Summary:

The speaker appears to be in need of an organ transplant (see dialysis, annotated in this database). Her son is the likely donor but there is an incredible irony in this: 30 years earlier she had tried to abort him, brutally ("the hangers I shoved inside"), before abortion was legal. Now, as she is told that her body might reject his, she remembers how she had previously rejected his body, and how he had refused to be rejected ("refusing my refusal").

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The narrator is an alcoholic who has signed himself into a "drying-out facility." He has been there before and tries to reassure his companion, J.P., that their unpleasant withdrawal symptoms will improve. J.P. likes to talk and the narrator encourages him to do so because he would rather listen to J.P.'s stories than think about his own predicament. After hearing about J.P.'s marriage--infatuation, love, children, drinking, fighting ("who knows why we do what we do?")--the narrator is able to tell his own story.

His story includes a wife with whom he was once happy but from whom he is now estranged, and a girlfriend who has received a cancer diagnosis. Each woman had brought him to the drying-out facility, at each separate occasion. "Part of me wanted help. But there was another part." The narrator's ambivalence extends to his relationship with these two women. He can't face his girlfriend's illness or her son, and he knows that if he calls his wife she will ask him "where I'm calling from" and he will have to explain.

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This anthology culls 1,500 excerpts from approximately 600 works of literature primarily written in the past two centuries and representing all major genres--the novel, drama, poetry, and essay. These brief selections highlight how literature portrays the medical profession and also provide ample evidence of many recurrent themes about the doctor-patient relationship and the personal lives of physicians present in the pages of fiction.

The book is organized into eleven chapters devoted to the following subjects: the doctor's fee, time, bedside manner, the medical history and physical examination, communication and truth, treatment, detachment, resentment of the medical profession, hospital rounds, social status, and the doctor in court. Many well-known authors including Anton P. Chekhov, Sir Arthur Conan Doyle, Ernest Hemingway, Thomas Mann, W. (William) Somerset Maugham, Leo Tolstoy, Tennessee Williams, and William Carlos Williams are featured in this anthology but less notable writers are also introduced. A twenty-three-page bibliography of primary and secondary sources is a useful element of the book.

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Vicki Forman's twins, Evan and Ellie, were born in 2000 at twenty-three weeks' gestation.  Fetuses could legally be aborted up to twenty-four weeks, but rules regulating treatment of extremely premature babies differed from one hospital to another.  Daughter of a doctor, Forman knew how slim were the chances of survival and how great the chances of serious disability if either of the twins did survive.  Grieving, but realistic, she and her husband asked for a DNR order, but learned that such orders did not strictly apply to the situation of children like their twins.  Instead, the line between  the parents' authority and the doctors' remained blurry and decision-making vexed not only by technical and emotional complications, but by conflicting legal guidelines as they made their way through many months of hospitalization and home treatment of their surviving son.

Ellie, the daughter, died at four days.  Evan lived for eight years with disabilities that completely reorganized family life, and required constant monitoring, management of equipment, and careful orchestration of parental relationship to their older child, Josie, and their special-needs child.  Much of the narrative covers the period of hospitalization during Evan's early months and the negotiations between parents, physicians, and other caregivers.  It also touches on Forman's own emotional responses to the strenuous learning curve required of a parent who suddenly finds herself with a special-needs child.

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This volume of new and selected poems was compiled during the last year of Jane Kenyon's life, while she was suffering from leukemia. It includes generous selections from her four published volumes of poetry, as well as 20 previously uncollected new poems. The book ends with an Afterword written by Kenyon's husband, poet Donald Hall, and the last poem she wrote, The Sick Wife (see annotation).

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Oswald Alving has returned home to visit his mother on one of the occasional visits he has made since leaving home as a young boy. He was sent away to prevent him from becoming morally contaminated by his father, Captain Alving, who subsequently died of syphilis. This time, however, he intends to stay and marry the maid, Regine; he is unaware that Regine is his half-sister, sired by the profligate Captain Alving.

Parson Manders, the mother's former lover, also visits and reprimands Mrs. Alving for not living a more conventional life and rearing her son. In the play's climax, Oswald reveals that he, too, is suffering from syphilis and will inevitably develop dementia. To make up for the past and to prove her love, Oswald asks his mother to give him a fatal dose of morphine when signs of dementia appear. At the end of the play it is not clear what she will do.

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The story begins with Theodore Roosevelt's funeral. The narrator, a reporter with the New York Times, decides to tell a story that happened more than 20 years earlier in 1896 when Roosevelt was Police Commissioner of New York City. A serial killer is murdering young male prostitutes.

