Summary:

Twelve contemporary stories set in Rhode Island and New York City. Major themes include the pain of cultural dislocation and cross-cultural experience ("Theng," "Shambalileh," "My German Problem"); human frailty and self-deception ("Sleep," "Juilliard"); and the personal and moral dimensions of medical practice. See the separate annotations for Laundry, The Good Doctor and Ambulance--three stories which are particularly relevant to Literature and Medicine.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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The poem depicts a fiercely wild and free woman who meets an untimely death in a motorcycle accident. The anatomy student views the cadaver as more than just "thirty-one-year-old female flesh," and fantasizes about what her life (and death) must have been like.

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Sea Creatures is Dr. Vernon Rowe's first collection and contains forty-eight poems divided into two sections: "Creatures of the Inland Seas" and "Out Far and In Deep." The poems are succinct and focused. Much of the imagery is derived from nature, as in the title poem, where the poet-neurologist-helicopter pilot likens his descent through the sky to a dive into a deep and ancient ocean. Poems in the first section are directly related to the poet's life as a physician; works such as "Paralyzed" "Brahms' First, First Movement" and "Wasted" are empathic portrayals of patients.

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A hapless country doctor describes with breathless urgency a night-time summons to attend a young patient. Events soon take on a surreal aspect as "unearthly horses" transport him instantaneously to the bedside. The doctor, preoccupied with personal distractions and grievances against those he is employed to care for, fails to find what is revealed to be a vile, fatal wound (symbolizing the Crucifixion?). He is humiliated by the villagers, who are "always expecting the impossible from the doctor," and doomed to an endless return trip, losing everything.

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This 14 line poem deals with a physician's compassion for a hopelessly ill patient ("An apparatus not for me to mend--") and his participation in active euthanasia. The patient, Annandale, was "a wreck . . . and I was there." The narrator asks the reader to view himself or herself "as I was, on the spot-- / with a slight kind of engine." (This "engine" is a hypodermic needle.) He concludes, "You wouldn't hang me? I thought not."

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In this long poem (47 quatrains), Annandale visits his doctor after years of absence and tells the doctor his story. When his wife Miriam died, he mourned her, "wept and said that all was done." Then he met Damaris, "who knows everything, / Knows how to find so much in me." Damaris, who became his second wife, comforts and accepts him. Even though sometimes "her complexities / Are restive" and she becomes angry, soon "She folds her paws and purrs again.

Annandale tells this story of late life happiness, then leaves the doctor's office. He never reaches home: "There was a sick crash in the street, / And after that there was no doubt, / Of what there was." In the last five quatrains, the doctor reflects on what he did for Annandale after the accident ("the one thing to do")--euthanasia.

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This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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This is a collection of short stories by a young physician, Stewart Massad, who completed a residency in obstetrics and gynecology and a fellowship in gynecologic cancer. The stories are all written in the first person, all physicians. The subjects include the physical/emotional demands of residency ("Fatigue"), especially as they strain a marriage; the motivations of a doctor who runs an abortion clinic ("Healers"); and a young doctor facing his own fatal illness and his experience as a patient ("Casualties"). While the stories do portray the difficulties (and often angst) of training, they do so without the despair/cynicism often found in other accounts of the same experience.

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The story is told from the perspective of an obstetrician's wife. She encourages her husband as he finishes school and gets his first job. Then she becomes pregnant. She tells of the changes in her body and in her perspective. Her husband is busy treating other women, while she goes to childbirth classes alone. He arrives just at the end of the birth. She wants him to be with her more often, but understands his need to be with his patients.

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