Summary:

This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Edgar Drake, a forty-one-year-old English piano tuner, accepts a commission from the 1886 British War Office to tune an Erard grand piano located in a colonial military outpost in Mae Lwin commanded by Surgeon-Major Anthony Carroll. Edgar leaves the squalor, fog and drizzle of London, as well as his middle class life and his wife Katherine, childless for eighteen years, for a journey by boat, train, carriage and horse to the exotic, intoxicating beauty of Burma.

En route, Edgar is surrounded by stories--a tale by the deaf Man With One Story, rumors about the legendary, eccentric Carroll's peace-making with the local Shan via music and cultural exchange, and socio-historical treatises about the Burmese, internecine wars, and British imperialism. The journey becomes a search for the meaning of home and purpose in Edgar's life. It is an adventure far beyond his prior imaginings and dreams.

The clash of cultures, British and Burmese, civilian and military, wealthy and poor, rule-bound and individualistic, is explored throughout the text. For example, a tiger hunt led by several British officials ends in disaster. Edgar meets Burmese culture on both grand and personal scales: street theatre; appealing, poverty-stricken children; the garb and cosmetics of various tribes; and, ultimately, the allure of Khin Myo, an educated Burmese woman who guides him to Mae Lwin and Carroll.

Carroll, a renaissance physician with a Victorian fervor for botanical and medicinal classifications and investigations, asks Edgar to assist him in his clinic. Common infectious diseases are diagnosed and treated by this forward-thinking physician, and he also performs finger amputations on the mangled hand of a boy without benefit of anesthetic. Other maladies are treated with local remedies and prayer. Meanwhile the delirium of malarial fever descends on Edgar.

Edgar does finally meet and treat the ailing, badly out-of-tune Erard piano. Edgar's expertise is required--his aural excellence and perfect pitch, his delicate yet callused hands, and his willingness to be innovative in the repair of a bullet hole. But what Edgar cannot be prepared for--intrigue and deceptions, fascination with the lush beauty of Burma, and his own shifting priorities and secret longings--is ultimately what sets his fate.

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In the book’s Introduction, Dr. Cleaveland explains his personal need for real and fictional heroes. Seeing himself often as a victim of cruel childhood peers, he sought protectors and savored particularly the exploits of World War II heroes. His heroes, he notes, delivered him safely through childhood and adolescence.

Cleaveland describes seeing a documentary movie about Dr. Croydon Wassel in 1944; Dr. Wassel became his first personal hero. A book about Dr. Wassel was read by Cleaveland many times; later, as an adult, Cleaveland looked for the book again and set out to ascertain its authenticity. From extensive research he found Dr. Wassel to be far more courageous than he had anticipated--"studied, found not wanting."

The author was introduced to the story of Dr. Billie Dyer in 1992 through a collection of short stories. Dyer was a black physician who kept a diary during his eighteen months in service in the U.S. Medical Corp during the First World War. Cleaveland found a copy of the diary in the public library in Lincoln, Illinois and learned more about a new hero.

Other heroes he writes about were Dr. Woodrow Dodson, who served sixty years as a "domestic medical missionary"; and Dr. Lonnie Boaz, a black physician, the son of a victim of a hate crime, who became a well known ophthalmologist, husband, father, civic leader, and reformer after starting out as a painter, janitor, and army medic.

Cleaveland considers some of his patients to be heroes: Vera Gustafson, a World War II nurse whom he interviewed extensively, later adding historical information to her story; Paulette McGill, a childhood diabetic cared for by Dr. Cleaveland for twenty years; and an obese diabetic who became a "universal friend," teaching others about devotion and courage. Other patients were also deemed heroic, each for some special reason.

The longest story, saved till the last, is about Dr. Janusz Korczak, described by Dr. Cleaveland as the most heroic figure he knows of. Korczak was a Polish, Jewish pediatrician who devoted his life to improving the welfare of children in the Warsaw ghetto; he was deported to the Treblinka concentration camp with the children. (A movie that came out in 1990 dramatically tells this story.)

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Summary:

According to the author's introduction, the most "beautiful and informative images of nursing are found on picture postcards" (xi). He has gathered over 580 full--color postcard images of nursing from 65 nations, documenting nurses' work in peace and war time and documenting, often in breathtakingly lovely images, an important part of nursing's history. Postcards from the years 1893 to 2002 (many of these from the "golden age of postcards," 1907 through World War I) follow nurses from factories to flu wards, from battlefields to mission welfare clinics.

