Summary:

A chronicle of the author's perceptions, thoughts, memories, and personal relationships during the months after he was diagnosed as having AIDS. Brodkey's mind and prose are as sharp as a knife's edge. Beginning with the desperate struggle for breath that signaled pneumonia and, retrospectively, "how my life ended. And my dying began," continuing with the reactions and decisions of himself and his wife, the first half of the essay spins out an observant, introspective, cerebral, even amusing account of his particular experience.

But AIDS is often a disease associated with more emotional baggage than other fatal illnesses, and in Brodkey's case we learn that he traces both his dying and his homosexual experiences to "the major drama of [his] adolescence", daily sexual abuse by his adoptive father, with the implied knowledge and acquiescence of his mother. Writes Brodkey, "I experimented with homosexuality to break my pride, to open myself to the story." "Now I will die disfigured and in pain."

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This is the last published entry in the journal kept by author Harold Brodkey, before he died of AIDS on January 26, 1996. Brodkey, ever the flamboyant writer, began a record of his diagnosis with AIDS and "my passage into nonexistence" in the pages of The New Yorker (see also earlier journal entry, Dying: An Update, annotated in this database).

In this last entry he focuses intensely on the end of consciousness that looms ahead. In spare poetic phrases he describes what he is attempting to grasp-- " . . . this wild darkness, which is not only unknown but which one cannot enter as oneself." He reflects also on memory, medication, creature comforts, family history, the legacy he leaves, and describes with amazement that he feels happy.

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A desperate patient visits a renowned oncologist with hope for a miraculous cure of his kidney cancer. The patient, a venture capitalist, doesn't want to die--can't face his death. He is willing to take whatever risk is necessary to survive. After a grueling course of experimental treatment and an expected period of remission, the cancer returns, leaving the patient (according to the physician-author) with an awful ending to his life--a death filled with regret.

What is revealed as Groopman deliberately walks "along the milestones" of his patient's life is more than the patient's story, however. For in addition to a chronicle of the disease's effect on his patient, the physician himself, and his concerns about the proper use of his knowledge and powerful tools also are revealed.

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Atul Gawande, a surgical resident at Harvard Medical School, asks in his well written essay, "when you see your patient making a grave mistake, should you simply do what the patient wants?" (p. 86) He answers this question by sharing a number of cases from his training that suggest that the orthodoxy of 'absolute respect for patient autonomy' may interfere with good patient care.

Gawande also gives the reader insight into the difficulties that young residents especially have in developing an artful approach to medical practice. He suggests that part of respecting autonomy is (at appropriate times) allowing patients to cede that autonomy to an authority figure. He argues further that, "patients frequently don't want the freedom that we've given them." (p. 89)

He also shares in his essay a personal experience with his youngest child. She was a premature baby who at eleven days old ended up in the intensive care unit. He was glad to put the ultimate decision(s) of how to care for his daughter in the hands of physicians--"they could live with the consequences, good or bad." (p. 90)

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A chance meeting with her former and most compassionate fertility doctor brought Wendy Wasserstein (at age 48, and after 8 years of effort) back to his fertility clinic. Two weeks later she got the news that she was pregnant, and six months after that, just as she was getting ready to tell her friends "that the twenty pounds I had gained were not the result of bad habits and anxiety," she developed preeclampsia and was hospitalized.

What follows in this ’Annals of Motherhood’ memoir is an account of her hospitalization; her subsequent delivery 16 days later of 1lb., 12oz. daughter, Lucy Jane (Lucy’s waving hand sonogram picture reminded Wasserstein of "Lucy in the Sky With Diamonds"); and her separation from Lucy, who spent two months in the neonatal intensive care unit.

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The italicized sentence under the title of this New Yorker essay summarizes it well: "Wanted: Highly accomplished young women willing to undergo risky, painful medical procedure for very large sums." Mead traces the phenomenon of women selling their eggs through the experience of Cindy Schiller, a 26-year-old law student who was "donating" her eggs for the third time.

