Zauner was 25 when her mother was diagnosed with an aggressive, late-stage, mid-life cancer. Zauner was a rebellious child, resentful of Umma’s version of tough love. Growing up the lone Asian student in her Oregon community, she felt both othered at school and an outsider among her mother’s Seoul relatives when she visited them each summer. Just as she was beginning to appreciate her Korean heritage and understand her mother’s love, she learned about Umma’s diagnosis.   

The first half of the memoir exuberantly brings to life scenes from Zauner’s childhood and her brief post-college years as a musician in New York City. Surprisingly, without hesitation, she paused her makeshift career and flew west to care intensively for her mother. Attempting to heroically save Umma, Zauner zealously learned to prepare the native foods they shared. “I would radiate joy and positivity,” Zauner pledged. “I would learn to cook for her—all the things she loved to eat, and I would single-handedly keep her from withering away” (69). Her optimistic culinary efforts produce a poetry of exacting descriptions of the flavors and textures and preparation of those foods. It’s grimly ironic that the chemotherapy her mother endured wiped out her ability to taste or digest Zauner’s loving offerings of health.  

The second half turns from living with Umma to living without her. Wishing to sustain her bond with her mother as Zauner grieved, she continued preparing her Korean family’s recipes. Walking down H Mart’s redolent aisles released “waves” of sorrow that mark the enduring ebb and flow of her grief. Unsuccessful with conventional therapy, she found cooking the best form of self-care: “Every dish I cooked exhumed a memory. Every scent and taste brought me back for a moment to an unravaged home. Knife-cut noodles in chicken broth took me back to lunch at Myeong Dong Gyoja . . . The kalguksu so dense from the rich beef stock and starchy noodles it was nearly gelatinous. My mother ordering more and more refills of their famously garlic-heavy kimchi” (212-213). An image of abundance in the midst of loss.

Zauner’s detailed descriptions of cooking and consuming invite readers to her table, reminding us—as previous celebrated writers have—of the power of the senses to evoke memory and the power of food to strengthen human bonds. Food also powers Zauner’s self-understanding and the unexpected transformational love for her mother: “The culture we shared was active, effervescent in my gut and in my genes, and I had to seize it, foster it so it did not die in me . . . If I could not be with my mother, I would be her” (223-224).  

Zauner’s writing is itself active and effervescent. Through her grief, she holds a steady, unflinching gaze on cancer and death. As she writes candidly about her family, Zauner is critically reflective about her own life. Her writerly achievement is the immediacy of her felt experiences, her grief and her joys made palpable. “Let me feel this,” she courageously writes, dismissing her Korean family’s admonitions to withhold tears (202). An unforgettable image of the process of loving transformation that Zauner experienced unfolds in her description of making the Korean staple kimchee. It is a slow, exacting process of fermenting cabbage that at first strikes her as “controlled death” because “[l]eft alone, a head of cabbage molds and decomposes. It becomes rotten, inedible. But when brined and stored, the course of its decay is altered. Sugars are broken down to produce lactic acid, which protects it from spoiling. Carbon dioxide is released and the brine acidifies. It ages. Its color and texture transmute. It exists in time and transforms. So it is not quite controlled death, because it enjoys a new life altogether” (223). 

As if miraculously, a few years after Umma died, Zauner’s itinerant music career took on a new life. The band she has fronted, Japanese Breakfast, recorded the album Psychopop with a song she wrote about her mother, “In Heaven.” Then they toured the U.S. and South Korea. Although her mother was skeptical about a musical career, Zauner imagined that Umma would be “glad that I had finally found a place where I belonged” (233). 

Crying in H Mart: A Memoir
Michelle Zauner

Publisher Alfred A Knopf
Place Published New York
Edition 2021
Page Count 239

Web photo by Portuguese Gravit

Realizing he was a member of a tangled (a favorite word of the author) group of transsexuals, James felt himself trapped in a conundrum of gender (he felt and considered himself female) versus sex (he was genotypically and phenotypically male). “To me gender is not physical at all but is altogether insubstantial; it is soul, perhaps, it is talent it is the essentialness of oneself” (p.25).  

After some fruitless interactions with the medical profession, Morris travels to Casablanca in the summer of 1972 to undergo sex-changing surgery and becomes Jan Morris. Unlike many if not most transsexuals, post-operatively Morris fared quite well emotionally and was quite happy with the change.  

