I. The Experience of Illness

Fiction

Allison, Dorothy Bastard Out of Carolina Genre: Novel Source: New York: Penguin, 1993. Summary: A coming of age narrative with valuable insights into abusive, dysfunctional families. Commentary:

This disturbing and powerful novel tells of family, child abuse, rape, and poverty from the perspective of a suffering young girl who struggles to find the seeds of survival. (Betsy Hart, Maine)

back to top : you are here Bontemps, Arna "A Summer Tragedy" Genre: Short Story Source: Arna Bontemps, The Old South: "A Summer Tragedy" and Other Stories of the Thirties. New York: Dodd-Mead, 1973. Summary: An elderly black couple chooses suicide over old age without dignity. Commentary:

In this story, a poor, black, sharecropper couple agrees to kill themselves rather than burden one another. The discussion eventually focused on the real tragedy of the story: the situation created by inequality, oppression, exploitation, denial of opportunity. Paired with May Sarton's As We Are Now, Doris Grumbach's "Coming Into The End Zone" and "What It's Really Like to Grow Old," Phillip Larkin's "The Old Fools," and Grace Paley's "Questions" and "My Father at 89." (Margery Irvine, Maine)

back to top : you are here Boyle, T. Coraghessan The Road to Wellville Genre: Novel Source: New York: Penguin, 1994. Commentary:

This book is loosely based on the life of John Harvey Kellogg, known for the cereal and for his health spa. The description of him seems to follow his life pretty accurately, but there are obvious embellishments around the margins. I chose this book on the advice of a colleague and circulated reviews. I hadn't read it ahead of time and wish I had! It is not well written, and it is slow going. There are some interesting points in it (and some funny parts) but I didn't find it to be a very good way to talk about alternative health care. We did have some reasonable discussion about what Kellogg's son George represents (dark/light, father/son, etc.). And we had a productive discussion about how to support people around us making choices that we worry about or that don't make sense to us. People were disappointed with this book (including me). (Susan Bell, Maine)

back to top : you are here Canin, Ethan "We Are Nighttime Travelers" Genre: Short Story Source: Ethan Canin, Emperor of the Air. New York: Harper, 1989. Summary: A story about an aging married couple. It raises issues concerning aging, dementia, relationships, illness, how live a meaningful life, and how to approach a story told by an unreliable narrator/patient. Commentary:

A beautifully written story about an elderly couple's marriage. Most of the discussion focused on the literary merits (considerable) of the story and the picture it presents of aging people and their relationships. (Margery Irvine, Maine)

A short story about love lost and regained as a man ages. Some saw it as a wonderful love story, others as this man's lost opportunity. (Allison Hepler, Maine)

back to top : you are here Carr, Pat "Sunday Morning" Genre: Short Story Source: Pat Carr, The Woman in the Mirror. Iowa City: University of Iowa Press, 1977. Summary: A brief story about the birthing experience from the point of view of a delivering woman. Commentary:

This was paired with Tolstoy's The Death of Ivan Illych in a session about life cycles. The discussion focused almost completely on the Tolstoy novella and the implications and experiences of death, about which our group had much to say. The primary value of both pieces was that they gave an intimate sense of what it is like to be the person undergoing the experience. (Kathy Ashley, Maine)

back to top : you are here Cather, Willa "Paul's Case" Genre: Short Story Source: Willa Cather, The Troll Garden and Selected Stories. Lincoln: University of Nebraska Press, 1983 (originally published in 1905). Summary: A short story about a young gay high school student who has an abusive father. The boy is enchanted with opera, and is miserable and misunderstood at school. He steals a large sum of money, takes a train to a big city where he fulfills some of his wildest dreams (living luxuriously in a fancy hotel for a few days), and then commits suicide. Commentary:

Although it was written in the early part of the twentieth century, Paul's despair is one that continues to resonate among many adolescents, making this a particularly moving and applicable story even today. Participants generally liked this reading, especially the evocative language in it. One said that she thought there wasn't one unnecessary word in it. Cather beautifully captures a sense of adolescent recklessness and quest for identity in the face of schools' attempts to impose bureaucratic order. Some participants missed the references to gay sexual identity; some focused on the meaning of the word "case" and drew connections to psychiatry. (Susan Bell, Maine)

back to top : you are here Chekhov, Anton "Misery" Genre: Short Story Source: Anton Chekhov, The Lady with the Dog and Other Stories. New York: Ecco, 1984. Summary: A short story about a father's search for someone to listen to his grief. Commentary:

This story did not generate a lot of discussion. (Betsy Hart, Maine)

This story elicited discussion of hospice care and the need of the families of those who are dying to have resources for dealing with their grief, as well as thoughts about how poorly we deal with death and dying in our culture and how difficult death is to discuss. (Muriel Fish, Maine)

back to top : you are here Cunningham, Michael The Hours Genre: Novel Source: New York: Farrar, Straus & Giroux, 1998. Summary: A novel based on Virginia Woolf's Mrs. Dalloway, told in alternating episodes of the main characters' lives in the present, interspersed with tales from the past. Consider pairing with Mrs. Dalloway (New York: Harvest Books, 1990; originally published in 1925), the classic novel that explores relationships, painful images of the past bleeding into the present, and future filled with lost desires and compromises. Commentary:

Cunningham's novel follows the interweaving lives of three characters: Clarissa Dalloway and her friend Richard who has AIDS; Mrs. Brown, whose life we follow beginning in the 1950s; and Virginia Woolf. It provoked discussion about depression, suicide, HIV, and minority sexualities. Participants found the non-linear prose challenging and the content disturbing. (Eve Raimon, Maine)

back to top : you are here Defoe, Daniel A Journal of the Plague Year Genre: Novel Source: New York: Penguin, 1966 (originally published in 1722). Summary: One of the earliest novels written in English, Defoe describes the range of public reactions to the 1664-65 epidemic of the plague in London, including public health measures, the efforts of quacks to offer hope and remedies to the public, efforts to escape in spite of the dangers doing so might bring to people in outlying areas, and the return to old patterns of daily life once the epidemic was over. Commentary:

While some participants found reading this book somewhat challenging and took me up on the suggestion to skip selected pages, most read the entire book. They used it to talk about the meaning of epidemics and the reactions of public health and government officials to them, the consequences of individuals' efforts to protect themselves, the notion of illness as retribution, and the tension between individual liberty and public responsibility. They questioned whether we have made progress today, since the questions surrounding SARS, AIDS, influenza, and other diseases today are so similar to those Defoe considered. (Marli Weiner, Maine)

back to top : you are here Doerr, Harriet Stones for Ibarra Genre: Novel Source: New York: Penguin, 1984. Summary: A married Californian couple move to Mexico, where the husband learns of his diagnosis of leukemia. His wife is in the process of documenting the traditional oral stories of the people of Ibarra, and weaves the native stories together with more contemporary visions of her husband's life and death. Commentary:

Beautifully written short novel about experience of death from a variety of perspectives, including cross-cultural.

back to top : you are here Edson, Margaret W;t Genre: Play Source: New York: Faber & Faber, 1999 (now easily found on VHS and DVD). Summary: A Pulitzer Prize winning play about a Donne scholar's encounter with her own death; a quite scathing portrayal of "experts", both doctors and scholars. Pair with Donne's Devotions Upon Emergent Occasions (Sonnets V and VI) and "Death Be Not Proud." Commentary:

Although there was some complaint that the doctors were being caricatured, there was also acknowledgement of Edson's deadly accuracy in portraying the linguistic absurdities and obfuscations in the medical situation. The play dramatized the crucial role of the nurse-caregiver, whose ethos differed from that of the research doctors, and — as in Tolstoy's Death of Ivan Illych and Tillie Olsen's stories-it portrayed the process of dying as one of potential moral insight. Part of a session on "Ethics and Meaning," Edson, Donne, and Robert Coles' "Medical Ethics and Living a Life" were grouped together. (Kathy Ashley, Maine)

Raises the issues of how far medicine can and should go to treat an illness, how focused on "cure" physicians can become, and how a patient fares when her humanness is forgotten. We read this play aloud (I assigned parts as we went along, giving everyone the chance to participate); participants responded to the artfulness of the work and to the honestly drawn content. (Elizabeth Cooke, Maine)

This slight, but marvelous rendition of the dramatic interactions between a Donne scholar dying of ovarian cancer and the various medical professionals who attend to her is a must for Literature & Medicine seminars. We talked about the written play after seeing a live performance of the play, and after several members of the group had seen the special on HBO [now easily found on video and DVD]. The opportunity to compare the written text, and our imaginings of it, to actual performances was wonderful. We had a lively and informed discussion, including some talk about Donne and the Holy Sonnets — and what poetry tells you. Very highly recommended for all groups! (Sydney Landon Plum, Maine)

W;t explores the relationship between an English professor dying of cancer and the doctors who treat her with an experimental protocol. Some participants objected to the way the play stereotyped both doctors and patients, turning them into caricatures and presenting them as dehumanized intellectuals and scientists. We used it to explore the question of what draws doctors to medicine (and by extension, people to other aspects of medical care, since the only caring character is a female nurse). They also talked about pain, about listening, about mistakes, about what gives a life meaning. I also gave participants a Donne poem examined in the text and some of his meditations; a few members of the group read more on their own. One volunteered to read the poem aloud, which we all found surprisingly moving. (Marli Weiner, Maine)

back to top : you are here Finger, Anne "Like the Hully Gully But Not So Slow" Genre: Short Story Source: Despite This Flesh: The Disabled in Stories and Poems. Ed. Vassar Miller. Austin: University of Texas Press, 1985. Summary/Commentary: This is a short story about a very smart eleven-year-old girl who uses canes and wears a brace to move around. Her father has a chronic mental illness. The story records her experiences of being different and of coping with her father's "moods." People in the group loved the portrayal of the girl, especially a letter she writes to an advice column. (Susan Bell, Maine) back to top : you are here Gilman, Charlotte Perkins "The Yellow Wall-Paper" Genre: Short Story Source: New York: Bantam, 1989 (originally published in 1892). Summary: A famous early feminist story about a woman suffering from an unnamed "nervous ailment" after the birth of her child. Her physician-husband brings her to rest at a country house; however, her "rest" includes an increased narrowing of her world, as she is told to give up all intellectual activity (including writing) and is eventually confined to her bedroom. She begins to see women confined within the yellow wallpaper of her room, mirroring her own confinement, as she has an emotional breakdown. A classic piece on the treatment of women by the medical profession at the turn of the twentieth century. back to top : you are here Haslett, Adam You are Not a Stranger Here Genre: Short stories Source: New York: Doubleday, 2002. Summary: A collection of stories, many of which deal with mental illness, particularly depression, and with the nature of families. Several of the stories also address homosexuality. Commentary:

Participants used these stories to talk about relationships between caregivers and patients (one referred to caregivers' need for patients to need them), the powers wielded by those who are ill, and the consequences of choosing not to be treated, especially for mental illness. (Marli Weiner, Maine)

back to top : you are here back to top : you are here Kafka, Franz The Metamorphosis and Other Stories Genre: Short Stories Source: New York: Dover, 1996. Summary: "The Metamorphosis" is Kafka's classic short novel about a man who wakes up one morning to find that he has been transformed into a giant insect. The story describes his family's increasing revulsion as his situation becomes ever more disgusting to them as well as to him. "A Hunger Artist" is an existentialist story in which a hunger artist attempts to revive the public's lagging interest in fasting and sells himself as a circus act, only to realize shortly before his death that his interest in fasting was only due to the fact that he had never found the kinds of foods that he liked, and therefore, his fasting was not honorable. Commentary:

Prompts discussion of the ways in which illness can transform, disfigure, and isolate a person. (Susan Bell, Maine)

Although some participants had difficulty with Kafka's writing, for the most part they understood this book as a parable. They used it to talk about the consequences of disfigurement, about the ways in which families' reactions to illness change as it stretches on past the limits of their willingness to accommodate it, and about experiences that might be worse than death. (Marli Weiner, Maine)

back to top : you are here King, Stephen "The Reach" Genre: Short Story Source: Stephen King, Skeleton Crew. New York: Signet, 1996. Summary: A short story about an old woman who travels over the frozen reach from the Maine island that she has never left to go to the mainland before she dies. She is accompanied on this journey by ghosts from her past. back to top : you are here back to top : you are here back to top : you are here McNally, Terence A Perfect Ganesh Genre: Play Source: New York: Dramatist's Play Service, January 1994. Summary: Two middle-aged women travel to India after one woman's son dies. Commentary:

Chosen because the play was being performed by a local theater company, this play proved to be one of the strongest readings of our season. The topic of the loss of children and its effect upon the family and community — and the difficulty of recovering-was especially timely for our group. While not presenting a medical situation per se, this marvelous, engaging play (the women are wonderfully drawn) highlights the feelings of helplessness felt by most medical professionals. Highly recommended. (Sydney Landon Plum, Maine)

back to top : you are here Minot, Susan Evening Genre: Novel Source: New York: Knopf, 1998. Summary: A woman on her deathbed from cancer mentally returns to a weekend 40 years prior and re-experiences through her daydreams meeting and then losing the love of her life, a young doctor named Harris Arden. back to top : you are here McFarland, Dennis The Singing Boy Genre: Novel Source: New York: Henry Holt, 2000. Summary: A mystery of sorts, which begins with the random shooting of a husband on a rainy Boston street, witnessed by his wife and eight-year-old son. The novel follows them from the scene of the murder to the emergency room in a Cambridge hospital, then to their home in the Boston area, and finally to their summer cottage on Cape Cod. Aside from the relationship between the mother and son, a central character in the book is the man's best friend, a black Vietnam vet who suffers from PTSD and works as an orderly in a hospital. The book ends on a hopeful note, as each of the individuals begins to come to terms with the loss. Commentary:

Even before the meeting to talk about this book, word was out about it. Participants couldn't put it down. (Susan Bell, Maine)

back to top : you are here back to top : you are here Moran, Thomas The World I Made For Her Genre: Novel Source: New York: Riverhead Books, 1999. Summary: A young man, totally paralyzed by his body's response to a case of chicken pox, is completely at the mercy of his nurses in the intensive care ward of a New York City hospital. As he has few friends (and those he has are uncomfortable with him), his relationships with the nurses who care for him become his link to life and a means for him to reflect on how he has lived his life. Infatuated with one of the nurses, he creates her life outside the hospital in his mind. Commentary:

Everybody agreed that the portrait of nursing, "warts and all," was accurate, and the various portraits struck a chord with each of the members of the group. The dramatic situation provides a panoply of medical problems-extreme resistance, recovery from paralysis-for consideration. Bring tissues for laughter and tears. My highest recommendation. (Sydney Landon Plum, Maine)

back to top : you are here Olsen, Tillie Tell Me a Riddle Genre: Short Stories Source: New York: Dell, 1961. Summary: The title story in the collection evokes the difficult ending of a woman's life after a long and combative marriage and demanding care of several children. "I Stand Here Ironing" powerfully raises issues about the difficulties of being a poor single parent. Commentary:

"I Stand Here Ironing" - The financial, emotional and social pressure on patients, not always apparent to caregivers, emerged naturally in discussion. Paired with "The Nurse's Story" by Peter Baida. (Ruth Nadelhaft, Maine)

"Tell Me a Riddle" - A stylistic tour de force about the life and death of a Russian immigrant woman. Especially effective in evoking the complex female experiences of nurturing and motherhood which had submerged the youthful revolutionary ideals of the central character. Without detracting from the integrity of the dying woman, the narrative also represents family dynamics with penetrating accuracy. (Kathy Ashley, Maine)

"Tell Me a Riddle" - The story led us to talk about marriage and what constitutes a "good" marriage, how families "work" and how this family's dynamics influenced their responses to and treatment of the woman who is dying, as well as her reflections on her position in the family. The story is beautifully written and provided a strong introduction to the first meeting of the seminar. (Susan Bell, Maine)

back to top : you are here O'Neill, Eugene Long Day's Journey into Night Genre: Play Source: New Haven: Yale University Press, 1989 (originally published in 1955). Summary: O'Neill's harrowing play about an alcoholic actor father, a drug-addicted mother, and their adult alcoholic sons, one of whom has tuberculosis. The play is a thinly disguised autobiographical account of O'Neill's experiences in his own Irish family. Commentary:

Participants used this play to discuss co-dependency and other dynamics within families, such as secrecy, denial, and loss. They also used it to think about alcoholism and other forms of addiction and how difficult these are for families and medical care providers to confront. One said that the play made her aware how often she does not deal with addiction with her patients because it is so much easier not to do so. (Marli Weiner, Maine)

back to top : you are here Paley, Grace "A Man Told Me The Story of His Life" Genre: Short Story Source: Grace Paley, Later the Same Day. New York: Farrar, Straus & Giroux, 1985. Summary: In this very short piece, a man who was discouraged from becoming a doctor recalls a moment when his knowledge and research helped him tell the doctor what was wrong with his wife, saving her life. back to top : you are here Porter, Katherine Anne Pale Horse, Pale Rider Genre: Novella Source: Pale Horse, Pale Rider (Three Novellas by Katharine Anne Porter). Orlando: Harcourt Brace Jovanavich, 1990 (originally published in 1939). Summary: A beautifully written, semi-autobiographical novella set during the influenza epidemic of 1918-1919 at the end of World War I. The story is told by a young woman reporter who finds herself surrounded by (and becoming numb to) illness and death; funerals for victims of influenza and fallen soldiers from the war are on every street corner, and hospitals are overwhelmed with patients. She herself becomes gravely ill, and as this happens, the narrative takes on a feverish, dreamlike quality. Pair with Ellen Bryant Voigt's collection of poems dealing with the pandemic, Kyrie. Commentary:

Most of the participants loved this reading. One said it was the most beautiful piece of writing she'd read in years. The ending was a surprise to most, who expected that Miranda would be the one to die. We talked about the tragedy of early death, the loss of so much youth and promise, and compared the 1918 flu to the contemporary HIV/AIDS crisis. The discussion also touched on the consequences for medical care when it is both overloaded and unable to heal the sick. This discussion moved back and forth in time as well as between the text and the participants' experiences (one or two of the individuals in the group told family stories about the 1918 epidemic). (Susan Bell, Maine)

We found the narrator's situation ironic, in that she in a way causes her lover's death, by infecting him. We also focused on the issue of survivor's guilt, but spent more time talking about the difficulties of reading the story, because of the handling of point of view. (Michael Burke, Maine)

back to top : you are here Potok, Chaim The Chosen Genre: Novel Source: New York: Fawcett Crest, 1967. Summary: The story of two Jewish boys-one Hasidic, one Orthodox — and their fathers in Brooklyn, New York in the 1940s, their conflicts with one another as tales of the Holocaust begin to be uncovered, and the two boys' movement into adulthood while clashing with their fathers about the religious paths they are about to pursue. The novel includes some early chapters dealing with an eye injury to one of the boys and his surgery and hospitalization. Commentary:

Literature & Medicine groups, including my own, respond very powerfully and positively to issues of diversity and conflicts of culture in The Spirit Catches You and You Fall Down. However, there is a great deal more diversity even within our groups than is readily apparent. The Chosen not only brings such issues to light, illuminating deep divisions within a religious culture ordinarily thought to be homogenized, but it also provides an absorbing story of the deliberate development of empathy in a brilliant but emotionally detached child. (Ruth Nadelhaft, Maine)

back to top : you are here Querry, Ronald Bad Medicine Genre: Novel Source: New York: Bantam, 1998. Summary: This novel is based on an actual hantavirus outbreak that took place in the Southwestern U.S. in 1993. It retells the events as medical mystery, as ghost story, and as meditation on the relationship between rationalist Western medicine and the beliefs of indigenous cultures. Commentary:

This book raised some good questions for the group: How do cultural differences shape perspectives on healing? What is the relationship between Western and Native American perspectives on healing? Can the multiple origins of disease include the spiritual, as well as the ecological, social, historical and biological? (Lisa Walker, Maine)

back to top : you are here Quindlen, Anna Black and Blue Genre: Novel Source: New York: Random House, 2000. Summary: A young mother escapes an abusive marriage and begins a new life in Florida. Although she is haunted by the fear that her ex-husband will find her, she eventually begins to regain her confidence and get her life back. Commentary:

Some participants did not find the novel "literary" enough, but all agreed it was an excellent account of living with domestic abuse and the deleterious effects it has on families. Issues and challenges of dealing with patients who continue to live in domestic violence situations despite the resources available to them dominated the discussion. (Muriel Fish, Maine)

back to top : you are here Salzman, Mark Lying Awake Genre: Novel Source: New York: Vintage, 2001. Summary: A novel about a contemplative nun whose crisis of faith leads to visions that inspire her to write powerful poetry, but who discovers that these visions are likely the result of a brain tumor that is easily cured by surgery. See also: Salon.com online interview with Salzman, Jan. 10, 2001. Commentary:

Raised powerful questions about spirituality, the brain, community, and faith; good discussion that was of particular interest in a Catholic hospital. Paired well with Lisel Mueller's poem, "Monet Refuses the Operation." (Betsy Hart, Maine)

This book raised many issues: What is disease? What is the nature of spirituality? Is a cure always preferable to an illness? Participants especially admired the quality of the writing of this short novel, as well as Salzman's sympathetic portrait of a religious woman-without any hint of postmodern irony. What worked particularly well in the discussion was the issue of how Salzman came to write the book, a process that took many years. He finally was able to finish it when he acknowledged the similarity between himself and his subject: both, he felt, persisted because they had faith-irrational and illogical though its foundations were. We talked at some length about how all of us need that faith in what we're doing. I suggest that facilitators who use the book read some of Salzman's interviews and the profile of him in The New Yorker, Vol. 76, Issue 29 (Oct. 2, 2000), p. 74. (Margery Irvine, Maine)

