Summary:

In the prologue to "The Anatomist" author Bill Hayes explains why he undertook the task of writing a biography of the author of the famous illustrated textbook "Gray's Anatomy." The reasons stem from his childhood and are multifold: an early interest in becoming a doctor, a fascination with religious (particularly Catholic) and artistic perspectives of the body coupled with an acceptance of his own homosexuality, a growing admiration for the writing and drawing in his bargain table copy of "Gray's Anatomy," and finally an attraction to a photograph of the enigmatic author in his anatomy lab - one of the few traceable artifacts of the man himself. Hence "The Anatomist" is not only a meticulous and fascinating biography of Henry Gray, the writer, and Henry V. Carter, the illustrator of "Gray's Anatomy," but also a memoir of the education and life of Bill Hayes himself during the period of research and writing this book. The book is a masterful mix of the history of medicine, anatomy education both current and historic, methodology of historical research, and poignant, insightful commentary on the frailties of human bodies and human relationships.

Hayes took three anatomy courses at University of California, San Francisco during the preparation of the book - one with pharmacy students, one with physical therapy students, and the final one with medical students. By the third course, Hayes was a pro at dissection and had first hand knowledge and appreciation of the skills needed to be an anatomist.

Because of the paucity of information available on Henry Gray, the bulk of the research rests on the diaries and letters of the tireless, self-critical and amazingly skilled younger member of the book's creative team - the artist-physician Henry Carter. Through Carter's diaries we learn of the formidable genius of Gray, his academic accomplishments, the genesis of the idea for the book, and Gray's early death at age 34.

Interestingly, in a pattern similar to that of Andreas Vesalius's "De Humani Corporis Fabrica," whose illustrator was most likely Jan Stephen van Calcar, the artist Carter receives scant reward or acknowledgement of his vast contributions to the book. Hayes's biography rectifies this hundred-and-fifty-year-old omission by tracking not only the career of Gray, but also Carter. Indeed, peppered throughout "The Anatomist" are more illustrations than quotes from "Gray's Anatomy."

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The Glass Castle, a gripping memoir about growing up devastatingly poor in America, opens with this first line: "I was sitting in a taxi, wondering if I had overdressed for the evening, when I looked out the window and saw Mom rooting through a Dumpster." (p. 3) Jeanette Walls slinks down in the taxi's back seat and returns to her Park Avenue apartment. A few days later, she manages to contact her homeless mother and take her out for dinner, offering her help, yet again. But her mother refuses, and when asked what Jeannette is supposed to say about her parents, her mother replies "Just tell the truth...[t]hat's simple enough." (p.5) And with these words, Walls launches into the history of her upbringing, with all the deprivations, suffering, joys, shame, exasperations, tribulations and sorrows - the story of the Rex and Rose Mary Walls' family.

Rex Walls is an alcoholic and dreamer, his wife an artist and egoist; both are psychotically blind to the basic needs of their four children. Yet the parents do feed the children with love and intellectual stimulation, managing to keep the family unit intact while the children figure out how to survive. The reader first meets the child Jeannette at age three when she is on fire, cooking hot dogs on the stove in a trailer park, completely unsupervised. She requires multiple skin grafts but enjoys the regularity of hospital food, until six weeks later her father abducts her from the hospital in the first of a series of "skedaddles" that the reader learns is the way Rex Walls stays ahead of bill collectors and other authorities.

At each miserable turn, the reader wonders if things can get any worse. They do. The family winds up living in a rotting hut without plumbing in the coal mining town of Welch, West Virginia. Rex steals money from his children, Rose Mary buys herself art books instead of food for the family. The kids eat garbage they secretly remove from trash bins at school.

But finally, one by one, the kids do escape, although, like everyone, they carry the past within them. To varying degrees, each is scarred. Nonetheless, Jeannette works her way through Barnard in New York City and becomes a contributor to MSNBC. Ultimately the book is a tribute to the gutsy resilience of some remarkable individuals.

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Bonjour Tristesse is a novel about a seventeen-year-old girl, Cécile, written by an eighteen-year-old, Françoise Quoirez (pen name Sagan). Published in 1954 in France and 1955 in the United States, the story was an immediate success.

