Sawbones Memorial

Ross, Sinclair

Last Updated: May-31-2023

Duffin, Jacalyn

Primary Category: Literature / Fiction — Secondary Category: Literature /

Genre: Novel

Summary:

Dr Hunter’s 75th birthday in April 1948 falls forty years to the day after he started practice in the little prairie town of Upward. He is retiring, moving away to the big city of Saskatoon, and the citizens have gathered to say fare-well. They celebrate in the patient lounge of the new hospital soon to open bearing the name of this long-time servant of all Upward’s needs--physical, mental, social. The doctor has donated his late wife’s piano and the board is already planning to sell it for much-needed cash. It tinkles softly, unwelcome songs are awkwardly sung, coffee and sandwiches served, while the crowd of locals chatters away sotto (and not so sotto) voce, with each other and the doc.

Over the course of the evening, forty years of memories unfold: births, couplings, deaths, desires, hostilities, random acts of kindness and of spite. Folks sidle up to the doc to express thanks for his support and wisdom. The pharmacist wishes he had prescribed more pills. The journalists want him to spill secrets for a feature article in the local rag. The minister engages him in a debate over the existence of God and the meaning of life—both of which the medic denies. Gossips watch, whispering to each other about the doctor’s imagined survival and his dead wife whose alleged frigidity justified his supposed numerous infidelities.

Shopkeeper Sarah’s revisits her embarrassed memories of adolescent attraction, that ripened into adult affection and pleasure that the doctor has long treated her son Dunc with almost fatherly care, taking him and the big but isolated Ukrainian boy, Nick, on house calls. Home from overseas with an English war-bride and now running the store, Dunc presides over the evening, trying to smooth conflicting undercurrents. The gossips speak sweetly to the newcomer bride and behind her back predict the marriage will fail.

It emerges that the incoming young medic will be Nick, once mercilessly bullied as a “hunky kid” by a few shiftless bigots still languishing in Upward. They are convinced that he is returning to extract his revenge. The old doctor defends Nick in his final words and urges his patients to help the young successor. He knows that they can briefly come together in a crisis, but he scolds them for their chronic lack of charity to strangers and to each other.

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The Pull of the Stars

Donoghue, Emma

Last Updated: May-02-2023

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It is Dublin in late autumn 1918, the waning days of World War I, and nurse-midwife Julia Power is suddenly thrust into the task of managing a small ward of heavily pregnant women who have contracted the deadly influenza. Having survived influenza herself, she does not fear infection, but she worries about her lack of experience. She also worries about her shell-shocked brother with whom she shares a home.

Two people appear to help: the intelligent but uneducated young volunteer Bridie Sweeney raised in an institution; and the legendary woman doctor Kathleen Lynn –who quietly reveals her competence and skill, even as authorities are lurking to arrest her.

Over the course of just a few days, they encounter recalcitrant mothers, complicated deliveries, battered wives, stillbirths, and deaths. Influenza adds special dangers to the natural event, but some patients survive their ordeal.

Although Bridie was to help for just one day, she learns quickly and returns. Julia is impressed by her diligence and drawn ever closer to her kindness and earthy wisdom. They pass a night together sharing confidences, and Julia begins to understand the physical and emotional mistreatment that Bridie suffered in the care of nuns. Their embrace awakens in Julia a yearning she had never imagined. But only hours later Bridie falls ill and succumbs rapidly to the deadly infection.

When an unwed mother suddenly dies after giving birth to a deformed child, Julia is horrified that the baby must be placed in an institution. Instead, she takes the baby home to an uncertain future but sparing the child the same horrors that Bridie once suffered.

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Strangers to Ourselves: Unsettled Minds and the Stories That Make Us

Aviv, Rachel

Last Updated: Oct-18-2022

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

When Rachel Aviv, the author of Strangers to Ourselves, was six years old, she simply stopped eating. She said she got the idea from the Yom Kippur fast. She was promptly checked into a psychiatric hospital where she became one of the youngest-ever patients to be given the diagnosis of anorexia. Through associating with older, more seasoned anorexic girls she became a sort of “anorexic-in-training” (p.13). Fortunately, after a few months she snapped out of it, and was discharged. She never suffered from the same symptoms again.

