LitMed: Literature Arts Medicine Database

The Expendable Man

Hughes, Dorothy

Last Updated: Aug-25-2023

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A young man, an intern at UCLA Medical Center, is heading out of Los Angeles on his way to his niece’s wedding in Phoenix. He has signed out for the long weekend and he is eagerly anticipating some time with his family, which will include (though he doesn’t know this yet) his niece’s college roommate, an eligible young woman from a prominent Washington, DC, family, who will be at the wedding also. Driving his mother’s late-model Cadillac, with his suitcase, medical bag, and his father’s golf clubs in the trunk, he is fifteen miles out of Indio and in the middle of nowhere when he spots a teenage girl by the side of the road. She’s a bit disheveled and is carrying a small canvas travel bag and a white plastic handbag and nothing else; she looks to him like the girls his younger sisters refer to as “cheap.” He pulls over and rolls down his window. She is sullen and somewhat evasive in answering questions, and she happens to be going to Phoenix also. Hugh feels that he can’t just leave her here, in the desert, where who knows who she might encounter, so he
offers a ride; he decides, however, that he will drop her off at the next town, where she can catch the bus.

What could possibly go wrong, right?

This is the set-up of Dorothy Hughes’ The Expendable Man, and the answer is, of course, plenty. It is not a big reveal to say that the girl’s motives seem dubious and she proves hard to be rid of, being dropped off and then showing up again, including showing up at Hugh’s Phoenix motel room, where he refuses to speak to her. It is not even a big reveal to say that the morning after she shows up at his motel room her body is found in a canal on the outskirts of Phoenix, and the autopsy reveals her to have been pregnant—and aborted. Nor is it a big reveal—indeed, it is only logical to assume—that the suspicion of the local police falls on Hugh, the last person—and conveniently, a physician—known to have seen her alive. It will be up to Hugh to prove his innocence despite the damning circumstances.

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Your Hearts, Your Scars

Talve-Goodman, Adina

Last Updated: May-25-2023

Field, Steven

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This slim volume of essays written by a young woman who had a heart transplant packs a wallop, albeit an understated one. The author, who had a congenital cardiac anomaly that required several surgeries—the first at one day old, another five days later, two more at the ages of two and four years—ultimately developed severe congestive heart failure at sixteen and underwent cardiac transplantation at the age of nineteen (none of this, by the way, is a spoiler; the introduction, written by her sister, lays this out in detail). Eleven years later she developed lymphoma, a side effect of the immunocompromise induced by her anti-rejection medications, and passed away at the age of 32. This book was published posthumously, the essays collated and edited by her sister and her friend and colleague at the literary magazine One Story.

The essays—there are seven of them—deal with life experiences, mostly in the form of encounters with other people, mostly post-transplant. “I Must Have Been that Man,” which won the Bellevue Literary Review’s Non-Fiction Prize, begins with a post-party liaison but centers on the author’s meeting with a man in an upended wheelchair out on the street on a rainy night; “Men Who Love Dying Women and Fishing” speculates about what might attract a man to a woman with a terminal illness; “Your Heart, Your Scars, Zombies” offers a novel take on the idea of a zombie occupying a liminal space between the living and the dead and analogizes that to the situation of the post-transplant patient; “Thank God for the Nights That Go Right” speaks to the serendipity—or Higher Power?—that seems to guide our experiences. They range over the timeline; one recounts a pre-transplant trip with other ill children to San Diego, others come from later in the author’s life. There is no linear temporal progression to the essays; rather, one gets the impression that they are simply being remembered spontaneously. Nonetheless, a clear personal narrative emerges.

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Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe

Poe, Edgar Allan; Hawthorne, Nathaniel

Last Updated: Jan-25-2022

Field, Steven

Primary Category: Literature / Fiction

Genre: Anthology (Short Stories)

Summary:

Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe is one in a series of books called Literature and Medicine dedicated to the exploration and explication of the intersection of the two titled disciplines. This volume, edited by L. Kerr Dunn, looks at the short stories (mostly—it includes one sonnet) of Nathaniel Hawthorne and Edgar Allan Poe from the viewpoint of each author’s use of, and in some cases experiences with, doctors, diseases, and the medical profession. The volume begins with an Introduction that situates the writings within the medical and social milieu of the period (the authors were contemporaneous) and illustrates the way in which the tales reflect the times.

