The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignác Semmelweis

Nuland, Sherwin

Last Updated: Mar-12-2015

Miksanek, Tony

Primary Category: Literature / Nonfiction

Summary:

In 1847, one of every six women whose babies were delivered by the medical students and supervising doctors at Allgemeine Krankenhaus (General Hospital) in Vienna died of puerperal fever (also known as childbed fever). In contrast, the incidence of this disease in women delivered by hospital midwives was dramatically lower and puerperal fever was quite rare when mothers had their babies born at home.While a few physicians (most notably Alexander Gordon and Oliver Wendell Holmes) realized that childbed fever was a contagious process, it was Semmelweis who identified the nature of the problem as stemming from the failure of obstetricians and medical students to wash their hands and change their clothing, especially after performing autopsies or doing surgery. He mandated that doctors and students wash with a disinfectant (chloride of lime) before examining any woman in labor.Despite the dramatic reduction of maternal mortality on his obstetrical unit, his ideas and methods were not well received. Semmelweis was reluctant to conduct experiments on animals to prove his theory and resisted publishing his findings in any medical journal. When he finally did write a book, The Etiology, the Concept, and the Prophylaxis of Childbed Fever, it was difficult to read and failed to impress many obstetrical experts.With his health failing and his behavior increasingly erratic and inappropriate, Semmelweis was committed to a state-run mental hospital. He died two weeks later. The official cause of death was sepsis secondary to an infection of his finger. The author is convinced, however, based on the autopsy report and findings upon exhumation of the body in 1963, that Semmelweis was beaten to death by the staff at the asylum. He may well have been suffering from Alzheimer's presenile dementia at the time.

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What the Dying Heart Says

Toomey, John

Last Updated: Feb-16-2015

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The nameless narrator has been hospitalized for months. A terrible accident while driving his Jeep. He survived, more or less. The other occupants of the vehicle - his wife and two children - did not. He watched them die. A traumatic brain injury and locked-in syndrome have left him unable to communicate. Although his body is useless, he assures us that he is completely lucid and resentfully aware of his circumstances. He desperately wants to die and admits, "I am already dead with grief" (p. 245).

The medical team caring for him won't call it quits. The narrator's brother, Tommy, informs them that his sibling would not wish to be kept alive in his current condition. But Professor Carson, the attending physician, insists that treatment will continue because the patient is not dead. Only one doctor, a compassionate Croatian female intern, comes forward as an ally of the narrator. She wonders out loud, "What man would want to live? Now?" (p. 242).

Even as the narrator's physicians prepare him for a brain-computer interface, he voicelessly implores Tommy to "convince these bastards to let me go" (p. 244) - to no avail, of course. Dying of a broken heart and helplessly being kept alive despite a shattered one, the narrator is doomed to a survival he does not want and to remembering the gruesome loss of his family that he cannot escape.

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Tenth of December

Saunders, George

Last Updated: Aug-27-2014

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A chubby boy with a vivid imagination and a terminally ill man intent on suicide share an adventure in survival on an extremely cold day. Robin plays make-believe as he heads to a pond in the woods. In the distance, he spots an emaciated man who appears to be wearing only pajamas. Fifty-three year old Don Eber is dying from cancer that's in his brain. Surgery and chemotherapy have not prevented its progress. He's come to the woods on this frigid day to die with dignity.

Robin finds Don's discarded coat on the ground and is determined to return it to the stranger. While toting the jacket, the boy falls through the ice of the frozen pond. Don sees Robin struggling in the water and realizes it is his fault that the well-intentioned kid is in danger. With great difficulty, Don makes his way to the pond and pulls the boy out. He removes Robin's wet clothes and replaces them with his own dry pajamas and the coat. He revives Robin and encourages him to run home.

Don is now naked, shivering, exhausted, and alone in the woods. But he no longer wants to end his life. He now understands its value, how "there could still be many - many drops of goodness" [249].
As he reminisces about the past, Don senses he is in a warm place. It is Robin's house. The boy has sent his mother to retrieve Don, and she has successfully rescued him.

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The Miracle Cures of Dr. Aira

Aira, Cesar

Last Updated: Jun-30-2013

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novella

Summary:

The protagonist-physician, Dr. Aira, is an almost 50-year-old sleepwalker who resides in Buenos Aires. He's nearsighted, introspective, and paranoid. Dr. Aira's fame stems from his "miracle cures" - even though it's not clear that he's ever actually performed one. Dr. Aira does not believe in God.

His initial encounter with "paranormal medicine" occurred during childhood when dog owners in his town were led to believe that by submitting themselves to a lengthy set of penicillin injections their pets would be painlessly neutered. Acknowledging the absurdity of that situation, he remained intrigued by the "possibility of action from a distance" (p10) and the lure of magical healing.

