Summary:

Subtitled "New and Selected Medical Poems," this volume includes poems on illness and healing from Downie's three previous collections, along with several new poems. A longer piece called "Learning Curve Journal" serves as a framework for the book.

Beginning with the desperate voice he hears on his first night as a "suicide line" volunteer, the poet reveals the shape of his own medical learning curve, moving poem by poem from "Orientation" through the realm of "Patient Teaching" and "Teaching Rounds" to "Pronouncing Death." Among the many strong poems in this collection are "Diagnosis: Heart Failure," "Louise," "Sudden Infant Death," "Wishbone," "Living with Cancer," and "Ron and Don."

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This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."

In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).

In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."

During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.

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This biography, first published in French in 1971, was written by a Soviet émigré living in Paris. She begins her introduction with a quotation from Chekhov, "Happiness and the joy of life do not lie in money, nor in love, but in truth" (1). She follows this statement with an observation of her own, "Chekhov makes no prognoses, never raises his voice, does not explain, insist, and above all, does not instruct. . .

He is the least Russian of the great Russian writers." To a large extent, her short biography is devoted to presenting a particular vision of Chekhov that might be called "compassionate objectivity." Although her subject may not have insisted or instructed his readers, Ms. Laffitte does. In fact, there is a hagiographic quality about this book that leads the reader to conclude that if Chekhov had been a believer, by now he would have been canonized as Blessed Anton of Moscow.

Ms. Laffitte proceeds in multiple short chapters. While they are generally in chronological sequence, each one also takes up an issue or theme in Chekhov’s life. She makes copious and skillful use of her subject’s letters and notebooks. She also devotes considerable attention to Chekhov’s medical career, unlike V. S. Pritchett, whose short biography entitled, Chekhov. A Spirit Set Free (1988, see annotation in this database) portrays medicine as more of a hobby than a serious enterprise for Chekhov.

Ms. Laffitte also has a habit of tying up loose ends without presenting much evidence for her point of view, or acknowledging that uncertainty exists. For example, when dealing with what she calls Chekhov’s "moral depression" of the mid-1890s, she concludes, "By a logical exertion of willpower, Chekhov was gradually to emerge from this moral depression" (168). It seems here that she considers depression--assuming this is the correct term to use in the first place--a weakness or failure of will, rather than a clinical disorder.

Nonetheless, this short literary biography (not out-of-print) provides much easier reading than most of the major Chekhov biographies that have appeared since it was published.

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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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Summary:

This series of 28 poems plus an envoy describe, from the patient's point of view, a 20-month stay in an Edinburgh hospital in the 1870s. The narrator delineates--from the cold and dread of Enter Patient through the giddiness of "Discharged"--his reactions to hospital personnel (from doctors and nurses to scrub lady); to his fellow patients (from children to the elderly, during bad days and holidays), to visitors, and to death.

Because he stays for 20 months, we also witness his seesawing emotions about his own state of health. The epigraph from Balzac suggests that a person in bed and ill might become self-centered, so the narrator purposefully maintains a dispassionate tone. It is a tone so distinct yet distanced that Jerome H. Buckley (William Ernest Henley: A Study in the "Counter-Decadence" of the 'Nineties, New York: Octagon Books, 1971, c. 1945) compares the poems to steel engravings.

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Old Chuan and his wife, the proprietors of a small tea shop, save their money to buy a folk medicine cure for their son, Young Chuan, who is dying of tuberculosis. The story opens with Old Chuan leaving their shop and going to the home of the person selling the cure, a "roll of steamed bread, from which crimson drops were dripping to the ground." The crimson drops, we soon learn, are blood from a young man recently executed, apparently for revolutionary activities.

The cure does not work and the mother of Young Chuan meets the mother of the executed revolutionary in the cemetery. Here they both behold a mysterious wreath on the revolutionary's grave, a wreath that Lu Hsun, in his introduction to this collection (which he entitled A Call to Arms), describes as one of his "innuendoes" to "those fighters who are galloping on in loneliness, so that they do not lose heart." (p. 5)

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Tom Fogarty is a sixteen-year-old boy who is introduced to both love and death in 1934. The object of his affection is Lily, the 14-year-old niece of a neighbor who lives across the street from Tom. Lily has tuberculosis and is waiting for a bed at the sanitarium where her parents are already being treated for the same disease. The relationship between the two adolescents is risky, passionate, forbidden, and ultimately transforming. Their romance is abruptly interrupted by Lily's death.

Tom's overwhelming grief over the loss of Lily coincides with torrential rain that cleans and nearly submerges the town of Troy, New York. Tom is further wounded when he fractures his clavicle during the flooding. His physician-father, a general practitioner, repairs Tom's injured collarbone but only time can mend the boy's broken heart.