Cécile's mother died when the girl was two, and she lives with her forty-year-old father, Raymond. Raymond enjoys parties, young women, drink and easy conversation. He, Cécile and his latest girlfriend, Elsa, sojourn on the southern coast of France, where Cécile meets and toys with a young law student. Cécile is mercurial in her thoughts, but once a true rival for her father's affections arrives at the summer house, her jealousy surfaces fully. Anne had been a friend of Cécile's mother, and, unlike Raymond's other love interests, is intelligent and similar in age.

Tragedy ensues from Cécile's plotting and her father's weaknesses, and the question remains whether suicide or an accident occurred.

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John Grogan's best selling memoir of his and his family's life with an exuberant, loving Labrador retriever pup that grew into an overly boisterous ninety-seven pound member of the family chronicles the joys and tribulations of dog ownership. Particularly, of Marley ownership. Marley flunked obedience school, required tranquilizers to tolerate thunder storms, destroyed possessions and jumped on people, to name a few traits.

The young married couple adopted Marley before they had children. The reader learns of the pregnancies and births of the Grogan's three children, including a miscarriage, ‘performance failure' during sex timed to ovulation, and an episode of post-partum depression, with an eye to what Marley was up to during that phase of family life, and especially how he responded to his owners' emotional states. Marley's protective stance towards not only the children, but also to a knifing victim in the neighborhood and to Grogan himself when he was struck by lightning, proved the dog's loyalty and devotion.

Marley lived a full life; as he aged, his hearing, sight and mobility worsened. He required emergency abdominal surgery at an old age, recuperated, but then suffered the same stomach bloat and twist problem again.

Grogan, a newspaper columnist, decided, after a period of intense grief, to write an article about Marley. "‘No one ever called him a great dog - or even a good dog. He was as wild as a banshee and as strong as a bull. He crashed joyously through life with a gusto most often associated with natural disasters...' There was more to him than that, however... ‘He taught me to appreciate the simple things...And as he grew old and achy, he taught me about optimism in the face of adversity. Mostly, he taught me about friendship and selflessness and, above all else, unwavering loyalty.'" (p. 279)

The column generated an avalanche of responses; fellow owners of bad yet lovable dogs wrote to the newspaper of their own experiences. These responses were cathartic to Grogan as he and his family learned to live without Marley, the dog who had taught them all so much: "the art of unqualified love." (p. 287)

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Nan Cohen's poem, Rope Bridge, from the collection of the same name, explores the intersections between science and art by lyrically describing a landmark psychological study on the attribution of emotion. The study, by Dutton and Aron in 1974, was based on the theories of Schacter and Singer from the previous decade. In one set of experiments, male volunteer subjects met a female assistant under two different circumstances - either in a benign setting or after braving the swaying Capilano Bridge. This bridge is suspended hundreds of feet above a river near Vancouver, British Columbia, Canada; subjects who met the assistant after crossing the suspension bridge were more likely to exhibit behaviors compatible with feelings of attraction to the woman.

The brilliance of Cohen's poem is the smooth interplay between scientific and poetic language. Imbedded in the poem are survey questions with lines ready for tick marks, as well as phrases such as "the attribution of a heightened state". The scientific language is not only juxtaposed, but intertwined with lyric flights: "Who would say: it is fear that takes my breath, / that wets my palms... / the fear that sleeps in me".

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In this compelling memoir, Grace, a writer, artist and teacher, unexpectedly finds herself attracted to a carpenter, Howard Staab, whom she meets when looking at a new home. Shortly after their relationship begins, Staab is told in a routine physical examination that he has severe mitral valve regurgitation and will require surgery. Staab, an active, otherwise healthy fifty-three year-old man, has no health insurance. The cardiac surgery will cost over $200,000. Thus Staab and Grace embark on a quest to find an affordable, but excellent surgeon and hospital. Grace details her efforts to find the best care possible, including correspondence with her son, Bryan, a Stanford medical student with interests in international health. These inquiries lead to the possibility of surgery in India.

After a useful, explanatory preface the book begins when Staab and Grace land in New Delhi and enter the Escorts Heart Institute. Staab undergoes a series of tests confirming the need for surgery, which is subsequently performed by Dr. Naresh Trehan. Through Grace's eyes, we also meet nurses, aides, other physicians, administrators and friends. The narrative follows the hospitalization, including dramatic complications and eventual recovery, and also backtracks to better detail the search for care and the predicament of un- and underinsured Americans. Grace also describes the post-hospital phase, including venturing out beyond hospital and hotel walls.

