Summary:

This memoir of a clinical psychologist (also a professor of psychology) chronicles her own depression over a period of a year and a half, from early symptoms, through near despair, electroconvulsive therapy, and hospitalization to recovery. The journey is detailed, not only in its treatment of her emotional states, but of her struggle to maintain family and professional life, keep her house and office organized, and attend to a dying friend.

As her bouts of panic and disorientation grow more apparent, first to herself and finally to others, she seeks refuge in spiritual retreats and in conversation with colleagues, ultimately submitting to treatment. She names the emotional "undercurrents" suggested in the book's title with moving precision: panic over sudden disorientation, anxiety about what to keep secret, frustration with her own unreliability, dread of small duties and ordinary appointments, heartache over her faltering efforts to be a good and present mother.

The consent to hospitalization costs a great deal in humility, in risking a controversial treatment, and in letting go of a professional persona she doesn't know whether she'll be able to retrieve. But clearly the book is written by a woman whose clarity is a testimony to regained mental health and exceptional intellectual clarity. It is not a professional record, but an intensely personal memoir of what was both an encounter with serious mental illness and a spiritual journey.

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A 199-page collection of twelve essays by undertaker and poet Thomas Lynch, superficially about his mortuary trade, but actually about much more--life and death; the process of mourning; how we human beings pass though our common lives with grace or desperation; how the graveside ritual serves memory, family, and society. In the preface, Lynch says that early on he came to understand that the undertaking trade he would inherit from his father had little to do with what was done to the dead, but everything to do with how the living responded to the deaths of loved ones, neighbors, and friends.

Particularly outstanding essays include "The Undertaking," in which Lynch divulges the practical and emotional secrets of his trade as he buries Milo, a man who owned a Laundromat; "Crapper," a humorous, rollicking essay that demonstrates our modern society's inability to deal either with the thought of dying or the actual dead body; "The Gulfatorium," a flight of fancy about building a graveyard in a golf course, but really about the nature of suffering and the afterlife; "Mary & Wilbur," about neighbors, about our fear of death and our impulse to memorialize; "Uncle Eddie, Inc.," about an uncle's "clean-up service" that sanitized rooms after messy suicides and about the natural order of life and death and the moral implications of our manipulation of that order through assisted suicide, abortion, and genetic manipulation. My personal favorite is the final essay, "Tract," in which Lynch says how he wants his own death and burial to be managed, how he, a witness to our final rituals, wants to be witnessed.

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Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:

From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.

The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.

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Alan Shapiro, poet and professor of English at the University of North Carolina, Chapel Hill, chronicles the life and death of his sister, Beth, who died of breast cancer at the age of 49. Beth lived the last four weeks of her life at a hospice in Texas--this memoir traces those weeks in particular and refracts them against decades of family dynamics, turmoil and triumph. The memoir is composed of 14 tersely named chapters ("The Death," "The Joke") followed by "Afterwords": six poems about Beth.

Alan is the youngest of 3 siblings; Beth was the oldest and David, an actor is the middle child. Despite, or perhaps because of their age difference, Beth and Alan were very close. It was he whom she asked to write her eulogy and it was he who stayed the entire 4 weeks of hospice, save for a brief trip home. From Alan's love and devotion grows an admiration for Beth's integrity in life and death.

Beth married an African-American man, fought for liberal causes, and suffered complete estrangement from her parents due to her choices. Her husband, Russ, must deal not only with the loss of his wife and their daughter's loss of her mother, but also with the prejudice of the Shapiro parents and the medical establishment. At one point Shapiro describes how, whenever he accompanied his sister and her husband to the doctor's office, Alan, not Russ, was treated as the spouse and decision-maker.

Shapiro vividly depicts the poignancy of parent-child relationships. Gabbi, the seven-year-old daughter who loves horses, gallops through the house with grace and abandon not possible at the hospice. Alan's anger at his father's actions and his forgiveness of his mother's accomplice role are also strongly demonstrated. A great strength of this book is the choice of detail: the mother completes a book of crossword puzzles during the vigil; the brother becomes infatuated with a particular joke he wants to memorize; nurses leave a solitary rose on the bed of the newly dead at the hospice.

Shapiro is keenly interested in being with his sister right at the moment of her death. He describes the end: "one long, deep, and profoundly eerie moan . . . That moan, I'm certain, marked the end of Beth, the end of life, though the body went on breathing for another minute or so, each breath a little fainter, weaker, the body's electricity guttering down, dissolving, till there was no breath at all." (pp. 111-2)

He also analyzes whether this was "a good death." There had been many gifts: Beth's recognition of her importance, her reconciliation with her father, and her acceptance of her mother's devotion. However, Shapiro also keeps the reader cognizant of Beth's suffering and the now motherless child, the spouseless husband and the myriad other ways that Beth's death marked a void.

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After a stressful trip to cold-war Russia in 1964, Saturday Review editor Norman Cousins tells how he developed a debilitating illness which confines him to bed. He is admitted to hospital for tests and treatments, and is diagnosed with ankylosing spondylitis, but his condition deteriorates and he is given a gloomy prognosis. He notices that the depressing routine of hospital life tends to produce side effects that aggravate his condition.

