Face Time

Moore, Lorrie

Last Updated: Oct-28-2020

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Fiction

Summary:

In the lonely glow of her computer, Lorrie Moore’s protagonist FaceTimes her father, who is quarantined in a hospital after contracting the COVID-19 virus following hip surgery. She explains to him the circumstances of the pandemic and names the celebrities and political personages who have tested positive for the virus. Befuddled by hydroxychloroquine, her father passes in and out of hallucination and lucid conversation but jokes when he can despite the side-effects of the “bullshit malaria drugs.” The counterpoint to her sadness for her father is revulsion for the “ghastly” new rituals and habits of indefinite quarantine—the performative antics of Zoom concerts, YouTube binges, bizarre insurance commercials, Bible readings, and social distancing. She is appalled, too, by “well-to-do white families in large suburban homes” that claim “the pandemic for themselves,” families that sanitize grocery bags and order from Amazon and Grubhub. Intermingled with the numbing ennui of quarantine is disgust for the consumerism that thoughtlessly implicates human life, the front-line workers who make these convenient services possible. The protagonist and her sisters coax the hospital staff to comfort their father, play his requested Brahms symphony (any one of the four will do), and give him lemonade, but the “visored hazmatted nurses dressed like beekeepers” are overwhelmed and appear unapproachable, even threatening.

These FaceTime calls become increasingly bewildering to the father. The protagonist’s sister invites her to join a disjointed three-way FaceTime, but the call is interrupted by one of the father’s hydroxychloroquine-induced hallucinations. With “a howl of anguish” and “grimace with agony and sorrow,” he utters German expressions recalled from his war days. The protagonist realizes that her father is “imagining he was a prisoner of war; that was what it must have felt to him—the cruel isolation, the medicine, the lights, the strange machines all around him.” Like the ebbing signal of a satellite in some faraway orbit, contact with her father grows tenuous. For the next FaceTime call, a nurse says her father is asleep. The following day, she waits again for a scheduled FaceTime chat. She phones the hospital to inquire about her father’s missed call but is put on hold, then disconnected. Later, at midnight, the hospital calls to inform her that her father has died.

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Hamnet

O'Farrell, Maggie

Last Updated: Oct-19-2020

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The underlying premise of this engrossing book is the well documented historical fact that William Shakespeare had a young son who died at age 11, relatively early in his father’s theatrical career. The son, named Hamnet, was one of twins born to William and Agnes Hathaway (O’Farrell refers to her as Agnes rather than Ann based on some public records) in 1585. The cause of death is unknown, but O’Farrell imagines that he fell victim to the plague. She weaves an electric narrative that begins with Shakespeare as an educated young man who is a teacher and private tutor to children in Stratford-on-Avon. His relationship with his glove maker father who has fallen on hard times is at a near break point. In the past, Shakespeare’s father had been an important town official but because of a mixture of misguided business deals and bad behaviors, he has become an object of public scorn. His rage at this reversal of fortune is directed at his bookish son. But then, Shakespeare meets Agnes Hathaway. She is 8 years older than William but entrances him with her unconventional personality and her exotic skillset including bee keeping and an uncanny ability to heal people with herbal remedies. They marry and have their first child 6 months later to be followed in short order by twins, Hamnet and Judith.

Agnes recognizes William’s unique potential and supports his choice to leave his family and head off to London to make his name in the theater world. Shakespeare rarely returns home to Stratford, and we only learn of his growing success indirectly. Agnes is forced to raise her children as a single parent and has to deal with her overwhelming grief when Hamnet dies. As she mourns the loss of her son, she is overcome with doubt about the fidelity of her absent husband, and her faith in their marriage is threatened. Ultimately, Agnes is given a playbill featuring the production of a new play written by her husband and she sets off on a trip to London to confront him on his own turf. She arrives uninvited at the Globe Theater in time to witness a performance of the play in which her husband has been able to channel his own grief at the loss of his son into one of the enduring literary works in the Western canon.

