LitMed: Literature Arts Medicine Database

The Doctor

Icke, Robert

Last Updated: Feb-28-2023

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

The Doctor is a new play that was “very freely adapted” from a work by 19th-century Viennese doctor/playwright Arthur Schnitzler. The author, Robert Icke, is an English playwright and director who is especially known for his reworkings of classics.

The doctor to whom the title refers is Ruth Wolff, the renowned and rather formidable director of a private medical institute. We learn that we are in the present day, and Dr Wolff is Jewish. At the play’s outset, the organization is attempting to secure funding for a new building, and a new head of pharmacology is about to be chosen. One of Dr. Wolff’s patients, a 14-year-old girl, is in sepsis following a self-induced abortion. Her health rapidly declines. When it becomes clear the patient is not going to make it, her parents send a Catholic priest to the hospital. Dr. Wolff prevents the priest from entering the room to administer the last rites.

Dr. Wolff’s actions set off a chain of events. Her confrontation with the priest goes viral on social media, resulting in a public relations nightmare for the hospital. In her characteristically uncompromising way, when asked to smooth things over, the doctor responds: “I think the lack of my having done something makes that really quite difficult” (p.31). She is labelled anti-Catholic and her car is painted with a swastika. Her choice for head of pharmacology, also Jewish, is deliberately rejected by the board in favor of a Catholic. The funding for the institute’s new building is suddenly in doubt as a formal inquiry is opened by the Minister for Health. Disgraced, Dr. Wolff is forced to resign.

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The Arrow Tree: Healing from Long COVID

Weliver, Phyllis

Last Updated: May-18-2021

Clark, Mark

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The title of this memoir derives from the Native American custom of bending a tree’s growth in order to indicate a direction of safe passage. The custom represents a reverent cooperation with nature through which a compassionate communication is accomplished: a message to other journeying souls as to how they might find a way to their flourishing. The title is exquisitely apt for this memoir, which echoes the gesture of the arrow tree, testifying to a safe passage through the wilderness of COVID. The author, a first-rate, published Victorian scholar, contracted COVID-19 in March 2020 upon her return from a sabbatical at the University of Cambridge, which was cut short as a result of the pandemic.

Weliver has suffered from symptoms ever since: hers is the experience of living with long COVID. The condition warrants her taking a leave from her university, and she returns to her childhood home of Interlochen, in northern Michigan. Her living in and engaging with the natural world there encourages her to undertake meditations about that world and her place in it as she lives with her illness. The writing—the foundational means of her healing—inclines her, crucially, to think with the stories of the Odawa (Ottawa) and the Ojibwe (Chippewa), Anishinaabek ("Original Man") of the region, which she researches as a means of deepening her understanding of her home, her origins, and the nature of her identity. Her quest for understanding turns not only to these stories, but to an integration of them with the wisdom of other guides in her life: authors of the Romantic and Victorian periods, poets and thinkers of Taoism and other ancient Eastern philosophies, mentors in her rich journey of studying both literature and music (she attended Interlochen Center for the Arts, Oberlin, where she double-degreed in English Literature and Voice (Music), Cambridge, and the University of Sussex), and her own family, particularly her mother. Her prose is accessible and welcoming, not at all the erudite sort one might anticipate from a reputable scholar: it invites curiosity and encourages insight that is, at times, breathtaking and joyous. This “arrow tree” memoir points its readers in the direction of a safe passage to the home of our natural world, where, in finding union with that world, we may experience healing not only from COVID but from habits of the heart that have left us more broken than we know.

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That Good Night: Life and Medicine in the Eleventh Hour

Puri, Sunita

Last Updated: Aug-13-2019

Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sunita Puri, a palliative care attending physician, educates and illuminates the reader about how conversations about end of life goals can improve quality of life, not just quality of dying, in her memoir, That Good Night: Life and Medicine in the Eleventh Hour. Thirteen chapters are grouped in three parts: Between Two Dark Skies, The Unlearning and Infinity in a Seashell. The arc of the book follows Puri as she is raised by her anesthesiologist mother and engineer father – both immigrants from India – Puri’s decision to enter medical school, her choice of internal medicine residency followed by a palliative care fellowship in northern California and her return to practice in southern California where her parents and brother live. Besides learning about the process of becoming a palliative care physician, the reader also learns of Puri’s family’s deep ties to spirituality and faith, the importance of family and extended family, and her family’s cultural practices.

