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

The house sits at the foot of a spring-green mountain, painted over with long cascading strokes of darker green, giving the impression of a verdant and peaceful setting. Contrast this to the brown ridge where the figure is sitting, huddled in a long sleeve jacket, hands tucked into pockets. The ridge is barren except for a single tree that is mostly bare branches with sparse pale-pink leaves.

Matthew Wong was a rising young painter who died of suicide on October 2, 2019. In a moving obituary by the New York Times, his mother explained that Mr. Wong “was on the autism spectrum, had Tourette’s syndrome and had grappled with depression since childhood.” This helps to explain the sense of isolation and longing in the painting, depicted by the solitary figure on a barren ridge, looking back at a house in lush green surroundings. The figure also appears to be physically cold, wrapped in long sleeve coat, hands tucked in pockets, with no skin showing, but is sadly separated from shelter by an icy white distance. This dynamic, amidst a landscape of majestic mountain rising into star-crowded sky, gives a sense of melancholy beauty and loneliness.

The title of the painting, “See you on the Other Side,” can be interpreted in numerous ways. Mr. Wong is known for incorporating mythical elements into his work, so is this the beginning of the hero’s journey? If the tree in the foreground is interpreted as being laden with pale pink flower buds, there is a sense of hope and promise that the figure is leaving home and will return triumphant on the other side. But the tree can also be seen as a representation of fall transitioning into winter, hanging onto a few withered leaves, as the last bright red autumnal leaf blows away. Is the figure heading away from the verdant house and mountain into winter, the season that classically symbolizes death? Does the other side refer to an afterlife? A third interpretation to consider is that the figure is not leaving the house, but actually trying to get there. In this case, on the other side would refer to crossing the vast white expanse where no path is marked and no help is in sight.

View the painting at Museum of Fine Arts Boston ➔

Matthew Wong’s Biography: www.matthewwongfoundation.org/biography
A previous version of this review was published in the NYU Literature, Arts, and Medicine Database.
Web image from www.matthewwongfoundation.org/

A Most Unexpected Path Laid by a Most Unexpected Disease

Dr. Ross Slotten chose family medicine to serve patients from cradle to grave. But, as he was entering practice, the AIDS virus was entering the community where his practice was situated, and he found himself serving patients much closer to the grave than the cradle. 

In June 1981, a few weeks before I began my internship in family practice [at Saint Joseph Hospital in Chicago], the Center for Disease Control in Atlanta had published the first report of a strange lethal infection among a cohort of gay men in Los Angeles. I had no clue then that the disease would soon kill friends, former lovers, colleagues, and patients; devastate tens of millions of people and their families worldwide; and consume my entire professional life and more than half my chronological one. (p.14)

From both the circumstance of time and place he found himself in, and the sense of necessity and compassion that claimed him, Slotten’s professional trajectory unexpectedly shifted away from traditional family medicine towards specializing in AIDS. His interest in AIDS, however, extended to personal considerations, because as a gay man, he was part of the population at risk, and harbored the same anxieties and fears he saw in his patients and throughout his social circles. His patients were principally gay men because of his geographic location in an established gay community and the resulting referral patterns. The book chronicles both his experiences as a physician taking care of gay men with AIDS, and his experiences as a gay man at risk for AIDS. For Slotten, these experiences were not independent of one another, which makes for rich insights on the complexities of both. 

Slotten spent a lot of time at Saint Joseph Hospital because his patients required intense medical support and specialized services. He tells how he and his practice partner pushed for establishing a specialized AIDS unit in the hospital. They bumped up against usual bureaucratic obstacles, plus a few more concerning issues specific to AIDS patients, but they ultimately prevailed. Slotten “was to spend the next fifteen years there, often heartbroken, occasionally inspired.” (p. 109) In contrast to his commitment, he recounts how some specialists he called for help with particular patients refused when told they had AIDS. Those occurrences stuck with him: “I couldn’t forgive those other physicians for abandoning me and my patients in the hours of our greatest need.” (p. 108)

With whatever little time he had left for volunteer and advocacy work, Slotten stayed local. He talks about the volunteer-run health clinics where he worked (e.g., the famed Howard Brown Clinic), and the housing facility he helped set up for homeless people with AIDS. He left protesting at the Food and Drug Administration, the National Institutes of Health, and the annual International AIDS Conference to others while he focused on his patients, his studies, his volunteer work, and his own safety.