The stories are grouped by author and arranged chronologically. Among the nineteen entries included are “The Minister’s Black Veil,” “Lady Eleanore’s Mantle,” “The Birthmark,” and “Rappaccini’s Daughter” for Hawthorne, and “The Black Cat,” “The Fall of the House of Usher,” “Berenice,” and “Some Facts in the Case of M. Valdemar” for Poe; each entry is preceded by a brief introduction and followed by discussion questions. An extensive list of scholarly references closes out the volume.

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Oli Otya? Life and Loss in Rural Uganda

Bruell, Lucy

Last Updated: Oct-27-2021

Field, Steven

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Most of us are aware that the discipline of Palliative Care, with its focus on excellent pain management, other comfort measures, and psychosocial and spiritual counseling, has made a dramatic difference in the way patients are treated near or at the end of life. However, for most of us, knowledge of Palliative Care is usually limited to how it functions in so-called “first world” countries. What is Palliative Care like in areas around the world that have less-effective systems of health care delivery?

Lucy Bruell’s documentary, Oli Otya: Life and Loss in Rural Uganda, aims to tell this story. Bruell, an award-winning documentarian (and coincidentally—and full disclosure—the Editor-in-Chief of the NYU Literature, Arts, and Medicine Database), follows a husband-and-wife team, an internist and a palliative care specialist, who travel each year to Uganda to volunteer with a small palliative care service based in a rural hospital. Along with the team nurse, nursing assistant, and spiritual counselor, and a medical student who has accompanied them for this trip, they see patients in the hospital, the clinic, and most of the time, in the patients’ homes, often covering many miles in a day in this rural area of the country.

It is the stories of these patients that constitute the heart of the film. A woman who has been catastrophically burned in a revenge crime, a man with metastatic cancer who can no longer walk, a woman with end-stage rheumatic heart disease who insists on gifting the team with a live chicken for their work, a young man with a progressive neurodegenerative disease whose mother ascribes his behavior to demons—we meet these and other patients as the team makes its rounds, interacts with villagers and herbalists, and fights to overcome shortages of critical medicines.

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THE GREAT INFLUENZA: A Story of the Deadliest Pandemic in History

Barry, John

Last Updated: May-25-2021

Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

John Barry’s The Great Influenza is a deep dive into the history of the influenza pandemic of 1918. But it is not simply a deep dive into the purely medical aspects of that history—as no medical histories truly are—but is in addition an exploration of the social and political currents of the time that coexisted with and facilitated the pandemic.

Although his story opens with the establishment of the Johns Hopkins Hospital in 1876, Barry immediately takes a detour into the history of medicine dating back to Hippocrates, and traces the history of medical/scientific thought from Ancient Greece to the end of the 19th century. He then introduces a series of physicians, scientists, and medical researchers who will play their parts in the story of the pandemic (this first section is called “The Warriors”) and outlines their training, research, and interactions.

It isn’t until page 91 that he takes us to the rural Kansas county in which the story of the pandemic begins. For although it was called the “Spanish Flu,” that was actually an eponym of convenience; in fact, the first cases of pandemic flu seem to have arisen on the American prairie. However, newspaper reporting on the new pandemic was felt by the Allies and Central Powers alike to be contrary to the public interest (the war was still raging), so it was left to neutral Spain, whose king had come down with the disease, to publish the early reports. In this section, “The Swarm”, Barry also briefly reviews the basic (not to worry, very basic) microbiology of viruses and the history of some prior pandemics. He follows this with the section called “The Tinderbox,” in which he traces the events leading up to the entry of the United States into World War I, and the importance of that war and the political and social conditions surrounding it in the history of the pandemic. From here on in the influenza itself takes center stage; in sections called “It Begins,” “Explosion,” “Pestilence,” “The Race,” and “The Tolling of the Bell,” the rapid and lethal course of the pandemic is described in gripping (no pun intended) detail. The last two sections discuss the scientific advances (and some false starts) brought about by the cadre of researchers working day and night to tame the outbreak, and then Barry finally turns to the retreat of the virus and ultimate end of the pandemic. The book ends as it began, returning to the stories of the individual men and women of science who engaged in the battle to beat the disease of which it had initially been said by many that “[t]his was, after all, only influenza.”

