LitMed: Literature Arts Medicine Database

Scales to Scalpels: Doctors Who Practice the Healing Arts of Music and Medicine

Wong, Lisa

Last Updated: Nov-01-2020

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Summary:

This is a quick and personal history of the Longwood Symphony Orchestra (LSO), a group of Boston area musicians who, in their working lives, are medical personnel. The first of its kind, there are now several such orchestras across the US and scattered throughout the world, notably in Europe. Lisa Wong, a pediatrician and violinist, tells her own history of medicine and music, including her involvement with the Longwood Symphony Orchestra over some 28 years. Other stories of individual doctor/musicians are threaded throughout the book, giving us a personal look at their interdisciplinary enterprise. While their medical specialties, ages, and backgrounds vary widely, while playing in the orchestra and, various professional ranks aside, they accept the direction of the conductor. While Wong mentions antecedents of medicine and music in ancient times, she chooses Dr. Albert Schweitzer as a patron saint for the LSO.

For Wong and her fellow doctors, there are links between music and healing. Music helps keep doctors (and patients) healthy by calming the heartbeat, relaxing muscles, and lifting the mind (p. 86). Music therapy (the psychotherapeutic use of music) and music medicine (the more general uses of music, often in medical settings) can assist in patient care. For example, a dementia patient named Ruth reawakened upon hearing music. Some patients choose to listen to music in the final days of their lives (p. 184).

For many doctors, music was an early pursuit. Neurological studies suggest that musical training helps develop “structural brain plasticity” that may show benefits in education and training. By contrast, however, sometimes musicians (doctors or not) develop overuse injuries and need specific physical therapy.

Music has applications in mental health, hospitals in general, and community partners. The LSO has partnered with some 40 nonprofits in the Boston area. In one example, they helped grow the Asian bone marrow registry from 3,000 to 11,000 people (p. 225). An LSO concert raised $30,000 for the Mattapan Community Health Center in South Boston.

Lisa Wong was president of the organization for 20 years. She writes, “Music goes a long way to heal entire communities. Social justice and social welfare are important determinants of health. Programs that look beyond the music are truly ‘Healing the Community through Music’” (p. 249).

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Smoke Gets in Your Eyes & Other Lessons from the Crematory

Doughty, Caitlin

Last Updated: Aug-31-2020

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

At 23 years of age, Caitlin Doughty went to work for a crematory in Oakland, California, and looked human mortality right in the eye. She reports on her first six years in the funeral industry, learning about it and also resolving to stay in it so that she can improve it. Her eye-witness account provides the basic narrative structure of this book.

She makes house calls to gather up the dead and drive them to the crematory. She is fascinated by several specific bodies, giving us portraits of them and their past lives. Some of them are our least-well-off citizens, and these occasion touching prose.

Doughty realizes that her fear of death has roots of seeing, at eight years of age, a child dying from a fall in a two-story shopping mall. Her work with bodies helps her heal from her trauma. She imagines that her history may be a parallel for American society as a whole that now hides, covers up, and ignores the realities death and dying. She specifically envisions changes that will result in healthier attitudes and practices in the funeral industry.

Doughty describes in detail how the dead are embalmed, made up to look “natural,” and presented to relatives at viewings. She criticizes these rituals as demeaning to the dead and causing unnecessary expense to their families. She describes Forest Lawn cemetery as the Disneyland of the Dead, recalling Jessica Mitford’s critical book, The American Way of Death (1963).

Having studied medieval history at the University of Chicago as an undergrad, Doughty brings many texts into her discussion, from history, anthropology, literature, philosophy, medico-legal discussions, religion, and social criticism. All societies have customs for dying, death, and burial; many of them, she feels, are healthier and more realistic than those of contemporary America.

Finishing her time at the crematory, she decides to stay in the industry in order to improve it. She graduates from the Cypress College of Mortuary Science and passes exams to become a licensed funeral director in the state of California. She posts her essays and manifestos on the Internet under the name “The Order of the Good Death.” Many others join her in a movement against American “death dystopia” (p. 234).

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Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life.

Aronson, Louise

Last Updated: Oct-07-2019

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction — Secondary Category: Literature /

Genre: Treatise

Summary:

Louise Aronson, a geriatrician, argues that we should create Elderhood as the third era of human aging, joining the earlier Childhood and Adulthood. This new concept will allow us to re-evaluate the richness of this later time, its challenges as body systems decline, and, of course, the choices of managing death. This important and valuable book is a polemic against modern medicine’s limits, its reductive focus, and structural violence against both patients and physicians. She argues for a wider vision of care that emphasizes well-being and health maintenance for not only elders but for every stage of life.

