Summary:

The idea for this anthology of poetry and prose about Alzheimer's disease patients and their caregivers arose from the editor's own experience writing about her mother. Encouraged by Tess Gallagher, Edward Hirsch, and others, Holly Hughes invited writers to contribute poems and short prose pieces that witnessed to the human experience of Alzheimer's disease. The resulting anthology includes about 120 pieces chosen from over 500 submitted. The editor has arranged these in a series of thematic sections, one of which, "Missing Pieces," contains the nine prose contributions to this primarily-poetry anthology. At the end of each work, the author has provided the reader with a brief (two or three sentence) comment on the circumstances that led he or she to write it.  Tess Gallagher's Foreword describes her experience living with, and caring for, her mother who suffered from Alzheimer's disease, two "widows together" (p. xv), during the months and years after Raymond Carver's death (Gallagher was married to Carver).

The works address an array of closely related themes in a wonderful variety of voices. A major focus is the Alzheimer's patient's slipping away, withdrawing, changing, whether it be toward dissolution, or into a different country. Sometimes the change reveals "your true life: / the bright unruffled water, / a sudden lift of wings," as in Linda Alexander's "Your True Life" (p. 23). Sometimes life has fled elsewhere, as in "No Destination" by Penny Harter (p. 67), or gradually dissolved ("Verbal Charms" by Melanie Martin, p. 41). Other poems evoke the unexpected and sometimes humorous antics of the demented. Witness, for example, Len Roberts' "My Uncle Chauncey Drove My Aunt Eleanor" (p. 36) and "Early Alzheimer's" by Sheryl L. Neims (p. 55). Another theme is the loving commitment of spouses who are taking care of a demented partner so many years after saying "I do" "This is what you signed on for / in such bodily earnest before the distractible / justice of the peace 64 runaway years ago" (E. A. Axelberg, p. 79). Parent-child relationships also take on new meaning, as in the touching poems "Bath" by Holly Hughes (p. 119) and "Pacific Sunset" by Arthur Ginsberg (p. 127). Finally, the inevitable themes of death and mourning pervade the anthology's last section entitled, appropriately, "Still Life."

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South Africans, Paul and Andrea, are lovers living in France. Paul is fiftyish and white; Andrea is thirty and “coloured.” He has just asked her to marry him. She travels to Provence ostensibly to research sites for a film to be based on Paul’s endlessly forthcoming novel about fourteenth-century plague. But the real reason for the journey is to test her feelings about his proposal—she is leaning to ‘yes.’

As five days roll by, she relives the trajectory of her life: her impoverished parents, her thwarted education, her angry, imprisoned brother, and the previous affair with Brian, a British historian with whom she was captured ‘in flagrante,’ sent to trial, found guilty, and offered prison or voluntary exile. Brian and Andrea left South Africa together, but their relationship eventually crumbled. She had trouble understanding his passion for the past and his love of detail.

In Provence, Andrea avoids places that Paul had wanted her to go, finding strength in solitude and independence. But that feeling is shattered when he asks her to rescue their penniless, black friend, Mandla, an anti-apartheid activist who has been betrayed by a comrade who turned out to be a spy.

Andrea doesn’t like Mandla, his sanctimonious accusations, arrogance, and probing. He is a racist and a male chauvinist, given to violence. But his constant questioning finally unleashes deeper memories of the shocking abuses of her life in apartheid South Africa—memories she has suppressed or attempted to blame on class struggle rather than racial intolerance. She tries to provoke his empathy with the terrible tragedy of the long ago plague. He resists, being concerned far more with the present, but he relents a little and begins to see racism as a plague and walls as feeble, futile attempts to exclude others.

Andrea falls for Mandla, makes love with him near the plague wall, and decides to refuse Paul and return to South Africa. But Mandla rejects a future with her because he wants no vulnerability in his struggle. He is killed in the night by a car. Was the death deliberate? accidental? suicide? Andrea leaves anyway.