The 2020s are approaching when Slotten writes about the preceding three-and-a-half decades. As he finishes the book he is still caring for people with HIV, but the horrible complications of AIDS are now infrequent since the availability of effective medications. His practice had been reliably stable and predictable for some time, a circumstance he could only dream of when he first started. That dream ended abruptly just as the book was released on July 15, 2020: Covid was surging.

Moments of Horror, Relief, Calm, and Then…

Slotten’s perspectives correspond with the trajectory of AIDS over the thirty-five years his memoir spans. Particular periods are discernable, beginning when gay men were presenting with illnesses associated with profound immunodeficiency of unknown cause. Another is the time of peak AIDS death and destruction represented by the moment in 1992 when Slotten hears from the Chicago Board of Health, “that no one had signed more death certificates in Chicago than I had.” (p. 122) The next moment arrives at the turning point when highly active antiretroviral treatment (HAART) became available, transforming HIV/AIDS for him “from a universally fatal disease…into a chronic one like diabetes…it was almost beyond belief.” (p. 186) Then the prolonged period of relative calm when AIDS became controllable—even preventable—with Slotten noting during a moment in 2016 that, “It had been almost a decade since I’d cared for someone with advanced HIV infection, and I hadn’t lost a patient to AIDS since 2004.” (p. 202)

The AIDS epidemic is known for and measured by the number of deaths that occurred. Slotten wants us to remember the misery the disease causes.

For those who didn’t experience that terrible time, or who’ve forgotten how terrible it was, let my chapters serve as a warning to the complacent and the ignorant: untreated HIV is as ruthless as any terrorist and as destructive as a nuclear device. (p. 3)

He drives this point home when he recounts the stories of individual patients tortured by Pneumocystis carinii pneumonia, Kaposi’s sarcoma, cytomegalovirus retinitis, herpes simplex infections, cryptosporidium dysentery, AIDS wasting syndrome, AIDS dementia complex, and progressive multifocal leukoencephalopathy among other medical horrors, and who often suffer many at the same time. And, all the while, he had little to offer but his wits and his compassion. 

Both attributes would be called upon again in 2020 as Covid struck. Though those with Covid did not produce nearly the fatality rate of AIDS, not nearly the severe comorbidities of AIDS, not nearly the stigma and prejudice as AIDS, and not any of the governmental insouciance seen with AIDS, it still caused a lot of death, suffering, grief, and misinformation at a time when only supportive care was available. Like AIDS, though, the Covid pandemic was transformed into a manageable syndrome with the availability of an effective vaccine, new antiviral agents, and better clinical management regimens.

Complacency remains a threat to the reemergence of any infectious disease. Indeed, AIDS is reportedly rising in poor and developing countries in 2026 as funding for AIDS treatment and prevention programs has been withdrawn from donor countries, mostly that from the United States. Lessons from Slotten’s book may thus be called upon again.

Notes

Book citation:
Slotten, Ross A. Plague Years: A Doctor’s Journey through the AIDS Crisis. University of Chicago Press, 2020. 224 pages

Plague Years is a good companion to the documentary film, 5B, which reports on how San Francisco General Hospital coped during the early years of the AIDS epidemic, and Rebecca Makkai’s novel, The Great Believers which features the stories of a group of gay men in Chicago also during the early years of the AIDS epidemic.

Dr. Slotten was a guest on an episode of The Clinic & The Person podcast to discuss his experiences during AIDS epidemic as he reported them in his book, and how well they match up with what we see in 5B and read in The Great Believers.