The book raised these questions: Is there a balance between reality and illusion, the spiritual and the material, faith and self-interest? What are the parallels between the religious life and the culture of medicine? When cure and loss are a patient's only alternatives, on what does she base her decisions? (Lisa Walker, Maine)

back to top : you are here Sarton, May As We Are Now Genre: Novel Source: New York: Norton, 1982. Summary/Commentary: In this short novel, an elderly woman is a consigned to a (very bad) nursing home by her relatives. Periods of despair, depression, and deteriorating physical and mental condition lead her to burn down the nursing home, thereby killing herself and the occupants. One of the participants voiced the most important issue raised by the book: What is it like to grow old in America? Much of the session's discussion focused on that question and the concomitant questions of nursing home care, funding for the aged, and finally, suicide and euthanasia. Although the participants criticized the book for its melodrama and over-simplification, they also felt that Sarton had accurately represented the feelings of many old people. Fortunately, our group included one woman in her late seventies, who was able to talk honestly and intimately about her own experience of growing old in America. Paired with: Arna Bontemps, "A Summer Tragedy;" Doris Grumbach, "Coming Into the End Zone" and "What It's Really Like to Grow Old;" Phillip Larkin, "The Old Fools;" Grace Paley, "Questions" and "My Father at 89." (Margery Irvine, Maine) back to top : you are here back to top : you are here Shakespeare, William Hamlet Genre: Play Source: New York: Dover Publications, 1992. Summary/Commentary: Shakespeare's classic tragedy about a prince who sets out to avenge his father's death. Hamlet evokes questions about what constitutes ethical behavior, and how much one should listen to the ghosts of one's mind, particularly when dealing with issues of mental illness. (Ruth Nadelhaft, Maine) back to top : you are here Shakespeare, William King Lear Genre: Play Source: New York: Washington Square Press, 1993. Summary: The aging Lear decides to divide his kingdom among his daughters, basing his decision on their demonstration of love for him. In doing so, he forsakes the daughter who loves him most. Later, finding himself powerless, disrespected, and at the mercy of his daughters, he goes mad as he realizes his foolishness. Commentary:

The play is enormously rich in its portrayal of age and family dynamics. It illuminates the possibility for personal transformation at any stage of life as well as the depth of understanding leading into and even out of madness and depression. The group was elevated by reading and discussing Shakespeare; they welcomed the challenge and the stunning language. Interestingly, the discussion also allowed the group members to consider their own family dynamics in a literary context. (Ruth Nadelhaft, Maine)

back to top : you are here Silko, Leslie Marmon Ceremony Genre: Novel Source: New York: Penguin, 1977. Summary: Ceremony is Silko's portrayal of Tayo, an emotionally wounded Native American soldier just back from fighting in World War II. Tayo makes his way home from the VA hospital where he is treated as insubstantial and where his Native American heritage is considered dangerous superstition. In response to his treatment, he begins to experience himself as existing somewhere between worlds in the form of a "white smoke," and eventually searches for something to heal what is damaged inside him. By his grandmother's arrangement, Tayo eventually submits to ritual healing. The ceremonial journey draws upon the power of the heritage and ancestry he and his Native American peers challenged when fighting the suspect war. Commentary:

Ceremony is an effective work. Readers came away from the ritual as exhausted as Tayo. Significantly, some found it hard to see the journey through to its conclusion. Those who did were duly rewarded. Silko deals interestingly with most of the predictable issues-race relations, governmental responsibility, mainstream versus traditional medicine. We paired Ceremony with Ernest Hemingway's "Indian Camp," which helped illustrate the idea that involvement with another culture sometimes leads to philosophical uncertainty. (John Zavodny, Maine)

back to top : you are here back to top : you are here Strauss, David Chang and Eng Genre: Novel Source: New York: Dutton, 2000. Summary: A novel about the lives of the nineteenth-century's most famous conjoined twins, who were born in Thailand, brought to the United States, and exhibited to the public, narrated by one of the brothers. Later they married sisters in North Carolina and became prosperous farmers and the fathers of numerous children. Commentary:

Participants found this story bizarre, yet compelling. Discussion centered around how much of the story was true, particularly when I shared with them details from Irving Wallace and Amy Wallace, The Two: A Biography (New York: Simon and Schuster, 1978), which is a conventional biography. They were particularly interested in the personalities of the two men and wondered whether Eng, the narrator, would have been just as unhappy with his life had they been able to be separated. (Marli Weiner, Maine)

back to top : you are here Tolstoy, Leo Death of Ivan Illych Genre: Novella Source: New York: Signet Classic, 2003 Summary: The story of the death of a man, Ivan Illyich, who has not lived well, and how he comes to term with his own death. Commentary:

Great discussion flowed out of this. People didn't like Ivan, but did admire and understand how he finally reconciled at the end, and they found this had a great deal of relevance for them, in terms of how they saw end of life care unfold around them. (Michael Burke, Maine)

back to top : you are here Updike, John "At War With My Skin" Genre: Short Story Source: John Updike, The Journal of a Leper. New York: Knopf, 1976. Summary: "At War With My Skin" is based on Updike's own chronic, serious skin disease. A potter, suffering from psoriasis, goes from having bad self-esteem due to his skin condition, but a successful career and love life, to clearing his skin with a dermatologist but losing both his career and his girlfriend. Commentary:

Part of a session on "Life Cycles," paired with Tillie Olsen, "Tell Me a Riddle," and Mary Oliver, "University Hospital, Boston." The three selections were the most eclectic of all those I chose. I'd recommend pairing the Olsen and Oliver and asking folks in the seminar also to read the other short stories in Olsen that also directly address the topic of "life cycles." Updike is powerful but didn't fit well with the Oliver and the Olsen.

back to top : you are here Winterson, Jeanette Written on the Body Genre: Novel Source: New York: Vintage Books, 1994. Summary: A philosophical love story about a woman diagnosed with cancer, her physician husband, and her affair with the narrator, who is given neither name nor gender. Commentary:

This novel provoked intense discussion, as participants found themselves quite disturbed by the author's refusal to identify the narrator's sex. Some were adamant that the narrator was a woman, while others were equally adamant that the narrator was a man. The reasons offered by both sides revealed a good deal to all of them about gender assumptions; they found their own reactions to having this most basic aspect of identity omitted quite destabilizing. Because the husband also offers the most up-to-date treatment for the woman's cancer, the novel also allowed participants to consider what constitutes the best care for illness and who should make decisions about that care. Participants were unanimous in concluding that quality of life mattered more than length, in spite of their sense of their obligations as professionals. (Marli Weiner, Maine)

This novel can be used for discussions of love and loss together with sexual difference. Its unorthodox narrative form presents a challenge to readers, but many participants could appreciate the lyrical prose. (Eve Raimon, Maine)

back to top : you are here Williams, Tennessee Suddenly Last Summer Genre: Play Source: New York: New American Library, 1958. Summary: A young woman who has seen the violent death of her cousin is placed in an insane asylum by her family because she cannot hold what she saw inside her. Her aunt, the deceased's mother, wishes for her niece to have a lobotomy. The play deals with issues of violence and sexual exploitation, as well as questions of what constitutes sanity.

Poetry

back to top : you are here Angelou, Maya "The Last Decision" Source: Maya Angelou, Shaker, Why Don't You Sing? New York: Random House, 1983. Summary/Commentary: A poem about a woman who chooses to make her own decisions as she approaches death. This poem didn't generate much discussion; a lot of time was spent on William Carlos Williams' poem "Birth," and the two short stories ( William Carlos Williams' "The Use of Force" and Doris Grumbach's "Coming Into the End Zone") with which it was paired. It might be better to use in a discussion focused solely on issues of death and dying. (Muriel Fish, Maine) back to top : you are here Auden, W.H. Selected Poetry of W.H. Auden Source: New York: Vintage, 1958. Summary: Includes "Funeral Blues," "Musee des Beaux Arts," "Letter to a Wound," and "Surgical War." The poems explore death, mourning, and the isolation experienced by the sick. back to top : you are here Brooks, Gwendolyn "The Bean Eaters" Source: Gwendolyn Brooks, Blacks. Chicago: Third World Press, 1991. Summary/Commentary: Aged couple in reduced circumstances have only each other, their memories, and-ambiguously-"fringes" to occupy their time. Brooks celebrates the passing of a street character with wit and humanity, in a rich rhythmic tradition. (Karin Dillman, Maine)

"The Bean Eaters" was paired with Pablo Neruda, "Larynx;" Josephine Miles, "The Doctor Who Sits at the Bedside of a Rat" and "Sheep;" Dylan Thomas, "Do Not Go Gentle into That Good Night;" Sharon Olds, "Miscarriage;" and Philip Larkin, "Faith Healing." All of these poems went over fairly well, but the truly outstanding discussions centered on "Miscarriage" and "Faith Healing." We discussed the poems in one long evening, our last session. Saving poetry for last was my choice, and I'm glad I did-people were better readers by then, and even those who thought that they weren't "good at" poetry did understand and enjoy it on the whole. (Allison Wallace, Maine)

back to top : you are here back to top : you are here Carver, Raymond "Gravy" Source: Raymond Carver, All Of Us: The Collected Poems. New York: Knopf, 1998. Summary/Commentary: The poet expresses his gratitude for ten years of life and love that he hadn't expected. Generated reflection on what people are grateful for in their lives and what makes life worthwhile, as well as discussion of alcoholism and sobriety. (Betsy Hart, Maine) back to top : you are here Carver, Raymond A New Path to the Waterfall Source: New York: Atlantic Monthly Press, 1990. Summary/Commentary: This collection includes the poems, "Late Fragment," "Letter," and "What the Doctor Said." "Late Fragment" is an extremely short, yet powerful and moving tribute to existence. "What the Doctor Said" describes a brief encounter in which the poet learns of his diagnosis of lung cancer, and evokes the mysteries of the human spirit facing mortality and the bewildering limitations of words. (Betsy Hart, Maine) back to top : you are here Ciardi, John "Washing Your Feet" Source: John Ciardi, Collected Poems. Fayetteville: University of Arkansas Press, 1984. Summary: The difficulty even a simple task may pose under conditions of obesity (or illness or disability). The poet invokes the images of ritual involved in foot washing, including the ballet dancers of Degas. back to top : you are here Cowper, William "The Cast-Away" Source: The Poems of William Cowper, Volume II: 1782-1785. Oxford: Clarendon Press, 2000. Summary/Commentary: This remarkable poem uses the image of a drowning man as a metaphorical exploration of suicidal depression. Cowper was deeply depressed all his adult life. Evangelical Christianity and supportive friends enabled Cowper not only to live with deep depression but also to write poetry and hymns for years. "The "Cast-Away" is a gripping account of his mental anguish immediately recognizable even in the age of anti-depressants. (Ruth Nadelhaft, Maine) back to top : you are here cummings, e. e "When God Lets My Body Be" Source: e.e. cummings, Complete Poems. New York: Liveright, 1994. Summary: A beautiful short poem about the immortality of the body in nature, even after death. Invokes images of death not as finality, but as a springboard for new life and regeneration. back to top : you are here back to top : you are here Dickinson, Emily Selected Poems Source: Boston: Little, Brown & Co., 1976. Summary: This volume includes "Because I Could Not Stop for Death," "Death is like the Insect," "The heart asks pleasure first," "I felt a cleavage in my mind," "I felt a funeral in my brain," "I heard a fly buzz when I died," "Just lost when I was saved," "Much madness is divinest sense," "My life closed twice," "Pain has an element of blank." Commentary:

"Because I Could Not Stop for Death" is a characterization of death as a gentleman escorting a lady rather than the classic fearful figure with black cloak and scythe. There is a courtliness here in the interaction between the two, and Dickinson's precise use of language complements Donne's. I used this with John Donne's "Death Be Not Proud" and Margaret Edson's W;t as another aspect of the way death has been viewed over the centuries. (Ann Fogg, Maine)

back to top : you are here Donne, John Devotions Upon Emergent Occasions Source: Montreal: McGill-Queen's University Press, 1975. Summary: Donne's classic work, which consists of 23 devotions of meditation and prayer exploring his experience of typhus. Donne explores the connection between the spiritual and physical implications of his illness, including the role of sin in physical illness. Commentary:

Sonnets V and VI - The early English was somewhat of a challenge to the participants, many of whom could not figure out what Donne was saying; however, when it was put into contemporary English the relevance was clear. Paired with the Margaret Edson play W;t. (Kathy Ashley, Maine)

back to top : you are here Donne, John "Death Be Not Proud" Source: Metaphysical Lyrics & Poems of the 17th Century. Ed. J.C. Herbert Grierson. Oxford: Clarendon Press, 1921. Summary/Commentary: This Holy Sonnet is Donne's classic ode to the eternal life of the spirit and the spirit's ability to "cheat" death by never succumbing to it. In it, Donne wittily reduces Death from the famous macabre equalizer to a pitifully ineffective creature. He argues with Death like the law student he once was. (At great pressure from King James I, he finally renounced his Catholic faith and became an Anglican priest, eventually Dean of St. Paul's Cathedral.) Combined with Margaret Edson's play, W;t, discussion of the poem centered on its punctuation, an issue raised in the play. One member of the group made the interesting contribution that her husband, a Donne scholar, says the semi-colon was not used in Donne's time. This work framed much of our discussion about illness for the next sessions; Donne's words were referred to frequently thereafter. We read "Death Be Not Proud" aloud numerous times, until Donne's words became ours, his meaning, ours. Discussion focused on modern medicine's approach to death. A profound experience. (Elizabeth Cooke, Maine) back to top : you are here Doty, Mark "Tiara" Source: Turtle, Swan & Bethlehem in Broad Daylight: Two Volumes of Poetry. Urbana: University of Illinois Press, 2000. Summary: A poem about a man dying from AIDS complications and risk-taking as the only way to live life fully. back to top : you are here Frazer, Vernon "What Am I?" Source: East Hartford, CT: Vernon Frazer, 1998. Available online at www.ddonin.com/Dammed.htm. Summary/Commentary: Poetic ruminations on illness, hypochondria, and the link between the behaviors of humans and animals. (Robert Schaible, Maine) back to top : you are here back to top : you are here Harper, Michael S. "Nightmare Begins Responsibility" Source: Every Shut Eye Ain't Asleep. Ed. Michael S. Harper & Anthony Walton. New York: Little, Brown & Co., 1994. Summary: An African American father watches his seriously ill newborn treated in the all-white hospital. Commentary:

Fears based on experiences and cultural memories of treatment of blacks by whites haunt the father in the poem. The care of the attending physician makes him see that experience and knowledge of history can harden into stereotype and cause unnecessary fear. (Karin Dillman, Maine)

back to top : you are here back to top : you are here Hoagland, Tony "Lucky" Source: Tony Hoagland, The Donkey Gospel. St. Paul: Graywolf, 1998. Summary/Commentary: The interchange between a son and his ailing mother. The roles of parent and child are reversed here, with the son bathing, feeding, and carrying his mother. However, the son sees this caretaking not simply as his responsibility to his mother, but as winning the final battle in a power struggle that has come between them. I recommend Tony Hoagland's "Lucky" for anyone interested in exploring power relationships in caregiver/patient interchange. (Peter Harris, Maine) back to top : you are here Howe, Marie "The Last Time" Source: Marie Howe, What the Living Do. New York: W.W. Norton & Co., 1998. Commentary:

A quietly powerful poem describing the last conversation the speaker has with her dying brother. This poem calls into question our fear of the dying, and suggests that it is really the lack of acceptance of our own inevitable deaths that frightens us. (Lizz Sinclair, Maine)

back to top : you are here Stephen Mitchell, Trans. The Book of Job Source: New York: HarperCollins, 1979. Summary/Commentary: Mitchell's translation of The Book of Job is both accessible and beautiful, making full use of the vivid and powerful imagery of the original. His introduction provides historical context as well as philosophical lucidity. Job is one of the earliest texts in Western culture to deal with the issue of suffering. Too often, people think they know what the book has to say and they assume that it counsels patience and religious practice in the face of acute pain and suffering. In fact, The Book of Job provides a number of responses, chief among them Job's defiance and insistence upon a direct hearing from God. Reading and discussing some of the great texts in our culture may be intimidating, but participants enjoy working with important literature and discovering its freshness and relevance. (Ruth Nadelhaft, Maine)

A beautiful translation of Job's struggle to understand why God has caused him to suffer, first the loss of his family and property and then bodily. Job, a righteous man, must endure his friends' efforts to convince him that he has sinned; he only comes to terms with his suffering when he encounters what Mitchell terms the Whirlwind. Paired with Barbara Ehrenreich, "Welcome to Cancerland." While some participants had difficulty reading the Bible as a literary text rather than as the word of God, all appreciated the beauty of Mitchell's translation. Participants found this a profound statement of the impossibility of understanding the meaning of suffering. With the Ehrenreich, the book allowed them to think about the balance between rage and acceptance as responses to illness. They commented that this book, like other classics, allowed them to talk about themes that transcend the present moment. (Marli Weiner, Maine)

back to top : you are here Kenyon, Jane Otherwise: New and Selected Poems Source: St. Paul: Graywolf, 1996. Summary: Several poems have been selected from this collection, including "Having It Out With Melancholy," about depression; "The Sick Wife," about how ordinary life is transformed by illness; and "Chrysanthemums." Often paired with Donald Hall's collection of poems, Without. Commentary:

"Back," "Now Where?" and "Let Evening Come" — The poet addresses a personified depression that has been a constant in her life. For this session, a participant brought in a videotape of Jane Kenyon and more of her poems for the discussion. (Kathy Ashley, Maine)

"Having It Out With Melancholy," "Back," and "Now Where?" — The poet takes us to the depths of her depression and reveals the moments when she finds her way back to the small pleasures of everydayness and the fleeting joys that survival offers. (Betsy Hart, Maine)

"Having It Out With Melancholy" - This powerful poem led to a discussion of depression and mental illness in general. There was an appreciation in the group for the way Kenyon takes on depression, characterizing it as a demon which has controlled her from birth, hanging around, always ready (like a satanic angel) to rescue her from her rare periods of joy. Paired with John Hockenberry's Moving Violations to broaden the scope of the disabilities discussion. The general reaction was that while people with mental illness meet their share of prejudices, their disabilities are often less visible, and therefore less open to misunderstanding, than physical disabilities. (Ann Fogg, Maine)

back to top : you are here Kovner, Abba Sloan-Kettering: Poems (Trans. Eddie Levenson) Source: New York: Schocken, 2002. Summary: Kovner was an Israeli poet who went to Sloan-Kettering for treatment for cancer of the larnyx, thus becoming a poet who literally had no voice. The poems describe his experiences in the hospital, including several inspired by anesthesia that recall his days in the Polish resistance against the Nazis. Commentary:

Although some participants walked into the session not quite sure what to think about these poems, the process of reading selected poems aloud and then discussing them offered a group not necessarily comfortable with poetry a way to appreciate its beauty and force. They found this a notably uplifting book, appreciating Kovner's ability to create beauty and meaning of the ending of his life. (Marli Weiner, Maine)

back to top : you are here Larkin, Philip "Faith Healing" Source: Philip Larkin, The Whitsun Wedding. New York: Faber & Faber, 1964. Commentary:

Set at a religious event at which lines of women approach a male faith healer, the poem sympathizes less with the healer's claims to be able to help specific maladies than it does with the women's deep need to have him address the greatest malady of all: a sense of not having known enough love. See Gwendolyn Brooks, "The Bean Eaters," for further commentary. (Allison Wallace, Maine)

back to top : you are here Lee, Li-Young "From Blossoms" Source: Li-Young Lee, Rose. Brockport, N.Y.: Boa Editions, 1986. Summary/Commentary: A collection of poems by a poet of Chinese ancestry. The poems deal with issues of acculturation, cultural identity, aging, and family relationships, among others. This poem creates with words the taste of a peach on a summer day, proclaiming "There are days we live as if death were nowhere in the background." The group loved this poem; paired well with Rachel Naomi Remen's Kitchen Table Wisdom. Both help us to see the healing that occurs when we are fully present. Great when your group needs something that is both profound and uplifting. (Betsy Hart, Maine) back to top : you are here Levertov, Denise "Daybreak" Summary/Commentary: A poet's early morning musings lead her to see her deceased father in a new way. The poem illustrates how the creative human mind finds meaning in the seeming minutiae of everyday life. It also tells us that grieving is a process requiring time and space. (Karin Dillman, Maine) back to top : you are here Lowell, Robert "Sick" Source: Robert Lowell, Selected Poems. New York: Farrar, Straus and Giroux, 1944. Summary: A powerful portrayal of the poet's struggle with bipolar disorder. (Betsy Hart, Maine) back to top : you are here back to top : you are here back to top : you are here back to top : you are here Miles, Josephine "Sheep" Source: Josephine Miles: Collected Poems, 1930-1983. Bloomington: Indiana University Press, 1999. Summary/Commentary: Having had her heart x-rayed, the speaker reflects upon all that is not in the picture: "the green pastures...the running streams of tears in their salty waters," and so on, playing on the sense of the word "heart" as the seat of the emotions. See Gwendolyn Brooks, "The Bean Eaters," for further commentary. (Allison Wallace, Maine) back to top : you are here back to top : you are here Mueller, Lisel "Monet Refuses His Operation" Source: Lisel Mueller, Alive Together: New and Selected Poems. Baton Rouge: Louisiana State University Press, 1996. Summary/Commentary: The poet wonders if a visual impairment might have contributed to Monet's genius. An excellent complement to Mark Salzman's Lying Awake, as both raise the questions of what gifts might be brought to us through illness. (Betsy Hart, Maine) back to top : you are here Neruda, Pablo "Larynx" Source: Pablo Neruda, Extravagaria. New York: Farrar, Straus & Giroux, 1974. Summary/Commentary: The speaker goes through the anxious experience of believing he has a terminal illness, but finds he does not. His reaction to the news that he will live is, surprisingly, not simple relief. See Gwendolyn Brooks, "The Bean Eaters," for further commentary. (Allison Wallace, Maine) back to top : you are here Nye, Naomi Shihab "Kindness" Source: Naomi Shihab Nye, Words Under the Words. Portland, OR: Far Corner Books, 1995. Commentary:

A Palestinian-American poet ponders the subtle aspects of the human experience in this collection of poetry. She addresses difficult topics like war with grace and wit. This powerful poem helps us to see ourselves in the suffering of a dead Indian, reflecting that "Before you know kindness as the deepest thing inside, you must know sorrow as the other deepest thing." Did not generate much conversation but was a wonderful complement to Naomi Shihab Nye's novel, Montana. (Betsy Hart, Maine)

back to top : you are here Sharon Olds "Miscarriage" Source: Sharon Olds, The Dead and the Living. New York: Random House, 1985. Commentary:

