Summary:

The title of Scannell’s book refers to an episode in her work with AIDS patients when she realizes that the "good doctor" she’d been taught to be--scientifically precise, medically focused and aggressive--was not what many of her patients wanted or needed. From that point on, she strove to understand the nature of her patients’ suffering and how they might be cherished and morally supported during the last weeks and days of their lives. In a series of essays she offers haunting portraits of the men and women she served--and of herself, as she learns to recognize and grapple with her own anger, grief, comfort, and joy.

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This account by the well known Indian/American blind writer describes experiences when he came to the United States at age 15 from New Delhi to attend the Arkansas School for the Blind. The title derives from an unusual ability (which Mehta possesses) to navigate one’s way by perceiving the physical surroundings "as sound-shadows by means of echoing sound and changes of air pressure around the ears." As a precocious teenager, Mehta had high ambitions for his future; this important period of his life represented both an opportunity and an impediment, requiring tremendous cultural, emotional, and physical adjustments.

Very well conveyed are the driving desire to be like sighted people, the need for independence and control, and to be accepted in the foreign culture while remaining in some ways superior to it. There are fascinating descriptions of how Mehta learned to travel with minimal assistance, high-dive, package ice-cream in a factory; of how he used money intended for other purposes to build an electronic retreat in a broom closet which allowed him to tape record, type, and to listen to Edward R. Murrow’s broadcasts, and of how he then paid back the money by taking correspondence courses in order to finish school one year early.

The normal adolescent awakening of sexuality, and the ambivalent dependence on parental guidance are also important aspects of the book. Writes Mehta in retrospect,"The three years of my life spent in Little Rock became sealed in a compartment of my mind which I dreaded to open . . . because . . . the near-total submersion in a residential school for the blind seemed to accentuate my blindness, when all along my aspiration had been to be a well-adjusted member of the seeing society outside."

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In these "narrative recollections" poet Gary Soto reflects on his Mexican American childhood in the ethnically mixed laboring-class neighborhoods of Fresno, California. His was a life lived at the margins--economic margins and cultural margins. In these recollections of family relationships, youthful mischief-making, farm and factory jobs, adolescent rebellion, and the transition to professional writing Soto subtly and humorously draws our attention to the discontinuities between the lived lives of Chicanos and Anglos.

"The Beauty Contest" describes how young Gary entered his younger half-brother in a playground beauty contest. "Strong build, a chipped tooth, half Mexican and half white--he might win, I thought." (43) Gary knows that only a lighter complexioned child could meet the Anglo standards of beauty that prevail. In fact, he has internalized those standards himself: " . . . we were awed by the blond and fair skinned kids in good clothes. They looked beautiful, I thought." We are led to infer that the Anglo contestants come from a world of comfort and parental attentiveness whereas Gary has been left on his own to tend to his brother while his parents are away at their work of manual labor.

In "Looking for Work" Gary wanted to imitate the Anglo families of the television programs that he continually watched. He tried to convince his siblings to wear shoes to dinner and improve their appearance so that "[w]hite people would like us more." (26) In "1,2,3," Soto reconstructs the shocking vindictiveness of an Anglo father after his young daughter falls off of a swing that is being pushed by Gary's Chicana friend, Rosie. Soto ends this piece, "I wanted to . . . explain that it was a mistake; that we also fell from the swings and the bars and got hurt . . . ." (15)

Soto foregrounds violence as an integral part of his childhood. The lead-off sketch, "Being Mean," recounts childhood pranks involving the setting of fires and abuse of pets. But this violence also included and was a response to verbal violence from others, such as being called "dirty Mexicans." (3) "Bloodworth" chronicles the evolution from fisticuffs--"all through elementary and junior high school, it was bob and weave, jab and stick" (95)--to the more controlled violence of the high school wrestling team.

Soto tells of his back-breaking farm laboring and factory jobs in "One Last Time" and "Black Hair." There is no romance in these episodes, "no grace" (124) in the miserable conditions, and no comfort. Rather, there is always the fear that he will forever have to "work Mexican hours, and in the end die a Mexican death, broke and in despair." (123)

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Subtitled "My Journey through Autism," Prince-Hughes's memoir leads the reader through a poetic, at times mystical, journey from "being a wild thing out of context" (1) to finding a way to understand the world and live "in context" (11). The author, an anthropologist, has Asperger's syndrome. Prince-Hughes explains that Asperger's is a form of autism in which the individual develops "age-appropriate" language and cognitive skills as well as "self-help skills" and curiosity about the environment but has marked difficulties with social interaction and shows the obsessive, ritualistic behavior similar to other autistic individuals.

