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Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.
Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.
This collection of 36 poems, some of which have been published individually in various literary magazines, is primarily about dead--or nearly dead--family members: a brother and sister lost to cancer; the speaker's palsied, nearly blind father dying of Parkinson's disease; his mother's struggle with chronic arthritis and heart disease.
The collection is divided into three untitled sections. The first deals primarily with the aging and death of the speaker's parents; the second with a wider range of abandonment and death, lost loves, dreams, innocence; the third almost exclusively with his sister's six year struggle with breast cancer and dying.
Joe Rose, a popular science writer, and his partner Clarissa, a Keats scholar, are picnicking in the English countryside when an accident happens: a hot air balloon carrying a man and his grandson goes out of control. Five men, including Joe, run to help, holding onto the balloon's ropes; when a gust of wind lifts the balloon, four men, including Joe, let go but the fifth holds on, is lifted high in the air, and falls to his death.
One of the would-be rescuers, Jed Parry, becomes obsessed with Joe, and begins to stalk him, interpreting all rejections as veiled invitations. Jed wants both to convert Joe to charismatic Christianity and, it seems, to become his lover. Communication is impossible, the police are no help, and under the strain Clarissa and Joe's relationship comes apart. In a restaurant, someone at the next table is shot, making Joe realize that Jed is trying to kill him. After breaking into their apartment, threatening Clarissa at knifepoint, and then attempting suicide, Jed is arrested and committed to a psychiatric hospital.
In a subplot, the dead man's widow suffers a loss exacerbated by the belief that her husband had been having an affair. Joe learns the truth about the suspected affair and is able to reveal to the widow that her husband had been faithful after all.
The book ends with two appendices: an invented article from a British psychiatry journal presenting Jed's case, and a letter written to Joe by Jed three years later, still hospitalized, and still, deludedly, in love.
Written by a medical historian who is also a physician, The Breast Cancer Wars narrates how breast cancer diagnostic methods and treatments have developed from the early twentieth century. More significantly, the book describes the debates and controversies that permeated this evolution and the ways in which not only clinicians and researchers, but, increasingly, women patients/activists shaped how we view, diagnose, and treat breast cancer today.
Individual chapters explore the influential (and ultimately contested) radical mastectomy procedure of William Halsted, the development of the "war" against breast cancer as a full-blown campaign developed and conducted within the public media and consciousness of the United States as well as within medical practice and research, the intertwined development of feminism and breast cancer activism, the "fall" of the radical mastectomy, and the continuing controversies surrounding mammography and genetic testing as modes of early detection and risk assessment. Lerner draws on a range of primary sources including texts from the archives of the American Cancer Society, the papers of doctors and patients, and advertisements from popular and professional magazines throughout the century.
A 63 year old biologist, blind since childhood, collects snails and shells in Africa. His self-imposed isolation is shattered after he is credited with saving the lives of an American woman and a native eight year old girl who are both suffering from malaria. The venom of a cone shell provides the cure. Strangers flock to the scientist’s abode hoping to find their own miraculous remedy, but instead a few discover tragedy or even death.
The biologist’s own adult son dies from a cone shell bite while visiting his father. In the end, the shell collector is also bitten by a cone and experiences both paralysis and clarity in his near-death condition. He survives with the aid of the young girl whom he had earlier cured of malaria.
The narrator, Latimer, begins the story with a vision of his death, which he attributes to a heart attack. He explains that, always sensitive after a childhood eye affliction and his mother's death, the further shock of a "severe illness" while at school in Geneva enabled him to see the future, and to hear others' thoughts--an experience which he describes as oppressive. He is fascinated by his brother's fiancée, Bertha, the only human whose thoughts are hidden from him, and whom he marries after his brother dies in a fall.
The marriage falters after Latimer eventually discerns Bertha's cold and manipulative nature through a temporary increase in his telepathy. When Latimer's childhood friend, the scientist Charles Meunier, performs an experimental transfusion between himself and Bertha's just-dead maid, the maid briefly revives and accuses Bertha of plotting to poison Latimer. Bertha moves out, and Latimer dies as foretold.
In the "free love" context of the nineteen-sixties, Harriet and David Lovatt are throwbacks to a more conservative, traditional, and family-oriented decade. Their life dream is to have a big house in the country filled with children, and it seems that they will succeed. After bearing four young children, however, Harriet is feeling the strain of years of childbearing, sleeplessness, money trouble, and her parents' and in-laws' disapproval of her fecundity.
Her fifth pregnancy is not only unplanned, but also unusually painful and disruptive. Harriet's doctor prescribes sedatives but finds nothing abnormal in her situation. When Ben is born, Harriet jokes that he is like "a troll or a goblin," but no one responds well to this unusually hairy and physically vigorous baby, who in turn does not respond to anything but his own desires and fears.
As he grows older, family pets and other children seem to be in physical danger. Health care professionals do not confirm the couple's conviction that Ben is not normal, but neither do they obstruct the decision to send Ben to a private institution, a removal that leaves the family temporarily happy until Harriet visits Ben and recognizes the institution for what it is, a place where all manner of "different" children are sent to live heavily medicated, physically restrained, and foreshortened lives away from families who do not want them.
