LitMed: Literature Arts Medicine Database

Editing Humanity

Davies, Kevin

Last Updated: Jun-28-2022

Coulehan, Jack

Primary Category: Literature / Nonfiction

Summary:

Editing Humanity explores the history, biology, sociology, and ethical import of CRISPR (“clustered regularly interspaced short palindromic repeats”), the major new DNA technology indicated in the book’s subtitle, “The CRISPR Revolution and the New Era of Genome Editing.” Using CRISPR, researchers can manipulate the DNA of animals, plants and microorganisms with extremely high precision. In particular, scientists now have the potential to customize the human genome.

What is CRISPR? To quote Davies, “CRISPR is a small subsection of the bacterial genome that stores snippets of captured viral code for future reference, each viral fragment (or spacer) neatly separated by an identical repetitive DNA sequence.” (p. 23) When the cell is reattacked by a virus, an RNA copy of that virus’ stored “signature” forms a DNA-splitting complex that destroys the incoming virus. In 2012, Jennifer Doudna, of the University of California, Berkeley, and Emmanuelle Charpentier, of the Max Planck Institute, Berlin, demonstrated that CRISPR could be engineered to edit any gene. One could, for example, replace a disease-causing mutation in any DNA segment with the healthy variant, thus preventing genetic disease.

The author, Kevin Davies is a geneticist and science writer whose previous books include Cracking the Genome and DNA: The Story of the Genetic Revolution. In Editing Humanity, he discusses an array of actual and potential applications of CRISPR technology, including human disease prevention by altering susceptibility of animal vectors, improving farm productivity, and even resurrecting extinct species. However, the most powerful and controversial topic is genetic manipulation of the human embryo. Davies devotes several chapters to the cautionary tale of the young Chinese scientist He Jiankui who engineered the world’s first gene-edited babies, and the scandal and disgrace that followed. (He was convicted in China of “illegal medical practice” and sentenced to prison.)

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The Dropout

Meriwether, Elizabeth

Last Updated: May-19-2022

Sood, Shefali

Primary Category: Performing Arts / Film, TV, Video

Genre: TV Program

Summary:

Based on the 2021 podcast of the same title produced by Rebecca Jarvis, The Dropout is an 8-episode miniseries starring Amanda Seyfried as the infamous biotechnology fraudster Elizabeth Holmes and Naveen Andrews as her much older boyfriend-turned-accomplice, Ramesh “Sunny” Balwani. The miniseries documents the real-life story of Elizabeth Holmes and her evolution from an ambitious, dedicated and somewhat awkward teenager into a ruthless, immoral and still quite awkward CEO of Theranos, a company she founded after dropping out of Stanford her sophomore year. She claimed to develop technology to run hundreds of diagnostic medical tests on a single drop of a patient’s blood. She defrauded hundreds of doctors, investors, pharmaceutical companies and even Walgreens along the way and put hundreds of patients who received faulty Theranos blood test results at risk. This year, Holmes was found guilty on four counts of fraud by a federal grand jury.

The miniseries begins in Holmes’ childhood and utilizes footage from her federal deposition and media interviews to document her evolution from having an innocent desire to invent something to help people to a grifter who put others in danger without a second thought. In her teenage years, Holmes idolizes Steve Jobs. Instead of boyband posters in her room, she has photos of him with Apple products. She spends a summer in China in a language immersion program, where she meets a man 30 years her senior, Sunny Balwani, and strikes up an uncomfortable friendship after learning of his success in business. She is shown to be somewhat of an outcast in school, practicing being excited for a party in a mirror and speaking almost every day with Balwani instead of her peers. Her conversations with Balwani mostly are about her ideas to help people and her desire to be a billionaire. This goal of helping others pushes her to study biomedical engineering at Stanford. She proudly proclaims to family friend Dr. Richard Fuisz, a physician-turned-inventor, that she is in the top 10% of applicants. At Stanford, she is incredibly focused on her goal to invent, and with an unrelenting fervor, she enrolls in graduate level classes and pitches ideas to professors. She is a teacher’s pet; however, when she pitches her idea for a medical drug delivery patch to Dr. Phyliss Gardner, a highly accomplished physician and researcher, her world crashes. Dr. Gardner immediately shoots down her idea and tells her to focus on her schoolwork before trying to invent the next big thing. Holmes can’t take no for an answer and quotes Yoda from Star Wars: “Do or do not. There is no try.” Dr. Gardner responds that in medicine and science, some things are impossible and recognizing that is also part of the scientific process.

