Summary:

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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Motivated at first by an attachment to her strict and demanding ballet teacher, as well as frustration and disgust with her own body compared to other dancers', Francesca develops an obsession with weight loss and increasingly ritualized forms of self-discipline in eating and exercise that lead to severe anorexia nervosa. It takes her family several months to see and acknowledge what is happening in front of them, during which she has trained herself to eat less and less, to throw up after meals, and to push herself to the point of exhaustion.

She becomes secretive, isolates herself from friends, and puts up a wall between herself and her parents, who are unable fully to understand the degree to which her behavior has gone beyond her control, but are worried. A compassionate male therapist with clear boundaries and a non-judgmental approach finally succeeds in disengaging Francesca from the mutually destructive downward spiral of family conflict around her illness;

he helps her to envision and desire her own health and to take responsibility for recovery. The story is told in the third person, but from Francesca's point of view.

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This first-person narrative of a runaway girl's short stay in a residential mental health center develops her impressions, resistances, and accommodations from her admission ("I can see right away it's a nuthouse") to her release. These include reluctant interviews with the staff counselor, uncomfortable encounters with nurses, observations of other patients' erratic behavior, and efforts, finally, to communicate with a very detached roommate.

"Stevie" speaks from a place of anger and mistrust. She attempted suicide in the girl's bathroom by slicing her wrists, but regards herself as otherwise quite competent. A turning point comes for her when her silent roommate sings a song she's written which ends with the words, "Don't forget to cry." This moment of vulnerability, which also unveils surprising talent and beauty, moves Stevie from anger toward curiosity and sympathy.

She takes steps toward friendship with her roommate, and finally toward reconciliation with her mother who, she realizes, really wants her home. As she leaves, Zena really addresses her for the first time, reminding her, "Don't forget to cry."

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Dedicated to the poet's mother, Naomi Ginsberg, the poem is a narration and a lament arising from Ginsberg's memories, three years after Naomi's death, of her life and of his life with her. This long poem is subdivided into 5 sections that address the dead woman directly.

The highly poetic Part I is a reflection on death, life ["all the accumulations of life, that wear us out" (p. 11)], mortality, the link between the dead and the living, the great unknown that lies beyond death--not in the abstract, but in the signs and symbols of Naomi's life/death and in the issues that remain for her son: "Now I've got to cut through--to talk to you / --as I didn't when you had a mouth." (p. 11)

Part II is a long narration of Naomi's life story, especially the history of her mental illness and of the role it imposed on Ginsberg himself. Ginsberg "was only 12" when he brought his mother to what was intended as a rest cure; instead, she became psychotic and was hospitalized, leaving Ginsberg with an everlasting sense of guilt. Separated from her husband, Naomi spent years of paranoia in chaos and institutionalization; son Allen vacillated between pity, disgust, escape in travel, and (homo)sexual exploration.

At the last meeting with his mother, in a mental hospital, she didn't recognize him. While living in San Francisco, two days after Naomi died, he received a letter from her: "Strange Prophesies anew! She wrote--'The key is in / the window, the key is in the sunlight at the window--I have / the key--Get married Allen don't take drugs . . . .' " (p. 31)

These passages give a vivid sense of mental disease and its impact on the family. Ginsberg is not self-pitying or self-indulgent in his description of the illness that laid siege to his mother's life and which so strongly influenced his own life for years. Modestly, he inserts: "I was in bughouse that year 8 months--my own visions unmentioned in this here Lament--" (p. 25)

The brief "Hymnn," is a blessing: "Blessed be you Naomi in Hospitals! Blessed be you Naomi in solitude! Blest be your triumph! . . . Blest be your last year's loneliness!" Part III (one page long) is a short recapitulation of Naomi's life, and uses her own cryptic words to try to make sense out of her life as well as of all life and death: "But that the key should be left behind--at the window . . . to the living . . . that can . . . look back see / Creation glistening backwards to the same grave . . . ." (p. 33)

Part IV, a chant, reaches beyond the personal to social history: "O mother / what have I left out"; (p. 34) "with your eyes of shock / with your eyes of lobotomy; " "farewell / with Communist party and a broken stocking"; "with your eyes of Czechoslovakia attacked by robots . . . ." (p. 35) Ending with the short part V, Ginsberg cries out to the shrieking crows circling in the sky above His mother's grave, "Lord Lord O Grinder of giant Beyonds my voice in a boundless / field in Sheol" (p.36) [Sheol is a Hebrew word meaning "the abode of death."]

