Showing 1 - 10 of 152 annotations tagged with the keyword "History of Science"

Annotated by:
Galbo, Sebastian

Primary Category: Literature / Nonfiction

Genre: Short Story

Summary:

Jolted awake by a ringing telephone, the narrator (assumed to be Mukherjee) listens to his mother give a tearful report of his 83-year-old father’s waning health. Telling her that he will book the next flight from New York to New Delhi, Mukherjee’s mother wavers, regretting that her call now spurs him to purchase expensive airfare. In a tone of knowing sarcasm, Mukherjee writes, “The frugality of her generation had congealed into frank superstition: if I caught a flight now, I might dare the disaster into being.” Arriving in “sweltering, smog-choked Delhi,” Mukherjee joins his mother in a hospital’s I.C.U. A physician himself, Mukherjee notes the facility’s piteously tumbledown conditions, its crumbling floors and exposed utilities, jibing that, if one were to trip on the concrete rubble, “a neurologist would be waiting conveniently for you around the corner.” No doubt accustomed to the comfortable amenities of American hospitals, Mukherjee magnifies the miserable disarray of the Delhi facility—a defective heartrate monitor, a fractured suction catheter, a hospital bed with cracked wheels, a delivery van used as an improvised ambulance. This world, far from New York, is mired in seemingly eternal disrepair: “Delhi had landed upside down. The city was broken. This hospital was broken. My father was broken.”

These would seem to be the smug observations of a dismayed tourist were it not for Mukherjee’s thoughts on the intricate and noiseless machinery of homeostasis, the cohesive force that sustains internal constancy. “There’s a glassy transparency to things around us that work,” he writes, “made visible only when the glass is cracked and fissured. […] To dwell inside a well-functioning machine is to be largely unaware of its functioning.” As Mukherjee witnesses the spiraling decline of his father’s health within a deteriorating, dismally ill-equipped healthcare system, he focuses on the regularities of equilibrium by juxtaposing the homeostasis of healthcare institutions and human bodies. Mukherjee relates a memorable story from his early career when he staffed nightshifts at an urban clinic, where his colleague, an older nurse, stacked oxygen masks, oiled oxygen valves, and arranged beds. He belittled the nurse’s exacting preparations as an “obsessive absurdity” but, when his first patient arrived with an asthma spasm, he realized how critical the clinic’s flawless order was to his life-saving efforts: “The knob of the oxygen turned effortlessly—who would have noticed that it had just been oiled?—and, when I reached for an I.V. line, a butterfly needle, just the right size and calibre, appeared exactly when I needed it so that I could keep my eyes trained on the thin purplish vein in the crook of the elbow.” Had these things not been prepared, had they not been finely tuned for use, had an instrument been misplaced, would Mukherjee’s patient have lived? He experienced an example of institutional homeostasis, conducive to optimum medical care, which facilitated essential processes to occur successfully without mishap.  

Now in the New Delhi hospital, Mukherjee notes that its medical staff has “to settle for a miserable equilibrium. Amid scraps and gaps and shortages, they had managed to stabilize [my father].” He arrives at another stark realization, “I had versed myself in the reasons that my father had ended up in the hospital. It took me longer to ask the opposite question: What had kept my father, for so long, from acute decline?” Recollecting his father’s life at home in between hospitalizations, Mukherjee references a different kind of homeostasis that helped to prolong his life. For example, when his father was unable to go to the local market to haggle for fish and cauliflower, the vendors came to his home for usual business— “The little rituals saved him. They […] restored his dignity, his need for constancy.” Mukherjee accentuates the protean workings of homeostasis, its variegated forms that sustain the patterns of normalcy that give regularity and meaning to human life—indeed, equilibrium is not only an infinitude of minute chemical and biological factors, but familiar ease in a world that one knows and loves. Equilibrium, however rigorously maintained, succumbs to decay. Mukherjee aptly quotes Philip Larkin’s poem, “The Old Fools”: “At death you break up: the bits that were you / Start speeding away from each other for ever / With no one to see.” Mukherjee notes that the experience of his father’s decline was not so much observing him disintegrate into a similar kind of molecular dust, as imaged in Larkin’s verse, as it was his solidity upheld by homeostatic forces, a steady chugging of biological gears that made intricate compromises to sustain his deteriorating body.

