Summary:

Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.

Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)

Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.

However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.

She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)

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This history of western medicine in the nineteenth century chronicles the lives of some men and women who were innovators in the field of medicine. Williams begins the book in the 1700s with the life of John Hunter and his influence on nineteenth century medical practice and research.

The book consists of 16 chapters, many of which, like the one on Hunter are biographic. For example, Williams writes of the contributions, education, and lives of Florence Nightingale, Hugh Owen Thomas (orthopedics), Marie Curie, Joseph Lister, Ignaz Semmelweis (maternal health), Patrick Manson (tropical medicine), Jean-Martin Charcot, and William Conrad Röntgen. Other chapters are more theme-oriented, such as body-snatchers, discovery of anesthesia, homeopathic medicine, blood transfusion, and medical use of spas.

Black and white illustrations, such as Mrs. Röntgen's hand in an X-ray photograph help the reader to appreciate the advances in medical knowledge in the nineteenth century.

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In this huge painting, Courbet depicts the funeral scene of an ordinary citizen of the village. The open grave at the center front of the painting is surrounded by a great S-curve of pallbearers, priest and altar boys, gravedigger, family and friends in mourning. The composition is, in many ways, classical, yet the subject matter-- the burial of an unknown villager--is starkly different from the grandiloquent depictions of famous historical events or wealthy, powerful people so common in contemporary 19th century painting. This deliberate and radical choice of subject is also reflected in the title of the painting, which only locates the burial by town and not person.

The grouping of mourners and attendants follows the horizon or distant cliffs--no one's head extends into the sky. Only the crucifix, held by a religious attendant, is outlined by the muted tones of the sky. The earthbound nature of life is thus emphasized, as the figures are framed by dirt and rock.

Courbet instills the human touch into his painting. An altar boy gazes with a look of innocence up at a pall bearer. A young girl peers around the skirts of her elders. Several grief-stricken women clutch handkerchiefs to their faces.

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Like the train images in the last two stanzas, this poem is a train of thoughts about medicine, doctors, and patients' relationships to doctors, medicine and illness. The poem begins with the narrator's (presumably the poet's) Chinese doctor writing a prescription in Chinese. The poet begins daydreaming about the characters, and this leads to a soliloquy about daydreaming and illness and the slower pace of the ill, hanging "suspended in the wallpaper" of waiting rooms.

A recollection of the poet's "lady doctor" and his infatuation with her leads to a revelation of his desire to have illness and suffering, just to be with her. He philosophizes "suffering itself is medicine / and to endure enough will cure you / of anything." He decides he'd like to suffer like his mother, who seemed to not only accept, but also relish, the sick role of the weak, dependent state.

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The poem is divided into six stanzas, each titled by a successive day. The subject of the poem is a woman's reaction to mammography and the unexpected "spot" that is discovered. The woman is shown the spot on the mammogram, and the agony begins: does she have breast cancer? The exam occurs on Thursday; she must wait until the following Tuesday to find out.

Meanwhile, life and relationships take on new meanings and tenderness. For instance, at a large family reunion, she is determined to laugh with the family about childhood reminiscences, even though her laughter is now bittersweet (she keeps her torment private from all but her lover).

Other days are filled with worry and nightmare. At long last, during a perfunctory call from her physician, she finds out that the spot is merely a protein deposit. Relieved, she thanks the physician, who remains uninformed of the depth of her patient's recent torment.

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In this book written for the layman, linguist George Lakoff and philosopher Mark Johnson cogently argue that metaphor is integral, not peripheral to language and understanding. Furthermore, "metaphor is pervasive in everyday life, not just in language but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature." (p. 3)

The authors adopt a broad definition of metaphor, examine common phrases for metaphorical interpretation, and offer a classification system of metaphor. For example, orientational metaphors are found in our ordinary language and are part of the spatial organization of our lives. When one says, "He dropped dead" or "He's at the peak of health," one is using the orientational metaphor that we live by: "Health and life are up; sickness and death are down." This orientation is not arbitrary; the authors point out that one lies down when one is ill.

Other types of metaphors categorized by the authors are structural and ontological (e.g., making a non-entity into an entity: "We need to combat inflation," or setting a boundary on a non-entity: "He's coming out of the coma"). The authors also differentiate metaphor from other figures of speech, such as metonymy, which relies more completely on substitution: "The ham sandwich wants his check."

The second half of the book address issues more philosophical in nature, such as theories of truth and how we understand the world, including the "myths" of "objectivism," "subjectivism," and "experientialism." These theories are reviewed with metaphor in mind. For example, objectivism relies on the separation of man from the environment and the subsequent mastery over the environment. Hence objectivism is rife with metaphors which confirm such ideas as "knowledge is power."

The authors conclude by stating that metaphors provide "the only ways to perceive and experience much of the world. Metaphor is as much a part of our functioning as our sense of touch, and as precious."