Web image by Medhum.org

Field Guide to Falling Ill: Essays by Jonathan Gleason 

New Haven, CT: Yale University Press, 2026, 256 pages 
ISBN 9780300282948

In these ten exemplary essays, Gleason mingles illness memoir, the challenges of caregiving, and loss (of health and spirit). Disease is portrayed not only as an aberration of the body’s normal homeostasis but also a distinctive event with social, cultural, and possibly historical meaning. Contagions (viruses, prejudices, even love) receive special attention as catalysts of uncertainty, anxiety, and sometimes terror. Spaces – inner, close, distant, and built – are similarly scrutinized. In 1623, the English poet John Donne declared that “the greatest misery of sickness is solitude.” The narrator of the title essay echoes that sentiment, describing “loneliness” as the world’s greatest sorrow. He volunteers as a part-time medical interpreter at a free clinic but suddenly becomes a patient himself with a blood clot in the left arm. These experiences lead to an understanding of the power and limitations of both language and empathy. Other essays explore organ donation, AIDS, mental illness and the demise of large psychiatric hospitals, Tay-Sachs disease and xenophobia, pain, addiction, and the trial of an Ohio doctor charged with multiple counts of murder. Throughout these pages, Gleason points out the hubris of medicine as well as its shortcomings. He writes, “We like to believe we know the vastness of the world, that everything can be explained through our current models of understanding” (p3). At some point (or maybe many times), however, we will all fall ill and become a patient. And that immense world with all its scientific knowledge will dramatically contract to our single suffering body longing to be comforted and cherished by others. 

“An Eye in the Throat” in Good and Evil and Other Stories (pages 57-96) by Samanta Schweblin, translated by Megan McDowell  

New York, NY: Knopf, 2025, 192 pages 
ISBN 9780593803103 

It’s every parent’s nightmare: a serious (and potentially preventable) injury to their child that occurs right in front of them. Here, the setting is Argentina in the 1990’s. Inquisitive two-year-old Elías chokes on a lithium battery from his grandmother’s digital calculator while his father is in charge of watching him play. A visit to the ER and then an appointment with the family doctor the next day offers little reassurance for the parents. On the third day, Elías begins coughing and develops a fever. An operation is performed to remove the lodged battery and repair tissue damage to the esophagus. A tracheostomy is performed, and he undergoes four operations in a span of six years. He is unable to speak. At one point, he mysteriously gets out of his car seat and briefly becomes lost at a gas station. Soon after, a landline phone at home eerily rings each night. When the father answers, there is no voice at the other end. The parents eventually separate. Elías comprehends that all family members are casualties, and with an amazing capacity for empathy concludes, “There is a hole in my throat, a hole in my body that hurts in theirs” (p79). He is enrolled in a special school for deaf and mute children and becomes an outstanding student who is enthralled by language and mathematical physics. Schweblin’s searing story about parental guilt and grieving, failed communication, and the remarkable resiliency of youth is guaranteed to leave you with a lump in your throat. 

A Prescription for Burnout: Restorative Writing for Healthcare Professionals by Carolyn Roy-Bornstein 

Baltimore, MD: Johns Hopkins University Press, 2026, 208 pages 
ISBN 9781421454733 

Burnout among physicians and nurses, accelerated by the emotional and physical crush of the Covid-19 pandemic, continues to be an urgent problem. Causes of burnout among health professionals include an erosion of autonomy, truncated time allotted for patient visits (but increased time required for inputting data into the electronic medical record system), feeling underappreciated, unrealistic expectations from patients and employers, and the daily exposure to the suffering of others. Roy-Bornstein, a pediatrician and a former RN, enthusiastically endorses reflective writing as an effective remedy for dealing with burnout (or perhaps preventing its occurrence). While not a new concept, her discussion includes research on the utility of restorative writing, some commentary on narrative medicine, and most importantly, more than 85 writing prompts (or Rx’s as she refers to them) for reflection and as a kind of therapeutic exercise. Organized into three sections – Addressing Emotional Exhaustion, Countering Cynicism, and Restoring Self-Efficacy – the book addresses issues of vulnerability, self-compassion, self-awareness, resilience, and optimism. There is no doubt that reflective writing can be healing and hopeful. Roy-Bornstein offers a helpful pathway to reducing the risk of professional burnout.  