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The film covers two days in the life of Frank Pierce (Nicolas Cage), a burned-out EMT (emergency medical technician) working the socio-economic underside of Manhattan. From the beginning, Frank is upset because recently all his patients have been dying on him, and he is haunted throughout by the hallucinated ghost of Rose, a young woman who collapsed on the street and died, apparently because he could not intubate her correctly.

Frank is highly stressed, he has no life outside his work, and he is self-medicating with alcohol. He tries to quit, but his boss keeps him on by promising time off in the future. In the film's first action, Frank does manage to miraculously resuscitate Mr. Burke, a heart-attack victim, but the patient winds up in the hospital with a very bad prognosis, so even that "saving" works against Frank.

Frank has encounters with numerous patients, many of them street people whose lives are out of control, some of whom are ER (Emergency Room) regulars, such as the demented young Noel (Marc Anthony). He also deals with (and is dealt with by) several highly idiosyncratic EMT partners in his ambulance rounds (John Goodman and others). Frank gets to know Mary Burke (Patricia Arquette), the daughter of the heart-attack victim, and they tentatively move toward being a couple who might help each other survive their lives.

Near the end, Frank, who knows Mr. Burke had tried to tear out his tubes during a brief moment of consciousness, and who feels he has been getting pleading messages from him to end his agonies, surreptitiously takes him off life support long enough for him to die. The physician who responds to the code decides not to attempt resuscitation of this patient who had already been resuscitated 14 times that day. Frank goes to tell Mary that her father has died (but not how), and exhaustedly falls asleep on her breast, apparently having forgiven himself because he has in some sense finally "saved" Mr. Burke.

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This is the second anthology from Donley and Buckley derived after many years of teaching "What's Normal?"--a literature and medicine course at Hiram College where they explore the cultural and contextual influences upon the concept of normality. With the first anthology, The Tyranny of the Normal, the editors focused on physical abnormalities (see this database for annotation). In this second anthology, the focus is exclusively on mental and behavioral deviations from societal norms. With this edition, Donley and Buckley present their case that, as with physical abnormalities, there is a similar tyranny of the normal that "dominates those who do not fit within the culture's norms for mental ability, mental health and acceptable behavior (xi)".

The anthology is divided into two parts. Part I is a collection of essays that introduce various clinical and bioethical perspectives on the subject of mental illness. These essays bring philosophic and analytic voices to the topic. Stephen Jay Gould's terrific essay on Carrie Buck and the "eugenic" movement in the United States in the early part of the 20th century illustrates one of the major themes that can be found throughout the anthology.

Oliver Wendell Holmes wrote the majority opinion in the 8-1 Supreme Court decision that sealed Buck's fate. Gould begins his essay reminding his readers of the often referenced Holmes quote, "three generations of imbeciles are enough." He then takes us on a fascinating historical adventure that uncovers a deeper and more complicated drama that led to this unfortunate period in American history, and the tragic incarceration and sterilization of Carrie Buck.

This essay, as with other stories, poems, and drama in the anthology, contemplates the relationship between societal values and mental illness, and illustrates how society through medicine can turn to the myth of "objective" diagnostic labels as a way to compartmentalize and control behavior and imaginations that are "abnormal." D. L. Rosenhan's essay from "On Being Sane in Insane Places" further illustrates the failure of the mental illness label. Irvin Yalom's story from Love's Executioner and Other Tales of Psychotherapy provides an example of what is possible when diagnostic labels are avoided, when health care professionals with power turn with humility, curiosity, and kindness toward others, substantiating that these qualities are far more powerful than statistical notions of "normal."

Part II is a collection of fiction, poetry and drama. Intended as a complement to part I, part II engages the reader in the lived experience of the narrators. It is divided into six sections. Section one considers children and adolescent experience of mental illness. Included are Conrad Aiken's "Silent Snow, Secret Snow," an excerpt from Susanna Kaysen's Girl, Interrupted (see annotation in this database), and an excerpt from Peter Shaffer's Equus (see annotation).

