LitMed: Literature Arts Medicine Database

American Sirens: The Incredible Story of the Black Men Who Became America’s First Paramedics

Hazzard, Kevin

Last Updated: Aug-02-2023

Schilling, Carol

Primary Category: Literature / Nonfiction

Summary:

Before the late 1960s, when someone had a medical emergency, their best hope was a “swoop and scoop” rescue. A police van or a hearse—if one appeared at all—would load up and drive the patient, unattended, unrestrained, to a hospital emergency department. On arrival, there was often little that could be done. In American Sirens, journalist Kevin Hazzard, himself a paramedic, reveals the story of the first fully trained paramedics who practiced life-saving medicine beyond hospital walls. Celebrated in Hazzard’s account are the Black men from the segregated Hill District of Pittsburgh that the visionary physician Peter Safar, inventor of CPR, recruited and trained.

Safar’s 1967 project to train and hire unemployed men from a community organization known as Freedom House was initially met with derision. How, his colleagues asked, could he trust people with a high school education, or less, to endure intensive medical training and perform it flawlessly? The training included fifty instruction hours in anatomy and physiology, more time learning CPR, advanced first aid, defensive driving, and medical ethics. Trainees also learned how to treat cardiac conditions, diabetic emergencies, bleeds, spinal and pelvic fractures, and overdoses. Most controversially, they were taught how to intubate patients. While only 24 participants in Safar’s first class of 44 succeeded, those who did provided evidence that paramedics were fully capable of saving lives. According to Hazzard, Safar’s emergency response project became the national standard.

Hazzard folds the project’s success into the stories of the men—all men at first—who took pride in contributing their life-saving skills to their community. Many of their lives changed direction in the process. Primary among them was John Moon, whose biography and dedication engagingly move the narrative forward. However, Hazzard also recounts how the project’s success met opposition from White residents wary of Black paramedics, a city government reluctant to fund them, and medically untrained police who felt upstaged. The final chapters recount the unravelling of the Freedom House first responders by the mayor of Pittsburgh. By 1975, political forces defunded the Freedom House crews and created a city-sponsored EMS run by the police. Only a few of the Freedom House paramedics chose to join or remain on the city ambulances. Most notably was John Moon, who rose in the ranks, recruited paramedics from low-income neighborhoods, and continues to keep the legacy of Freedom House alive.

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Tomorrow and Tomorrow and Tomorrow

Zevin, Gabrielle

Last Updated: Dec-12-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Among the many binaries that can be used to describe people, an easily observable one is how seriously they take the games they play. There are those who play basketball or Scrabble to simply relax and enjoy the camaraderie of their playmates. And then there are others for whom games are invested with considerably more significance, where winning in rotisserie baseball or a golf match becomes a statement about their core values, the meaning of life itself. Gabrielle Zevin’s wonderfully engaging novel, Tomorrow and Tomorrow and Tomorrow, is dedicated to those who proudly include themselves in the latter category.

The novel spans nearly thirty years and centers on three exquisitely drawn characters who are brilliant and appealing and whose raison d’etre is to design and promote the best computer games. Sam and Sadie are intellectual outliers from vastly different backgrounds. Sam’s Korean single parent mother is an actress wannabe, and he is actually raised by loving grandparents who own a pizza store in Koreatown in Los Angeles, while Sadie grows up in a supportive family of high achieving professionals. They meet by chance while Sadie is in junior high school. As part of her required community service, she visits Sam while he is hospitalized to treat a horrific leg injury (I am leaving out crucial details about how that happened). Sadie is drawn to Sam – her more than 900 hours of visits break the record of service time donated – and he in turn is able to overcome the chronic pain he endures and to open himself up to someone else.

