Summary:

Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

View full annotation

Summary:

A husband and wife in Ireland struggle to make ends meet. Corry and Nuala, each 31 years old, have 3 children. Corry works at the joinery. He also carves religious statues on the side. A wealthy English woman is impressed by his artwork and encourages Corry to pursue his craft fulltime. His talent is undeniable, but there is no market for his wooden statues.

Now Nuala is pregnant and Corry is without a job. The English woman's wealth has vanished, and she can no longer help the couple financially. Nuala offers to sell her unborn baby to an infertile couple, Mr. and Mrs. Rynne, who long for a child of their own. Mrs. Rynne is shocked by Nuala's proposition and rejects it. Corry turns down work as an apprentice tombstone engraver but accepts a job working on the roads.

Nuala is angry about the way events have unfolded. She finds solace, however, in the concrete shed that functions as her husband's workshop. As she views the wooden figures of saints, Madonnas, and the Stations of the Cross created by her husband, Nuala concludes, "The world, not she, had failed" (152).

View full annotation

Summary:

The physician-narrator celebrates his 24th birthday in the company of two midwives and a feldsher (physician’s assistant). They toil in a remote area of Russia where conditions are harsh. The doctor tells the group about a peasant woman who requested a refill of belladonna (an atropine-like drug) that was prescribed for stomach pain the day before. Although the instructions were to take five drops as needed, the bottle was completely empty already. Since the woman had no signs of belladonna poisoning, the feldsher concludes she shared it or maybe even sold it to other villagers.

The group shares other stories about patient mistakes and misguided beliefs. That same night a man comes to the doctor’s house. He is a miller suffering from recurrent fevers. The physician diagnoses malaria and remarks how sensible and literate the patient is. Powdered quinine is prescribed to be taken once a day before the onset of fever. Soon the doctor receives word the miller is dying. The patient has defied the instructions and taken all 10 doses of quinine at one time to expedite his recovery. His stomach is pumped, and he survives the overdose.

View full annotation

Summary:

The narrator is an inexperienced and overworked doctor in a remote region of Russia. Although accustomed to seeing as many as a hundred or more patients in a day, a blizzard brings him unexpected relief. Only two patients show up in the clinic. He welcomes the prospect of a leisurely day but soon receives a summons for help from a physician in a nearby district.

A bride-to-be has fallen out of a sleigh and is unconscious. The narrator travels more than 2 hours to lend his help, but she is already dying. He later realizes the young woman had a fracture at the base of the skull. Ignoring advice to stay the night, the doctor insists on returning home. Four hours after departing in a sleigh, the doctor and driver are lost and trapped in the snow. With great effort, the two men free the sleigh and horses from the drifts.

As their journey resumes, wolves chase the sleigh until the doctor fires his pistol. Finally, he sees the lights of his hospital in the distance. Once safe in his house, the doctor picks up a manual containing information about skull fractures but decides instead to go to sleep.

View full annotation

Summary:

It is a sad world when Pelayo discovers an old man with large, weathered wings stuck in the mud. It has been raining for three days. The beach is a mixture of rotting crabs and sludge. Stench is everywhere. Worst of all, Pelayo's baby is ill with a fever.

Because the strange visitor possesses wings and speaks an unknown dialect, no one knows for certain who or what he is. He seems awfully decrepit to be a supernatural being. A neighbor thinks he's an angel who has come for the baby. Pelayo and his wife, Elisenda, suspect he is a sailor or castaway. The parish priest, Father Gonzaga, believes the old man is not an angel but rather an imposter.

After examining the man with wings, the doctor decides it is impossible such a creature is even alive. The old man is locked in a chicken coop and treated like a freak. People pay five cents to view him, and before long, Pelayo and Elisenda make enough money to build a mansion. Their newborn child regains his health.

When the boy is older, both he and the old man with wings contract chicken pox. The old man is mistreated and burned with a branding iron. All he eats is eggplant mush. The town is visited by many carnival attractions including a woman transformed into a spider because she defied her parents. People eventually lose interest in the old man. One winter he has a fever and is delirious. He not only survives but grows new wings. His clumsy attempts at flight eventually improve and one day he disappears into the horizon.

View full annotation

Summary:

I like sound. This declaration by the peculiar protagonist, Klausner, speaks volumes about his character. He builds a device intended to transform inaudible high frequency tones into sounds that can be discerned by the human ear. His invention is a three-foot long black box resembling a small coffin that contains a complex electronic mechanism.

Klausner takes his machine outdoors to test it. At first, all he hears through the earphones connected to the contraption is a humming noise, but soon he perceives a shriek each time his neighbor cuts the stem of a rose in her garden. He decides to experiment further. Klausner strikes a large beech tree with an axe and immediately hears an unsettling noise similar to a scream. He apologizes to the tree.

