Summary:

The thirty-four autobiographical essays were written while Klass was a medical student in the Harvard class of 1986. Many of her short chapters were previously published as columns in magazines, journals and newspapers. The insightful but often funny stories cover a variety of scientific and clinical subjects, lifestyle, eating habits, and relationships with other professionals, including nurses.

Pregnancy and the birth of her son half-way though training makes her experience somewhat unusual. In several other essays, including "Macho" and "Learning the Language," Klass reveals her particular sensitivity to language and the advantages and disadvantages of professional discourse.

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Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.

For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.

An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.

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This is the most detailed and comprehensive biography of Anton P. Chekhov written to date. Rayfield is a Chekhov scholar who published an earlier biography of the writer in 1975. There are numerous biographies of Chekhov available. In the Preface to this book, Rayfield explains why he wrote it. Chekhov's life is documented by a vast amount of archival material, much of which was unavailable to Western scholars in the past. Russian scholars have studied these sources extensively, but the studies they have published use only a small part of the material. Rayfield's own study convinced him that by drawing liberally from these archives he could write a new biography that would increase our understanding of Chekhov's life and character.

Rayfield's approach is strictly chronological. The book consists of 84 short chapters, each one named and subtitled with the period covered (e.g. July - August 1894). Rayfield sticks closely to the texts, developing a rather staccato style that is heavy on factual statements and light on his own interpretations. He also chooses not to discuss Chekhov's writings as such, except to present brief summaries of the plays and some of the more important stories, and to indicate relationships between Chekhov's life and his art.

The new material gives us a much better view of the day-to-day texture of Chekhov's life, his interactions with family and friends, and his interesting and enigmatic relationships with women. The book also includes a helpful diagram of the Chekhov family tree, two maps of Chekhov's country, and many photographs.

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This is the narrative of an old doctor. Once greatly admired, he is now ridiculed by young doctors who find his techniques outdated and his lectures boring. His specialty is microbiology; his lab works on AIDS. His daughter asks him to support a group demanding that researchers release without so much delay the preventive drugs they are developing for AIDS patients. The doctor refuses on the grounds that the drugs need more testing. Later he finds out that his son is dying of AIDS.

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In this remarkable book of essays, Rafael Campo explores his coming-of-age as a gay Cuban-American physician. He presents us with a series of stories illuminating his childhood and college experience, skillfully interweaving them with narratives from his life as a young physician, especially his interactions with patients dying of AIDS. We follow the author from Amherst College, through Harvard Medical School, to his medical residency in San Francisco. At each step Campo is a close observer of human character and motivation--his own and others. At each step he asks, "Who am I? Who am I becoming?"

He discovers his identity as a gay man, an Hispanic man, a poet, and, finally, as a healer--not four identities, but one. He discovers, too, the healing power of connecting with patients, the "poetry of healing," something far different from the orthodox image of the physician-as-detached-or-distanced from his patients. Though Campo rejects the concept that physicians are agents for social change ("naive," he calls it), he brings sensitivity and poetry to bear on his continued search for "some way to give."

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The narrator of this long, lyrical musing is a psychiatrist who works with autistic children. Though much of the narrative is a reflection on her mid-life relationship with a journalist lover who risks death to report on places in political turmoil, her observations about her patients provide a recurrent motif and reference point.

Several long passages detail the fascination and frustration involved in working with her young patients, what she has learned from them about limits, patience, and the semiotics of autism. She also reflects on how that learning has allowed her to understand "normal" people differently. One of the subtle but strong themes of the story is the question of what "normal" means.

A secondary focus is her close attachment to her two grown sons. This is developed through memories of particular scenes of their childhood that she identifies as bonding moments. Another focus is her relationship with her mother, now dwindling into mental incompetence and squalor in her old age. Thinking about these relationships, with lover, sons, mother and patients, is a way of taking stock of how the strands of her life have brought her to a place of qualified peace in mid-life.

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Dr Bernard Rieux (William Hurt) says good-bye to his ailing wife at the Oran airport in South America. Their only child is dead. She has gone to the distant capital for tests and he plans to join her in a few days. But a mysterious epidemic of rats and what turns out to be bubonic plague breaks out. The city is sealed by draconian authorities who separate family members and drag people from their homes. Rieux decides to stay; months pass and his wife will die before he can see her again.