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This novel chronicles the long journey home of a Civil War soldier, Inman, to Cold Mountain in North Carolina. The story begins in a military hospital, and Inman's neck wound, a long difficult-to-heal horizontal slice received in battle, is drawing flies. Inman is a moral man, and the brutality and killing he has witnessed on the battlefield lead him to leave the hospital AWOL and journey secretively, by foot, back to Ada, his love.

The trip is perilous; Inman is subject not only to the difficulties of near starvation and a poorly healing wound, but also the cruelties of people he meets along the way. However, every so often, he is also succored by compassionate people, such as the goat woman who provides the cure for his neck wound, if not for the wounds inside. Intertwined with Inman's story is Ada's: her preacher father dies of tuberculosis, leaving her utterly unable to provide for her own basic needs on the farm. Fortunately, a self-reliant young woman, Ruby, joins Ada on the farm, and helps transform both the farm and Ada.

The book details the ways of nourishment: physical (precise descriptions of food, its paucity and preparation) and nonphysical (themes of love, generosity, intellectual curiosity, and spiritual questing underpin the book). Cold Mountain itself provides both types of nourishment by offering hope, goals, shelter, food and a place where love and forgiveness are possible despite the savagery of man.

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This history of western medicine focuses on British life in the eighteenth century. Williams begins his treatise by wondering if "we realize sufficiently what we have escaped by being alive in the twentieth, not the eighteenth, century." He then catalogues in the subsequent 12 chapters the agonies not only of illness but also of medical treatment in the 1700’s.

Topics are wide-ranging and include blood-letting, parturition, infant malnutrition, rampant infectious diseases, maltreatment of the insane, surgery prior to anesthesia, water therapy, and military medicine. Primary source quotations interspersed in the narrative add to the drama. For example, the deposition of a widower (his wife died while pregnant) is quoted: " . . . Being taken ill of a paine in her right side under her short ribb together with a great difficulty of breathing having but 14 weeks to go with Child Mr Hugh Chamberlen Senr was sent for to take care of her, who thereupon gave her in the space of nine days four vomitts, four purges, and caused her to be bled three times to the quantity of eight ounces each time: Then gave her something to raise a spitting after which swellings and Ulcers in her mouth followed . . . . " (p. 31)

A few medical advances at the close of the century are also described, notably the smallpox vaccine developed by Jenner and the administration of First Aid to wounded soldiers at the frontlines (developed by Larrey). The text is accompanied by black and white illustrations, such as an inside view of Bedlam (Bethlehem Hospital) by William Hogarth (A Rake’s Progress, plate VIII).

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This thoroughly researched book helps us understand John Keats's life and work in terms of his medical training. Goellnicht argues that, contrary to some critics' view that Keats was "anti-scientific" or "anti-intellectual," Keats incorporated much of the knowledge gained from his six years of medical training into his poetry.

The book begins with a chapter of biographical information about Keats, emphasizing the nature of medical training in the early nineteenth century, but includes Keats's self-diagnosis of tuberculosis. The heart of the book consists of four chapters, organized by scientific topic, which relate the specifics of Keats' s medical training to his writing: Chemistry, Botany, Anatomy and Physiology, and Pathology and Medicine.

Excerpts of Keats' poetic and epistolary writing are examined in each of these chapters in light of Keats' scientific and medical knowledge. For instance, in the chapter on Botany, the uses of specific botanical species in his writing are examined in terms of what was known of materia medica (see annotation for Ode on Melancholy. Furthermore, the author explores Keats's interest in plants and trees as metaphors for life, such as his interest in "the flower as a vital, but passive, being that exists in a state akin to negative capability."

The author concludes the book with a summary statement about each of the chapters (e.g., " . . . from pathology he adopted the approach of viewing aspects of life, in particular love and poetic creativity, in terms of morbid and healthy states . . . ") and also the caveat that the book is not meant to in any way diminish other profound influences on Keats, such as his interactions with other Romantic poets. Goellnicht notes, however, that Keats himself united the worlds of medicine and poetry in his poem, "The Fall of Hyperion," in which he describes the poet as a physician.

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Dr. Papper, a revered figure in the field of anesthesiology, questioned why it took so long for anesthesia to be "discovered": after all, pain and suffering existed long before the mid-nineteenth century. This book is a result of Papper’s graduate studies in literature and history and explains his thesis that "societal concern with pain and suffering, and the subsequent development of surgical anesthesia in the Romantic era . . . are outgrowths of Romantic subjectivity."

The book provides biographies of scientists, physicians and poets, such as Humphry Davy, Thomas Beddoes, Sr., Samuel Taylor Coleridge and Percy Bysshe Shelley, along with analyses of Romantic poetry as related to pain and suffering. Papper theorizes that the exchange of ideas amongst these intellectuals and the political upheavals of the time paved the way for society to recognize that the pursuit of happiness could include the relief of pain.

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