Summary:

This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."

In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).

In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."

During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.

View full annotation

Summary:

While driving away from a dangerous city in an area of north Afghanistan ravaged by war, three men must journey by foot when their car is damaged in an accident. Donk is an American combat photographer. Hassan is a young Afghan translator. Graves is a British journalist suffering from a severe case of malaria and in desperate need of medication.

They arrive at a remote village ruled by a warlord, General Ismail Mohammed. Medication is unavailable there and transportation to a larger city is not possible for at least another day. The local doctor recommends an herbal remedy for the treatment of malaria, and General Mohammed attests to its effectiveness. The medicinal grass grows only in a nearby mountain valley. Two soldiers escort Donk and Hassan to the vale. They encounter a convoy of transport vehicles that have been incinerated by a bomb blast.

When the grass is finally in sight, Donk and Hassan race towards it even as the two soldiers shout at them. Too late! Donk steps on a bomblet and the device detonates. Badly injured (and maybe even mortally wounded), Donk and Hassan lie on their backs and gaze at the sky. They are surrounded by the thick grass they hoped might save the life of their companion, Graves.

View full annotation

Summary:

During a sabbatical year in Florence, English professor and writer James McConkey immersed himself in reading Anton Chekhov’s works, as well as biographies of the Russian writer. He began to feel a particular affinity for Chekhov’s crisis of 1889-1890 and his resolution of that crisis by traveling alone to Sakhalin Island off the eastern coast of Siberia to investigate conditions in the penal colonies that the Russian government had established in that distant region. Perhaps because McConkey himself was recovering from a series of traumatic experiences in his own life, he felt a kinship to this depressed young Russian author and his search for a new direction in life.

McConkey responded to this feeling of kinship by writing To a Distant Island, which is partly biographical, in that it retells the story of Chekhov’s six month long journey to Sakhalin Island in 1890; and partly a memoir, in that McConkey relates Chekhov’s life events to the feelings and events of his own life at the time. McConkey establishes this perspective from the beginning, when he explains why he refers to Chekhov throughout the book as "T": "I honor the man too much to call him by name throughout an account, which. . . is bound to be a fiction of my own" (8).

To a Distant Island dwells especially on the motivation for Chekhov’s journey to Sakhalin, a question scholars have debated for a hundred years now. Of the many contributing reasons for the trip, McConkey chooses to highlight and fictionalize "the suicidal tendency that surfaced again a decade later in the marriage his health simply couldn’t afford" (26). McConkey refines this to "T. wants to escape--he wants out, at whatever the personal cost" (27). It is in this state of mind (or soul) that the brilliant and sensitive T. begins his journey to the end of the earth.

Perhaps as a metaphor that characterizes any human quest, McConkey devotes most of the writing and energy to T’s justification, preparation, and outward-bound journey. Only 37 pages remain for the story of what happens to his hero once the goal is achieved; and less than 6 pages for the homeward trek (or homeward "sail" in this case). [This is a technique, come to think of it, quite the opposite of Homer’s in "The Odyssey"!]

The conclusion? "Sakhalin, then, gave to T. nothing he hadn’t known all along. . . Perhaps despair--that absence of hope--is a requisite for any deepened understanding of a universal hope for something never to be found in the present time or place" (82).

View full annotation

Summary:

A trader from the north arrives by boat in Miriam's village carrying bright and beautiful bolts of fabric--the juliana cloth of the story's title. The trader chooses to trade fabric for sex with some of the village women and girls; for others, perhaps the less appealing, he will take only money. Miriam wants a piece of the cloth, but hasn't the coins to buy and is not offered a trade. Over time, the village watches the more adventurous and attractive women and some of their male partners sicken and die from a strange new malady.

Miriam's mother, a widowed government employee, warns Miriam of the relationship between the deadly sickness and sexual behavior. The officials have promised condoms, but even had they arrived, the programs for education and understanding were not in place. The last we see of the 16-year-old Miriam, she is succumbing to her own adolescent sexual desires with a local boy.

View full annotation

Summary:

Gabriel Garcia Marquez was born in 1928 and is best known in the English-speaking world for his novel, One Hundred Years of Solitude, which appeared early in his career in Spanish (1967) and later in English (1970). He was awarded the Nobel Prize in Literature in 1982 and in 1988 published the novel, 0008 (see annotation), which received considerable attention for its evocative story of love and memory.

Garcia Marquez's autobiography is recent (2002, 2003); it covers the first twenty-seven years of his life in Columbia, ending in 1955 when he is sent as a journalist to Geneva to cover the Big Four Conference for his newspaper in Bogota. Although he remained in Europe for three years after that the book does not cover that period.