Jan Morris’s writing is as humorous and eloquent as James Morris’s was. She describes how magazines like Rolling Stone, publishers like Random House, and thousands of readers have never cared what gender or sex was holding the pen; how life changed in clubs, restaurants, and in taxicabs, where Jan met the first man to kiss her, post surgery, “in a carnal way” (p.151). Morris records that “all I did was blush.” 

As the chronicle of one sensitive and highly literate man’s journey from manhood to womanhood, Conundrum offers much commentary on the states of mind of a transsexual, a highly polished writer undergoing the humoral, mental, emotional, and cultural changes of such surgery.  

Prior to surgery, Morris writes about feeling deprived of an identity: “I realize now that the chief cause of my disquiet was the fact that I had none. I was not to others what I was to myself. I did not conform to the dictionary’s definition–‘itself and not something else’ ” (p.40-41). All Morris wanted “was liberation, or reconciliation–to live as myself, to clothe myself in a more proper body, and achieve Identity at last” (p.104). It took courage but it was worth it and Conundrum reads like nothing more, and nothing less, than a successful odyssey of the sexual soul. 

Jan Morris died in 2020, aged 94. 

Jan Morris: Journalist, Historian, ‘Writer About Place’ – Faculty of English

Conundrum
Jan Morris 
New York Review of Books Classics, paperback 2006: 176 pages 
Originally published by Faber and Faber, London, 1974 

Web image by medhum

At age nine, first misdiagnosed and finally identified as having facial bone cancer (Ewing’s sarcoma), Lucy underwent several surgeries and more than two years of intensive chemotherapy and radiation treatments. Pain and nausea, anxiety and fear of more pain and nausea were only part of the ordeal. The young Lucy became aware of what it is to be severely, chronically ill. Her sisters behaved differently toward her: they were polite. “Suddenly I understood the term visiting. I was in one place, they were in another, and they were only pausing.” Even her father felt uncomfortable at her hospital bedside, and Lucy was relieved that he came infrequently.

But being at home was worse: in the hospital the other patients and the staff expected little from her and she felt no guilt or shame; amidst her family, she blamed herself for the tension, arguments over money, and her mother’s depression, even though these elements had existed prior to her illness. Her hair fell out and she became dimly aware that people were staring at her face. Nevertheless, “I . . . was naturally adept at protecting myself from the hurt of their insults and felt a vague superiority . . . . “

Well enough to return to school, Lucy’s disfigured face drew taunts from classmates; she understood finally that she was perceived as ugly and that she would not be loved. Only on Halloween, when she could mask her face, did she feel free and joyful, unconcerned about her appearance, “normal.” Her moods now alternated between despair, determination, and escapism. She became convinced that only facial reconstruction and a restored appearance would make life bearable.

During years of reconstructive surgery Lucy evolved complex rationalizations to give meaning to her suffering. Two anchors had stabilized her existence throughout the misery: a passionate adolescent love of horses, and an adult love of poetry. Eventually outward appearance and inner life became harmonious. “The journey back to my face was a long one.”

Unfortunately, Lucy’s story does not end here. At age 39 she committed suicide. Soon after, her close friend, writer Ann Patchett, wrote a book about their friendship, Truth & Beauty: A Friendship, published in 2003 (HarperPerennial).

Lucy Grealy Interview in 1994 (20 Min.)

Autobiography of a Face
Lucy Grealy
Houghton Mifflin 1994 Boston: 256 pages

1995 Whiting Award Winner in Nonfiction , Poetry: https://www.whiting.org/awards/winners/lucy-grealy
Web image generated from the book cover by Medhum.

Apollo On Call

In this episode of Apollo on Call, Dave is joined by Luki Danukarjanto to discuss Atul Gawande’s book on end-of-life care, as well as relate it to their aging parents and their own experience getting older. They also examine the medical perspective to the situation is well-being or survival the goal of end-of-life care?

