Summary:

In four lengthy chapters, the biographies of Haydn, Mozart, Beethoven, and Schubert are carefully presented. Special attention is given to health, both physical and psychological, throughout life and at its end. Autopsy information is included. In particular, the author emphasizes the impact of illness on the composers' relationships with family members and doctors, and on their musical composition.

Evidence is derived from a wealth of primary sources, often with long citations from letters, poetry, musical scores, prescriptions, diaries, the remarkable "chat books" of Beethoven. Neumayr also takes on the host of other medical biographers who have preceded him in trying to retrospectively 'diagnose' these immortal dead.

Late eighteenth- and early nineteenth-century Vienna emerges as a remarkable city of musical innovation and clinical medicine. The composers' encounters with each other link these biographies. Similarly, many patrons, be they aristocrats or physicians, appear in more than one chapter, such as the Esterhazy family and Dr Anton Mesmer.

The disease concepts of the era, prevalent infections, and preferred therapies are treated with respect. Rigid public health rules in Vienna concerning burial practices meant that ceremonies could not take place in cemeteries and may explain why some unusual information is available and why other seemingly simple facts are lost.

Biographical information about the treating physicians is also given, together with a bibliography of secondary sources, and an index of specific works of music cited.

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An automobile accident left Mary Swander nearly paralyzed and coping with chronic pain. After several incorrect diagnoses, she saw a neurosurgeon who told her that a disk in her neck ruptured "at C6 and punched a hole in the spinal cord. The flu virus went into the cord and infected it." She had central cord syndrome (which can paralyze arms) and myelitis (which can paralyze legs).

Other than traction, the doctors said they could not do anything more for her. She went to New Mexico where herbal medicines of a curandera and spiritual healing by a Russian Orthodox monk helped her. She now walks without a cane.

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Physician-scientist Lewis Thomas turns to pressing, threatening issues in this collection of 24 essays, many of which have been published in Discover magazine. The book opens and closes with meditations on nuclear warfare--the atom bombs of World War II and the escalation of worldwide tensions and technology that can combine to destroy the human race. In between, other essays, such as "On Medicine and the Bomb" and "Science and 'Science,'" also focus on these issues.

Less apocalyptic essays concern Thomas's experience with requiring a pacemaker, the state of psychiatry, lie detectors as evidence for essential human morality, and his abiding interest in language and scientific research.

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During a sabbatical year in Florence, English professor and writer James McConkey immersed himself in reading Anton Chekhov’s works, as well as biographies of the Russian writer. He began to feel a particular affinity for Chekhov’s crisis of 1889-1890 and his resolution of that crisis by traveling alone to Sakhalin Island off the eastern coast of Siberia to investigate conditions in the penal colonies that the Russian government had established in that distant region. Perhaps because McConkey himself was recovering from a series of traumatic experiences in his own life, he felt a kinship to this depressed young Russian author and his search for a new direction in life.

McConkey responded to this feeling of kinship by writing To a Distant Island, which is partly biographical, in that it retells the story of Chekhov’s six month long journey to Sakhalin Island in 1890; and partly a memoir, in that McConkey relates Chekhov’s life events to the feelings and events of his own life at the time. McConkey establishes this perspective from the beginning, when he explains why he refers to Chekhov throughout the book as "T": "I honor the man too much to call him by name throughout an account, which. . . is bound to be a fiction of my own" (8).

To a Distant Island dwells especially on the motivation for Chekhov’s journey to Sakhalin, a question scholars have debated for a hundred years now. Of the many contributing reasons for the trip, McConkey chooses to highlight and fictionalize "the suicidal tendency that surfaced again a decade later in the marriage his health simply couldn’t afford" (26). McConkey refines this to "T. wants to escape--he wants out, at whatever the personal cost" (27). It is in this state of mind (or soul) that the brilliant and sensitive T. begins his journey to the end of the earth.