Aronson argues that contemporary society favors youth and values of action, speed, and ambition, while it ignores—even dislikes—aging, older people, and the elderly. She says ageism is more powerful than sexism or racism—as bad as those are. Medical schools ignore the elderly, focusing on younger patients, especially men, and medical students perceive geriatrics as boring, sad, and poorly paid. Primary care, in general, seems routine and dull. By contrast, medical treatments, especially high-tech, are exciting and lucrative. In medical schools a “hidden curriculum” focuses on pathophysiology, organ systems, and drugs, ignoring patients’ variability as well as their suffering and pathos. Further, business and industrial models make “healthcare” a commodity, and nowadays “doctors treat computers, not people” (p. 237). Aging has become “medicalized” as a disease. Medicine fights death as an enemy, often with futile treatment that may extend a dying process.

Instead, Aronson says we need to bring back the human element, putting care of people at the center, not science. She calls for a new paradigm with ten assumptions (p. 378). Number 2 reads: “Health matters more to both individuals and society than medicine.” Number 9 claims, “As an institution, medicine should prioritize the interests of the people over its own.”

Many practical changes would follow, from redesigned “child-proof” drug containers to buildings and public spaces that are more congenial to older people—and, in fact, to everyone else. We should change our attitudes about old age. For example, we might use the adjective “silver” for a medical facility that is friendly to and usable by older people. Changing our attitudes about aging can help all of us imagine more positive futures for each one of us and for all of our society.

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Salt in My Soul: An Unfinished Life

Smith, Mallory

Last Updated: Aug-16-2019

Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Mallory Smith died of complications following a double-lung transplant for cystic fibrosis (CF). She was twenty-five years old and kept an extensive journal on her computer for 10 years. Salt in My Soul: An Unfinished Life is her memoir, edited by her mother, Diane Shader Smith, from the 2,500 pages of notes, observations and reflections which Mallory Smith wrote. The title refers to the intimate relationship of salt imbalance in cystic fibrosis, and the fact that Mallory felt her most well while swimming in the sea. Diagnosed at age three, she spent much of her days and nights treating the disease with medication, nutrition, chest percussive treatments, breathing treatments, adequate sleep, and aggressive treatment of infections. Unfortunately, while still a child her lungs were colonized with B. cepacia, a resistant bacteria ‘superbug’ which makes transplantation highly risky and hence leads to most centers to not accept CF patients onto their wait lists. Ultimately, University of Pittsburgh does accept Mallory as a transplant candidate, although her health insurance puts up every road block possible to her receiving care.

Mallory Smith was extraordinarily accomplished – she graduated from Stanford University Phi Beta Kappa, and became an editor and freelance writer. She was also deeply engaged with life and others; she was grateful for her loving, devoted family, and she developed close, fierce friendships within the CF community, among classmates, and eventually, she fell in love.

She resists being called ‘an inspiration.’ She writes: “I’m not an inspiration. I’m just a person, grounded in compassion, striving to achieve empathy and wanting to make my way with goodness and grace.” (p. 171) She marvels at the miracle of life: “Our existence is the result of stars exploding, solar systems forming. Our Earth having an environment hospitable to life, and then, finally, millions of highly improvable events accumulating over millions of years to bring us, a capable and conscious bag of stardust, to the here and now.” (p 111) Her memoir is a story of living and dying from CF, but it is also an inside look at the brief life of young gifted writer.

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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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The Scar: A Personal History of Depression and Recovery

Cregan, Mary

Last Updated: Jun-11-2019

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The Scar is a powerful, thoughtful, and moving book, part memoir about the author’s illness across some 30 years, part history of depression and its treatment and part essay to evoke cultural and personal values about sickness, suffering, health, and death. Cregan, a gifted stylist herself, draws on literature that deals with human suffering, mortality, and wisdom. She frankly describes her sorrows and hopes, the death of her baby, her attempts to kill herself, and her survival today with many blessings.

The title refers to a scar on her neck, a result of her effort to cut her throat with a piece of glass so that she would die. This attempt, in a hospital, reflects the depth of her illness and the failure of her caregivers to prevent it. Her book explores the complexity and variety of mental patients and the range of medical responses—some useful, some not—to treat them. Writing as a survivor, she draws on her journal, hospital records, emails, interviews, and more; she is part journalist, detective, archivist, and forensic pathologist—as if doing an autopsy on the suicide she attempted.

Ch. 1
What Happened describes the birth and immediate death of her daughter Anna and her descent into depression and initial hospitalization.

Ch. 2
What Happened Next discusses mental hospitals and her perceptions of being a patient in one. A dramatic paragraph describes her cutting her throat (p. 51).

Ch. 3
How to Save a Life presents electroconvulsive therapy (ECT), from the jarring images of “One Flew Over the Cuckoo’s Nest” to her own experience of some 17 treatments; she reports that these helped in recovery.

Ch. 4
The Paradise of Bedlams gives a history of mental hospitals. She is hospitalized three months, “a prisoner,” in her term.

Ch. 5
Where Do the Dead Go? explores the dilemmas of the living as they mourn the deaths of people they love, including approaches from Judaism and Christianity. Mary has nightmares about her lost baby. She discusses Freud, Rilke, T. S. Eliot and others. She buries Anna’s ashes.