Section two includes stories that capture the world of mental disability and retardation. An excerpt from Of Mice and Men and Eudora Welty's short story Lilly Daw and the Three Ladies are included. Charlotte Perkins Gilman's The Yellow Wallpaper (annotated by Felice Aull; also annotated by Jack Coulehan) is in section three where women's experiences with mental disorders is the theme (these are annotated in this database).

Section four and five focus on men and mental illness. War experience is considered in the works of Toni Morrison and Virginia Woolf. Section six concludes the anthology. Alzheimer's disease and dementia are examined in Robert Davis's My Journey into Alzheimer's Disease, and in the story, "A Wonderful Party" by Jean Wood.

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The author first presents an introduction and rationale for the concept of using creative writing as therapy, either self-prescribed or as part of professional treatment. She then provides practical guidelines for starting a journal (Chapter 3), and for beginning to write poetry, fiction, and autobiography (Chapter 7).

The text includes an accessible introduction to images and metaphors--aspects of the craft--as well as to methods of capturing dream material (Chapter 6) for use in one's creative writing. The later chapters present therapeutic writing in various contexts--as group work (Chapter 9), or in various institutional settings (hospital, nursing home, hospice, and prison). There are examples of therapeutic writing, especially poetry, throughout the book.

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Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.

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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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Editors Angela Belli, professor of English at St. John’s University in New York, and Jack Coulehan, physician-poet and director of the Institute for Medicine in Contemporary Society at the State University of New York at Stony Brook, have selected 100 poems by 32 contemporary physician-poets for this succinct yet meaty anthology. The book is subdivided into four sections, each of which is prefaced by an informative description and highlights of the poems to follow.

Section headings take their names from excerpts of the poems contained therein. There are poems that describe individuals--patients, family members ("from patient one to next"), poems that consider the interface between personal and professional life ("a different picture of me"), poems that "celebrate the learning process" ("in ways that help them see"), and poems in which the poet’s medical training is brought to bear on larger societal issues ("this was the music of our lives").

Several of the poems have been annotated in this database: Abse’s Pathology of Colours (9); Campo’s Towards Curing AIDS (13) and What the Body Told (94); Coulehan’s Anatomy Lesson (97), I’m Gonna Slap Those Doctors (21), The Dynamizer and the Oscilloclast: in memory of Albert Abrams, an American quack (129); Moolten’s Motorcycle Ward (105); Mukand’s Lullaby (33); Stone’s Talking to the Family (79) and Gaudeamus Igitur (109).

Other wonderful poems by these authors are also included in the anthology, e.g. Her Final Show by Rafael Campo, in which the physician tends to a dying drag queen, finally "pronouncing her to no applause" (11); "Lovesickness: a Medieval Text" by Jack Coulehan, wherein the ultimate prescription for this malady is to "prescribe sexual relations, / following which a cure will usually occur" (131); "Madame Butterfly" by David N. Moolten, in which the passengers in a trolley car are jolted out of their cocoons by a deranged screaming woman (142).

Space prohibits descriptions of all 100 poems, but each should be read and savored. Some others are particularly memorable. "Carmelita" by D. A. Feinfeld tells of the physician’s encounter with a feisty tattooed prisoner, who ends up with "a six-inch steel shank" through his chest as the physician labors futiley to save him (23). In "Candor" physician-poet John Graham-Pole struggles with having to tell an eight-year old that he will die from cancer (27). Audrey Shafer writes of a Monday Morning when she makes the transition from the "just-awakened warmth" of her naked little son to tend to the patient whom she will anesthetize "naked under hospital issue / ready to sleep" (72).

In "The Log of Pi" Marc J. Straus muses about being asked "the question / I never knew" that he "pretend[s] not to hear" whose "answer floats on angel’s lips / and is whispered in our ear just once" (113). Richard Donze wants to know why "Vermont Has a Suicide Rate" (132). Vernon Rowe remembers the "hulk of a man" who shriveled away from an abdominal wound and begged, " ’Let me go, Doc,’ / and I did" (44).

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