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The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.
Author Horace Davenport is a retired professor of physiology who had a distinguished career in medical science. This book reflects his more recent interest in the history of medicine and physiology in the 19th and 20th centuries. The best summary of this transcription with commentary resides in the author's own introductory paragraph, paraphrased here: From 1899 to 1900 fourth year medical students at the University of Michigan doing their medicine and surgery rotations attended a diagnostic clinic twice a week with George Dock, A.M., M.D., professor of theory and practice of clinical medicine. Dr. Dock had a secretary make a shorthand record of everything that was said at these clinics by Dock himself, the patients, and the students.
The clinics and recording of the interactions continued until the summer of 1908 when Dr. Dock left Michigan for a position at Tulane. The typed transcripts of these sessions fill 6,800 pages. This book is Davenport's distillation and, on occasion, clarification of these documents. In these transcriptions resides not only a view of the practice of academic medicine at the turn of the 20th century, but also a glimpse at one clinician's interpretation of clinical material in his own time.
A young art student falls off a ladder and literally lands into the arms of a middle-aged doctor. Daisy Whimple is a poor, homeless woman with multiple body piercings. She has volunteered to decorate the Gynae Ward of the hospital where she had once been a patient undergoing surgery for a complicated abortion.
Dr. Damian Becket is an obstetrician and gynecologist. He is a lapsed Catholic who is separated from his wife. Becket is interested in modern art and attracted to an art historian, Martha Sharpin. The hospital has a collection of medical antiquities in need of cataloging. Some of the pieces are treasures but others are horrible relics. Martha is in charge of organizing the collection, and Daisy is paid to assist her.
Because she has nowhere to live, Becket invites Daisy to stay at his apartment. They make love every night for one week until she leaves. While attending an art exhibit, Becket and Martha spot a sculpture of the goddess Kali. The figure is comprised of artifacts "borrowed" from the hospital's collection including prosthetic arms, antiquated instruments, and body parts. It is designed by Daisy.
The sculpture is not the only unexpected thing created by Daisy. She is pregnant by Becket. Daisy requests an abortion but he insists that she have the baby. The pregnancy is almost miraculous given the damage done to Daisy's fallopian tubes from her previous abortion. It turns out to be a difficult delivery and Becket must perform it since he is the most qualified obstetrician at the hospital. The baby is a healthy girl. The newborn child radically changes the lives of Daisy, Becket, and Martha, yet the three of them have no clue what to do next.
Summary:The physician prepares himself to deliver the news of a death to a family. His white coat symbolizes this role in his professional life; and when he takes it off at home, he becomes only a man with chores to do around the house. Yet that chore, replacing a lightbulb, seems to symbolize rebirth and the sustenance derived from personal life which allows the physician to continue in his often difficult role.
Martin Nanther is a member of the British House of Lords, having inherited his title from his great-grandfather, Henry. Physician to Queen Victoria, Henry specialized in hemophilia, the disease that Her Majesty was known to have passed to her son, Leopold, and other descendants. While the House of Lords considers a Bill to abolish hereditary peerage and Martin's much younger, second wife is obsessed with becoming pregnant, he escapes into his slow research for a biography of Henry
His patient genealogical investigations uncover deaths in infancy of several young boys in his own family, and Martin soon realizes that hemophilia (rather than the family's legendary tuberculosis) is the cause. Was that irony merely a coincidence? Or was hemophilia in his own lineage the impetus for his grandfather's research and position in life? And why was the disease hushed? Was it possible that his grandfather deliberately sought a bride with the trait in order to investigate it in his own progeny?
Martin soon finds himself wondering if this well-respected, medical man actually committed murder, or was he merely waylaid by unexpected love? Without giving too much away, suffice it to say that the answers prove so surprising and so disturbing, that Martin decides to abandon the biography of his ancestor, even as he learns that his inherited peerage has been revoked and that his next child will soon be born.
A surgeon attending a medical meeting becomes bored and hires a prostitute. When he awakens next to her in bed the following morning, he first observes, then palpates a suspicious lump in the right breast of the sleeping woman. Although he informs her of the abnormality and the need for further evaluation and treatment, the surgeon cannot bring himself to divulge the possibility (or even likelihood) that the breast lump is malignant.
It is the prostitute who acknowledges (and eventually proclaims) that the lump might be cancer. She realizes that breast cancer might prove fatal to her livelihood as well as her life. The surgeon appears less upset by the diagnosis and potential suffering associated with it than the realization that both he and the tumor were rivals, "each feeding on her flesh" in a competition to consume the woman.
He pays the prostitute one hundred dollars for her services and cannot wait to exit the room. She offers him ten dollars for his consultation, but the surgeon refuses the fee with the excuse that he doesn't make house calls.
Tenderly Lift Me is the latest publication from Kent State University Press in the Literature and Medicine series edited by Martin Kohn and Carol Donley. Not all the 39 caregivers Bryner honors through poetry, biographical sketches and photos are nurses, but all have discharged their caregiving duties as the title indicates: tenderly. The book opens with a preface by Bryner who wants "people to care about nurses the way nurses care about people who are total strangers" (p.xii). A literate and insightful introduction by Suzanne Poirier and Rosemary Field follows.
