Summary:

First published in 1991, and available in reprint edition, this is a compendium of selected artworks and excerpts of diverse medical and literary writings from pre-Hippocratic times to the end of the 20th C. Each chapter integrates selections from medical or scientific treatises, with commentaries written by historians, essays by physicians and writers, and prose and poetry by physicians and by patients. The 235 images in this book include illustrations from medical textbooks and manuscripts, as well as cartoons, sculptures, paintings, prints and sketches. The colour illustrations are stunning and copious, and provide a visual narrative that resonates with each chapter of the book.

The first part of the book, Traditional Medicine, includes chapters on Ancient, Medieval, Renaissance, and Enlightenment medicine. These serves as a preamble for the second part, Modern Medicine, which includes art, medicine and literature from the early 19th century to the end of the 20th century.

The chapter “From the Patient’s Illness to the Doctor’s Disease” illustrates the rise of public health and scientific research with excerpts from works by Edward Jenner, John Collins Warren, René Laënnec, and John Snow, together with experience of epidemic diseases described by writer Heinrich Heine in his essay on “Cholera in Paris”. The chapter on “Non-Western Healing Traditions” includes botanical research by Edward Ayensu, a short story by Lu Hsun and the writing and paintings of George Caitlin on North American Indian healing.

In the patient-focused chapter, “Patient Visions: The Literature of Illness,” are stories of sickness by Thomas DeQuincey, Leo Tolstoy, Giovanni Verga, Katherine Mansfield, André Malraux, and Robert Lowell. The chapter which follows, “Scientific Medicine: the Literature of Cure,” provides the medical counterpoint with personal correspondence by Freud, medical treatises by Wilhelm Roentgen and Louis Pasteur, an essay on surgical training by William Halsted, and an excerpt from George Bernard Shaw's play, Too True to Be Good, in which a microbe takes centre-stage.

There are chapters on “Medicine and Modern War,” which includes personal writing by nurses Florence Nightingale and Emily Parsons, and poems by Walt Whitman, and Emily Dickinson, and “Art of Medicine,” with works by Arthur Conan Doyle, Anne Sexton, James Farrell and W.P. Kinsella.

The final chapter, “The Continuing Quest for Knowledge and Control,” contains no medical treatises but rather ends with personal reflections by the writer Paul Monette on AIDS, and by physician-writers, John Stone, Sherwin B. Nuland, Lewis Thomas, Dannie Abse, and Richard Selzer.

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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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This Japanese horror story is set in a hospital in financial crisis, short of supplies and staff. We see various nurses and doctors struggling with their working conditions. A patient is injured falling out of bed, a nurse practices her IV technique on an unconscious burn patient, a demented woman wanders the hallways talking to apparitions she sees in mirrors. Two events set the central plot in motion: the burn patient dies because of a medication error and those present—Dr Akiba (Koichi Sato) who was responsible and Dr Uozumi (Masanobu Takashima) who was supervising, as well as the nurse who gave the lethal dose and her supervisor—decide to cover up the mistake, and a patient is brought to the ER suffering from a mysterious infection that is liquefying his internal organs.

Dr Akai (Shirô Sano), a senior physician, demands that Drs Akiba and Uozumi begin a study of the infected patient, despite their terror. The patient is never shown directly, but we see green ooze running from his bed. Akai argues that that discovering the pathogen causing this illness will raise money for the hospital, but the real incentive he offers is blackmail: he knows about the mistake and the cover-up.

As the night proceeds, all those involved in the error are infected, taking on zombie-like characteristics, behaving abnormally (a nurse attempts to transfuse her own blood into a corpse; a doctor tries to strangle a patient who has asked to have his pain relieved) and oozing green fluid before dying. With Dr Akiba, however, we begin to realize that the pathogen is not purely somatic. Dr Akai may in fact be the dead burn patient, the “green” ooze is red blood seen through the distorted perception of those haunted by guilt, and the title’s infection is the contagious fear felt by health care professionals who, for various reasons, are incapable of the infallible work of healing that is expected of them.

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Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.

In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.

The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.

