Showing 91 - 100 of 490 annotations tagged with the keyword "History of Medicine"

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is a huge and wonderful book about cancer, the collection of diseases that sickens people all over the globe and kills many of them. An epigraph to the book states, “A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer,” but the book also describes medical advances that now heal, prevent, or palliate most forms of cancer.

Mukherjee, a cancer physician and researcher, has several strong themes. He sees cancer as an affliction with a long history, a story worthy of a biography; indeed recent discoveries show it to be rooted in our genes (although external factors such as viruses, asbestos, and tobacco smoke can cause genetic disruption). The story of cancer implies a surrounding triangle, the stories of sick people, treating physicians, and biological researchers, all of which Mukherjee artfully weaves across 472 pages. Cancer has Rohrschach blot qualities: depending on time, place, and role in life, humans have perceived different attributes of cancer. As the book ends, however, there is a coalescence of scientific understanding that is satisfying—although there is certainly more to be learned and we are all still vulnerable to genetic errors and, of course, we are intractably mortal.

Another strand is the nature of stories themselves, their twists and turns, presumed early solutions, and personal and social values embedded in them. Mukherjee threads throughout the book the case of a contemporary kindergarten teacher, Carla Reed, who has a leukemia. He bookends his text with ancient Persian Queen Atossa with (presumably) breast cancer. Reed, healed by the end of the book, was Mukherjee’s patient; Atossa was described by Herodotus: both suffered emotional turmoil because of their disease.  Mukherjee understands the affective dimensions of disease for patients and caregivers alike; literature represents these in various ways, and he quotes in his chapter epigraphs and in his prose many writers who describe human experience deeply: Aleksandr Solzhenitsyn, Susan Sontag, Charles Dickens, Thomas Mann, William Carlos Williams, Carlo Levi, and Italo Calvino, to name a few.

The primary story, however, is the interplay of cancer and a large cast of observers, investigators, doctors, scientists, activists, and government officials. Sidney Farber and Mary Lasker dominate the first 100 pages with their two-decade war against cancer. While surgery—historically dramatic and disfiguring—had been a mainstay for treatment of cancer, Farber pursued a biochemical route, which elaborated into chemotherapy, the second major approach of the late 20th century.

Mukherjee also explains ancient views, Hippocrates’, Galen’s humors, Vasealius’ anatomy, Hunter’s stages, Lister’s antisepsis, and Röntgen’s X-rays, which became the third major approach. By 1980, however, the American “War on Cancer” had not been won.

Further advances in cellular biology and genetics would be needed to make targeted molecular therapy possible.  Mukherjee tells this complicated story clearly and engagingly, showing the human investigators to be personable and dogged in their pursuits.  

Another important approach is prevention. The biostatistical work of Doll and Hill, for example, showed the links between tobacco and lung cancer. Screening, such as Pap smears and mammograms, also saved lives, but the basic cellular understanding still eluded investigators.

The final 150 pages explain the search for and discovery of genetic factors, specifically oncogenes. Harold Varmus and J. Michael Bishop were the leaders, winning a Nobel Prize in 1989. Bert Vogelstein, Judah Folkman, Robert Weinberg and Douglas Hanahan took the work further, opening the doors for such drugs as Herceptin, Gleevec, and Avastin. 

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Candice Millard portrays several figures in the 19th century whose lives came together to change history: newly-elected President of the U.S. James Garfield; the insane would-be assassin Charles Guiteau; Doctor Bliss, the arrogant physician who claimed control of Garfield's care; Alexander Graham Bell, who invented a device to find the bullet; and major political figures of the time. Ironically, Garfield attended the Centennial Exhibition in Philadelphia in 1876 where Joseph Lister was displaying his germ theory of infection and Alexander Graham Bell demonstrated his telephone. But when Guiteau shot Garfield in 1881, the bullets did not kill him.  What killed him after months of suffering was the massive infections caused by the doctors' probing without clean hands or clean instruments. At the autopsy, the doctors saw evidence of massive infections, but the bullet was encysted and harmless. All the probing by the doctors created a tunnel, but it was not the path of the bullet.  "Gentlemen, we have made a mistake," said the doctor.

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The Story of San Michele

Munthe, Axel

Last Updated: Nov-14-2011
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The author takes us on a highly colorful autobiographical tour of his medical career - his personal life never enters this account - from a classical medical education in Paris as a young expatriate Swede (he remains expatriate the entire book) to his internal medicine practice in France, including a tour of Naples as a volunteer during the cholera epidemic of 1881 and his finally settling in Italy. There are also anecdotes - many of them side-splitting and told with uncommon skill - about conducting a corpse back to Sweden, a truly thrilling journey to Lapland,  encounters with the legendary Charcot, his return to San Michele whence the book begins with a mythopoetic retelling of his first visit there, and his last years at San Michele as patron of a community (both local and international) and as collector and explorer of the nearby Mediterranean.        