The book, divided into eight parts, contains biographical sketches and interviews with nurses or tender caregivers, their photographs, and poems by Bryner in which she speaks in the voices of the individual nurses, celebrating but never sentimentalizing their stories.
Some of the nurses are daughters of blue-collar workers: Carol Johnson (p. 77) went on to become a cardiothoracic nurse practitioner, harvesting veins for open heart surgeries. Helen Albert (p. 52), the granddaughter of a slave, became "the first black registered nurse hired in Warren, Ohio." The nurses celebrated are both living and dead; some are aged, this book the only vessel that might hold their histories. All the caregivers, like Father Damien, born in 1840, caretaker to a colony of lepers in Molokai, come alive in Bryner's prose and poems, speaking to us in image and metaphor as well as fact and biography.
There are journal entries from Kate Cumming, who cared for confederate soldiers during the Civil War (p. 151), and comments from contemporary nurses, like Sylvia Engelhardt, one of the first nurses to graduate from an associate degree program and feel the "sting of labels" (p. 69), or Theresa Marcotte Kokrak (p. 46) who remembers traveling though Canada's seventy-below wind-chill to report to duty. Bryner celebrates the nurses' accomplishments as well as the daily events, the doubts and frustrations, the dark moments that these nurses have overcome in order to care for others, nurses who are "human, and sometimes a little heroic, but not from heaven" (P. xii).
While on an airplane, Carson experiences abdominal pain. He is a divorced man in his fifties and a sales representative for a computer and information technology firm. He spends much of his time traveling and fancies himself "a connoisseur of cities." The increasingly severe stomach pain forces Carson to reschedule his business meeting and retreat to his hotel room.
His suffering mounts and he decides to visit the emergency department of the city hospital. Carson is evaluated by two young male doctors and later a middle-aged female physician. Despite blood tests and X-rays, his diagnosis remains murky and a surgical consultation is obtained. The surgeon suspects appendicitis. He postulates that Carson may have a retrocecal appendix and explains that in such cases the anatomical location of the organ often confounds the diagnosis.
Carson undergoes surgery. His appendix is indeed retrocecal and rupturing. He spends five days convalescing from the operation. During that time he acquires an intimate knowledge of the city from his stay at the hospital. The experience revitalizes him. Carson reasons that the world is miraculous in part because it is so simple yet still spectacular.
For three weeks the narrator has been working as a clerk in the emergency department. His good friend, Georgie, is a hospital orderly. Both men abuse drugs, and Georgie steals them from the hospital. The ER staff includes Nurse (an overweight woman who shakes) and the Family Service doctor (a physician with limited competence who is not well-liked).
At 3:30 A.M., a man named Terrence Weber arrives at the ER. He has a hunting knife stuck deep in his eye. Ironically, his other eye is artificial. Weber's wife apparently tried to blind him because he ogled the woman next door. The doctor immediately decides the situation is beyond his expertise and calls for an ophthalmologist, neurosurgeon, and anesthesiologist.
Meanwhile Georgie is prepping Weber for surgery. The drugged-up orderly, who cannot even tie his shoe at this point, somehow removes the knife by himself. Weber's vision is fine. Later on, the narrator and Georgie get lost while driving around in a pick-up truck without headlights. The truck runs over a jackrabbit on the road. Intent on making rabbit stew, Georgie cuts the animal open with the hunting knife he had earlier removed from Weber's eye. The rabbit is pregnant with eight miniature bunnies inside her.
Georgie decides to save the babies. Unfortunately the narrator forgets about the rabbits and accidentally squashes them to death. At the end of the story the two men encounter a hitchhiker who has gone AWOL from military service. Georgie promises to take him to Canada.
Manlius is a 5th C Roman patrician living in Provence who has studied with the wise, reclusive Sophia. He writes his understanding of her teaching in his essay, 'Dream of Scipio,' which trades on an essay by the great Roman orator, Cicero. Sensing that the Empire is gravely threatened, he makes a pact with barbarians, sells out his neighbors, slays his adopted son, and becomes a bishop of the Christian religion, which he has long despised. Late in this ruthless and doomed attempt to salvage what he values most in his world, Sophia makes it clear that he has misunderstood her teaching.
Olivier is an astonishingly gifted 14th century Provencal poet whose intolerant father tries to stifle his love of letters, among which is Manlius's 'Dream'; his father destroys the manuscript, but Olivier recopies it from memory. As plague advances on their region, Olivier finds a mentor in the high churchman, Ceccani, who is bent on keeping the papacy in Avignon. He plans to destroy Jews as symbolic expiation for plague, widely construed to be a form of divine punishment. Olivier befriends a Jewish scholar and falls in love with his beautiful heretic servant.
The 'Dream' and the imprisonment of his friends lead Olivier to question and then betray his mentor. Either because of his efforts to save them, or for his role in a murder, he is mutilated--his tongue and hands cut off to rob him of speech and writing. The brutal mutilation appears early in the book--it is not fully explained until the end.
Julien is a French historian who has studied the poet, Olivier, and the rendition of Manlius' manuscript. He finds solace in his erudition as his county falls to the Nazi occupation. An old school friend who is a collaborator, gives him work as a censor and tolerates Julien's Jewish lover, the artist Julia. In the end, Julien is forced to choose between saving either another school friend in the Resistance or Julia. He chooses Julia, looses her anyway, and commits suicide in a vain attempt to warn his friend.