Summary:

Doris Grumbach, novelist and critic, experienced the landmark of her seventieth birthday as a traumatic event. She resolved to keep a diary during the months surrounding this time, both to record her "despair" and to seek answers to "what has my life meant?" The result is a relentless reflection on the losses associated with growing old, and on the loss of civility associated with contemporary urban life. Yet there is the liberation which age allows, in setting priorities and discarding the trivial. Ever observant and informed, Grumbach’s commentary on the present and the past is both interesting and moving.

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This story concerns the death of a child and failures of communication. Scotty, an eight year old, is hit by a car on his birthday. His mother had ordered a birthday cake but "there were no pleasantries between" her and the baker. Scotty is hospitalized, unconscious, and the cake is forgotten. Dr. Francis reassures the anxious parents that all will be well when the boy wakes up.

The baker phones the parents’ home in the dead of night (when he does his baking) because the cake hasn’t been picked up, but they can’t figure out who he is or what he wants. At the same time the doctors and staff can’t and won’t answer their questions about why Scotty isn’t waking up. Dr. Francis comes to the hospital to check the child, looking tanned, meticulously dressed, as if he has just been out for the evening- he has a life outside of the hospital, but the parents have none. When they do run home, separately, to take a break, the baker torments them with his mysterious late-night calls. Their confusion and isolation deepen. The child dies-"a one-in-a-million circumstance."

The mother finally realizes that it is the baker who has been calling and tracks him down, enraged. She unleashes all of the anger which she had been unable to express to the doctors. The baker is stunned to learn about the child’s death; he begs forgiveness and offers them warm delicious cinnamon rolls. "Eating is a small, good thing in a time like this" and they are comforted.

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Summary:

Helen van Horne, the good doctor, has left her solitary practice as a physician in rural East Africa to become chief of the Department of Medicine at City Hospital. She is a tough, hard-as-nails woman who has given up the comforts of marriage, family, and human indiscretion for her profession. While the folks in South Bronx initially "hate" her because of her skin color, they soon learn that van Horne is a model of rectitude, dedication, and compassion. The Hispanic chief resident becomes her disciple.

Van Horne's yearning for human comfort and sexual gratification brings her into intimate contact with a lazy, irresponsible, but charming male student. Out of weakness, she tells the failing student that he will pass the rotation, but is later challenged by the chief resident, who has left her own lazy husband and dedicated herself to be "just like you." Van Horne realizes her own weakness, allows the failing grade to be recorded, then contemplates (but rejects) suicide.

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A physician stands in the laundry, folding her baby’s diapers, and thinks about Mr. Dantio, who died of wildly metastatic cancer. She reflects on the development of her relationship with Mr. Dantio during the time that she was pregnant. Toward the end, he developed a lung infiltrate, maybe a type of pneumonia. There was a chance that a biopsy might have helped--perhaps he had a treatable infection--but she recommended against it. Now she wonders about this decision. She wonders also about what the other physicians think of her: "you don’t really want to be a doctor anyway, you must be conflicted to have a child . . . . " She remembers seeing Mrs. Dantio in the supermarket shortly after her husband died, and crying with her. She asks herself: Will I ever be a REAL doctor, "because in moments of great stress I revert to my native tongue."

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Summary:

A medical student at Lincoln Hospital in the south Bronx is called to the Emergency Room, where a gang war is going on. She plunges through fighting bodies in the waiting room to reach the treatment area, where she is enlisted to ride an ambulance with a critically injured and intubated patient. During the trip, the ambulance jerks, the tube comes out, and the student tries but fails to ventilate him with mouth-to-mouth respiration. At the other hospital, she is turned away from the cafeteria because her clothes are blood-soaked. The patient dies. Although she feels terrible, her friend Marie, a practical nurse, comforts her with a touch of ordinary love, a photo of her new grandchild.

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Twelve contemporary stories set in Rhode Island and New York City. Major themes include the pain of cultural dislocation and cross-cultural experience ("Theng," "Shambalileh," "My German Problem"); human frailty and self-deception ("Sleep," "Juilliard"); and the personal and moral dimensions of medical practice. See the separate annotations for Laundry, The Good Doctor and Ambulance--three stories which are particularly relevant to Literature and Medicine.

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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This is the first person narrative of Maarten, a seventy-one year old man who is experiencing a rapidly progressive loss of intellectual function. It is a harrowing yet poetic account of mental deterioration, revealed in an on-going chronicle of daily life and disjointed memories. The reader experiences what Maarten experiences, not only through descriptions of what life is like, but through the sequencing of thoughts and actions.

At first Maarten is just aware of being uneasy and anxious, "this feeling of being absent while being fully conscious" and he knows, from the comments of his wife, that he must be behaving absent-mindedly. His hold on familiar certainties becomes shaky--he’s not sure of how the rooms in his house are arranged. His wife, Vera, is his anchor and he realizes that his behavior has become deeply disturbing to her, as well as incomprehensible to himself. As Maarten becomes increasingly forgetful and unable to function, Vera is alternately worried, exasperated, and profoundly understanding.

Finally, Maarten is institutionalized--his thoughts disintegrate--yet we know from his observations of "the utterly moronic community" that he still has some awareness of what is happening. Although he no longer recognizes his wife, he listens to "a woman" whisper that "the spring is almost beginning . . . ."

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Summary:

A young doctor, just graduated, arrives at the country hospital to which he is assigned. He is fraught with anxiety because of his inexperience, especially when he meets the seasoned feldsher and midwives, who sing the praises of his predecessor. During the night his first patient arrives: a girl who was caught in a brake (a machine for threshing flax) and is now mangled and near death. No one expects her to live. The feldsher whispers, “She'll die now.” Yet the doctor feels compelled to try to save her, despite his ignorance. He amputates a leg, he continues treatment, the girl hangs on. Eventually she recovers. The new doctor has established his reputation in the district.

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Summary:

This novel is set on San Pedro Island off the coast of Washington in 1954. Kabuo Miyamoto, a member of the island's Japanese-American community, is on trial for the murder of Carl Heine, a fellow fisherman. Heine's boat was found drifting one morning, with his body entangled in a net. While the death initially appeared accidental, bits of circumstantial evidence accumulate that seem to implicate Miyamoto.

Miyamoto's family was unjustly cheated out of some land by Heine's mother during the time the island's Japanese community was incarcerated in a "relocation camp" in California during the War. The dead man's traumatic head wound appeared suggestive of a Japanese "kendo" blow. Carl Heine's blood type was found on a wooden gaff on Kabuo Miyamoto's boat.

As the trial proceeds, the story of Carl, Kabuo, and what happened that night gradually evolves, as does the tale of Ishmael Chambers, the local newspaper reporter, who had a "charmed love affair" with Kabuo's wife when they were both adolescents, just before the Japanese families were sent away in 1942. It is clear, however, that this is more than a story of one man's guilt or innocence; it is a story of a community's fear and prejudice against the Japanese-Americans in its midst.

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