Summary:

Children wasting away, in pain, infected with parasites whose life cycle continues "bodies to fingers, / fingers to lips, of lips to eggs / and eggs to worms." That cycle is echoed in the human experiences of "loneliness to pangs of loss" and of "deep escape to deep connection." The actual parasites take on symbolic significance and become the worm that inhabits us all, whether we be sick kids or weary health care providers.

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Pale, gaunt children from the backwoods hills of Kentucky bring their stool specimens to school so the visiting physician can check for worms. But these sinewy kids come from a long line of leathery ancestors "bred from one tough root"--and they keep on surviving whether they have worms or not. They "shall inherit" the earth, whether or not physicians treat them.

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Spoiler Alert: The ending of this thriller is revealed in the final paragraph of the summary. The threat of terrorism and the moral code of a physician place Dr. Collin Reeves in a very difficult position. The young American doctor is a specialist in parasitology and tropical diseases. He has trained and worked around the world - London, Kuwait, Brazil, and Africa. He presently practices in Mexico City. The U.S. Embassy refers sick American tourists to him. Dr. Reeves is also a CIA operative who enlisted after 9/11 to fight terrorism. After two years as an employee of the U.S. Intelligenge Service, he is disenchanted and wants out. Dr. Reeves is appalled by the brutal handling of terrorist suspects. It is his job to treat them and keep them alive long enough to obtain information or a confession.

Dr. Reeves loves Mexico, painting, and living day to day. He hates arrogance, disease, and human misery. His boss, Alex Law, is the chief of the CIA station in Mexico. He and his pal, Butch Nickels, have been in the spy business a very long time. Law is an alcoholic. His wife finds a lump in her breast that proves to be malignant. Dr. Reeves and his father (a surgeon practicing in San Francisco) arrange treatment for the woman in California where she undergoes a double masectomy.

Law has some clues that a group of al Qaeda in Mexico are plannning an attack. He worries they intend to bomb a city in California. Law's intuition is pretty good. A husband (Mohammad) and wife (Fatima) from Baghdad are set on revenge. Their young son was killed by an American bomb in Iraq. The husband, a physician, was mutilated by the same bomb. Unaware of her true background and her mission of destruction, Dr. Reeves falls in love with the beautiful woman who calls herself Dolores Rios. At one point, he kills a policeman and wounds another to rescue the woman. When her husband is bitten by scorpions, Dr. Reeves saves his life.

Members of the al Qaeda cell eventually capture Dr. Reeves and some of his friends. They plan to crash a stolen airplane into a California city. Dolores has a change of heart, but her husband is intent on revenge and becoming a martyr. Dr. Reeves offers to accompany the terrorists in exchange for Dolores being left behind. Still recovering from the effects of the scorpion bites, Mohammad figures it might be wise to have some medical expertise readily available. Shortly after take-off, Dr. Reeves manages to crash the plane but he is killed by gunfire in the process. The terrorist attack is averted. When Alex Law locates Dolores, he allows her to go free and start a new life. The doctor would have wanted it that way and Law allows him that much.

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Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.

In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.

The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.

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This book, designed to accompany an exhibition "on the frequently Excessive & flamboyant Seller of Nostrums as shown in prints, posters, caricatures, books, pamphlets, advertisements & other Graphic arts over the last five centuries," displays and comments on 183 illustrations associated with the art of quackery. As the title suggests, Helfand surveys the graphic material of quackery of England, France, and America during the modern period, although most of the material dates from the eighteenth and nineteenth centuries. In his introduction, Helfand discusses the uncertain boundaries between "regular" (now termed allopathic) physicians and their "irregular" or "empiric" counterparts--quacks.

Through the mid-nineteenth century, many practitioners of both sorts relied on pharmaceutical agents like mercury, antimony, and opium; developed trade symbols and packaging; and flaunted the honorific "Dr." and their affiliation with science. Many patients visited both regulars and irregulars, who might consult with each other. Some physicians even prescribed quacks' proprietary preparations. Helfand also notes differences, such as irregulars' lack of medical training, exaggerated advertising, refusal to disclose the contents of their products, and use of entertainment and sometimes even religion in their "medicine shows."

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Bewell examines the rise of "colonial geography," the assumption that disease naturally belongs to the colonial setting. He argues that British colonialism was "profoundly structured" by disease encounters, as diseases began to piggyback on the increased mobility of both troops and trade (2). The book traces colonial disease as both figure and reality in travel journals, diaries, medical treatises, prose, and poetry of the eighteenth century and the Romantic period. It focuses on the rising British anxiety about colonial disease from the mid-eighteenth through the mid-nineteenth century.