Dr. Aira's nemesis is Dr. Actyn, Chief of Medicine who tries to ridicule Dr. Aira and debunk his claims. Dr. Actyn sets elaborate traps including one with a "dying" actor on an ambulance who Dr. Aira refuses to cure.

Dr. Aira obtains enough money to devote 10 months solely to writing his secrets and eventually self-publishing his knowledge in the form of pamphlets. His plan is interrupted by an urgent request to perform a miracle cure on a terminally-ill cancer patient. He consents and makes a house call to treat the wealthy man. After one hour of intense deliberation and theorizing, Dr. Aira's work is complete. Laughter erupts. The "patient" is a fake. It's his archenemy Dr. Actyn in disguise. Dr. Aira's failure is captured on camera.

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My Heart

Mehmedinovic, Semezdin

Last Updated: Jun-27-2013

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A 50-year-old man is showering when he experiences pressure in his chest and throat associated with profound fatigue. An ambulance is called, and the emergency medical personnel inform him that he is having a heart attack. As he lays bare on his bed, his emotions switch from shock to indifference to a sense of calm with acceptance of impending death.

The narrator is a poet and a foreigner. In the hospital, his complicated name gets truncated to "Me'med" for convenience. He emigrated with his family from Zagreb to America in 1996, but still wakes from sleep haunted by memories of Kalashnikovs firing in Sarajevo.

He has stents placed in two obstructed coronary arteries and is immediately asymptomatic. At the Washington, D.C. hospital where he is treated, the narrator encounters a collection of fellow-foreigners: an elderly Slovak roommate suffering from Alzheimer's disease, a young Somali nurse, an African echocardiographer, and an Indian physician. A few days later, when he is discharged from the hospital, he feels fear and insecurity even though his medical problem has been fixed.

The narrator's world is now different. He is no longer who he was. When he returns to his apartment, hints (cigarettes and ashtrays) of his prior life are missing. He has a chance to change, another opportunity to restart his life.

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The Sickness

Tyszka, Alberto

Last Updated: Aug-23-2012

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It started with a faint. Javier Miranda, a generally healthy 69-year-old man living in Venezuela, attributes his episode of dizziness to the summer heat and humidity. His only child, Andres Miranda, is a physician whose intuition tells him something is seriously wrong with his father. The doctor obtains blood work and schedules a CT scan and MRI of the brain for Javier. The medical work-up reveals rapidly progressing lung cancer with metastases to the brain. Violating his credo of complete honesty with patients, Dr. Miranda lies to his father and reassures him instead. Dr. Miranda's mother died when he was just 10 years old. Now his father's remaining lifespan has dwindled to a couple of months. The doctor must find a way to break the bad news to his dad.

Meanwhile, Dr. Miranda receives multiple messages - phone calls, e-mails, and letters - from a difficult and persistent patient. Ernesto Duran suffers from dizzy spells and multiple other symptoms. It could be panic disorder or maybe Ernesto is a hypochondriac. Dr. Miranda instructs his office secretary, Karina, to deal with these communications and remind the patient that there is nothing more that can be done for him. When Ernesto admits he is stalking the doctor, Karina worries. Pretending to be Dr. Miranda, she begins corresponding with Ernesto via e-mail. Before long, Karina develops symptoms similar to Ernesto's and experiences empathy for him.

When his physician-son finally summons the courage to announce the terminal diagnosis, everything changes for Javier - his mood, personal relationships, and awareness of his body's metamorphosis. He perceives the smell of rot associated with his physical deterioration. Dr. Miranda's frame of mind also changes as he copes with his father's impending death. Javier's deathbed request is simply for his son to shatter the terrible silence by talking about the two of them.

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Turn of Mind

LaPlante, Alice

Last Updated: Jun-19-2012

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Dr. Jennifer White, age 64, is read her rights in a Chicago police station. But how much does the retired orthopedist who specializes in hand surgery really understand? Dr. White has Alzheimer's dementia. Her score of 19 on a mini-mental state examination (MMSE) is consistent with a moderate degree of cognitive impairment. She is questioned about the death of a neighbor, 75-year-old Amanda O'Toole, who lives 3 houses away. Amanda happens to be Dr. White's best friend and the godmother of her daughter. Amanda died at home, the result of head trauma. Four fingers of her right hand were cleanly and expertly chopped off. It seems that Dr. White is genuinely incapable of recalling whether she committed a murder or not. The physician is not charged with the crime but remains a suspect.

Dr. White's memory and mind are no longer reliable. In her lucid moments, she jots down notes in a journal. She dubs the notebook her "Bible of consciousness" [5] and it assists her in filling in the blanks of her past life. Her husband James has died. She has approximately $2.5 million of financial assets. Her two adult children - Mark and Fiona - squabble. Throughout the course of her disease, family secrets are revealed and intimate details are exposed. Relationships fray.