Puri writes extensively about patients and their families, as well as her mentors and colleagues. She plans and rehearses the difficult conversations she will have with patients in the same way a proceduralist plans and prepares for an intervention. She provides extensive quotes from conversations and analyzes where conversations go awry and how she decides whether to proceed down a planned path or improvise based on the language and body language of her patients and their family members. We visit patients in clinic, in hospital, and at home, and at all stages of Puri’s training and initial practice. Some of the most charged conversations are with colleagues, who, for example, ask for a palliative care consultation but want to limit that conversation to a single focus, such as pain management. We also learn of the differences between palliative care and hospice, and the particularly fraught associations many have with the latter term. She feels insulted when patients or families vent by calling her names such as “Grim Reaper” or “human killer” (p. 232), but understands that such words mean that more education is needed to help people understand what a palliative care physician can do.

As a mediator of extremely difficult conversations, where emotions such as shame, guilt, fear, helplessness and anger can swirl with love and gratitude, Puri finds the grace to acknowledge that all such emotions are part of the feelings of loss and impending grief, and to beautifully render her reflections on these intimacies: “Yet although I am seeing a patient because I have agreed that they are approaching death, if I do my job well, what I actually encounter is the full force of their lives.” (p. 206) Having met many dying people she notes: “Dying hasn’t bestowed upon them the meaning of life or turned them into embodiments of enlightenment; dying is simply a continuation of living this messy, temporary life, humanly and imperfectly.” (pp 221-2)

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Survivors

Pratt, Arthur

Last Updated: Jul-19-2019

Thomas, Shawn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

For much of the western world, the Ebola crisis came and went without much fanfare. Perhaps we were jolted by the initial news stories, taken aback by the images from affected areas, and slightly unnerved by the travel advisories as we entered security lines at the airport. But for the most part, the Ebola outbreak was an abstract crisis affecting people on the other side of the world, multiple continents away. The closest that most Americans came to Ebola was to hear in the news about the four diagnosed cases in Texas and New York City. It is safe to say that most of the world remains unaware of the depths of this crisis in the West African hotspot countries of Liberia, Sierra Leone, New Guinea, and Nigeria.

Arthur Pratt is a Sierra Leonian pastor and filmmaker, and he witnessed firsthand the invisible enemy that threatened to destroy his country, the communities, and the families that lived there. Despite the human cost that this disease extracted from the West African people, Pratt was inspired by how the people in Sierra Leone rose up to defend their country from a viral invasion that was attacking “the fabric of what it means to be African.” He felt it necessary to tell the world the story of Sierra Leone’s unsung heroes, and so he created a documentary titled Survivors, which focused on the work done by the ambulance drivers and nurses, interwoven with personal stories of children, mothers, fathers, and communities touched by the disease. Survivors gets up close and personal to the 21-month battle against Ebola in West Africa, and shows how the common people of Sierra Leone risked everything to come together and fight back against an existential threat.

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Hope and Grace: Spiritual Experiences in Severe Distress, Illness, and Dying

Renz, Monika

Last Updated: Dec-14-2017

McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Dr. Monika Renz’s work with dying patients is unusual if not unique in the way she appropriates and applies insights from Jungian depth psychology, practices available in patients’ faith traditions, and musically guided meditation to invite and support the spiritual experiences that so often come, bidden or unbidden, near the end of life. An experienced oncologist, Dr. Renz offers carefully amassed data to support her advocacy of focused practices of spiritual care as a dimension of palliative care, but is also quite comfortable with the fact that “neither the frequency nor the visible effects of experiences of the transcendent prove that such experience is an expression of grace” because “unverifiability is intrinsic to grace.” Still, her long experience leads her to assert not only that “grace” can be a useful, practical, operative word for what professional caregivers may witness and mediate but also that affirmation and support of patients’ spiritual, religious, or transcendent experiences in the course of dying can amplify and multiply moments of grace, which manifest as sudden, deep peace in the very midst of pain, profound acceptance, openness to reconciliations, or significant awakenings from torpor that allow needed moments of closure with loved ones. Describing herself as “an open-minded religious person and a practicing Christian,” she reminds readers that God is a loanword, whose basic form in Germanic was gaudam, a neutral participle. Depending on the Indo-Germanic root, the word means “the called upon” or “the one sacrificed to . . . .” Openness to the divine in both patients and caregivers, Dr. Renz argues, can and does make end-of-life care a shared journey of discovery and offer everyone involved a valuable reminder that medicine is practiced, always, at the threshold of mystery.