Harriet brings Ben home, where he grows up amid what remains of the Lovatts' domestic fantasy, and finds community in a gang of thuggish older boys whom Harriet suspects are involved in various criminal acts. As the story closes, Ben has left home and Harriet imagines him in another country, "searching the faces in the crowd for another of his own kind" (133).
In "Fortitude" Dr. Elbert Little, a Vermont family physician, visits the laboratory of Dr. Frankenstein and his trusty assistant, Dr. Tom Swift. Frankenstein has only one patient, Sylvia Lovejoy. His life work has been to keep Lovejoy alive. In 78 operations over the last 36 years, Frankenstein has replaced every one of her organs with prosthetic devices, so that now she consists of a head on a tripod, attached by tubes to various machines.
Frankenstein controls her mood, as he controls all her functions, from a "fantastically complicated" master console. Usually he makes sure that she feels joyful and loving, but last month a transistor went bad in one of the machines and she felt depressed for a while; so depressed, in fact, that she wrote to Dr. Little and asked him to bring her some cyanide.
Lovejoy's only friend is Gloria, the beautician who comes every day to care for her hair. Gloria is horrified over what Sylvia Lovejoy has become; she sees only a "spark" of the real person remaining, but she knows that the "spark" wants to die. After Frankenstein fires Gloria for speaking about death in Sylvia's presence, she sneaks back into the room when Sylvia is sleeping and puts a loaded revolver in her knitting bag.
Later, Sylvia finds the gun and tries to kill herself, but her prosthetic arms have been designed not to allow her to do that. Instead, she shoots Frankenstein, who promptly becomes the second head attached to the machines. (It seems he has designed all the prosthetic organs to be able to serve two "persons," so that he and Sylvia will be able to "live in such perfect harmony . . . that the gods themselves will tear out their hair in envy!")
Spencer Nadler, a surgical pathologist for over 25 years in southern California, offers 8 essays, as well as an introduction, epilogue and 9 full color histopathology plates in this collection. As he explains in the introduction, Nadler began his training in surgery, but, during a required year of surgical pathology, he finds his true vocation: "I realized a flair for surgical pathology that I had never demonstrated in surgery." (p. xix) However, over the years, he realizes he misses patient contact--these essays, written over 10 years, are forays into an unusual relationship: the pathologist-patient relationship.
Each essay is about a different patient (or other contact) and tissue. One of the most compelling is the first, "Working Through the Images," in which a woman (Hanna Baylan) with metastatic breast cancer seeks Nadler out so that she may view her cancer cells. She arrives in his office unannounced at 6 p.m. and he proceeds to not only show her the slides, but to listen to her. He becomes a witness to her pain, loneliness, sorrow and hope.
"For years I have processed thousands of such cases, determined the manifold forms of disease, but I've never been an intimate part of anyone's illness, never felt the connections of cells to a larger self." (p. 12) During later visits, Baylan cries in his arms and even brings her youngest son in to meet Nadler and view her cells. By this time, Nadler is completely connected to her: "This is heartrending to me, for I have come to love her . . . I can no longer think of Hanna in terms of the cells I see on her slides." (p. 21)
Other chapters highlight fat and bariatric surgery; neurologic disorders such as brain tumor, Parkinson's, Alzheimer's and paraplegia; heart disease; sickle cell disease; and palliative care. Each chapter conveys Nadler's visual sophistication and ability to graphically describe cells. For instance, within a fat cell "a large fat globule steamrolls other cell contents flat against the outer membrane until it bulges like a mozzarella." (p. 32) More importantly, Nadler ably extends his cellular acuity to the larger human dimension.
Dr. Sacks was growing up in London during World War II and had a very traumatic experience when he was sent away from his home for protection from the bombing. He and his brother were sent to a boarding school, where they were beaten and underfed. Sack's home had been filled with a wonderful extended family of physicists, mathematicians, teachers, and chemists, in addition to his parents who were both practicing physicians. Being unusually bright and talented, Sacks responded to a wide variety of stimuli when he returned to this environment.
He became fascinated with the chemistry of metals and with the periodic table of elements. An uncle, for whom the book is named, was a manufacturer of light bulbs with tungsten filaments and encouraged him in setting up his own chemistry laboratory in the family laundry room, to do experiments. The family allowed him a great deal of freedom, which encouraged his creativity.
In writing about these experiences Sacks includes the history of the development of chemistry concepts that fascinated him. It was only much later that his interests moved on to the natural sciences and medicine. He says that his parents had been tolerant and even pleased with his early interests in chemistry but by the time he was fourteen they felt that the time for play was over. He kept a journal from the age of fourteen and took advantage of every opportunity to read broadly and experience nature, music and art.
In retrospect, however, Sacks felt that life was shallower after he left behind his passion for chemistry. He says that he dreams of chemistry at night. This description of such intense interest in the world around him and the people he read about or knew explains a great deal about his great success as a neurologist and as a remarkable story teller.