In addition to Schiller's observations, the article is full of information about the clinical dimensions of egg donation--the donor shuts down her ovaries so that none of her eggs ripen and none of her follicles develop, followed by injections of follicle-stimulating hormones, followed by eggs that are "sucked out, one by one," and whisked away to be fertilized in a petri dish. Most of the article addresses the legal and ethical dimensions of egg donation, the hopes and expectations of those seeking donors, and the new-found marketing strategies of the American fertility industry.

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Subtitled "What happens when patients find out how good their doctors really are," this article starts with an important statement: "Every illness is a story, and Annie Page's began with the kinds of small unexceptional details that mean nothing until seen in hindsight."

This is the introduction to a look at a child with cystic fibrosis and how her family sought the best care for her.

The author, Dr. Atul Gawande, goes on not only to tell their story but also the story of the way in which the understanding of this disorder has increased and the unusual rigor with which centers that specialize in the disease are evaluated.

He also includes stories of other sufferers to emphasize the importance of surveillance of their care.

These stories allow him to generalize about the way physicians' care is evaluated in general by the public and our medical organizations and how difficult it is to be at the high end of the Bell Curve. The author concludes, "When the stakes are our lives and the lives of our children, we expect averageness to be resisted."

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Healy focuses on the social and cultural meaning of disease in Britain during the early modern period (roughly the sixteenth and seventeenth centuries). Her chapter on "The Humoral-Paracelsan Body" discusses how the humoral theory of Galen, at this time still dominant in constructing a notion of the human body and its functions, was challenged by a new Paracelsan medicine, with its emphasis on spirit and on experiment instead of book-learning, and by the emergence of syphilis. She also establishes the genre of the "regimen[t]," a text advising how to achieve personal and social order.

Her two chapters on "The Plaguy Body" review the late-medieval and Renaissance history of the plague and argue that the social meaning of the plague as a trope of violence and rebellion shifts over the course of the sixteenth century, from a judgment on Britain's "rich extortioners," careless of the welfare of the poor, to the threat represented by London's unruly urban underclass.

Healy's two chapters on "The Pocky Body" argue that the new disease of syphilis became another dominant metaphor for social disorder because it helped focus anxieties about cultural hypocrisy, corruption, and degeneration, linked to the problems of sin generally and excessive appetite in particular. Her final chapter examines "The Glutted, Unvented Body," another powerful figure of excessive appetite, threatening that the body (and its appetites) would dethrone the head (the site of reason).

Healy demonstrates the importance of debates over the glutted, headless body as a way for British writers to negotiate the problems of a trade imbalance and the tricky terrain of resistance against the intemperate Stuart monarchs, culminating in the execution of Charles I in 1649. In the book as a whole, Healy reads literary and historical texts by authors as diverse as William Bullein, Thomas Dekker, Lucretius, Erasmus, William Shakespeare (Measure for Measure and Pericles), and Milton (Comus).

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This slim volume dips into "quotable quotes" drawn from literature and historical writings dating back several centuries. The quotes are put forth by physicians, patients, observers of medical issues, and writers of fiction as well as essayists. Each quote is but a few lines. The author, the source, and the date (when known) are provided for each quotation.

Many of these quotations will be familiar to persons who are widely read or who study the literature by and about medicine. Some of the quotes are scatological in the sense that they address issues of bodily parts and functions; others are simply amusing, while many are profound observations. The range is wide and the selections eclectic.

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The aim of this collage of anecdotes from medical history is largely to entertain, though it is pointedly instructive in its focus on reasons for and results of medical mistakes, misapprehensions, and serendipitous breakthroughs. Gordon's dryly humorous skepticism and general irreverence is balanced by an obvious delight in the intellectual play that characterizes the history of science.

The stories he tells range from Hippocrates to the present with a heavy focus on the 18th and 19th centuries. The book includes a good representative collection of visual art and photography documenting moments in medical history upon which Gordon casts a cold but twinkling eye. Chapter titles such as "Discoveries in the Dark," "Sex and its Snags," "Odd Practices," and "Freud, the English Governess and the Smell of Burnt Pudding" give a bit of the book's flavor.

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