He befriends two stranded French journalists, Martine (Sandrine Bonnaire) and Tanto (Jean-Marc Harr), who volunteer as aides. They visit Joseph Grand (Robert Duvall) who keeps the cemetery statistics and writes an interminable novel. Tanto and Grand contract the disease but manage to survive under Rieux's care.

Constantly palpating her body in fear, Martine is desperate to flee, even as she strives to evoke passion from the emotionally numb Rieux. She is robbed and incarcerated by Cottard (Raul Julia) an unscrupulous profiteer. As the epidemic wanes, the journalists, the doctor, and Grand are reunited, but in that same instant Cottard shoots Tanto dead. Rieux and Martine are left sobbing in each others arms.

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A woman medical student finds herself in a hierarchical dilemma while rotating through her internal medicine clerkship. She is helping to take care of a middle-aged man who has been hospitalized for a diagnostic work-up. As a consequence of invasive procedures ordered by his physicians to determine the cause of his symptoms, the patient has suffered serious complications and is moribund. The doctors are evasive with the patient and his family, who beseech the medical student for an explanation. Even though she has been instructed by the physicians to refer all issues back to them, she follows her own convictions and tells the truth: "Your father is dying."

As a result of this "insubordination," she is called in to see the head of the department, a man of "legendary diagnostic skill" with a long tenure at the hospital. He says that he will have her dismissed, and launches into a long diatribe, making the case for a paternalistic medicine in which the patient needs to believe that the physician is omniscient and possesses quasi-magical healing powers. "Miracle, mystery, and authority," he says, are at the heart of what physicians can do for their patients and to undermine these is to do harm to the vast majority of the sick. Having made his point, he terminates the interview but reinstates the student, who, it is suggested, is so grateful (for his advice or for not being dismissed?) that she kisses him.

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This is a collection of stories and sketches by a practicing neurologist. Most of the material is clinical and autobiographical. In "Mrs. Bachman" a new patient enters the doctor's office, carrying a thick stack of medical records. It all started in 1946 and no doctor has ever found the explanation of her condition. Meanwhile, the doctor is wearing contact lenses for the first time. His eyes begin to tear. Mrs. Bachman thinks that he is crying over her misfortune. She consoles him, "I want you to know that you are the kindest, most sympathetic man I have ever met."

In "Intensive Care" an elderly woman is agitated after a seizure. The staff try unsuccessfully to calm her. Finally, her husband approaches and kisses her. She settles peacefully and they hold hands.

The doctor in "Continuing Medical Education" finally discovers metastatic breast cancer as the cause of a psychotherapist's neck pain, long after he and other physicians had told her again and again that the "driving mechanism" of her chronic pain was "unresolved anger and frustration." In a longer essay, "The Narrow Bridge," the author reflects on the meaning of healing, "Healing helps us find a place in this world for ourselves and for each other."

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As a young woman, Fermina Daza kept a lengthy and passionate correspondence with Florentino Ariza, who was socially her inferior, but was desperately in love with her. They became engaged through their letters, exchanged through hiding places and telegrams in code.

But one day, when Fermina Daza comes close to Florentino Ariza in the market, she feels suddenly ill and tells him it was all a mistake. Instead, she marries Dr. Juvenal Urbino, a European-educated perfectionist, who falls in love with her on a medical visit. Their tumultuous but affectionate marriage lasts over fifty years, through a civil war, cholera outbreaks and the Doctor's brief affair with a patient. Juvenal Urbino distinguishes himself by instituting policies to combat cholera. He dies, falling from a tree as he attempts to catch his pet parrot.

Florentino Ariza comes to the wake. He is now about seventy and controls a wealthy shipping operation. After the other guests leave, he approaches Fermina Daza, saying, "I have waited for this opportunity for more than half a century, to repeat to you once again my vow of eternal fidelity and ever-lasting love."

She throws him out of the house, but continues to think of him. He becomes a regular visitor. Finally, they take a boat ride together, down the rivers that are being slowly drained and poisoned, listening for the cries of the manatees. They do not return, but prepare to sail on forever.

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