As an adult, Aviv began to think about what had happened to her. The only remnant of her experience was a diary entry from age 8: “I had a diseas called anexexia” (p.231). Had she even had the disorder, or had the diagnosis been a mistake? Why had she not gone on to have “an anorexic ‘career’” (ibid.), while one of the girls who had mentored her ultimately died of anorexia-related causes? In order to answer these questions for herself, Aviv meets with the therapists who treated her more than thirty years ago as well as with the family of her deceased copatient.

As a result of Aviv’s introspection, she becomes intrigued by people whose psychiatric diagnoses do not fully capture the complexities of their situation. Strangers to Ourselves presents detailed case histories of several such individuals. Bapu is an Indian woman whose visions have caused her to be diagnosed with schizophrenia. Are they delusions, or is she a mystic? Naomi is a socially disadvantaged black woman who has struggled unsuccessfully to get ahead. During a manic episode, she jumps into a river with her young twins, one of whom dies. Her claim that “white people are out to get me” (p. 146) is ignored because her doctors insist that “delusions couldn’t on some level make sense” (p. 150). Yet another woman, Laura, bounces from diagnosis to diagnosis, and sleeps fourteen hours a day because of all the medication she is on. She becomes one of these people who no longer even know if their lack of functioning is “due to their underlying disorder [or] the heavy medications they’d taken for it” (p. 203).

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The Sleeping Beauties and Other Stories of Mystery Illness

O'Sullivan, Suzanne

Last Updated: May-23-2022

Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Longform journalism

Summary:

In Sweden, hundreds of children lie unconscious for months or even years in their homes or hospitals. Full neurologic evaluation, including MRIs, EEGs, and other studies reveal no abnormalities. None of these children are Swedish. They are immigrants from the Near East or former Soviet republics, whose families are seeking permanent asylum in Sweden. If asylum is granted, the children gradually recover. Neurologists have named this mysterious illness “resignation syndrome” and classified it a functional neurological disorder.

Suzanne O’Sullivan, an Irish neurologist, set out in 2018 to study children suffering from resignation syndrome, a project that led her to investigate other outbreaks of mysterious illness around the world. In The Sleeping Beauties, O’Sullivan discusses many such disorders, ranging from grisi siknis in Nicaragua (convulsions and visual hallucinations) to a form of sleeping sickness in Kazakhstan. These disorders have several features in common: absence of findings on medical and psychiatric tests, contagiousness (i.e. they seem to spread rapidly among populations in close contact), and significant morbidity.

Dr. O’Sullivan notes “there is a disconnect between the way mass psychogenic disease is defined and discussed by the small number of experts who study it and how it is understood outside those circles.” (p. 257) The public finds reports of such illnesses difficult to believe. In the United States, we tend to believe that such illness, if it exists at all, occurs only in “backward” cultures and not in our enlightened society. On the contrary, the author presents “Havana syndrome,” as a case of mass psychogenic disease that first appeared among American diplomats in the Cuban capital in 2016. No consistent brain abnormalities have ever been found, and extensive study has ruled-out the possibility of a sonic weapon. Dr. O’Sullivan believes that Havana syndrome is very likely a functional neurologic disorder occurring against “a background of chronic tensions within a close-knit community.” (p. 257)

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The Genetic Lottery: Why DNA Matters for Social Equality

Paige Harden, Kathryn

Last Updated: Mar-28-2022

Trachtman, Howard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The Graduate is a movie classic from what seems like a bygone era. It is accompanied by great music by Simon and Garfunkel and has one of the most famous one-word lines in cinema history. When Benjamin Braddock is wandering aimlessly around the pool at a graduation party thrown in his honor, a friend of his parents asks him what he plans to do with his post-collegiate life. Another family friend jumps in and volunteers, “Plastics.” There are many who will also give a one-word answer to any medical school graduate searching for a career – Genetics.