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The Flight Portfolio

Orringer, Julie

Last Updated: Jan-29-2021

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It’s 1940, and France has fallen to the Nazis, leaving the country divided between occupied France in the north, and so-called “Free France,” with its government at the spa town of Vichy, in the south. The Vichy government is headed by Marshall Phillippe Petain, a collaborationist puppet of the Germans running a collaborationist puppet state. But unlike the north, the south is still technically unoccupied, and people fleeing the Nazis from all over Europe make their way there in the hope of finding a way off the European continent, and so a kind of black market in emigration develops, centered in the port city of Marseille.

Among the groups working out of Marseille is the Emergency Rescue Committee, an organization set up by the journalist and editor Varian Fry and his friends, and with the support of Eleanor Roosevelt. The ERC has sent Fry to Marseille with a list of names of people to be assisted to emigrate, and the list is a Who’s Who of the European cultural elite: artists, writers, philosophers, and the like, many of whom are Jewish and/or have opposed the Nazis and are thus wanted by the Gestapo. It is Fry’s job to shelter them, get them fake transit visas, and ultimately smuggle them out, usually to neutral Spain or Portugal, or even directly to the States. The Vichy government, which has an agreement with Germany to surrender any identified fugitives, knows this is going on, and together with their German allies, is always hot on the trail of these now stateless refugees, and thus hot on Fry’s trail also.

The Flight Portfolio is based on several of the thirteen months Fry spent in Marseille as the representative of the ERC. Along with his staff, he “brings in” (and successfully gets out) Marc Chagall and his wife, Franz Werfel and Alma Mahler Gropius Werfel, Max Ernst, Lion Feuchtwanger, a young Hannah Arendt (“Name?” “Johanna Arendt. My friends know me as Hannah”), and others. All the while, he and his staff are but one step ahead of the agents of Vichy and the Gestapo. And during this time, Chagall has been compiling the flight portfolio, a collection of artworks which testify to the humanitarian crisis in Europe, to be smuggled out as a warning to the free world.

Complicating the issue—and a major part of the story line—is the fact that Fry, whose wife Eileen had stayed behind in New York City, has reconnected with a Harvard classmate named Elliot Grant with whom he had been romantically involved as an undergraduate. Grant has come to Marseille to be with Gregor Katznelson, a fellow Columbia University professor who has returned to Europe to find his son Tobias who has disappeared. Tobias is a brilliant young Berlin physicist and is wanted at all costs by the Gestapo for his scientific acumen and his value to weapons development. Gregor is desperate to secure his safe passage to New York. Fry promises Grant that he will get Katznelson’s son to safety. When the elder Katznelson returns to the United States, Fry and Grant resume their relationship, and Varian finds himself becoming increasingly emotionally involved with Grant and distanced from Eileen, although he still loves her. Ultimately Tobias shows up in Marseille; but there is another fugitive, a world-renowned and respected artist, who has been waiting, is in immediate danger, and needs to get out of Europe. And only one can leave on the waiting ship.

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The Winter Soldier

Mason, Daniel

Last Updated: Jun-20-2020

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When The Winter Soldier opens, Lucius Kszelewski, youngest son of a patrician Polish family living in Vienna, is on a train bound in the dead of winter for a field hospital in the Carpathian Mountains. It is 1915, and Austria-Hungary is at war with Russia. Lucius, a medical student, has completed only six semesters of medical school, but World War I has intervened, and due to a shortage of physicians in the army the government has decreed that students may graduate early, become doctors, and immediately be commissioned. Lucius has done so and is on his way to Lemnowice, a Galician village, where he believes he will work with other physicians and finally learn to be “a real doctor.”