This all changes soon after pitching an idea for a blood test using a single drop of blood to Dr. Channing Robertson, an influential chemical engineer at Stanford. He backs her idea and gives her capital for a company. She encourages her parents to let her drop out of Stanford, citing Steve Jobs, Michael Dell and other influential tech leaders as examples, and uses her tuition money to establish Theranos.

Theranos, a combination of the words therapy and diagnosis, takes off, with significant roadblocks, fueled only by Holmes' dreams. Holmes neither has the scientific background nor the leadership skills to lead the company. She does little in the chemistry labs and her lack of engineering, chemistry and medical knowledge prevents her from being able to pitch the idea successfully to healthcare venture capitalists. The blood testing device requires technology that would take years to build and require significant scientific collaboration that does not exist at Theranos. She needs data for investors that the devices are complete and work, so enrolls the faulty, not yet completed devices in a trial testing the blood of cancer patients. This leads to a tense encounter between lead engineer Edmond Ku and Holmes outside a cancer clinic. Ku states that he is an engineer, not a healthcare provider, and he is uncomfortable looking these patients in the eye and testing their blood on a machine he knows does not work. He is clearly very upset; but Holmes forces him to go inside and collect the samples. The clinical trial goes nowhere.

After almost running the company into the ground, she convinces the Board to let her stay CEO if she brings on Balwani, with whom she is in a romantic relationship, as chief operating officer. Balwani offers advice on how to be a CEO of a tech company and encourages her to change her management style. The departments at Theranos become siloed to a point that scientists have no idea what is happening in the executive, marketing and media departments and vice versa. All information comes from Holmes. She spends no more time in the lab and has no meetings with lab personnel, but her name is on every patent. She markets herself as a young female tech CEO in a landscape dominated by men in sweatshirts. Her charisma and newfound business acumen allows her to secure a deal with Walgreens in which Theranos’ devices will be in Walgreens Wellness Centers for use by patients. She does not tell any of the scientists working on the device and does not consult any physicians. She shares no data with Walgreens about the design of the device, its accuracy or validity, citing trade secrets. When her lead chemist, the celebrated Dr. Ian Gibbons, catches wind of this plan, he confronts Holmes, who fires him on the spot for not having the same vision. Amidst pressure from the scientists, she rehires him the next day, but prevents him from working in the lab ever again. The toxic environment created by Holmes eventually causes Dr. Gibbons to commit suicide.

The Theranos devices for the Walgreens agreement fail quality control checks and cannot be used. Holmes and Balwani create a plan in which they use Siemens devices with Theranos logos to run the single drop blood patient samples which have been diluted to provide enough sample to be read by the Siemens machine. This leads to wildly inaccurate results being sent to patients. Examples include a high estrogen reading in a woman with a history of ovarian cancer, suggesting remission; a high thyroid hormone level in a pregnant woman already on thyroid medication, almost prompting her doctor to alter her dosage, which would be fatal for the fetus; and a high troponin level in a man with cardiovascular disease indicating he may be having a myocardial infarction. The lab technicians are aware of these inaccurate results. Eventually two techs, Erika Cheung and Tyler Schultz, the grandson of former Secretary of State George Schultz a and a Board member at Theranos, leak what is happening to a journalist, John Carreyrou at the Wall Street Journal, despite immense legal and physical threats from Holmes and Balwani. Eventually, using evidence from Cheung, Schultz, former scientists at Theranos, and physician-advocates among others, Carreyrou writes an article in the Journal exposing Theranos and Holmes for what they are --frauds. This spirals into the Centers for Medicare and Medicaid Services shutting down Theranos labs indefinitely and leads to thousands of lawsuits regarding Theranos products. Holmes loses all credibility and is arrested on federal charges of fraud and conspiracy to commit fraud.