Using imagery reminiscent of both evolutionary and Biblical theories of the origins of life (and of the "mistake" she sees in the latter explanation), the speaker reflects upon a bloody visit to the bathroom, in which she loses a fetus. See Gwendolyn Brooks, "The Bean Eaters," for further commentary. (Allison Wallace, Maine)

back to top : you are here Owen, Wilfred The Poems of Wilfred Owen Source: New York: W.W. Norton & Co., 1986. Summary: The British poet Wilfred Owen was killed just before WORLD WAR I ended. Although he had written poetry before going to war, it was his experiences in the trenches that inspired his most powerful work. During the war he suffered from shell shock and was sent to recuperate at a Scottish hospital where he met and was encouraged by fellow poet Siegfried Sassoon. Pair with Pat Barker's novel, Regeneration. Commentary:

His poems are stirring tributes to soldiers and powerful indictments of the losses brought about by war. Participants wanted to read his poems out loud but were unable to talk about them because of the horrific images in them. (Susan Bell, Maine)

Many of our readers have an initial aversion to poetry, but pairing poems with fiction and non-fiction works demonstrates how poetry illuminates the deep emotions and psychological insights found there. Owen's poems are a horribly accurate representation of the true situation of men at war. (Sydney Landon Plum, Maine)

We read Pat Barker's Regeneration and "Dulce et Decorum Est" by Wilfred Owen along with Jeanne Bryner's poem, "This Red Oozing," in a session entitled "Violence and War." We began by reading the Bryner poem aloud, followed by Owen's. Discussion ranged from analysis of post-traumatic stress syndrome, to the role (seen as limited or compromised) of the caregiver in such situations. (Kathy Ashley, Maine)

back to top : you are here Piercy, Marge "The Long Death" Source: Marge Piercy, The Moon is Always Female. New York: Knopf, 1980. Summary: A nine-stanza poem (fifty-seven lines) about a slow and painful death from radiation exposure. The poet wonders why people only focus on their illness instead of attempting to confront those responsible for it. back to top : you are here Piercy, Marge "My Mother's Body" Source: Marge Piercy, My Mother's Body. New York: Knopf, 1985. Summary: In this title piece, the poet outlines her attempt to deal with her mother's death, from discussing the funeral to going through her mother's things and remembering times when she and her mother disagreed. back to top : you are here back to top : you are here Plath, Sylvia "Lady Lazarus" Source: Sylvia Plath, Ariel. New York: Harper and Row, 1966. Summary: A 30-year-old woman chillingly describes her three suicide attempts. This collection foreshadows Plath's suicide at the age of 31. back to top : you are here Sassoon, Siegfried The War Poems Source: New York: Faber and Faber, 1993. Summary/Commentary: Sassoon's poems, about the horror of infantry combat during World War I, are often sarcastic and bitter. However, Sassoon elegantly captures the ways British soldiers relinquished their innocence in combat. Pair with poems by Wilfred Owen and Pat Barker's novel, Regeneration. back to top : you are here back to top : you are here Sassoon, Siegfried Collected Poems of Siegfried Sasson Source: New York: Faber & Faber, 1986. Summary: A collection of Sassoon's World War I poems, most of them bitter denunciations of officers and those who sent them into war. Commentary:

We read "The Rear-Guard," "Spring Offensive," "Prayer for those on the Staff," "Died of Wounds," and "Does It Matter?" The poems prompted discussions of how veterans of Vietnam felt about their officers, and how these veterans needed to tell stories to the health care providers, as a means of resolving guilt. (Michael Burke, Maine)

back to top : you are here Voigt, Ellen Bryant Kyrie Source: New York: Norton, 1995. Summary: Poems about the great flu pandemic of 1919. Pair with Katherine Ann Porter's Pale Horse, Pale Rider. back to top : you are here Walker, Alice "Medicine" Source: Alice Walker, Once. New York: Harcourt-Brace, 1968. Commentary:

An adult's recollection of the passionate love between her elderly grandparents, a love that sustains them even through the pain of illness and old age. A beautiful, simple tale. Though it did not generate much discussion, the group loved reading it. A poem that reveals that which is therapeutic may have little to do with medicine. (Betsy Hart, Maine)

back to top : you are here Whyte, David "The Well of Grief" Source: David Whyte, Close to Home. Langley, WA: Many Rivers, 1990. Commentary:

Beautiful in its simplicity, this poem plunges below "the still surface on the well of grief" to find "the source from which we drink." Did not generate much discussion, but the group loved reading it. A beautiful and redemptive poem that examines the connection between grief and joy. Paired with Kathleen Finneran's book, The Tenderland. (Betsy Hart, Maine)

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Non-Fiction

back to top : you are here back to top : you are here Bauby, Jean-Dominique The Diving Bell and the Butterfly Genre: Memoir Source: New York: Knopf, 1997. Summary: Memoir written by the young editor of a French fashion magazine who suffered a stroke that left him only able to blink one eye. Commentary:

One of the most moving readings of the series, though not necessarily one that generated discussion beyond appreciation. The almost unimaginable situation of someone at the peak of his career as an editor in Paris being condemned by a stroke to virtually total paralysis but full consciousness was surpassed only by the miracle that the narrator was able to find a way (through a dedicated therapist and assistant) to dictate this autobiography. Paired with Kenyon's "Having It Out With Melancholy" and Cisneros' "Arturo Burro." (Kathy Ashley, Maine)

This beautifully written and sobering work raised questions about the end of life, about the nature of paralysis and the care offered to such a patient, and about a person's will to live. Participants responded with awe at the artful writing and the courageous story. As with every work, we read aloud passages at the start in order to bring the author's words alive and into the room. (Elizabeth Cooke, Maine)

back to top : you are here Beck, Martha Expecting Adam: A True Story of Birth, Rebirth, and Everyday Magic Genre: Personal narrative Source: New York: Berkley, 2000. Summary: The author explores her and her husband's decision to carry to term and raise their son, who was diagnosed in utero with Down's syndrome. back to top : you are here back to top : you are here Cousins, Norman Analysis of an Illness as Perceived by a Patient Genre: Personal narrative Source: New York: Bantam, 1981. Summary: The author's account of taking his healing into his own hands, and the benefits that followed quickly after his decision to attend to his body's signals and instincts, not necessarily only the recommendations of his physicians. Commentary:

Personal account of triumph over severe illness by a gifted writer. Explores the mind's ability to influence the body's health. (Esther Rauch, Maine)

back to top : you are here DeBaggio, Thomas Losing My Mind: An Intimate Look at Life with Alzheimer's Genre: Personal narrative Source: New York: Free Press, 2002. Summary: DeBaggio began this book almost immediately after being diagnosed with Alzheimer's at 57. He chronicles his increasing losses by describing his frustration, depression, concerns for his family, and efforts to share his understanding of his experiences with others. The writing in some sense parallels his increasing debility, which adds to its interest and sadness. Commentary:

Participants appreciated this illness narrative from the inside, recognizing that we rarely read accounts of the loss of intellectual abilities. We all puzzled about DeBaggio's seeming inability to imagine his illness from the perspective of his wife and wondered about the extent to which the book had been edited by others. All of this made for fascinating discussion, with comparisons to Lauren Slater's Lying, among others. (Marli Weiner, Maine)

back to top : you are here Ehrenreich, Barbara "Welcome to Cancerland" Genre: Essay Source: Harper's Magazine, November 2001. Summary: This article is a scathing attack on the corporate nature of what cultural theorist Ehrenreich calls our contemporary "breast cancer culture." It argues that corporate America has infantilized women with pink bows and teddy bears to mask the much more difficult and threatening issue of environmental pollution and its relations to various cancers. Commentary:

Group members found the author's tone strident but the article provoked meaningful discussion. (Eve Raimon, Maine)

back to top : you are here Ehrlich, Gretel A Match to the Heart: One Woman's Story of Being Struck By Lightning Genre: Personal narrative Source: New York: Penguin, 1995. Summary: Nature writer Ehrlich writes of her life after being struck by lightning near her Wyoming ranch. She finds it difficult for her ailments to be properly diagnosed and her memoir challenges the medical world to create new methods of measuring electrical injuries. Commentary:

This is the rather lyrical recounting of the author's experiences after being struck by lightning. This was our least successful reading. The book is difficult to read, but that had been the case with other texts. I think people gave up on the book because there wasn't a sense that the author was getting anywhere, with her understanding of her physical condition or with getting better. Furthermore, all of our other readings had revealed something about the connections between people that illness makes, or breaks. However, Ehrlich is a loner and remains so throughout. We would not recommend this book to other groups. (Sydney Landon Plum, Maine)

back to top : you are here Fadiman, Anne The Spirit Catches You and You Fall Down Genre: Non-fiction Source: New York: Farrar, Straus, and Giroux, 1998

(For annotation see Social Perspectives and Policy, Non-fiction)

back to top : you are here Finneran, Kathleen The Tender Land: A Family Love Story Genre: Memoir Source: New York: Houghton Mifflin, 2000. Summary: A beautifully written memoir about an Irish Catholic family that suffers through the suicide of the author's brother at age 15. Through a long accumulation of love and family memories, family members are able to work through their grief by maintaining their bonds with one another. Commentary:

This memoir by a young woman whose brother committed suicide at age 15 after being ridiculed at school is an intimate portrayal of her Catholic family and its grief. Our discussion was deep and challenging, though some found the book could have benefited from editing to pare it down. (Betsy Hart, Maine)

back to top : you are here Frank, Arthur The Wounded Storyteller Genre: Personal narrative Source: Chicago: University of Chicago Press, 1995. Summary: An explanation of modernist and post-modernist views of illness, and the creation of "life narratives" to overcome serious illness and reconnect the power of the mind over the body. Commentary:

Frank is a sociologist who had two life-threatening diseases before age 40 (prostrate cancer and heart disease). The book is a narrative about his illness experiences as well as a reflection on medicine and nursing's approach to caring for him. Frank explores the moral meanings of illness and confronts the tendency in medicine and nursing to reduce people to organs and systems. People in the seminar generally didn't like the book-physicians were quite defensive about his depiction of medical care-but it stimulated a very fruitful discussion about the gap between the perspectives of physicians (and to a lesser extent, nurses) and patients. (Susan Bell, Maine)

back to top : you are here Fries, Kenny Body, Remember Genre: Personal narrative Source: New York: Dutton, Plume, 1997. Summary: The author's search through his past and medical histories, to uncover the source of his being. Commentary:

Fries is a poet; you may know his poem "Anesthesia." This is a memoir of his childhood and young manhood as a disabled person who struggles to come to terms with his disability, including several surgeries as a child, as well as his homosexuality and his Jewish identity. It is compellingly written. Fries was born with severely deformed legs and feet, although he is mostly able to walk. (Marli Weiner, Maine)

back to top : you are here Grant, Linda Remind Me Who I Am Again Genre: Personal narrative Source: London, Granta Books, 1998. Summary: A memoir written by the daughter of a woman suffering from dementia, focusing on the family's immigrant history as well as the decision of the two daughters to institutionalize their mother. Commentary:

This book inspired a rich discussion of quality vs. length of life, particularly because many of the participants were facing such concerns for their own parents. Grant writes about her family's myth-making and her efforts to uncover the truth from her mother, who was not only unable to remember the past as she grew older but reluctant to tell the truth about it even as a young woman. The family, which fled Poland in the face of anti-Semitic persecution, developed strategies for survival that included deceiving authorities and appearing to assimilate while retaining cultural distinctiveness. These and other forms of dissembling made Grant's efforts to learn about her background nearly impossible, even though aspects of her story seemed familiar to many readers. The participants were interested in the dynamics of the family as roles within it changed, in identity and personal history, and in the tensions between the author's desire for her mother's safety and the social service providers' emphasis on having her remain at home. (Marli Weiner, Maine)

The group had a strong negative reaction to this book. The craziness and shiftiness of Grant's mother, her seeming disinterest in consistency or factual truth made it hard to talk about the disease as a separate problem. It almost seemed that the family had collective dementia from the get-go. It was a frustrating story about a dysfunctional family that was just made worse by the disease. Two positive aspects of Grant's account were her relationship with her sister, and with a doctor who took a lot of time to talk to her about the nature of dementia and the soothe Grant's own guilt about finally putting her mother into a nursing home. (Francette Cerulli, Vermont)

back to top : you are here back to top : you are here Grumbach, Doris Coming Into the End Zone Genre: Memoir Source: New York: W.W. Norton & Co., 1991. Summary: The author approaches her seventieth birthday with a mixture of anticipation and regret. This memoir is her attempt to recollect her life in the days surrounding her birthday in the hopes of answering the question, "What has my life meant?" Commentary:

We read an excerpt from this book about aging. Although of some interest, it was not as thought- and discussion-provoking as Grumbach's New York Times op-ed piece, "What It's Really Like to Grow Old" (November 1, 1998, section 4, page 15), a remarkably dyspeptic point of view. (Margery Irvine, Maine)

back to top : you are here back to top : you are here Hockenberry, John Moving Violations : War Zones, Wheelchairs, and Declarations of Independence Genre: Personal narrative Source: New York: Hyperion, 1995. Summary: The angry and funny memoir of this journalist focuses on the nineteen years since the car accident in which, at nineteen, he became a paraplegic. Hockenberry exposes the hidden and not-so-hidden discrimination facing disabled people in the US. Commentary:

The discussion was lively, starting with objection to Hockenberry's arrogance and his anger. This led to discussion of whether disabled people are justified in their anger at being treated first as disabled rather than for what they do, and of the way Hockenberry finally comes to terms with his disability. Others found much to gain from this inside report of living with disability, including a doctor learning more about rehabilitation, and a social worker who could better understand his father's unspoken feelings about the leg he had lost in his twenties. To further broaden the theme of living with disability, I paired it with Jane Kenyon's poem about depression, "Having It Out with Melancholy." (Ann Fogg, Maine)

back to top : you are here back to top : you are here back to top : you are here back to top : you are here back to top : you are here Lorde, Audre Cancer Journals Genre: Personal narrative Source: Argyle, New York: Spinsters Ink, 1980. Summary: Prose and poetry about Lorde's experience with breast cancer and a mastectomy from her perspective as an African American lesbian woman. Commentary:

Exploring Lorde's own process of recovery and her outrage at the response of a nurse to Lorde's choice not to wear a prosthesis after mastectomy underscored the issue of disfigurement and how we relate to it. Again, a major theme was how do we-patient and provider-react to illness and life changes? (Elayne Clift, Vermont)

back to top : you are here back to top : you are here back to top : you are here Murphy, Robert The Body Silent Genre: Personal narrative Source: New York: W.W. Norton & Co., 1987. Summary: A cultural anthropologist's account of his own progressive paralysis and of the "culture of disability" in which he comes to reside. Commentary:

Robert Murphy was at the height of a distinguished career in anthropology when he learned that he had a benign but ultimately paralyzing tumor in and around his spinal column. The book he wrote describes his own journey into quadriplegia as well as his growing understanding of a culture of disability not easily (or willingly) recognized by those outside it. His account includes a discussion of Columbia University's commitment to make its campus wheelchair accessible as well as meditations on paralysis as both an all-too-real condition and a metaphor of human existence. Though two groups of readers initially reacted with some defensiveness to Murphy's book, which includes shrewd commentary about the doctors, hospitals, and the able-bodied, it has become a touchstone even for those who initially criticized it. (Ruth Nadelhaft, Maine)

The author's approach is unexpected, unusual and courageous. As an anthropologist he studies the disabled while being part of his own subject matter. The fact that Murphy made his living with his mind meant that he could continue to work in spite of growing physical limitations. Some group members were annoyed with him for his steadfast and stoic refusal to go very deeply into his negative feelings about his condition, but the thoroughness of his reports from this frontier left no stone unturned when it came to the effect of physical disability on one's personal and social identity. (Francette Cerulli, Vermont)

I've used this book in two seminars, which reacted quite differently to it. One group, with a significant contingent of physicians, expressed annoyance at Murphy's anger and saw him as self-pitying, self-indulgent, and self-absorbed. One physician, however, was inspired to travel around the hospital building in a wheelchair in order to see what that would be like. The other group was far more sympathetic to Murphy, reflecting on the thoughtfulness and irony with which he could view his situation. (Marli Weiner, Maine)

back to top : you are here Nuland, Sherwin B. How We Die Genre: Non-fiction Source: New York: Knopf, 1994. Summary: Nuland's book addresses the biochemistry and physiology of dying, but also, through anecdote and narrative, dying as it's experienced by both patients and caregivers. Commentary:

In some ways the most successful of all the readings: not only well written, but philosophically and ethically important. There are so many issues brought up by this book, and the discussion that followed was searching and revealing. Nuland makes us all confront mortality and the decisions we will have to make as our own lives approach their end. Also, of course, the end-of-life decisions made by caregivers are a significant part of the book. As accompanying readings, I recommend the poems "What the Doctor Said" and "Letter" by Raymond Carver, "The Ship Pounding" and "Her Long Illness" (excerpts) by Donald Hall, and "35/10" by Sharon Olds. (Margery Irvine, Maine)

back to top : you are here Nuland, Sherwin B. The Wisdom of the Body Genre: Personal narrative Source: New York: Knopf, 1997. Summary: "The Will to Live" (Chapter 1): This chapter explores, through the story of one woman's struggle to survive a medical emergency, the human will, an element that Nuland argues is perhaps the most important factor in a physician's ability to discover, through experience and inner knowing, the cause of an illness. Commentary:

"The Will to Live," (Chapter 1): Participants were somewhat put off by Nuland's "arrogance." But this was a positive thing, as it led to a discussion of the physician's nature, a product of training and personality. (Elizabeth Cooke, Maine)

back to top : you are here back to top : you are here Paget, Marianne A Complex Sorrow: Reflections on Cancer and an Abbreviated Life Genre: Personal narrative and Essays Source: Philadelphia: Temple University Press, 1993. Summary: The experiences of a sociologist who studies error in the context of medical practice who finds herself the object of a misdiagnosis that leads to her premature death. The collection contains several styles of writing: an analysis of medical mistakes and their legal treatment (Paget had been researching this prior to her cancer diagnosis); a description of the process of writing and performing a play, The Work of Talk, based on a taped dialogue between a female patient and her male doctor; a revision of that play; Paget's letters and journals while undergoing treatment; and finally, the epilogue that a friend and caregiver wrote after her death. Commentary:

A Complex Sorrow was read along with Atul Gawande's essay, "When Doctors Make Mistakes" in a session on "Mistakes." A Complex Sorrow stimulated most of the discussion in the session, although much of it was not about the topic but rather about the posthumous construction of the text. The script dramatizes many of the ideas in the author's previous essay "Medical Work" by focusing on the discourse patterns in physician-patient interactions. We read the second half of the script aloud, just going around the group, each in turn taking a speaker's lines. It was very effective and participants were obviously getting Paget's points about the medical profession's manipulation of language. Predictably, this session elicited more resistance to the readings than any of the others, although it also prompted much personal revelation and meditation upon the state of the profession. It was clear, however, that the group left our discussion with the ideology of technical perfection intact. The readings had not (as far as I could see) convinced anyone that the profession should accept the inevitability of mistakes and work differently to mitigate their severity. (Kathy Ashley, Maine)

A Complex Sorrow was compiled after the author's death; it includes both sociological writings on medical mistakes and Paget's musings on her own impending death, which was hastened by such a mistake. By opening the topic of medical mistakes, the book allowed participants to discuss more fully than ever before their own relationships with patients; one physician said he found acknowledging his own mistakes liberating, another said that since reading the book she had begun talking with patients about mistakes. The book also discusses the ways in which (social) scientific writing is presented; it includes the author's re-writing of a scholarly article about the failure of communication between a male doctor and a female patient. Having the group read sections of this aloud was quite effective. (Marli Weiner, Maine)

We read aloud from The Work of Talk, purposefully crossing gender lines and professional identities, and discussed the doctor's refusal to acknowledge what the woman told him. There was a general sense of awe at Paget's ability to accept without bitterness the mistakes that led to too-late diagnosis of her cancer. We compared the progression from analysis to feeling taken by Vivian Bearing (the central character in Margaret Edson's play, W;t, which we had read earlier) and Marianne Paget, both educated professionals. We discussed Paget's support group who cared for her in her home and the differing terms in which Paget's journal and Marjorie DeVault's epilogue describe the same event. When I asked if the aversion to saying "cancer" in The Work of Talk is current, the discussion turned to acknowledging death in the company of a dying person's hearing. (Ann Fogg, Maine)

back to top : you are here Paget, Marianne The Unity of Mistakes: A Phenomenological Interpretation of Medical Work Genre: Essay Source: Philadelphia: Temple University Press, 1988. Summary: A report by a sociologist who studied error in the context of medical practice. Commentary:

"Medical Work" - This phenomenological/philosophical examination of making medical mistakes was a difficult read for the group, and almost everyone expressed their problems in figuring out what the author was saying. However, several people responded to the difficulty by rereading and found the essay rewarding once they had taken time to reflect on its ideas. (Kathy Ashley, Maine)

back to top : you are here back to top : you are here Picardie, Ruth Before I Say Goodbye: Recollections and Observations From One Woman's Final Year Genre: Personal Narrative Source: New York: Henry Holt, 2000. Summary: Ruth Picardie was a mother of young twins and a newspaper columnist when she was diagnosed with breast cancer. This book puts together the columns she wrote during the last year of her life, as well as her e-mail correspondence and-perhaps most thought provoking and controversial-an afterward by her widower. This is a deceptively simple, slim volume written by a caustic, witty, smart British journalist. Commentary:

The most important issue raised by the book was what physicians and nurses have to offer dying patients. The same issue was raised by the readings with which I paired Picardie's: Tolstoy's The Death of Ivan Illych, and poetry by Donald Hall and Jane Kenyon. Many participants did not care for Picardie the person (acerbic, cynical, brash) nor for her type of humor (black, bleak), but the discussions about her opinion of medicine (both traditional and alternative), about how she confronted her illness, and about the family dynamics were good ones. I was interested to note that the participants were eager to talk about how Ivan Illych and Ruth Picardie confronted their own mortality-but loath to extend the discussion to themselves (shades of Tolstoy!). (Margery Irvine, Maine)