Vesalius’s illustration, “Skeleton Contemplating a Skull” from Wellcome Collection

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

Agnes recognizes William’s unique potential and supports his choice to leave his family and head off to London to make his name in the theater world. Shakespeare rarely returns home to Stratford, and we only learn of his growing success indirectly. Agnes is forced to raise her children as a single parent and has to deal with her overwhelming grief when Hamnet dies. As she mourns the loss of her son, she is overcome with doubt about the fidelity of her absent husband, and her faith in their marriage is threatened. Ultimately, Agnes is given a playbill featuring the production of a new play written by her husband and she sets off on a trip to London to confront him on his own turf. She arrives uninvited at the Globe Theater in time to witness a performance of the play in which her husband has been able to channel his own grief at the loss of his son into one of the enduring literary works in the Western canon.  

I first became aware of this book in a New York Times article that appeared in the early stages of the COVID 19 pandemic shutdown. It was recommended as a worthwhile book to read in quarantine. I had never heard of Maggie O’Farrell but the two-sentence summary captured the book and author perfectly. I do not think O’Farrell is a prophetess, but she was nothing if not attuned to our times and circumstances. Assuming she was writing this novel well before coronavirus escaped the food market in Wuhan, the way she frames Hamnet’s death in the setting of the bubonic plague in Stratford is inspired. Her story captures the explosive fear that envelops the town as the plague spreads — you can feel the wind in your face as the townspeople slam the door shut in the face of anyone suspected or proven to be infected. The story is written in the present tense which heightens the sense of immediacy of events as they unfold for William and his parents, Agnes and her family, and the people living in Stratford. O’Farrell’s prose feels Elizabethan – in the description of glove making, removing honey from a beehive, preparing shrouds for the dead child. As I read, I found myself looking up many more words than usual; the language itself has the power to transport you back in time.  

But, while the choice of bubonic plague as the cause of death may have been fortuitous for book clubs and book sales in the world we lived in during the pandemic, I do not think it is the driving force in this book. The dominant theme is how we deal with grief from any cause. O’Farrell is not the first author to use the death of a child as a vehicle to explore the myriad consequences triggered by the loss of a loved one, especially for parents who lose a young son or daughter. The steady movement of the plot to the climactic scene in London makes Shakespeare’s response seem the more substantive. His literary genius has enabled him to channel his sadness at the loss of the son he adored into the creation of an authentic character into whom he could project all the hopes and dreams that he had for Hamnet.  

Interestingly, O’Farrell never names Shakespeare throughout the novel, referring to Shakespeare always as “he” or “him” I can only speculate what O’Farrell means to convey with this literary device. I think she is acknowledging that it is the truly rare individual who can accomplish what Shakespeare was able to do in redirecting his grief from personal sadness into a timeless literary masterpiece. We are thus like Agnes who must go through our day-to-day routine, try to find meaning in tragedy and the courage and strength to stay on our feet and continue to move forward. That is Agnes’ accomplishment — that she can summon the will to travel to London to confront William, and by her action have the goodness of heart to realize that her husband shares her loss. She is able to appreciate the gift he has been given to transform his personal grief into a meaningful expression that the world can share. With this newfound knowledge, her marriage will be reinvigorated, and their mutual love will be reinforced. Agnes is thus the named character who occupies center stage as the story unfolds.  

O’Farrell has written a truly beautiful book that brings to life the pain of loss and the capacity of men and women to endure. As we coped with the COVID-19 pandemic as individuals and communities, many were forced to deal with unexpected pain, suffering and death. Hamnet is a book for our time. Physicians and all other health professionals do their best to support families and communities as they deal with untimely loss of loved ones. I only hope that it will not set the bar too high on expectations of how to transform grief into meaning. We are not all going to be Shakespeares but we can hope to be Agneses, who can still find joy and meaning in our lived lives in the aftermath of devastating loss.   

Hamnet
Maggie O’Farrell 
Alfred Knopf, 2020: 384 pages 

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

Directed by Anne Kauffman, the play features “Primes,” or holographic simulations of the dead intended for therapeutic use by the living. June Squibb—who, at 96, is making history as the oldest performer to open a Broadway show—astonishes as Marjorie, an impish 85-year-old with dementia using a much younger version of her husband Walter (an uncanny yet tender Christopher Lowell) to regain and retain her memory. Marjorie’s daughter Tess (the incredible Cynthia Nixon) is skeptical and fearful of the technology, whereas Tess’s husband Jon, played by a standout Danny Burstein, is a fan—until an on-the-nose change of heart in the penultimate scene. 