Klausner telephones his personal physician and implores him to come immediately. When Dr. Scott arrives, Klausner asks him to don the earphones. The inventor smacks the tree once more with the axe. Only this time, a large branch comes crashing down smashing the sound machine to pieces and barely missing Klausner. He asks Dr. Scott what he heard, but the physician is not sure. Klausner insists that the gash in the tree trunk be sutured, but the doctor explains he cannot suture through wood. Still holding his axe, Klausner commands the physician to paint the cut with iodine and check on the tree tomorrow.

View full annotation

Summary:

Fifteen selections--short stories, essays, and memoir--make up this collection. Two stories are notable: The Whistlers' Room and Atrium: October 2001 (see annotations). The title story is a translation and retelling of an obscure German tale published 75 years ago. Set in a military hospital in Germany during World War I, four soldiers share a common wound--throat injuries and laryngeal damage necessitating a tracheostomy for each man. This remarkable quartet of patients forges a fellowship of the maimed.

"Atrium: October 2001" describes the random meeting between a physician and a terminally ill teenager in the hospital atrium. The subject of death dominates their discussion. "Parable" chronicles an elderly doctor's efforts to comfort a dying man, and in the process, ease both their suffering.

Excerpts from Selzer's diary reveal much about the character of the author as well as the characters in his life. He also reminisces about growing up in Troy, New York. Approximately one-quarter of the book is devoted to Selzer's musings on works of art (sculpture and painting). Lighter fare includes a discussion of life behind the podium, a description of his home, and a new ending for A Tale of Two Cities by Charles Dickens.

View full annotation

Summary:

The unnamed narrator of the story is a "dreadfully nervous" character who disputes the allegation that he might be crazy. He contends that his disposition arises from a heightening of the senses: "Above all was the sense of hearing acute" (74). The narrator provides care for a wealthy elderly man. For some inexplicable reason, the narrator becomes obsessed with the diseased eye of the old man. The narrator likens it to a vulture’s eye and is so haunted by the Evil Eye that he decides to murder the old man.

He meticulously plans the murder. After one week of preparation, the narrator charges into the old man’s bedroom after midnight and kills him using the heavy bed the victim had been sleeping in to either crush or suffocate him. Even after the murder, the victim’s heart continues beating for many minutes. The narrator carefully dismembers the body in a tub. He conceals all the pieces under the floor boards.

At four o’clock in the morning, three policemen arrive. A neighbor heard a scream and notified the police. They are here to investigate. The narrator maintains his composure and even entertains the police. After all, he has committed the perfect crime. Suddenly, he hears a repetitive noise like the ticking of a watch. At first soft, the sound grows louder and louder. No one else hears it. What is the cause of the noise--paranoia, his conscience, auditory hallucinations, a supernatural clue, or (most likely) the sound of his own pounding heart? The narrator can no longer tolerate the thumping and confesses to the murder: "I admit the deed!--tear up the planks!--here, here!--it is the beating of his hideous heart!" (78)

View full annotation

Summary:

The narrator is still grieving over the recent death of her father, D.M. He suffered from emphysema and died from a sarcoma of the intestine that metastasized to other organs. While visiting Sweden, the narrator explores the Royal Library. There she discovers the celebrated Encyclopedia of the Dead--a massive collection of thousands of volumes chronicling in detail the lives of ordinary people who have died.

She finds the biography of her father and takes notes while reading it throughout the night. Fifty years of his life in Belgrade are summarized in only 5 or 6 pages yet amazingly nothing seems to be left out. No detail is too small--the first day he ever smoked a cigarette, an episode of food poisoning, a love letter.

The text is illustrated with a picture of her father and an odd flower. Late in life, he began painting floral patterns like the one depicted in the book. According to the Encyclopedia, his interest in painting paralleled the onset and progression of his cancer. In fact, the narrator learns that the flower in the book closely resembles the appearance of the sarcoma that claimed his life.

View full annotation

Summary:

The practice of medicine in equatorial Africa is both a challenge and an escape for Dr. Koestler. The physician from New Zealand works at a Global Aid mission in Zaire. He has toiled there a long time but is still a loner. His best friend appears to be a pet baboon named George Babbitt. The monkey drinks whiskey and smokes cigarettes. It is a clever creature with a mean streak and is generally despised by everyone except Koestler.

Two young American doctors arrive at the mission to assist Koestler. While the three physicians and the bush pilot drink whiskey and smoke marijuana, Koestler instructs the new doctors on some of the laws of jungle medicine: Use only disposable needles and then destroy them. Never transfuse a patient unless they require at least 3 units of blood (since all blood will likely be contaminated by Hepatitis B or HIV). Safe sex means no sex. Speed matters. Avoid getting involved because feelings will inevitably obstruct your work.

Although a leopard is roaming outside the confines of the mission, Koestler ventures into the darkness of the jungle to search for George Babbitt who has run off with a bottle of whiskey. In a locale teeming with life, the physician remains essentially alone--by choice.

View full annotation