This volume can produce a successful discussion about terminal breast cancer from both the patient's and the caregiver's perspective. Participants were challenged by the ironic nature and bluntness of Picardie's British vernacular wit. Paired with the Barbara Ehrenreich essay, "Welcome to Cancerland." (Eve Raimon, Maine)

back to top : you are here Rimpoche, Sogyal The Tibetan Book of the Dead and the Living Genre: Non-fiction Source: San Francisco: Harper, 1994. Summary: Tibetan teacher Rimpoche transforms the ancient text, while introducing readers to the fundamentals of Tibetan Buddhism and gradually moving to the topics of death and dying. Commentary:

Rimpoche's Tibetan Book brought into final focus a seminar-long exploration of how to deal with the dying. Everyone responded positively to the beliefs that Tibetans attach to dying. We read the first chapter. (Peter Harris, Maine)

back to top : you are here Slater, Lauren Prozac Diary Genre: Personal narrative Source: New York: Penguin, 1999. Summary: Slater, one of the earliest subjects to take Prozac shortly after its arrival as a drug for the treatment of depression, writes about her experiences as a patient. Commentary:

Slater eventually went on to become a clinical psychologist and therapist as well as a highly skilled writer. Her account is laced with irony and self-scrutiny as well as some scathing reflections on the world of mental illness and treatment. Discussion was lively with several members of the group irritated by Slater's tone but impressed by her experience and openness. The Penguin edition contains a brief reader's guide written by Slater along with an interview in which she speaks candidly about her motives and writing process. (Ruth Nadelhaft, Maine)

back to top : you are here Slater, Lauren Lying: A Metaphorical Memoir Genre: Personal narrative Source: New York: Penguin, 2001. Summary: Slater has constructed a complicated narrative that describes her experience with epilepsy and a very difficult relationship with her mother. Commentary:

This is a provocative, brilliant, and sometimes exasperating book that engaged the group in strenuous and thoughtful discussion. There is still some question in the minds of a few members of the group about the "truth" of the story Slater tells, but most agreed that she conveys "truth" even if she alters "facts," and it's not clear that she does alter facts. What Slater wants to convey is the lived experience of her disease and she does it with extraordinary skill and emotional resonance. (Ruth Nadelhaft, Maine)

A profoundly untrustworthy narrator, who is a clinical psychologist, makes this book provocative. Among the most compelling books I've used in these seminars; participants keep talking about it session after session and year after year. Readers are never sure whether Slater actually has epilepsy or not; by the end of the discussion, participants believed that the truth did not matter, in spite of their professional interest in diagnosis and cure. The discussion compared patients' narratives of their experiences with those of medical care providers, and also raised questions about memory, personal history, identity, the connection between mind and body, and the authority of science. Participants struggled with the multiple truths set forth in the book: personal, historical, medical. Facilitators might find it helpful to read Slater's memoirs as well (Welcome to My Country and Prozac Diary). (Marli Weiner, Maine)

back to top : you are here back to top : you are here back to top : you are here back to top : you are here Thomas, Lewis "Leech, Leech" Genre: Personal narrative Source: Lewis Thomas, The Youngest Science: Notes of a Medicine Watcher. New York: Viking, 1983. Summary: A doctor's reflection on what medicine was, is, and what it will become. It begins with a recollection of the author's childhood observing his father's medical practice, and continues through his own practice into his retirement. back to top : you are here Vertosick, Frank T. "A Woman's War" Genre: Non-fiction Source: Frank T. Vertosick, Why We Hurt: The Natural History of Pain. New York: Harcourt, 2000. Summary: Neurosurgeon Frank T. Vertosick explains the evolutionary, physiological, and psychological reasons for pain in Why We Hurt: The Natural History of Pain. This book helps ease suffering by explaining its origins, and reminds us that we all experience pain in our lives. Commentary:

In this fifth chapter, the author reveals his own encounter with the pain of childbirth. Not until he witnessed the labor of his wife did Vertosick begin to comprehend the nature of childbirth pain or the cultural assumptions still evident in its treatment. Stunned by what he observed, Vertosick did some research which, from a neurosurgical perspective, complements the findings of other writers such as Judith Walzer Leavitt. (Ruth Nadelhaft, Maine)

back to top : you are here back to top : you are here

II. Being a Care Giver

Fiction

Alcott, Louisa May Hospital Sketches Genre: Short Stories Source: Bedford, MA: Applewood Books, 1993. Summary: This collection of related stories is based on Louisa May Alcott's experience of serving as a nurse during the Civil War, during a time when utilizing female nurses was the subject of much debate within the medical community. Commentary:

With Alcott's quick wit, sensitivity to details, and insights into the human spirit, this brief book brings history alive. It raises questions about women's role in war and the birth of nursing as a profession. It worked well paired with excerpts of Susan Reverby's Ordered to Care, which examines this period in nursing history, and also paired with Mary Oliver's poem, "University Hospital, Boston." (Betsy Hart, Maine)

back to top : you are here Baida, Peter "A Nurse's Story" Genre: Short Story Source: Peter Baida, A Nurse's Story. Jackson: University Press of Mississippi, 2001. Summary: This moving story of the nursing profession is set in the 1970s and 80s when nurses' unions were forming. When one particular nurse stands up for the rights of her peers, she helps to bring change, along with much heartache, to her life and the life of the hospital where she works. Commentary:

A break from the doctor-centered works we read in so many of the sessions, this carefully crafted narrative about the death of a nurse after a long career stimulated discussion about the importance of a nurse's work, especially in relation to her union organizing activities. Participants noted the role of the leading character, who was not a militant person but was convinced to join the union because she felt the health care of her patients was jeopardized by changes the hospital was making. (Kathy Ashley, Maine)

This led to an animated, and at times emotional discussion of the nursing profession in the last thirty years. Personal experiences were shared, eyes were opened, and in the following sessions, this was well remembered as the discussion with the most life and energy. Issues of hierarchy were raised. Participants responded with gusto to this story. (Elizabeth Cooke, Maine)

We learn about community, labor organizing of nursing staff, the relationship between nurses, and the relationships of a strong woman with her family and community. Generated much discussion of nursing, aging and power. (Betsy Hart, Maine)

We were a little confused about whether the nurse's union-organizing work was the central part of the story, and whether that was what we should be focusing on. The discussion was not very lively. (Michael Burke, Maine)

Peter Baida's short story presents the life and career of a Catholic nurse in a Catholic hospital who reluctantly gave support to a union and now, drifting towards death, reflects on her experiences. It is a straightforward and moving presentation of the sometimes-conflicting demands of nursing. It was particularly appropriate for discussion in a local Catholic-run hospital where the dilemmas of staff are still very similar to those in Baida's story. The nurse is a moving and relevant protagonist. It was paired with Tillie Olsen's "I Stand Here Ironing." (Ruth Nadelhaft, Maine)

back to top : you are here Barker, Pat The Eye in the Door Genre: Novel Source: New York: Penguin, 1995. Summary: This is the second book of Barker's trilogy about World War I; the first is Regeneration. All three books describe the horrors of combat, not on the field but in the aftermath. This book, set in 1918 England, focuses on the post-war persecution of homosexuals and conscientious objectors. Commentary:

For fans of Pat Barker, and there are many, this is about the best of the Regeneration trilogy. It gives groups a chance to range outside of matters that are more obviously scientific/medical; the novel is beautifully written and structured, dense with detail. (Margery Irvine, Maine)

back to top : you are here Barker, Pat Ghost Road Genre: Novel Source: New York: Dutton, 1995. Summary: This is the third in Barker's trilogy of novels following the trauma and recovery of Billy Prior, a working class man elevated to officer status in British Forces in World War I. Commentary:

Barker expertly juxtaposes the gritty and ultimately fatal experiences of the fictional Billy Prior with the memories and growing insights of William Rivers, an actual psychiatrist and anthropologist who specialized in treating shell-shocked soldiers, among them Siegfried Sassoon and Wilfred Owen. The book and the two preceding it (Regeneration and The Eye in the Door) are all superb as fiction and as inquiries into medical/psychiatric history. (Ruth Nadelhaft, Maine)

back to top : you are here Barker, Pat Regeneration Genre: Novel Source: New York: Penguin, 1993. Summary: A fictional account of poet Siegfried Sassoon's relationship with the doctor who treated him for mental illness after Sassoon refused to continue serving as an officer in World War I in protest against its human carnage and waste of life. Pair with Sassoon's "Attack" and Wilfred Owen's "Dulce et Decorum Est." Owen also figures in the novel. Commentary:

Barker's novel is the first of a trilogy, based on events that occurred in England during World War I: Siegfried Sassoon, now known as one of the great poets of the war, threw his medal into the ocean and wrote a public statement against the war. Instead of being court marshaled, a friend engineered an alternative understanding of his actions and he was sent to Craigmore to be treated by psychiatrist/anthropologist Dr. Rivers. This novel is so powerful that one of the participants said she had nightmares about it; another said she couldn't read the chapter on electric shock treatment. Perhaps the most (of many) moral dilemmas raised in the book concerns the psychiatrist's: he heals soldiers' minds so they can return to the front. One of the physicians in the seminar asked whether that's what "we" do too: heal patients and send them back into "hellish" situations. Some of the poetry of Sassoon and Owen is included in the book (although not always in its entirety). (Susan Bell, Maine)

Barrett, Andrea Ship Fever Genre: Novella and short stories Source: New York: W.W. Norton & Co., 1996. Summary: In the title story of this collection, a young Canadian doctor finds himself at the forefront of a terrible outbreak of typhus, a result of the appalling conditions suffered by the thousands of Irish immigrants aboard ships fleeing the Great Potato Famine of 1847. Vividly captures the overwhelming nature of the epidemic and the great suffering it brought. The novella raises questions of what public health authorities can do in such urgent and fast-developing situations, and raises questions concerning attitudes towards immigrants. back to top : you are here Bloom, Amy A Blind Man Can See How Much I Love You Genre: Short Stories Source: New York: Vintage, 2001. Summary: Amy Bloom is both a highly successful fiction writer and a practicing therapist. The stories, especially the title story, are sharply observed and often mordantly witty. Bloom writes of sex-change operations, cancer, and Parkinson's disease with scrupulous detachment coupled with compassion, an unlikely combination. Commentary:

"A Blind Man Can See How Much I Love You" - Paired with Frankenstein, this story, of a mother's thoughts and experiences with a transsexual daughter on the eve of becoming a son, was an effective means of exploring contemporary issues of human creation. While the discussion focused more on Frankenstein than this story, participants appreciated the sympathy with which the mother in the story viewed her child's circumstances. They used it to deepen their discussion of the role of technology in medicine and its role in the surgical construction of bodies seen as more ideal than those given them by biology. (Marli Weiner, Maine)

back to top : you are here Bontemps, Arna "He Read To Her" Genre: Short Story Source: Vital Lines: Contemporary Fiction About Medicine. Ed. Jon Mukand. New York: St. Martin's Press, 1990. Summary: A husband communicates his commitment to his sick wife by reading aloud to her from Moby Dick. back to top : you are here Bulgakov, Mikhail "The Murderer" Genre: Short Story Source: Mikhail Bulgakov, A Country Doctor's Notebook. London: Collins and Harvill, 1975. Summary: A young physician in rural Russia at the beginning of the twentieth century is called into a blinding snowstorm to attend to a patient. Commentary:

Bulgakov's writing is so clear and direct that it is easy to forget his distance in time and culture from the subject of his collection, remembrances of his early medical practice. This story highlights the difficult rhythms and loss of privacy (and sleep) that come from choosing the medical life. (Sydney Landon Plum, Maine)

back to top : you are here Camus, Albert The Plague Genre: Novel Source: New York: Vintage, 1991 (originally published in 1947). Summary: Camus' story of the outbreak of the bubonic plague in war-torn North Africa. Camus introduces us to Dr. Rieux, the unlikely hero of a war on death itself. Rieux finds himself faced with tragic personal circumstances (separation from his ailing wife) and a demanding professional crisis (a modern outbreak of a medieval disease). Rieux and a misfit band of men determined to find meaning in absurdity fight the plague for its duration. The reader experiences the siege mentality as though she is one of the quarantined townspeople for whom Rieux and company are fighting. Camus brings to life the monotony, pettiness and simplicity of daily life under the threat of death, and we can't help but feel his description is finally a concentrated rendering of human existence itself. Commentary:

Camus' lucid and unsparing writing draws readers deeply into the course of the plague that devastates all segments of society. While it is always tempting to see the plague as a contemporary disease such as AIDS, readers in the hospital setting are also involved in and moved by the ways in which key characters respond to the epidemic. They make connections to characters, responsibilities, and beliefs in their own lives. (Ruth Nadelhaft, Maine)

Existentialist novel of epidemic and death; the plague a metaphor for the Nazi invasion of Europe. Set in northern Africa and written just after World War II, this novel describes a city's response to an outbreak of bubonic plague, centering on the actions of the doctor. The book raises questions about the response of public health officials to epidemics, as well as the nature of evil and human responses to it. It provoked a lively discussion ranging from moral responses to the Holocaust and AIDS to the nature of individual responsibility for family and community. (Marli Weiner, Maine)

In this highly readable novel, Camus exposes us to the existential philosophy he and others brought to the literary world in the mid-twentieth century. The themes of freedom, personal responsibility and commitment in the face of absurdity emerge from richly layered personal narrative and plot. In the end, The Plague confronts death itself and allows the reader to decide whether the inevitability of death makes life meaningless or is the very source of all purpose. (John Zavodny, Maine)

back to top : you are here Carver, Raymond Where I'm Calling From: New and Selected Stories Genre: Short Stories Source: New York: Random House, 1989. Summary/Commentary: "Cathedral" is about a man's encounter with a blind man who helps him see in a new way. Initially uncomfortable and threatened by the man's blindness, the narrator's viewpoint is transformed by the blind many as together they help one another "see" a cathedral. In "A Small Good Thing," Carver's weighty subject is the death of a child, and the anguish that the parents experience while dealing with misinformation from the medical staff and an agonizing waiting period. We read two versions of this Raymond Carver short story, both of which deal with how a family copes with the death of a child, each exploring in different ways the interplay between anger and compassion. (Peter Harris, Maine)

"A Small Good Thing" prompted good discussion about how solace is provided and the role of compassion in human affairs. Readers liked the story, and found the couple's situation moving and the baker's act understandable. We argued over whether his actions were ordinary humanity, or extraordinary. (Michael Burke, Maine)

back to top : you are here Chekhov, Anton "A Doctor's Visit" Genre: Short Story Source: Anton Chekhov, The Lady with the Dog and Other Stories. New York: Ecco, 1984 (originally published in 1898). Summary: A young doctor learns the power of listening with empathy to a patient whose medical problems have less to do with the physical, and everything to do with the overwhelming pains of anxiety and depression. back to top : you are here Chekhov, Anton Ward Number Six and Other Stories Genre: Short Stories Source: Oxford: Oxford World Classics, 1998. Summary: Seven highly differentiated stories with a compassionate view of a physician who can neither kill nor cure. back to top : you are here Cooley, Martha The Archivist Genre: Novel Source: Boston: Little, Brown & Co., 1998. Summary: The post-World War II story of Matthias, a librarian in charge of maintaining an archive of T.S. Eliot's letters to an American woman. A young female poet who comes to the library to read the papers evokes in Matthias a remembrance of his wife, who committed suicide in a mental institution. This novel challenges both Matthias' and the reader's obligation to maintain the memories of the dead. Commentary:

Weaving together themes of memory and remembrance, love and madness, loneliness and connection, along with jazz, poetry, and the Holocaust, this novel offers a rich opportunity for discussions of peoples' struggles with understandings and experiences too painful to endure. It evoked strong emotions in seminar participants, who found its account of a woman's disintegration into madness compelling, in part because of how "sane" her reactions appeared to be. The beautifully written novel also engaged participants with its surprise ending that raised questions about what can be considered appropriate moral behavior-as opposed to controlling and irresponsible actions. This novel works particularly well near the end of the seminar, when participants will have had more experience discussing complex themes and emotions. I've used it in two different groups, once with several Eliot poems mentioned in the novel. (Marli Weiner, Maine)

back to top : you are here Crane, Stephen "The Monster" Genre: Short Story Source: The Great Short Works of Stephen Crane. New York: Harper and Row, 1968. Summary: A small town doctor attempts to recreate the burned skin of a black man who saves his son from a house fire. This causes negative feelings about the doctor and his family throughout the town, eventually alienating them from the rest of the townspeople. back to top : you are here Crane, Stephen "Episode of War" Genre: Short Story Source: Norton Anthology of American Literature. New York: W.W. Norton & Co., 1995. Summary: Doctors in the Civil War. back to top : you are here Davies, Robertson The Cunning Man Genre: Novel Source: New York: Viking, 1995. Summary: A novel about a physician who treats his patients by listening to them. back to top : you are here back to top : you are here Gilman, Charlotte Perkins "Dr. Clair's Place" Genre: Short Story Source: New York: Feminist Press, 1973. Summary: Nice counter-narrative to her more famous story, The Yellow Wall-Paper. Here the doctor is portrayed as sensitive and socially conscious (as in a number of Gilman's stories). back to top : you are here Hemingway, Ernest The Short Stories of Ernest Hemingway Genre: Short Stories Source: New York: Charles Scribner's Sons, 1966. Summary: "God Rest You Merry Gentleman" shows a botched patient-caregiver interaction. Particular focus on problematic nature of communication around sensitive subjects such as sex. "Indian Camp" raises several troubling issues in the context of medical care, particularly that of insensitivity to cultural differences; in this case in the handling of a difficult childbirth and, later, a suicide. Commentary:

"Indian Camp" helped illustrate the idea that involvement with another culture sometimes leads to philosophical uncertainty. We paired "Indian Camp" with Silko's novel, Ceremony. (John Zavodny)

The story prompted a lively discussion of the arrogance of doctors and how health care professionals sometimes don't treat the whole person, but focus only on the localized problem. Participants didn't understand why the uncle disappears, or why the son feels as though he will never die, but this wasn't a problem in the discussion. (Michael Burke, Maine)

back to top : you are here Howatch, Barbara The Wonder Worker Genre: Novel Source: New York: Fawcett Books, 1998. Summary/Commentary: The story of a clergyman torn between the good use and the abuse of his genuine healing gift. Wounded healers misdiagnose the conditions of a number of people who come to a British church where a gifted healer of almost miraculous personal power conducts a healing program. (Esther Rauch, Maine) back to top : you are here Jewett, Sarah Orne The Country Doctor Genre: Novel Source: New York: Bantam Classics, 1999. Summary: Set in Maine, this is the story of a young woman who follows in the footsteps of her father to become a doctor. She must choose between marriage and her career as a doctor, and between the confining life of a small town and the expansion of her career. back to top : you are here Jewett, Sarah Orne "Mrs. Todd" Genre: Short Story Source: Sarah Orne Jewett, The Country of the Pointed Firs. Boston: David R. Godine, 2000. Summary: The herbalist and the doctor work in the same nineteenth-century Maine community. Mrs. Todd finds peace and fulfillment in healing herbs and hospitality. back to top : you are here Kafka, Franz "A Country Doctor" Genre: Short Story Source: Franz Kafka: The Complete Stories. New York: Shocken Books, 1995. Summary: Surrealistic short story from the viewpoint of a doctor harried by circumstances beyond his control. Making an emergency house call during a snowstorm, he has to abandon his female housekeeper to the attacks of a strange man lurking around his home, the same man who made the trip to the sick patient possible when he provided horses for the doctor's buggy. Commentary:

Explores the difficulty of identifying with patients' suffering through imagery reminiscent of Shamanistic medicine, in which the healer struggles with irrational forces greater than himself. The group found it very strange, but very compelling, too. (Allison Wallace, Maine)

back to top : you are here Kenney, Susan Sailing Genre: Novel Source: New York: Viking, 1988. Summary: The book is a novel based on the author's husband's experiences with a very rare malignant tumor. Sailing is a metaphor for their experiences. A central dilemma in the book concerns making choices for medical care based on length versus quality of life. Another dilemma concerns when it's time to let go and die (or let someone die.) Commentary:

We agreed in the seminar that this is basically a love story, focusing on the relationship between the two main characters over a period of several years. The book is a bit confusing, but this confusion mirrors the experiences of Phil and Sarah as they respond to his continuing need for treatment and his deteriorating health. Seminar participants moved back and forth between passages in the book and accounts of their own experiences caring for people who were dying. Not everyone was enthusiastic about the book, although most were, but everyone was enthusiastic about the topics it encouraged us to talk about. Mary Oliver's poem, "When Death Comes" complemented the book; the last line of the poem, "I don't want to end up simply having visited this world," sums up much of what Phil wants from his life after illness. (Susan Bell, Maine)

back to top : you are here Lahiri, Jhumpa Interpreter of Maladies Genre: Short Stories Source: New York: Houghton Mifflin, 1999. Summary: The stories in this beautifully crafted collection are set in the U.S. and India. Three are especially relevant for Literature & Medicine seminars: The central character in the title story is an Indian man who translates the maladies of patients for a physician and works on the side as a tour guide. "A Temporary Matter" is about an Indian-American couple whose baby is stillborn and whose marriage falls apart afterwards. "The Third and Final Continent" is about the relationship between a very old woman who lets rooms in Cambridge, MA and a young Indian man who rents a room from her on the day men land on the moon. Commentary:

This book engendered discussion beyond topics ordinarily covered in Literature & Medicine seminars, including the meaning of "culture" (what constitutes American culture and how it is represented). The notion of "translation" is one we spent quite a lot of time on, how health care givers translate patients' complaints into meaningful diagnoses, and the difficulties of communication between doctors and patients. (Susan Bell, Maine)

All the stories in this collection are worth reading and discussing. The author, of Indian descent but born and educated in the U.S., provides moving examples of the difficulty of mediating between cultures. (Ruth Nadelhaft, Maine)

back to top : you are here back to top : you are here Mates, Susan "The Good Doctor" Genre: Short Story Source: The Good Doctor. Iowa City: University of Iowa Press, 1994. Summary: A doctor is torn between her dedication to medicine and her requirements as a human being; she leaves a career in Africa to work at a New York City hospital. Commentary:

Raises questions about the trajectory of medical careers and life choices and, in particular, the role of gender in those decisions. Bryner's "This Red Oozing," Schafer's "Who Owns the Libretto?," Mates' "The Good Doctor," Welty's "A Worn Path," and Williams' "The Use of Force" were all paired together in a session about knowledge and power. (Kathy Ashley, Maine)

back to top : you are here Mates, Susan Onthank Laundry Genre: Play Source: Medical Readers' Theater: A Guide and Scripts. Ed. Todd Savitt. Iowa City: University of Iowa Press, 2002. Summary: A woman doctor in the late stages of pregnancy and early post-partum explores the stresses and attitudes she endures as a doctor who is also a woman and a mother. Commentary:

Discussing this play pulled out the emotional plug for a lot of caregivers who also have families to care for. Paired successfully with Hard's poem "Socialized Medicine" and LeVasseur's poem "Lullaby" in a discussion of "Circles of Care." (Francette Cerulli, Vermont)

back to top : you are here back to top : you are here Moore, Lorrie "People Like That Are The Only People Here: Canonical Babbling in Peed Onk" Genre: Short Story Source: Birds of America. New York: Knopf, 1999. Summary: This humorous yet deadly serious story looks at the experience of a couple whose toddler son develops cancer, and who come up against the medical world and the culture of illness. Commentary:

This story raises issues of physician insensitivity, of the medical system and its treatment of the illness but not the person, and of the honesty and truth surrounding the treatment of cancer. The humor of this story makes it easy to discuss the shortcomings of physicians and medicine. Participants responded with full hearts to this story. (Elizabeth Cooke, Maine)

The group dove into this story and the entire collection. They found the account of the baby's tumor absolutely gripping and were convinced that they could learn volumes about what really goes on in the hearts and minds of patients and families from this story. (Ruth Nadelhaft, Maine)

I paired this story with Anne Fadiman's The Spirit Catches You and You Fall Down. While the pairing worked well, participants were so engrossed with the Fadiman that there was relatively little discussion of the story. It allowed them to talk about the extent to which love of children transcends cultural differences and is sometimes manifested in troubling ways. Most of the participants found the story's narrator self-centered; some also found her hysterical and irresponsible-although they did not see the parents in the Fadiman's book in the same light. (Marli Weiner, Maine)

A very popular, if upsetting, story. The off-beat tone of the narrator as she tries to joke her way through the fact of her son's illness highlights the sense of unreality and unfairness we feel about life-threatening illness in a child, and shows how different people need different things to help them through a crisis. Moore confronts the "supposed-to-feel's" handed out to parents of kids with cancer, and doesn't accept them all. Paired very successfully with LeVasseur's poems "Hospital Parking Garage" and "Danny Boy" in discussing families. (Francette Cerulli, Vermont)

back to top : you are here Naylor, Gloria Bailey's Café Genre: Novel Source: New York: Vintage Books, 1993. Summary: An odd group of people congregate at Bailey's Café, a haven for broken people to either heal or end their lives. The action takes place in 1948 but goes back in time, sometimes by centuries, and features mostly people of color at crisis points in their lives. Commentary:

This book challenges the group to confront issues of poverty, race, and class at the same time as it allows them to contemplate their hospital as some version of the liminal space of "Bailey's Café." (Eve Raimon, Maine)

back to top : you are here back to top : you are here Paley, Grace "A Conversation With My Father" Genre: Short Story Source: The Collected Stories. New York: Farrar, Straus & Giroux, 1994. Summary: The narrator, a writer, and her elderly father discuss the narrator's writing style. In a roundabout way, the father and daughter have a conversation about the father's impending death and how it means different things for each of them. Commentary:

This prompted a good, if brief, discussion about the power of story, which reminded us of earlier session in which we'd discussed how important it is to listen to patient's story: how important to them, how important to their health, and how important to the health care provider. (Michael Burke, Maine)

back to top : you are here Powers, Richard Operation Wandering Soul Genre: Novel Source: New York: Perennial, 1994 Summary: An overwhelmed fifth-year resident in pediatric surgery in an inner-city Los Angeles public hospital tries to distance himself from the pain of his patients' lives. However, he meets an immigrant child (Joy) with whom he cannot maintain that distance; his fear of harming her during surgery leads him to make a fatal decision that will continue to haunt him. Commentary:

(Refers to excerpts: pp. 27-37, 70-105, 118-122, and 247-253.) This book is a difficult read, but worth the effort. Our group focused on the chapters describing Joy and physical therapist, Linda Espera, who challenges the main character to remain present to the emotional needs of his young patients. The sections focus particularly on Espera's efforts at "narrative therapy" for the children in the pediatric ward. Do we collude with history by turning atrocities of war, disease, and abandonment into fairy tales and epic? Can Espera's narrative therapy work for children who will never get "the regimen of blessed, bourgeois, fictive closure they have missed"? (Lisa Walker, Maine)

back to top : you are here Quindlen, Anna One True Thing Genre: Novel Source: New York: Delta, 1997. Summary: This first-person novel recounts the experience of a young woman who leaves her high-powered career in the city to return home to a small college town to care for her dying mother. It portrays the young woman's view of her mother dying of cancer as well as the reactions of her father and brothers. Commentary:

The novel raises questions about the right to die, about the difficulty both family members and neighbors have in communicating with a terminally ill person, and about the process of letting go of life. Paired with Jane Kenyon's poem, "Things," which reflected the mother's viewpoint. (Ann Fogg, Maine)

Overall, this book worked very well and we had a good discussion. But for some, it was too grim and too much a "woman's book." (Peter Harris, Maine)

back to top : you are here Sams, Ferrol Epiphany Genre: Novellas Source: New York: Penguin, 1995. Summary: Three novellas, full of humor, written by a physician who focuses on revelations born of unlikely interchanges between patient and physician. back to top : you are here back to top : you are here Selzer, Richard "Imelda" Genre: Short Story Letters to a Young Doctor. New York: Harvest Books, 1996. Summary: A physician recalls accompanying a brilliant plastic surgeon on a humanitarian mission to Honduras, where a young woman died from malignant hypothermia before the surgeon could operate on her. The surgeon secretly returned to the body to perform the operation anyway, and the narrator is still haunted by the surgeon's possible motivations. Commentary:

We did this as a staged reading and then explored the ethics of the doctor's actions and his motivation. This story was an enigma to all of us to some degree, but again, it generated a good discussion about one's interiority and actions. A reprise of the question: What makes a good doctor?

back to top : you are here Selzer, Richard "Mercy" Genre: Short Story Source: Letters to a Young Doctor. New York: Harvest Books, 1996. Summary: Examines a doctor's fascination with the body's resistance to death, and the doctor's own strong feelings when family members call upon him to end suffering with a mercy killing. Commentary:

Not quite as compelling as Kafka's "A Country Doctor" and Welty's "A Worn Path, " with which I paired this. (Allison Wallace, Maine)

Good piece for raising the issue of physician-assisted suicide, whether as a legal entity, or in an unspoken way. Readers found the doctor's dilemma quite familiar and understandable. (Michael Burke, Maine)

back to top : you are here back to top : you are here Selzer, Richard "Tube Feeding" Genre: Short Story Source: The Doctor Stories. New York: Picador, 1998. Summary: A short story, written by a surgeon, portrays the relationship between a dying woman and her caretaker husband. Commentary:

The story offers a graphic description of the physical manifestations of the woman's disease and the interventions to keep her alive, and the complexities in the relationship between the two characters. (Betsy Hart, Maine)

back to top : you are here Silko, Leslie Marmon Ceremony Genre: Novel

(For annotation see Experience of Illness, Fiction)

back to top : you are here Vonnegut, Kurt "Fortitude" Genre: Play Source: Wampeters, Foma, & Granfalloons. New York: Delta, 1999. Summary: One-act play full of black humor about modern medicine's ability to keep a patient alive by substituting machines for individual organs as necessary. Commentary:

Comments pointedly on the degree to which such heroics may be more for the doctor's than the patient's "good," or sense of well-being. Elicited strong reactions, good and bad. (Allison Wallace, Maine)

back to top : you are here Welty, Eurdora "A Worn Path" Genre: Short Story Source: A Curtain of Green and Other Stories. New York: Harcourt-Brace, 1941. Summary: A touching short story about an old woman's love for her ailing young grandson, her relationship to the natural world, and her remarkable self-reliance. Commentary:

Written in a lyrical, fable-like style, this narrative about an aged black woman's trip through the Southern winter landscape to get medicine for her grandson focuses on the meaning of her experiences and her motivating love. (Kathy Ashley, Maine)

An African-American grandmother makes a periodic pilgrimage on foot in order to bring her ailing grandson medicine that offers some relief from pain. Along the way, she faces physical, mental, and spiritual trials, including the dismissive racism and ageism of a health care worker. The grandmother's quiet, selfless persistence, and the overall simplicity (somewhat deceptive) of the narrative, made this piece a nice balance to Kafka's "A Country Doctor." (Allison Wallace, Maine)

back to top : you are here Williams, William Carlos The Doctor Stories Genre: Short Stories Source: New York: New Directions, 1984. Summary: A book full of wonderful stories about birth, life, and death and the power of the doctor to heal and be healed. "The Use of Force" recounts a physician's resort to force in a suspected case of diphtheria when he attempts to examine a young immigrant girl's throat. "The Girl With the Pimply Face" recounts his interactions with a young immigrant girl suffering from acne. Commentary:

"The Girl with the Pimply Face" - The brevity and directness of the author's writing show the situations and people that fire his work as a physician. The spunky girl and the poor, rough immigrant surroundings appeal to Williams in ways that are not unlike his attraction to the "red wheelbarrow." As a physician and as a poet Williams has found what nourishes him creatively and professionally. (Karin Dillman, Maine)

"The Use of Force" - A classic story about doctor-patient relations elicited a range of responses, from identification to revulsion, but also raised the issues of power in medical situations, of social class, and of the doctor's responsibilities and emotional investments. (Kathy Ashley, Maine)

"The Use of Force" elicited a positive response. Participants discussed the use of force in general as well as specific cases; all were struck by the writer's ability to bring to life a universal experience faced by health care providers. (Elizabeth Cooke, Maine)

back to top : you are here Williams, William Carlos "Girl with a Pimply Face" Genre: Play Source: Medical Readers Theater: A Guide and Scripts. Ed.,Todd Savitt. Iowa City: University of Iowa Press, 2002. Summary: When a physician goes to a tenement to treat the sick baby of an immigrant family, he meets the baby's adolescent sister and is taken by her spunk, forthrightness, and budding sexuality. He helps her clear up her complexion, and deals with the emotions of her mother, who is upset about her other sick child. Commentary:

The doctor frankly admires this spirited teenager. He dispassionately describes the stark living conditions of this family, as well as their distrust of him and the mother's perhaps lying about the family income. All offer good jumping-off points for discussion of cultural differences and those things a doctor may feel but doesn't usually speak of frankly because of his/her elevated position. Paired very successfully with Rafael Campo's essay "Like a Prayer" in discussing Loving the Unloveable. (Francette Cerulli, Vermont)

Poetry

Appleman, Philip "After the Faith Healing" Source: Philip Appleman, Darwin's Ark. Bloomington: Indiana University Press, 1984. Summary: A poem about the power of a parent to reject medical care for his child, in the name of religious convictions. The child, a diabetic, perishes in the night without his medication, which is withheld by his father who believes that evangelical faith will make him well. An important social commentary regarding the connections among faith, medicine and healing. Commentary:

People found the poem annoying and infuriating. Many missed the irony of the narrator and the way the narrator is able to both represent this fundamentalist point of view and critique it. We got bogged down in criticizing this way of viewing "healing." (Michael Burke, Maine)

back to top : you are here Appleman, Philip "Alive" Source: Articulations: The Body and Illness in Poetry. Ed. Jon Mukand. Iowa City: University of Iowa Press, 1994. Summary/Commentary: A powerful poem about the dynamics of relationships when one member of a family is dying, often causing distraught relatives to attempt to "hang on" to the dying individual for their own comfort. back to top : you are here Auden, W. H. "The Art of Healing" Source: W.H. Auden: Collected Poems. New York: Random House, 1968. Commentary:

A poem addressed from the poet to his deceased doctor. The poet reveals that what is most valued is the physician's own ability to be human. In this simple but rich portrait, he contrasts the extremes of medical arrogance with true healing. (Betsy Hart, Maine)

back to top : you are here Bryner, Jeanne Breathless Source: Kent, OH: Kent State University Press, 1995. Summary/Commentary: "Butterfly" - A very tender, yet graphic poem from a nurse's perspective about young men dying of AIDS in a hospital ward. Despite the nurse's initial discomfort with the young men, she seeks to comfort them in a caring and compassionate way.

"This Red Oozing" - A poem about a nurse's response to a woman who has been raped (Bryner is a nurse). Raises issues of violence, power, and class. This very powerful poem elicited much discussion about the psychological effects of violence. (Kathy Ashley, Maine)

back to top : you are here Cisneros, Sandra "Arturo Burro" Source: Sandra Cisneros, My Wicked Wicked Ways. New York: Random House, 1992. Summary: A short poem about a family's reaction to their mentally disabled child, told in the voice of a sibling. Commentary:

This raised the issue of the shame that often surrounds disability in our society. (Kathy Ashley, Maine)

back to top : you are here Davis, Courtney and Judy Schaefer, Eds. Between the Heartbeats: Poetry and Prose by Nurses Genre: Poetry, essays and fiction Source: Iowa City: University of Iowa Press, 1995. Summary: A collection of poetry, essays, and short stories by and about registered nurses that has inspired nurses all over the world. These works deal with care giving from nurses' unique perspective. (See also under Being a Caregiver, Non-Fiction) Commentary:

The poems raised discussion about what a doctor can do and what a nurse can do, and brought out many personal stories, all of which underscored the experience of being truly present with a patient. (Elizabeth Cooke, Maine)

I'd highly recommend this collection as a way of demystifying poetry for participants. The selections are uneven but the group I facilitate was inspired enough to try a directed poetry-writing exercise as "homework" for the following meeting. (Eve Raimon, Maine)

"Who Owns the Libretto?" by Judy Schaeffer - A dialogue between parents who are researching their child's illness and feeling guilty about it. Paired with The Spirit Catches You and You Fall Down, the doctor-parent communication issues become evident, even when the parents are college-educated. (Ann Fogg, Maine)

"The Body Flute" by Courtney Davis - This poem, the first reading the group discussed, was a very interesting introduction: I was amazed by the diversity of opinion on this piece, which focused on intimacy between nurse and patient, and loss/disappointment. Some readers thought Davis was the ultimate in empathy; others found her utterly self-centered and aloof! This made for an extremely interesting debate that helped our group get to know each other and give each other permission to disagree. I think it set a great tone for how we would "operate" and helped us bond quickly, despite differences of opinion. (Elayne Clift, Vermont)

"Lullaby," by Jeanne LeVasseur, is a beautiful, detailed description of the intimacy a nurse feels towards one of her dying patients. The poem shows how the nurse can be a conduit between the dying person and the bereaved. Paired with Susan Onthank Mates' "Laundry" and Walter Hard's poem "Socialized Medicine" in discussing "Circles of Care." In "Hospital Parking Garage," by Jeanne LeVasseur, a man walks to his car holding his wife's belongings after she has died, and places them into the passenger seat beside him. A short, compassionate look at how death changes the world for those left behind. Paired successfully with Lorrie Moore's short story "People Like That Are the Only People Here" and LeVasseur's poem "Danny Boy," in which couple keep vigil day after day over their son, in a coma after a car accident. The imagery in this poem is heart-breaking and beautiful, all the magical little actions the mother and father go through in hopes of bringing their son back to consciousness when the chances seem nil. No matter how we love them, we can't always stand between our children and harm. In "The Body Flute, a nurse talks about how the dying and the dead belong to the nurse who cares for them in a way they belong to no one else. This poem was especially popular for its honesty about the sense of intimate possession and exclusivity the nurse feels towards the dead. No one else performs the rites that she/he does. Successfully paired with Jerome Groopman's essay "Dying Words" in discussing "Death and Dying." This poem gave rise to a discussion about how the needs of the nurse to care for the dying in a way she/he sees as fitting are sometimes at odds with what the family wants. (Francette Cerulli, Vermont)

back to top : you are here Dickinson, Emily Selected Poems Source: Boston: Little, Brown & Co., 1976. Summary: This volume includes "Because I Could Not Stop for Death," "Death is Like the Insect," "The Heart Asks Pleasure First," "I Felt a Cleavage in my Mind," "I Felt a Funeral in my Brain," "I Heard a Fly Buzz When I Died," "Just Lost When I was Saved," "Much Madness is Divinest Sense," "My Life Closed Twice," and "Pain Has an Element of Blank." Commentary:

"Surgeons Must Be Very Careful" - A brief but incisive poem that crystallizes the tension between the technology of the surgical profession and the mystery of life. (Kathy Ashley, Maine)

The group really enjoyed this deceptively simple poem about surgery and the responsibilities of surgeons. The poem generated discussion about accountability at all levels of health care. (Muriel Fish, Maine)

back to top : you are here Hall, Donald Without: Poems Source: New York: Houghton Mifflin Co, 1998. Summary: Intensely graphic and moving poems about the illness and death of the poet's wife, the poet Jane Kenyon. Commentary:

A narrative in poetry which recounts Kenyon's struggle with leukemia and a bone marrow transplant, as experienced by her husband. He tells of their life, her illness, her death and his grief in his first year without her. Generated powerful discussion about love, suffering and grief. Paired successfully with several of Kenyon's poems about depression. (Betsy Hart, Maine)

Explores the chaos in being a partner to a person dying of cancer. The medical world appears to toss the narrator and his wife about, as in a sea of confusion, pain, false hope; the disease itself turns life inside out. Participants, in general, did not like the selection. Many had trouble making sense of it on their own and time was limited in discussing it; I recommend allowing plenty of time if these poems are used by others! (Elizabeth Cooke, Maine)

back to top : you are here back to top : you are here back to top : you are here Jacobson, Susan "Going Home" Source: Life On the Line: Selections on Words and Healing Ed. Sue Brannon Walker and Rosaly Demaios Roffman. Mobile: Negative Capability Press, 1992. Summary: In this poem, a nurse calms a patient whose "pain and fear are beyond his ability to control" after an extremely painful procedure. Commentary:

A rousing poem celebrating nurses' combinations of courage and compassion. The group responded strongly to this poem-I recommend it. The anthology the poem is in is uneven, but it is arranged thematically: "Abuse," "Death and Dying," "Illness," "Relationships," "Memory," "Rituals and Remedies," and "White Flags From the Silent Camp." (Peter Harris, Maine)

back to top : you are here Levertov, Denise "Window-Blind" Commentary:

This poem provided hope and perspective in a discussion of the treatment of mentally ill patients. The windows might feel closed or we might close them in fear or anger with ourselves or others. Light, healing, the spirit enter regardless. (Karin Dillman, Maine)

back to top : you are here Masson, Veneta Rehab at the Florida Avenue Grill Source: Washington, D.C.: Sage Femme Press, 1999. Summary/Commentary: Vivid, unpretentious, intimate poems, written by a nurse who cares for an under-served population in a poor urban neighborhood. We read several of Veneta Masson's poems throughout the year, and the group liked them so much that we plan on reading the brief collection in its entirety next year. These poems speak to clinicians: the voice is so familiar, and the patients so like our own. The best works by a nurse that we have found, and some of the most accessible poetry, enjoyed even by those who shy away from this genre. (Betsy Hart, Maine) back to top : you are here Miles, Josephine "The Doctor who Sits at the Bedside of a Rat" Source: Kinds of Affection. Middletown, CT: Wesleyan University Press, 1967. Summary: Satirical treatment of medicine's ability to "communicate" with lab animals but not with patients. Commentary:

"The Doctor who Sits at the Bedside of a Rat" was paired with Pablo Neruda, "Larynx;" Gwendolyn Brooks, "The Bean Eaters;" Dylan Thomas, "Do Not Go Gentle into That Good Night;" Sharon Olds, "Miscarriage;" and Philip Larkin, "Faith Healing." All of these poems went over fairly well, but the truly outstanding discussions centered on "Miscarriage" and "Faith Healing." We discussed the poems in one long evening, our last session. Saving poetry for last was my choice, and I'm glad I did-people were better readers by then, and even those who thought that they weren't "good at" poetry did understand and enjoy it on the whole. (Allison Wallace, Maine)

back to top : you are here Oliver, Mary "Mockingbirds" Source: The Atlantic Monthly, February 1994. Summary: The poet reflects that the greatest gift may be the "willingness to be attentive." Commentary:

Paired well with Reman's Kitchen Table Wisdom. Both illustrate the power of listening and being fully present. (Betsy Hart, Maine)

back to top : you are here Oliver, Mary "University Hospital, Boston" Source: New and Selected Poems. Boston: Beacon Press, 1992. Summary: Poem about visiting a sick loved one; overtones of Civil War suffering and recent epidemics. Commentary:

This poem resonated with experiences in the group of caring for people with HIV/AIDS during the early years of the epidemic and stimulated discussions about nature/culture and cycles. I'd recommend pairing it with Tillie Olsen's work. (Susan Bell, Maine)

back to top : you are here Sexton, Anne "Doctors" Source: The Complete Poems. Boston: Houghton Mifflin, 1982. Summary: The power and frailty of doctoring. back to top : you are here Straus, Marc One Word Source: Evanston, IL: Northwestern University Press, 1994. Summary: Various powerful and direct short poems by an oncologist about spoken and unspoken communication between doctor and patient. Commentary:

Marc Straus's One Word worked very well because it dealt with the subtexts of both an oncologist's remarks and his patient's oblique way of expressing fear or denial. It also confronted the oncologist's sense of being inadequate. Particularly effective were a series of poems that interrogate the notion of cost-benefit analysis of chemotherapy protocols. (Peter Harris, Maine)