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Losing Thomas & Ella: A Father's Story

Weaver-Hightower, Marcus

Last Updated: Aug-23-2020

DiLeonardo, Olivia

Primary Category: Literature / Nonfiction — Secondary Category: Literature /

Genre: Graphic Memoir

Summary:

Dr. Weaver-Hightower wrote, illustrated, and published this powerful graphic work in the Journal of Medical Humanities. The comic itself is presented in a traditional paneled format, with a few exceptions, and rendered in a moody ink wash in black, white, and various shades of darker and lighter greys. The story is told in the authentic, sometimes faltering voice, of the father of Thomas and Ella, a pair of twin infants who died at 22 and 24 weeks into pregnancy. Beginning with their harrowing trip to the hospital, the comic describes the father and mother’s loss of Ella, shortly after she was born prematurely; their subsequent wait for Thomas to reach the “viable” age of 24 weeks; his stillbirth; and the couple’s sudden discharge from the hospital, going home with “empty arms”. The story then transitions into “The Long After”, including the funeral and the phases of the parents’ grieving process. The father describes his grief, frustrations, the couple’s differing ways of coping, and his ambivalence and anger toward religion as a source of comfort or deeper understanding. On the last page, he recounts their hopes and fears as they enter into their second pregnancy, concluding with panels of the father wrestling with how to understand and process this loss. The final panel is an image of the father in profile, expressionless, saying nothing, a fitting conclusion to a story for which words seem to fail.

With this piece, the author introduces us to the genre of the “research comic”. The comic is followed by a methodological appendix, which explains the author’s process for choosing, capturing, and relating this history in words and illustrations, as well as his rationale for selecting a comic or graphic memoir format for the piece. The author also elaborates upon the concept of the comic as a form of “rigorous, informative research” (226). The appendix is very interesting and will satisfy the curiosity of readers asking the questions, “How did he do this?”, or “Why is this story a comic?”, but the piece stands on its own without the appendix, as well.

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The Bridge in the Jungle

Traven, B.

Last Updated: May-15-2020

Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The Bridge in the Jungle is a novel about the tragic death of Carlos, an 8 or 9 year old (no age is given) hyperactive Mexican boy, and the aftermath of his mother's overwhelming grief for him, sometime in the early 20th Century in a very poor village deep in the jungle. (The lack of specific details are intentional, as I shall discuss below.) The narrator is an American man staying in the village while looking for alligator skins and bird feathers to sell in the U.S.. He observes the little boy's brother, who works in the oil industry in Texas and has just returned for the weekend, give his little brother brand new shoes. Carlos is overjoyed to wear them since all the villagers but the pump master's wife wear threadbare rags for clothes. This is the little boy's first pair of shoes, much less shiny new American ones. While sitting outside in the village with his host, both waiting for an outdoor party, the narrator hears an ominous splash that is Carlos falling to his death off the treacherous bridge, a bridge that has no railings. The remainder of the novel depicts the grief of the young mother - a grief that reaches the suffocating proportions of Greek tragedy - and her villagers' genuine support.

Described in minute detail by the narrator, the villagers - who have turned over every stone in the woods, dived many times in the river, and ridden to nearby villages to find Carlos - turn to an old man who requests a perfectly flat piece of wood and a stout candle. He then meticulously fastens the candle to the wood and carefully launches this raft of mystical exploration and recovery on the river. Every villager watches this ceremony with rapt attention. It is truly a riveting passage, for the raft travels under its own power from the river bank against the current, meandering slowly towards the bridge where it finally stops, despite the current, under the bridge, the only place no diver has yet looked:

"The board in the meanwhile has wandered farther under the bridge, but always in a right angle to the fifth post. Now it is under the middle of the bridge. From here it sails towards the fourth post, though only for about a foot. And here it stops as if it were nailed to the water. It does not mind the current nor the light breeze that sweeps softly across the surface of the river. The manner in which the board has halted is entirely different from that in which it stopped before. Now and then it trembles slightly, as if something were breathing against it from below. But it no longer whirls. ... The board begins softly to dance as if impatient. It seems that it wants to be relieved of its torture. It wriggles, swings about itself, though it does not move as much as two inches. One might think it is trying to go down to the bottom."
(page 110-1)

A villager dives and retrieves Carlos and hands his body to his mother:

"With an indescribable nobility and solemnity, and in his eyes that pitiful sad look which only animals and primitive people possess, he steps slowly forward. And Perez, the man whose daily task it is to fell the hard trees of the jungle and convert them into charcoal, lays that little water-soaked body in the outstretched arms of the mother with a tenderness that makes one think of glass so thin and fragile that a single soft breath could break it."
(page 113)

The villagers, in a procession that is tragicomic, take Carlos' body to the graveyard where a well respected teacher, now drunk from all the mescal others have offered him, gives an eulogy that suggests Christ's Sermon on the Mount. However, with inverted symbolism, this sermon is for, not by, Jesus and is delivered by a drunken priest-figure who is so drunk he falls into the open grave. To Traven's credit he introduces this farcical moment to emphasize how none of the villagers, much less the author, and, consequently, the reader, laughs at a decent man trying his best to honor Carlos. It is truly a most moving finale to a most moving book.

