Showing 31 - 40 of 45 annotations contributed by Carter, III, Albert Howard
Summary:Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.
This book in large-format (11 1/8 x 8 3/4 in.) is made up primarily of wonderful illustrations but there is also clear and clever text; both media clearly explain the structures and systems of the human body. Although nominally listed as “Juvenile Literature,” The Way We Work is sophisticated and detailed enough to educate and entertain adult readers, without losing the interest of intelligent young readers.
The drawings, in pencil and watercolor, are dazzling: large, colorful, with a variety of layouts and perspectives. Many go across double-page spreads, and many include a witty image of one or more small observers. In “Mapping the Cortex,” for example (pp. 158-159), an enormous, multicolored brain takes up most of two pages; it is partially exploded into 11 areas, labeled by name and function, and coded (sensory, motor, or association). A tiny (one-inch) man below with a question mark over his head looks at a dangling rope (I think) hanging from the brain. A small text block fits in the lower left-hand corner.
The book is organized by seven chapters, each for a body system, such as “Let’s Eat” (digestive system), “Who’s in Charge Here?” (nervous system), and “Battle Stations” (immune system). While the parts of the body (anatomy) are clearly shown, the book stresses biological process (physiology), truly “the way we work,” and in considerable detail. In “Let’s Eat,” for example, there are 50 pages, starting from what foods we eat, our sense of smell, taste receptors, teeth, chewing muscles, salivary glands and saliva, the entire alimentary canal, including biochemical and molecular activity, the roles of pancreas, liver, and kidney, and urinary and fecal outputs.
Children of all ages will enjoy “Journey’s End,” which shows a gigantic rectum miraculously suspended over a cityscape, with dump trucks arriving below it to receive stupendous loads. Indeed, there is much humor in the book, both in the drawings and in the text blocks.
This is another wonderful book from Dr. Sacks. The subtitle, “Tales of Music and the Brain,” is accurate: we have a charming and informative mixture of stories of patients and the neurophysiology that interprets how music is processed and performed. The book is synthetic in combining cases from his practice, other clinical reports, letters from correspondents, references to medical literature, and even Sacks’s own personal experiences with music.
Sacks finds that humans have a “propensity to music,” something “innate” in human nature, perhaps like E. O. Wilson’s biophilia. “Our auditory systems, our nervous systems,” he writes, “are indeed exquisitely tuned for music” (xi). Although humans have been involved with music for millennia, it is only in the last few decades that medical imaging (functional MRI, PET) has shown what areas of the brain are active when music is heard.
While humans routinely enjoy music, the book emphasizes unusual events and neurological patients, in short, departures from the norm. Sacks—himself a lover of music—reports on his own experiences with hallucinatory music and anhedonia (loss of pleasure) in hearing music. He describes going to hear the great baritone Dietrich Fischer-Dieskau but finding that he could not, on that day, perceive the beauty of the music. Another condition “amusia,” or loss of musical ability, can be chronic, acquired, or temporary.
Some patients have had injuries or diseases of the brain that change how music is perceived. A man hit by lightning is suddenly obsessed with piano music. Another man (who survived a brain infection) has amnesia about many things but can still make and conduct music at a professional level. The concert pianist Leon Fleisher visits Sacks to discuss his dystonia, or loss of muscle function in one hand (with implications for the brain). Rolfing and Botox helped him heal and he returned to two-handed performances.
Sacks discusses other phenomena that involve brain structures, for example, perfect pitch; persons with this ability have “exaggerated asymmetry between the volumes of the right and left planum temporale” (128). People who experience synesthesia (perceiving notes as colors) have cross activation of neurons in different areas of the brain. Professional musicians (and patients with Tourette’s) demonstrate cortical plasticity, that is they have expanded areas of the brain for particular uses. Children with Williams syndrome have brains influenced by a microdeletion of genes on one chromosome; they have some cognitive deficits and also a great responsiveness to music. For some conditions, the brain determines all; for others, behavior components are also important.
This is a gripping and poignant account of newsman Bob Woodruff’s brain injury and recovery. He was injured in Iraq by a roadside bomb on January 29, 2006, shortly after being named co-anchor for ABC’s World News Tonight. A public figure—even a celebrity—his injury and recovery were well publicized, bringing to light the injuries of many kinds suffered by soldiers (not to mention civilians) in war-torn Iraq. Woodruff received every benefit American military medicine could offer and had impressive support of ABC and various luminaries. He made a spectacular recovery against all odds.
