Excerpts from a Family Medical Dictionary
Rebecca Brown
(Grey Spider Press) $45

When someone you love departs in death, it is difficult to know how to describe the sudden distance between you and that person. The most common response is to describe it in spatial terms: he "passed over;" she "went to a better place." It is as if the person who died has been exiled, but the person left behind has also been exiled. Death creates two exiles; there is no home country in between the states of life and death.

In Excerpts from a Family Medical Dictionary, Rebecca Brown describes her mother's death as a long journey. There is no one moment when the death comes--whoosh--there is no solace of spiritual release. There is only a drawn-out, agonizing decline, mapped in abrupt diagnoses, in sudden remissions, in awkward expressions of love. Brown and her brother and sister are there to help their mother through the end, are guides trying to imagine the next country over, a country they haven't yet seen but can only glean through the telescope of their mother's suddenly supernatural vision:

One morning she awoke with a start. She sat straight up in bed and said, "Is everything ready?"

My brother and I were with her. We'd been watching her sleep. Her skin was shiny, her eyes were bright, her hands were scrabbling across the sheet....

"Yeah," my brother said. "Everything's ready, Mom."

"Oh good." She sounded relieved. When she lay back against the pillows she looked old again.

Part of this "getting ready" for departure involves putting everything in some semblance of order, and Brown uses the format of a dictionary to help with this. Each small section of the book is prefaced by the definition of a word. All of these words are straightforward medical terms--"chemotherapy: the treatment of infection or disease by doses of chemical drugs"; "hypnophobia: an irrational fear of sleep"--that, in context, shed their cold clinical skins and take on a heated double meaning.

The short pieces that follow these definitions also work as definitions, albeit very personal ones. That they are "excerpts" suggests that the narrative is sculpted out of a larger volume, perhaps selecting only those definitions particular to the story at hand. The stories define, for example, hypnophobia as particular to Brown's mother:

One night she dreamt that she was falling up.

"The ceiling was covered with flowers and I was falling up into them," she said. She said the flowers were white and pretty colored and they smelled clean and sweet but she was afraid. Something was pulling her, lifting her up.

After this dream she was afraid to sleep.

Brown's stories-as-definitions effectively illustrate how real life burgeons out of its vocabulary. In fact, the restraint of the form begins to strain against itself, like a spirit might strain against skin. The book as container becomes uncomfortably close; a bandage. The small-press publisher Grey Spider Press does an admirable job of subtly conveying this through the design, created by C. Christopher Stern and Jules Remedios Faye. The book is tall and relatively skinny. It looks like an old, old textbook, but also uncomfortably like a grave marker of some sort. The cover material is thick and bulky. It feels like a paper bandage. Inside, the medical-red title text looks violent against the creamy white pages. The book is surprisingly heavy. It is a somber, strong volume.

Brown, whose previous books have also explored themes of death (The Gifts of the Body) as well as structural devices (The Dogs: A Modern Bestiary), attends to the real-life transcription of her mother's death with tenderness and honesty. She does not dress the story up in the flowery language with which we usually bedeck sadness; neither does she strip away her sentimentality. She travels carefully, trying to remember her landmarks. And when she comes to recognize the direction in which she travels, she begins to prepare for a very long exile.