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Weather

Offill, Jenny

Last Updated: Apr-03-2020

Carter, III, Albert Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Weather is a strange, disturbing, and important book. Offill uses fragments of prose—typically a few lines or half a page—to present a small group of characters in New York City who experience dread, unhealthy behaviors, and many difficult choices. The fragments jump from topic to topic and points of view, suggesting chaos in the characters, in much of modern life, and even in the structure of this novel. “Weather” suggests “whether”: whether humans can survive not only from one day to the next but also in the long term that includes the climate crisis threatening our earth.

The cast of characters is small and carefully arranged. Lizzie (our main focus) is married to Ben; they have a son Eli. Lizzie’s brother Henry is married to Catherine, and they have a baby girl, Iris; Ben and Lizzie have problematic mothers. A genogram of these and other related characters looks like the cast of a Restoration comedy, full of harmony and good will, but in Weather conflicts swirl and grow chaotically. Catherine divorces Henry. Ben suddenly goes on a three-week trip. Widespread complications include street drugs, alcohol, diet abnormalities, sleep deprivation. There are also mental problems such as confusion, hallucination, loneliness, delusions, and panic, as well as economic difficulties. Only Catherine has a career path, but, at the end of the book, she appears to be “tilting into the abyss too” (p. 179), according to Lizzie.

While some fragments describe thoughts and actions of the characters, others present a giant whirlpool of cultural, environmental, and historical topics, including doomsday preppers, Rapturists, and the end of civilization, also gun rights, multicultural frictions, popular religion, a need for a strongman to govern, noticeably sick people and loss of medical services. Other topics touched on include hate literature, mob rule, suicide, torture, as well as references to Fukushima, the Holocaust, and 9/11. Many of these worry our characters; others are simply mentioned as “the surround” for all people around the world. Our characters have fantasies of hope but usually feel panic, dread, loneliness, guilt, or despair. Sylvia (Lizzie’s former professor and sometime boss) is an academic who appears to understand climate change and the need to warn people, but she gives up, saying “there’s no hope” (p. 133).

The first 127 pages swirl around the characters with little progression of story. The next section (4) accelerates the craziness among them all. The last two sections seem more “stable,” but with no actual resolutions. Lizzie says “I will die early and ignobly” (p. 187). In the very last pages, she takes the boy Eli (the only normal major character) to a playground. Later she kneels by her bed and prays for “Mercy” (p. 197). Following the last page, we see only a one-line URL: www.obligatorynoteofhope.com. Is this part of the novel? Do we click on it?

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Death is But a Dream: Finding Hope and Meaning at Life's End

Mardorossian, Carine; Kerr, Christopher

Last Updated: Mar-17-2020

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Criticism

Summary:

In Death is But a Dream, Christopher Kerr, MD, PhD, the Chief Executive Officer and Chief Medical Officer of Hospice & Palliative Care Buffalo, shares his patients’ end-of-life dreams and visions. The content and intensity of these dreams vary, but often center on patients’ transient meetings with predeceased loved ones, offering a deeply spiritual sense of peace during periods of physical suffering.

Using patient interviews, Kerr’s book does not fetishize dream events as ghostly commotions or in terms of pseudo-mysticism, or insist on using a religious framework for their interpretation, explaining rather that bearing witness to and legitimizing end-of-life dream experiences constitute a new ethical imperative in the practice of palliative care: “A true holistic approach to patient care must also honor and facilitate patients’ subjective experiences and allow them to transform the dying process from a story of mere physical decline to one of spiritual ascension” (Kerr 28). Case after case, his research documents that because end-of-life dreams provide patients with a singular emotional and psychological comfort that no palliative medication can simulate, hospice professionals need to validate patient dreams by listening carefully and compassionately.

With this in mind, end-of-life dreams serve as a kind of counter-narrative to dominant cultural understandings and representations of human experiences in hospice, specifically stereotypes of terminally ill individuals as being incapable of meaningful communication, creativity, and understanding. Kerr’s patients’ narratives reveal that end-of-life dreams and visions are not trauma-inducing experiences or instances of religious prophecy, but “help reframe dying in a way that is not about last words and lost love but about strengthened selves and unbreakable bonds across lives” (142).