When he arrives, he finds that the hospital is an expropriated village church overrun by rats and ravaged by typhus, and he is the only physician. The hospital is run by a nun, Sister Margarete, assisted only by orderlies, and the patient load runs the gamut from fractures and gunshot wounds to gangrenous legs and massive head trauma. The front is only a few kilometers away, and the wounded arrive continuously; the quiet and formal Sister Margarete confidently and surreptitiously guides him through rounds, surgeries, and battlefield medicine. Lucius is initially wary of her, perhaps a bit awed by her, and ultimately falls in love with her.

The transforming event is the arrival of the winter soldier, Jozsef Horvath, brought in from the snow mute and shell-shocked, but with no visible wounds. Lucius is fascinated by diseases of the brain and mind, and this patient presents a tremendous challenge. Lucius is sure that Horvath has “war neurosis,” what the British physicians of the time were calling shell shock and what we today would call PTSD, and he is determined to understand and heal him. Lucius and Margarete make slow progress with their patient, but his attempts to care for Horvath have unintended effects, and Lucius must then deal with the consequences of his actions.

The war, and the hospital routine, go on. One day, while Lucius and Margarete are relaxing in the woods, Lucius asks her to marry him. Margarete runs off, and Lucius returns to the village, but Margarete is not there. While Lucius and the staff search for her, Lucius gets lost; he stumbles onto a battlefield and is dragooned into service with a regiment of the Austrian infantry. He escapes and tries to make his way back to the field hospital, and to Margarete, but Lemnowice has fallen to the Russians. The hospital has been evacuated—and Margarete has disappeared. Lucius’ search for her will take him across the war-torn remnant of the Empire.

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The Eye in the Door

Barker, Pat

Last Updated: Jun-08-2020

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The Eye in the Door is the second volume in Pat Barker’s Regeneration trilogy (the first and third volumes, Regeneration and The Ghost Road are also annotated in this database). It continues the story of Dr. William Rivers and the soldiers he treats for shell shock, what we today would call Post-Traumatic Stress Disorder, in World War I era Britain. The action has now shifted from Craiglockhart War Hospital, near Edinburgh, to London; and while Rivers remains a primary character, seeing patients now at a London clinic, this volume focuses on Rivers’ relationship with Billy Prior, an officer who was treated at Craiglockhart after a service-related nervous breakdown.

Billy Prior, released from service on the Front and now serving on “home duty,” is working in the Intelligence Unit of the Ministry of Munitions, a domestic information-gathering and surveillance unit. England, on wartime footing, is rife with paranoia and conspiracy theories, and the primary objects of state surveillance are two groups of people felt to be disloyal or untrustworthy: conscientious objectors, or “conchies,” and homosexuals, who are seen as both abnormal and subversive. The state is unremitting in its hounding and pursuit of these two groups, and is in fact “the eye in the door,” always watching and ready to pounce.

Although Billy is an officer and has a position in the surveillance apparatus, he is living a double life, and is doubly at risk in this environment. He is bisexual; the book opens with him failing to complete the seduction of a young woman and promptly thereupon having a liaison with a fellow officer whose wife and children are out of town. This officer, who also works in the Ministry, has been vaguely threatened about his association with the presumed network of homosexual subversives. In addition, while Billy is not a pacifist, he has friends from his childhood in working-class northern England who are conscientious objectors. These friends may or may not have participated in terrorist activities, are either currently in jail or wanted by the police, and are no surer than Billy is as to exactly whose side he is on.

Prior plays a dangerous double game, attempting to use his position in the government to help his old friends, and continuing treatment with Dr. Rivers, as his past psychological traumas continue to intrude upon, and complicate, his personal and professional lives, building to a powerful conclusion.