In "Say Ninety-Nine" and "Spawning Season," the physician-author ponders both the patient's experience of illness and the power wielded by the doctors who care for them. The vivid imagery and profound insights into the culture of medicine and the roles played by patient and doctor resonated particularly with the physicians in the group. Paired successfully with poetry by Veneta Masson that deals with similar subjects from a nursing perspective. (Betsy Hart, Maine)

back to top : you are here Thomas, Dylan "Do Not Go Gentle Into That Good Night" Source: Collected Poems of Dylan Thomas. New York: New Directions, 1971. Summary: Thomas's famous poem, where he tries to convince his father to fight against impending death. See commentary under Josephine Miles, "The Doctor who Sits at the Bedside of a Rat." (Allison Wallace, Maine) Commentary:

Most readers hadn't seen the poem for years, and were amazed to see how differently they read it now. Previously, they were inclined to see the narrator as someone who is speaking to an older person (perhaps a father) and urging them to live on, for that person's sake; now, as older readers, we saw that the narrator may have selfish reasons for making this appeal. This prompted a good discussion about how often self-interest is at the heart of health care decisions in families. (Michael Burke, Maine)

back to top : you are here Whitman, Walt "Vigil Strange I Kept on the Field One Night" Source: New York: Norton, 1978 Summary: Civil War poem in which the narrator maintains a loving vigil for an unknown soldier. Commentary:

The group had an interesting reaction, in feeling as though the empathetic narrator is not doing anything unusual: this is the way all nurses act, according to them. so the enormous empathy didn't seem unusual. (Michael Burke, Maine)

back to top : you are here Williams, William Carlos "The Last Words of My English Grandmother" Source: The Collected Poems of William Carlos Williams, Volume I, 1909-1939. New York: New Directions, 1986. Summary/Commentary: Williams was both a physician and a well-respected poet who worked primarily with poor immigrant families in New Jersey. The poet asks who it is we are treating when we try to make a dying old woman comfortable. (Betsy Hart, Maine) back to top : you are here Williams, Carlos Williams "The Birth" Source: The Collected Poems of William Carlos Williams, Volume II (1939-1962). New York: New Directions, 1986. Commentary:

Williams was both a physician and a well-respected poet who worked primarily with poor immigrant families in New Jersey. In this vivid poem, Williams describes a challenging delivery, declaring himself a feminist while he marvels at the amazing feat of a woman giving birth. (Betsy Hart, Maine)

Non-Fiction

Ackerman, Diane A Slender Thread Genre: Memoir Source: New York: Vintage, 1998. Summary: A poetic memoir about service on a suicide hotline that reveals the interconnections between our suffering and lives. The writer views crisis as an innate part of human experience. back to top : you are here Alvord, Lori Arviso The Scalpel and the Silver Bear Genre: Personal narrative Source: New York: Bantam, 1999. Summary: A memoir by the first Navaho woman surgeon, recounting her efforts to integrate her training as a surgeon with the culture and spirituality of her people. Commentary:

This book teaches us much about cross-cultural care and medical training, but also much about what is healing in our own lives. Paired with Margaret Edson's play, W;t. We had a stimulating discussion about the culture of health care. (Betsy Hart, Maine)

back to top : you are here Bayley, John Iris and Her Friends: A Memoir of Memory and Desire Genre: Memoir Source: New York: W.W. Norton, 2000. Summary: Bayley tells the story of the descent into Alzheimer's disease of his wife, novelist Iris Murdoch. Commentary:

While Bayley provides a moving and lucid account of the effects of Alzheimer's disease on his wife, he also provides a very compelling and useful narrative of his own coping strategies. The memoir is as much an excursion into Bayley's secure memories as it is a chronicle of Murdoch's loss of such memory. (Ruth Nadelhaft, Maine)

back to top : you are here Berger, John A Fortunate Man Genre: Essay Source: New York: Vintage Books, 1997 (originally published in 1967). Summary: Long essay that closely follows a family doctor in rural England and meditates on the challenges posed by practicing in an impoverished cultural backwater as well as the qualities in this particular doctor that enable him to do so successfully. Commentary:

Includes many insightful remarks on the nature of empathy and doctor-patient identification, and on class and rural/urban tensions (which is one reason I chose to use it in a rural hospital). Worked well, though next time I probably wouldn't use it as the first selection-it isn't "light" reading. (Alison Wallace, Maine)

back to top : you are here Boyd, Doug Mad Bear: Spirit, Healing, and the Sacred in the Life of a Native American Medicine Man Genre: Biography Source: New York: Simon & Schuster, 1994. Summary/Commentary: Mad Bear was a member of the Bear Clan of the Tuscarora Nation of the Six-Nation Iroquois Confederacy of the United States and Canada. A Native American rights activist, he was also a medicine man and a leader with great power and influence both among his own people and cross-culturally. In this personal and captivating narrative, Doug Boyd recreates Mad Bear's tales of magic, his healing powers, and Native American legends. A rich and colorful portrait of the fascinating life of a vibrant, spiritual man. (Esther Rauch, Maine) back to top : you are here back to top : you are here Campo, Raphael "The Desire to Heal" Genre: Essay Source: The Poetry of Healing: A Doctor's Education in Empathy, Identity, and Desire. New York: W.W. Norton & Co., 1997. Summary: A gay, HIV-positive Latino doctor, who is also an accomplished poet, reflects on becoming a doctor, relations with patients, and his own illness. Commentary:

About a doctor coming to grips with not just the humanness, but the sensuality of practicing medicine, and how he came to it. (Allison Hepler, Maine)

back to top : you are here Campo, Rafael "Like a Prayer" Genre: Essay Source: A Life in Medicine: A Literary Anthology. Robert Coles, M.D. & Randy Testa, Eds. New York: The New Press, 2002. Summary: As an intern working with AIDS patients, Campo is enraged when a junkie, a "low-life" with AIDS, assumes from Campo's name that he is Catholic and asks him to pray for him next time he goes to church. Then, when Campo accidentally gets stabbed in the hand by an IV needle from another AIDS patient, he confronts his own outcast status as a gay man rejected by the Church. He comes to accept his spiritual nature and his connection to all who suffer and love. Commentary:

This essay was very popular. Subjects ranged from "homosexuality is a sin," to the comfort of differing spiritual beliefs, to what people believe happens after death, if anything. Paired very successfully with the play "The Girl with a Pimply Face" in discussing "Loving the Unloveable." (Francette Cerulli, Vermont)

back to top : you are here Cassel, Eric J. The Nature of Suffering and the Goals of Medicine Genre: Essays Source: New York: Oxford University Press, 1991. Summary: A treatise which explores the paradox of suffering caused by treatment. Commentary:

It raises the question: What is the physician's responsibility in understanding pain and suffering? The piece helped the group to discuss how they are in relationship with their patients and how they are in touch with their own feelings about what is asked of them - as practitioners and as people. Both this piece and "Facing Mortality: The Virtue of a Common Life" by David Loxtercamp are written with exquisite sensitivity, which was reflected in the discussion. (Elayne Clift, Vermont)

back to top : you are here Coles, Robert "Medical Ethics and Living a Life" Genre: Essay Source: Robert Coles, The Call of Stories. Boston: Houghton Mifflin, 1989. Commentary:

Coles articulates the challenges of attending to ethical issues in medical practice, with reference to a number of novels that illuminate dilemmas in medical ethics. What Coles calls the tensions between idealism and practicality was the theme running through many of our discussions and one that participants wanted to address. Paired with John Donne's poems and Margaret Edson's play, W;t. (Kathy Ashley, Maine)

The group did not like this essay; they found Coles too preachy. The general consensus was that in health care everyone is trying to do the best they can, and are hopefully making the right moral and ethical choices on a daily basis. (Muriel Fish, Maine)

back to top : you are here Coulehan, Jack "Tenderness and Steadiness: Emotions in Medical Practice" Genre: Essay Source: Literature and Medicine 14 (Fall 1995): 222-236. Summary: The editor of the journal Literature and Medicine summarizes the basic dilemma for doctors of maintaining distance and closeness. back to top : you are here Davis, Courtney and Judy Schaefer, Eds. Between the Heartbeats: Poetry and Prose by Nurses Genre: Poetry, essays, and fiction Source: Iowa City: University of Iowa Press, 1995. Summary: A collection of poetry, essays, and short stories by and about registered nurses that has inspired nurses all over the world. These works deal with care giving from nurses' unique perspective. (See also under Being a Caregiver, Poetry) Commentary:

"Euthanasia" by Belle Waring - A powerful personal essay about an incident of euthanasia performed by a nurse on an infant, how she tells another nurse what she has done, and that nurse's reaction to the event. This essay generated a lot of discussion about euthanasia, hierarchies within nursing staff, emotions involved with administering final doses of morphine to patients, and caring for terminally ill infants. (Muriel Fish)

"Hospital Course" by Sarah Collings - A personal essay written by a nurse who cared for a chronic smoker with heart disease and how that patient dies as a result of insisting on being allowed to smoke while in the hospital. A lot of frustration was expressed in caring for patients who continue to smoke (and drink alcohol or abuse other drugs) in spite of serious illness and how sometimes it's difficult to feel compassion for them. (Muriel Fish)

back to top : you are here Doty, Mark Heaven's Coast Genre: Personal narrative Source: New York: HarperCollins, 1997. Summary: A poet's account of his lover's death from AIDS and his own grieving. Commentary:

This book was effective in the seminar because it shows the family's perspective so completely, with only occasional interventions from health care providers. It also opened discussions of religion, ranging from the spiritual implications of illness to how individuals (both the dying themselves and their care givers) find comfort-in Doty's case, from animals and nature, among other sources. Participants appreciated the beauty of the writing and found much to compare with The Death of Ivan Illych, appreciating this as a good death surrounded with love, community, and ceremony. Participants found the book a useful way to address their own assumptions about homosexuality. I paired this with some of Doty's poems treating the same events; these were not discussed much and participants found them repetitive. (Marli Weiner, Maine)

back to top : you are here Dugan, Matt "Repose" Genre: Essay Summary/Commentary: This personal essay by a young physician helped us explore "why bad things happen to good people." We talked about Kubler-Ross's five steps of death and dying, and participants were able to identify their own feelings (e.g. fear, fatigue, loss, pain). A key question in our discussion was whether the author's experiences are unique to neophytes or equally relevant for seasoned doctors. (Elayne Clift, Vermont) back to top : you are here Fisser, Timothy J. "Pies" Genre: Essay Source: A Life in Medicine: A Literary Anthology. Robert Coles, M.D. & Randy Testa, Eds. New York: The New Press, 2002. Summary: In this one-page essay, Fisher describes "a small good thing" that happened to him in medical school when, for a moment, he relaxed enough to allow an elderly male patient tell an earthy story about a prank he and his brothers played when they were kids. Commentary:

Though this is about a touching moment in which the maskes drop off doctor and patient, many in the group (all women that particular time, as I recall) were so disgusted by the nature of the trick the boys played (peeing into the little hole in the top of apple pies their mother had left on the porch to cool) that the poignancy of the connection between the two main characters got lost. Maybe it was a guy thing. (Francette Cerulli, Vermont)

back to top : you are here back to top : you are here Gawande, Atul Complications: A Surgeon's Notes on an Imperfect Science Genre: Essays Source: New York: Henry Holt, 2002. Summary: All of Gawande's essays focus on the hard work of making daily decisions about patient care. A surgeon, he writes with great feeling about the mistakes he's made and the ones he's observed. All of these appeared originally in The New Yorker. Commentary: "When Doctors Make Mistakes"

We read this in a session on "Mistakes," along with Marianne Paget's A Complex Sorrow. Gawande's essay, with its accessible combination of personal narrative and sociological analysis, was easily accepted by the group as an accurate and insightful take on a worrisome problem. Discussants all recognized that the culture of medicine assumes professionals can and should routinely achieve perfection, even if that goal is not realistic. (Kathy Ashley, Maine)

This honest, gutsy essay treats doctors as no more or less mistake-prone than the rest of humanity. Using narratives from his own experience and observation, he looks analytically at the failure of malpractice suits, at the value of weekly Morbidity and Mortality Conferences, and at ways to revise medical procedures and technologies to prevent good doctors from making mistakes. There was much discussion about the M&M, which in different hospitals some members had experienced as valuable and others as vicious, and we discussed Gawande's distinction between guilt (about an act that was wrong) and shame (feeling one's self to be wrong). The discussion went on to the difficulties doctors have trying to read all levels (words and body language) of a patient's message, trying to overcome their own prejudices, and reacting to patients who "doctor shop." I paired it with Marianne Paget's A Complex Sorrow, both of which treat errors as human and which find lawsuits ineffective in lessening medical errors. This session was the only one in which both assigned writings got equal time in the discussion. (Ann Fogg, Maine)

The focus of the discussion was on the theme of "complications" in treatment, and prompted various stories from participants on similar problems in their experience. The book was treated more as a springboard for sharing stories, than it was as a literary document. There wasn't much discussion of it, by itself. (Michael Burke, Maine)

A surgical resident's surprisingly honest description of medical mistakes, the culture which envelops them, and the cloistered discussions which physicians have about the sometimes deadly mistakes made by even the best of doctors. (Betsy Hart, Maine)

back to top : you are here Gitter, Elisabeth The Imprisoned Guest: Samuel Howe and Laura Bridgman, the Original Deaf-Blind Girl Genre: Biography Source: New York: Farrar, Straus and Giroux, 2001. Summary: The book is a joint biography of a mid-nineteenth century reformer and the young girl he taught to speak and write after she lost her sight and hearing at age three. Both became quite famous as a result of Howe's efforts at publicity and self-promotion. Commentary:

Participants used this book to discuss attitudes about difference and the ethical issues surrounding helping those who are different. They agreed that Howe exploited Bridgman, yet also recognized that he made her life richer than it otherwise would have been. They also discussed what it was possible for Bridgman to know, how she thought, what the range of her emotions was, how she expressed herself, and extended those questions to think about how all of us perceive ourselves and others. (Marli Weiner, Maine)

back to top : you are here Groopman, Jerome "Dying Words" Genre: Essay Source: The New Yorker, October 28, 2002. Summary/Commentary: This excellent article helped us explore how doctors should/do deliver bad news. We talked about the challenge of translation to some audiences, the challenge of truth and hope, and the challenge of honesty and self. We also explored the segue between medicine and religion. (Elayne Clift, Vermont)

Dr. Groopman, an oncologist, writes about the part of his job that is the hardest: delivering the news to patients that their illness is going to kill them. He had to learn this over the years, as his medical training gave him no preparation from her initial diagnosis through her death. His sensitive but clear reporting of all aspects of what goes on between doctor and patient is especially moving. Here is a physician who mirrors and meets his patient's emotional needs, and doesn't leave all the work of caring to the nurses. He stays with his patient and her parents as she dies, but there is nothing self-congratulatory in his description. Successfully paired with Courtney Davis' poem "The Body Flute" in discussing Death and Dying. (Francette Cerulli, Vermont)

back to top : you are here Heyman, Jody Equal Partners: A Physician's Call for a New Spirit of Medicine Genre: Personal narrative Source: New York: Little, Brown & Co., 1995. Summary: A physician's plea for medicine to change the power imbalance that often keeps patients from having a voice in their own care. A memoir of her first years after graduating from medical school, when she develops a seizure disorder due to a vascular tumor in her brain that results in neurosurgery, anti-seizure drugs, and an awareness of the failings of medicine from the patient's perspective. Commentary:

This is very much a first book, but quite powerful in recounting Heymann's experiences as a patient and as a resident at Harvard's teaching hospitals. It also raises questions about inequities in health care and about health care in the developing world, as the author travels to pursue her interest in underserved communities in Latin America. Unfortunately, our group was so put off by weakness in the writing, and by personality traits that they did not like in the author, that the important messages in the book were lost in our discussion. Most group members thought it was a chore to read. (Betsy Hart, Maine)

back to top : you are here Higonnet, Margaret R., Ed. Nurses at the Front: Writing the Wounds of the Great War Genre: Fiction and Personal narrative Source: Boston: Northeastern University Press, 2001. Summary: The graphic accounts of two nurses' experiences during World War I. Horrifying descriptions of the lives of nurses at the front lines, and the great carnage of human life that takes place during war. Higonnet has provided those interested in literature and medicine with a ready-made pairing of her own. Mary Borden and Ellen N. La Motte were nurses, witnesses and scribes at the Western front of World War I. The introduction tells how each traveled a unique path to her front line field hospital. The excerpts (from Borden's The Forbidden Zone and La Motte's The Backwash of War) demonstrate how each found her own style to record the routine tragedy of life at the front. Commentary:

These collected writings were the basis of moving discussions in the seminars, in part because a few of the participants had been in Vietnam as medics or nurses. The discussion centered on how best to think of the role of medicine in war, which the authors present as having the purpose of patching men up in order to send them out to be wounded again or killed. Participants also talked about change in medicine, in that there was little these nurses could do to help the men in their care, and the absence of change in terms of the ultimate isolation of death. One of the two groups with which I used the book was able to compare the writings of the two nurses included in it, exploring the class differences between them and their different reactions to the soldiers, while the other saw the book as a bit repetitive. Neither group liked the introduction, written from the perspective of a literary critic, although most of them read it all rather than just the biographical section as I had suggested. (Marli Weiner, Maine)

This confederacy of styles and vision makes for a powerful reading experience. Compare La Motte's often-prosaic account of a nurse's-a woman's-daily life at a field hospital with Borden's dreamlike reminiscences of the same bloody and basic existence. La Motte counts the human cost of medical success in "A Surgical Triumph," while Borden's "Moonlight" chases answers during a sleepless night. Both powerful in their own way, as a de facto team, Borden and La Motte engage the reader in an accounting both of war and of ways of experiencing it. Alongside Nurses at the Front we read selections from Visions of War, Dreams of Peace (edited by Lynda Van Devanter and Joan Furey), a collection of poems by women involved with Vietnam. (John Zavodny, Maine)

back to top : you are here Hilfiker, David "Mistakes" Genre: Essay Source: Healing the Wounds: A Physician Looks at His Work. Omaha: Creighton University Press, 1998. Summary: A doctor mistakenly aborts a healthy fetus. Pair with Atul Gawande's essay, "When Doctors Make Mistakes". Commentary:

There was doubt about whether or not the section about the pregnant woman was true because of the errors that were made. According to the group, the mistakes were easily preventable. Many wondered if Hilfiker used literary license with his story to make his point. But maybe that was the point: even in obviously preventable circumstances, it's easy to make mistakes. Standardization of procedures and use of equipment were discussed, along with why change is slow (installing, learning, and teaching the new procedures takes time and money). The perceived embellishment of details turned readers off to this reading. (Muriel Fish, Maine)

back to top : you are here Hine, Darlene Clark Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890-1950 Genre: History Source: Bloomington: Indiana University Press, 1989. Summary: In this well-researched work, Hine examines the professionalization of black nurses through institutional developments in hospitals, training schools, and nursing organizations. back to top : you are here back to top : you are here Huyler, Frank The Blood of Strangers: Stories From Emergency Medicine Genre: Personal narrative Source: New York: Henry Holt, 2000. Summary: Lyrical medical vignettes of encounters with memorable patients and other doctors in an emergency room setting. Commentary:

The collection can prompt discussion about the strange intimacy between patient and caregiver, as well as more common topics like medical mistakes. At the same time, Huyler's detached, professional voice and his spare, Hemingway-esque writing style alienated some readers. (Eve Raimon, Maine)

back to top : you are here back to top : you are here Kincaid, Jamaica My Brother Genre: Personal narrative Source: New York: Farrar, Straus & Giroux, 1997. Summary: An account of her brother's death from AIDS, by a virtuoso writer. back to top : you are here Lerner, Gerda A Death of One's Own Genre: Personal narrative Source: New York: Harper Collins, 1980. Summary: Lerner, an historian who helped create the field of women's history, describes her husband's death from a brain tumor and tells the story of her family's resistance to the Nazis in this powerful book. Not simply an illness narrative, the book explores the consequences of evil and suffering and identifies the moral resistance to both as part of what it means to be human. Commentary:

Participants were moved by this account of human resistance to death and devastation. Although some were less than sympathetic to Lerner for what they viewed as her glorification of personal heroism, they recognized in themselves the commitment to resist death on every front, even when such resistance might not be appropriate for the patient. (Marli Weiner, Maine)

back to top : you are here Loxtercamp, David "Facing Mortality: The Virtue of a Common Life" Genre: Essay Source: A Life in Medicine: A Literary Anthology. Robert Coles, M.D. & Randy Testa, Eds. New York: The New Press, 2002. Summary: This reflection explores medical ethics and the role of collaboration in the practice of medicine. It also touches on the relationship of the practitioner to others, both actual and ideal. Commentary:

This piece helped the group to discuss how they are in relationship with their patients and how they are in touch with their own feelings about what is asked of them-as practitioners and as people. Both this piece and The Nature of Suffering and the Goals of Medicine by Eric J. Cassel are written with exquisite sensitivity, which was reflected in the discussion. (Elayne Clift, Vermont)

back to top : you are here McPhee, John Heirs of General Practice Genre: Non-fiction Source: New York: Farrar, Straus & Giroux, 1986. Summary: McPhee's book grows out of his observations of rural Maine family health practices. It focuses on the role of family medicine: what it can and cannot do. Commentary:

This book stimulated a "back to rural health care" movement some of the seminar participants knew about firsthand. It was an especially welcome book, since it was based on the lives of physicians in northern Maine and it gave rise to lively discussion drawing on the historical perspectives of group members who now practice in Maine. Paired with Ibsen's An Enemy of the People and Baida's "A Nurse's Story" in a session on "The Social Roles of Medical Professionals." (Kathy Ashley, Maine)