The author has divided his book into seven chapters: "Symbols of Care," "Twentieth--Century Postcard Art," "As Advertised: The Nurse on the Advertising Postcard," "Portraits," "War!" "An American Photo Postcard Album," and "Parade of Nations." Each chapter begins with an intelligent, fascinating explanatory essay by the author, and each chapter ends with copious notes revealing the origins and stories behind the postcards. The book has an extensive bibliography and is well indexed.

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Summary:

This is an exhibition catalogue for a show of 16 photographers who documented major topics in health over the last century. Carol Squiers, curator of the show, provides ten essays, amply illustrated by photos, on critical topics such as child labor, domestic violence, environmental pollution, AIDS, veterans of war, and aging. Some 80 per cent of the images treat American subjects.

Lewis Wickes Hine's photographs of child labor are dramatic and disturbing; these document children in coal mines, cotton mills, glass works, etc. in the first part of the 20th century. The Farm Security Administration sponsored photographers (including Dorothea Lange) to represent the New Deal Health Initiatives. Topics include farm labor, poverty in the South and Southwest, and inoculations. W. Eugene Smith created a photographic essay for Life magazine about Maude Callen, an African-American nurse-midwife in 1950s rural South Carolina.

Donna Ferrato documented domestic violence in the U.S. in powerful, personal shots, including a series of an actual attack. David T. Hanson created triptychs about environmental pollution: one panel shows a map of the area, a middle panel gives descriptive text, the last panel is an aerial shot in color. Eugene Richards spent time in the 1980s in Denver General's Emergency Room. Eleven black and white photos show the turmoil and drama.

Gideon Mendal documented HIV/AIDS in several African countries. Lori Grinker took photos of army veterans (some without hands) but also noncombatants harmed by war, including children. Ed Kashi presents images of aging Americans, rich and poor, urban and rural. Sebastião Salgado provides photos of vaccination in Africa and Asia.

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Gilbert begins her narrative with the event that inspired her to write: her husband's death in 1991 after a routine prostatectomy. "Though he was in robust health apart from the tumor for which he was being treated, Elliot died some six hours after my children and I were told that his surgeon had successfully removed the malignancy. And for the first six months after he died, death suddenly seemed plausible ... "(1).

But whereas her book Wrongful Death (annotated in this database) deals with Elliot Gilbert's death, the present work takes the author through death's door into personal reflection and research across a vast area, including personal, cultural, and literary aspects of death. Larger than a memoir, her work universalizes her personal experience with dying and death. And writing is what she does and what she has to do: "THIS is the curse. Write" (92).

Gilbert divides her material into three main sections, each containing several subsections: 1. Arranging my mourning: five meditations on the psychology of grief; 2. History makes death: how the twentieth century reshaped dying and mourning; and 3. The handbook of heartbreak: contemporary elegy and lamentation. The 27 illustrations she has selected range from the Isenheim Altarpiece by Matthias Grünewald to recent photographs by Dan Jury, to Maya Lin's Vietnam War Memorial. In these symbolic representations, Gilbert finds our universal fear of the process of dying, "If this is what it is, GrŸnewald seems to be telling the viewer, for Our Lord to die the death, what must it be for those of us less staunch, less noble - in short, less divine?" (115).

Traditional elegy, by John Milton and Percy Bysshe Shelley, on the other hand, seeks to comfort the poet and reader with the hope of a life hereafter, but modern secular poets like William Carlos Williams and Samuel Beckett offer no solace at all. The older term "expiration" gives hope that our spirit may survive our death. But "termination," the twentieth-century word for death, describes how humans and animals die, in our post-Darwinian world. Her word for this is nada. The holocaust stands as the ultimate ex-termination, or death by technology.

Seeking to understand Sylvia Plath's disease- and death-filled poetry, Gilbert travels literally to Berck-Plage, France, and figuratively, through the notorious "Daddy," "Lady Lazarus," and "Getting There." As a woman and a writer, Gilbert is fascinated by Plath: "For perhaps more than anyone else - more even than her much-admired Wallace Stevens himself - she really did articulate not just the vision but the 'mythology of modern death' that Stevens tentatively proposed" (310). The author contrasts Plath with nineteenth-century Walt Whitman who said, "... to die is different from what anyone supposed, and luckier" (332). Whitman seems to be ambivalent or even positive towards death; Emily Dickinson, of his same century, finds death terrifying.