The book is mostly told by Lee Woodruff, Bob’s wife, who flew to Germany on a moment’s notice to see him at the Landstuhl Military Hospital, who waited 36 days for him to wake up, who saw the CT scan with rocks embedded in his head, who managed their four children and household during the long recovery time, and who writes vividly and personably. There are also flashbacks about the lives of Lee and Bob, truly a remarkable couple: their courtship, their time in China and London, their decision to use a surrogate mother to have their second two children.
Bob himself contributes pages, before and long after the accident. Thirty-one photos, both black and white and in color, enliven the text. One photo shows the interior of a critical Care Air Transport Team, a C-17 cargo plane outfitted like an ICU to transport wounded soldiers. Throughout, the costs of warfare on people, society, materials, and land (not to mention dollars) is dramatically evident.
This is a short piece, a scant twelve pages, in which Williams remembers Alan, an uncle who had mental deficits. During his breech birth, Alan’s brain was starved of oxygen. In the dominant American culture, Alan is called “retarded, handicapped, mentally disabled or challenged.” Williams concludes, “We see them for who they are not, rather than for who they are.” (p. 29) The title of the work refers to an Alaskan totem pole figure whose expression reminds her of Alan. In Tlingit culture, there’s a story of a kidnapped boy who lived with the Salmon People. When he returned twenty years later, he was seen as a holy man, not an “abnormal.”
To the young Terry Tempest, Alan demonstrated enthusiasm and spontaneity, for example bowling with reckless glee, regardless of where the ball went. When she asked him how he was feeling, he said, “very happy and very sad,” explaining that “both require each other’s company.” (p. 31) She liked his direct answers, those of a person we sometimes call a wise fool. Later, he lived in a “training school,” a joyless, ugly, and smelly place where abnormal children in Utah were sent and warehoused. Suffering from epilepsy, he wore a football helmet to protect him from sudden falls.
At age 22, Alan made the choice to be baptized into the Church of Jesus Christ of Latter-Day Saints. Williams describes the ceremony and how the family supported him through it (including yet another violent epileptic episode). When Alan died at age 28, Williams was 18. Looking at the totem pole, she remembers Alan, seeing him for who he truly was.
Oschman, a former cell biology researcher, applies his scientific training to the emerging field of energy medicine. While previous investigators (Franz Anton Mesmer, Guillaume Benjamin Armand Duchenne, Edwin D. Babbitt, Harold Saxon Burr) were either ignored or selectively accepted, healers from ancient times have used touch to heal or even cure the human body, and the human body itself has sophisticated strategies to heal itself.
Oschman shows how the body is a living crystal with electricity, magnetism, and light flowing through it, often at higher speeds than the standard neurology model. Quantum physics applies here, as well as piezoelectricity (pressure electricity), explaining how energy flows through water molecules in the collagen that invests every internal structure of the body. Proteins in the body are semiconductors, and our brain waves may even be tuned to standing energy waves (Schumann resonance) that surround the earth itself.
Oschman collects data and illustrations widely, from acupuncture, Qi Gong, massage, yoga, meditation, Zen, and of course, standard medicine. The latter, he argues, whether through scalpels or pharmaceuticals, can be understood as energy medicine. Even better, in his point of view, would be an imaginative synthesis of standard medicine with many (other) forms of energy medicine.
This is a collection of 91 poems on medical topics by medical students, physicians in training, and attending physicians; two are Canadian and the rest American. The poems are organized by six traditional groups of medical training and advancement in the profession: Medical Student, First Year; Medical Student, Second Year, Medical Student, Clinical Years; Intern; Resident; and Attending. There are no sections for pre-meds, retired doctors, or other programs (naturopath, chiropractor).
The editors have done a good job of picking well crafted and evocative poems. A dozen have been previously published. For the most part, the poems are short, easily fitting on one page. Almost all are in free verse, although there is one group of haiku, one prose poem, and an impressive sequence of ten Shakespearean sonnets “Breughel at Bellevue” by Anna Reisman.