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Summary:

The headstrong beauty Marcella Boyce, who has acquired radical political views while at school, returns home and becomes engaged to Aldous Raeburn, the son of her father's neighbor Lord Maxwell and a moderately conservative politician and landowner. Marcella champions Jim Hurd, a local poacher accused of murder (who is prosecuted by Raeburn): she nurses his grieving wife and dying, consumptive son and arranges his legal representation by Edward Wharton, a Socialist politician and Raeburn's romantic rival.

After Hurd's execution, Marcella breaks off her engagement, trains as a nurse, and turns her reformist efforts toward the London poor instead of the rural poor in rural villages. She refuses Wharton's offer of marriage and finally accepts Raeburn's hand.

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Summary:

Don Wanderhope grows up in a Dutch Calvinist family, but his father is a searcher, always questioning the tenets of his faith and the meaning of life. Don's life progresses through a series of traumas: his older brother dies of pneumonia; Don develops tuberculosis; his girlfriend at the sanitarium dies of tuberculosis; and, later, his wife commits suicide. Despite all this, however, there is one shining ray of hope and love in Don's life--his daughter Carol. By the time she turns 11, father and daughter are inseparable pals.

At this point Carol develops leukemia. At first they think it is strep throat and she responds to antibiotics: "She feels a lot better. Give her another day or two and you can take her home. But, anyhow, we've eliminated everything serious." (p. 165) But shortly thereafter, while father and daughter are on vacation in Bermuda, she becomes severely ill again, and soon the diagnosis of leukemia is confirmed.

This begins many weeks of progressive spiritual suffering for Wanderhope, as his daughter suffers terrible physical symptoms and medical interventions. He is reduced to bargaining with God, and to begging at the shrine of St. Jude: "Give us a year." Initially, his prayers seem to be answered as Carol responds to chemotherapy, but then she develops sepsis and dies, "borne from the dull watchers on a wave that broke and crashed beyond our sight." (p. 236)

After Carol's death, Wanderhope vents his anger at God and becomes overwhelmed with grief. However, months later, when going through Carol's things in preparation for selling the house, he discovers an audiotape that Carol had made during her illness, a message that she had left for her father: "I want you to know that everything is all right, Daddy. I mean you mustn't worry, really . . .

(You've given me) the courage to face whatever there is that's coming . . . " (p. 241) The tale ends with Wanderhope's final reflection: "Again the throb of compassion rather than the breath of consolation: the recognition of how long, how long is the mourner's bench upon which we sit, arms linked in undeluded friendship, all of us, brief links, ourselves, in the eternal pity." (p. 246)

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Summary:

Orlov is a young playboy in St. Petersburg whose father is an important political figure. The narrator (the "anonymous man"), who is actually a political activist (perhaps even an anarchist), assumes a new fake identity and takes a job as Orlov's footman, in order to get inside information to use against his father. While working undercover in this way, the narrator ("Stefan") observes a domestic tragedy. Orlov charms and then seduces a beautiful young married woman, Zinaida Fyodorovna Krasnovsky, who subsequently leaves her husband, shows up on Orlov's doorstep, and moves in with him.

Zinaida bursts with romantic visions and loves Orlov passionately. However, Orlov thinks the whole thing is a bore. He can't bring himself to throw her out, yet he detests her assault on his freedom. Eventually, he begins spending weeks at a time away from the flat, supposedly on an inspection tour in the provinces, but he is simply avoiding Zinaida by staying at a friend's house in St. Petersburg. Meanwhile, "Stefan" experiences a growing compassion for the poor woman, who has given up her husband and family for love.

As a result of this situation, "Stefan's" political ideals sink into the background; for example, he gives up an opportunity to murder Orlov's father and, thereby, achieve his radical objectives. Eventually, he confesses the truth to Zinaida--that Orlov has deceived her and doesn't want her. "Stefan" also reveals his true identity (Vladimir Ivanitich) and entices her to flee with him to Europe.

They spend the next several months traveling together. At one point Vladimir has an acute exacerbation of "pleurisy" (actually tuberculosis) and, while nursing him back to health, Zinaida realizes that Vladimir is in love with her. This is a crushing blow to their relationship, because she was under the impression that he had been helping her for purely altruistic, idealistic reasons.

Meanwhile, Zinaida, who is ill herself and pregnant with Orlov's child, dies in childbirth. The baby (Sonya) survives, and Vladimir spends two happy years caring for her, until he, too, is about to die of tuberculosis. At the end of the story, Vladimir meets with Orlov, and they make arrangements for old Krasnovsky--Remember him? He was Zinaida's husband--to take the child and raise her as his own.

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