Death is But a Dream upends medical research, or certain “limitations of science,” that oversimplifies end-of-life dreams by attributing them to neurological deterioration, oxygen deprivation, and the side effects of pain management medication (11). The general lack of rigorous, serious-minded research in end-of-life dream experiences is inseparable, in part, from institutionalized medicine’s “inability to see dying as anything but a failure” which has produced a healthcare system that “reflects a limited view of the totality of the dying experience” (7). The patient accounts that Kerr documents, however, reveal an undeniable dimension of human experience at life’s end whose complexities may be well beyond the reaches of full scientific understanding. End-of-life dreams seem to be part of an elaborate system of compensation (to borrow a term used by Siddhartha Mukherjee), as the mind works overtime to activate and animate certain memories to diminish the physical realities of dying. “There is an adaptation—substantive, spiritual yet cognitively meaningful,” writes Kerr, “a mechanism through which the patient can emerge from the dying process with a positive psychological change” (69). Indeed, the mystery of end-of-life dreams—their visions of loved ones; of seeking forgiveness, healing, and understanding within weeks, sometimes days, of one’s death; of comforting apparitions and visitations—points to a miraculous capacity within the human heart that eases the life-to-death transition.

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Man's 4th Best Hospital

Shem, Samuel

Last Updated: Feb-28-2020

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Most of the group are reunited in this sequel to the 1978 blockbuster, The House of God: narrator Dr. Roy Basch and his girlfriend (now wife) Berry, former fellow interns (Eat My Dust Eddie, Hyper Hooper, the Runt, Chuck), surgeon Gath, the two articulate police officers (Gilheeny and Quick), and the Fat Man (a brilliant, larger-than-life former teaching resident). As interns, Basch and his comrades were a crazy, exhausted, cynical crew just trying to survive their brutal internship. Years later, the midlife doctors have changed but remain emotionally scarred.

The Fat Man (“Fats”), now a wealthy California internist who is beginning a biotech company targeting memory restoration, is recruited to reestablish the fortunes – financial and prestige – of Man’s Best Hospital which has slipped to 4th place in the annual hospital rankings. He calls on his former protégés to assist him in an honorable mission, “To put the human back in health care” (p34). Fats enlists other physicians (Drs. Naidoo and Humbo) along with a promising medical student (Mo Ahern) to staff his new Future of Medicine Clinic (FMC), an oasis of empathic medical care that strives to be with the patient.

Every great story needs a villain. Here the main bad guys are hospital president Jared Krashinsky, evil senior resident Jack Rowk Junior, and CEO of the BUDDIES hospital conglomerate Pat Flambeau. The electronic medical records system dubbed HEAL is a major antagonist, and the FMC docs wage war against it and the “screens.”

Poor Roy Basch works long hours, deals with family problems, has trouble paying bills, and experiences health issues (a bout of atrial fibrillation, a grand mal seizure, and alcohol use). Fats has warned of a “tipping point when medical care could go one way or another, either toward humane care or toward money and screens” (p8). Alas, the computers and cash appear victorious. A major character is killed. Many of the doctors working in the FMC including Basch leave the clinic. And fittingly, Man’s Best Hospital plummets in the latest rankings from 4th to 19th place.

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The Soul of Care: The Moral Education of A Husband and a Doctor

Kleinman, Arthur

Last Updated: Feb-10-2020

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A dramatic prologue depicts Joan Kleinman screaming and hitting her husband Arthur in bed. She is ill with Alzheimer’s disease and does not, for that moment, recognize him. The following chapters provide a long flashback, beginning with Arthur’s family background, his youth as a tough street kid in Brooklyn, his medical education, and his marriage to Joan. We learn of their work in China, travels, and professional success. Arthur gradually realizes that the US health care system has become “a rapidly fragmenting and increasingly chaotic and dysfunctional non-system” (p. 126). Further, he sees a reductive focus on patients as mere biological entities, ignoring their personal, familial, and cultural natures. As a result, “Caregiving in medicine has gone from bad to worse.”

Joan suffers from an atypical kind of Alzheimer’s that increased over “that dismal ten years” (p. 156) with Arthur providing care to her, at cost to himself. There is no home health aide, no team approach with doctors, indeed no wider interest in her care other than the state of her diseased brain. Kleinman vividly describes the toll on her and on him.

