Summary:

Lenny's development from childhood to adolescence concurs with India's independence from Britain and the partitioning of India into India and Pakistan. The interwoven plots give each other substantial meaning. Partly because Lenny's family are Parsees, a religious and ethnic minority that remained relatively neutral in post-Partition religious conflicts, she has access to people of all ethnicities and religions, both within Lahore and in other locales. More significantly, she has access to a wide variety of viewpoints both pre-and post-Partition through her Ayah, a beautiful woman whose suitors are ethnically and religiously diverse.

Lenny's passionate love of Ayah and the loss of innocence that accompanies their changing relationship through the Partition is an energetic center to the plot. Lenny's relationships with her mother, her powerful godmother, and her sexually invasive cousin are also important to the novel. Lenny's polio forms a significant early narrative thread. Other minor but compelling subplots include Lenny's parents' changing relationship, the murder of a British official, and the child marriage of the much-abused daughter of one of Lenny's family's servants.

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This novel is based on the facts of an actual hantavirus outbreak that took place in the southwestern US in 1993, retelling the events as medical mystery, as ghost story, and as meditation on the relationship between rationalist western medicine and the beliefs of local indigenous cultures.

Dr. Push Foster is part Choctaw and part white, raised in Oklahoma. He returns to Arizona as an Indian Health Services physician at the time an outbreak begins of what is later identified as Hantavirus Pulmonary Syndrome. Western medicine and traditional health beliefs and practices overlap in the investigation and response to the illness as it infects and kills Navajo people.

Querry presents us with a convincing epidemiological investigation into the virus, but also suggests an alternative, or complementary, etiology for the outbreak: an archaeologist has stolen a sacred stone from the Hopi people with the help of a Navajo witch, or shape-shifter, the title's "bad medicine" practitioner. This theft, the novel suggests, is the reason that only Navajo, and one white person (the archaeologist's partner) become ill.

The climax of the story is a showdown between the shape-shifter, a Hopi village headman, and the ghost of a woman killed trying to save her people from the 1805 massacre of Navajo by Spanish troops at Muerto Canyon. (The virus, when first identified, was named Muerto Canyon Virus.) This woman becomes a figure of both vengeance and reconciliation, an uneasy meeting of cultures that echoes and informs the work of Push Foster and his colleague, Sonny Brokeshoulder: both are men of Indian blood with a "white" upbringing and who return to their culture bearing Western medical training, but do not deny the traditional knowledge either.

Unlike most medical thrillers, this book does not offer reductive explanations and answers; instead, we are left with the certainty that traditional and western thinkers must collaborate, not only to care for patients, but to take care of the natural environment on which all our health depends.

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Tessa Quayle, the young wife of a British civil servant in Kenya, is mysteriously murdered. Tessa, a lawyer, had been an outspoken human rights activist, and something of an embarrassment to her husband. But shaken from his marital and political complacency by her death and the rumors that quickly surround it, Justin Quayle sets out to solve the mystery and in doing so inherits her cause.

Tessa had discovered, as Justin now learns, that a new tuberculosis drug was being prematurely tested on Kenyan patients: clinical trials were effectively being carried out on the African population by the drug's giant pharmaceutical producer without the patients' knowledge or consent, but with the support and cover of a global corporation with African interests and of the British High Commission in Kenya. Lethal side effects and deaths were being concealed, the drug retitrated and retested in preparation for its safer and more lucrative release in the west in time for a predicted rise in incidence of multi-resistant strains of TB.

Justin, now a kind of rogue agent, uncovers the layers of sinister plotting to be expected in one of Le Carré's intelligence thrillers, but in the process we are led to consider, vividly, the interlocking roles of international biomedical research, postcolonial political interests, and global capital in determining the fates of impoverished, uneducated, and deeply vulnerable patients in developing countries--as well as the fates of those who try, often against all odds, to offer them the best available care. The novel also gives us, in Justin Quayle's odyssey, a moving study of desire, loss, regret, and, finally, outraged action.

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Frank Eloff, the novel’s narrator, is a white doctor working at a hospital in the former capital of one of South Africa’s now-defunct independent homelands (rural areas set aside by the apartheid government for black "separate development"). The hospital, in its deserted and decaying city, is understaffed and understocked, and there are hardly any patients. Those who do arrive usually need to be taken elsewhere if they need any significant treatment. The homeland’s former leader, the Brigadier, has returned as a criminal gang leader to loot the place, and a white former army commander, now in the employ of the present government, is trying to capture him.

Frank moved to this place when promised directorship of the hospital (and in flight after his wife left him for his best friend), but the previous director has not left yet, and Frank is in a kind of personal and professional bureaucratic limbo. He has a sexual relationship with a black woman who runs a roadside souvenir stall. It is not quite prostitution, not quite a love affair: she is married, speaks little English, and Frank regularly gives her money.

