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Infobytes: Book Review

SPINAL CORD INJURY IS THE SPRINGBOARD FOR TREATMENT OF FAMILY ISSUES IN BEST‐SELLING NOVEL

Jones, Pamela

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Ms. Jones is Chief of the Scientific Publications Section in the Office of Communications and Public Liaison of the National Institute of Neurological Disorders and Stroke.

SPINAL CORD INJURY IS THE SPRINGBOARD FOR TREATMENT OF FAMILY ISSUES IN BEST-SELLING NOVEL By Pamela Jones The Dive From Clausen's Pier By Ann Packer 384 PAGES. KNOPF 2002

Enjoying a summertime outing with friends near Madison, WI, 20-something Mike Mayer impulsively dives into a lake he has swam in all his life. But the lake is shallower than usual. He hits bottom and suffers a major injury to the spinal cord that leaves him paralyzed from the shoulders down, a C5-6 injury.

From this first scene of The Dive From Clausen's Pier, the best-selling first novel by Ann Packer, the narrator Carrie Bell, Mike's girlfriend and presumed wife-to-be, relates how this tragedy affects her life and her emerging life plan.

“When something terrible happens to someone…the person…to whom it's happened takes on a kind of horrible glow in your mind…Mike's accident happened to Mike, not to me, but for a long time afterward I felt some of that glow.”

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RESPONSE FROM SIGNIFICANT OTHERS

The Dive From Clausen's Pier is the story of Carrie's, not Mike's, “horrible glow” – and, as such, neurologists reading this novel should know that this book does not focus so much on the feelings of the patient with a spinal cord injury – but on the response of his significant other.

Indeed, the reader learns, in perhaps too much detail, about Carrie's inner thoughts, especially her guilt that she does not know how to act around Mike and his grief-stricken family, guilt that in the months before he dove into that lake she was beginning to question whether she even wanted a future with Mike.

Ms. Packer describes the Madison hospital where Mike receives his medical care as “a city, with distinct neighborhoods and commercial areas, and corridors inside like long, long streets.”

Figure. Ann Packer i...
Figure. Ann Packer i...
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Like others, I have twice spent days in such “cities” with nothing to do but wait and stroll those long streets. In both cases I was waiting for death to end suffering at the end of a life lived fully. Carrie's waiting is a different sort; she is waiting to decide if, under the new terrible conditions, she can act on her urge to break away from Mike.

“How much do we owe the people we love?” she asks. She wonders if she “has to give up her life for Mike.” If “that's the choice I had to make.” At about this point in the novel I began to grow a little tired of Carrie.

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STORIES FROM AN ACCIDENT

There are many poignant stories radiating from this accident and the author makes a valiant attempt to give us insight into Carrie's story. But some readers, like me, may wish we were privy to Mike's feelings about what has happened to him. As the early action swirls around Mike in his halo and his struggle to adjust, we hear only Carrie's inner monologue about her personal anguish. Finally, she can bear it no longer (fortunately for me, as I was growing tired of her hand-wringing), and we are swept away with her as she silently and secretly escapes to New York City.

But even as Carrie grows more attached to both New York and a new man in her life, Kilroy, she never stops thinking about Mike. These musings are a bit heavy-handed. “My worry about him slipped into high gear, and I felt stripped by the tension of it, just opened wide,” and “My body ached,” and “I was exhausted…my eyes stinging and my back and neck aching.” For readers wondering what is happening to Mike back in Madison, it is hard to be terribly sympathetic to Carrie's stinging eyes.

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MEDICAL HARDWARE DETAILS

The author does not give us a great deal of medical information, but perhaps very little is needed to convey the enormity of the loss Mike suffers and the shock it is to those who know him best: his family, his circle of friends, Carrie. But she gives us some hardware details – the breathing tube, the ventilator, the halo.

Sometimes Mike gets lost in all of this hardware. He stops being a three-dimensional character, with feelings of loss and confusion, and instead becomes merely an extension of the technology that surrounds him. This may be a clever device to show the reader exactly how dehumanizing such an injury can be, but it left me feeling distanced from Mike.

The medical team is mostly in the background but does include the central casting neurosurgeon – “Dr. Spelman…was the neurosurgeon, and his cool detachment has us all cowed” – and the bearded and gentle counselor, Dave King. This character and his role in helping Mike adjust to his new life should be appealing to social workers and counselors everywhere.

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FEELINGS OF NEGLECT

The author also relates what another doctor is thinking, something Carrie seems to be able to do at will: “A pair of doctors walked by and one of them happened to look right at me…I thought for a moment that he understood what we were going through, and I felt touched, even comforted. Then I realized; we were just another case to him, the periphery of some illness or accident.”

Neurologists or physicians, in general, might make note of Carrie's feelings of feeling neglected or dehumanized, as the author here suggests that patients and families could benefit from just a little more attentiveness – especially in dealing with these types of catastrophic situations.

Most readers might agree that Carrie's desire to have a full relationship with a man is understandable, and I suspect that many of us would follow her path. I hope not, I hope most of us would do it differently. I judged Carrie badly for slipping out of Madison into the night, and I couldn't even forgive her behavior on the grounds of youth or immaturity. The effect of this judgment, right or wrong, was a feeling of sympathy for not just Mike, but Carrie's mother, friends, and others left behind in Wisconsin.

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IMPORTANCE OF FAMILY

The Dive From Clausen's Pier is in many ways a novel about family attachments and the difficulties of maintaining them. Liberally spread throughout the background of the novel are important family members such as absent fathers, including Carrie's who left when she was three, Kilroy's distant and well-to-do mother and father, Carrie's saintly mother, the friends in New York who become like family, and the family and family-like friends left back in Madison.

The importance of family is summed up in an exchange between Carrie and one of her New York artist friends, Lane. “Miss Wolf [Lane's employer] is always telling me that the family is the enemy of the artist. Well I think the family is the artist. Just like the sky is, or all the books you've ever read.”

It is hard to imagine a tidy and satisfying way to end such a novel. I'm glad it wasn't my task. So it is not a criticism I make with much heart when I say that the novel ends on a murky note. I was, however, happy to be away at last from Carrie's woes.

Mike was a more likable character than Carrie, although readers don't learn much about him outside of that glow of his illness. There are glimpses of him though, and I liked the plain man that Mike seems to be. There is a warmth about him and much dignity in his behavior as he adapts to his new life, slowly at first but always in a way that felt true. It is hard to know for sure, but I think most people in Mike's situation would react positively, as he did, to the attentions of friends, family, and those caregivers who are given more than just a walk-on role.

Despite my reservations about her treatment of the main characters, Ms. Packer offers readers a crisp writing style and this novel is a quick, easy read. My predicament was that I heard myself say far too often about Carrie, “Quit whining.”

©2003 American Academy of Neurology

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