Summary:

In this rich opening chapter of his work on the Nazi doctors, Lifton lays out the groundwork for answering the question of how German doctors became the agents of Hitler’s vision of the purified Aryan race, sterilizing involuntarily several hundred thousand citizens with a variety of mental and physical deficiencies. His answer, in brief: a romanticized genetics coupled with total political control.

Amazingly, the Nazi medical atrocities were carried out not against the opposition of Germany’s medical establishment, but with its approval. (Of course, there were individual dissenters, the more vocal of whom were removed from positions of authority or put to death). Nazi leaders worked hard to convert medical people to the official position. This was accomplished partly by force, but also partly by metaphor, as the normal language of medicine was used to hide the unethical nature of what doctors were being asked to do.

Individual patients were replaced by the racial term "Volk," meaning the (Aryan) people, and their rights were superceded by their doctors’ new duty to assure the health of this collective political idea. According to Nazi publicity, the Aryan race was in grave danger of "Volkstod," of dying out, because its genetic pool had been contaminated both by the transmission of inherited genetic defects and by the "foreign invasion" of Jews and their intermingling with members of the "superior" Aryan race.

To save their new patient, German doctors were expected to carry out the sterilizations, medical experiments, and, later, the euthanasia required by Nazi doctrine, which, in the words of one Nazi writer, declared that "misery can only be removed from the world by painless extermination of the miserable." Doctors were urged not to worry about ethical issues, because Nazi medicine was "nothing but applied biology."

In these ways, says Lifton, Hitler’s racial policies were ’medicalized’ and their evil made less obvious. Those who went along were billed as the "saviors of mankind," the "alert biological soldiers" whose actions would restore the purity of the Aryan race. Jewish doctors were not invited, of course, their research having been officially discredited in the mid-1930s, Lifton tells us, and their medical licenses revoked in 1939--in spite of the fact that they made up half the doctors in some large cities.

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This is American writer Richard Wright's story of his life as a black child in the American South (Mississippi, Tennessee, and Arkansas) in the early decades of the 20th century. Black Boy opens with the disaster in which Richard at the age of four accidentally burns down his grandparents' house and is beaten nearly to death by his mother as punishment. The book ends with Richard's hopeful escape north to Chicago at the age of eighteen.

In between are years of heart-stopping survival stories, as Richard, an intelligent and willful child who tries to resist many of the demands of his strongly segregated environment, runs head-on into the hatred of racists and the deep poverty, hunger, and oppression that so often were the lot of the system's victims. (On the subject of hunger, one of the book's working titles was American Hunger, and Wright was chronically hungry all these years. He gets so used to extreme hunger that at one point late in the book after a short interlude with regular meals he is surprised to discover that he can suddenly read faster!)

Black Boy, originally published by Harper & Bros. in 1945, is only the first half of Wright's original manuscript. After production had begun on the complete manuscript, Wright accepted an offer from the Book-of -the-Month Club to make his book one of their selections if only the first half were published. The second half was first published in its entirety by Harper & Row as American Hunger in 1977. The 1993 edition titled Black Boy (American Hunger) brings both halves together for the first time. The second volume describes Wright's experiences in Chicago from 1926 to 1936, including his frustrating attempt to work with the Communist Party as a way of supporting unemployed workers during the Great Depression.

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Witty Ticcy Ray tells the story of Dr. Sacks’s treatment of a 24-year-old man with disabling Tourette’s syndrome. The first half of the essay is mainly medical-historical, with some technical language. When Sacks first tries treating Ray with a minute dose of Haldol, Ray finds that even that low dose too effective. It breaks up the rhythms that have determined his life since the age of 4, and he doesn’t like it. Later, a second trial using the same dose succeeds, Sacks believes, because Ray had by that time accommodated mentally to a change in self-image.

Still, over time Ray missed his old wildness and speed, and he and Sacks agree on a compromise: During the week, Ray takes Haldol and is the "sober citizen, the calm deliberator." On weekends, he is again "’witty ticcy Ray,’ frenetic, frivolous, inspired"--and a talented jazz drummer. This, according to Ray, offers Touretters an acceptable artificial version of normals’ balance between freedom and constraint.

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The speaker of this poem undergoes surgery for some kind of abdominal cancer--the important detail being that her mother had recently gone through the same experience and died several months later. A number of images convey the strangeness and alienation of serious illness. The mother’s cancer is an "embryo of evil" that curiously grew inside her like her own daughter (the speaker). The hospital room is the place "where the snoring mouth gapes / and is not dear."

And at her mother’s bedside the speaker finds that she must "lie / as all who love have lied." Her body hair shaved for her own operation, the speaker finds important values have been stripped away: "All that was special, all that was rare / is common here. /. . . Fact: the body is dumb, the body is meat." Coming out from under anesthesia, the speaker calls for her mother.

