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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The Pull of the Stars

Donoghue, Emma

Last Updated: May-02-2023

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It is Dublin in late autumn 1918, the waning days of World War I, and nurse-midwife Julia Power is suddenly thrust into the task of managing a small ward of heavily pregnant women who have contracted the deadly influenza. Having survived influenza herself, she does not fear infection, but she worries about her lack of experience. She also worries about her shell-shocked brother with whom she shares a home.

Two people appear to help: the intelligent but uneducated young volunteer Bridie Sweeney raised in an institution; and the legendary woman doctor Kathleen Lynn –who quietly reveals her competence and skill, even as authorities are lurking to arrest her.

Over the course of just a few days, they encounter recalcitrant mothers, complicated deliveries, battered wives, stillbirths, and deaths. Influenza adds special dangers to the natural event, but some patients survive their ordeal.

Although Bridie was to help for just one day, she learns quickly and returns. Julia is impressed by her diligence and drawn ever closer to her kindness and earthy wisdom. They pass a night together sharing confidences, and Julia begins to understand the physical and emotional mistreatment that Bridie suffered in the care of nuns. Their embrace awakens in Julia a yearning she had never imagined. But only hours later Bridie falls ill and succumbs rapidly to the deadly infection.

When an unwed mother suddenly dies after giving birth to a deformed child, Julia is horrified that the baby must be placed in an institution. Instead, she takes the baby home to an uncertain future but sparing the child the same horrors that Bridie once suffered.

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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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Bookends: A Family Doctor Explores Birth, Death, and Tokothanatology

Boron, Susan

Last Updated: Dec-06-2022

Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Through ten short chapters, family doctor Susan Boron explains the origin of her neologism, “tokothanatology,” the study of common practices that surround both birth and death, events that “bookend” our existence. Daughter of an obstetrician who pioneered family-centered birth and spouse of a man who worked in palliative care, Boron noticed the tremendous similarities in the gestures, rituals, and obligations of dealing with both the beginning and the end of life. The obligations extend to the loved ones in the sphere of patients in care--a practice, she writes, “from pre-cradle to post-grave.”

One chapter reviews the rituals emerging from many different cultures and religions; another examines portrayals of birthing and dying in image and word; yet another addresses the impact of sudden and unanticipated outcomes. Ethical and legal dilemmas and the contingencies imposed by time and place are discussed frankly.

Recognizing the advantages of medical technologies, she is nevertheless skeptical of their utility in every case and includes practical advice for dealing with pain, showing that midwifery techniques could enhance palliation. Throughout, she acknowledges that things have changed, are changing, and will change again. Sources are referenced in footnotes.

In the end, the repeated message is one we’ve heard many times before, offered in a refreshing way: the importance of empathy and of listening to the patient's wishes in birthing and in dying.

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Ward Rounds

Beernink, K. D. (Kenneth Dale)

Last Updated: Apr-25-2022

Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This is a collection of poems about patients, written by a young physician in the late 1960s. The book is organized around the theme of a hospital ward. Each poem is named for a patient and has the patient’s disease as its subtitle. The poet composed these poems during his own illness when, as he says in the original Introduction, “my patients reappeared to me, and I lived again in my mind all the many emotions we experienced together.” K. Dale Beernick died of chronic myelocytic leukemia at the age of 31 in 1969. In Ward Rounds he recounts his experiences as a medical student and house officer. He uses a variety of forms and techniques, including rhyme, blank verse, haiku, and even one villanelle. The poems vary in quality and impact. Among the best are "Penny Brown" (rheumatic heart disease), "Theodosus Bull" (delirium tremens), "Anonymous" (spontaneous abortion), and "Minnie Freeme" (post-necrotic cirrhosis).