In the last scene, Holmes visits the office with her new dog to speak with a former Theranos lawyer, who can no longer find a job as a result of the scandal. She boasts about her new boyfriend. The lawyer confronts her, “you hurt people.” Holmes denies this vehemently saying she just ‘failed to deliver’ as CEO and runs frantically out of the office where she breaks down while waiting for her Uber.

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When We Cease to Understand the World

Labatut, Benjamin

Last Updated: May-09-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Historical Fiction

Summary:

When we think of genetics and pedigrees, we expect our traits and characteristics to be passed down in a predictable pattern from parents to children. In his book Far From the Tree , Andrew Solomon labels this transmission from one generation to the next as vertical identity. However, his book focuses on circumstances where inheritance follows what he calls a horizontal pattern. In these cases, the offspring have an inherent or acquired trait that is foreign to their parents. They land far from the anticipated spot under the tree canopy and are dramatically different from their parents. He or she must acquire their identity from a peer group that is outside the parents’ experience. One chapter in Solomon’s book focuses on genius as seen through the lens of the violinist Joshua Bell and his family. Most of us would gratefully welcome a child of genius whether in science, architecture, or music and embrace the apple that landed far from the tree. Reading Benjamin Labatut’s riveting book might cause you to rethink this thought experiment.

Nothing will quite prepare you for the literary world that Labatut has invented. It is a unique blend of fact and fantasy, an incremental layering of fictional conceits on known historical details. A stream of people from history pass through the book, some deservedly famous and others more obscure. But all of them are possessed of genius. All of the characters lived through the turbulent first third of the 20th century when quantum mechanics revolutionized the traditional understanding of physics. They confronted the challenge that this new knowledge presented to the grand view that people had held about how the universe was designed and operated.

The book opens with Fritz Haber, whose research on nitrogen fixation chemical reactions provided the basis for the production of fertilizers, pesticides and explosives. Haber’s work had diametrically opposite effects on the course of history. On the one hand, he enabled dramatic increases in agricultural crop yields and prevented global hunger. At the same time, his discoveries increased the carnage in World War I and yielded compounds that led to innumerable deaths by asphyxiation in the trenches in no-man’s land and, later, in the Nazi death camps. There is Karl Schwarzschild who was able to solve Einstein’s equations in the general theory of relativity while fighting in the German front lines during World War I. He identified the potential existence of black holes, Schwarzschild singularities, long before Stephen Hawking made them famous. Alexander Grothendieck, considered the most influential mathematician of the last hundred years, also passes through the pages of Labatut’s book. After an extraordinarily creative career in which he totally upended established concepts in geometry and number theory and other mathematical fields, he ended up abandoning his life’s work. He devoted himself to Buddhism and, retreating to a secluded village in the Pyrenees, he lived out his last years alone and unrecognized. Erwin Schrodinger is forced to enter a Swiss sanatorium to convalesce from tuberculosis. While there, under the influence of a teenage girl similarly afflicted with tuberculosis, he derives his wave equation and the Psi function to explain the wave-particle duality of light and matter. Even Schrodinger is perplexed by this discovery. He cannot reconcile himself fully to the truths of quantum mechanics and spends the rest of his scientific life trying to unify it with Einstein’s Theory of General Relativity. Finally, towering over the narrative is Werner Heisenberg. He agonizes over the discrepancy between the Newtonian physics that he has learned in the university and what he is uncovering in his research into the subatomic realm. He is overcome in a semi-mystical vision and articulates the uncertainty principle. Heisenberg realized that his matrix mathematics put an end to the stable universe created by the Enlightenment in which everything is governed by rational laws of nature and observable cause and effect.

By focusing on these men (sadly, not a woman among them) of uncommon genius, Labatut vividly illustrates how the gift of deep insight drives intense scientific creativity but also agonizing psychic pain. It is as if the awareness of hidden truths is inextricably linked to human suffering. This summary may sound pedantic and unbearably heavy. Only if you enter into Labatut’s unique literary space will you appreciate the inventiveness and intelligence of this overpowering book, all 191 pages of it. It is well worth the trip.

