of conversation that might help.

Mog’s boyfriend, who was with Mog on the night of the shooting and sustained an injury but survived, offers one source of help in Annie’s process of emerging from grief, but the help becomes confused with romantic attentions that eventually, with the help of a therapist, Mog realizes she needs gently to renounce. Her belated decision to see a therapist comes at the suggestion of a friend’s mother who sees how stuck the family is in their evasions of the grief process. She initiates the visits on her own steam, with the approval of her rather passive but supportive father, and with a rather tense policy of noninterference from her mother.

Eventually, as Annie starts college, she finds herself able to move along toward remembering Mog and speaking about her freely while also reclaiming her own life and ambitions without guilt for leaving her sister "behind." Her father assures her that her mother will "be alright." In the meantime, Annie realizes not everyone has to heal the same way, and she has, with help, found a way that works for her.

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Spencer Nadler, a surgical pathologist for over 25 years in southern California, offers 8 essays, as well as an introduction, epilogue and 9 full color histopathology plates in this collection. As he explains in the introduction, Nadler began his training in surgery, but, during a required year of surgical pathology, he finds his true vocation: "I realized a flair for surgical pathology that I had never demonstrated in surgery." (p. xix) However, over the years, he realizes he misses patient contact--these essays, written over 10 years, are forays into an unusual relationship: the pathologist-patient relationship.

Each essay is about a different patient (or other contact) and tissue. One of the most compelling is the first, "Working Through the Images," in which a woman (Hanna Baylan) with metastatic breast cancer seeks Nadler out so that she may view her cancer cells. She arrives in his office unannounced at 6 p.m. and he proceeds to not only show her the slides, but to listen to her. He becomes a witness to her pain, loneliness, sorrow and hope.

"For years I have processed thousands of such cases, determined the manifold forms of disease, but I've never been an intimate part of anyone's illness, never felt the connections of cells to a larger self." (p. 12) During later visits, Baylan cries in his arms and even brings her youngest son in to meet Nadler and view her cells. By this time, Nadler is completely connected to her: "This is heartrending to me, for I have come to love her . . . I can no longer think of Hanna in terms of the cells I see on her slides." (p. 21)

Other chapters highlight fat and bariatric surgery; neurologic disorders such as brain tumor, Parkinson's, Alzheimer's and paraplegia; heart disease; sickle cell disease; and palliative care. Each chapter conveys Nadler's visual sophistication and ability to graphically describe cells. For instance, within a fat cell "a large fat globule steamrolls other cell contents flat against the outer membrane until it bulges like a mozzarella." (p. 32) More importantly, Nadler ably extends his cellular acuity to the larger human dimension.

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This story is claimed by its narrator to be a chapter in his biography of the Russian writer, Nikolai Gogol. He begins by saying he knows some intimate details of Gogol's life and that as his biographer he feels obligated to reveal them, though as his friend he might have kept all this to himself.

After setting the reader up for some perhaps prurient "facts," the narrator tells us that Gogol's wife was a life-sized balloon, anatomically correct and quite voluptuous. Claiming to be the only person besides Gogol who has ever seen this creation, the narrator goes on to tell us an occasion where he heard her speak. He describes how she developed her own personality, in spite of the fact that she was a balloon, and that she even contracted syphilis, which subsequently infected Gogol.

The narrator and Gogol are celebrating the silver anniversary of Gogol and his wife when the novelist gets insanely irritated with her, inserts a bicycle pump into her, and inflates her until she explodes. Gogol then throws the rubber pieces into the fire (much as he had burned his manuscripts earlier). He also throws into the fire a balloon baby boy. The story closes with the narrator again defending his position of biographer, providing the truth about Gogol to the reader.

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