The book, highlighting the fact that Grace and Staab face more than one cultural challenge in this journey, contains both a medical terms glossary and a short list of Hindi terms. Ultimately, Grace concludes she would consider returning to Escorts or a similar hospital should she or a loved-one require surgery, even without the insurance issue. She states: "India, the land of contradictions. Organized chaos. A third-world country with first-world state-of-the-art medical care available for a fraction of the cost of the same procedures here in the U.S." (p. 259)

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This memoir chronicles the pre-adolescent and adolescent years of the author, the son of an alcoholic, abusive mathematics professor father and a psychotic Anne Sexton-wannabe confessional poet mother. The only family member who does not abuse the boy in any way is estranged--an older brother with Asperger’s syndrome. Meanwhile, the amount of trauma to which young Burroughs is subjected boggles the mind. Just when one thinks it couldn’t get any worse, it does.

Burroughs, who loves bright, shiny, orderly things, also likes doctors--paragons of cleanliness, virtue and wealth. Unfortunately, his mother’s psychiatrist, Dr. Finch, described as a charismatic Santa Claus-look-alike, is unethical, bizarre and squalid. As Mrs. Burroughs becomes more and more dependent on Finch, she allows her son to be adopted into the crazy Finch household.

This family includes wife Agnes, who copes with her husband’s infidelity by sweeping madly; son Jeff, daughters Kate, Anne, Vickie, Hope and Natalie; grandson Poo; and adopted son, Neil Bookman, who is twenty years older than Burroughs and homosexual. When Burroughs is thirteen, and has told Bookman that he, too, is gay, Bookman forces the boy to have oral sex. They become lovers.

The Finches, meanwhile, exhibit their quirks and weird tendencies in multiple ways. "Bible-dipping" is popular to read the future, as is prophesying by examining Dr. Finch’s turds. A patient with agoraphobia, Joranne, lives in one of the rooms--in fact, she has not left the room in two years. Young Burroughs is allowed to smoke and drink. When Burroughs says he doesn’t want to return to school, Dr. Finch facilitates this desire by giving Burroughs alcohol and pills to fake a suicide gesture, then hospitalizes the boy.

Yet Burroughs manages to befriend a couple of the Finch daughters, and to survive his childhood. The book closes with his departure for New York City and with an epilogue outlining various people’s outcomes. Finch lost his license due to insurance fraud.

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This video is the film of the staged one-woman play written and acted by white South African Pamela Gien. The play begins in 1963, in a white suburb of Johannesburg, in the fenced yard of the Grace family and their black servants. Gien starts as six-year-old Lizzie Grace. Gien then fluidly shifts roles to enact twenty-eight different characters from newborn to age eighty-two, black and white, male and female--who talk, gesture, sing and dance in this tour-de-force performance.

The set contains only a large, plain swing; even the berry-bearing syringa tree to which the swing is attached is left to the imagination. Gien’s costume is similarly muted--she is barefoot and wears a beige jumper over a simple tee shirt. A sound system provides music of ethnically diverse origins at appropriate moments.

The play opens with Gien swinging and talking in a girlish voice and using exaggerated childlike gestures. Lizzie exclaims that she is "a very lucky fish": she proceeds to explain to the audience the meaning of her favorable white nailbed spots. Lizzie is, by self-definition, a "hyperactive," outspoken child with great imagination and energy. She is cared for by Salamina, a loving nanny and servant.

Lizzie’s father is Dr. Isaac Grace, who delivers Salamina’s baby in the home. The child, Moliseng, "has no papers" and is harbored illegally by the Grace family--a constant source of worry for all, including Lizzie. Isaac is a Jewish atheist, and Lizzie’s mother, Eugenie, is Catholic and of English descent. Their neighbors, however, are bigoted Afrikaners and create great tension for the Grace household. "Don’t ever make this place your home," advises Dr. Gien to his daughter after dealing with racist clients who do not want to be in the same examining room after a black patient.