After his father emerges from the coma, Mukherjee enlists curious pedestrians to help lift him into a makeshift ambulance. His father’s jostled body resembles a “botched Indian knockoff of an ecstatic Bernini.” The thematic kernel of Mukherjee’s narrative, homeostasis, draws scrutiny not only to the experiences of individual bodies but the systems and institutions that heal them, to the material environments in which fragile bodies are cared for, repaired, and rehabilitated. “The hospitals that work, the ambulances that lift patients smoothly off the ground: we neglect the small revolutions that maintain these functions,” reflects Mukherjee, “but when things fall apart we are suddenly alert to the chasms left behind.”
 

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Summary:

This is a gripping, informative, and well-researched book about human blood. An accomplished journalist, Rose George, covers a variety of topics, largely in the U.S., Britain, and Canada but also in Nepal, India, and South Africa. She describes many current issues, provides historical background, and speculates on future technologies, such as replacement of blood by other fluids. There are nine sections:

 “My Pint”  While the book’s title refers to the author's volume of blood, this chapter’s title refers to a single pint she is donating. We read about blood supply (donated and stored blood) in the U.S. and—by contrast—in India.

“The Most Singular and Valuable Reptile” refers to the leech. This arresting chapter describes both historical and  modern uses of leeches to gather blood from humans. She visits a company called Biopharm in Wales where leeches are raised and prepared for shipment to medical clinics and hospitals.  

 “Janet and Percy” is a historical chapter focusing on Dame Janet Maria Vaughan, a central figure in creating the Blood Transfusion Service in England during WWII and Percy Oliver, who guided its predecessor, the London Blood Transfusion Service.  

“Blood Borne.”  This chapter describes Khayelitsha, South Africa, “the ugly backside of Cape Town” (p. 100): a place of poverty, crime, rape, sexual predation, and HIV. While rich nations provide assessment and treatment for people with HIV, poor nations have many citizens infected with the virus and, over time, rising rates of infection. 

 “The Yellow Stuff” describes the plasma portion of blood; it can be frozen (as FFP) and used as a filler for bleeding or trauma patients. Unlike blood—which can only be given without payment—plasma can be collected from paid donors. It is a largely traded commodity, part of a multi-billion dollar industry worldwide. Plasma carries Factor VIII, a crucial protein for clotting blood; hemophiliacs lack this and are at risk for death by bleeding externally or internally. Some plasma has been tainted, for example by HIV.

“Rotting Pickles.”  In Western Nepal (and other places), menstruation is taboo. George writes, “We are in a minority among species, and among mammals, to bleed every month.” She reviews historical views of women’s periods, mostly negative. Worldwide, there are many taboos, but also some educational efforts for public health that are helpful in impoverished areas.  

 “Nasty Cloths.” This tells the unusual story of an Indian man named Muruga, “a poorly educated workshop helper” who became a leader in creating sanitary protection for menstruating women. Worldwide, the feminine hygiene industry is some $23 billion. George also reviews related history, including Toxic Shock Syndrome from tampons.  

 “Code Red.” Bleeding is often a fatal factor in trauma, even with the best efforts to transfuse blood into the patient, unit after unit. George observes open chest techniques at a resuscitation. She reviews breakthroughs in blood typing, component therapy, and “buddy transfusions.”  

“Blood like Guinness: The Future.” George starts with images from the past: vampires, human drinkers of blood, past and, even, present. She interviews a purveyor of the concept that “young blood” is healthier than older blood. Can there be, discovered or created, blood substitutes that also save lives? 

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Annotated by:
Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Yuval Noah Harari’s best-selling book “Sapiens” is subtitled “A Brief History of Humankind.”  While this may seem to bespeak a bit of hubris—it would seem that 414 pages might be, despite the modifying adjective of the subtitle, a little too condensed to cover 2.5 million years (albeit only the last 70,000 or so in any kind of detail)—the impression after finishing is that he may have done it, or at least, done the effort proud.  Mustering a combination of data and insights from the domains of history, archeology, genetics, biology, paleobiology, economics, and sociology, among others, Harari weaves an organized narrative that attempts to answer the questions of who we are and how we got here.