Check out Dave’s Substack for more! https://davidmhsu.substack.com/

Web image by Age Cymru 

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The collection opens with a poem, “Dedication” (p.1), dedicating the poems that follow to those “dear friends” who share, and so understand, the sufferings of ongoing illness. The implication is that healthy people cannot, yet, truly enter that world and, in fact, “fear” those who must live there. Yet Silver’s poems are a way into that universe. Tender and fierce, the poems in this collection seem to arise fully formed from the deepest part of Silver’s existence. The poems in section I present us with the harsh realities of illness and the anticipation of loss. In the acknowledgements, (p.72), the author notes that the poems in this section are “in honor of my sisters with inflammatory and advanced breast cancer.” In “Advent, First Frost,” she likens that “feathered prophecy” to “a bowl of frozen tears” (p.6) and in “Stage IV,” she writes that she is “taboo, now,” that she and others use words that once embarrassed them, “courage, prayer, miracle.” Even so, she is aware that “Our passports have been stamped– / our wrists and collar bones have been marked” (p.7). In a lovely prose poem on page 11, she writes in memory of her friend, Susan: “Ulysses will sail the storms till he dies. And so, my dear ones, will we” (p.11), combining, as she often does, the reality of approaching death with hope, dignity, and strength. In “Leaving the Hospital” (p.23) and “On a Line from Virginia Woolf’s Diary,” Silver celebrates the return, even if temporary, to life: “And the day takes my body back simply, / the way a mother dresses her child” (p.14). For me, the most moving poem in this section is the title poem, “I Watched You Disappear” (p. 22-23). It is a litany of regret, loss, anger, and pain, related not in poetic images but in plain and deeply human language: “I hate spring, its prettiness. / Your heart kept beating. Why didn’t it just stop?” 

Section II consists of seven, short one-stanza poems based on images from Grimms’ fairy tales. It seems that the first two lines of each poem serve as metaphorical statements about the realities of advanced breast cancer. “Owl Maiden” begins “No transformation’s instant. / Her hair fell out first, replaced by quills” (p.29). “Strawberries in Snow” begins “Belief comes easily to the ill. / Miracles fall from their lips like gems” (p.31). And “The Flowered Skull” offers these opening lines: “The magician finds them, young or old, / mothers, maidens–to him–no matter–” (p.34). The final poem in this section is a tale told to her son, Noah. In “The Hazel Tree,” Silver is the mother who “died and grew into a tree,” “each nut a word she’d grown to tell her son / now that her speaking human voice was gone” (p.35).  

In Section III, she turns, as she did in her first collection, to poems about her family. She visits again the (actual) doors of her life (“Doors” p.39), expresses regret at being impatient with her son, “Ubi Caritas Deus Ibi Est” (p.41), and in other poems examines moments of her family life, especially those shared with her son, father, sister, and husband. This section’s poems rarely mention illness, yet as they share family stories, they hint at the inevitability of loss. The final poem in this section, “Sea Glass,” ends with lines that could be applied as well to the way poems might be born from the wages of a life: “Something salvaged, sunlit, / gem-like. Something saved / from the grinding into grit” (p.55).  

Section IV, like section II, contains only seven poems, three of them commentaries on paintings and, through those commentaries, observations on illness and suffering as well. “Late Renoir” speaks of how the artist painted to “smudge away doubt” and to submerge “the mutilations of war, his dead wife, / the black he banished from his palette” (p.59). The long poem “Valentine Gode-Darel (1873-1915)” is a reflection on the five paintings by Ferdinand Hodler that captured his lover’s sickness, decline, and death (p.60). “Portraits in the Country,” (page 63), offers a glimpse into the poet’s resignation and acceptance of death, a mindset supported by her faith in both the human and the holy: “But I will not rush to put down my sash. / Instead, I will turn the leaf of my book. See with what gentle gravity God / lets it hover, in balance, then fall to its side.” The book’s last poem, “The Firebird,” suggests that words, especially poems, might hold truths that sound louder than the approach of death: “The bell ringing in your throat will drown / out the train’s slow grieving” (p.67). 

These poems are beautifully crafted, often primal, and they touch the deepest reaches of personal illness and the shadow of mortality. Readers who have breast cancer or who have family or friends living with breast cancer, might find these poems difficult to read–others under the same circumstances might find them difficult and yet, at the same time, essential. For me, dealing with the reality of an aggressive breast cancer afflicting someone I love, these poems provide a window into an experience I can only observe from a distance, even if that distance is only an embrace away. These poems provide a portal into the emotions, fears, regrets, and pleas that might be hiding behind a patient’s or a loved one’s exterior of cheerful optimism and determination. We can’t walk the path that a woman with advanced breast cancer is traveling. But these poems help us be companions on the way. 