Many poems treat dramatic moments in training: the anatomy lab, first gynecological exams, physician-patient relationships, especially when a patient is gravely ill or dying. Several poems in the first three sections comment on the differences between the normal social world and the intense medical world of the hospital. Throughout there are references to the pressures of high-tech, unfeeling medicine. Indeed Jack Coulehan sounds this theme in his introduction; he writes that "steadiness and tenderness" are both needed in medical practice.
As an anthropologist with training in comparative biology, Jablonski is particularly interested in the natural history of humans: how did humans evolve to gain the varied appearances we see today? In particular, she investigates how our skin developed into a covering that is unique among animals in three ways: (1) it is naked--effectively hairless--and sweaty, (2) we come in a wide array of colors (not just the traditional four), and (3) we use our skin as a surface for decoration, a "social placard," which we cover or bare at will, and on which we put make-up, tattooes, scarifications, and piercings, all ways of expressing cultural and personal values.
Our ability to sweat allowed us to cast off the usual mammalian fur coat and to be active even in the heat of the day (when many creatures take shelter). Humans, therefore, could do more and be more as thinkers, builders, and social creatures.
As to our color variations, Jablonski argues that the main root of modern humans came out of East Africa; these people were black, because a lot of melanin in their skin was the best way to avoid too much ultraviolet radiation, although some is needed to create Vitamin D. As humans migrated to the north and the south, Darwinian selection favored lighter skin pigmentation in order to use the lower levels of sunlight.
Jablonski writes, "Dark skin or light skin, therefore, tells us about the nature of the past environments in which people lived, but skin color itself is useless as a marker of racial identity" (p. 95). And, noting an irony: "Naturally dark people in many parts of the world are increasingly seeking ways to lighten their skin, while the naturally light-skinned are trying to find new ways to darken theirs" (p. 159).
We often take our skin and all its functions for granted; our consciousness can change quickly, however, if we experience a skin disease, a sunburn, or a thermal burn (see Carter and Petro, Rising from the Flames: The Experience of the Severely Burned). Jablonski discusses a variety of illnesses, including burns, dermatitis, and skin cancers. Other topics include the importance of touch, how skin relates to emotion and sex, and experiments in artificial skin, useful for covering patients with severe burns.
Jablonski presents a dozen color plates, 44 figures, and maps to enliven her text.
Fraser’s subtitle is accurate; this book tells about a middle-aged woman rediscovering her difficult past of incest from her father and abuse, as a child, from another man. She tells her life story of growing up in a working-class neighborhood in Hamilton, Ontario, Canada, going to university, marrying, and becoming a journalist. All the while, anger and rage fuel her, but it is only after surgery (for fibroids) and psychotherapy that she can recall the abuse and has it corroborated by others. Fraser understands that her personality split into three personae; she uses her dreams, her writing (including six novels), and her childhood drawings to understand what happened to her. Finally she is able to forgive her father (although after his death) and continue with her successful career as a writer.
Sims sees his book in the tradition of blazons anatomiques, “poetic tributes to the individual parts of the female body” originating in France in the mid-sixteeenth century. He adds, of course, men, including Adam. Working from head to toe, Sims assembles a very wide variety of scientific facts, cultural perceptions, and representations of the human body by artists, writers, and scientists.
Sims sticks to the outside of the body—no internal organs, nor, it follows, no sense of the integrated body. After a brief Overture (on skin), Part One, Headquarters, treats hair, face, eye, ear, nose, and smile (mouth). Part Two, The Weight of the World, discusses arms, hands, breasts, and the navel. Part Three, “A Leg to Stand On” (but no mention of Oliver Sacks), deals with “Privy Members” (the genitals), the buttocks, legs, and feet. There is no concluding chapter.
Sims draws on sources as diverse as Greek myth, Darwin, Lombroso, French painters, movies, popular culture, Jane Goodall’s chimps, the Bible, feminist writers, William Blake, etymologies, anthropologists, and modern science writers. There are some references to Native American cultures, Africa, and the East, but he stays mostly in the Western tradition.
Chapter 8, “The Monkey’s Paw,” is a good example of Sims's method. He discusses (in this order) handshakes, carpal tunnel problems, Michelangelo’s God and Adam on the Sistine ceiling, the “phalangeal formula” of handbones in mammals, Jesus’s crucifixion, Robert Schumann’s hand troubles, the importance of the thumb for humans, fingerprints, palmistry, and handedness (Ben Franklin was left-handed) and more in 40 pages. The interesting facts keep coming, but there is no basic theme or concluding overview.