Summary:

The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

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A physician seeks solace at the South Pole. Her planned one year stay there is cut short when she discovers a lump in her breast. The attempts to care for her at the South Pole (with telecommunicated help from the U.S.) prove insufficient and a plan to rescue her is successful.

There's more than the drama of illness in a remote location in this book, however. Intertwined with this story of illness is the story of the author's troubled marriage (to her physician-husband), the eventual estrangement from her children, the support of her family of origin, and most fascinatingly the daily rhythms of living (and doctoring) at the South Pole. Scattered throughout the memoir are occasional critiques of "corporate" medicine and poems that inspired the author throughout her ordeal.

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At the age of 42, Barbara Rosenblum learns, after several misdiagnoses, that she has advanced breast cancer. This book, co-written by Rosenblum, a sociologist, and her lesbian partner, Sandra Butler, a feminist writer and activist, is a record of their lives together from the diagnosis until Rosenblum's death three years later. Early on, Rosenblum decides that her dying will be exemplary and self-conscious, and she and Butler use their writing as a way to create an illuminating examination of their lives over those three years.

The book's title is accurate; the writing takes the form of alternating meditations by two women, on the effects of cancer on their relationship, their work, their families, and their social, political, and spiritual beliefs. Especially significant are the differences between their voices, and the differences between the experience of the person who is dying and that of the person who is going to have to survive and grieve. The writers bravely explore the conflicts between them as well as their profound bonds.

After a mastectomy and eighteen months of chemotherapy, Rosenblum has a very brief respite, followed by liver and lung metastases, and prolonged further chemotherapy. A few months after ending treatment, she dies at home.

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This essay provides a rich and detailed critique of the medical view of women in 19th-century America. As the keywords suggest, the authors cover many topics. To mention a few: the coming of male dominance in medicine; the patronizing and disabling characterization of women as "weak, dependent, diseased," and naturally patients; S. (Silas) Weir Mitchell and his treatment of Charlotte Perkins Gilman; the social role of female invalidism in upper middle class culture; the "scientific" view of woman as evolutionarily devolved; and what the authors call "the expert-woman relationship."

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This brief autobiography, written when Schweitzer was mid-50's, summarizes his life and thought up to 1931. He presents illustrative factoids and incidents from his childhood and student years, then briskly covers his development as a minister, philosopher, biblical scholar, musician, and musicologist, all before he reaches Chapter 9 (p. 102), which is entitled, "I Resolve to Become a Jungle Doctor." He greatly enjoyed his life as a scholar, yet was plagued by "the thought that I must not accept this happiness as a matter of course, but must give something in return for it." (p. 103)

He was particularly struck by the fact that so many people in the world were "denied that happiness by their material circumstances or their health." At around this time (1904), Schweitzer came across a publication of the Paris Missionary Society, which described the needs of their Congo mission. This article changed his life. In 1905, at the age of 30, he enrolled in medical school at the University of Strasburg. (Thus, Schweitzer became a forerunner of today's nontraditional applicants who leave other promising careers to enter medicine.)

Schweitzer and his wife began their work at Lambaréné in Gabon, West Africa, in 1913. As a result of the Great War in late 1917, they were sent back to France and detained as enemy aliens until mid-1918. They returned to Lambaréné and rebuilt the hospital in 1924. Between then and 1931 when Out of My Life and Thought was written, Schweitzer devoted most of his time (as he would for the rest of his life) to doctoring at his hospital in Gabon.

This memoir also includes brief intellectual asides describing many of Schweitzer's famous works, such as The Quest of the Historical Jesus (1906), J. S. Bach (1908), On the Edge of the Primeval Forest (1920), Philosophy of Civilization (1923), and The Mysticism of Paul the Apostle (1930).

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In the second volume of her trilogy of memoirs (which begins with American Girl and ends with Speaking with Strangers), Mary Cantwell, a former fashion magazine editor and writer, describes her marriage, the birth of her two daughters, her career advancements, and her divorce, with Manhattan in the 1950s as the backdrop.

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This memoir begins in Africa, where Dr. Grim is with Médecins sans Frontières managing a meningitis outbreak in Nigeria. Conditions are appalling, but she has come here because of burnout: "so I won't be back home and in the ER" (11). Later in the book, she describes her other "escapes" from the Emergency Room, caring for war refugees in the Balkans.

The book centers, however, on life in an American emergency department, as Grim remembers it from the vantage point of Africa (where she does eventually become nostalgic for well-stocked supply cupboards and a more comprehensible chaos). She organizes her stories into a series of "Lessons in Emergency Medicine," in which she addresses the reader directly. After going through a step-by-step account of death in the ER, illustrated with several moving and alarming cases, she concludes: "Congratulations: you have successfully declared someone dead. Now, as an encore . . . you'll get to do it all over again" (28).

The ironic, even bitter, tone warns us of the difficulty of working in such perpetually crisis-ridden circumstances, but it does not conceal a vulnerability that seems necessary to doing the job well, such as when Grim has to tell a family that the father has died of the heart attack he had at his daughter's wedding: "you just stood there," she says, "looking at the corsage, the tuxedo and the pearls . . . You had no idea what to say and you don't really remember what you finally came out with" (26).

The stories are organized around several lessons: "How to deliver a baby," "How to crack a chest," "How to write a prescription" (which includes a discussion of addiction to prescription medication and a withering account of the doctor who overprescribes), and, as if it's as inevitable as the rest, "How to burn out."

By the book's final chapter, emergency medicine has merged, along with the vaccination of refugee children and the impossibility of treating tetanus in Nigeria, into the story of almost unreasonable determination in the face of endless frustration--but this, Grim shows in her final chapter, "Why I do what I do," is the point. Against this backdrop her final story, about the rescue of a child, makes its point: the feeling of saving a life explains all the rest.

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Summary:

Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.

Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).

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This work describes a young girl, Barbara, growing up in a poor rural Alabama family with a charismatic but abusive father and a nurturing mother unable to leave him, even for the sake of the children. Barbara suffers facial malformation, partly because of malnutrition and no access to dental or medical care.

Her gums cannot close over her buck teeth, her skull is longer and narrower than it should be, her bite does not close properly, and she has several black moles on her face. When she finally has major facial surgery, she is in her late twenties with a six year old son. He does not recognize the pretty women who comes home from the hospital.

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The first chapter of this memoir consists of two words: "I exaggerate." The narrator then tells us the story of her childhood and early adult experiences as an epileptic. After having her first seizure, at the age of ten, she spends a month at a special Catholic school in Topeka, Kansas, where the nuns teach epileptic children to fall without hurting themselves. This falling may or may not be literal; it is certainly symbolically apt.

During adolescence, Lauren begins lying, stealing, and faking seizures to get attention. She reveals that she has developed Munchausen's Syndrome, whose sufferers are "makers of myths that are still somehow true, the illness a conduit to convey real pain" (88). A neurologist, Dr. Neu, performs surgery severing Lauren's corpus callosum, effectively dividing her brain in half and markedly alleviating the seizure disorder.

Later she attends a writer's workshop where she begins an affair with a married man, a writer much older than she. After it ends badly, she starts going to Alcoholics Anonymous (although she does not drink) and tells her story with such authenticity that when she later confesses that she is NOT an alcoholic, no-one believes her, dismissing her true story as denial. The memoir ends both with her recognition of the value of narrating and with a silent fall to the snowy ground, as the nuns taught her to do, in the knowledge that the sense of falling (rather than the material certainty of landing) is all that is finally, reliably, real.

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