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A Constellation of Vital Phenomena

Marra, Anthony

Last Updated: Jan-12-2020

Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Anthony Marra’s debut novel (published in 2013) is set in Chechnya, the rebellious Caucasus republic that broke away from Russia in 1994, was in short order mired in two wars thereafter, and ultimately lost its independence and was re-incorporated into Russia as a semi-autonomous “federal subject” state. Marra does not ease us into his story, but propels us headlong into it; it is 2004, and eight-year-old Havaa awakens to find that her father Dokka, suspected of aiding Chechen rebels, has been taken away by Russian troops, who have also burned her house to the ground. She is alive only because Akhmed, her neighbor and her father’s friend, has spirited her out of her house in the middle of the night and hidden her in his. Akhmed takes it upon himself to protect Havaa; he knows that the soldiers will be looking for her, because even though the official wars are over, Chechnya remains in the midst of a brutal battle for control, and the policy of the state is to “disappear” not only those it perceives as its enemies, but also their family members.

Akhmed manages to get Havaa to the abandoned local hospital, where he believes she will be safe. The hospital is staffed only by a smart, tough, and competent surgeon named Sonja, assisted by a nurse. Sonja is an ethnic Russian from the area who trained in London and then returned to her homeland. She agrees to shelter Havaa on the condition that Akhmed, who trained as a doctor but is painfully aware of his inadequacies in that profession (he wanted to be an artist), stay on also as her assistant surgeon. Soldiers and civilians on both sides arrive in need of care in a hospital barely functioning, with little in the way of staff or supplies.

Sonja meanwhile is searching for her sister who has disappeared into the chaos of the Chechen wars; she believes that Natasha is alive, but hasn’t heard of her, or from her, in years (we will, in the course of the novel, hear Natasha’s story and learn of another side of the underbelly of this war). She comes to believe that Akhmed may hold a key to Natasha’s whereabouts, and Sonja of course holds the key to whatever measure of safety exists for Havaa—and thus for Akhmed as well. Other locals, a local Chechen historian, his turncoat son, and various governmental and non-governmental functionaries round out the cast in the novel. Akhmed must negotiate in a world where anyone could be an informer, and one person clearly is; where the price for falling into the wrong hands could be death or worse; where federal troops and rebels vie to outdo each other in brutality; and where the rest of the population spends every waking minute simply trying to survive in a lawless society and a landscape gutted by ongoing strife. When the various narrative arcs ultimately link up the ending is a powerful one.

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Sapiens: A Brief History of Humankind

Harari, Yuval

Last Updated: Dec-17-2018

Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Yuval Noah Harari’s best-selling book “Sapiens” is subtitled “A Brief History of Humankind.” While this may seem to bespeak a bit of hubris—it would seem that 414 pages might be, despite the modifying adjective of the subtitle, a little too condensed to cover 2.5 million years (albeit only the last 70,000 or so in any kind of detail)—the impression after finishing is that he may have done it, or at least, done the effort proud. Mustering a combination of data and insights from the domains of history, archeology, genetics, biology, paleobiology, economics, and sociology, among others, Harari weaves an organized narrative that attempts to answer the questions of who we are and how we got here.

He divides the story into four assigned landmark periods in human history: The Cognitive Revolution (the earliest organization of humans into groups which evidence the use of tools and the beginnings of culture), The Agricultural Revolution (the impact of the learned ability to cultivate the land, with its shift from hunters and gatherers to farmers, and by necessity, from nomadic to settled tribes, and the beginnings of towns), The Unification of Humankind (the aggregation of people into larger groups and the emergence of money (and the earliest capitalism), religion, social expansion and conquest), and The Scientific Revolution (the development of science and the incredibly rapid acceleration of knowledge in the last five or six hundred years). The titles of the periods are, however, only guideposts, for the sections are broader in scope than simply farming or science. The section on the scientific revolution, for example, interweaves scientific progress with economics and imperialism (which are themselves interwoven, after all), religion, and philosophy. And that same section leads Harari to speculate, at the end, as to where the digital revolution and the development of artificial intelligence might be leading us and what we might say about our future as a species.

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