The group I was working with were divided about McPhee's book: about half thought it was undistinguished, outdated, boring; the other half liked it very much (one doctor remembered reading it in medical school and having it "change his life"). We did have a fairly productive discussion about family practice in general and the social issues brought up by the book. I admit to a bias in favor of creative non-fiction in general and McPhee in particular, but I probably would not use this book again. Paired with William Carlos Williams' "The Last Words of My English Grandmother," "The Birth," "The Practice," "The Artist," and "Le Medecin Malgré Lui;" and Lewis Thomas' "House Calls." (Margery Irvine, Maine)

back to top : you are here Mangerich, Agnes Jensen, Evelyn Monahan, and Roseanna Neidel Albanian Escape: The True Story of U.S. Army Nurses Behind Enemy Lines Genre: History Source: Lexington: University Press of Kentucky, 1999. Summary: The account of the escape of Army nurses during World War II from Nazi forces in Albania. A harrowing tale of the dangers suffered and duties performed by nurses during World War II. back to top : you are here Manning, Martha Undercurrents: A Life Beneath the Surface Genre: Memoir Source: San Francisco: Harper, 1996 Summary: The story of a psychotherapist who is herself severely depressed. Her only effective treatment is ECT. Commentary:

This book was added because the group wanted to read something that dealt with mental illness. Relatively short and very gripping. While I would have preferred more time for this, it did engage the group and provide an opportunity to talk about the psychic demands of their professions, and the fact that "there but for the grace of God…" Again, empathy was a theme.

back to top : you are here back to top : you are here back to top : you are here Ofri, Danielle Singular Intimacies: Becoming a Doctor at Bellevue Genre: Memoir Source: Boston: Beacon Press, 2003. Summary: Ofri is an attending physician in the medical clinic at the legendary Bellevue Hospital in New York City and a teacher of young physicians at her alma mater, New York University. She also co-founded and edits the much-praised Bellevue Literary Review, and is a co-editor of the award-winning Bellevue Guide to Out-Patient Medicine: An Evidence-based Guide to Primary Care. Her book, Singular Intimacies: Becoming a Doctor at Bellevue, is about her experiences as an intern and resident at the institution that shaped her as a physician. In "Stuck," she shares the fear of a young intern who, accidentally exposed to a patient's blood, is comforted by that patient, an elderly nurse's aide who hugs the weeping novice and assures her that she is not HIV-positive. In "Change of Heart," she and her senior colleagues grapple with whether or not an affable, drug-addicted patient should receive a transplant. In "Charge" offers a real look at the frustration doctors face in managing a hostile, aggressive, racist patient. Commentary:

As a physician-writer, Ofri is in the company of William Carlos Williams, Atul Gawande, Richard Selzer, Perri Klass, and A.J. Cronin, all of whom have understood the value of wedding humanities to health care. Her book has been hailed as "a beautiful book about souls and bodies, sadness and healing," and she has been called a "born storyteller as well as a born physician." Ofri writes with humor and compassion as she draws you into her own experience of training and doctoring. Each vignette in this engrossing book allows the reader to experience the reality, with all its challenges and rewards, of being a caring health provider and a sensitive student of the human condition. Interestingly, her work was not entirely well-received in a group comprised of physicians, nurses, technicians, a Hospice worker, an ethicist, a dentist and a pharmacist. They found Ofri largely idealist and naive. While they condemned the lack of institutional support she received, they felt that she had crossed boundaries in allowing a patient to physically comfort her, and they saw her as too inexperienced to write with authority. Some participants felt she was a weak writer altogether. In her defense, some did find the humanity in her storytelling refreshing. (Elayne Clift, Vermont)

back to top : you are here Parker, Ted "I know Every Word I Say Is Being Listened To" Genre: Personal narrative. Source: Parting Company: Understanding the Loss of a Loved One: The Caregiver's Journey. Ed. Cynthia Pearson and Margaret L. Stubbs. Seattle: Seal Press Feminist Publishers, 1999. Summary: A young oncologist discusses his experience as a physician who treats cancer patients, his need to remain somewhat detached and to close off his emotions, and how his life is given over to the needs of his patients. Commentary:

Participants did not really relate to this physician's way of responding to a job that everyone agreed is most difficult, but it led to good discussion of how physicians face the loss of their patients and how a caregiver has other options in responding to patients and to work. (Elizabeth Cooke, Maine)

back to top : you are here Remen, Rachel Naomi Kitchen Table Wisdom: Stories that Heal Genre: Essays Source: New York: Riverhead Books, 1997. Summary: A collection of real-life parables that proves that oral traditions in this country are still alive and well. This collection of stories shows us the best about humanity and ourselves. Commentary:

A great book when a group asks for something uplifting and enjoyable to read; it also has substance. The discussion focused on the ways people grow through illness and suffering and the lessons providers learn from their patients. Includes pieces on holistic medicine, spirituality, and the physician author's own experiences with Crohn's disease. Most group members thoroughly enjoyed it; a few would have preferred only a few excerpts, specifically the essays "Silence," "Professionals Don't Cry," and "Prayer." (Betsy Hart, Maine)

This was read in a session called "Inside the Profession." It ended up being a wonderful discussion about healing and curing, about relationships with patients, and a lot about nurses in particular. While this group perhaps works in a more intimate environment than some other hospitals and tried to de-emphasize any medical or professional hierarchies, the discussion helped identify some of them. (Alison Hepler, Maine)

"Silence" is a very short piece about the author's early memory of an experience with an elderly patient in a nursing home, focusing on how silence and patience can be a healing cure and a way into a patient's heart. It hit home with numerous participants and led to a good discussion about how to know what a patient needs. Participants talked about assumptions about how to be with a patient, and about the time limits of their work. (Elizabeth Cooke, Maine)

back to top : you are here Reverby, Susan Ordered to Care: The Dilemma of American Nursing, 1850-1945 Genre: History Source: New York: Cambridge University Press, 1987. Summary: A socially insightful history of nursing in America since the Civil War. back to top : you are here Roberts, Cokie "Sister" Genre: Essay Source: We Are Our Mothers' Daughters. New York: W. Morrow, 1998. Summary: In this brief essay, the journalist looks at sisterhood, the death of her sister from breast cancer, the community that got them through it, and the contributions and limitations of the doctors who they encountered. back to top : you are here Selwyn, Peter Surviving the Fall: The Personal Journey of an AIDS Doctor Genre: Personal narrative Source: New Haven: Yale University Press, 1998. Summary: A doctor's account of his first ten years out of medical school, working with HIV positive patients during the first years of the AIDS crisis. Selwyn mirrors this narrative with a more personal and painful narrative of his father's suicide during Selwyn's childhood. back to top : you are here back to top : you are here Small, Hugh Florence Nightingale: Avenging Angel Genre: Biography Source: New York: St. Martin's Press, 2000. Summary: A biography of the famous caretaker drawing from personal papers that have not been used by other biographers. Small discusses Nightingale's illness after the Crimean War and attempts to prove that it was not caused by neurosis as previously recorded, but by the overwhelming guilt that she could have saved more lives, had she enforced the sanitary procedures she knew were crucial to preventing deadly infections. back to top : you are here Smith, Winnie American Daughter Gone to War Genre: Memoir Source: New York: William Morrow and Company, Inc., 1992 Summary: (Chapter Six, "January 1967: Hard Roads to Travel") A chapter from a memoir by a Vietnam-era nurse, in which she contrasts the brutal reality she lives in Vietnam, with her mother's assumptions from the States, as expressed through letters. Commentary:

We focused only on the disjunction between the veteran's experiences of war, and how difficult it is for others to understand what they experienced. (Michael Burke, Maine)

back to top : you are here back to top : you are here Ulrich, Laurel A Midwife's Tale: The Diary of Martha Ballard, 1785-1812 Genre: History Source: New York: Random House, 1990. Summary: Early American social and community relations seen through the eyes of a Maine midwife. The mother of nine children, Martha Ballard spent the last 27 years of her life at the center of the medical services of Hallowell, Maine. Commentary:

Combining excerpts from Ballard's diary with skillful explorations of their meaning, this work offers a complex interpretation of the roles of women as caregivers while medicine was beginning to be professionalized. Participants in the seminar found it difficult reading; those who persisted found their efforts rewarded by a solid understanding of the ways in which the practice of medicine has changed over time. The discussion centered on changing practices of birth, in part because of the presence of a nurse-midwife, and on the changing social context of medicine. Physicians in particular were struck by what it meant to practice medicine in such a different context, long before modern notions of disease causation or effective remedies. I suggest choosing chapters from the book rather than asking participants to read all of it. (Marli Weiner, Maine)

back to top : you are here Verghese, Abraham My Own Country: A Doctor's Story of a Town and its People in the Age of AIDS Genre: Personal narrative Source: New York: Simon & Schuster, 1994. Summary: An Indian doctor's experiences treating AIDS patients in rural Eastern Tennessee during the early years of the epidemic. Commentary:

This was the only text for the session "Treating Epidemics." Since it is a long book with numerous AIDS cases narrated, I suggested that the group read chapters 1-9, 17, 28, and 31. A few people did read the whole book, but most followed by suggestion. Discussion was enriched by the fact that many of the participants in our group had lived through the initial period of recognition of the AIDS epidemic described by Verghese in his book. One doctor was in San Francisco in the early 1980s and others were elsewhere across the country, so they supplied their own stories. As with Fadiman's The Spirit Catches You and You Fall Down, the group was curious about what had happened to the protagonist since the book was published; the Internet supplied some up-to-date information. (Kathy Ashley, Maine)

Verghese is from South India, grew up in Ethiopia, and was a resident in infectious diseases in Boston and Tennessee. The book is an account of his experiences caring for people with HIV/AIDS in the early years of the epidemic, as well as his experiences living in a small southern U.S. town. Participants were uniformly positive about this book. We had a particularly candid and moving discussion about how people die, how to know and respect their wishes. We also talked about being outsiders-racially, ethnically and sexually. And we talked about relationships between caregivers and sick people during long-term illnesses inside and outside of medical settings. (Susan Bell, Maine)

We started the discussion of this memoir with the comment, "I couldn't put it down." Verghese's honesty about himself, his culture, and his marriage, his curiosity and fascination about gay lifestyles and the "characters" he treated, and his ability as a storyteller drew people in. Many could identify with his immersion in his work and the burn-out that follows, not only in medicine but also in fields like education and social work. Many also identified with the problem of balancing professional standards and family responsibilities. One member offered her experience at AIDS camp, where at first she was the only straight person. I paired it with Susan Sontag's "AIDS and Its Metaphors," which no one in the group had been able to finish. Her theory that certain diseases come from somewhere else, from "others," whom we find it easy to reject because they're not like ourselves, is something we see happening to Verghese's patients. (Ann Fogg, Maine)

back to top : you are here Williams, Terry Tempest Refuge: An Unnatural History of Family and Place Genre: Personal Narrative Source: New York: Random House, 1991. Summary: An account by a Mormon woman of her mother's cancer in the context of her family history, nuclear weapons testing and a flood in the Great Salt Lake. Includes the moving narrative "The Clan of the One-Breasted Women" which addresses the bravery of her female relatives who have dealt with breast cancer as a result of radioactivity present from nuclear testing and fallout in the 1950s. Commentary:

One of our group's favorite books, often referred to three years later. The writing about both family and illness is powerful and intimate. Some seminar participants loved the naturalist's descriptions about the devastation of the birds in the Great Salt Lake. A couple found these chapters less engaging. Generated powerful discussion about family, community, grief, and relationships of mothers, daughters, and granddaughters. (Betsy Hart, Maine)

III. Voices from the Edge

Fiction

back to top : you are here Frazier, Charles Cold Mountain Genre: Novel Source: New York: Vintage, 1998. Summary: Cold Mountain is an odyssey set in the middle of the American South during the last days of the Civil War. Commentary:

This Homeric journey is at once an exercise in just how much suffering humans can take and give and also a study in redemption. Inman's character is cold, but understandable in an unrelenting sort of way. He realizes, almost too late, the absurd childishness of war and seeks to reclaim the life he deferred to join the fighting. Ada's relationship with Ruby, a woman who comes to live with her and show her how to sustain herself after her father's death, allows Frazier the opportunity to explore female strength and independence. Stobrod, Ruby's fiddle-playing father, is the clearest example of someone in need of (and eventually receiving) redemption. Musicians Dirk Powell, Tim O'Brien and John Herrman have put together a beautiful compact disc called "Songs From the Mountain" to accompany the novel and perform many of the fiddle tunes mentioned in Frazier's book, as well as other period pieces. (John Zavodney, Maine)

back to top : you are here Hawthorne, Nathaniel "The Birthmark" Genre: Short Story Source: Nathaniel Hawthorne: Selected Tales and Sketches. New York: Penguin, 1987. Summary: A scientist obsessed with perfecting his wife's beauty by removing her birthmark, succeeds in removing the birthmark, but accidentally kills his young bride in the process. back to top : you are here back to top : you are here LeGuin, Ursula Left Hand of Darkness Genre: Novel Source: New York: Ace Books, 1991 (originally published in 1968). Summary: The novel follows an envoy in his attempts to draw the civilizations of a distant planet (Winter) into the global federation. Among its many differences from Earth, Winter is populated by beings who are of indeterminate gender. Commentary:

LeGuin's novel is a remarkable achievement, which owes much to her own background as the daughter of two notable anthropologists (the Kroebers). Though the group found much to quibble with, the novel allowed them to come to grips directly with issues about gender, which have been significant in the experiences of most members. (Ruth Nadelhaft, Maine)

back to top : you are here Morrison, Toni The Bluest Eye Genre: Novel Source: New York: Simon & Schuster, 1970. Summary: The tale of a dysfunctional Southern family as told from the perspective of two teenage sisters. The story focuses on the consequences of racism and resistance. back to top : you are here Proulx, Annie "On the Antler" Genre: Short Story Source: Heart Songs and Other Stories. New York: Scribner, 1995. Summary: A story about deep conflicts between people in a rural community, showing that our understanding of people is always flawed and incomplete. Commentary:

Proulx describes the poverty and hardship of the rural poor, yet portrays her characters with deep respect. The main character's acquisition of the readings he covets and then his liberation from them is a story of epic dimensions and liberation of soul. (Karin Dillman, Maine)

back to top : you are here Saramago, Jose Blindness (Trans. Giovanni Pontiero) Genre: Novel Source: New York: Harcourt, 1997 Summary: A novel by a Nobel Prize-winning Portuguese author about the consequences of an epidemic of blindness that eventually strikes an entire population-except one person. This epidemic brings out the range of what it is to be human, in all its kindness and cruelty. Commentary:

This novel is useful for considering social order and the consequences of breakdown of that order. I've used this book with two groups, both of which found it painful yet powerful to read. The harrowing descriptions of the efforts made by social authorities to contain the spreading epidemic of blindness and the chaos that results when they are unsuccessful serve both as a metaphor of medical authority and a nightmare of modern life. The experience of the one person who remains sighted is terrifying, yet a way of thinking about what it means to be human. One person said it shows what happens when human beings stop being human; others debated the relative merits of dignity and survival and considered the possibility of hope in a brutal world. I suggest reading this novel near the end of the seminar. (Marli Weiner, Maine)

back to top : you are here Schlink, Bernhard The Reader Genre: Novel Source: New York: Vintage, 1995. Summary: A fifteen-year old German boy becomes involved in a passionate relationship with a woman in her thirties; after many years of separation, he encounters her again on trial for participating in a terrible act against Jewish survivors of the camp in which she served as a guard. Commentary:

Discussion of this book is always fertile and thoughtful. Schlink probes his narrator's detachment and lack of empathy while telling a story at once thoroughly grounded in history and transcending its particularity (post-World War II Germany). The death of feeling and the erosion of human sympathy are at the heart of the contemporary medical world, and practitioners of all sorts are eager to make connections with this book. (Ruth Nadelhaft, Maine)

back to top : you are here Silko, Leslie Marmon Ceremony Genre: Novel Source: New York: Penguin, 1977. Summary: Ceremony is Silko's portrayal of Tayo, an emotionally wounded Native American soldier just back from fighting in World War II. Tayo makes his way home from the VA hospital where he is treated as insubstantial and where his Native American heritage is considered dangerous superstition. In response to his treatment, he begins to experience himself as existing somewhere between worlds in the form of a "white smoke," and eventually searches for something to heal what is damaged inside him. By his grandmother's arrangement, Tayo eventually submits to ritual healing. The ceremonial journey draws upon the power of the heritage and ancestry he and his Native American peers challenged when fighting the suspect war. Commentary:

Ceremony is an effective work. Readers came away from the ritual as exhausted as Tayo. Significantly, some found it hard to see the journey through to its conclusion. Those who did were duly rewarded. Silko deals interestingly with most of the predictable issues-race relations, governmental responsibility, mainstream versus traditional medicine. We paired Ceremony with Ernest Hemingway's "Indian Camp," which helped illustrate the idea that involvement with another culture sometimes leads to philosophical uncertainty. (John Zavodny, Maine)

back to top : you are here Some, Malidonma Of Water and the Spirit Genre: Novel Source: New York: Penguin, 1995. Summary: Personal account of a small African boy, kidnapped by French missionaries, trained for fifteen years by Jesuits at a French Catholic mission, who runs away, back through the jungle to his childhood home. He must endure a one-month Dagara initiation into the tribe with boys much younger than himself. Commentary:

The boy learns many things, among them the best way to integrate the two cultures of which he is now a part. His insider's view of white colonialism in Africa is revealing. (Esther Rauch, Maine)

back to top : you are here back to top : you are here Watson, Larry Montana, 1948 Genre: Novel Source: New York: Simon & Schuster, 1993. Summary: A disturbing tale written from the perspective of a boy, now grown to adulthood, reflecting on the trauma to his family and his community caused by the sexual abuse and murder of a Native American girl. The villain is his uncle, a doctor. Commentary:

Our group found this well-written novel raised questions about power, cross-cultural care, community, family, and rural America; an upsetting, but most worthwhile discussion. Paired successfully with Naomi Shihab Nye's poem, "Kindness." (Betsy Hart, Maine)

back to top : you are here Weisel, Eli Dawn Genre: Novel Source: The Night Trilogy: Night, Dawn, the Accident. New York: Noonday Press, 1994 (Dawn was originally published in 1961). Summary: A young survivor of the Holocaust becomes a member of an Israeli group engaged in the attempt to create a State of Israel. He is assigned the job of killing a British soldier as retaliation for the British decision to hang a member of the Israeli underground. Commentary:

The spector of "terrorism" loomed large as we began this year's Literature & Medicine seminars. Weisel's short novel not only puts a human face on terrorism but also confronts us with the nature of individual responsibility in the face of large-scale national and international fury. (Ruth Nadelhaft)

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Poetry

Dove, Rita Selected Poems Source: New York: Pantheon Books, 1993. Summary/Commentary: In "Lady Freedom Among Us," Dove pictures the Statue of Liberty as a street person whose presence we try to ignore. Her role is to make us see and to force us to expand our definition of democracy. In "The Great Palace of Versailles," the voice of the other (or outsider) points to the seedy side of white cultural icons and affirms her own ability to create beauty out of almost nothing. (Karin Dillman, Maine) back to top : you are here back to top : you are here Harjo, Joy "Perhaps the World Ends Here" Source: The Woman Who Fell From the Sky. New York: Norton, 1996. Summary: The poem is about where life begins and ends, where joy and pain are spoken, and where we learn life's lessons. (Karin Dillman) back to top : you are here Herbert, Mary Sidney, Countess of Pembroke "The Dolefull Lay of Clorinda" Source: The Triumph of Death and Other Unpublished and Uncollected Poems. Ed. G. F. Waller. Salzburg: Universität Salzburg, 1977 (written in 1595). Summary/Commentary: A woman's expression of grief for the death of her brother. How do we express grief? What words do we use and how are these words shaped by cultural traditions? How do we know when the conventional phrases come from the heart? (Karin Dillman, Maine) back to top : you are here Homer The Iliad and The Odyssey Source: Robert Fagles, Trans. New York: Penguin, 1999. Summary: The two epics focus on the Trojan War, with first Achilles and then Odysseus as protagonists. Commentary:

I recommend using the two epics either jointly or sequentially in two years, along with the classics-trained psychiatrist Jonathan Shay's book, Achilles in Vietnam. The Fagles translation is magnificent and is aided by comprehensive introductions. Discussion of all the works was intense and profitable. The relevance of the ancient stories and characters, demonstrated both within the texts and by Shay's use of Achilles to exemplify the traumatized combat soldier, was a revelation to the group. The lingering effects of war, long after hostilities cease, and the underlying assumptions about the necessity for and value of violence were powerful subjects for discussion. Assumptions about gender and child rearing and about the ends of human experience reflected again and again on our own times and practices. (Ruth Nadelhaft, Maine)

back to top : you are here Hopkins, Gerald Manley "As Kingfishers Catch Fire" Source: Poems. London: Humphrey Milford, 1918. On-line edition: Bartleby.com Commentary:

A poem that takes on meaning as one begins to feel at ease with the series of images contained in the long comparison. It is well worth the effort and the poem provides a rich and ringing affirmation of the spiritual transformation of Ivan Illych. (Karin Dillman, Maine)

back to top : you are here back to top : you are here Hughes, Langston The Collected Poems of Langston Hughes Source: Ed. Arnold Rampersad and David Roessel. New York: Vintage, 1959. Summary/Commentary: Includes "Share-Croppers," "The South," "Uncle Tom," and "Democracy." Pair with Jones' Bad Blood and/or Reverby's "Rethinking the Tuskegee Syphilis Study" and Brandt, "Racism and Research." These poems provide an insightful portrait of the South during the period in which the Tuskegee Syphilis Experiment was initiated. (Betsy Hart, Maine) back to top : you are here back to top : you are here Lee, Li "From Blossoms"

(For annotation see Experience of Illness, Poetry)

back to top : you are here Oliver, Mary "When Death Comes" Source: New and Selected Poems. Boston: Beacon, 1992. Summary/Commentary:

A poem about the desire to live one's life to the fullest. The Oliver poem complements Susan Kenney's novel, Sailing; the last line of the poem is "I don't want to end up simply having visited this world." (Susan Bell) back to top : you are here Pastan, Linda "Notes From The Delivery Room" Source:PM/AM: New and Selected Poems. New York: W.W. Norton, 1982. Summary: A poem about childbirth.