Miscellaneous 
“Strawberries in Snow” was first published in the Bellevue Literary Review (V12N1).  

Publisher Louisiana State University Press 
Place Published Baton Rouge 
Edition 2014 
Page Count 73 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database .  
Web image created by Medhum.org

In her second collection, “I Watched You Disappear” Silver’s poems invited us to accompany her on her journey through treatment, anger, despair, determination, and faith. This third collection (her penultimate) continues the author’s beautifully written illness narrative, again presenting moments of joy and of despair, and always of hope. 

Silver places her title poem, “From Nothing” (pg. 1), before Section I as an epigraph to the entire collection. “Each death I witness makes me more my own,” she writes, and although the poem sees “muscle shredded” and “bone sheared,” the poem’s last lines lift, as do many of Silver’s poems, into hope and faith: “and my molecules will vault, emerging. / From darkening days, the light will surge and flee.” Section I begins with poems of memory–“Summers in Vermont” with her family (pg. 5)–and “Coincidence,” when her sister’s child is born on the same day that Silver holds her breath and presses her “shorn chest” to an X-ray machine (pg. 7). The memories here are of family moments, both the joyful and those tinged with such “darkening days.” In “Luzerne,” she recalls when time was “consigning” her to such darkness, but two things saved her: her son, the poet’s hand touching his “damp blond hair,” and poetry, “offering itself like a pair of velvet shoes” (pg.13). Silver develops the idea of poetry as a special entity, a gift that enables her to walk forward in her journey, in “Raven” (pg. 15). She imagines a raven lifting her, holding her, and then setting her down in her home, where, she says, “dawn drove a pen into my hand.” This sense of urgency and necessity pervades all of Silver’s poems, as if she has been commanded to write her story.  

Section II begins in “Anguish” (pg. 19) a stunning poem about the loss of her first child, a daughter, but the section ends in joy with “After a Favorable PET Scan” (pg. 38). It might be difficult to find another poem by any author that offers such resounding relief and happiness. This poem, especially, speaks to how terrible every test is for those who are suffering, for those whose test results might mean more medication, more surgery, or less time to live. The celebratory release felt by patients when results bring good news must be a special kind of joy: “Oh world, I will give you all my love. / I will race like a child through the fields, / I will chase off the unkindness of ravens. / My words will grow thick as marshes, / sheltering nests in salty steams.” The poems in Section II are some of the most beautiful and moving poems in this collection. See especially “Tenebrae” (pg. 21), a plea for life; “Poise” (pg. 26), a rant against giving in to cancer; “Snow White” (pg. 30), a poem of mourning for self and others; and “Four Prayers for Forgiveness” (pg. 34-35), a poem that turns illness into beauty: “–the scattered lumps in my lungs / become church domes roofed in green mosaics, / my bones’ fissures fill in with grass-green yarn. / . . . I open my eyes and all is golden.” 

Section III seems to present a corrective reaction to the joy expressed in the final poem in Section II. The poems in this last section are short, mostly one stanza, a catalog of things that are broken, cracked, ripped, or chipped. The warning that nothing lasts forever is implied in poems such as “Partings” (pg. 44) and “Woman with a Hole in Her Stocking” (pg. 45), in “Red Never Lasts” (pg. 47) and “Autumn” (pg. 57). Yet, as always in Silver’s poems, the warning is tempered by the beauty of her words and the depth of her insight into what it is to suffer over the course of an illness that has remissions and recurrences, that sees the body changed and relationships altered. In “Ideal Speech” (pg. 58), she writes “Listen to the Holy Ghost. She blows through you, / she blows her poems right through you.” Even when days seem darkest, the ideal speech for Silver is poetry, and she is the “you” through which the Holy Ghost speaks these auricles. In the book’s final poem, “Three Roses” (pg. 59), the author once again works her spell, turning illness into beauty and despair into hope. “Where only my scar line remains, a red rose blooms. / Luscious, full, so open that if it dropped a single petal, / it would not be as lovely as it is this very moment.” And in the poem’s final lines, “Lay her hands on my chest–here, I give it to you. / Feel your palm on my skin heat and spark,” What is the “it” she gives us? I believe that Silver invites us, as Whitman did, to merge with her and to live within her words, which are her flesh, the poems she writes and then gives us to read and ponder.  

