Eric Blau, MD, the author of Common Heroes: Facing a Life Threatening Illness, practices internal medicine with SCPMG at Kaiser Permanente (KP) in San Diego in the Department of Preventive Medicine and is also a professional photographer. Common Heroes is the first of Dr. Blau's several successful ventures into medical photojournalism. It is this fusion of his talents in both fields that brings to us the drama of the lives of people with fatal illnesses. The book opens with the observation that, "To be terminally ill in America often means dying in isolation... I naively thought I was comfortable with the subject of dying and would be just the person to impart my knowledge. Armed with this hubris, I began my project." (Introduction, p. iv)

Common Heroes is a series of revealing portraits of KFHP members, most now dead, and their thoughts about having a fatal illness. In the Introduction, Dr. Blau says, "I realized illness was not the essence of their lives. What became clear is that these people were living under a handicap partly created by their illnesses and partly by the dysfunctional responses of their families, friends, and health care workers... Repeatedly, the people I photographed talked of how hard it was to get important people in their lives to talk openly about issues of illness and dying." (Introduction, p. v)

Cecilia Succetti found that the surgeon who diagnosed her breast cancer did not understand that the news was overwhelming. Fortunately, she got a helpful second opinion: "... He just looked at me and asked, 'Are you scared?' I said, 'I'm petrified.' He put his hands on either side of my face and said, 'We're going to make it better.' That was all I wanted to hear. I knew he couldn't take away my cancer, but I wanted to know I wasn't alone." (p. 14)

Many of the people Dr. Blau interviewed were more concerned about the effect of their illness on those close to them than about their own mortality. David Goodbody worried about his wife: "My wife asks about how I am doing, but she doesn't want to get into how she's doing. She avoids the fact that she is wearing herself down caring for me and that she isn't getting much attention... She doesn't want to open up and share her own feelings." (p. 70)

Many in the book speak of having their friends disappear when it became known they were mortally ill. Few, however, had a more outrageous experience than Sherri Marsh had with a nervous clerk at the Department of Motor Vehicles. After delivering a string of idiotic remarks, the clerk told Sherri that she couldn't drive--because chemotherapy had made her bald!

Like Mrs. Marsh, most had the foibles of others imposed on their own illnesses. For example, leukemia developed during Tanya Brundage's pregnancy. She and her husband decided to terminate the pregnancy: "The only doctor who seemed upset with my decision was my high-risk pregnancy doctor, which I could understand." (p. 48)

Robert Cyr died of AIDS. This man, who was a kind and thoughtful teacher said, "My advice to friends and family of someone who has a serious illness is to allow them to talk about it... The two most important things for me are just to have someone to talk to and have someone with me." (p. 33)

Dr. Blau has also published a book, Stories of Adoption, about how adults who were adopted as children are affected by meeting their biologic parents. His current effort in medical photojournalism will become a book about obesity.

Common Heroes is still in print and is thematically linked to the next book in this review. Both books are about the difficulty we all have in speaking about the most important issues in our lives. This difficulty may show up in boardrooms as agendas packed with trivia, in everyday life as speech laden with empty stock phrases, and in medical settings as avoidance, isolation, and abandonment. An opportunity, disguised as a difficult and avoidable problem, therefore awaits us.

Common Heroes: Facing a Life Threatening Illness. Eric Blau, MD. Troutdale, OR: NewSage Press; 1989. 93 pages, paperback, $15.95. ISBN 0-939165-12-0

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