He divides the story into four assigned landmark periods in human history: The Cognitive Revolution (the earliest organization of humans into groups which evidence the use of tools and the beginnings of culture), The Agricultural Revolution (the impact of the learned ability to cultivate the land, with its shift from hunters and gatherers to farmers, and by necessity, from nomadic to settled tribes, and the beginnings of towns), The Unification of Humankind (the aggregation of people into larger groups and the emergence of money (and the earliest capitalism), religion, social expansion and conquest), and The Scientific Revolution (the development of science and the incredibly rapid acceleration of knowledge in the last five or six hundred years).  The titles of the periods are, however, only guideposts, for the sections are broader in scope than simply farming or science. The section on the scientific revolution, for example, interweaves scientific progress with economics and imperialism (which are themselves interwoven, after all), religion, and philosophy. And that same section leads Harari to speculate, at the end, as to where the digital revolution and the development of artificial intelligence might be leading us and what we might say about our future as a species.  




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From Fish to Philosopher

Smith, Homer

Last Updated: May-17-2018
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Most students of biology are well aware of our humble beginnings as puny, single-celled lifeforms. The mechanism of our remarkable transformation was famously described by Charles Darwin in his groundbreaking text On the Origin of Species, published in 1859. In many respects, Darwin’s magnum opus was just the opening chapter of a much broader discussion of how we humans have taken our current form. Darwin elucidated only a general process of adaptation and evolution in the face of environmental pressures. He left his successors with the more onerous task of applying this rule to the tortuous history of human evolution.

Rising to the occasion nearly a full century later was Homer Smith, a prominent kidney physiologist who spent much of his life and career as the Director of Physiological Laboratories at the NYU School of Medicine. Dr. Smith shares his account of our evolutionary history in his 1953 book From Fish to Philosopher. In the book, he posits that organisms must have a system for maintaining a distinct “internal environment” in order to have any sense of freedom from the perennially dynamic external environment. He guides the reader through the various biological filtration devices that have come and gone over the eras, culminating with the fist-sized organs dangling next to our spines.


The book is often billed as a detailed treatise on how modern-day mammalian kidneys have arisen from their more primordial forms – a fair assessment, especially given the author’s background. But this book offers readers something much more ambitious in scope than a rehashing of his work in renal physiology. For example, the first chapter of the book, “Earth”, highlights geological milestones that molded the early environment of the first known lifeforms. In Dr. Smith’s words,

“the history of living organisms has been shaped at every turn by earth’s vicissitudes, because every geologic upheaval, by causing profound changes in the distribution of land and sea, has had profound effects on the climates of both, and hence of the patterns of life in both” (pp. 9).

By the final chapter, “Consciousness”, he has begun to ponder questions of metacognition and learning. He marvels at how our complex nervous system has allowed classical pianists to balance the rigidity required for technical prowess, and the fluidity required for creativity. This is not a textbook about our kidneys. From Fish to Philosopher is a story of mankind’s genesis, told through the existential musings of a physiologist who left no stone unturned.

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Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Victorians Undone is no ordinary history book.  If you have ever felt dissatisfied by a sterile biography, wondering if its subject actually possessed bodily functions, look no further.  Here, British historian Kathryn Hughes undoes centuries of sheltering the reader from the unseemly by putting it on full display.  While the very term “Victorian” evokes an image of propriety, it was also a time of population displacement from the country to cities where “other people’s sneezes, bums, elbows, smells, snores, farts and breathy whistles were, quite literally, in your face”  (p. xi). The author seeks to rectify the imbalance by creating a history that puts “mouths, bellies and beards back into the nineteenth century“ (p. xiv), which she hopes will “add something to our understanding of what it meant to be a human animal“ (p. xv) during the Victorian Era.  

The book consists of five essays, each following a part of the body of an historical figure. In the first, entitled “Lady Flora’s Belly,” we learn about the tragic saga of Queen Victoria’s lady-in-waiting.  Did Flora’s protuberant abdomen conceal a tumor or a baby?  It was harder to find out than one might think.  Most women went through their lives without ever exposing their private parts to anyone but their husband.   Medical consultation when unavoidable might be conducted discretely, by post. 
 

Other essays focus on George Eliot’s hands, Fanny Cornforth’s (the lover of Dante Gabriel Rossetti, the Pre-Raphaelite painter) sensual mouth, and the beard that Charles Darwin’s grew to hide his eczema.  The book concludes with the gruesome tale of the dismemberment of Fanny Adams, an early case study in forensic pathology. The term "Fanny Adams" soon came, in navy slang, to mean unpleasant meat rations.