Miscellaneous 

In my annotation of Silver’s second collection, “I Watched You Disappear,” I wrote that her poems might be difficult for some to read: “These poems are beautifully crafted, often primal, and they touch the deepest reaches of personal illness and the shadow of mortality. Readers who have breast cancer or who have family or friends living with breast cancer, might find these poems difficult to read–others under the same circumstances might find them difficult and yet, at the same time, essential.” The poems in this collection can be as raw as they are hauntingly beautiful. But, as do her other books, this one again opens to us a world apart, one we cannot enter unless we share this author’s diagnosis and illness trajectory. If we are caregivers or care receivers, if we suffer or we watch loved ones suffer, these poems plunge us into emotions that we ignore at our peril.  

Publisher Louisiana State University Press 
Place Published Baton Rouge 
Edition 2016 
Page Count 65 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database. 
Web image created by Medhum.org

Susan Sontag has said, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick.” Author Lina Meruane challenges the idea that people with illnesses are necessarily separated into a different kingdom than those who are not sick, asserting instead that illness can be part of anyone’s normality. She makes this case through her novel, Nervous System. The novel tells the stories of four family members and a boyfriend who, at one time or another, develop a serious illness or help take care of one of the others with a serious illness: it’s all illness, it’s all the time, it’s normal. We talk with Dr. Meruane about her idea of illness as normality as she presented it in the novel, and about how its atypical structure and its evocative and memorable prose contribute to the stories told and the ideas offered.

Co-host

Daniel Albrant

Source
Nervous System by Lina Meruane, translated by Meghan McDowell, Graywolf Press, 2021.

Links
–Lina Meruane’s bio
–Russell Teagarden’s blog piece about the novel, Nervous System, and his blog piece about the MRI scene in the novel.
–Russell Teagarden’s blog piece about Lina Meruane’s novel, Seeing Red.
–Video conversation between Lina Meruane and Meghan McDowell about Nervous System.
–Interview with Lina Meruane in LALT magazine about Nervous System.

A big thanks to Lina Meruane for sharing her thoughts on illness as normality and her writing processes.

The Clinic & The Person is a podcast developed by our editor Russell Teagarden to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide.

Web image by Medhum.org

In Sophocles’s Oedipus Rex, a plague ravages Thebes as divine punishment for an unpunished crime—the murder of the eponymous king’s predecessor.

Two and a half millennia later, illness remains a metaphor in Robert Icke’s buzzy retelling of the Freud-genic tragedy, now on Broadway after a West End run last fall. Susan Sontag, who cautioned that portraying disease as a symbol of social decay can stigmatize patients, would likely disapprove. (Perhaps, apotheosized on Mount Olympus, she cursed Lesley Manville, who plays Oedipus’s wife and—spoiler alert—mother Jocasta, with an illness; Denise Cormier filled in when I saw the production.)

At curtain rise, on a stage-wide video screen, Oedipus (a charismatic and commanding Mark Strong)—reimagined as a politician on the cusp of electoral victory—tells a throng of eager reporters and supporters: “The civic body is ill. And that isn’t… chemicals in lakes—it’s us; we’re sick… The water got poisoned, and we got used to the taste.”

Economic inequality and xenophobia abound, as do rumors surrounding the death of Laius, the former ruler and Jocasta’s former husband. And so Oedipus promises to open an investigation. This off-script announcement exasperates his campaign manager and brother-in-law Creon (John Carroll Lynch), but Oedipus is steadfast in determining what happened. In Icke’s adaptation, probing the metaphorical plague is less a divine mandate and more a political act of narrative control. And, as Oedipus doubles down on transparency, what he uncovers about a fateful crossroads unravels his sense of self.

The truth of Oedipus’s identity is old news for most viewers, and we know that he is going to win. Yet Hildegard Bechtler’s set—an office with a hodgepodge of furniture, TV screens, and a clock counting down until the release of the election results—cultivates a palpable sense of uncertainty.