Ch. 6
Early Blues discusses modern attempts of science and the pharmaceutical industry to create drugs for mental illnesses, with influences from psychodynamic and biological concepts.

Ch. 7
The Promise of Prozac discusses that famous (notorious?) drug; she takes it on and off while working on her PhD, then other drugs as they became available.

Ch. 8
No Feeling Is Final sums up many themes. She’s in her late 30s, remarried, and trying to conceive. After IVF, she’s pregnant. Baby Luke is born. She understands that the scar on her neck has an analogue with Odysseus’ scar on his leg: a symbol of survival through hard, even desperate times, for her a “double trauma: the loss of my child, the loss of myself” (p. 243).

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Go Set A Watchman

Lee, Harper

Last Updated: Apr-25-2019

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Now 26 years old, Scout (Jeanne Louise) returns home to Maycomb, Alabama, where she encounters many changes. Her brother has died. Her heroic father, Atticus Finch, who defended the wrongly accused man in the earlier acclaimed novel (To Kill a Mockingbird) is still carrying on his legal practice and his role as a wise pillar of the community, despite his advancing age. He is approached to defend a black man who has killed a white man in a motor vehicle accident.

Scout renews contact with old friends, including Hank who still hopes that she will marry him. The old places spark memories told in deftly written flashbacks that beautifully evoke the atmosphere of a small southern town in the heat of summer. Some flashbacks– an imagined pregnancy following a chaste kiss and an escapade with falsies at a school dance-- are hilarious renditions of ‘tweenage’ angst, typical of any time or place.

But Scout is disgusted by the social spying, the rumors that easily build, and the latent racial hatred that lurks everywhere. The memories of her “color-blind” childhood make her confrontation with the cruel, racial tensions in the more recent time all the more upsetting. Even her beloved nanny, Calpurnia, is now alienated with distrust and repressed anger. The climax comes when she witnesses her father, as chair of a meeting, give the floor to a notorious racist. Scout confronts him and he launches into a long self-justifying and not entirely convincing defense of the need for free speech. The disquieting conclusion is ambiguous.

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Eighth Grade

Burnham, Bo

Last Updated: Feb-26-2019

Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Exit West

Hamid, Mohsin

Last Updated: Oct-22-2018

Redel-Traub, MD, Gabriel

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Exit West, a novel by Mohsin Hamid, follows two young lovers as their (unnamed) Middle Eastern city descends into war. The story is an intimate look into how quickly war can warp the quotidian routines of daily life. It begins by introducing us to its protagonists. Nadia is a fiercely independent and thoroughly modern woman; she lives alone, rides her vespa around and listens to jazz records. Saeed is perhaps a bit more traditional—he lives with his parents—but is still a typical university student (he brings a joint to one of his and Nadia’s early dates.) The city is a cosmopolitan one, if not a bit outdated. However, as Nadia and Saeed’s relationship deepens, the initial hints of insurgency become apparent: drones and helicopters buzz constantly overhead, a night curfew is implemented, the window with a nice view becomes a liability as gunfire breaks out. The city descends bit by bit into all out war. As this happens, rumors of magical doors that whisk people away to distant lands begin to circulate. Nadia is keen to find one of these doors; Saeed is hesitant to leave in part because his parents are unwilling to join them. Eventually with growing violence in the city, the couple decides to enter a door and together are transported to Mykonos where they join hundreds of other migrants and refugees from all over world who are living in makeshift homes. The second half of Hamid’s novel follows the couple’s life as refugees, traveling from Greece to England and eventually to the USA. Hamid portrays the psychological cost of exile, loss and dislocation—a cost which slowly drives Nadia and Saeed apart.

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Far From the Tree

Solomon, Andrew; Dretzin, Rachel

Last Updated: Sep-13-2018

Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Andrew Solomon’s 2012 book Far From the Tree is a study of families with children who are different in all sorts of ways from their parents and siblings to degrees that altered and even threatened family functions and relationships. Years after its publication, director Rachel Dretzin collaborated with Solomon to produce this documentary based on his book. At the time of filming, the children were already adults or were well into their teens. The film looks at how the families came to accept these children and how they sought—with varying success—happiness.

The documentary focuses on five family scenarios: homosexuality (Solomon’s own story); Down syndrome; dwarfism; murder; and autism. Anyone in these families or anyone who knew these families would never invoke the familiar idiom “the apple doesn’t fall far from the tree” when talking about these children. These apples fell far from the tree, and Solomon builds on that twist to the idiom to characterize the relationship between the affected children and their families as “horizontal.” By extension, Solomon characterizes the relationship of children who are not different from their parents and siblings in any appreciable manner as “vertical.”

Only one of the original characters from the book appears in the documentary; the other families are newly “cast.” The film captures the lives of these families with all their challenges and successes, and intercuts footage from home videos the families provided. Dretzin also filmed interviews with parents and in some cases their children. The footage and interviews show how families evolved in their acceptance of their children and their situations as best they could. The best was still heartbreak for some, but real happiness was achieved for others.

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