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Slow Medicine: The Way of Healing

Sweet, Victoria

Last Updated: Dec-13-2017

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Victoria Sweet describes her training in medical school, residency, and work in various clinics and hospitals. From all of these she forms her own sense of what medical care should include: “Slow Medicine” that uses, ironically, the best aspects of today’s “Fast” medicine.

Her dramatic “Introduction: Medicine Without a Soul” describes poor—even dangerous—care given to her elderly father at a hospital. An experienced physician, she calls Hospice and saves him from a “Death Express” the hospital has “quality-assured” (pp. 6, 8).

The book continues with 16 chapters in chronological order. The first ten describe Sweet from a late ‘60s Stanford undergrad and “a sort of hippie” (p.14), next a learner of “facts” in preclinical studies at Harvard, plus the clinical rotations (including Psychiatry, Internal Medicine, Pediatrics, and electives), then an internship as a doctor and her work in various clinics and hospitals. Throughout she’s collecting skills, concepts, even philosophies (Jung, feminism, Chinese chi, value of stories). She also describes particular patients important to her learning. She dislikes “just good enough” medicine at the VA (p. 95), “unapologetic budgetarianism” (p 141), medicine that is reductive and uncaring, and futile care for dying patients.

Halfway through, we find an “Intermission: In which Fast Medicine and Slow Medicine Come Together.” With a year off, Sweet signs on as physician for a trekking group headed for Nepal. Unexpectedly, she treats an Englishman in the Himalayas. Returning home, she treats a man whose pulse is declining and rides a helicopter with him to a hospital. She realizes that she can take on the full responsibility of being a doctor, including when to use Fast medicine and when to use Slow.

The following chapters deal with the 1980s emergence of AIDS, a hand injury to Sweet (she sees herself as “a wounded healer,” p. 182), her new understanding of medicine as “A Craft, A Science, and an Art” (Chapter 12) and conflicts between medical care and economics-driven medicine (“checked boxes,” administrators, quality assurance, even outright corruption). She scorns use of the labels “health-care providers” and “health-care consumers” (p. 211) and discovers Hildegard of Bingen’s medieval vision of medicine. She works for 20 years at Laguna Honda, the topic of her earlier book God’s Hotel (2012). Chapter 16 closes the book with “A Slow Medicine Manifesto.”

Sweet pays tribute to her teachers, both in a dedication to the book, and throughout the pages: professors, preceptors, nurses—especially a series of Irish Kathleens—and patients. There are some 20 case studies of patients throughout the book, their medical dilemmas, their personalities, and Sweet’s Slow Medicine that involves creating a healing relationship with them, finding the right path for treatment, even watching and waiting.

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Wandering in Darkness: Narrative and the Problem of Suffering

Stump, Eleonore

Last Updated: Mar-10-2017

Clark, Mark

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

Wandering in Darkness is an intricate philosophical defense for the problem of suffering as it is presented by medieval philosopher Thomas Aquinas.The work addresses the philosophical / theological problem of evil, which might be expressed as follows: if one posits an all-good, all-powerful God as creator, yet suffering exists in the world, then (a) God must be evil, since he created it; (b) God is less than all-powerful, since suffering came to be in his creation, and he could not stop it; (c) God is evil and weak, since suffering came to be in his creation, and he did not want to stop it; or (d) suffering is an illusion. No alternative is, of course, very satisfying. In her book, Eleanore Stump augments Thomas Aquinas’s theodicy by reflecting upon what she calls “the desires of the heart,” a dimension of human experience that Aquinas leaves largely untreated in his consideration. Stump explores this dimension by breathtaking exegeses of Biblical narratives as narratives: the stories of Job, Samson, Abraham, and Mary of Bethany. “Understood in the contexts of [these] narratives,” Stump argues, “Aquinas’s theodicy explains in a consistent and cogent way why God would allow suffering" (22).

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