Ultimately, modern death is embarrassing; death avoidance prevails, notably among doctors. This despite the fact that the first patient a medical student sees is a cadaver. Death is a doctor's failure and it is easier to blame the patient than to accept the death. Death in an American hospital is a "humanectomy", or physical removal of the individual's humanity as she/he is attached to IVs, monitors, feedings tubes, and other mechanical devices.

Modern hospital death is demeaning, because patients are granted little privacy, their TV sets are set to blaring; all personnel, including doctors, enter their rooms unannounced: "Whereas the patient is emotional - fearful, angry, needy - the doctor is detached, abstract, 'objective' " (189). Clearly, the author still lovingly mourns her dead husband bleeding to death alone in a hospital room. Energized by lost love, she writes and documents and works her way toward death.

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The novel is set in Washington, DC in April, 1865. At fourteen, Emily is sole caretaker of her mother who is dying of tuberculosis. Her neighbor, Annie Surratt, is her best friend, though their mothers have been estranged for some time. Both families have deep roots in the South. Annie’s brother, Johnny, an object of Emily’s romantic fantasies, has recently left on a secret mission. The war is nearly over. Emily’s uncle Valentine, a physician, wants to take custody of her after her mother dies, but because her mother has also felt estranged from him, Emily resists. Still, after her mother’s death, she does go to live with her uncle, and learns that he (with his two assistants, one of whom is a woman who is 1/8 African American) has a lively practice among the poor and the African Americans who have flooded the streets of Washington since the emancipation.

Valentine is called to Lincoln’s bedside the night of his assassination, and participates in efforts to track down John Wilkes Booth and his accomplices, one of whom appears to have been Johnny Surratt, who has escaped to Canada. In the course of her time there Emily discovers that her uncle and his assistant are involved in elaborate, marginally legal, schemes to obtain bodies for study at the medical college. Emily, at first horrified by this discovery, comes to recognize the good that comes of anatomical studies and to sympathize with her uncle’s efforts to bring about legislation making the acquisition of bodies for medical research easier. Annie’s mother is hanged as an accomplice in the Booth conspiracy, Annie leaves town, and Emily comes to understand a great deal more about the harsh terms on which life must be lived in times of national crisis and ideological warfare. The story ends with her growing interest in medicine as a possible career path.

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Doctor Yashvin sits with his colleagues and admits, "I have killed a man." The story of his resistance activity during the Bolshevik revolution ensues. The young doctor was called to serve as the personal physician of an enemy colonel. In this command the doctor witnesses horrible atrocities against common people as well as resistance fighters, the last straw being the brutal beating of a woman who comes demanding to know why her husband has been shot. Called upon to attend to a knife wound sustained by the colonel and finding the latter in a vulnerable position, Yashvin takes advantage of the moment, shoots the colonel dead, and escapes.

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Summary:

This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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Losing Julia is narrated by Patrick Delaney, age 81, a World War I veteran, who lives, somewhat independently, in Great Oaks, an assisted living facility. Still able to go into town to get new clothes, books, etc. and enchanted with the kindness and loveliness of Sarah and other female staff members, the well-educated and quick-witted protagonist offers a fresh perspective on "institutional" care.

Much of Patrick’s story, however, concerns Daniel, a war-time buddy, and other soldiers in his embattled unit prior to and during the hellacious Battle of Verdun. Several soldiers are carefully and memorably drawn by the stories they tell about life at home and their aspirations. Daniel stands out as Patrick’s closest friend in the trenches, a young man who is courageous, rational, fearful, and in love with Julia.

Like his peers, Patrick listens to Daniel’s lyrical recollection of the woman others can only imagine. Patrick realizes that he has fallen in love with Julia’s image. Most of the men, including Daniel, are killed brutally in one of the war’s most savage battles. When Patrick’s post-war efforts to find the elusive Julia fail, he marries, works as an accountant, and has two children. Like the war, Julia remains, however, a constant shadow throughout his life.

When a war monument is constructed ten years later on the site of the last atrocious battle, Patrick, his wife, his toddler son, and his sister-in-law journey to Paris. With his family happily detained in Paris, Patrick goes to Verdun alone for the monument’s unveiling ceremonies with many other veterans and grieving family members. It is here that Julia appears and the two become lovers during the time at Verdun and then for a short time in Paris.

The story, non-sequential in its presentation, weaves the various elements of aging, memory, war, love, and loss together for readers to untangle and follow.

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