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Non-Fiction

back to top : you are here Byron, Don "Tuskegee Experiment" Genre: Music Source: Tuskegee Experiments, Audio CD. Arthur Moorhead, Prod. Nonesuch Records, 1992. Summary/Commentary: A powerful jazz piece (with words) about the Tuskegee Experiment; a good way to start the discussion of this issue. See references for Bell, Hughes, Jones and Brandt. (Diana Long, Maine) back to top : you are here Fadiman, Ann The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors and the Collision of Two Cultures Genre: Non-fiction Source: New York: Farrar, Straus & Giroux, 1997. Summary: The moving and sad story of a Hmong refugee family from Laos who comes into sharp conflict with the American medical system when their daughter is diagnosed with epilepsy. Misunderstanding, unwillingness to see the need of the family, language barriers, and finally, cultural barriers, lead to a tragic conclusion. Commentary:

This intensely moving anthropological narrative examines a myriad of topics including cross-cultural miscommunication, medical mistakes made by the most thorough doctors trying their hardest, the spiritual meaning of illness in the Hmong community, and the residual effects of the CIA's secret war in Laos. It portrays a family's struggle with the medical community, their daughter's epilepsy, and the great divide between their understanding of the world and that of the providers who treat their daughter. (Betsy Hart, Maine)

This worked well in the middle of the seminar sessions. The group was both enthusiastic and devastated in their responses to this book. My intent in using it was to emphasize the nature of cultural difference itself, which abounds in the practices of all the seminar members but which is less extreme and often less noticed than it is in the book. One member of the group, new to the seminar, brought the book to an administrative meeting, using it to push the hospital finally to incorporate teaching about cultural differences into its guidelines. The discussion was very rich and personal. Not only do some members of the group think the book should be required for medical school teaching, but they also think we might benefit from using it more than once in any seminar's history. (Ruth Nadelhaft, Maine)

This book describes the clash of medical understandings between the Hmong parents of a child with epilepsy and her doctors in California. It was an effective way to start the seminar, because the doctors are portrayed sympathetically and because the book opens the question of how misunderstandings occur without malice on either side-and with ignorance on both. Fadiman's account is balanced and nuanced, providing insight into different systems of medicine and the cultural beliefs that support them, as well as into personal (or familial) responsibility for health care. I paired this with Lorrie Moore's "People Like That Are the Only People Here," about having a child with cancer, which raised questions of cross-cultural similarities and differences in the experiences of parents with sick children. (Marli Weiner, Maine)

back to top : you are here Gollaber, David L. Circumcision: A History of the World's Most Controversial Surgery Genre: Non-fiction Source: New York: Basic Books, 2000. Summary: Beginning with the biblical covenant requiring circumcision, Gollaber traces the history and meanings of this surgery. He devotes one chapter to female circumcision (genital mutilation). Commentary:

This is an important and compelling study of a practice too often taken for granted in human cultures, Western and non-Western. Discussion of this text, at least one chapter, was excellent: candid, often revelatory. (Ruth Nadelhaft, Maine)

back to top : you are here Lakoff, George and Mark Johnson Metaphors We Live By Genre: Non-fiction Source: Chicago: University of Chicago Press, 1980. Summary: A persuasive discussion of the role of metaphor in medicine as in all conversation. Commentary:

I paired this text with a chapter from Nor Hall's The Moon and The Virgin. It looks at language from a linguistic perspective: the images we use unknowingly in everyday language. How can awareness of this make us better listeners for patients? I also asked participants to bring their own examples. In the sick and depressed, language is often flat and stuck in narrow views of the causes of illness, of life in general, and of the healing process. To help a patient to break out of such flatness by suggesting an image can be an important step. (Karin Dillman, Maine)

back to top : you are here Miller, D.A. "Sontag's Urbanity" Genre: Essay Source: The Lesbian and Gay Studies Reader. Ed. Henry Abelove, Michele Aina Barale, and David M. Halperin. New York: Routledge, 1993. Summary: Critique of Sontag's AIDS & Its Metaphors. back to top : you are here back to top : you are here Reverby, Susan and James H. Jones, Eds. Tuskegee Truths: Rethinking the Tuskegee Syphilis Study Genre: History Source: Chapel Hill: University of North Carolina Press, 2000. Summary: Collection of writings on the Tuskegee syphilis study, which took place from 1932, when it was initiated by the U.S. Public Health Service, to 1972, when it was halted. Conducted in Macon County, Alabama, the study traced the effects of untreated syphilis on roughly 399 poor black men who had syphilis and 201 who served as controls. Commentary:

I chose Allen Brandt's essay, "Racism and Research," and Susan Reverby's essay, "Rethinking the Tuskegee Syphilis Study," to use for a session on Tuskegee instead of Jones' Bad Blood (which I had used many times in teaching undergraduates) because I thought they would focus the discussion more directly on the moral questions that I was interested in addressing: What constitutes "good" nursing? How can nurses talk back to physicians and what responsibility do they bear for doing so? What constitutes a "good" experiment (scientifically and ethically)? How does race (and racism) infuse medical care? And is the South any different from the North (and the 1930s any different from the 1990s)? Brandt and Reverby take significantly different positions on Nurse Rivers' actions/choices in the experiment. (Susan Bell, Maine)

"Rethinking the Tuskegee Syphilis Study: Nurse Rivers, Silence, and the Meaning of Treatment" is a historical essay about how the African American nurse in the Tuskegee Syphilis Study, who gathered the men every year for their non-treatment and who worked with the white doctors at the Public Health Service, used different identities (exemplified in her use of language) as she talked about her different relationships with participants and physicians. Reverby's article points out how gender, race, and class were deeply embedded in Rivers' professional identity. (Alison Hepler, Maine)

Susan Bell's chapter, "Timeline of Events for Tuskegee Syphilis Experiment," is a schematic chronology of the Tuskegee Experiment and its aftermath. A very helpful reference for participants to have when reading about Tuskegee. (Diana Long, Maine)

back to top : you are here Sontag, Susan Illness as Metaphor and AIDS and Its Metaphors Genre: Essays Source: New York: Picador, 2001 ("Illness As Metaphor" was originally published in 1978; "AIDS and Its Metaphors" in 1989). Summary: The relationship between science and metaphor in understanding disease. Two lengthy and provocative essays. Commentary:

In "AIDS and Its Metaphors," Sontag continues her scholarly analysis of the ways humans think about disease, including bubonic plague, tuberculosis, leprosy, cholera, syphilis, cancer, and now AIDS. She thoroughly discusses the way metaphors (the body as fortress, the disease as attacker, as alien) have colored the way we think not only about diseases, but about those who suffer from them. This group found it a difficult read, and none of them had managed to finish it or to gain much from it. I dug out some of the ideas for which I selected it, particularly her definition of "plague" as a disease that comes from somewhere else and that can be regarded as affecting mainly poor, deviant, or unclean people, like bubonic plague, syphilis, and now AIDS. Abraham Verghese's memoir, My Own Country, with which I paired it, shows various ways even medical people treat AIDS patients as "others." There was general disagreement with her repudiation of the battle metaphor for illness, citing the visualization of Pac-Man-like images that seek out and destroy cancer cells and the language commonly used in obituaries: "a courageous battle with cancer." We also looked at Sontag's treatment of stories printed in papers outside the U.S. about AIDS as a CIA-created virus that has come back to haunt us. Perhaps this is one of the works people went away determined to keep trying, but I rather doubt it. If I were to use it again, I would use carefully selected excerpts, but the tightness of her writing would make such a selection difficult. (Ann Fogg, Maine)

While Sontag's essays sparked an interesting contrast between the co-facilitator's literature background and mine in history (she found the literary references to consumption rather familiar while I was horrified that anyone would think that TB was a "romantic" disease), I am not sure they did what we had hoped, which was to talk about how illness is defined. We did end up finding the "real" bits we could latch onto, such as diseases that carry a social stigma, and how we use language, especially metaphors. (Allison Hepler,Maine)

The experience of a group I worked with was illuminating in a few respects. One member, a pathologist, took issue with Sontag's language about cancer as "invasive," and brought in slides to demonstrate that damage to cells came from within and not without (not a native speaker of English, he had misunderstood Sontag's prose, but the presentation he gave was fascinating). Also, this group identified for themselves the ability to have a powerful discussion about a book they did not all like. They all recognized the ways in which they had become used by language rather than self-conscious users and were grateful for the new self-awareness. (Ruth Nadelhaft, Maine)

back to top : you are here Tomes, Nancy The Gospel of Germs: Men, Women, and the Microbe in American Life Genre: History Source: Boston: Harvard University Press, 1998. back to top : you are here Wexler, Alice Mapping Fate Genre: Personal narrative Source: Berkeley: University of California Press, 1996. Summary: The history of a family in which the author's mother and other family members develop Huntington's disease, along with an account of their efforts to encourage research into identification of the gene. Commentary:

This book explores the connections between family and disease history. At first convinced of the importance of advancing scientific knowledge, the author concludes with her concerns about the dilemmas of what to do with that knowledge; specifically, with the question of whether to be tested for the presence of the genetic marker whose presence would inevitably signal an incurable degenerative disease. Discussion focused on the implications of scientific and medical knowledge, on what it means to "help" people, and on lay medical activism. One participant, a geneticist, reported that she gave the book to some families with whom she worked and said that it had changed the way she practices. (Marli Weiner, Maine)

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IV. Social Perspectives and Policy

Fiction

Barrett, Andrea The Voyage of the Narwhal Genre: Novel Source: New York: Norton, 1998. Summary: A novel about a controversial voyage to find an arctic explorer in the mid-nineteenth century and the compelling desire for public acclaim that inspired it. The novel explores issues of scientific curiosity, treatment of native peoples of Greenland, human ambition, and qualities of leadership. Commentary:

Participants understood this adventure story as a way to talk about science, history, cultural differences, deaths that can and cannot be prevented, and growth within human beings. Perhaps the richest part of the discussion centered around how to deal with people in leadership positions whose behavior is far from acceptable. (Marli Weiner, Maine)

back to top : you are here back to top : you are here Camus, Albert The Plague Genre: Novel

(For annotation see Being a Caregiver, Fiction)

back to top : you are here back to top : you are here back to top : you are here back to top : you are here Ibsen, Henrik An Enemy of the People Genre: Play Source: New York: Penguin, 1977. Summary: A late nineteenth century Norwegian country doctor calls for change, challenges the status quo, and is punished. Commentary:

Read with McPhees's Heirs of General Practice and Baida's "A Nurse's Story" in a session on "The Social Roles of Medical Professionals." Some participants found the hundred-year-old Norwegian play difficult to digest. However, discussion revealed that everyone had understood the plot and the point of the play, in which local economic interests prevailed over health needs of the community. It made a bracing contrast to McPhee's tale of general practitioners in Maine, a much more utopian narrative. (Kathy Ashley, Maine)

back to top : you are here back to top : you are here McEwan, Ian Atonement Genre: Novel Source: New York: Anchor, 2001. Summary: This novel, by a Booker Prize-winning British writer, is the story of the consequences of a young girl's lie for her sense of herself and for her family. Among other things, it includes a section describing the retreat to Dunkirk and another that focuses on nursing at a military hospital during World War I. However, the center of the story is the moral consequences of the girl's behavior. Commentary:

Participants agreed that McEwan had written a remarkable account of the complexities of a young girl's mind and of the consequences of mistakes. They debated the meaning of war and purposeless deaths, questioned medical progress, and explored the fine lines between reality and experience, belief and truth. (Marli Weiner, Maine)

back to top : you are here back to top : you are here back to top : you are here O'Brien, Tim The Things They Carried Genre: Novel Source: New York: Broadway Books, 1990 Summary: A novel that mixes up fiction and non-fiction, through the narrator and author Tim O'Brien, and uses this conflation to comment on the Vietnam War and the experience of the soldiers in it. Can be excerpted by chapters, as they are strong works on their own. Commentary:

Some people loved the book; surprisingly, some disliked or even hated it. They found the confusion of fiction and nonfiction not only difficult, but annoying and disingenuous. The diversity of reactions, instead of creating a compelling dialogue, made the discussion uncomfortable and divisive. (Michael Burke, Maine)

back to top : you are here Selzer, Richard "Imelda" Genre: Short Story

(For annotation see Being a Caregiver, Fiction)

back to top : you are here Shelley, Mary Frankenstein Genre: Novel Source: New York: Signet, 2000. Summary: Frankenstein, having created a living being, is appalled by what he recognizes as a monstrous form of life and disavows his creation. Commentary:

Mary Shelley uses the occasion of writing a "ghost story" to examine the moral underpinnings of rapidly-expanding scientific knowledge as well as the craving for familial love and acceptance. The novel sustains many levels of enquiry. (Ruth Nadelhaft, Maine)

Most participants had never read the novel, familiar as they were with the movies and other representations of the story, and so were surprised by what they found. While a few found the reading slow-going, they were stunned by the relevance of the issues raised by the book. Discussion centered around what it means to be human, the nature of families, and the role of science and technology in medicine and life. Participants were so moved by Frankenstein's creation that they not only named him, but also continued to refer to him by that name in subsequent discussions; they viewed him as representing the desire for connection in a hostile society as well as the consequences of desire not being met. (Marli Weiner, Maine)

back to top : you are here Watson, Larry Montana, 1948 Genre: Novel

(For annotation see Voices from the Edge, Fiction.)

back to top : you are here Weisel, Eli Dawn Genre: Novel

(For annotation see Voices from the Edge, Fiction)

Poetry

back to top : you are here back to top : you are here Hard, Walter "Socialized Medicine" Source: A Mountain Township. Middlebury: Vermont Books, 1933. Summary: This gently humorous poem compares the old general practitioner who had time to visit with the entire family when he made house calls, to the new one who always seems to be in a hurry. Commentary:

Paired successfully with the play "Laundry" by Susan Onthank Mates and the poem "Lullaby" by Jeanne LeVasseur in a discussion of "Circles of Care." (Francette Cerulli, Vermont)

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Non-Fiction

Brumberg, Joan Jacobs The Body Project: An Intimate History of American Girls Genre: History/social commentary Source: New York: Vintage, 1997. Summary: Brumberg, an historian, chronicles the ways in which girls in the past 150 years have tried to change their bodies to suit prevailing assumptions about how they should look and be, including dieting, piercing, hymenectomies, and cosmetic surgery, with the collaboration of their parents and doctors. Brumberg urges the creation of a more protective environment for girls today. Commentary:

This book provoked some of the most heated discussions of the sessions. Some were frustrated by the absence of attention to boys and men, others wondered why Brumberg was so troubled by vanity, still others saw her as doctor-bashing. All agreed that discussing the consequences of the consumer culture and the tension between peer pressure and individuality was essential to their roles as health care providers. (Marli Weiner, Maine)

back to top : you are here Byron, Don "Tuskegee Experiment" Genre: Music

(For annotation see Voices from the Edge, Non-Fiction)

back to top : you are here Carson, Rachel Silent Spring Genre: Non-fiction Source: New York: Mariner Books, 2002. Summary: One of the most influential books of the twentieth century, this study tracks the devastating effects of the pesticide DDT in the water and soil of the earth and in the bodies of birds, fish, wildlife, and humans. Commentary:

There was some resistance to reading this non-fiction work, feeling that it would be too "dry." However, a selection of chapters chosen to outline the situation and causes of Carson's concern made the "mountain" into a hill. Discussion not only in terms of the public health and environmental issues surrounding the use of pesticides (especially in a state with a still-large farming population), but also branching off to other issues of hospital environmental safety, and to the topic of breast cancer (linked to the environmental pollutants in Silent Spring and from which Carson died). Worth the effort, and a different kind of read. (Sydney Landon Plum, Maine)

back to top : you are here back to top : you are here Ely, Elyssa "The Disquieting Declaration" Genre: Essay Source: The Boston Globe, February 4, 2004 Summary: An essay about an interaction between a mental patient and his court-appointed legal guardian. Commentary:

Prompted a good discussion of the limits of empathy, and whether the lawyer could have done more to connect to his client, the patient, or whether such a thing would be appropriate. (Michael Burke, Maine)

back to top : you are here Gilligan, James Violence: Reflections on a National Epidemic Genre: Essay/Social Commentary Source: New York: Vintage, 1997. Summary: Gilligan argues that violence is best understood as a problem in public health and preventive medicine. He suggests that the "structural violence" that is the result of poverty causes far more deaths than violent acts such as homicide. Commentary:

Gilligan's conclusions can be controversial, but his attention to underlying causes raises important questions about the role of medicine in attending to structural violence. (Robert Schaible, Maine)

back to top : you are here Jones, James H. Bad Blood: The Tuskegee Syphilis Experiment Genre: History Source: New York: Free Press, 1993. Summary: The account of the U.S. Public Health Service's 30-year experiment on poor black men in Alabama. See also Jones' and Susan Reverby's collection, Tuskegee Truths: Rethinking the Tuskegee Syphilis Study, Langston Hughes' poetry, and Don Byron's musical piece on the Tuskegee experiments. Commentary:

Provoked a long discussion of professional expectations about care and whistle-blowing. (Diana Long, Maine)

back to top : you are here back to top : you are here back to top : you are here back to top : you are here back to top : you are here Leavitt, Judith Walzer Brought To Bed: Childbearing in America 1750-1950 Genre: History Source: New York: Oxford University Press, 1988. Summary: This book is a history of women's experiences of childbirth in America from colonial times through the 1950s. Commentary:

Concerned with the social as well as medical experience of childbirth, this book provoked a spirited discussion. Participants were surprised that the same biological event could have such rapidly changing social meanings; they were particularly interested in Leavitt's argument that those meanings were as much determined by women themselves as physicians. While a few objected to the writing, most found the book offered a way of thinking about medical change that helped them understand their own experiences with patients who arrive informed by extensive research on the Internet and influenced by drug companies' advertisements. They also reflected on the tensions caused by medicalization of biological processes, on medicine as a gendered practice, and on the ways in which their own roles as providers were shaped by the experiences of individual patients and society at large. (Marli Weiner, Maine)

back to top : you are here Leavitt, Judith Walzer Typhoid Mary: Captive to the Public Health Genre: History Source: Boston: Beacon Press, 1996. Summary: The story of Mary Mallon, an Irish working class woman who, in the early twentieth century, was labeled a typhoid carrier and involuntarily isolated for 26 years. Mallon became a symbol of the menace to public health when she was diagnosed as an asymptomatic carrier of typhoid but refused-or was unable for economic reasons-to give up her work as a cook. Leavitt's biography tells her story, which included exile on an island for much of her life, from a variety of perspectives. Commentary:

While some participants found Leavitt's telling of Mallon's story from multiple perspectives repetitive, they used it as the basis for a lively discussion of public health. Some argued that protecting the public's health had to come before any consideration of individual liberties, while others maintained the importance of respecting individual circumstances. (Marli Weiner, Maine)

back to top : you are here Miller, Judith, Stephen Engelberg, and William J. Broad Germs: Biological Weapons and America's Secret War Genre: History Source: New York: Simon & Schuster, 2001. Summary: An accessible and engrossing history of biological terrorism by three reporters from the New York Times. Commentary:

I would recommend this text highly to facilitators looking for a way to help caregivers learn more about the history and current level of scientific knowledge about biological warfare and its connections to the military and to public health systems. Participants found the writing accessible and the content absorbing. (Eve Raimon, Maine)

back to top : you are here back to top : you are here back to top : you are here Reverby, Susan and James H. Jones, Eds. Tuskegee Truths: Rethinking the Tuskegee Syphilis Study Genre: History

(For annotation see Voices from the Edge, Non-Fiction)

back to top : you are here Rosenberg, Charles The Cholera Years: 1833, 1842, 1866 Genre: History Source: Chicago: University of Chicago Press, 1987. Summary: Social responses to the disease leading to the rise of public health in the nineteenth century. Commentary:

Excerpts taken from a historical study of three cholera epidemics in the U.S., with a focus on New York City. Illustrates the understanding of disease at that time, and how it affected the economic, political, and religious life of the country, not to mention the lives of those physically affected by the effects of the disease. (Alison Hepler, Maine)

back to top : you are here Rosenberg, Charles The Care of Strangers Genre: History Source: Baltimore: Johns Hopkins University Press, 1987. Summary: Social relationships in the American hospital in the nineteenth and twentieth centuries. An excellent starting point for discussion of our relationships now. back to top : you are here Rothman, Sheila Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History Genre: History Source: New York: Harper Collins, 1994. Summary: Based on diaries, journals, and letters of sufferers from TB in American before 1870. back to top : you are here Schlosser, Eric Fast Food Nation Genre: Non-fiction Source: New York: Houghton Mifflin, 2001. Summary: This book is about how the fast food industry has changed everything about American (Western, for that matter) life: our health, our economy, our landscape, our education, our family life, our values. An excellent and thought-provoking book with wide-ranging impact. Commentary:

Everybody was happy to have read this book, although the health implications were not new to them (we did have a discussion about public health, family practice, and nutrition.) The selections on economics, education, and landscape (in other words, the broader influences of fast food) engendered much discussion. (Margery Irvine, Maine)

back to top : you are here Shay, Jonathan Achilles in Vietnam: Combat Trauma and the Undoing of Character Genre: Non-fiction Source: New York: Atheneum, 1994. Summary: Connections between Homer's Achilles and Vietnam veterans who suffer from PTSD (also see annotations for Homer's The Illiad and The Odyssey). Commentary:

Shay's book relates directly to contemporary medical issues. Trained as a classicist before he became a medical doctor and psychiatrist, Shay uses the Iliad as the benchmark for Vietnam veterans both to illuminate and to limit their attempts to construct their own narratives. (Ruth Nadelhaft, Maine)

back to top : you are here Showalter, Elaine Hystories: Hysterical Epidemics and Modern Culture Genre: Non-fiction Source: New York: Columbia University Press, 1997. Summary: Showalter blames inexhaustible media coverage for the spread of such disparate conditions as Gulf War Syndrome, Recovered Memory and alien abduction. In her treatment, Chronic Fatigue Syndrome presents as the heir apparent to the "Hysteria" throne. Commentary:

Showalter's literary critic style sometimes trips up the reader, but most in our group found the "Epidemics" compelling enough that we made it through, or past, the somewhat jargony introductions. The chapter from which the book gets its title stands out as both more readable and more compelling than most of the other chapters. Interestingly, the individuals in our group understood the logic of the infectious nature of psycho-media-genic hysteria, but most identified at least one "epidemic" that s/he felt (at least at the beginning of the discussion) didn't rightly belong on the list. (John Zavodny, Maine

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