Romanticism and Colonial Disease examines the development of the field of medical geography, tracing the cultural meaning of various disease theories focused on climate, topography (disease landscapes), diet, habit, gender, and of course race. Bewell argues that British identity was based on a relational model, in which national health, and even "British" diseases such as tuberculosis, could be understood only in contrast to the tropical diseases that defined colonial lands.

The Asiatic cholera pandemic of 1817, as it approached ever nearer to British shores, shook the nation by explicitly showing that colonial disease had become global. Chapters focus on specific projects and problems, such as the doomed attempts to explore the Niger River and "open" West Africa to European trade, or the problem of the diseased colonial soldier, rather than tracing a general history.

Bewell includes readings of Tobias Smollett, Oliver Goldsmith, William Wordsworth, SAmuel Taylor Coleridge, George Gordon Byron, William Hogarth, Thomas De Quincey, John Keats, Charlotte Bronte, and the Shelleys, as well as little-known writers like Joseph Ritchie and Thomas Medwin.

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The journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC) in Atlanta, features artwork on its cover. Under the guidance of managing editor, Polyxeni Potter, these images are selected to enhance the journal's communication of its scientific public health content. Among the goals that govern the choice of its cover art are the editors' intention to illustrate ideas, stimulate the intellect, and fire the emotions (personal communication).

Acompanying each image is a one-page commentary on the artist, the topic depicted, and its relevance to infectious disease. Cover art (and commentary) from past issues can be accessed from the title page of each current issue.

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This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Edgar Drake, a forty-one-year-old English piano tuner, accepts a commission from the 1886 British War Office to tune an Erard grand piano located in a colonial military outpost in Mae Lwin commanded by Surgeon-Major Anthony Carroll. Edgar leaves the squalor, fog and drizzle of London, as well as his middle class life and his wife Katherine, childless for eighteen years, for a journey by boat, train, carriage and horse to the exotic, intoxicating beauty of Burma.

En route, Edgar is surrounded by stories--a tale by the deaf Man With One Story, rumors about the legendary, eccentric Carroll's peace-making with the local Shan via music and cultural exchange, and socio-historical treatises about the Burmese, internecine wars, and British imperialism. The journey becomes a search for the meaning of home and purpose in Edgar's life. It is an adventure far beyond his prior imaginings and dreams.

The clash of cultures, British and Burmese, civilian and military, wealthy and poor, rule-bound and individualistic, is explored throughout the text. For example, a tiger hunt led by several British officials ends in disaster. Edgar meets Burmese culture on both grand and personal scales: street theatre; appealing, poverty-stricken children; the garb and cosmetics of various tribes; and, ultimately, the allure of Khin Myo, an educated Burmese woman who guides him to Mae Lwin and Carroll.

Carroll, a renaissance physician with a Victorian fervor for botanical and medicinal classifications and investigations, asks Edgar to assist him in his clinic. Common infectious diseases are diagnosed and treated by this forward-thinking physician, and he also performs finger amputations on the mangled hand of a boy without benefit of anesthetic. Other maladies are treated with local remedies and prayer. Meanwhile the delirium of malarial fever descends on Edgar.

Edgar does finally meet and treat the ailing, badly out-of-tune Erard piano. Edgar's expertise is required--his aural excellence and perfect pitch, his delicate yet callused hands, and his willingness to be innovative in the repair of a bullet hole. But what Edgar cannot be prepared for--intrigue and deceptions, fascination with the lush beauty of Burma, and his own shifting priorities and secret longings--is ultimately what sets his fate.

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Set in 1894 and based on a history of the logging projects among the California sequoias, this is a story of Francie, whose sister died in an accident six years earlier. She chafes under her parents' excessive protectiveness since Carrie's death. She loves the woods, and longs to do something to keep the loggers from cutting down the ancient sequoias, especially the oldest and largest, a tree over 2500 years old. Through a little sleuthing based on her sister's diary, she finds out that the property on which the ancient tree sits actually belongs to an old hermit, not to the logging company.

In an effort to get the company to stop before cutting the oldest tree, she rides the dangerous log flume into town to alert the one journalist she knows will support her cause. They arrive in time to save that tree and some of the others, and, perhaps as importantly to Francie, her mother and father begin to see her not only in terms of their loss of Carrie, but as a young woman independently interesting, daring, and very much alive.

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