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This powerful book of black and white photographs contains four sections labeled: I. The End of Manual Labor, 1986-, II. Diverse Images 1974-87, III. Famine in the Sahel, 1984-85, and IV. Latin America, 1977-84. In addition, photographs accompany the prose-poetry opening essay, "Salgado, 17 Times," by Uruguayan writer Eduardo Galeano and the concluding essay, "The Lyric Documentarian," by former New York Times picture editor Fred Ritchin. This oversize book concludes with a list of captions for the photographs and a detailed two-page biography of Salgado. Essentially the photographs cover Salgado’s impressive work from 1974-89.

Every image is of a person or people. Many are suffering, many are starving, grieving, keening, dying, displaced. Many are children. Many are laboring under impossibly harsh conditions such as the teeming, mud-coated manual laborers of the Brazilian Serra Pelada gold mine. An Ethiopian father anoints the corpse of his famine starved, skin and bone child with oil. An old man, squinting in the sun, leans over to touch the arm of an equally thin and weak man in a Sudanese refugee camp. Rarely, the people are smiling or celebrating.

The photographs are global: Angola, Bangladesh, Bolivia, Brazil, Chad, Cuba, Ecuador, Eritrea, Ethiopia, Mali, Mexico, Portugal, Sudan, Thailand, and more. As Galeano notes, "This much is certain: it would be difficult to look at these figures and remain unaffected. I cannot imagine anyone shrugging his shoulder, turning away unseeing, and sauntering off, whistling." (p. 7) [156 pp.]

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Among the "scenes from everyday life" which constitute so-called "genre" painting in 17th Century Dutch art, the profession of medicine was often lampooned. In Gerritt Dou’s painting, the doctor is depicted as a deceiving charlatan, marketing his products with impressive but unsubstantiated claims about their effectiveness. In Dou’s hometown of Leiden, with the Blauwpoort (Blue Gatehouse) in the background left, the quack has set up shop outside the studio of a painter. [At the Web Gallery of Art on-line site, select "D" from the Artist Index, scroll down for Dou, select "Page 2".)

The artist gazes out of his window, holding the tools of his trade, a pallet and brushes. Directly beside him the quack stands under a Chinese umbrella, with stopper in his hand, and presents the patent medicine in a large glass vial to his audience. On his table is a document with a large and authoritative red seal, indicating his credentials and bolstering his credibility. On one side is a barber- surgeon’s basin, on the other is a monkey.

A crowd has gathered around, including a huntsman with a dead rabbit suspended on his rifle, a man with vegetables in a cart, and a woman with a pancake griddle and batter in a large bowl in the right foreground; she is cleaning and diapering a child. In the right foreground a woman gapes at the doctor and his medicine, unaware that her pocket is being picked. In front of her sprawls a child who holds a bread crust to bait and capture a small bird. In the left foreground is a tall, twisted and dead tree; across from it at the corner of the artist’s studio is a living tree lush with foliage.

While Nicolas Tulp (see Rembrandt’s "The Anatomy Lesson of Nicolaes Tulp") enjoyed a reputation as the "Vesalius of the North," this painting is more typical of the prevailing popular depictions of the doctor, not just in the Netherlands but elsewhere in Europe and equally subject to mockery and suspicion. At this time medical care was provided by local physicians, but also by traveling barber-surgeons whose skills and knowledge were dubious.

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In this account of early practitioners and advocates of 'inoculation,' or the use of tiny amounts of smallpox contagion to induce a mild case of smallpox and immunity, author Carrell weaves prodigious historical research with fictionalized dialogue to create a tale of two prominent figures: Lady Mary Wortley Montagu of London and Dr. Zabdiel Boylston of Boston. Both Lady Mary and Boylston suffered scarring from smallpox, and, by living in the early 18th century, both witnessed the devastation of epidemics in terms of public health and private loss.

Both were also aware of the use of inoculation to prevent severe disease in Turkey (Lady Mary visited with her ambassador husband) and in Africa (on the advice of Cotton Mather, Boylston interviewed Africans, slave and freemen, living in Boston). Both faced formidable challenges and risked personal security to promote the use of this technique. Both proved their belief in the technique by the inoculation of their own children. And both, perhaps, met. At the behest of the Royal Society, Boylston traveled to London, witnessed numerous inoculations, and presented his Boston experience to the Society.