Roosevelt invites the infamous Dr. Laszlo Kreizler to form a special unit to track down the killer. The unit also includes the narrator and three members of the police department. Kreizler's qualification is that he is an alienist who champions the radical new concept of forensic psychiatry: the belief that one can predict a criminal's behavior by reconstructing his personality based on evidence in the crimes themselves. This concept smacks of determinism. Thus, Kreizler was violently opposed by many, including the religious establishment, who believed Kreizler was denying that people were morally responsible for their crimes.

Because of the sensitivity of their mission, the small investigative unit operates secretly, but runs into powerful opposition. Over several months Kreizler and his colleagues perform the seemingly impossible job of identifying and tracking down the killer, using Kreizler's psychological methods.

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Struck Dumb is a collaboratively written play based on the firsthand experience of stroke by one of the authors, Joe Chaikin. Chaikin, when about 50 years old, suffered a stroke during an operation for a faulty heart valve, which left him aphasic. Co-author van Italie, stated that this play "is a theatrical metaphor for the aphasic character's mind: his written thoughts literally come flying in at him from all sides of stage in full view of the audience." In this way an actor who is aphasic and can read, can play the role.

The main character, Adnan, is a "50ish" Arab-American living in Venice, California who has suffered a stroke. The "scenes" in the play revolve around a day in the life of Adnan beginning with "waking up," ending with "sunset," and in between with "practicing words," "my house," "the mall," and other everyday, yet extraordinary, concerns.

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The French writer Alphonse Daudet (1840-1897) developed the form of tertiary syphilis called tabes dorsalis in the early 1880’s. Tabes progressively destroys the structures of the dorsal column of the spinal cord, leading at first to lower extremity ataxia and neuropathic pain, and eventually to paralysis of the legs associated with intractable pain. Daudet sought treatment from the leading neurologists of his time, including J. M. Charcot and C. E. Brown-Séquard, but the disease progressed relentlessly.

At some point Daudet began making notes for a book about his illness. He spoke to several of his contemporaries about this project, but the book never became more than a collection of brief notes, which were collected and published posthumously as "La Doulou" (Provencal for "pain"). This short book, translated here by Julian Barnes, consists of "fifty or so pages of notes on his symptoms and sufferings, his fears and reflections, and on the strange social life of patients at shower-bath and spa." (p. xiii)

The notes are generally in chronological order, beginning with short comments like "Torture walking back from the baths via the Champs-Elysées" (p. 4) and "Also from that time onwards pins and needles in the feet, burning feelings, hypersensitivity." (p. 6) In a long section toward the end Daudet comments on his experience at Lamalou, a thermal spa that he visited annually from 1885 to 1893. "I’ve passed the stage where illness brings any advantage or helps you understand things; also the stage where it sours your life, puts a harshness in your voice, makes every cogwheel shriek." (p. 65)

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The author introduces his book by saying, "I should like to write a book to help people cope with inexplicable pain and suffering." He is "profoundly suspicious" of the genre of books that attempt to explain why a good and all-powerful God allows us "to undergo suffering for seemingly no reason." Thus, he distinguishes his investigation from theodicy in the traditional sense (an explanation of why God allows suffering); rather, Hauerwas wishes to explore why human beings believe it is so important for us to ask why God allows suffering.

The narrative backbone of this book is provided by fictional and non-fictional texts about the suffering and death of children. The prime fictional example is The Blood of the Lamb, Peter De Vries's 1961 novel about an 11-year old girl who dies of leukemia and the anguish of her father. This fiction, however, was based on De Vries's personal experience. [See annotation in this database.] Hauerwas also explores several non-fictional accounts of dying children, especially Where Is God When a Child Suffers? by Penny Giesbrecht, The Private World of Dying Children by Myra Bluebond-Langner, and Lament for a Son by Nicholas Wolterstorff.

Traditionally, suffering and death were interpreted in the context of religious meaning (e.g. part of God's plan, punishment for sin, etc.) Yet, the fact that God allows evil--in the form of suffering--to occur poses a problem, if God is both all compassionate and all-powerful. Modern medicine dispenses with the meaning of illness--disease and suffering are pointless and should be eliminated, if possible. Likewise, in modern society our preferred death is sudden like a bolt of lightning (no suffering), while in the past people looked for a "good death," which might involved a period of suffering during which the person could become reconciled to family, friends, and God.

Nonetheless, even if we adopt a scientific point of view, as human beings we can't help attributing narrative meaning to our illnesses. Thus, when adults suffer, we place their suffering in the context of a life story that may include a number of layers and dimensions. We "dilute" the suffering in the context of story. However, childhood suffering and death appear to truncate narratives, sometimes even to abolish them. Therefore, the suffering seems particularly meaningless, and it feels more "evil" and more devastating.

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