Perhaps as a metaphor that characterizes any human quest, McConkey devotes most of the writing and energy to T’s justification, preparation, and outward-bound journey. Only 37 pages remain for the story of what happens to his hero once the goal is achieved; and less than 6 pages for the homeward trek (or homeward "sail" in this case). [This is a technique, come to think of it, quite the opposite of Homer’s in "The Odyssey"!]

The conclusion? "Sakhalin, then, gave to T. nothing he hadn’t known all along. . . Perhaps despair--that absence of hope--is a requisite for any deepened understanding of a universal hope for something never to be found in the present time or place" (82).

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Fifty-two year old Pete, the hospital mailman, suddenly experiences severe abdominal pain. He is evaluated and treated in the emergency room. His diagnosis is acute surgical abdomen, but the exact cause of his pain is still unknown. The surgeon-narrator determines that the severity of Pete's condition mandates exploratory surgery. During the operation, "an old enemy" (18) is encountered--pancreatitis.

Afterwards, the surgeon assures Pete that he will get better. One week later though, the mailman dies. His death has been painful. An autopsy is scheduled, but the surgeon deliberately arrives 20 minutes late. He does not want to view the intact body of his deceased patient. No matter, the pathologist has waited for him to arrive before beginning the post-mortem examination. The pathologist closes Pete's eyelids before starting the autopsy, mindful of how the mailman's "blue eyes used to twinkle" (21) when he delivered the mail everyday.

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Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.

Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.

Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."

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When faced with breast cancer and chemotherapy, Catherine Lord chronicles her illness in a literary performance piece by adopting the online persona of Her Baldness--a testy, witty, passionate presence who speaks forthrightly about her fears to a highly selective listserv audience of friends, family, and colleagues. The fragmented, multifaceted format of this autobiographical text includes photos, lists, e-mail narrations of her illness, responses from friends, plus the quick-tempered, no-holds-barred ruminations of Her Baldness on what cancer, chemotherapy, and baldness have meant in her life.

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This book contains 29 short essays by physician-scientist Lewis Thomas, originally published in the early 1970s in The New England Journal of Medicine. The essays center on science, and range in focus from the molecular (e.g., DNA) to the subcellular to the organism to social interactions and all the way up to the search for extra-terrestrial life. Some themes reappear in several essays: science as a grand, engaging enterprise worthy of the brightest minds; communication between organisms creating the intricate dance of the social organism; the relationship of man to both nature and the grand scheme of the universe.

Lewis is fascinated by communication not only at the cellular level, but also at the pheremonal and cerebral level: "Language, once it comes alive, behaves like an active, motile organism" (90). The ant and its colony, as an example of a simultaneous individual and integrated social organism, form a link for Thomas between the enclosed unit of a cell and the complex interactions of a society. Indeed, macro-micro comparisons continue throughout the essays, and even conclude the final essay, "The World's Biggest Membrane," which lauds the atmosphere as protector, filter, and provider: "Taken all in all, the sky is a miraculous achievement. It works, and for what it is designed to accomplish it is as infallible as anything in nature. . . it is far and away the grandest product of collaboration in all of nature" (48).

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This sensitive, but profoundly realistic narrative, of a journey from the lively, healthy marriage of two individuals deeply in love with life and with one another into the abyss of Alzheimer's dementia is told from the viewpoint of one partner. The author allows the reader to enter into her struggle with the month-to-month diminution of her beloved husband's world. The progression over the entitled "25 months" contains just the right amount of flashback to give the reader a sense of who Jack had once been and what life had held for both members of this partnership--the better to accentuate the sense of loss that this disease underscores.

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Selzer tells four stories of surgical loss: a surprise loss on the operating table, the drowning of a sick child in a flood in wartime Korea, the sudden death of a professor due to a perforated ulcer, and the loss of some facial mobility in a young woman following the removal of a tumor in her cheek. As we move from one vignette to the next, the narrator's mood goes from despair to accepting to redeemed, with various forms of love the agent.

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