Despite a slew of prescription medications (galantamine, an antipsychotic, an antidepressant, and a benzodiazepine as needed), Dr. White's mental status and behavior deteriorate. Her confusion, wandering, forgetfulness, and episodes of agitation worsen. The story is structured in four sections, based on the residence of the protagonist: First is Dr. White's time in her own home aided by a live-in caregiver, Magdalena. Next is her stay in an assisted living facility. Then she briefly escapes from that place and has a 36 hour adventure of sorts. Finally, Dr. White is incarcerated in a state mental health facility.

Ultimately, the circumstances of Amanda's death are made known. And while Dr. White did not kill her best friend, the surgeon was present at the scene with a scalpel in her hand. Another character was there too.

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The Land at the End of the World

Lobo Antunes, Antonio

Last Updated: Dec-12-2011

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Haunted by his past actions and wartime experiences, the narrator empties his soul to a silent stranger - a woman sitting and drinking with him at a bar in Lisbon. He tells her about his participation in the colonial war between Portugal and Angola in the early 1970's. He admits to the conflict that still rages inside him. Six years earlier, as a physician in his twenties, he was drafted and shipped 6,000 kilometers from home for a slightly more than two year stint as an army doctor. He left behind a pregnant wife.

While in Africa, he witnessed the waging of a crazy war and was called upon to patch up its many casualties. He describes the maiming, inhumanity, and death that he observed. Questions about political power and morality trouble him. In the midst of this horror, he becomes increasingly cynical and skeptical. On his return home, the narrator acknowledges that he has lost part of himself in Africa. He gets divorced, feels hopeless, and is incapable of shrugging off loneliness.

He and the woman leave the bar and go to his apartment where they have a sexual encounter. She has been an adept listener. The narrator's lengthy confession may have been therapeutic for him. But like everything else in this doctor's post-military service life, any solace is brief. The war has polluted him, and he struggles to clean up the mess.

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Tinkers

Harding, Paul

Last Updated: Jul-06-2010

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

George Washington Crosby is dying from kidney failure. The eighty-year-old man has a crumbling body - Parkinson's disease, cancer, diabetes, and previous heart attacks - and a murky mind. He is hallucinating and his memories are disordered. George occupies a hospital bed in the living room of a house that he constructed himself. His family keeps him company as they await his imminent demise.

Some of George's thoughts revolve around his passion for clocks and his skill in repairing them. Most of his memories center on his father, Howard Aaron Crosby. About seventy years earlier, Howard owned a wooden wagon and a horse and scratched out a living as a tinker and a peddler of household goods. Howard's father had been a Methodist minister who exhibited worsening signs of mental illness. The man was eventually escorted out of his home. Only a young boy at the time, Howard would never see his father again.

Howard suffered from frequent and violent epileptic seizures. His wife and the family doctor thought Howard should be admitted to the Eastern Maine State Hospital, an institution housing feebleminded and insane individuals. Howard had a different opinion. One evening, he left his wife and four children and headed to Philadelphia. He took a new name and a new wife. He found work in a grocery store. The frequency of his seizures decreased dramatically.

George's final memory before death is a vivid one. He recalls a Christmas dinner in 1953. Someone is at the door. It is a surprise (and brief) visit by Howard to George's house. It is the first time that he has seen his father since George was twelve.

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The Incalculable Life Gesture

Lasdun, James

Last Updated: Feb-16-2010

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Richard Timmerman doesn't see eye-to-eye with his sister, Ellen. After their parents die, the siblings inherit the house. Richard wants to sell his share of it, but Ellen won't budge. She and her son continue to live in the home. As an elementary school principal in upstate New York, Richard already has a lot on his mind.

He notices a swelling under his chin. Three weeks later, the lump is still there. He visits Dr. Taubman, but the family physician is uncertain of the diagnosis. It might be a benign enlarged lymph node but a lymphoma cannot be ruled out. Richard focuses only on the possibility of cancer. A CAT scan is scheduled along with a referral to an ENT specialist for a biopsy.

Richard questions the radiologist supervising the scan about the results. She will not tell him. He suspects that she is holding back the truth. He next sees Dr. Jameson, the ENT specialist. The young physician examines Richard and then reviews Richard's CAT scan. The doctor's verdict is a salivary gland stone (sialolithiasis) that will likely pass on its own.

At first, Richard is angry with his family physician for not making the correct diagnosis. Soon his irritation gives way to relief. Richard has received a medical reprieve. There is no lymphoma. No treatment is necessary. Life is suddenly glorious. Richard's joy is transient. He telephones his sister to announce the good news and to patch things up with her. Ellen is unimpressed by Richard's recent scare and his magnanimity. The phone call leaves Richard uncertain and fearful about his future.

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