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The Empathy Exams

Jamison, Leslie

Last Updated: Aug-02-2021

Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Blue Ticket

Mackintosh, Sophie

Last Updated: Sep-07-2020

Martel, Rachel

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In Blue Ticket, Sophie Mackintosh constructs a dystopian vision of modern life for women. Ambiguously set in space and time (given the technology presented we know it takes place around the present day, and not much else), Mackintosh’s universe is one in which a girl’s destiny is set at the time of her first period, when she receives either a white ticket or a blue ticket from the government. These designations are supposedly based on intense scrutiny from the State, and they determine the path each woman will lead. White ticket women, as they’re called, are destined for motherhood, having been deemed worthy of childrearing. Blue ticket women, implanted with a permanent intrauterine device and forbidden from getting pregnant, are bound for the working world, bound for a "free" life that "could change at any time." Each girl must leave her family to start a new life after her ticket is drawn, and the white tickets and blue tickets immediately diverge. The white ticket girls are ferried safely to their destination cities, while the blue ticket girls must brave the open road on foot and alone, fighting for survival and the privilege of an adult life.

We meet Calla, the narrator, as she teeters on the brink of menarche. One by one her female classmates have disappeared from around her, and she is one of only three girls left in school when her period finally arrives. She draws a blue ticket, and embarks on a new life as a chemist, initially living the free and unencumbered life that blue ticket women are supposed to lead. Yet desire for a child smolders inside her, a “dark” feeling that crawls under her skin until it is impossible to ignore. Desperate, Calla removes her IUD and finds a man, known only as R, to unwittingly father her child. When R learns what she has done he turns his back on her, disgusted by her aberrant behavior.

Calla’s illicit pregnancy is communicated to the government by her doctor, known as Doctor A. In this world, citizens are required to meet with their doctor regularly, and the doctors, who act as a hybrid between therapist and primary care provider, report their patients’ thoughts and behaviors to the government. Doctor A offers to terminate the pregnancy with no consequences, but Calla refuses, a decision from which there is no coming back. Calla is provided with a backpack of basic survival tools and a map, and told that she must be prepared to flee to the border at any moment—the government will give her a head start to reward her years of loyal service, but even so, they’re sure to find her before she can cross.

The question of what will happen if she is caught haunts Calla as her pregnancy progresses and she awaits the signal to flee. When it finally arrives, in the form of government emissaries on her doorstep, Calla’s final view of her old life as she speeds away is of her neighbors destroying her home. On the road, Calla is once again alone and vulnerable. Strangers, eager to take advantage of a lone woman, pose a more immediate threat than the government. Yet Calla’s outlook takes a turn for the better when she meets Marisol, a self-assured blue ticket woman who is also pregnant and headed for the border. The two protect each other, and as time goes on they are joined by other blue ticket women on the run, and one white ticket woman, who fears returning to her husband after an illegal abortion. Determined to escape the lives chosen for them, their freedom rests not only on their individual tenacity, but also on their ability to help each other. Yet the question of who to trust looms large, and casts a shadow as they flee towards a new life.

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I Hear Their Voices Singing: Poems New and Collected

Davis, Cortney

Last Updated: Jul-24-2020

Donley, Carol

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Cortney Davis has divided this collection of her poetry into seven major sections which she calls “Voices.” The first and last sections are “Voices of Healing” which frame and wrap around the others: “Home,” “Desire,” “Suffering,” “Faith,” and “Letting Go and Holding On.” The sections include previously published poems as well as new ones. Davis is known for her ability to see and understand what is going on and to express that in ways that help the reader “get it.” This collection also shows her ability to hear the unique voices that express suffering, faith, desire—and to convey empathic understanding of the speaker. Sometimes she gets angry with the speaker. The poems range through time, from her childhood, nursing training, nursing experiences, deaths of her parents, to more current experiences with grandchildren. Throughout there is a consistent caring and compassion, mixed with many other feelings, many of them contradictory.

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One Child Nation

Wang, Nanfu; Zhang, Jialing

Last Updated: Apr-10-2020

Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

This Side of Doctoring: Reflections from Women in Medicine

Chin, Eliza Lo

Last Updated: Nov-09-2017

Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians. Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few.

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334). The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185) The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor.
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field. Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul". Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151)

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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