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The Shapeless Unease: A Year of Not Sleeping

Harvey, Samantha

Last Updated: Apr-04-2022

Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In the opening dialog, the author, Samantha Harvey, tells a friend what this book is about.

Friend:    What are you writing?
Me:    Not sure, some essays. Not really essays. Not essays at all. Some things.
Friend:    About what?
Me:         Not sure. This and that. About not sleeping, mainly. But death keeps creeping in. (p. 1)

That’s as good a description of the book as could otherwise be offered.

As unstructured as the book’s content is, so is the book’s format. The only breaks in the text are distinguished by infinity signs. Time stamps are placed within the text between some of these breaks. The times are sequenced during a night (or a composite of nights) when Harvey is awake between midnight and 7:30 am. Texts following the time stamps describe the acute effects of insomnia on her at those particular moments and could be read as diary or journal entries.

Harvey’s insomnia came suddenly at the age of forty-three and morphed into an unrelenting assault that at times made her wonder if the only sleep available to her is the sleep of the dead.

When I don’t sleep and don’t sleep and don’t sleep, I don’t want my life; neither do I have in me the propulsion (courage? know-how?) to take it. So I have to endure my life when it’s unendurable, and this is an impasse. (p. 33)

Can I escape this? The sword hangs. There is nothing to put my mind at rest – every day presents a new threat: the night. Every night is a battle, most often lost, and any victory is one day long, until its challenger comes along: the next night. I understand why people kill themselves, or break down. (p. 82)

Throughout the book, across all the text sections, and following all the time stamps, Harvey details what insomnia does to her physically, psychologically, and existentially. She desperately explores the possible causes such as menopause, fear, traffic noise, and Brexit among others, and heartbreakingly tells of all she has done to get sleep such as seeing doctors, smiling more, counting blessings, and changing behaviors. None come to any effect, as she reports to her unhelpful doctor.

I do these things, they don’t help.
Over time they will.
Over time they haven’t.
I feel unhelpable.
Nobody is unhelpable.
I am.
Nobody is. (p. 139)

Just as Harvey had informed her friend, she takes up other topics in other forms that directly or indirectly relate to her insomnia, and sometimes do not relate at all. Among the various forms are vignettes; thoughts and obsessions; meditations; and a short story. Topics include deaths in the family (including a dog’s); peculiarities of different languages; why so many TV shows have the word “secret” in their titles (she spends “nights spent thinking about this”) (p. 67); what fuels insomnia; how worry, anxiety, and fear differ from one another; writing; time; and the relationships between science and religion, and between reason and faith. Harvey’s background in philosophy shows.

A year on, Harvey discerns a cure for insomnia. Using a metaphor involving swimming against waves and currents or with waves and currents, the cure is to be derived from the “wisdom in knowing that we are sometimes the cause and influencer of our own currents and tides, which we make in otherwise still waters.” She further elaborates on this idea and how it leads to a moment when “you’ll drop each night into sleep without knowing how you once found it impossible” (p. 175).

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Seven and a Half Lessons about the Brain

Barrett, Lisa Feldman

Last Updated: Jan-24-2021

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor.

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123).

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Transcendent Kingdom

Gyasi, Yaa

Last Updated: Oct-12-2020

Martel, Rachel

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Transcendent Kingdom opens with a reminder that the past rarely stays put. Gifty, a sixth year PhD candidate in neuroscience at Stanford University School of Medicine, is reckoning with a relapse of her mother’s depression. After years of remission, Gifty’s mother is unable to get out of bed, and Gifty decides that she should come stay with her in California. With her mother lying in her bed at home, Gifty’s work in the neuroscience lab is charged with a weight beyond that of a typical student trying to publish papers and make it to graduation. Her study of the neural circuits that underlie reward seeking behavior and addiction in mice not only applies to her mother’s disease, but also to the impetus for her mother’s first depressive episode—her cherished older brother Nana’s long struggle with opioid addiction and death by heroin overdose. As Gifty, long accustomed to keeping her emotions to herself and clutching her past close to the chest struggles to keep her mother afloat, she reflects on how her past continues to hold power and relevance.