In this important new book, Kathryn Harden provides staunch support for the key role of genetics in health, disease, and in human well-being. She provides a remarkably clear primer on genetics in accessible language. Harden begins with statistical issues like the normal distribution and Bayesian priors. In her capable intellectual hands, she uses analogies that effectively move the teaching agenda forward. With recipes as a framing image for genetics, she demonstrates the relationship between the coding material in the DNA nucleotide sequence and the actual building blocks, namely the proteins that do the heavy lifting inside cells. Concepts like genetic recombination, linkage disequilibrium, and monogenic versus polygenic disorders are introduced and make perfect sense. She then builds on this foundation to consider genome-wide association studies (GWAS) which represent the powerful tool that has been introduced to explore the relationship between genetic endowment and health. That is where things start getting complicated.

When people think of medical genetics, they usually have classical Mendelian disorders in mind. They are caused by mutations in a single gene that disrupts a protein pivotal to normal health. Examples are sickle cell disease, hemophilia A, or muscular dystrophy. However, many health problems like hypertension that are associated with significant global disease burden are polygenic. This means that they are caused by less dramatic mutations in a number of genes that in the aggregate lead to the disease. Harden details how quantitative assessment of the contribution of these minor variations in a large array of discrete genes enables the formulation of polygenic risk scores (PRS) for these conditions. These measures provide estimates of susceptibility to developing other polygenic conditions like obesity, cardiovascular disease, and diabetes.

As a psychologist, Harden’s work focuses on the application of PRS to non-medical aspects of human behavior such as impulsivity, attentiveness, job satisfaction, and executive function. The waters remain relatively calm until Harden’s fellow psychologists venture into the realm of educational achievement and lifetime income status. Harden methodically reviews relevant studies that have been done with siblings, twins, adoptees, and family trios. She dissects them and highlights when investigators have misinterpreted their data. There is a steady drumbeat of data, almost too much at times. But the overall consensus that emerges is that PRS and other measures of heritability continue to show a genetic component for these psychosocial outcomes in large population studies. The challenge that Harden raises is how to incorporate this knowledge about genetics into a better understanding of these aspects of human behavior and if and how to address abnormal manifestations.

Questions remain concerning how genetics “causes” these changes and how to interpret the findings. What is determinative? Is it genetics i.e., nature, or is it all environment i.e., nurture? There are those, like Harden, who advocate for thoughtful analysis and utilization of all the GWAS data. She highlights the difference between use of PRS to assess outcomes within populations versus between populations. In sharp contrast, there are others who resist the introduction of genetics into psychology. Pointing to the sordid history of eugenics and its degeneration into the creation of racial hierarchies, the opponents of the Harden’s work dismiss it as unscientific at best and destructive at worst. Harden makes a compelling case for the validity of the science and a spirited defense of the thoughtful use of genetics dismiss it as unscientific at best and morally repugnant at worst.

Harden provides a strong defense of the science and statistical methods and offers a spirited argument that without acknowledging the role of genetics in human achievement, society will be unable to thoughtfully address inequalities and restore balance. Her work touches on many other pressing issues including human autonomy, agency, freewill and the role of government intervention. She outlines a social agenda that acknowledges the importance of genetics as a contributing factor. But it incorporates a recognition that its distribution in the population is solely a matter of luck and does not serve as the basis for a hierarchy of human worth. I leave it to readers to judge for themselves the validity of her proposals, but her commitment to making this world a better place is not in question.

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Main Street: How a City's Heart Connects Us All

Thompson Fullilove, Mindy

Last Updated: Apr-19-2021

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Ethnography

Summary:

Mindy Thompson Fullilove, MD, is a Black social psychiatrist with wide-ranging interests; her book analyzes factors that support or diminish the health of cities as places that sustain its citizens. Over many years, she has visited and studied 178 cities in 14 countries, and she draws on the work of experts from several disciplines to address the fundamental question: how may we best live together?

Her discussion moves through five concepts for understanding the health of a city by describing a dozen cities ranging from Paris to Jersey City. Each features a “Scroll,” a two-page presentation of photos, graphics, and text. Her discussions give an inductive basis for her concepts that become criteria for assessing the health of any city.

(1) Box (“in all sizes and shapes”): the surrounding shape of buildings, street, and sky; it gives an identity to the city’s center with its useful assets such as stores, post office, bank, food, and entertainment.

