Strong at the Broken Places: Voices of Illness, a Chorus of Hope

Nursing Book Club

Strong at the Broken Places: Voices of Illness, a Chorus of Hope

Living with a chronic illness is explored through interviews and first-person experiences.

By Richard M. Cohen; HarperCollins Publishers, 2008
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Reviewed By Christine Contillo, RN, BSN

Richard Cohen has already written extensively about his personal struggles with multiple sclerosis and colon cancer. He has used his strength as an author/journalist to allow readers to better understand the toll this chronic disease has had on him. Strong at the Broken Places takes that understanding to a different level as he relates interviews with five people, all dealing with huge difficulties most of us hope desperately to avoid in our lifetime. In fact, the odds of that are against us — as we live longer, we will likely cope with chronic disease ourselves or become caregivers for a loved one.

Mr. Cohen selected five very different people struggling with five various illnesses — some likely to be fatal, and others certainly disabling. He probes how the illness has affected their day-to-day life and the lives of those around them, sometimes by including discussions with family members who offer a different viewpoint. Their individual personality may have much to do with how they take on their challenge and their spirituality may help shape their hopes for the future.

Strong at the Broken Places Book ReviewDenise has amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease, a fatal neuromuscular disease that leaves her increasingly incapacitated as she continues to live alone. As she pushes her puzzled family away, the author pushes her to acknowledge that she will eventually need to accept help from others for even the most rudimentary tasks. Were relationships difficult for her before the disease, or is it the dependency fostered by ALS that makes it difficult for her to acknowledge her impending loss of control? Control issues are so central to her being that Mr. Cohen is able to question her about the possibility of suicide as one of her choices, and her answers may surprise us.

His anger with his own situation comes through loud and clear, but it’s tempered by the lives and views of those he interviews. He continually asks the questions that they themselves might be trying to ignore and shares the answers with us. A few are able to accept their situation and the help given by their families with a level of dignity that it seems he has not yet been able to find. Clearly, the relationships Mr. Cohen developed through this book have been helpful to him. A conference held at Harvard and described at the conclusion of the book may have served to further him on this path to acceptance.

Mr. Cohen’s work involves a carefully selected group of people whose responses underscore much of what he wants to reveal and have us believe about chronic disease. Denise with ALS says, “It took a disease to open my eyes and forced me to muster the courage to do something” but, of course, not all patients have the courage or the financial ability to conquer the goals they set for themselves.

Ever wonder how patients feel about the way they are treated by physicians who are unable to cure them? “Asked if the way he was handled by the doctors just added unnecessary emotional pain, Buzz looked at me as if that was about the stupidest question he’d ever been asked.”

And while we know that many of the chronically ill are depressed, Mr. Cohen’s patients are mostly hopeful for the future. Larry becomes a spokesman for the mentally ill and says “to take (away) my illness would be to remove the meaning and purpose I now have. Mine is a purposeful life.”

Strong at the Broken Places forces the reader to regard truths that may be easy to ignore until faced with illness. Chronic disease in the U.S. can be costly to the point of becoming financially devastating. It can wreak havoc on relationships and force people to pick up lifelong burdens they never anticipated. Nurses who know their patients only in clinical settings should read this for insight into the emotional lives of those who exist apart from the burden of symptoms brought to their visits.

Christine Contillo, RN, BSN, has worked as a nurse since 1979, and has written extensively for various nursing publications, as well as The New York Times.

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