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The River of Consciousness

Sacks, Oliver

Last Updated: Mar-01-2018

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Two weeks before his death in 2015, Sacks oversaw this collection of essays and charged Kate Edgar, Daniel Frank, and Bill Hayes to arrange its publication. The essays touch on various fields—evolution, botany, chemistry, medicine, neuroscience, and the arts, and focus on major figures such as Darwin, Freud, and William James. The major theme—as indicated by the volume’s title—is how minds (of humans, chimps, even jellyfish) interpret and remember what the senses perceive in normal and in limited states. While we read in the Foreword that “a number” of the pieces originally appeared in The New York Review of Books, there are no citations for dates and places.  

“Darwin and the Meaning of Flowers”: Sacks describes Darwin’s research with flowers that support evolution; flowing plants display qualities of sensitivity to “contact, pressure moisture, chemical gradients, etc” (p. 19). Sacks recalls the pleasures of investigating flowers as a youth in his London garden.  

“Speed” : Drawing on personal experience and a wide variety of anecdotes (including his encephalitic patients described in Awakenings), Sacks muses about mental perceptions, slow and fast, normal and drug-enhanced, dreams, and our ability to imagine “all speeds, all time” (p. 59).  

“Sentience: The Mental Lives of Plants and Worms”: Starting with Darwin and coming forward, Sacks discuss how worms, jellyfish, and even trees may be considered to exhibit “mind.” Near the end, we read, “if one allows that a dog may have consciousness of a significant and individual sort, one has to allow it for an octopus too” (p. 76).  
   
“The Other Road: Freud as Neurologist”: The opening paragraph ably sums up the essay. “Everyone knows Freud as the father of psychoanalysis, but relatively few know about the twenty years (from 1876 to 1896) when he was primarily a neurologist and anatomist; Freud himself rarely referred to them in later life. Yet his neurological life was the precursor to his psychoanalytic one, and perhaps an essential key to it (p. 79).   
   
The next three may be considered as a group because they deal with lapses or outright failures in perception, memory, or health. Because Sacks reports on his own life experience, these are the most personal.
“The Fallibility of Memory” describes Sacks’s memories of the bombing of London in the winter of 1940-41. It turns out that one memory, according to family members, is right, but the other is actually a version of a letter describing a bombing.

The essay continues to discuss such topics as false memories, auto-plagiarism, unconscious plagiarism, and fabulation. He concludes, “Our only truth is narrative truth, the stories we tell each other and ourselves—the stories we continually recategorize and refine” (p. 121). In a short piece, “Mishearings,” Sacks reports how his increasing deafness makes new (and sometimes hilarious) perceptions of spoken words.  

Surely the last written—and in many ways the most poignant—“A General Feeling of Disorder” discusses feelings of being ill. Sacks, at age 81, describes his metastatic liver cancer and, in detail, an arduous treatment. Although warned of weakness and pain, he writes of “a sort of negative orgasm of pain” and other disturbing side effects (pp. 155-59) in vivid detail.  

“The Creative Self” discusses forms of creativity including play, scholarship, unconscious borrowing, and subconscious insight. Sacks is less interested in a Freudian model than an evocation of “an entire hidden, creative self” (p. 144).            

The final two, “The River of Consciousness” and “Scotoma: Forgetting and Neglect in Science” deal with theories of how the mind works and, more collectively, how scientific breakthroughs occur. The former essay explores cinematic models for perception in James and Bergson and much later models of the 100 billion neurons of the brain working on networks, coalitions, or populations. He finds that a specific mechanism is unlikely to be found and, “Even the highest powers of art—whether in film or theater, or literary narrative—can only convey the faintest intimation of what human consciousness is really like” (p. 174).

In “Scotoma” (or “memory hole”), he looks at discoveries that were over-looked for many years . Later they were rediscovered as important for understanding various phenomena: Tourette’s syndrome, phantom limbs, and, his specialty, migraines.

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Leonardo da Vinci

Isaacson, Walter

Last Updated: Jan-09-2018
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Leonardo da Vinci – the name alone evokes images of an artistic virtuoso, the Renaissance man, the mind behind the Mona Lisa. Though known best as an artist, his work extended beyond paintings into a myriad of disciplines, with notebook entries documenting his studies of optics, bird flight, comparative anatomy, hydraulics, and countless others. And yet what has been obscured by the shadow cast by his prolific career are the details of how a young man from a town called Vinci became Leonardo da Vinci. What did he do every day? What did he eat? Who were his friends? Did he even have any? We tend to immortalize Leonardo as a god, and yet he was human after all, not unlike the rest of us. This realization should encourage us to study one of history’s most celebrated humans, and see if we ourselves might be able unlock our own inner genius.