A genuine bond is forged between the young adolescents that resurfaces a few years later when they bump into each other unexpectedly in a Cambridge subway station. Sam is a student at Harvard and Sadie is studying at MIT. They are both computer geniuses and in the early 1990s there is no better way to leverage their knowledge than to design innovative and complicated computer games. They are able to program games that combine literary structure, musical background, and state-of-the-art color graphics in the service of a narrative environment that challenges the intelligence and sustains the interest of the player. Joined by a common friend, Marx Watanabe, Sam’s roommate at Harvard, who becomes their devoted and creative producer, they develop a game called Ichigo, a tale of a child lost at sea who must find his/her (a key part of the game) way home. The game is based on the famous wood block print, “The Great Wave” by Hokusai and becomes an international bestseller. They are vaulted into the world of the rich and famous.

The novel chronicles their professional struggles over the following decade to maintain the same high level of creativity and mass appeal. Conflicts arise about assigning credit for their creations and dividing up the public accolades and recognition. There are the expected strains that are bound to develop in such a closely knit team of creative collaborators who are working 24-hour days to meet unrealistic production deadlines. And of course, there are complicated interpersonal relationships that develop that in such a high-pressure workplace. There is true joy, but it is always mixed with intense feelings of envy and nostalgia for simpler times. Other partners and love interests enter the story. But among this intriguing cast of characters, Sam is singularly complex, and his leg injury and chronic disability are crucial elements in the plot; he suffers from severe phantom limb pain and ultimately he is forced to have his damaged lower leg amputated. How he copes with his disability, real and imagined, alters the arc of the story to a significant degree. Sam cannot escape his feelings of being an outsider, even as he feels himself drawn to Sadie. The imaginary computer game world leaks into reality. Violence dramatically intervenes in the story and ineradicably alters the course of events (no spoiler alert). The novel that focuses on the creation of a virtual reality has a lived-in texture and fullness. I anticipate that most readers will find the ending to be satisfying, an exquisite expression of the complexity of human fate and interpersonal relationships.

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Medical Bondage: Race, Gender, and the Origins of American Gynecology

Cooper Owens, Deirdre

Last Updated: Nov-28-2022

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

In Medical Bondage: Race, Gender, and the Origins of American Gynecology, Owens argues that the emergence, practice, and professionalization of American gynecology in the 19th century were inextricably enmeshed with the institution of slavery and discourses of biological racism. “Modern American gynecology,” writes Owens, “could certainly exist without slavery, but slavery’s existence allowed for the rapid development of this branch of medicine, and especially of gynecological surgery” (6). As she shows, gynecology developed as quickly as it did only because white American physicians had access to women’s bodies marked as racially inferior. That gynecology’s maturation accelerated in the American South is no indication that its practitioners had a humane interest in enslaved women’s health (66). On the contrary. Owens argues that slave owners were invested in maintaining the reproductive health of enslaved women in the interest of increasing the size of their population: “Thus the repair of any medical condition that could render an otherwise healthy slave woman incapable of bearing children further strengthened the institution of slavery” (39). Additionally, there were broader implications, as medical research using enslaved women’s bodies produced knowledge about how to treat, in turn, white women: “Black lives mattered medically because they made white lives healthier and better” (107).

This leads Owens to argue why enslaved women should be esteemed as the maternal counterparts to the oft-celebrated white ‘fathers’ of American gynecology: “. . . black women, especially those who were enslaved, can arguably be called the ‘mothers’ of this branch of medicine because of the medical roles they played as patients, plantation nurses, and midwives. Their bodies enabled the research that yielded the data for white doctors to write medical articles about gynecological illnesses, pharmacology, treatments, and cures” (25). This is especially true, as she points out, when examining the medical research of the lauded gynecologist, James Marion Sims, who opened and operated a “sick house” for enslaved women suffering from gynecological ailments (36). Sims operated this clinic to devise a surgical solution to a serious and commonplace gynecological issue among enslaved women, vesico-vaginal fistulae. As an enterprising young physician, Sims took advantage of enslaved women’s bodies to conduct his surgical trials. Eventually, he triumphed and cured an enslaved woman, and published the results in a respected medical journal, thus enshrining his reputation (39). The point, Owen emphasizes, is that “[t]hanks in large part to his experimentation on enslaved black women, Sims had established himself as one of the country’s preeminent gynecological surgeons less than a decade after he began his gynecological career” (39). Medical Bondage thus strives, in part, to restore the lives and contributions of these enslaved women to the story of American gynecology’s genesis.