Later she realizes that, unlike her mother, she will probably survive. The last lines are comic in a self-deflating way, as the speaker gives herself get-back-to-life marching orders partly in the voice of her mother, concluding: "and run along, Anne, run along now / my stomach laced up like a football / for the game." (About 120 lines, in 6- and 9-line stanzas)

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One morning in the shower Joyce Wadler, "a journalist, forty-four, Jewish, never married," discovers a lump in her left breast. In this brief, bright, and very readable account, Wadler describes what happened next, taking us through medical examination, diagnosis, and successful lumpectomy and chemotherapy.

But this is much more than a simple patient’s story. For one thing, Wadler is an intrepid researcher, and we learn a good deal about breast cancer and the often agonizing therapeutic choices its victims face. For another, she does not separate her medical adventure from the rest of her life, which includes a day job as a writer for People magazine, a book project, a semi-functional relationship, and a Jewish mother.

Finally, Wadler uses her ironic-sardonic sense of humor to great advantage--remarking, for instance, that through her post-diagnosis impulse to live in the present and not worry about her lover’s monogamy, cancer had made her "the dream girl of every uncommitted man in Manhattan"!

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An epigraph preceding this 28-line poem, apparently from notes by the physician-writer’s physician-father, sets the action of the poem in Wales in 1938. In the operating room, the surgeon attempts to locate the brain tumor of a patient who was under only local anesthesia because of his blood pressure. In those days in that place, finding the tumor was a "somewhat hit and miss" procedure that seems to have involved looking for it with one’s fingers.

A grotesque image, but all goes well until the patient, in a "gramophone" or "ventriloquist" voice not his own, cries out, "Leave my soul alone, leave my soul alone!" The doctor withdraws from the brain, but the patient then dies, after which the mood in the operating room is shocked and speechless, as "silence matched the silence under snow."

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The surgeon Jack McKee (William Hurt) carries on an outwardly successful practice while treating his patients with aggressive sarcasm and general disrespect. "There is a danger in becoming too involved with your patients," he warns his residents, reminding them of the surgeon’s credo: "Get in, fix it, get out." Then McKee himself is diagnosed with cancer of the vocal chords, and the doctor discovers patienthood. The process is enormously uncomfortable for him, as he experiences a sharp decline in autonomy and everything that goes with it, and he begins to develop some empathy for those he has always scorned.

Particularly inspiring are several encounters with a coldly professional specialist and a platonic friendship with a young cancer patient named June (Elizabeth Perkins) who is dying because her doctors failed to diagnose her brain tumor. By the end of the film, Dr. McKee is both recovered and converted, and in the last scene is requiring his residents to spend 72 hours as hospital patients as part of their medical training.

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((Note: This film has a surprise ending that will be discussed below.) Tenoch (Diego Luna) and Julio (Gael Garcia Bernal) are friends, two sex-obsessed 17-year-olds boys who flirt with the beautiful and somewhat older (and married) Luisa (Maribel Verdú), at a wedding and invite her to drive with them to an imaginary beach. She pays little attention, but after discovering that her husband has cheated on her again, she decides to flee her crumbling and childless marriage and calls the boys to see if the invitation is still good. The boys quickly make real plans and all three take off to a remote destination.

There is a lot of driving, and the three talk a lot about sex, and then have it. When things threaten to blow apart because of jealousy between the immature boys, Luisa steps in aggressively to take control of the road trip to make it continue to work for her. After she imposes her rules, there are some fine moments of peace at the beach, with Luisa enjoying the natural beauty of the waterfront and also a more mature relationship with the boys. She even attempts a tender if unhappy telephone farewell with her unfaithful husband.

At the beach, Luisa becomes close to a local fisherman, his wife, and their young child, and when the boys have to get back, Luisa announces she is staying at the beach with the fisherman's family. A month later the boys hear that she has died from cancer. A voice-over tells us that the boys will eventually split up with their girlfriends and never see each other again. Luisa's achievement is what remains.

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Warren Schmidt, played by Jack Nicholson, is a middle level officer in an Omaha insurance company who faces retirement and, shortly afterward, the sudden death of his wife of 42 years. He struggles with emotional chaos and mental confusion and with the nagging thought that his life is over and that he has failed to make the world better in any way.

An additional complication is that his only child, Jeannie (Hope Davis), is planning to marry a man (Randall, played by Dermott Mulroney) Schmidt strongly feels is below her. He tries several times to prevent the marriage but fails at that, too. Returning home from the wedding in despair, Schmidt finds a piece of mail with a drawing made by a young boy in Tanzania he had begun to support just after he retired, and the final scene shows him deeply moved.

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Dr. Thomas Stockmann, a public-minded doctor in a small town famous for its public baths, discovers that the water supply for the baths is contaminated and has probably been the cause of some illness among the tourists who are the town's economic lifeblood. In his effort to clean up the water supply, Dr. Stockmann runs into political cowards, sold-out journalists, shortsighted armchair economists, and a benighted citizenry. His own principled idealism exacerbates the conflict. The well-meaning doctor is publicly labeled an enemy of the people, and he and his family are all but driven out of the town he was trying to save.

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