Walter Isaacson aids us in this study with his thoroughly researched biography of Leonardo da Vinci. He adds this to his growing portfolio of biographies of history’s great minds, including Benjamin Franklin, Albert Einstein, and Steve Jobs. In this most recent biography, Isaacson takes us through the life and times of Leonardo, highlighting milestones of his career, while also underscoring some of the seemingly trivial habits that were signatures of Leonardo’s personality and worldview.

Born of illegitimacy and openly gay, Leonardo was no stranger to defying convention. In fact, many of his grandest discoveries were a result of his willingness to challenge commonly accepted wisdom. Yet his greatest asset was his relentless curiosity and unquenchable thirst for knowledge, a recurring theme of Isaacson’s biography and of Leonardo’s life. Intertwined with this curiosity was his tendency to draw connections across disciplines, blurring the lines between art and science. Everything that Leonardo produced – whether his sketches of war machines, his treatises on anatomy, or his timeless portraits – was a manifestation of his desire for unifying knowledge.

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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Eric Kandel, the 2000 Nobel Prize winner in Physiology or Medicine, has an abiding interest in art for its own sake, and also in how art can inform his primary work in brain science, especially as both art and science can be understood through reductionism.

My central premise is that although the reductionist approaches of scientists and artists are not identical in their aims—scientists use reductionism to solve the complex problem and artists use it to elicit a new perceptual and emotional response in the beholder—they are analogous (p. 6).  

Kandel’s aim, however, is more than just explaining how reductionism is used in brain science and in modern art. He is also out to show in a larger sense how science and the arts, which now exist as “two cultures,” are more alike than not. 

My purpose in this book is to highlight one way of closing the chasm by focusing on a common point at which the two cultures can meet and influence each other—in modern brain science and in modern art. Both brain science and abstract art address, in direct and compelling fashion, questions and goals that are central to humanistic thought. In this pursuit they share, to a surprising degree, common methodologies (p. 3).   

This slim volume comprises four parts amply supplied with schematics of brain structures and nerve tracts, and with reproductions of modern art works. The two middle parts are concerned with how reductionism applies to brain science and to art, respectively. The introduction places the topic within the context of the two-culture divide. The final part argues that art reduced to a set of core elements (e.g., form, line, color, and light) can add to the understanding of how the brain works, just as brain science reduced to a set of core elements (e.g., top down and bottom up processing of images) can add to the understanding of how art can be perceived and used to evoke certain responses.      

Bottom up processing refers to “universal rules that are largely built into the brain at birth by biological evolution and enable us to extract key elements of images in the physical world, such as contours, intersections, and the crossings of lines and junctions” (p. 22) This inborn circuitry is all that is needed for perceiving figurative art, and as a result produces uniform perceptions among viewers. Top down processing refers to the information the brain needs to perceive images when bottom up processing is insufficient, like in the case of abstract painting. It “incorporates the information our brain receives from the external world with knowledge based on learning from earlier experiences and hypotheses testing.” This includes “people we have seen and known, environments we have been in, as well as memories of other works of art we have encountered” (p. 23). Top down processing thus brings the viewer into the creative process and results in differences in perceptions among individuals of a particular work of art.  

In Kandel’s and many others’ telling, modern art was the response to the advent and expanding use of photography. No longer was figurative painting needed to render life as it is. Artists became free to explore and experiment with other ways to generate perceptions of life. Starting with impressionism and progressing through abstract expressionism and pop art, Kandel describes how painters in particular reduced their art to form, line, color, and light. They invited—demanded—that viewers participate in creating what they perceive. Brain science was able to use these elements also to map places in the brain where this processing takes place and to associate these elements with the different responses they produce. To illustrate these concepts, Kandel features the works of Turner, Monet, Kandinsky, Mondrian, de Kooning, Pollock, Rothko, Morris, and Warhol among others.  

In the end, Kandel is asserting—hoping—that reductionism in art will serve brain science because it will show “how we process unconscious and conscious perception, emotion, and empathy.” (p. 188). And, that reductionism in brain science will help artists “enhance traditional introspection with the knowledge of how some aspects of our mind work” (p. 189).