The successful set embodies Mikhail Bakhtin’s notion of the chronotope, or the inextricable fusion of time and space in literature. The literary theorist cites the road as one example of a chronotope. Social divisions such as class, nationality, and religion collapse, and time unfolds unpredictably through chance encounters rather than routine.

In Oedipus, as election night comes to a close, movers strip the campaign headquarters bare, transforming the space into a chronotope that mirrors how our hero is stripped of everything he once believed about himself. The ticking clock heightens the temporal pressure, heralding the landslide victory while portending the inexorable revelation that Oedipus did what every little boy dreams: killed Dad and married Mom.

Bakhtin also argues that chronotopes allow abstract ideas about philosophy, society, and cause and effect—say, the limits of free will and the illusion of power—to “take on flesh and blood.” Oedipus highlights the vital role chronotopes play in narratives, even if the coda transports us to the start of the campaign, undoing everything.

And even if much of the script doesn’t sparkle. For instance, Jocasta telling Oedipus “You’ll be the death of me” and calling him “baby boy” feels heavy-handed. Modern updates to Oedipus’s family dynamic have mixed success. The parts of adoptive mother Merope (Anne Reid) and daughter Antigone (Olivia Reis) are a welcome addition and expansion, respectively, bringing understated humor and wisdom. On the other hand, Icke casts one of Oedipus’s sons, Polyneices (James Wilbraham), as gay and the other, Eteocles (Jordan Scowen), as unfaithful. This framing raises an uneasy question: Are we meant to read queerness as a moral transgression on par with infidelity or incest? (Sontag, who was bisexual, probably wouldn’t be thrilled by this either.)

Icke’s greatest writing, however, is Jocasta’s hesitatingly revealed, harrowing backstory: She was only 13 when Laius raped her and forced her to abandon the resulting child. Jocasta recalls the delivery in visceral detail: the fluorescent lights of the hospital, the newborn Oedipus’s mucus-slick body. But she is denied the opportunity to share her traumatic account on her own terms; in his relentless quest for answers, Oedipus forces her long-hidden narrative, precipitating the discovery of their true relationship.

Narrative medicine emphasizes that this kind of listening can be destructive to both patient and listener. Indeed, Jocasta kills herself, and Oedipus gouges out his eyes with her heels. (Not very healing.)

Some narrative humility would have served Oedipus well. As Sayantani DasGupta writes, “narrative humility acknowledges that our patients’ stories are not objects that we can comprehend or master, but rather dynamic entities that we can approach and engage with, while simultaneously… engaging in constant self-evaluation and self-critique about issues such as our own role in the story.” With greater narrative humility, Oedipus might have better seen Jocasta—and himself.

Icke’s Oedipus teaches us that listening must be humble, ethical, and emotionally attuned; had it been so, perhaps the drama’s seemingly inevitable ending could have been averted.

Oedipus, through Feb. 8 at Studio 54 in New York; oedipustheplay.com.

Bakhtin, Mikhail. “Forms of Time and of the Chronotope in the Novel: Notes toward a Historical Poetics.” The Dialogic Imagination: Four Essays by M.M. Bakhtin, edited by Michael Holquist, translated by Caryl Emerson and Michael Holquist, University of Texas Press, 1981, pp. 84-258.

DasGupta, Sayantani. “Narrative Humility.” The Lancet, vol. 371, no. 9617, 2008, pp. 980-981. thelancet.com/journals/lancet/article/PIIS0140-6736%2808%2960440-7/fulltext

Web image from Sonia Friedman Productions Limited.

The Names opens with a woman, Cora, accompanied by her very talkative 9-year-old daughter Maia, on her way to register her newborn baby son and officially name him. She is married to an abusive husband who expects her to name him Gordon, the name that has been given by long-standing family tradition to every first-born son. Knapp immediately confounds expectation by then splitting the narrative into three distinct streams. She creates a novelistic triptych based on whether Cora, in fact, submits and names the baby Gordon, uses a charming alternative, Bear, offered by her chatty daughter, or substitutes a name of her own choosing, Julian, that she hopes will honor and be appreciated by her husband even if it represents a break in the line of Gordons.  The choice of each one  of these three names results in a distinctly different narrative arc that emerges over the 35-year span of the book. In the Gordon stream, Cora and her children  remain trapped in the tense and hostile domestic environment. In the second, Bear version, Cora accepts her daughter’s suggestion for a name. When her  husband returns from work that day, he goes berserk  and, in a rage, commits a savage murder. He is imprisoned and the mother and children achieve some degree of independence. Finally, in the third, Julian, narrative, where Cora gives the baby the name of her choosing, the husband grows increasingly violent and kills his wife a few years later. The children end up being raised by their maternal grandmother in Ireland and are forced to grapple with the untimely loss of both parents. 

