Summary:

This is a collection of 111 poems, all about women who are old. As the editor says in her introduction, it is not a book about becoming old, but about being old, and the book bears the pointed reminder that an old woman is still a woman, as well as being old (vii). The poems are arranged in ten sections, from portraits of old women (usually grandmothers, here) as seen by the young, through explorations of their work and wisdom, their relationships and sexuality, the vivid and sometimes shocking realities of their bodies, their illnesses and weaknesses, institutionalization and nursing homes, and finally, their confrontations with death and the sense of loss in those they leave behind.

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The poet likens a sudden awareness of middle-age to "a pear [that] spoils from the inside out" of which one "may not be aware / until things have gone too far."

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The narrator find himself in the kitchen where "the faucet drips" and "The magnets on the refrigerator crawl down / with the gravity of expired coupons and doctor bills." He looks into the refrigerator, trying to remember whether he has seen any of its contents before. He is preoccupied with his body, which is aging. His mind wanders. Suddenly, he is alert again, oriented to the present and ready to take charge--of his diet and of his life. "I'm full of hope. / I open the refrigerator. / I've seen this stuff before."

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This is a collection of stories and sketches by a practicing neurologist. Most of the material is clinical and autobiographical. In "Mrs. Bachman" a new patient enters the doctor's office, carrying a thick stack of medical records. It all started in 1946 and no doctor has ever found the explanation of her condition. Meanwhile, the doctor is wearing contact lenses for the first time. His eyes begin to tear. Mrs. Bachman thinks that he is crying over her misfortune. She consoles him, "I want you to know that you are the kindest, most sympathetic man I have ever met."

In "Intensive Care" an elderly woman is agitated after a seizure. The staff try unsuccessfully to calm her. Finally, her husband approaches and kisses her. She settles peacefully and they hold hands.

The doctor in "Continuing Medical Education" finally discovers metastatic breast cancer as the cause of a psychotherapist's neck pain, long after he and other physicians had told her again and again that the "driving mechanism" of her chronic pain was "unresolved anger and frustration." In a longer essay, "The Narrow Bridge," the author reflects on the meaning of healing, "Healing helps us find a place in this world for ourselves and for each other."

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In her youth, Mrs. Palfrey had been a model British woman. She married a military man, moved to Borneo and lived happily and properly, giving direction to the natives. She and her husband retired in Britain. Now, however, Mrs. Palfrey is a widow. Her daughter Elizabeth, who lives in Scotland, has not invited her to stay and she is not sure she would want to. Instead, she courageously decides to move into the Claremont Hotel in London, where she meets the other permanent residents who, like herself, are old and rather poor.

Mrs. Palfrey gets the attention and envy of the group when she tells them that her oldest grandchild and heir, Desmond, works at The British Museum and will undoubtedly be coming to visit. He never comes.

One day as Mrs. Palfrey is out for a walk, she falls. A young man, Ludovic Myers (Ludo), comes out of his basement apartment to help her. He takes her inside, doctors her knee, and gives her a cup of tea. He is trying to write a book and finds her an excellent study.

Mrs. Palfrey asks him to pretend to be Desmond so that she can save her reputation. He agrees. Mrs. Palfrey fancies that she is in love with him. They meet rarely, though once he invites her to dinner at his house. He makes an otherwise lonely and dull existence exciting. He is the only one who visits The Claremont without immediately rushing out, feeling as if a terrible duty has been fulfilled.

When one of the older residents at The Claremont becomes incontinent, the management forces her to move. She dies quickly, alone in an understaffed nursing home. Mrs. Palfrey has another fall and winds up in the hospital. Ludo comes to see her; he spends more time with her than any of her family.

She dies.

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As a young woman, Fermina Daza kept a lengthy and passionate correspondence with Florentino Ariza, who was socially her inferior, but was desperately in love with her. They became engaged through their letters, exchanged through hiding places and telegrams in code.

But one day, when Fermina Daza comes close to Florentino Ariza in the market, she feels suddenly ill and tells him it was all a mistake. Instead, she marries Dr. Juvenal Urbino, a European-educated perfectionist, who falls in love with her on a medical visit. Their tumultuous but affectionate marriage lasts over fifty years, through a civil war, cholera outbreaks and the Doctor's brief affair with a patient. Juvenal Urbino distinguishes himself by instituting policies to combat cholera. He dies, falling from a tree as he attempts to catch his pet parrot.