A new doctor, Laurence Waters, arrives. He is fresh from medical school, sent to the hospital in order to complete the rural community service year required by the government of all new physicians. He and Frank become roommates and begin an uneasy friendship. Laurence is an idealist, planning to make heroic changes, but he misunderstands the complex balance of tolerance, cynicism and patience that characterize survival at the hospital, and his well-intentioned efforts, such as trying to end theft from the hospital and to establish a clinic in a local tribal village, lead to disaster. The novel ends with Frank appointed hospital director at last, and things returning to their depressingly ineffective "normality."

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Vanya and Uncle Nicolai, two orderlies in a morgue, are preparing for funeral the body of Trepov ("Known everywhere simply as Trepov" (63), a hated officer because of whom "more [Russian] people were murdered than absolutely necessary." Trepov is the pawn of "the Little Father" (64); both very well may be cruel administrators of an invading force, not necessarily Russians themselves, although this is not clear.

What is clear is that Vanya, the younger orderly, despises Trepov. After finishing the dressing of the cadaver in military finery, replete with "all those gilt-enameled medals" (64). Vanya suddenly closes the door, to Uncle Nicolai’s bewilderment. Even more surprising is Vanya’s determined slapping of Trepov’s face three times. With tacit approval from Uncle Nicolai, Vanya then kicks Trepov. Finally, Vanya slaps, with all his strength "the corpse’s face again. Now we can go, he stammered, his face flushed with the thrill of it." (65)

Vanya goes to bed thinking about the son his wife is expecting (since there was no ultrasound between 1908 and 1912 when Csáth most likely wrote this story, this detail remains mysterious) and how he will boast to him about "that day’s doings." And then he falls fast asleep, "breathing evenly, deeply, like all healthy people" (65).

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A young woman observes the slow decline of her grandmother into dementia and her grandfather’s reaction to the situation. Issues of denial, anger, autonomy, and intimacy rise to the surface—and expose the formerly private dimensions of their marriage. The illness also stresses her own relationship and invites the idea that someday she and her partner could be projected into a future with the same vulnerability.

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A night on the town with two friends turns into "an attack of nerves" for Vasilyev, a law student. The three students spend the night drinking and visiting houses of prostitution; Vasilyev is horrified and repulsed by the women, who he thinks are "more like animals than human beings." The social problem of prostitution becomes an obsession; he is so fixated on finding a solution that he is in moral agony. His friends, among whom is a medical student, are concerned only with his health; they take him to a psychiatrist who "cures" Vasilyev with bromide and morphine.

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The narrator is a Vietnamese husband who has a beautiful, flirtatious wife. They have been living in the New Orleans area for more than a decade, arriving in America after the fall of South Vietnam. The husband tells a remarkable story about the lengths to which he has gone, both in Vietnam and in America, to intercept and discourage his wife’s extra-marital interests. The narrator is humorously self-deprecating and matter-of-fact.

In Vietnam, he was a spy for the Americans, and able to "bring fire from heaven" in the form of American rocket attacks to scare off his wife’s would-be lovers; in America, he adapts to the local culture by consulting a "low-down papa" voodoo specialist. What follows this consultation is a hilariously told sequence of events that succeeds finally in winning the wife’s loyalty.

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The author tells the story of two Native-American (Chippewa) families whose lives interweave through several generations during the years 1934-1984. The primary setting is a reservation in North Dakota. The main characters, Marie and Nector Kashpaw and Lulu Lamartine, are colorful, sympathetic people caught in a love triangle that endures for most of their adult lives. "Love medicine" represents an attempt by a Kashpaw grandson to assure once and for all that his aging grandfather will love and be true to his wife and cease "hankering after the Lamartine." The plan ends in disaster when corners are cut and the authentic old Indian customs for preparing the "love medicine" are circumvented.

There is a strong sense of the blending of cultures--religion, medicine, commerce, education all take on the distinctive qualities of an evolving mixed culture. Displacement and disenfranchisement are a fact of life, taken almost for granted, with humor, but not without a response. "They gave you worthless land to start with and then they chopped it out from under your feet. They took your kids away and stuffed the English language in their mouth . . . They sold you booze for furs and then told you not to drink. It was time, high past time, the Indians smartened up and started using the only leverage they had-federal law." (p. 326) So begins an initiative to establish a gambling casino; "gambling fit into the old traditions . . . . "

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As much about the abusive treatment of women, and the clash of traditional and contemporary mores as it is about the HIV/AIDS pandemic, this beautifully crafted novel tells the story of a nineteen-year-old Mosa (for mosadi--woman) who has already lost two brothers to AIDS. The reader is caught up in the mega-deaths and non-mention of the dreaded acronym, AIDS, as the story unfolds. At their brother’s gravesite Mosa’s one remaining living brother is halted as he shovels in the final loads of earth: "All around him were fresh graves . . . He looked at the not fresh, fresh graves, and noted the dates of birth. Young people who had died prematurely . . . He had known about their long illnesses, their deaths and their funerals." (p. 20)

The author is the first (and only) female judge of the High Court of Botswana and a human rights activist. She is internationally renowned for bringing about the Dow Case, which challenged Botswana nationality laws; she argued successfully for revisions allowing women to pass their nationality on to their children.

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