Marjorie Prime’s central flaw is that it favors concepts over dramatic depth. The characters are well-acted but underdeveloped, and almost all they do is talk; the biggest event may be Marjorie urinating herself. Yet, despite its slow pace and formulaic structure, Marjorie Prime is intelligent and poignant. 

Marjorie’s memories are embellished and sanitized for her comfort and convenience. The fallibility of memory is hardly a novel concept, but the Primes enable this reconstructive process and also become a stand-in for genuine connection in the wake of grief, preventing the family from confronting painful realities and repairing their relationships.  

By the time the truth fully surfaces in the unsettling final scene, which makes adroit use of a stage turntable (props to scenic designer Lee Jellinek), there are no humans left to heal. When storytelling is delegated to AI, truth becomes archival rather than relational; however, truth must be witnessed between living people in order to be ethically and therapeutically meaningful.  

Playwright Jordan Harrison’s Primes, like flesh-and-blood clinicians, absorb and co-construct patients’ accounts of self, yet they are disembodied, unfeeling, and ultimately unable to act with compassion, turning dynamic stories into datasets.   

Marjorie Prime, through Feb. 15 at the Helen Hayes Theater in New York; 2st.com/shows/marjorie-prime.  

“Much of healthcare happens in interpersonal moments,” write Maura Spiegel and Danielle Spencer in the first chapter of The Principles and Practice of Narrative Medicine—and machines are good at many things, but participating in a truly interpersonal moment is likely not one of them. Several studies have suggested that models perform worse for underrepresented groups because they are trained on datasets that lack racial, cultural, and linguistic diversity. Additionally, AI may miss subtle emotional cues and fail to interpret tone, context, and metaphors, which, one bioethicist [1] predicts, could “fundamentally alter” how trust is practiced in healthcare. Others [2] have underscored that “AI should be viewed not as a replacement for the physician, but as a partner in delivering empathetic, patient-centered care.” 

However, AI is not wholly bad. For example, a recent systematic review [3] found that applying natural language processing (NLP) to unstructured text in electronic health records (EHRs) can detect signs of cognitive impairment. Some [4] have found solace in text-based simulations with lost loved ones. And perhaps technology should be viewed as a vehicle for strengthening partnerships between clinicians and patients. Designed by Gabriela Gomes, the video game Healing Spaces aims to help those with neurodegenerative diseases connect with their caregivers. It is a multisensory experience: an app with beach and forest scenes, and a box with aromatherapy that smells like pine trees. Healing Spaces may evoke memories or even create new ones between caregiver and patient, unlike the Primes’ hollow curation. 

Healing Spaces also includes sunscreen-scented lotion that caregivers can use to massage the hands of those in their care. Needless to say, holograms and lotion don’t pair well. “You can’t touch a hologram. So there’s something about them looking so much like your loved ones, but not being able to quite achieve intimacy with them,” said Harrison during Marjorie Prime’s Off-Broadway run about a decade ago. “The loneliness can never be quite extinguished, never satisfied, because they’re just pixels.”  

[1] Kerasidou, Angeliki. “Artificial Intelligence and the Ongoing Need for Empathy,  Compassion and Trust in Healthcare.” Bulletin of the World Health Organization, vol. 98, no. 4, 2020, pp. 245-250. pmc.ncbi.nlm.nih.gov/articles/PMC7133472/. 

[2] Ghenimi, Nadirah, et al. “Integrating AI with Narrative-Based Medicine: Enhancing Patient-Centered Care in Primary Practice.” Perspectives in Primary Care, 5 Dec. 2024, info.primarycare.hms.harvard.edu/perspectives/articles/integrating-ai-with-narrative-based-medicine.  

[3] Shankar, Ravi et al. “Natural Language Processing of Electronic Health Records for Early Detection of Cognitive Decline: A Systematic Review.”npj Digital Medicine, vol. 8, no. 1, 2025, p. 133. pubmed.ncbi.nlm.nih.gov/40025194/. 

[4] Fagone, Jason. “The Jessica Simulation: Love and Loss in the Age of A.I.” The San Francisco Chronicle, 23 July 2021, sfchronicle.com/projects/2021/jessica-simulation-artificial-intelligence/. 

Web image from 2nd Street Theater.