(2) Circle: the larger area surrounding a Box—maybe a half a mile in radius. Its health requires ease of travel to and from the box.

(3) Line: usually the Main Street that runs through the box, therefore a central path to town. Good transportation is important, and the main street can be quite long, for example Palisades Avenue in Englewood, New Jersey.

(4) Tangle: a dense network of streets and highways that connect to main streets and the Box.
(5) Time: no city is static; as years go by, there are changes for good or ill.

Fullilove mentions politics, capitalism, poverty, disincentives, tribalism, racism, highways, malls, interstates, and “urban renewal” that destroyed neighborhoods of minorities, as well as redlining against Blacks and gerrymandering school districts to segregate Black and white students.

In “Naming and Framing the Problem,” she turns to a larger overview of challenges for cities in many places, but especially in the US: (1) “deep structure of inequality” (p. 211), such as the legacies of slavery, lynching, the 3/5 Compromise, and the Trail of Tears, as well as white supremacy today (2) ecological damage, including industrial farming, deforestation, and global warming, and (3) the inertia of the status quo.

Citing Dr. Martin Luther King, Jr., and Father Richard Rohr, Fullilove affirms love as the root for social justice, political activism (p. 211) so that cities might become what Thomas Edison termed “factories of invention” that will support the mental health and well-being of all of its citizens.

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Together

Murthy, Vivek

Last Updated: Nov-09-2020

Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Longform journalism

Summary:

Since the first surgeon general was sworn into office in the 19th century, the Office of the Surgeon General has positioned itself as the leading voice on public health matters in the United States. In recent history, the office has had its highest profile campaigns rallying against issues such as tobacco use, obesity, and HIV/AIDS. Considering the combination of prevalence, morbidity, and mortality associated with these health issues, there is no doubt that any effort to stem the tide was a worthwhile endeavor.

When Dr. Vivek Murthy became the surgeon general in 2014, his office continued the historical campaigns against these health issues. At the same time, Dr. Murthy began investigating a looming epidemic within our borders: loneliness and social isolation.

It may be hard to convince the average person that loneliness is a problem of similar scale as tobacco use, obesity, or AIDS. There is no question that loneliness is unpleasant, even if it only lasts for a few moments. But the notion that one’s state of mind can predispose to disease or premature death somehow feels like a stretch. Addressing this skepticism, Dr. Murthy writes in his book about Dr. Julianne Holt-Lunstad, a psychologist at Brigham Young University who also faced a great deal of cynicism surrounding her research into the effect of social relationships on “everything from our behavior to our cellular function.” She had a breakthrough in 2010 when she published a massive study analyzing the health outcomes of over 300,000 participants, categorized by their degree of social connectedness. She found that social isolation was significantly linked to premature death, representing a risk nearly as serious as pack-per-day smoking, and more serious than obesity, alcohol use, and lack of exercise. Dr. Holt-Lunstad’s research spurred further studies which linked loneliness to heart disease, stroke, and depression, amongst other diseases.

These findings are hard to ignore, especially in light of the ongoing opioid addiction crisis and rises in teenage depression and suicide, all of which have been linked to loneliness and social isolation. In Together, Dr. Murthy weaves together scientific research, personal anecdotes, and current events to create a manifesto for tackling the next great public health crisis.

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The Talking Cure: New and Selected Poems

Coulehan, Jack

Last Updated: Sep-10-2020

Kohn, Martin

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The Talking Cure is Jack Coulehan’s 11th book, seven of which, including this collection, are books of his poetry. This collection begins with selected works from his six previous books of poetry and continues with a selection of poems in the imagined voice of Chekhov. These sections are followed by previously uncollected poems, and the book ends with 25 new poems reflecting the title of this book--“The Talking Cure”. The poems represent multiple viewpoints—patients, caregivers, family members as they struggle to make sense of the vicissitudes—and unexpected joys—in life. The poems have appeared over the past four decades in medical journals (primarily Annals of Internal Medicine and Journal of the American Medical Association) and in many literary journals including Prairie Schooner and Negative Capability Press.