Owens’ study takes a surprising turn, arguing that “. . . the later development of modern American gynecology can no more be disentangled from Irish immigration than it can be separated from its roots in slavery” (90). This shift in racial and geographic focus parallels the similar roles of enslaved black women of the South and poor, immigrant Irish women of the urban North in the development of gynecology. Owens shows how racial alterity was “mapped onto” poor Irish immigrant women living in major urban centers, such as New York City (20). As many Irish immigrant women suffered poverty, inadequate (if any) medical care, sexual assault, and were drawn into prostitution (and the attendant onslaught of venereal diseases), they became ideal medical subjects for gynecologists. Physicians eventually published their Irish patient case studies, which “. . . helped to create the foundation for the racist laws that colored the Irish as not quite white and sometimes placed them alongside black people as biological models for racial inferiority” (90). Just as Southern gynecologists had access to enslaved women’s bodies, their Northern counterparts treated and experimented on racially othered immigrant women. In this way, Owens argues, “[t]he scientific and medical beliefs that doctors held about Irish women were nearly indistinguishable to [sic] those they held about African women” (115). Overall, Medical Bondage articulates a well-researched and sobering retelling of the dominant accounts of American gynecology.

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Born to Be

Cypriano, Tania

Last Updated: Feb-26-2021

Glass, Guy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Born to Be is a documentary about the trailblazing work being done at the Mount Sinai Center for Transgender Medicine and Surgery.

The film’s central figure is Jess Ting, a plastic surgeon who studied music at Juilliard before making a career switch to medicine. Scenes of him with patients are interspersed with domestic clips where he is at home with his children and playing the double bass. Just a few years ago Ting had never even performed a single gender-affirming surgery. He is the first to admit that he did not expect his career to take this turn: “Essentially, they just asked everyone else, and everyone said no except for me. Everyone thought I was nuts.” Be that as it may, Ting appears to have found his calling. In a short time, he has performed well over a thousand gender-affirming surgeries, pioneered new procedures, and helped to start a fellowship training program.

The stories of several of the Center’s patients are interwoven with that of Dr. Ting. One client, Cashmere, is a retired sex worker. Years of botched silicone injections have left her face chronically swollen. Now in her 50’s, she hopes to have the effects reversed, and to finally undergo the vaginoplasty she has been dreaming of her entire life. Another patient, Devin, 22, goes through a transition during the course of the film, renaming herself Garnet. Not withstanding strong family support, years of bullying in school have taken their toll as she struggles with depression.

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The Beauty in Breaking

Harper, Michele

Last Updated: Sep-18-2020

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The Beauty in Breaking is the memoir of an African American physician who, in her own words, has “been broken many times” (p. xiii).

Despite maintaining a veneer of affluence, the author, her mother and siblings live in constant fear of being battered by her father. Following one particularly vicious attack, she accompanies her injured brother to the local emergency room. That day she serendipitously discovers her calling: “As my brother and I left the ER, I marveled at the place, one of bright lights and dark hallways, a place so quiet and yet so throbbing with life. I marveled at how a little girl could be carried in cut and crying and then skip out laughing” (p. 18).

Much later, the author (Michele Harper) undergoes a shattering breakup and divorce. She endures disappointments at work, some of which, regrettably, can only be explained by the color of her skin.

As she picks herself up time and time again, Harper discovers her inner resilience: “The previously broken object is considered more beautiful for its imperfections” (p. xiii). She learns from the experience of her own suffering to develop compassion in her clinical work. The bulk of the Beauty in Breaking is devoted to case studies of the author’s clinical encounters with patients in the emergency room.