With the blessing of one of his doctors, he checks out of hospital and into a comfortable (yet less expensive) hotel where the food is better and he can watch funny movies while he medicates himself with high doses of Vitamin C. He is convinced that the slow improvement in his condition is owing to his individualized methods of therapy and his having taken charge of his own situation.

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The purpose of this collection of essays written by teachers of literature and medicine is to serve as a guide for those who are preparing courses or seminars in the field. The collection is divided into four sections, each one approaching the theory and pedagogy of the discipline in a different way: one section is made up of model courses; a second views the subject matter from the standpoint of individual texts, authors, or genres; the third takes a broader look at some effects of literature on the practice of medicine and/or nursing and the role illness and medicine have played in the creation of literature; the fourth is a collection of resources available in the field. There is blurring of some of the boundaries of the sections, but read in the whole, the collection provides a good sense of the way medicine and literature is being taught in this country at this time.

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This is a scholarly book and the author, who is an exceptionally good writer, has gone to great lengths to search out original source material, much of which has not been examined by previous authors. Instead of retelling Elizabeth Blackwell's story she relates in some detail that of Sarah Adamson Dolley, another important pioneer woman physician who was the third woman medical graduate in America. She also was one of the eight founding members of the earliest society of women physicians in the United States.

The book also details the period in the late eighteen hundreds and early nineteen hundreds which was referred to as "maternalist medicine," when women began to pursue their careers in public health. After being "sidelined" in the first half of this century, the numbers of women physicians began to slowly increase, greatly aided by the new women's movement and the equal opportunity era.

Dr. More does an excellent job of bringing together the history of women physicians with the history of medicine from 1850 until the present. Her descriptions of women physicians' lives and problems are evenly presented and make interesting reading. The evolution of medical education in general is also well described. Her conclusion is not unexpected--that the greatest obstacle facing women practitioners today is the need to accommodate the demands of childbearing and child rearing with their professional lives.

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Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

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This book is the very personal story of one woman's struggle against a debilitating mental illness, which fortunately she was helped to overcome in time to allow her to complete her medical education and become a practicing physician. She says that the material was recalled partly from a diary kept during the time of original events, from memories of others, and from medical records.

The first chapter describes the author as a medical student assigned to a psychiatric service; subsequent chapters go back to the beginning of her personally perceived problems at age six, concluding with her amazing recovery after being treated with dialysis and her eventual acceptance to and success in completing medical school.

Dr. North's descriptions of her own perceptions of the sensations she experienced, the voices which talked to her and her remarkable persistence in school despite this are mesmerizing. Also, her description of treatment by physicians and care in mental institutions is very instructive. Her description of family relationships is intrinsic to the telling of her story. This book describes the anguish of mental illness from the inside.

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Gottlieb, nearing thirty years old, discovered her childhood diaries in a closet in her parents' home as she searched for some chemistry notes to aid in her quest to attend medical school. This book is "based on diaries" she wrote when she was diagnosed with and underwent treatment for anorexia nervosa. It is the writing of a precocious, strong-willed preteen who enjoys chess, being unique, writing, and getting straight A's in school, yet who is lonely and desperate to fit in and be popular.

Lori is eleven years old, lives in Beverly Hills, California with her fashion-conscious, loves-to-shop mother, her somewhat distant stockbroker father, her older brother David who now is into music and friends and not-Lori, and her best friend Chrissy, a pet parakeet. Lori's diary entries are filled with astute observations of adults (teachers, parents, relatives, medical personnel, even a television star she meets, Jaclyn Smith) and classmates.

She is wry and witty. An early entry gives an English essay she rewrote to get an "A". These "power paragraphs" are generously and hilariously sprinkled with "proper transitions" such as "to begin with", "moreover", and "on the other hand" that her teacher insists are necessary for readability. This essay provides telling insights about Lori's perceptions of her family, particularly (note transition word) her mother's superficiality.

Lori is surrounded by messages of the glories of thinness for women. Every female she encounters, from peer to adult, is on a diet, counts calories, avoids desserts and gossips about how other women and girls look. The culture is not only anti-obesity, but pro-superthinness. Hence it is logical that Lori, angry about being taken from school to go on a family trip to Washington, D.C., begins her rebellion and search for control by skipping meals and dieting.

She gets the attention she craves from her parents. Her schoolmates ask her for diet advice and admire her weight loss. Self-denial, obsession with calories (that she believes can even be gained by breathing), and secret exercising lead to an alarming weight loss in this already skinny kid.

Her mother takes her to the pediatrician, who prescribes whole milk which Lori refuses. He refers her to a psychiatrist, who eventually hospitalizes her for behavior modification, observation, and a possible feeding tube. At the hospital, Lori meets medical students, nurses and fellow patients, but becomes progressively more depressed, dehydrated and lonely. She attempts to run away and makes a suicide gesture. Finally, she sees herself for what she has become--an emaciated stick figure.

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