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In the eighteenth century, Europe began to take stock of the horrific infant mortality in foundling homes and hospitals. Infant feeding and care became a major preoccupation for charities and philanthropic doctors. Some organized systems of wet nurses in the communities and institutions to provide for motherless children. 

At the same time, syphilis was becoming a serious problem in newborns. The sexually transmitted disease, which swept the continent following the voyages of Columbus, was known to affect babies born to infected mothers. Since the early sixteenth century, doctors had been convinced that mercury was of benefit.

Founded in 1724, the Vaugirard Hospital of Paris was the city’s home for orphans. By 1780 it had made room for mothers with syphilis and their children.  Sometimes the mothers died, or well-off families would abandon their sick children. Healthy wet nurses were engaged to feed these babies.

Eventually, the wet nurses were viewed as a technology—a vehicle--for administering mercury to the babies through their milk. Many of these healthy women fell ill, either from the mercury or by infection from their charges. Nevertheless, the practice continued into the nineteenth century. The wet nurses did not know (or were not told) that the children were infected. The physicians in charge of this experiment also attempted unsuccessfully to vaccinate the wet nurses against syphilis. That experiment also spread the disease.

Remarkably, some wet nurses brought suits against the doctors or the birth families. Occasionally they won damages, and finally the law was changed to offer greater protection.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

An engaging historical analysis of several aspects of the history of madness and art. It includes chapters on the history of

- the portrayal of mentally disturbed people;

- the idea that creative genius is enhanced by mental illness;

- architecture of psychiatric hospitals;

- art therapy; and

- the use of art as a semiotic tool for diagnosis.

Several case studies of individual artists, such as Richard Dadd or Adolf Wölfli are used to exemplify each theme. Special attention is given to artistic movements such as romanticism and expressionism. It is completed by excellent endnotes, a good bilbiography, and detailed annotated index.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The journalist author investigates the hidden lives of his father and his grandfather, both physicians. He is motivated by the mysterious silence that pervaded the ancestral home in a wealthy Toronto neighborhood, and by the frightening tendency to depression and suicide that stalks his family members like an Irish curse.

He uncovers many details of the early adventures of his parents, the failure of their marriage, and his father’s doomed career. From his beginnings as a debonair socialite, the father, Jack, embarks on a promising medical career as an allergist; however, he virtually sinks into taciturn misery and alcoholic self-destruction, unable to express affection or joy. Jack’s endless travails as a patient through shock therapy, analysis, and heavy psychiatric drugs are presented in merciless detail using hospital records and interviews with caregivers. The author’s self-indulgent anger with his self-absorbed father drives the research deeper into the earlier generation, to learn about the grandfather of whom his parents rarely spoke.

The author's grandfather, Irish-born John Gerald FitzGerald (1882-1940), son of an immigrant pharmacist and an invalid mother, strode through the exciting scientific world of the early twentieth century like a medical Forrest Gump. At first, he is drawn into the new fields of psychoanalysis, psychiatry, and neuropathology; cameo appearances of Freud, Ernest Jones and C.K. Clarke light up the story. But then this elder FitzGerald is swayed by the need to control infections and produce vaccines. He travels Europe and the United States for three years learning bacteriology.

Upon his return to Canada in 1913, he fearlessly launches a Canadian-made solution, outfitting a stable and a horse farm to produce rabies vaccine and diphtheria anti-toxin. The initiative evolves into the famous Connaught Laboratories and the School of Hygiene, its academic arm. Other luminaries enter the story– such as Banting and Best of insulin fame and C.B. Farrar of psychiatry. FitzGerald served as Scientific Director of the International Health Division of the Rockefeller Foundation and as Dean of the University of Toronto medical school.

Nevertheless in his late fifties, having accomplished so much, the grandfather crashes into doubt, depression and self-destruction, believing himself a failure and consumed with guilt for some never-disclosed transgression. Did his stellar achievements, his high expectations, and his baffling demise dictate the collapse of his son Jack?

