Every Picture Tells a Story...and Then Some

This is a book that wears its heart on its jacket. On the front: an evocative title, a subtitle that suggests both storytelling and social concern, and a photograph of an appealing elderly Black man; and on the back, an outpouring of praise from eminent physicians in end-of-life care. And, lest we miss the message, the acknowledgments end with the author's invocation of the immortal words of Mother Teresa: "The poor, I do not tire of repeating this, are wonderful."

How does one review such a book? Very, very carefully.

"Dancing with broken bones" is a reference to Psalm 51, in which David begs forgiveness for his sins against God—seducing Bathsheba and sending Uriah, her husband, to fight the Ammonites, knowing he would be killed. Suffering caused by sin and followed by repentance and joy is a familiar theme in Black churches; indeed, the book's title comes from the title of a sermon given late in the book by a son of one of the dying men. In some ways the book itself is also an extended sermon.

The "portraits" are both a series of photographs showing the decline and death of several men and women in inner-city Indianapolis and their stories as told to and by David Wendell Moller. Moller is a sociologist and director of medical humanities in the School of Medicine at the University of Missouri Kansas City.

The use of narrative as a teaching tool and a means of self-expression is in the ascendancy in medical education. As someone who has used this form herself, and who has worked with others to write their stories, I know both its power and its limitations. The stories we tell are always selective; we choose the incidents, the examples, the details that best serve our purpose. As a compassionate and skillful social worker once told me matter-of-factly about her clients, "Everyone lies." Sometimes there is a conscious effort to conceal or to position ourselves in a better light, and sometimes we have so thoroughly avoided confronting painful memories or truths that they never even come into the frame.

The stories Moller's subjects tell are no different. Moller's primary subject—and the one he comes to care most deeply about—is Cowboy, a 73-year-old man who lives in a crude jerry-built shelter. At first Cowboy says that his three children ignore him because they "don't like his lifestyle." Only much later do we learn that he abandoned all of them and lived for, as he puts it, "cash and flash—flash and cash." When by chance he met an adult son, he was shockingly cruel and dismissive. Moller acknowledges the damage Cowboy has done to his children, but ignores his ill treatment of their mothers and the numerous other women in his life. "Estranged" is a word that occurs a lot in this book. By staying with his subjects over a period of months, Moller had an unusual opportunity to hear more of their stories, but undoubtedly some things did not surface.

The filter of the author's lens adds yet another layer of interpretation. Moller came to his project with a clear agenda: "In giving a voice to [the subjects'] sorrow, the injustice of poverty, the evil of racism, and the harm inflicted by inequality will be exposed. Its purpose is also to illustrate their uniqueness as persons in the hope that others will be better able to understand and respect their lives" (p. xii). Tread very, very carefully indeed. This book, then, is not just an extended sermon, but also an advocacy tool—not that there is anything wrong with that.

An advocate has to present his or her case in the most persuasive manner, and Moller writes in a vivid and compelling style. While he acknowledges that several of his subjects have made some remarkably poor judgments in their lives and have hurt others deeply and irrevocably, he explains these acts as results of their impoverished, unloved childhoods, their lack of education and opportunity, and all the other ills that beset...