In a short second part, Paul writes to Andrea of his own growing doubts about their future together despite his love.

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Summary:

Elegy is a poetic journal, comprised of 64 short poems, describing the year following the poet's son's death. Ms Bang's 37 year old son, Michael Donner Van Hook, died in June 2004 in lower Manhattan of an overdose of prescription medications. Giving herself a year to write the poems in Elegy, Ms Bang submitted many of them individually and then published them in the current monograph form in 2007.

The elegy is a poetic form going back over 2500 years and originally consisted of elegaic couplets, alternating lines in hexameter and pentameter. Traditionally they were initially used for lament. Since the earliest Greek and Roman poets, many poets have written poetic laments, very few of them any longer in elegaic couplets. The most famous elegies in English have been Milton's Lycidas, Shelley's Adonaïs, and of course Tennyson's In Memoriam. Modern poets writing elegaic poetry include Heaney, Hardy, Stevens, and Plath, the last particularly when writing about her father. 

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Summary:

Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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A tightly walled cube-shaped block of buildings seemingly made of child’s building blocks looms in the midst of a barren foreground of stony rubble and a background of hazy nondescript sky. No sign of life, human or vegetation, anywhere. Entirely in shades of muted yellow, orange, ochre and brown, coloring suggestive of a crematorium, the canvas reeks of desolation.The only window into the tomb-like image, seen from above, is a carved cut-out star of David through which can be glimpsed a more detailed view of the abandoned ghetto. Barely visible, a pale yellow cloth remnant of the star of David stitched to their clothes to identify Jews sits atop one of the rooftop slates.

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Summary:

Late in the twentieth century, the young doctor Goodheart fails in a city practice and accepts a salaried position in the country.  Even there his difficulties persist. A challenging patient—the Reverend Pastor--refuses a tiny muscle biopsy that would not only confirm the diagnosis of trichinosis, but establish the doctor’s reputation. “I would rather die than let myself be skewered alive!” the pastor shouts (p. 11).

Deeply discouraged Goodheart wanders into the country at twilight, sighing, “If only there were a means of making the human body as transparent as jelly fish” (p. 13). Suddenly a woman appears in a blaze of light. She is “Electra the spirit of the twentieth century” (p. 15). She gives the astonished doctor a box and bids him open the lid. The nearby tree immediately becomes “as transparent as a jelly fish” (p.17). Next the box, judiciously aimed, illuminates the inner workings of a frog.

Goodheart applies his box to the ailing pastor and sees parasites teaming throughout his body. Then he effects a dramatic cure with helminthotoxin made from the worms themselves—a treatment that had been invented sometime during the century.

The box proves to be a simple electrical device, easily replicated. Declining financial recognition, to the vexation of his wife, Goodheart communicates the workings of the box to the world with no mention of Electra. But fame and riches flow his way and he dies in old age an honored man.

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Summary:

On February 16, 2003, readers of The New York Times Magazine came upon Harriet McBryde Johnson's cover story, "Unspeakable Conversations," and a remarkable image of her gazing directly at those readers from her power wheelchair.  Her story memorably recounts her uncompromising, yet civil disagreements with Utilitarian philosopher Peter Singer about nothing less than the value of her life.  That narrative essay is one of eleven stories published in Too Late to Die Young.

They make the case that philosophers and others have incorrectly imagined Johnson's life, and the lives of others with chronic and disabling conditions, as burdensome and not worth living.  Born with a degenerative neuromuscular disease, Johnson grew up in a family that appreciated her; she practiced law in her native Charleston, South Carolina, and became nationally known for her disability activism.  Still, she encountered a world filled with people who feared her condition.  Fear, she found, led them to assume that disability inevitably brings suffering and to use that assumption to justify acts that would prevent her birth.