In “Mandatory Evacuation Zone,” Felice Aull has gathered 63 beautifully crafted poems in which she examines the intricacies of language and loss, of grief and healing.  Each of the book’s five sections considers these themes in slightly different ways, always in language that is understated, vivid, and exact.  In Section I, we read poems that focus on the author’s complicated family history and her early loss of homeland.  In “Tracings” (page 15), an unknown relative (thanks to online genealogy searches) reaches the narrator and wants to meet her.  She, however, only wishes to learn “. . . how my parents / and my infant self / made our tortuous way out . . . . ” Brought in infancy from Germany to America, the author suffers the loss of both native homeland and native language (“Notes from an Alpine Vacation” page 16).  She searches photos of her mother and ponders museum note cards illustrated by Holocaust survivors (“Museum Notecards” page 18), imagining what she can’t quite know and yet can’t quite forget.  

Section II finds the narrator as a young woman in American, awakening to sexuality (“Gay Blades,” “Camp Counselors Make Out,”  “On the Staircase” pages 29-31), becoming a wife and mother, and then a grandmother.  A grandchild’s birth is both joyful and yet another “slipping toward / the edge of separation” (“Daughter in her Eighth Month” page 37). 

In Section III, the author turns her gaze to observations of the world around her, around us, aware of how many come to loss and death.  “Be prepare to mourn,” she tells us in “Disaster in October” (page 49), and in the moving poem, “I Saw the Smoke,” re-visions September 11th in words stripped of sentimentality and therefore made more powerful. 

Sections IV and V confront bodily loss through aging and illness, noting how, in so many ways, we try both to capture and to let go: “You snap photo upon photo / hoping to grasp and preserve / what cannot be grasped” (Capturing Alaska” page 66).  We learn of the most personal losses in poems of biopsies, surgeries, and chemotherapy.  When facing the unknown, every event might seem to hold a prediction.  In “Stunning Blows,” a doorman stuns a mouse, claims that it’s dead.  But the narrator, aware of the wages of time, writes, “But I still see it, like death, / moving toward me” (page 81).  At the book’s end, we return to language, how it too can leave us (“Forget That” page 90).  Yet in the collection’s final, gentle poems, the poet is “able, finally / to walk past the park’s redbud tree / without weeping” (“Immunity” page 96).

Although there are many poems that confront loss both recalled and experienced. grief for self and others, illness and the unknown in this collection, there are also poems of great acceptance and ultimate joy: “These gifts and losses, every year, mine” (“The Key to Gramercy Park” page 98).  The poems in “Mandatory Evacuation Zone,” show us how poetry can help us to “declutter” (see “Divesture” page 99) and release, and at the same time, hold on to and embrace.

Kelsay Books, California 2017: 100 pages

Felice’s website: https://www.feliceaull.com/

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A previous version of this review was published in the NYU Literature, Arts, and Medicine Database

Egon devotedly cares for his sick wife despite her warning, “You will get it from me” (p111). Soon she is unresponsive. As Egon listens for a heartbeat with his ear against Edi’s motionless chest, he can only auscultate the distant, faint beat of his unborn child’s heart that is quickly silent. He tragically describes Edi’s corpse: “Her body being both cradle and coffin, within a minute” (p128). Egon feels compelled to make multiple sketches of his dead wife. 

Before long, Egon experiences harsh bouts of coughing, fever, and chills. He becomes remorseful about the drawings he made of Edi and burns them in the kitchen stove. Egon gazes at the fire, knowing he too will die shortly but aware that he will be survived by all his other artwork. 

This short story imagines the final days of Austrian painter Egon Schiele and his pregnant wife Edith. He died at age 28, just three days after she passed away, both victims of the 1918 influenza pandemic. 

A stunning and sorrowful re-creation of what the end of life might have felt like for a young husband and his expectant wife during the 1918 pandemic. The tale highlights the risk of love, the inescapable weight of dread, and the connection between creativity and illness. 

Primary Source 
Blank Pages and Other Stories (pp105-138) 

Publisher 
W.W. Norton & Company, New York, 2022: 34 pages 
A previous version of this review was published in the NYU Literature, Arts, and Medicine Database.
Web image by Medhum.org

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