Garcia Marquez was born in Aracataca, Columbia in his grandparents' home, the first child in a family that grew to include ten younger siblings. He had a hectic childhood being reared by his parents' large extended family, which included several children sired by his father with women other than his mother.

Finances were always tenuous; when he worked as a journalist he was an important supporter of the family. He received a broad classical education at the Jesuit College in Bogota, where he began his writing career. Later he studied law and journalism but did not finish law school. He read extensively from all genres of literature.

Garcia Marquez's family relationships and personal experiences were traumatic in many ways as was the political situation in Columbia. It was a tumultuous initiation to a life of creative writing. His words quoted on the flyleaf describe the book: "Life is not what one lived, but what one remembers and how one remembers it in order to recount it."

View full annotation

Summary:

The practice of medicine in equatorial Africa is both a challenge and an escape for Dr. Koestler. The physician from New Zealand works at a Global Aid mission in Zaire. He has toiled there a long time but is still a loner. His best friend appears to be a pet baboon named George Babbitt. The monkey drinks whiskey and smokes cigarettes. It is a clever creature with a mean streak and is generally despised by everyone except Koestler.

Two young American doctors arrive at the mission to assist Koestler. While the three physicians and the bush pilot drink whiskey and smoke marijuana, Koestler instructs the new doctors on some of the laws of jungle medicine: Use only disposable needles and then destroy them. Never transfuse a patient unless they require at least 3 units of blood (since all blood will likely be contaminated by Hepatitis B or HIV). Safe sex means no sex. Speed matters. Avoid getting involved because feelings will inevitably obstruct your work.

Although a leopard is roaming outside the confines of the mission, Koestler ventures into the darkness of the jungle to search for George Babbitt who has run off with a bottle of whiskey. In a locale teeming with life, the physician remains essentially alone--by choice.

View full annotation

Summary:

Dr. McKechnie begins his overview of the history of the practice of medicine in British Columbia with records of Coastal Native practices encountered by the first explorers of the Northwest Territory in the 18th century. This opening section of the work contains interesting folklore regarding some of the methodologies and medicinals utilized, and terminates in descriptions of the rites surrounding the initiation of a new Shaman.

Moving forward in time, the author explores the early naval medicine of the seamen and their captains, including the early intermingling of the explorers with the Coastal Indians. The plagues of smallpox, measles, syphilis, and tuberculosis attributed to the arrival on the western continent of organisms to which the natives were not immune are covered briefly.

The third portion of the book is devoted to the changes in medical practice on this particular frontier as the emerging science of the 19th century moved gradually westward. The final chapters cover the century of the great world wars and the progressive advances in medical science as they affected the residents and physicians of British Columbia.

View full annotation

Summary:

This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.

The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."

View full annotation

Summary:

When we view photographs of war-torn bodies, piled-up corpses, or starving children, are we changed? How about the photographer, whether a professional or an amateur, who takes such pictures? Do these photographs teach us about suffering--or do they numb us over time and simply cause us to turn away? In this slim book Sontag re-visits her ideas in "On Photography," published 25 years ago.

Her aim, it seems, is not so much to answer the above questions but to provoke us by her statements, urging us at least to THINK about what happens when suffering is viewed third hand; because after all, she reminds us, we see only what the photographer wanted us to see. When scenes of violence are as close as our morning papers or our TV screens, Sontag's is an important debate.

She also gives a brief history of photo-journalism, from the Crimean and Civil Wars to the almost instantaneous transmission of images from Operation Iraqi Freedom. In chapters that sometimes seem to disagree with one another, she plays the devil's advocate and views the IDEA of photographs of suffering from all directions. Can gruesome photos be artistic? Should they be? And if a war photo is posed--a corpse moved for a better shot or a battle scene restaged to make it more dramatic--is the effect enhanced or decreased? She considers the impact of candid photos versus those technologically manipulated; she discusses how photos, and their impact on us, change when the names of the victims are revealed.

View full annotation

Summary:

This film is based on the true life story of Lucille Teasdale, one of Canada's first female physicians. She received many refusals for positions in Canadian hospitals so she joined an Italian colleague to work in a Catholic mission hospital in Uganda. She and her colleague later married and continued their work at the hospital where they trained nurses and doctors, sheltered refugees, and gradually modernized their facilities. They spent their lives caring for the lost, sick, and dying in a world of poverty, tribal conflict, and civil war.

A daughter was born to them. The child resented her mother's commitment to the patients in the hospital. After being sent to Italy for school, she finally recognized her parents' dedication and became a physician herself, working in Italy and helping to support the hospital. Dr. Lucille contracted AIDS from surgical injuries but continued to work until her death in 1996.

View full annotation