As the author relates, her poor social skills, discomfort with physical closeness, sensory sensitivities (to touch and odors for example) and other odd behaviors annoyed her instructors and triggered taunts and even physical abuse from classmates and acquaintances. She describes her misery one such day when she was confronted by an impatient teacher: "I often couldn't take in people as whole entities, even when I was relatively relaxed . . . I was caught in a whirlwind of horrible sensory information and unrelenting criticism" (43).

Getting through each day was filled with emotional pain and suffering, and required a tremendous expenditure of energy in usually unsuccessful attempts to "fit in." Complicating her social isolation was the gradual recognition that her adolescent sexuality was somewhat blunted or, if anything, inclined toward lesbianism. She began drinking (alcohol) in the seventh grade. At 16 she left school and home, embarking on a long period of alcoholism, drug dependence, a "hippie" lifestyle and outright homelessness.

Prince-Hughes had always found refuge in nature, but later she also took pleasure in the physical activity of dancing, becoming a club performer in Seattle. During time off one day, she packed lunch and ate it at the zoo. She spent three hours watching the gorillas. "It was so subtle and steady that I felt like I was watching people for the first time in my whole life . . . Free from acting, free from the oppression that comes with brash and bold sound, blinding stares and uncomfortable closeness that mark the talk of human people. In contrast, these people spoke softly, their bodies poetic, their faces and dance poetic, spinning conversations out of the moisture and perfume, out of the ground and out of the past. They were like me" (93).

Thus began the author's profound relationship and identification with gorillas, an interaction that changed her life, resulting eventually in scholarly work and a Ph.D. in interdisciplinary anthropology, a faculty appointment, and gradual understanding of her own neuroatypical condition, not diagnosed as Asperger's until she was 36 years old.

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Yoshino has written a book that is both treatise and memoir. Taking his cue from Erving Goffman's introduction of the term "covering" (in Stigma: Notes on the Management of Spoiled Identity), Yoshino writes from his own experience as a young gay Japanese American who is also a lawyer and scholar at Yale University. Covering, Yoshino proposes, is "to tone down a disfavored identity to fit into the mainstream" (ix). He identifies three historical and individual stages of dealing with disfavored identity: conversion, in which the individual and/or society try to transform an identity to render it more acceptable (for example, attempts to convert homosexuals into heterosexuals); passing, in which the individual hides the undesirable identity to a greater or lesser extent depending on circumstances; and covering, in which the individual openly acknowledges the undesirable identity but suppresses behavioral aspects of the identity that could draw unwelcome attention (for example, a gay male publicly holding hands with or kissing another gay male).

The author discusses these concepts specifically with relevance to his gay identity in part one of the book, detailing how he went through these three phases himself. Part two elaborates on racial and sex-based covering, and part three discusses Civil Rights and legal issues that surround covering. Yoshino argues that contemporary American society imposes covering on certain groups--gays, blacks, women, disabled people, Jews, Asian Americans--and ultimately in some manner on everyone. The bases for this imposition are pressures to conform and to assimilate. He identifies "covering axes: appearance ( . . . 'I own brown suede bucks'); affiliation ('I listen to National Public Radio . . . '); activism ('I do not mind how white television casts are . . . '); and association (' . . . I married a white woman')" (125).

Beyond that, according to the author, our laws and their interpretation by the Supreme Court "instruct the mainstream to ignore [difference] and the outsider group to mute it" (182). This is an inevitable result of the great pluralism of contemporary society--the courts cannot protect all separate groups that exist.

In the final chapter Yoshino proposes a new paradigm for Civil Rights: universal liberty (rather than equality among groups) based on "our common humanity." This paradigm would allow individuals to live "authentically" and in good psychological health. Yoshino invokes the concept of health proposed by theorist, D. W. Winnicott: living according to one's "True Self" while the "False Self" "is reduced to a 'polite and mannered social attitude,' a tool available to the fully realized True Self" (185).