Flashlight is the story of a Korean man, Serk, who leaves his native country as a child with his family for a better life in Japan and grows up there. He moves to the United States as a young man​,​  marries a beautiful but mysterious woman, Anne, from the Midwest, and is hired to join the science faculty of a small mid-level college. They have a precocious daughter, Louisa, who is an amalgam of her parents’ genetic input and more than match for both of them. The novel opens with Serk and the 10-year old Louisa walking along the beach in the early evening. The following morning, the girl is found unconscious and hypothermic at the water’s edge​,​ and the father has vanished. The presumption is that he slipped among the rocks jutting into the ocean, was swept away by the waves and drowned at sea. All is not, however, as it seems. There is international skullduggery involved, though it would be unfair to disclose more. Regardless of the cause of the father’s disappearance,  just as in ​The Names​, the lives of all the main characters in  ​Flashlight​ are ​ irrevocably ​changed by the sudden unexpected event at the beginning of the narrative. The mother-daughter relationship, which can be fraught in the best of circumstances, is profoundly disturbed. The mother, who suffered for many years from undiagnosed multiple sclerosis, is unable to overcome her own physical disability and achieve inner peace. The daughter, despite her obvious intellectual and physical gifts, is incapable of empathizing with others and develops a nearly feral persona. Serk’s story resurfaces in a surprising turn of events. Although there is constant switching of viewpoints and time frames, ​Flashlight​ has a more conventional structure than ​The Names​. 

​​​Why review these two books together? Doctors are taught and are obligated to treat patients one at a time. The guiding principle is that each person who seeks care should be evaluated and managed as an individual. The underlying cause of disease should be identified as precisely as possible​,​ and the therapy should be prescribed that has the highest likelihood of success and matches each patient’s expressed life goals and priorities. However, patients are almost never seen in isolation. Doctors are trained to compare and contrast the men, and women and children that they encounter, to find commonalities and differences among them in the hope that this wider, more nuanced  field of vision will sharpen their diagnostic acumen and improve their therapeutic recommendations for each patient that they treat. 

I suggest that reading these two novels together provides a literary example of how an analysis of two books that at first appear to be similar reveals different insights about the ramifications of sudden, life altering occurrences.  This is concretized by the contrasting authorial  ​​tone, warm and fuzzy in The Names versus cool and detached in Flashlight, and how we as readers engage with these two books. 

​​The Names​ details the consequences of Cora’s impulsive decision about what name she should give to her newborn son. ​Flashlight​ recounts the unspooling of the characters’ lives after one of them disappears while walking along the beach with his daughter. In ​The Names,​ the fateful event is a personal human choice, in ​Flashlight​ it is an inscrutable act by an unseen, hostile foreign government. This stark difference is manifest in the way readers experience the subsequent stories. As one moves through the 35-year span of ​The Names​, each 7-year interval in which Knapp picks up the story of the “three” sons feels organically linked to preceding period. The actions of Cora, her children, and the supporting cast of characters follow a trajectory that feels smooth and organic. It is true that while unexpected events intrude into each named narrative – Bear, Julian, and Gordon – the global sweep feels grounded and recognizable. There is admittedly a temporary sense of disorientation and a need to regain one’s footing ​in the plot ​as Knapp switches gears and advances to the next 7-year interval in the story of the triply named son. The narrative scenery and settings are abruptly changed​,​ and it can take the reader a few pages to get oriented and mentally  ​​settled. But within each tale, there is pervading tenderness and a sense of human initiative.  