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Brave Story

Miyabe, Miyuki

Last Updated: Jul-20-2020

Brinker, Dustin

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Wataru Mitani is an average fifth-grade student in east Tokyo. Rumors of ghosts in a deserted, semi-built edifice lead this young boy and his friend Katchan to investigate it on their own. The next school day, they learn of a new transfer student named Mitsuru, a mysterious, handsome young boy whose standoffishness and manner of speaking make others think he’s far older than a middle-schooler. He becomes a centerpiece of the ghost rumors when he seems to accidentally take a picture of one while on an art class outing near the building. Meanwhile, Wataru starts hearing a mysterious voice at his home. He convinces himself that it’s a fairy à la his favorite video game, pushing him to follow Mitsuru’s lead and take pictures around his room in the hopes of catching a glimpse of the voice’s owner.

Trouble begins for Wataru during a visit from his paternal Uncle Lou when the two decide to investigate the abandoned building. After his uncle steps away to take a call, Wataru sees a golden door appear within the building, out from which steps Mitsuru. Both boys are shocked. Mitsuru immediately returns through the door, and Wataru attempts to follow him. Through the door, Wataru finds himself falling a great distance. He lands in a desert and shortly thereafter becomes surrounded by strange wolves with large, corkscrew mouths. He is saved by a wandering humanoid bird who reveals that he is known as a karulahkin and that the world they are in is known as Vision.

Our protagonist then awakens in the home of the building’s owner with his Uncle Lou at hand. When Lou attempts to take Wataru back to his hotel for the night, the boy forces out the truth: his father had called when they were in the building to inform Lou that he has decided to leave the household, divorce Wataru’s mother, and start a new life with an old lover. The entire family is devastated. Soon thereafter, Mitsuru goes missing, and Wataru overhears his mother gossiping about the murder-suicide of Mitsuru’s family by his father. That night, Wataru is awoken by the appearance of Mitsuru, dressed as a sorcerer, who explains that he has been chosen as a Traveler to journey through Vision in the hopes of meeting the Goddess of Destiny and changing his fate. He gives Wataru a pendant that should allow him to do the same once he travels through the gate in the abandoned building. Mitsuru then disappears, leaving Wataru to begin his adventure to Vision.

Once back in Vision, Wataru again meets the wizard, and he explains that Wataru must collect five gemstones and place them in hilt of this sword to gain access to the Tower of Destiny and meet the Goddess. On the way to the nearest town, he meets the lizardman Kee Keema who transports Wataru to the city, explaining the political situation of Vision along the way. The world is divided between those who believe in the Goddess and those who believe in the Old God, a deity purported to surpass the Goddess in every way. Followers of the latter are mainly ankha, what is known in the real world as human, and they espouse great intolerance to the world’s humanoid, animal inhabitants, known as beastkin. Kee Keema agrees to accompany Wataru on his journey. Over the course of the next few days, Wataru’s main party and alliances are established: Kee Keema and another beastkin named Meena will accompany him across Vision. As they get into various mishaps, the group encounters Mitsuru, now a powerful sorcerer with no concern for the death and destruction his magic causes. The boys come to learn that Vision is a reflection of their own imagination and understanding of life. It is further revealed that the appearance of two Travelers is an omen of a thousand-year sacrifice demanded by the Goddess: two people, one a citizen of Vision and the other a Traveler, are chosen to give their lives and act as the Barrier of Light to protect Vision and the real world.

A competition arises between the two boys from Japan, each thinking that the sacrifice will be the one who completes the journey last. Wataru is always one step behind Mitsuru in his collection of the gemstones, culminating in a final clash where Mitsuru destroys the entirety of an imperial capital, virtually eradicates all citizens, and unleashes a demon horde that had only been kept at bay by the final gemstone. Escaping the carnage, Wataru manages to gather four gemstones and is transported to the Tower of Destiny, the final trial from which only Wataru emerges alive. At the apex of the tower, he finally meets the Goddess. His wish is spent, not on himself, but on the salvation of Vision from the demon hordes. Returning to the real world, Wataru uses his knowledge and growth from Vision to handle the fallout of his home situation, supporting his mother as they transition into their new lives.

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