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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.
Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.
The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.
Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.
Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."
This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."
The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).
The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.
Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.
The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.
The author of this memoir is a poet and writer who developed systemic lupus erythematosis (SLE) during her first year at the University of Pennsylvania. Initially, her condition was difficult to diagnose, which led to her first negative encounters with physicians and the health care system. Later, Ms. Goldstein developed unusual neurological manifestations of SLE. Once again, she had trouble convincing her doctors that her symptoms were not only real, but also disabling. She was fortunate enough to come across a few good physicians who respected her as a person and earned her trust.
Despite her chronic illness, Ms. Goldstein thrived throughout college and graduate school. She approached each new challenge with such a positive attitude that some of her doctors considered her emotionally unstable. (I guess they thought it would be more "normal" for her to lose hope and turn herself into an invalid.) Her graduate work in literature focused on the new field of literature and medicine.
Fred McCann is an energetic man in his thirties, something of a playboy, when the Second World War breaks out. He becomes a soldier, and in an Italian village one day he goes to a pump for a drink of water. The pump is booby-trapped and explodes. He is blinded and loses all four limbs. The story traces the development of a relationship between Fred and Alice, his nurse in the military hospital.
As he learns to submit to being entirely helpless, reliant on Alice for all his needs, he gradually begins to adapt to his new condition. Then Alice changes everything by having sex with him. At first their new and obsessive relationship makes him happy, restoring some of his old sense of himself as a man. When Alice is moved to another duty and replaced by a sadistic male nurse, Fred is so devastated and makes such a scene that he gets Alice back.
To celebrate her return, Alice sneaks some whiskey into his room and they get drunk. She then says something that appalls him: she calls him her "thing" and confides that she has always hated men, who look at her and touch her and have power. Fred is nauseated, seeing himself reduced to nothing more than a "a phallus on its small pedestal of flesh." He realizes now that he is no longer a man, and later that night he manages to drag himself out into the garden, where there is a small pool in which he drowns himself.
In 371 E. C. (Efican Calendar) a woman named Felicity Smith gives birth to Tristan, a child with such severe congenital defects that the doctors advise her to let him die. Felicity is an actress and the head of a theater troupe in Chemin Rouge, the capital of a small fictional country called Efica. Instead of getting rid of her son, Felicity takes him to live in the tower of her theater.
The boy actually has three fathers (Bill, Wally, and Vincent), each of whom in his own way accepts responsibility for the horribly deformed child. The boy grows up with the ambition to become an actor, even though he is only three and a half feet tall, his speech is almost unintelligible, and he inspires revulsion in almost everyone that he meets for the first time. Nonetheless, he thrives in the close-knit theatrical community.
When Tristan is eleven, agents from Voorstand murder his mother, who has entered politics and become a "persona non grata" in Voorstand. Tristan also fears for his life, but nonetheless avenges his mother's death by writing subversive pamphlets. Many years later, at the ripe old age of 23, Tristan and Wally (one of his fathers) travel illegally to Voorstand where they encounter many adventures before the novel comes to a satisfactory conclusion.
Dingle the Fool lives in the family home with his two sisters, their husbands, and their infant children. Their mother left the house to all three in equal shares. One sister, Joanna, wants to sell the old place and buy a modern home. The other sister, Dierdre, wants to remain in the house, especially for Dingle's sake.
Dingle plays in the mulberry patch and doesn't seem to understand much. He has a dirty old tennis ball that he believes is full of happiness. One day Dierdre gives in and agrees to sell. When she tells Dingle, he cuts the tennis ball in half, intending to give part of it to his sister.
However, when he sees that the tennis ball is empty (no happiness!), he cries and goes out to climb his favorite tree. Later that night, the house burns down. But Dingle is found safely sleeping in his tree. Joanna and Dierdre face the prospect of a lovely new house, but Dingle has to go to an institution.
The story covers the months from early diagnosis of a retinal disorder through stages of treatment and loss of vision to a six-month stay at a residential facility to train the newly blind in life skills, including Braille. Sally Hobart was a 24-year-old elementary school teacher when she began suddenly and rapidly to lose her vision.
In the months that followed, she went through several surgeries and other treatments that are sometimes successful in restoring vision, but all efforts failed. She was left with very cloudy partial vision--only enough to distinguish colors, light and dark in the lower half of the vision field.
She tells about the fear, the frustrations of partial information and false hope, the tension between herself and her fiancé (they finally called off the engagement), the support (and also confusion and pain) of friends and family, and the emotional adaptation to a whole new life while learning to become independent as a blind person.
This work touches upon a wide range of issues, more or less closely related to the trauma surrounding, the management of, and the aftermath of sustaining a serious burn. Divided into three sections, the work first defines burns not only on a biological basis, but as distinguished psychologically and historically from other forms of physical trauma.
In Part II the authors explore ancient myths and then images from modern culture that they contend define social perceptions about the meaning of being a burn victim. The final section poses problems that remain in the technique of burn management in its most holistic sense. An extensive bibliography/filmography completes the book.
The short stories and poems collected in this attractive large-format volume are arranged in sections that focus on particular problems and crises children may face that isolate them from "normal" peers. Themes include sickness, disability, hospitalization, loss, conflict, developmental change, and loneliness.
The stories are simple, most 2-3 pages followed by a few questions to talk about. Each story is accompanied by hand-drawn illustrations. Characters featured in the stories represent a range of ethnicities and socio-economic situations. An introduction gives guidelines to help adults use the book as an instrument for helping children cope with difficult times.
Julia Sweeney performs on film the dramatic monologue that she wrote and performed "live" on stage. The period of her life on which she focuses are the nine months of her brother's dying, when he and her parents moved into her home--an idyllic bungalow that she had set up for herself, following her recent divorce. Instead of having the opportunity to enjoy the freedom of being single again, she is thrust into the thicket of family relationships, the sadness of her brother's poor health, and the demands made by his treatment for lymphoma.
Her parents, she says, have always been for her a "source of comedy, or a reason to be in therapy." These are the resources Sweeney is able to tap as she comments with humor and insight on living like a child in her own home, as her mother takes over the household and bickers with her father, who is drinking too much. But even as she jokes about the clash in lifestyles between herself and her parents (after all, she hasn't lived with them for 16 years), she weaves into the narrative the nature of life with her brother, whom she accompanies for his daily radiation treatments and whom she ministers to as he undergoes chemotherapy.
While not minimizing the seriousness of her brother's illness, she (as well as he) can find the surreal humor in their medical encounters. Thus Julia Sweeney describes how, when scar tissue prevents further injection into his spinal fluid and the doctors recommend a brain "shunt" for that purpose, assuring them that other patients "love their shunts," brother Mike not only agrees to the procedure, but adopts the slogan, "I love my shunt" for every conceivable situation.
The surreal becomes the real when Julia learns that she too has cancer--a rare form of cervical cancer that will require a hysterectomy. Even as she describes her shock and horror at this new blow, Sweeney takes comfort in Mike's sense of humor: he accuses her of getting even with him for taking "the cancer spotlight." Her narration of picking up her own pathology slides and of making the decision not to have her ova ("eggs") harvested and fertilized are both funny and poignant.