In Chronic Progressive, a collection of 151 short poems divided into three parts, Marion Deutsche Cohen, a well spouse, continues her startlingly candid account of caring for her husband Jeff that began in her previous collection, Epsilon Country (1995, see annotation).  Part I of Chronic Progressive describes Cohen's frustrations during the last of the 16 years that she cared for Jeff at home, as multiple sclerosis left him almost completely dependent on her.  Mother of four, a prolific writer, a poet, and a mathematician, Cohen describes unrelenting stress when family services and insurance providers fail her, when she feels she must protect the sanctity of her home as health care aides and agencies treat it like a hospital or nursing home, or when she's exhausted, which is most of the time.  "It's a state, a / chronic state, a chronic progressive incurable state," she writes (55).

The middle section, the longest, follows Cohen during the ten years Jeff resides in Inglis House, a Philadelphia care facility.  These poems mix reflections on the past with working out the rhythms of life without Jeff in the house, but still unshakably on her mind.  In this section, she also writes "The Last Love Poem for Jeff" and anticipates his death in "A New Vow": "I will give you the best deathbed anyone ever had" (108).  In Part III, Cohen experiences relief and begins life with a new spouse after Jeff's death.  She recalls herself as ". . . the one he began with, the one he'll end with / the one who's been too much in the middle" (162).  But she quickly turns to "Wedding Preparations Former Well Spouse Style" and the "Love Poem for Her New Love."

Taken altogether, the poems reveal a profound effort to sustain vitality and remake ways of living-with integrity-at the edge of human endurance.  "Yes, how readily we reclaim our territories," Cohen observes near the end of her book (180).


Like Epsilon Country and Dirty Details: The Days and Nights of a Well Spouse (Cohen's 1999 narrative plea for reforms that address the conditions of families providing chronic care), the poems in Chronic Progressive can be difficult to read.  Cohen refuses to spare us any of the dirty physical details or her ambivalence or her anger about the level and duration of care she provides for Jeff.  But her refusal challenges readers to ask how much labor of care is too much.  Certainly, we recognize that caregiving responsibilities arise from special relationships, such as marriage.  Certainly, many people find deep satisfaction, despite their frustrations, performing familial caregiving.  But are responsibilities for such caregiving unconditional?  Who decides?  Cohen's poems give us the opportunity to view accurate descriptions of what the labor of care entails, physically and psychically, before answering those questions or speaking of the ethics of care.

Cohen makes the psychic effects of care available in form as well as content.  The poems have the immediacy of journal entries.  Several are precisely dated, as "Phone Call From the Hospital A La Molly Bloom," which inscribes the date of Jeff's death before an explosion of relief that's bound to unsettle many readers: "Yes / Yessie yessie yes. . . Yes! Under my breath. / Yes! Behind my back" (169-170).  The poems are brief, most with short lines, short stanzas, strings of monosyllabic words, and some unpredictable line breaks, all suggesting someone taking quick breaths.  Staccato rhythms, like a heartbeat, carry the words from the first to last lines.  There's also insistent, simple rhyming, as in children's verses, seeming like Cohen's attempts to create order in her universe from sound.

Most poems, located in an "incessant present," express the "emotional battering" and frustration that recall Arthur Frank's descriptions of the voice of chaos in The Wounded Storyteller (99,101), annotated in this database.  Yet, despite making the caregiver's vulnerability so readily available, Cohen's poems reveal her resisting that vulnerability with the arduous work of sustaining a self through her labors: parenting, writing, teaching, sustaining friendships, risking new intimacies, and railing against the universe.  Not everyone will agree with Cohen's ethical or poetic choices.  But her poems make valuable and necessary contributions to understanding significant consequences of medicine's ability to sustain us in states of chronic illness.


Plain View Press

Place Published

Austin, TX



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