In contrast, ​Flashlight​ has a staccato disjointed feel. The novel changes location and time period without clear reason. The nature of the characters, why they do what they do, and the basis for the choices they make, seem inexplicable, as if they are acting randomly and have no control over their lives. ​​Unlike the protagonists in ​The Names,​ who one wants to see overcome their difficulties, ​ and ​for whom one subconsciously roots for their ​well-being​, there is a reluctance to embrace or even sympathize with the characters in ​Flashlight​. They feel remote and distant until nearly the end of the book. It is Choi’s brilliance as a writer that maintains the cohesiveness of the composition and ensures that the reader remains fully committed to the novel and motivated to ultimately understand and come to grips with the plight of the people who populate the literary world she has created. 

Occasionally, as readers, we may encounter two novels that complement one another. ​The Names​ and ​Flashlight​ fell into that circumstance for me. As a pediatrician, I was taught to try to understand the impact of primordial events on the life trajectory of my patients, how singular experiences can have long lasting repercussions for health and disease. But these events are not all the same. Some are internal, reflecting private human decisions, and others are external, reflecting trials and challenges imposed unpredictably by the outside world. The warmer narrative of ​The Names​ reflects the former circumstance while the opaque tone of ​Flashlight​ mirrors the arbitrary and cruel act that launches the story. ​For physicians, ​appreciating the disparate impact of vastly different life events on people will improve our understanding of patients’ experiences and help us provide more compassionate care. These two books, taken together, illustrate the underlying objectives of MedHum, namely, to explore how humanities can meaningfully shed light on ​the ​human experience and the practice of medicine​.

The Names  
Florence Knapp  
Pamela Dorman Books/Viking, New York  
2023, 328pp  

Flashlight 
Susan Choi 
Farrar, Straus, Giroux
2025,  450pp 

Web image created by Medhum.org

A MacArthur Fellow and author of several acclaimed novels, Antrim has previously published a memoir of his upbringing with his alcoholic mother. In this new memoir, flashbacks of childhood neglect and chaos are juxtaposed with the present day as he takes the reader through the acute phase of his illness: a lengthy hospitalization, a course of ECT, discharge from the hospital, rehospitalization, and eventual stabilization.  

The author considers his condition to be suicide, noting that “depression is a concavity, a sloping downward and a return. Suicide, in my experience, is not that. I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish…I will refer to suicide, not depression” (pp. 14-15).   

The book ends on a hopeful note. After several relationships that might be described as codependent, Antrim meets his current partner, whom he marries. He sees the roof of his building through his window and remembers a certain Friday in April but is comforted by the sound of his wife playing Chopin and Bach on the piano.  

This is an exceptionally brave book. Antrim does not attempt to whitewash his situation in any way. Surely it is humiliating for someone so successful to acknowledge he has been utterly debilitated. He loses track of time. He gains weight and cannot fit into his clothes. His new book is released, but he is in no condition to help promote it. At first, he objects to being called psychotic but eventually it comes as a relief to know he is understood. One Friday in April will be inspirational to others who have suffered to see how an accomplished person is reduced to being allowed to use his razor only under strict supervision.   

At times Antrim touches on the link between mental illness and creativity. If he had hoped the cathartic exercise of writing about his childhood would have stopped his illness he learns otherwise: “Writing had not stopped my dying. (p. 80)” At another point, his friends joke that his diagnosis “might enhance my literary reputation” (p. 115). Finally, in one of the more poignant episodes in the book, Antrim gets a call from the novelist David Foster Wallace and is encouraged to undergo ECT. He has an excellent response to that treatment, but later learns that Wallace has hanged himself.  

While a diagnosis of psychotic depression fits best with the range of symptoms the author manifests, his point about suicide as a distinct disorder is well taken. In fact, the most recent edition of the DSM (Diagnostic and Statistical Manual) took the major step of including Suicidal Behavior Disorder as a “condition for further study.” This corroborates the author’s experience and means that SBD might be included in a later edition. (see also https://www.frontiersin.org/articles/10.3389/fpsyt.2020.499980/full)   

Those who are looking for an exposé or critique of the mental health system will not find it here. Antrim credits his psychiatrists and the hospital with helping him get through an unbearable time. One Friday in April is a book that will give reassurance to people who have endured suicidal thoughts that if they persist they will get better.  

Publisher W.W. Norton & Company 
Place Published New York 
Edition 2021 
Page Count 141 

Web image from Wikicommons
An earlier version of this review was published in the NYU Literature, Arts and Medicine Database