Her stories, conversationally and often humorously, ask readers to question why they burden some people with calls to justify their lives or to assure the world that they experience pleasure.  Each story recounts an episode that reveals the pleasures Johnson experienced as an active agent in the world.  She ran for a county office, represented her state at a Democratic National Convention, stood her ground for free speech and against Secret Service tactics when President Reagan spoke at her law school, protested Labor Day Week-end telethons, traveled to Cuba to cover a disability conference for a magazine, advocated for clients in employment discrimination cases, and made many, many friends.

Feeling exhilarated rather than confined by her wheelchair, she bears witness, perhaps unexpectedly, to another pleasure:  "the simple delight of movement."  She writes of maneuvering around Charleston, "I zoom through chaotic swarms of tourists, zip around the raggedy sidewalks . . . loop around every inconveniently placed garbage can, with maximum speed and also with style and grace" (252).  But her stories also describe her wheelchair stumbling over incompatible surfaces, one of which sends her to an emergency room far from home.  This episode also brings moments of grace, this time with the ER staff.  After learning who she is, they Google her on-line profiles and writings.  Delighting in their patient with unpredictable needs, they place print-outs of her electronic portfolio in her chart.

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Summary:

Two months after he starts writing poetry, the narrator collapses. The maid finds him on the floor. An ambulance arrives at the scene. Two EMT's - Mike and Bob - check the condition of the novice poet. Their assessment includes the patient's orientation, his chief complaint, his favorite form of poem (the sonnet), and the last time he used iambic pentameter. Mike reads the poet's unfinished villanelle that remains stuck in a Smith Corona typewriter. The EMT deems it awful. The ambulance crew generates a list of possible diagnoses that includes an aneurysm in the language center of the brain and (more plausibly) writer's block. The duo decide that the narrator requires evaluation in the hospital for bad poets. All of their ambulance patients receive supplemental oxygen during transport. Every poet additionally gets a copy of verse by Rainer Maria Rilke to read during the trip.

The hospital for bad poets is a teaching hospital. A swarm of medical students participate in the evaluation of the narrator. His working diagnosis is "chronic acuteness." A young physician, Dr. Krupp, takes charge of the case. He also reads the narrator's incomplete poem and agrees with the opinion of Mike the EMT. The poem stinks. Dr. Krupp listens to the narrator's breath sounds and commands him to recite poetry during the examination. The physician announces, "Poetry is the equivalent of ventilation. Poets breathe for one another, they breathe for all of us" [p 147]. Dr. Krupp decides that the narrator's problem is serious enough to warrant hospital admission for one week's worth of observation. The doctor then scurries off to treat another poet whose situation is much more serious than the narrator's.

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Summary:

In the time of house calls, the doctor-narrator is summoned to care for an ailing newborn. He discovers hospital-caused diarrhea and a severe congenital heart problem that can't be fixed. He also discovers the baby's fifteen-year-old sister, who has a bad case of acne and a direct, no-nonsense style that he finds very attractive.

The narrator's colleagues ridicule his interest in a family consisting of alcoholic and deceptive parents and a daughter who is not only chronically truant but notoriously promiscuous sexually. (To the narrator's enthusiasm about the young girl, his wife responds, "What! another?") In spite of these warnings, the narrator returns several times, probably without compensation, to check on the baby's diarrhea and feeding and to help the girl with her complexion.

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Summary:

The overworked doctor-narrator finds himself extremely irritated by the requests of a poor immigrant couple in their twenties to examine their infant. He spouts an alarming number of cultural and economic prejudices and tries to avoid seeing them. They persist, however, and the doctor examines the child, whom he finds healthy. The husband then asks if the doctor can examine his wife. The doctor flashes his anger again but agrees.

He finds her legs extremely bowed, probably from severe childhood rickets, and asks the husband about her history. It turns out that she had grown up in Poland during World War I and had lost all her family. As he hears of the woman's suffering, the doctor becomes empathetic, suddenly understanding the couples' fearful tenacity which had so annoyed him before. The woman responds in kind, and the doctor-patient relationship changes significantly for the better.

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