Kleinman is aware of the privilege he has as a Harvard doctor, well known for his psychiatric work, his teaching and writing, and his wealth—in contrast to other patients and families. Some patients go bankrupt from medical bills.

Visits to nursing homes reveal a wide range of social conditions, contexts, and levels of care; the best have a sense of “moral care” (p. 200). Joan’s final days are hard. Supportive family members agree to her living will and healthcare proxy for morphine pain control only. She dies, apparently “at peace” (p. 232).

In the last pages Kleinman introduces the notion of “soul” as “essential human interactions” (p. 238). He discusses some of the limits of medicine (see paradoxes below) but also praises local efforts to improve humane care, such as team approaches, uses of narrative medicine, and medical/health humanities programs.

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Breaking & Mending: A Junior Doctor's Stories of Compassion and Burnout

Cannon, Joanna

Last Updated: Oct-21-2019

Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A British physician-writer reflects on her topsy-turvy medical training emphasizing the mental and emotional burden of becoming a doctor. In 22 brief chapters with titles including "The Darkest Hour," "Buried," and "The Wrong Kind of Kindness," a struggle between hope and despair furiously plays out - in patients, hospital staff, and the narrator.

Dr. Jo (as one patient calls her) remembers interviewing for medical school admission, the difficulty dissecting a cadaver, starting lots of IV's, dutifully toting an almost always buzzing pager, and breaking bad news. She shares with readers her own serious car accident with resulting facial injuries. She comments on the underfunded UK National Health Service (NHS) that is "held together by the goodwill of those who work within it, but even then it will fracture" (p104).

Anecdotes of memorable encounters are scattered throughout the narrative: a fortyish woman in the emergency department who describes a fast pulse and sense of impending doom diagnosed as having an anxiety attack who ten minutes later suffers a cardiac arrest, a man with severe schizophrenia, a suicide, an elderly blind person, a young woman with metastatic breast cancer.

But the lessons that have stuck with her are primarily dark and somber ones. "Sacrifice and the surrender of the self are woven into the job" (p77). She realizes that "perhaps not all good doctors are good people" (p125) and that as wonderful and essential as the virtue of compassion is, "compassion will eat away at your sanity" (p16). She chooses psychiatry as a specialty where kindness, empathy, creating trust with patients, and careful listening work wonders for people. "I learned that saving a life often has nothing to do with a scalpel or a defibrillator" (pp13-14).

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Ladysitting: My Year with Nana at the End of Her Century

Cary, Lorene

Last Updated: Sep-03-2019

Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In Ladysitting, novelist and memoirist Lorene Carey writes candidly and reflectively about the year and a half she cared for her century-old, ferociously independent paternal grandmother. The experience became a critical moment for personal and familial discovery. Carey’s intensive caregiving began when Nana Jackson could not be discharged from the hospital to the house where, for decades, she had lived by herself. Growing up, Carey enjoyed enchanted weekends of indulgence in Nana’s sunlit suburban home in South Jersey, a respite from her family’s life in urban West Philadelphia. Partly in gratitude for those weekends, partly from a sense of duty, Carey made physical, emotional, and spiritual space for Nana in the home she shared with her husband, a minister, and their teenage daughter. Along with Carey’s own artistic, community, and professional commitments, she also maintained the property management business that her grandmother ran until her confinement. Carey’s decision to become Nana’s primary caregiver brought momentary satisfactions along with overwhelming frustrations.

Carey’s narrative agilely transitions between present encounters with Nana Jackson and the past: her own past and her African- and Caribbean-American relations’. By doing so, Carey tries to make sense of the complicated woman in her care, herself, and relationships within her family. She discovered generations of mostly “free-people-of-color,” several financially and politically successful, whose ambitions confronted Reconstruction, the Jim Crow South, the migration north, and the “lynchings [that] made sure that every gain would be paid for in blood and money, if not by [her family], then by other black people, somewhere.” How might that history, Carey asks, help her understand her family’s generations of divorces (including her own), alcoholism, deceptions, estrangements, and the elusive efforts of one generation to build on the accomplishments of the others?

It took Carey ten years to research and reflect on that question. And then to write, hoping “to clear away the rage, uncover the simple grief, stored in the muscles that seized up then and cannot remember how they were before, and to convince us both, Nana and myself, that she has left this plane. And to forgive.”

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