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Having previously described his seven years as a family practitioner in rural Minnesota (Healing the Wounds, Pantheon Books, New York, 1985) Hilfiker now has turned his attention to a decade in inner-city Washington, D.C., where he practiced what he calls "poverty medicine." These introspective essays are written in a style similar to that of his first book and detail the profound struggles of the overwhelmingly African-American community he serves and lives with.

Also examined are his and his family's battle to live with their white middle-class privileges in the midst of this impoverished community. This book very effectively alternates between the numerous stories of his personal encounters with patients and deeply reflective commentary about those encounters. Prescriptions are not offered other than that a new art of caring for the poor is needed.

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Writer Paul Monette's first-person account of living through his lover Roger's last nineteen months with AIDS, from diagnosis to death (1986), told in language that is poetic and highly articulate. The couple faces not only progressive physical degeneration (Monette calls time with AIDS a "minefield") but also the agonizing issues of truthtelling with their families, friends gay and straight, and the world, in "the double closet of the war."

Fact-finding is a constant obsession in this story, not only about who is positive and who knows, but also in the rapidly-changing medical arena, where through Monette's extraordinary efforts Roger becomes the first person west of the Mississippi to be put on the drug, AZT. Monette is so devoted a caregiver that he often loses himself--a problem he solves in part by turning to the subject of AIDS as a writer.

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Primo Levi was imprisoned at the Auschwitz concentration camp in 1944. He survived the experience, probably in part because he was a trained chemist and as such, useful to the Nazis. Soon after the war ended, he wrote several books about his experience. The Drowned and the Saved, however, was written 40 years later and is the work of memory and reflection not only on the original events, but also on how the world has dealt with the Holocaust in the intervening years. Fundamental to his purpose is the fear that what happened once can happen (and in some respects, has happened) again.

Chapter 1, "The Memory of the Offense," dissects out the vagaries of memory, rejection of responsibility, denial of unacceptable trauma and out and out lying among those who were held to account by tribunals as well as among the victimized. Levi does not spare himself: "This very book is drenched in memory . . . it draws from a suspect source and must be protected against itself" (34). Even so, he insists, memory and the historical record are crucial to combating Nazi assumptions that their deeds would go unnoticed (they were destroying the evidence), or disbelieved.

In "The Gray Zone" (2) Levi challenges the tendency to over-simplify and gloss over unpleasant truths of the inmate hierarchy that inevitably developed in the camps, and that was exacerbated by the Nazi methodology of singling some out for special privileges. He outlines the coercive conditions that cause people to become so demoralized that they will harm each other just to survive. (And when they refused to collaborate, they were killed and immediately replaced.)

Chapter 3, " Shame," is, in my opinion, the most profound and moving section of the book. Levi begins it by discussing a phenomenon that occurred following liberation from the camps: many who had been incarcerated committed suicide or were profoundly depressed. This Levi attributes to shame and feelings of guilt. "Coming out of the darkness, one suffered because of the reacquired consciousness of having been diminished . . . Our moral yardstick had changed [while in the camps]" (75). Beyond that, there is the sense that "each one of us (but this time I say 'us' in a . . . universal sense) has usurped his neighbor's place and lived in his stead" (81-82).

In the concentration camp, says Levi, it was usually "the selfish, the violent, the insensitive, the collaborators of the 'gray zone,' the spies" who survived ["the saved"] while the others did not ["the drowned"] (82). Only the drowned could know the totality of the concentration camp experience, but they cannot testify; hence, the saved must do their best to render it. Since Levi was one of those saved, he is "in permanent search of a justification . . . " and although he feels compelled to bear witness, he does not consider doing so sufficient justification for having survived. In this chapter Levi also discusses why inmates did not commit suicide during their incarceration:" . . . suicide is an act of man and not of the animal . . . because of the constant imminence of death there was no time to concentrate on the idea of death" (76).

"Communicating" (4) deals with the emotional and practical consequences of not being able to understand the German commands of the captors, or the conversation of the mostly German speaking prisoners (Levi was Italian but spoke some German). Levi also describes the additional suffering of those who were cut off from all communication with friends and family. "Useless Violence" (5) gives examples of how the Nazis tormented their prisoners with "stupid and symbolic violence."