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Annotated by:
Donley, Carol

Primary Category: Literature / Nonfiction

Genre: Investigative Journalism

Summary:

In 1951 when Henrietta Lacks was dying of cancer in the colored ward of Johns Hopkins, cancer cells taken from her without her knowledge "became the first immortal human cells grown in a laboratory"(4).  Known as HeLa cells, they are still reproducing today and are used world wide in research for cancer, cloning, genetics, Parkinsons, and many technologies. Henrietta's family did not know she was the source of these immortal cells until scientists began testing the family members too.  Poor and black, they were very angry to find the white establishment had made fortunes using HeLa cells while the family got nothing for it and couldn't even get good health care. In her thorough and careful investigation, Rebecca Skloot interviewed the Lacks family; scientists, doctors, and others who worked with HeLa cells; historians; journalists; ethicists. This book traces the complex stages of her search for the truth about what happened to Henrietta Lacks, her HeLa cells, and her family.

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Tainted

Pennie, Ross

Last Updated: Sep-01-2010
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Zol Szabo, is public health doctor for the Hamilton Ontario region. He is also a single parent to a seven-year-old, Max, because his wife could not deal with Max’s physical disability. But Sol thinks there is hope for Max in an injection of a miraculous new substance called “Endotox” that may loosen the contractures of his arm. Soon he his investigating a cluster of variant CJD (mad cow) cases that may be related to Endotox. But they also seem to be connected to the grocery store where Sol does his shopping. The products that all victims had in common were an imported candy and a sausage, both Max’s favorites.

Conspiracy theories about corrupt pharmaceutical companies and the antics of a pair of unethical mink farmers lead the investigation in many different directions, all personally threatening to Sol because of the health of his son or the ire of his boss. Pressure from his superiors to avoid publicity cramps Sol’s freedom. He seeks help from an attractive woman detective who, of course, sticks with him to the terrifying (and satisfying) conclusion.

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The Gross Clinic

Eakins, Thomas

Last Updated: Jul-22-2010
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Professor Samuel D. Gross of Jefferson Medical College is demonstrating an operation for osteomyelitis of the femur in the surgical amphitheater in 1875 in this highly dramatic, powerful scene. Light glints off his forehead, and his visage is stern, calm, and surrounded by a halo of gray-white hair. The bloody fingers of his right hand hold a blood-tipped scalpel. He appears to have just made an incision and is turning away to demonstrate his work.

To the surgeon’s left is the patient, lying in right lateral decubitus position, with exposed leg and buttocks. Assistants are retracting the wound, further dissecting within it, and holding the patient’s legs. Blood is on their hands, instruments, and the patient’s leg. The patient’s face is obscured by the chloroform soaked towel that the anesthetist is using to administer general anesthesia. The white of this towel and the operating table’s sheet are the only other bright white values besides the surgeon’s head in this mostly dark painting.

Adding to the drama is the stricken pose of the patient’s female relative--to the surgeon’s right. For charity cases, a family member was required to be present during the surgery. She averts her head and raises her hands, clenched in a claw-like fashion, to block her view.

In the gallery are variously interested and disinterested observers--mostly medical students--in casual poses and dimly seen. The exception is the artist’s self-portrayal--he is studiously drawing in the front row. Dr. Gross’s son (also a surgeon) is standing in the entry tunnel.

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This guide identifies short film clips designed to support “Cinemeducation,” word and method both coined by the editor Matthew Alexander. The editorial team consists of three family therapists--two psychologists and a social worker—with input from 26 other psychologists, behavioral scientists, and family physicians—all American, with the exception of one Brazilian. Most contributors train residents in family medicine. Both more and less than a scholarly treatise, this book is predominantly an annotated index.

Thirty short chapters are devoted to various subject themes: chronic illness, sexual behavior, aging, substance abuse, research, and medical error. In a paragraph or two, the clinical problem is outlined, then subheadings introduce specific, related keywords exemplified by the scenes selected. The plot and main actors of every film are summarized briefly at its first mention; a single movie can be cited in several different chapters. Each clip is similarly described and located precisely within the film (minutes and seconds).

In this manner, 125 films are parsed for 400 scenes, ranging in length from 1 to 6 minutes.  Most are Hollywood films, released since 1980. Questions for discussion accompany each film clip. The consistency and concise descriptions are admirable, but, sadly, the year of release is not supplied. 

A few chapters break from this format. One discusses aspects of technology. Another attempts evaluation of this teaching method through a ten-year retrospective survey of physicians who had been exposed to films in residency. The response rate was 60% but a fifth were rejected because the respondents could not recall the use of films. The remaining 48% who could remember the use of film clips found the method memorable, fun, and effective; however, they thought it would benefit from more context and amplification.

Appendices point to similar resources and more films under other keywords without details. This database is cited by URL without any description.

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