Florentino Ariza comes to the wake. He is now about seventy and controls a wealthy shipping operation. After the other guests leave, he approaches Fermina Daza, saying, "I have waited for this opportunity for more than half a century, to repeat to you once again my vow of eternal fidelity and ever-lasting love."

She throws him out of the house, but continues to think of him. He becomes a regular visitor. Finally, they take a boat ride together, down the rivers that are being slowly drained and poisoned, listening for the cries of the manatees. They do not return, but prepare to sail on forever.

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Laurence "Tubby" Passmore is a successful scriptwriter for a television sitcom, in his mid-fifties, married and the father of two grown children. He is indecisive and inexplicably depressed, unhappy with himself, his fat body, bald head, wonky knee, and impending impotence. At least, he is confident in his marriage to Sally, an attractive, self-made academic who enjoys sex; on weekly jaunts to London, he maintains a supportive but platonic relationship with the earthy Amy.

Seeking to alleviate his woes, he dabbles in acupuncture and aromatherapy and regularly attends a blind physiotherapist and a woman psychiatrist; the latter counsels him to write a journal. His wife suddenly announces her wish for a divorce and the television network invokes a contractual obligation to make unwelcome demands on his skills. These events shatter his unappreciated but complacent "angst" and deepen his identity crisis.

Laurence scrambles to rediscover himself. He reads the gloomy, Kierkegaard--because he identified with the titles--and he travels to the existentialist's Copenhagen. He pushes the boundaries of his relationship with Amy in a maudlin trip to Tenerife. He befriends a philosophic squatter, called "Grahame" (with an "e" no doubt to distinguish him from Graham Green whose "writing is a form of therapy" is an epigraph to this book). He flies wildly off to Los Angeles hoping to rekindle a one-night stand "manqué." Finally he recalls and tracks the Irish Catholic, Maureen, his first girlfriend from forty years before. Maureen has suffered too--the death of her son and breast cancer; he finds her on the Road to Compostella.

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The narrator recalls a boyhood encounter with Rab, a majestic dog. Rab causes the lad to make friends with his master, James Noble, a simple horse-cart driver. Six years later, James brings his beautiful old wife, Ailie, to the hospital where the narrator is now a medical student. She has breast cancer and the surgeon tells her that it must be operated the following day. James and the dog are allowed to remain nearby.

Ailie endures the operation in brave silence, commanding silent respect from a lively group of students. James nurses her tenderly, but she develops a fever and dies a few days later. Shortly after her burial, he too falls ill and dies. Rab refuses to eat, becomes hostile, and is killed by the new driver.

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An intern in internal medicine is frustrated by his weekly clinics; he seems unable to understand why most of his patients come to see him, why they seem happy when they leave, and wonders when he is going to have the chance to do "real" medicine, such as ordering tests and making sophisticated diagnoses. One day, he sees an elderly woman who had been worked up over the years for "heart pain" without finding a diagnosis. In the past she had seen other residents for no discernible reasons.

At this visit, the author recognizes that she seems upset, encourages her to talk, realizes that she reminds him of his grandmother. The woman reluctantly admits she has fallen in love with a younger man. The resident is respectful towards her, and recognizes the beautiful woman she had once been. He begins to realize that she has experienced much that he hasn't, and that she has much to teach him about life and about being human.

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Goya has painted his own portrait as he was during an illness in his old age. The ailing artist sits upright in an olive-green dressing gown; his face is pale and is hands clutch at the sheet against which the carmine blanket glows as the most vivid color element in the painting. He is surrounded and supported by his physician who offers him medicine in a clear glass. The background is both dark and dense, revealing two shadowy figures behind Dr. Arrieta's elbow.

An inscription runs along the bottom border of the canvas, forming a kind of ledge or barrier. It reads in translation: "Goya thankful, to his friend Arrieta: for the skill and care with which he saved his life during his short and dangerous illness, endured at the end of 1819, at seventy-three years of age. He painted it in 1820."

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