Lizzie’s liberal, generous grandfather is brutally murdered by a Rhodesian freedom fighter shortly after the resolution of another crisis: Moliseng, suffering from malnutrition, is missing from the overcrowded hospital. The play then fast forwards through Lizzie’s college years, when Moliseng, at age fourteen, is murdered in youth riots. Lizzie leaves for America, land of the (she pounds her chest) "free and brave." She returns years later, with her infant son named for her grandfather, to visit her father, her demented mother, and, above all, her beloved Salamina.

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This collection of essays by surgeon-writer Atul Gawande (author of Complications: A Surgeon's Notes on an Imperfect Science --see annotation) is organized into three parts (Diligence, Doing Right, and Ingenuity) and includes an introduction, an afterword entitled "Suggestions for becoming a positive deviant," and reference notes. Each part is comprised of three to five essays, which illustrate, as Gawande explains in the introduction, facets of improving medical care - hence the title of the collection: Better: A Surgeon's Notes on Performance. In typical Gawande style, even the introduction contains tales of patients - a woman with pneumonia who would have fared far worse had the senior resident not paid close and particular attention to her well-being, and a surgical case delayed by an overcrowded operating room schedule. Such tales are interwoven with the exposition of themes and the detailing of the medical and historical contexts of the topic at hand.

The essays, though loosely grouped around the improvement theme, can easily be read as individual, isolated works. The concerns range widely both geographically (we travel to India and Iraq as well as roam across the United States) and topically. For instance, we learn about efforts to eradicate polio in rural south India and the dedicated people who devise and implement the program. Another essay, far flung from the plight of paralyzed children, is "The doctors of the death chamber," which explores the ethical, moral and practical aspects of potential physician involvement in the American system of capital punishment (from formulating an intravenous cocktail ‘guaranteed' to induce death to the actual administration of such drugs and pronouncement of death).

In sum, the topics of the eleven essays are: hand washing, eradicating polio, war casualty treatments, chaperones during physical examinations, medical malpractice, physician income, physicians and capital punishment, aggressive versus overly-aggressive medical treatment, the medicalization of birth, centers of excellence for cystic fibrosis treatment, and medical care in India. The afterword comprises five suggestions Gawande offers to medical students to transform themselves into physicians who make a difference, and by including this lecture in the book, what the reader can do to lead a worthy life.

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In this collection, twenty-two medical students and young physicians across the United States eloquently recount the process of medical education for those who do not believe they fit standard measures of student demographics. The editors, Takakuwa, an emergency medicine resident physician; Rubashkin, a medical student; and Herzig, who holds a doctorate in health psychology, group the essays into three sections: Life and Family Histories, Shifting Identities, and Confronted.

Each section is prefaced by an essay explicating the essay selection process, the history of medical school admissions policies and requirements, the basic progression of medical education and the reasons for this collection, such as "putting a human face" (p. xx) on the changing characteristics of admitted medical students: "With their diversity and through their self-reflections, we hope that these students will bring new gifts and insights to the practice of medicine and that they might one day play an important role in transforming American medical education into a fairer and more responsive system." (p. 141)

Additionally, a foreword by former Surgeon General Joycelyn Elders outlines her experience as a black woman entering medical school in 1956, including eating in the segregated cafeteria. The book concludes with recommendations for further reading and improvements to the medical education process as well as with brief biographies of the contributors and editors.

The range of essays is impressive: diversity itself is given a new meaning by the variety of narrative voices in this volume. Contributors include people from impoverished backgrounds, both immigrant (Vietnamese, Mexican) and not. One student, marginalized by his academic difficulties, began a homeless existence during his first clinical year. Others were made to feel different because of being African or Native American.

In two essays, mothers defy labels placed on them (pregnant black teen; lesbian) and describe the trials and triumphs of their situations. Students write of being subjected to ridicule, ignorance and prejudice due to their gender, interest in complementary medicine, political and advocacy views, or religious beliefs. Due to pressures to conform, even students from what might be considered more mainstream in American culture (e.g., growing up in a small town, or being Christian) can experience the effects of being "different" when in medical school.

A number of essays communicate the difficulties of illness, disability and bodily differences. Issues include recovered alcoholism (rather tellingly, this is the only essay that is anonymous), obsessive compulsive disorder, sickle cell anemia, Tourette Disorder, attention deficit hyperactivity disorder, chronic pain, and obesity. The authors balance their narratives of hardship with insights into how their struggles improve their opportunities for empathy, perspective and fulfillment as physicians.

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