The daughter of Ghanaian immigrants, Gifty grew up in the predominantly white community of Huntsville, Alabama. Homesick and miserable amid a climate of overt racism and everyday micro-aggressions, Gifty’s father abandoned the family to return to Ghana, leaving four-year-old Gifty and 10-year-old Nana to be raised by their mother. Wryly referred to as “The Black Mamba” by Gifty, their mother, an enigmatic mix of deep tenderness and removed resolve, works long hours as a home health aide to make ends meet. A deeply religious woman, she finds solace in The First Assemblies of God Church, a Pentecostal congregation that, at times, seems to be the only thing keeping her afloat. Gifty, too, is deeply pious as a child. Continuously striving to be good and consumed by questions about God, she writes to God in her journal in an attempt to find religion in the everyday.

Yet Gifty’s faith starts to fracture in early adolescence. Her brother Nana, a basketball star and hometown hero, becomes addicted to prescription opioids following an injury on the court. The ensuing years of conflict overwhelm Gifty with feelings of shame, and sometimes even hatred towards her brother. This, combined with increasing recognition that her religious community—so reverent of Nana when he was healthy and so quick to give up on him when he became ill—is not the bastion of morality she once idealized it to be, prompts Gifty to reevaluate her upbringing. When Nana dies and her mother sinks into a depression that culminates in a suicide attempt, Gifty gives up on religion altogether.

As a college student at Harvard, Gifty continues to eschew overt religious affiliation. Still, she can’t shake the feeling that there’s more to be understood about the human experience. Call it the soul, call it the mind, call it the sub-conscious, Gifty longs to understand the neurologic underpinnings of the behavioral choices that make us who we are. She ultimately chooses to study neuroscience because its rigor appeals to her—if she can decipher which neurons control the behaviors that led to her brother’s addiction, then maybe those behaviors can be changed and controlled. But the more experiments she conducts the more she is forced to grapple with the fact that science can only take her so far. Reconciling her prior absolute belief in God with her current scientific practice isn’t as easy as switching one for the other. Maybe, transcending to a higher level of understanding requires a merging of the two, a recognition that understanding ourselves takes, and is in it of itself, an act of faith.

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Pain Studies

Olstein, Lisa

Last Updated: Jun-10-2020

Carter, III, Albert Howard

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

“All pain is simple” reads the opening sentence of this unusual and striking book. The next sentence reads, “And all pain is complex.” These two sentences foreshadow many puzzles to come: how do we live between chaos and control? Why can’t doctors figure migraines out? Why don’t they agree on a treatment for a particular patient? Olstein is a poet and long-term migraine sufferer. Her book offers many observations about pain, and her attempts to define it, describe it, and plumb its nature through language. There is no linear narrative or argument, rather 38 very brief chapters—usually three to five pages—and many of these could be read in a different order.

Olstein uses the terms “studies” and “research” for her efforts to capture pain, to explain it, and to understand the cause(s) of her disease. Her mother had migraines; women have three times the rate of men; she had a childhood head injury. Do any of these factors explain her disease? No. And what treatments work? She lists some 50 drugs/supplements/activities she has tried to deal with her illness. None of these have worked in a definitive way. Further, she lists some 30 side-effects she has experienced from these various treatments (pp. 74-75). She has had multiple migraines, one lasting three months, but she also says drugs keep pain at bay: “mostly the medication does work” (p 90).

Some disparate figures help her focus her inquiry: Joan of Arc (possibly a migraine sufferer), the TV character Dr. Gregory House (racked with chronic pain, he is an opioid addict), Virginia Woolf, and Hildegard of Bingen (possibly a migraine sufferer). Also ancient writers such as Lucretius, Pliny the Elder, and Antiphon the Sophist, and contemporaries from different fields, such as mathematics and neurology. Also she refers to poems by Emily Dickinson, Elizabeth Bishop, and C. D. Wright, as well as to an article on gendered literature by Siri Hustvedt.