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Weather

Offill, Jenny

Last Updated: Apr-03-2020

Carter, III, Albert Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Weather is a strange, disturbing, and important book. Offill uses fragments of prose—typically a few lines or half a page—to present a small group of characters in New York City who experience dread, unhealthy behaviors, and many difficult choices. The fragments jump from topic to topic and points of view, suggesting chaos in the characters, in much of modern life, and even in the structure of this novel. “Weather” suggests “whether”: whether humans can survive not only from one day to the next but also in the long term that includes the climate crisis threatening our earth.

The cast of characters is small and carefully arranged. Lizzie (our main focus) is married to Ben; they have a son Eli. Lizzie’s brother Henry is married to Catherine, and they have a baby girl, Iris; Ben and Lizzie have problematic mothers. A genogram of these and other related characters looks like the cast of a Restoration comedy, full of harmony and good will, but in Weather conflicts swirl and grow chaotically. Catherine divorces Henry. Ben suddenly goes on a three-week trip. Widespread complications include street drugs, alcohol, diet abnormalities, sleep deprivation. There are also mental problems such as confusion, hallucination, loneliness, delusions, and panic, as well as economic difficulties. Only Catherine has a career path, but, at the end of the book, she appears to be “tilting into the abyss too” (p. 179), according to Lizzie.

While some fragments describe thoughts and actions of the characters, others present a giant whirlpool of cultural, environmental, and historical topics, including doomsday preppers, Rapturists, and the end of civilization, also gun rights, multicultural frictions, popular religion, a need for a strongman to govern, noticeably sick people and loss of medical services. Other topics touched on include hate literature, mob rule, suicide, torture, as well as references to Fukushima, the Holocaust, and 9/11. Many of these worry our characters; others are simply mentioned as “the surround” for all people around the world. Our characters have fantasies of hope but usually feel panic, dread, loneliness, guilt, or despair. Sylvia (Lizzie’s former professor and sometime boss) is an academic who appears to understand climate change and the need to warn people, but she gives up, saying “there’s no hope” (p. 133).

The first 127 pages swirl around the characters with little progression of story. The next section (4) accelerates the craziness among them all. The last two sections seem more “stable,” but with no actual resolutions. Lizzie says “I will die early and ignobly” (p. 187). In the very last pages, she takes the boy Eli (the only normal major character) to a playground. Later she kneels by her bed and prays for “Mercy” (p. 197). Following the last page, we see only a one-line URL: www.obligatorynoteofhope.com. Is this part of the novel? Do we click on it?

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Time Out of Mind

Moverman, Oren

Last Updated: Mar-06-2020

Bruell , Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

A construction crew enters an abandoned apartment in NYC and finds an older man in a wool overcoat asleep in the bathtub. He can’t tell them his name or how he got there, just that he’s waiting for his friend, Sheila, to come back to the apartment. The building manager (Steve Buscemi) throws him out of the building and into a life on the street, drinking, sleeping wherever he can, and riding the trains. His name, we later find out, is George (Richard Gere), and he is one of NYC’s homeless men. George can’t seem to remember much about his past, only that his wife died of breast cancer, he lost his job, and he has a daughter (Jena Malone) who works at a nearby bar but wants nothing to do with him. After nights trying to find a warm place to sleep, George ends up at the Bellevue Men’s Shelter where he is befriended by Dixon (Ben Vereen). Dixon shows George the ropes—how to apply for assistance, where to get a copy of his birth certificate, where they can get a shower up in the Bronx. But Dixon disappears, removed from the shelter ostensibly for being disruptive. George is left on his own.

We don’t know who Sheila is, or even whether she is real. George sees a woman (Kyra Sedgwich) pushing a shopping cart by the river and calls out to her. She’s not Sheila. They share a couple of cans of beer and spend the night in a park near the river. “ You’ve got to get along to get along,” she tells him. Your real friends will look out for you on the street.” But in the morning she is gone- George wakes up to laughter from boys who are snapping photos of him under his blanket. On his own again, in and out of shelters, George drops by the bar to see his daughter, hoping to overcome their estrangement.

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