In "The Intellectual in Auschwitz" (6) Levi speculates about how and in what circumstances being educated or cultured was a help or hindrance to coping with the situation. In this chapter he considers also whether religious belief was useful or comforting, concluding that believers "better resisted the seduction of power [resisted collaborating]" (145) and were less prone to despair. Levi, however, was never a believer, although he admits to having almost prayed for help once, but caught himself because "one does not change the rules of the game at the end of the match, not when you were losing" (146).

Chapter 7, "Stereotypes," addresses those who question why many concentration camp inmates or ghetto inhabitants did not attempt to escape or rebel, and why many German Jews remained in Germany during Hitler's ascendance. As in all the other chapters of his book, Levi discusses the complexity of these situations. "Letters from Germans" summarizes his correspondence with Germans who read his earlier books. The book ends ("Conclusion") with the exhortation that "It happened, therefore it can happen again . . . " (199).

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In this rich opening chapter of his work on the Nazi doctors, Lifton lays out the groundwork for answering the question of how German doctors became the agents of Hitler’s vision of the purified Aryan race, sterilizing involuntarily several hundred thousand citizens with a variety of mental and physical deficiencies. His answer, in brief: a romanticized genetics coupled with total political control.

Amazingly, the Nazi medical atrocities were carried out not against the opposition of Germany’s medical establishment, but with its approval. (Of course, there were individual dissenters, the more vocal of whom were removed from positions of authority or put to death). Nazi leaders worked hard to convert medical people to the official position. This was accomplished partly by force, but also partly by metaphor, as the normal language of medicine was used to hide the unethical nature of what doctors were being asked to do.

Individual patients were replaced by the racial term "Volk," meaning the (Aryan) people, and their rights were superceded by their doctors’ new duty to assure the health of this collective political idea. According to Nazi publicity, the Aryan race was in grave danger of "Volkstod," of dying out, because its genetic pool had been contaminated both by the transmission of inherited genetic defects and by the "foreign invasion" of Jews and their intermingling with members of the "superior" Aryan race.

To save their new patient, German doctors were expected to carry out the sterilizations, medical experiments, and, later, the euthanasia required by Nazi doctrine, which, in the words of one Nazi writer, declared that "misery can only be removed from the world by painless extermination of the miserable." Doctors were urged not to worry about ethical issues, because Nazi medicine was "nothing but applied biology."

In these ways, says Lifton, Hitler’s racial policies were ’medicalized’ and their evil made less obvious. Those who went along were billed as the "saviors of mankind," the "alert biological soldiers" whose actions would restore the purity of the Aryan race. Jewish doctors were not invited, of course, their research having been officially discredited in the mid-1930s, Lifton tells us, and their medical licenses revoked in 1939--in spite of the fact that they made up half the doctors in some large cities.

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This is American writer Richard Wright's story of his life as a black child in the American South (Mississippi, Tennessee, and Arkansas) in the early decades of the 20th century. Black Boy opens with the disaster in which Richard at the age of four accidentally burns down his grandparents' house and is beaten nearly to death by his mother as punishment. The book ends with Richard's hopeful escape north to Chicago at the age of eighteen.

In between are years of heart-stopping survival stories, as Richard, an intelligent and willful child who tries to resist many of the demands of his strongly segregated environment, runs head-on into the hatred of racists and the deep poverty, hunger, and oppression that so often were the lot of the system's victims. (On the subject of hunger, one of the book's working titles was American Hunger, and Wright was chronically hungry all these years. He gets so used to extreme hunger that at one point late in the book after a short interlude with regular meals he is surprised to discover that he can suddenly read faster!)

Black Boy, originally published by Harper & Bros. in 1945, is only the first half of Wright's original manuscript. After production had begun on the complete manuscript, Wright accepted an offer from the Book-of -the-Month Club to make his book one of their selections if only the first half were published. The second half was first published in its entirety by Harper & Row as American Hunger in 1977. The 1993 edition titled Black Boy (American Hunger) brings both halves together for the first time. The second volume describes Wright's experiences in Chicago from 1926 to 1936, including his frustrating attempt to work with the Communist Party as a way of supporting unemployed workers during the Great Depression.

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