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This Way Madness Lies

Jay, Mike

Last Updated: Oct-17-2017
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction — Secondary Category: Visual Arts / Visual Arts

Genre: History

Summary:

This Way Madness Lies was published in partnership with London’s Wellcome Collection for the exhibition “Bedlam: The Asylum and Beyond,” which ran from September 2016 - January 2017 and was curated by Mike Jay and Bárbara Rodriguez Muñoz. It is a book that was meant to accompany the exhibition, yet which, by virtue of the substantial text and reproductions, can stand alone.  

The book traces the history of treatment of the mentally ill by following the colorful story of Bethlem Royal Hospital from its antecedents in the Middle Ages up to the present.  Its sway over the public imagination evidenced by its appearance in everything from Jacobean Drama to “Sweeney Todd,” Bedlam has truly attained archetypal status.  An archetype, yet also a real functioning hospital.  Sections of the book entitled “Madhouse,” Lunatic Asylum,” and “Mental Hospital” chronicle the facilities designed respectively during the 17th/18th, 19th, and 20th centuries, and explain how they reflect changing notions of madness in each era. 
 

The first structure was visually grand but lacked a foundation, a metaphor for what was going on inside: “a façade of care concealing a black hole of neglect” (p. 39).  It became a tourist attraction along the lines of the zoo, with nothing preventing the public from gawking at and taunting the inmates.  While its replacement gave the impression of being more functional, conditions proved equally squalid.  On the other hand, 19th-century Europe and the United States saw asylum reforms, as well as the medicalization of madness as an “illness” and the ascent of psychiatry as a branch of medicine.  Finally, in 1930, the buildings still in use in Monks Orchard, a suburb of London, were constructed.


By contrast, we learn about treatments elsewhere, most notably Geel, Belgium.  There, for centuries, as an alternative to being warehoused in psychiatric hospitals, the mentally ill have been successfully boarding with townspeople. 
 

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Essex Serpent, The

Perry, Sarah

Last Updated: Sep-07-2017
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The idea for her second novel came to Sarah Perry in a flash (Ref. 1) as her husband was telling her about the 1699 sighting of a serpent or dragon in Henham, a village slightly to the northwest of the town of Essex, where Ms.Perry was born in 1979. The late 19th century events of the novel occur primarily in Aldwinter, a fictional fishing village on the Blackwater estuary.  Divided into 4 books (with titles derived from a 1669 pamphlet on the Serpent), each with subdivisions by month, further subdivided into chapters, the story takes place over 11 calendar months, from New Year's Eve to November, 1892. Although the story does not feel complicated and should not be difficult to describe in a synopsis, it is a tribute to the novelist's Dickensian talents  that in fact it is somewhat complex, involving four couples and their various children and friends and their increasingly intricate relationships, all revolving around the palpable feeling in Aldwinter that the famous Essex Serpent has returned, resurfaced, or decided to re-animate all the lives therein. The protagonist is Cora Seaborne,  a recently widowed free-thinker, adept in biology and natural sciences, and mother of an adolescent boy, Francis, who would nowadays probably receive the label "autistic." After the death of her abusive husband from oropharyngeal cancer, Cora becomes emotionally involved with Luke Garrett, the treating surgeon, an idiosyncratic, brilliant man, who has a bosom buddy, George Spencer (simply called "Spencer"), a very wealthy former medical school classmate. With an introduction from her friends Charles and Katherine Ambrose, Cora and Martha - her intimate companion - visit William (often referred to as just "Will") and his wife Stella Ransome in Aldwinter, where Will is the parish minister and father to three children. The eldest is Joanna, a precocious adolescent girl one imagines, alongside a younger Cora, as a younger version of this novel's author, who describes herself as vibrantly curious of all her surroundings while growing up in Essex as a young girl. (Ref. 2)

With the arrival of Cora and Martha in Aldwinter, the narrative begins in earnest with the development of the mounting anxiety over the mysterious events (a missing boat, unexplained drownings) attributed to possibly a resurgent Essex Serpent besetting Aldwinter; Luke's miraculous operation saving a man named Edward Burton from a knife wound to the heart; the increasingly romantic relationship between Cora and Will, to Luke's dismay; Stella's rapidly progressive pulmonary tuberculosis; the disappearance of Naomi Banks, a friend of Joanna; and an attack on Luke by the same man who had knifed Edward Burton. By novel's end, without spoiling the plot, most loose ends have been cauterized, left more neatly dangling or deftly retied.  


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