Summary:

Antonia Redmond is a young Harvard-trained doctor who has returned to the East African village where she was raised by American parents to establish a medical practice. Her efforts are frustrated by inadequate supplies and funding, an under-trained staff, and patients whose superstitions and mistrust make diagnosis and treatment difficult. She deals daily with a conflict of cultures, trying to maintain her medical methods and standards in an environment where she competes with the authority of native healers.

Esther, daughter of a native healer who has some familiarity with and respect for Western medicine, envies and longs for Antonia’s Western training and attaches herself to her as a disciple. In her encounters with patients, Esther finds that she has an inexplicable gift for healing which baffles her as well as Antonia and complicates their already tenuous relationship. Esther’s gift forces Antonia to reexamine some of her most basic assumptions about what constitutes healing.

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This unusual collection of contemporary art features full color prints of what might be termed comic doctor archetypes. Entitled by specialty, paintings feature doctors in a variety of incongruous settings that constitute fantastic anachronistic commentary on the situation of the doctor relative to different social groups or social expectations.

"The Internist," for instance, is represented as a modern female doctor in a medieval setting, commenting ironically on the various institutional pressures that come to bear upon women in the medical profession and expectations of the internist in particular. "The Pathologist" is featured getting his comeuppance as the doctor who usually has "the last word" in a confrontation with the figure of death--a skeleton straddling a Jungian snake among a horde of rats on the office floor. Each of the paintings is accompanied on the opposite page by a brief, but informative and insightful commentary by Spence.

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The story of Avram Halevi of Toledo, a late 14th-century Jewish doctor forced to convert to Christianity at the age of ten. He becomes a physician and surgeon in Montpellier and returns to the poor Jewish sector of his native city to live a dangerous professional life, serving the Christian rich. His relationship with the beautiful, ambitious Gabriela founders as his people are scattered in yet another attack by misguided Christian zealots.

His cousin, Antonio, is cruelly tortured and Halevi euthanizes him in prison. Escaping Toledo, he returns to Montpellier where he finds friends, a wife, a family, and eventually a professorship--but religious rivalry again intervenes through the brutality of a worldly cardinal. Try as he might to remain above the fray of religious and political struggles, Halevi is stripped of all he holds dear and dragged into controversy again because he senses what is morally right.

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This fine collection of short memoirs and stories by doctors offers a variety of narratives about memorable moments in medical education and practice that raise and explore practical and ethical issues in medicine. An explicit aim of the editors was to focus on some of the rewards in medical life as well as the struggles it entails--those often being inseparable.

Starting with a section on medicine and poetry which includes memories of William Carlos Williams by two of his well-known students, Robert Coles and John Stone, and a reflection on illness in poetry by Rafael Campo, the collection is then divided into two major sections: "Grand Perspectives" and "Intimate Experiences." The former includes narratives that show the development of practices, conflicts, or learning over time spent in hospitals and clinics, observing the careers of elders in the profession or the parade of patients whose expectations and needs stretch the physician's creative resources. Several, including Perri Klass and David Hilfiker write about particular patients whose cases became personal landmarks.

In the latter section, stories focus on single cases or incidents in the lives of doctors, some humorous, some tragic, some bemusing, all attesting to the chronic ambiguities of the work of healing and to the very human tensions that arise in institutions that both enable and inhibit the compassion all good doctors want to exercise.

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This three-part collection of poems offers powerful images and vignettes from the life of a family practitioner living and working among the urban poor. The first section is the most explicitly medical in theme, including poems that pay painful tribute to a mother after stillbirth, a hydrocephalic child, an addict covered with boils, a young man murdered at eighteen, an old man with a failing heart.

The second section weaves images from the writer's personal story together with those from his life as physician, and the third focuses primarily on life lived as a gay man among the sick and dying, patients to be treated and friends to be mourned while life remains to be claimed and savored.

Despite the pain and grief attested to in many of the poems, a lively voice of clarity, compassion, and consent to the goodness of life even on hard terms gives the collection a defining note of celebration. Pereira's lines about a bereaved Cambodian seamstress suggest something true about his own work: ". . . she joins the circle / of other Khmer women to sew. / Punctuating the fabric / with yellow thread, finding her remnants / into a piece that will hold." ("What is Lost")

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This collection by a physician-poet covers a wide spectrum in topic and tone. The poems in the first of the four sections speak in voices of those waiting surgical outcomes, those whose loved ones are about to undergo invasive and dangerous procedures, those who are coming to terms (partly clinical terms) with death. The poems in the second section focus more explicitly on Jewish experience, and on experiences of suffering that take place in the wider context of biblical tradition and recent history.

The third section features lighter-hearted poems, many rhymed, that make playful reference to moments in domestic life and relationship which, while not free of suffering and anxiety, are also the stuff of laughter. The fourth focuses on love--erotic, romantic, familial--and death, which includes the ordinary losses that living through time entails. Elegiac, wistful, musing, and poignant, they end the collection in a complex, sustained key that holds an elegant tension between sorrow and hope.

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The title of Scannell’s book refers to an episode in her work with AIDS patients when she realizes that the "good doctor" she’d been taught to be--scientifically precise, medically focused and aggressive--was not what many of her patients wanted or needed. From that point on, she strove to understand the nature of her patients’ suffering and how they might be cherished and morally supported during the last weeks and days of their lives. In a series of essays she offers haunting portraits of the men and women she served--and of herself, as she learns to recognize and grapple with her own anger, grief, comfort, and joy.

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This amusingly told narrative by a surgeon/author begins by describing how "wrong-headed [it is] to think of total submersion in the study and practice of medicine." He sets aside time to read at his neighborhood library, where he befriends six elderly, indigent "regulars." In spite of himself, the physician will out. His powers of medical observation and empathetic character lead him to perform a most menial task: cutting the overgrown toenails of these severely arthritic people in order to alleviate their pain.

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The setting is the children's ward of a hospital in Paterson, N.J. during the Great Depression. Alternating between a cynicism born of desperation, and empathetic concern, the physician-narrator describes the sorry condition of his young patients, virtually abandoned by their parents. He muses that they would be better off left untreated so that they would not have to live the inevitably wretched lives ahead of them.

One child in particular has captured his attention. She is Jean Beicke, an eleven month old, malnourished, deformed girl suffering acutely from broncho-pneumonia. The nurses and he look after her, and she responds to their care by taking nourishment and gaining weight. This is tremendously rewarding and reinforces their interest in her, but to their consternation she continues to be very ill. "We did everything we knew how to do except the right thing." "Anyhow she died." The benumbed mother is persuaded to allow an autopsy; the physician wants to understand what went wrong although he "never can quite get used to an autopsy."

The postmortem uncovers an infection of the mastoid process which has spread to the brain. The narrator and the "ear man" berate themselves for having failed to take proper steps to identify and treat the infection. In the end, however, the physician is still unable to resolve the dilemma of wanting passionately to have saved his patient's life, and knowing that the life saved would have been one of misery.

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Having previously described his seven years as a family practitioner in rural Minnesota (Healing the Wounds, Pantheon Books, New York, 1985) Hilfiker now has turned his attention to a decade in inner-city Washington, D.C., where he practiced what he calls "poverty medicine." These introspective essays are written in a style similar to that of his first book and detail the profound struggles of the overwhelmingly African-American community he serves and lives with.

Also examined are his and his family's battle to live with their white middle-class privileges in the midst of this impoverished community. This book very effectively alternates between the numerous stories of his personal encounters with patients and deeply reflective commentary about those encounters. Prescriptions are not offered other than that a new art of caring for the poor is needed.

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