Largely written during a writing residency, these are incisive notes plus associations as she plumbs not only her illness but also her responses—as poet, as thinker, as searcher for healing—to the bizarre, long, difficult path of her migraines. (We have only brief mentions of her personal and family life.) While she refers to some scientific literature, it is more often that her insights come from artistic fields such a literature, sculpture, drama, and popular music. She writes that her work with a therapist over a dozen years has been helpful to her.

There is no conclusion…nor can there be. Her illness, treatment, and writing are all works in progress. Patients are different; doctors are different; science evolves. In their many forms and presentations, migraines are mysterious and complex, as this book creatively and powerfully shows. Olstein writes, “The beauty, the love, is in what we perceive” (p. 144). We may take this observation as the guiding principle for the book.

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The Age of Wonder: How the Romantic Generation Discovered the Beauty and Terror of Science

Holmes, Richard

Last Updated: Oct-14-2019

Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Richard Holmes refers to this book as his “account of the second scientific revolution, which swept through Britain at the end of the eighteenth century, and produced a new vision which has rightly been called Romantic science” (p. xv). He pins the first scientific revolution to the seventeenth century and centers it on the work of Newton, Hooke, Locke, and Descartes. He brackets the second around 1768, when James Cook began his voyage circumnavigating the world, and 1831, when Charles Darwin began his voyage to the Galapagos islands. Holmes calls this period “The Age of Wonder.”

Cook’s voyage carried Joseph Banks among its crew. Banks, a young man of great wealth and privilege, joined the expedition as a botanist to assist in the collection of botanical and zoological specimens from stops in the southern hemisphere. He was successful in this endeavor, and made observations about island life along the way (especially while on Tahiti). A few years after his return, he became the president of the Royal Society and would remain so for the next forty–two years.

The Society offered scientists (known then as “natural philosophers”) a place to publish papers, present findings, gain notoriety, receive funding, and develop networks. In his role as President, Banks was connected to many of the scientists included in the book.

William Herschel and Humphrey Davy are the most prominent figures Holmes covers. Herschel was an accomplished musician and amateur astronomer before he built telescopes that helped him see, characterize, and record heavenly bodies never seen before. While conventional thinking of the time considered the universe to be static, placed by a divine hand, Herschel viewed it as continually evolving. Holmes also gives Herschel’s sister, Caroline, her just due as first his assistant and then as a noted astronomer in her own right.

Holmes focuses on Davy’s more well-known advances in chemistry: finding new elements; analyzing human effects of gasses comprising “common air” and “factitious airs” (e.g., nitrous oxide); inventing a safety lamp for miners; and applying the voltaic battery to chemical analysis. Holmes also details Davy’s role as a popularizer of science through well-received public lectures.

Aside from a chapter on Mungo Park’s ill-fated expedition to Africa, the other chapters have less focus on individuals and more on notable events. One concerns the first flights of hot air balloons, and another on the speculations of electricity as a life force that led to Mary Shelly’s novel, Frankenstein; Or, The Modern Prometheus. The final two chapters are in the service of Holmes’s view that “Science is truly a relay race, with each discovery handed on to the next generation” (p.468). He identifies the next generation of scientists and pays particular attention to William Herschel’s son, John, and to Davy’s protégé, Michael Faraday. Both went on to accomplished and celebrated careers.

Holmes embeds the historical scientific developments and legendary figures into the ordinary daily life and human follies of the time. He describes how scientists and explorers sought public and private funding, and how they collaborated with one other on some occasions and competed with one another on others. We read of court intrigues, societal jostling, courtships and marriages, extramarital affairs (chaste and tawdry), and family relationships (devoted and fractious).

A broader context Holmes provides involves the interplay among the scientists and explorers he covers and some of the important figures in literature, poetry, and art of Romantic era. Samuel Coleridge, William Cowper, John Keats, Mary Shelley, Percy Bysshe Shelley, Robert Southey, and Joseph Wright of Derby among others make appearances in the stories Holmes tells. He details the friendships between them and the influences they had on each other.

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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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