Summary:

Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."

Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.

The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.

Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Edgar Drake, a forty-one-year-old English piano tuner, accepts a commission from the 1886 British War Office to tune an Erard grand piano located in a colonial military outpost in Mae Lwin commanded by Surgeon-Major Anthony Carroll. Edgar leaves the squalor, fog and drizzle of London, as well as his middle class life and his wife Katherine, childless for eighteen years, for a journey by boat, train, carriage and horse to the exotic, intoxicating beauty of Burma.

En route, Edgar is surrounded by stories--a tale by the deaf Man With One Story, rumors about the legendary, eccentric Carroll's peace-making with the local Shan via music and cultural exchange, and socio-historical treatises about the Burmese, internecine wars, and British imperialism. The journey becomes a search for the meaning of home and purpose in Edgar's life. It is an adventure far beyond his prior imaginings and dreams.

The clash of cultures, British and Burmese, civilian and military, wealthy and poor, rule-bound and individualistic, is explored throughout the text. For example, a tiger hunt led by several British officials ends in disaster. Edgar meets Burmese culture on both grand and personal scales: street theatre; appealing, poverty-stricken children; the garb and cosmetics of various tribes; and, ultimately, the allure of Khin Myo, an educated Burmese woman who guides him to Mae Lwin and Carroll.

Carroll, a renaissance physician with a Victorian fervor for botanical and medicinal classifications and investigations, asks Edgar to assist him in his clinic. Common infectious diseases are diagnosed and treated by this forward-thinking physician, and he also performs finger amputations on the mangled hand of a boy without benefit of anesthetic. Other maladies are treated with local remedies and prayer. Meanwhile the delirium of malarial fever descends on Edgar.

Edgar does finally meet and treat the ailing, badly out-of-tune Erard piano. Edgar's expertise is required--his aural excellence and perfect pitch, his delicate yet callused hands, and his willingness to be innovative in the repair of a bullet hole. But what Edgar cannot be prepared for--intrigue and deceptions, fascination with the lush beauty of Burma, and his own shifting priorities and secret longings--is ultimately what sets his fate.

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This collection of nonfiction writings by fiction author Amy Tan includes multiple genres: essay, email, responses to journalist's questions, eulogy, love poem, university presentations, travel journal entries, and a commencement speech. Hence Tan terms the work "musings." Consonant with the multiple genres are multiple topics, ranging from memoirs of childhood and young adulthood, writing tips, fun portraying a dominatrix in a writers' rock-n-roll band, work on the film version of The Joy Luck Club, and past and present tragedies and struggles.

Much of the book, however, centers on medically-related themes. Prominent themes are: her diagnosis of neuroborreliosis--a form of late-stage Lyme disease--detailed in the final essay entitled "The Opposite of Fate"; her traumas such as the torture and murder of her best friend; the death of her father and brother from brain tumors; a car and a skiing accident; the cancer death of her editor and, woven throughout, the complicated psyche of her mother, Daisy Tan.

Daisy's extreme emotions ruled the family, and her behaviors, such as threatening not only suicide but also murder (she held a knife to Amy's throat), caused profound responses in her daughter. Probably one of the most adaptive responses was Amy Tan's use of their complex relationship in developing the nuanced mother-daughter relationships that characterize her fiction. Daisy's decline and death from Alzheimer's disease are also detailed here.

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This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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This video depicts Robert Coles, noted author, psychiatrist, documentator and humanist, teaching his popular undergraduate course, "The Literature of Social Reflection," at Harvard University in 1990. The film begins with a bell tolling in a steeple and students entering the lecture hall. Excerpts from his lectures are presented in 4 parts: I: Ruby; II: Seeing--The Paintings of Edward Hopper and The Stories of Raymond Carver; III: Praying; and IV: Potato Chips and Tolstoy.

Some additional documentary clips are shown, such as footage of six-year-old Ruby Bridges being escorted into a previously all-white New Orleans school amidst a screaming mob during forced integration of schools. In between segments, brief interviews of Coles’ students let the viewer know that his message is getting through: it matters how you live your life--it matters a great deal.

Coles teaches with stories and these stories are riveting. In 1960, while in the Air Force and assigned to a psychiatric detail, he befriends young Ruby after he witnesses her courage in entering the school building. He comes to know her family and teacher.

Several months later, during the morning escort, Ruby stops in front of the school and says something which makes the mob even more frenzied. Coles is asked by the teacher to tell Ruby not to do that again. Upon gentle questioning, it turns out that Ruby was not talking to the mob, but to God: "Please God, try to forgive those people because they don’t know what they’re doing."

It was a prayer she said every morning, usually a couple of blocks away from the school, but that morning she had forgotten to do it earlier. Coles discusses the remarkable gift of forgiveness instilled in this brave child by her parents, who despite poverty and lack of opportunity to advance in life, were able to love and teach their children values and grace.

In Part II, Coles uses paintings by Edward Hopper, a poem by Raymond Carver ("What the Doctor Said" (annotated by Felice Aull and Irene Chen, also annotated by James Terry) and Carver short story (Cathedral) to illustrate how difficult it can be to truly communicate with and know another person. And how magical the moments are when we do.

In Part III, Coles shows some of the children’s drawings that he has collected during his documentary work. Coles delights in describing what the children said about their drawings at the time they created them. He clearly respects them and their ideas.

The last part ends with the story of the death of Coles’s mother at Massachusetts General Hospital. In her dying days she befriended an African-American woman, whose job was at the bottom of the hierarchy of the hospital: an orderly. After Coles’s mother died, it was this woman--not any doctor or nurse--who taught Coles how to take the time and be with his mother, rather than rush off as he was preparing to do. Coles asks, "Who was the doctor, the healer, the wise person?"

He notes that these twists are characteristic of many stories, such as those by Flannery O’Connor. He then concludes before a standing ovation: "Let us be good to one another, live on behalf of one another . . . . We are lucky to have these writers . . . and to have the lives that can include them."

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Anne Lamott, a writer, recovered alcoholic, former addict and impassioned Republican-hater, finds herself pregnant in her mid-thirties, and decides to have the baby. This journal is a chronicle of her son Sam’s first year. She is fiercely self-deprecatory and funny and unafraid to talk about the dark side of parenting an infant: the fear, exhaustion, anger, emotional swings; that 4 a.m. inability to cope with the crying neediness of the baby.

She is a single parent barely able to pay the bills, but she has a tremendous support network of family, friends, and the people of her church--all of whom clearly love Sam and love her. And then, when Sam is 7 months old, crawling "like a Komodo dragon," the author’s best friend Pammy is diagnosed with metastatic breast cancer. The author, who discovers the depth and resonance of love because of the gift of Sam, must now learn loss. She questions her faith, which she cannot justify on a cerebral level, but still hopes that God loves and guides her the way a parent loves and guides a child.

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The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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The narrator needs a break from her unnamed troubles, so, on the recommendation of a friend, travels to a Texas farm to live with a German-American family for the month of March. The Muller extended family members are hard-working folk, at times gruff and laconic, but who clearly care for and love one another. The narrator is intrigued by the servant girl, Ottilie, who although disabled, disfigured and mute, cooks and serves meals for the twenty members of the household.

Ottilie later shows the narrator a photograph from her childhood, and the narrator (and reader) is startled to find out that not only was Ottilie a normal child, but she is also the eldest daughter of the matriarch and patriarch. Many of life’s milestones are encapsulated in the month, including a wedding, a birth, a natural disaster, and finally the death of Mother Muller. The family continues to ignore Ottilie and her suffering; in the end, only the narrator reaches out to aid Ottilie in her grief.

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