The book also chronicles the natural course of the disease, its various symptoms, forms and popular treatments, and the political impact of smallpox on the royal families of Europe and business interests in Boston. The medical research of various doctors is detailed. In particular, selected Newgate prisoners were offered pardon in return for participation in an experiment conducted by Mr. Maitland, who also inoculated Lady Mary's children. These experiments were used to test the safety and efficacy of inoculation prior to royal inoculation.

Ultimately, detractors of inoculation ceased their vitriolic attacks, as the risks of inoculation were proven to be far lower than exposure without such protection. The success of inoculation paved the way for Edward Jenner, often called 'the father of immunology,' to successfully use cowpox to induce smallpox immunity later in the 18th century.

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This collection of poems combines mournful reveries of the individual and collective losses of the U.S. AIDS epidemic in the 1980s and '90s with haunting recollections of the losses of childhood. Ghost Letters begins and concludes with poems in which the memories of love and rich relationships interweave with incantations of loss and keen descriptions of caring for the dying. In between is a section of poems that recreate the sweetness and pain of the speaker's childhood and the transformation that his father's death effects on the entire family.

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Please note that in order to properly annotate this novel, the novel's surprise ending will be revealed here. Snowman--who used to be called, Jimmy--is a rare survivor of a dreadful catastrophe that seems to have been both the product and the demise of modern science. He lives in a tree, clad in rags, hiding from relentless heat and hoarding his precarious cache of food and alcohol, while he tries to obliterate consciousness and avoid contact with a peculiar race of beings, the Crakers. Through a series of reminiscences as he makes his way back to where he once worked, Snowman's past slowly advances to meet his future.

The world heated up to be uninhabitable desert and genetic engineering created more problems (and species! [pigoons, rakunks, wolvogs]) than solutions. People became increasingly reliant on artificial environments--both internal and external--while their purveyors--drug and technology firms--held ever greater but unthinking power. The world was divided into two: the rich, safe controlled spaces and the dangerous chaotic realm of the poor. Then an epidemic wiped out most of the human race.

Two friends are central to the story: brilliant but inscrutable Crake whose nerdy gift for science had a role in engineering the 'pure' Crakers and the horrifying world that they occupy; and beautiful, seductive Oryx whose regard of knowing innocence heaps scorn upon messy human desire and emotion. They are the Yin and Yang of the "constructed" world. Only at the end, the reader learns that Oryx was murdered by Crake, who was slain by Snowman. It seems that his arduous journey was simply to destroy the history of the events that he had written and left behind.

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A collection of short stories loosely connected to each other by centering on the experiences of four people from their first encounters during medical school and continuing into young middle age.

The first and third stories “Getting into Medical School, Part I” and “Part II,” are about study partners, Fitzgerald and Ming, who have trouble admitting their love for each other until she is accepted to medical school and he is not. Ming teaches Fitzgerald how to prepare successfully by passing along learning tips her physician-cousin provided her in exchange for sex. In the second story, Ming meets fellow students Sri and Chen and drifts away from Fitzgerald. In the third, he wrestles with feelings of rejection and misery as he realizes she has opted for a relationship with the more culturally “appropriate” Chen; however, her study tips pay off in more than one way when he meets Ming’s unsavory cousin at his medical school interview.

Later stories describe clinical encounters with specific cases, one of the most memorable being “Winston,” about Sri’s relationship with a paranoid person; the tale is told alternatively from the doctor’s perspective and the patient’s. in “Afterwards,” Sri must explain to a man’s wife and son, how he died suddenly at a strange hairstylist salon; the news disturbs the family who discover that the supposedly impotent diabetic had been a regular at a sex shop.

Fitzgerald and Chen become emergency physicians. Less settled, Fitzgerald tries several settings, including working for an air ambulance company. His problem with alcohol emerges from deep disaffection and brooding resentment over Ming’s callous rejection years earlier and her subsequent marriage to Chen. The problem begins to threaten his judgement and seriously compromises his health when he falls ill.

In the ironically titled “Contact Tracing” both Fitzgerald and Chen contract SARS (the latter from the former) during the (real) 2003 Toronto epidemic. They are isolated in adjoining rooms separated by glass and phone each other for support and discussion. They reminisce about Sri who has died of cancer and muse on the relevance of do-not-resuscitate orders. The outcome is both humorous and surprising.

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