Summary:

Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:

From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.

The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.

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Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

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In the first poem, Starting the I.V. (see this database) the poet tells us that he will approach the secrets of the body without flinching, "I have learned not to hesitate here, / not to let fears of my own" get in the way. The instrument he uses is the poem. Through these poems he reveals some of the hidden truth of the healing relationship. "A transformation," he calls it, "as if through this intimacy / we have become part / of each other." ("Physical Exam")

Watts captures the pain and horror of illness in striking images. For example, the numbness felt by a person suffering from multiple sclerosis "felt like oatmeal / drying on the skin" and the disease itself was "this moth of his nightmare / . . . eating at the wool / of his nerve endings." ("ms") In another poem ("restrictive") a patient's tortured breath "creaks like a tight box / a ship in a storm." Among the most remarkable of these 35 poems are "The Body of My Brother," "July 16th," "Chronic Pain Syndrome," and the exquisite prose-poem, "The Girl in the Painting by Vermeer."

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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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Editors Angela Belli, professor of English at St. John’s University in New York, and Jack Coulehan, physician-poet and director of the Institute for Medicine in Contemporary Society at the State University of New York at Stony Brook, have selected 100 poems by 32 contemporary physician-poets for this succinct yet meaty anthology. The book is subdivided into four sections, each of which is prefaced by an informative description and highlights of the poems to follow.

Section headings take their names from excerpts of the poems contained therein. There are poems that describe individuals--patients, family members ("from patient one to next"), poems that consider the interface between personal and professional life ("a different picture of me"), poems that "celebrate the learning process" ("in ways that help them see"), and poems in which the poet’s medical training is brought to bear on larger societal issues ("this was the music of our lives").

Several of the poems have been annotated in this database: Abse’s Pathology of Colours (9); Campo’s Towards Curing AIDS (13) and What the Body Told (94); Coulehan’s Anatomy Lesson (97), I’m Gonna Slap Those Doctors (21), The Dynamizer and the Oscilloclast: in memory of Albert Abrams, an American quack (129); Moolten’s Motorcycle Ward (105); Mukand’s Lullaby (33); Stone’s Talking to the Family (79) and Gaudeamus Igitur (109).

Other wonderful poems by these authors are also included in the anthology, e.g. Her Final Show by Rafael Campo, in which the physician tends to a dying drag queen, finally "pronouncing her to no applause" (11); "Lovesickness: a Medieval Text" by Jack Coulehan, wherein the ultimate prescription for this malady is to "prescribe sexual relations, / following which a cure will usually occur" (131); "Madame Butterfly" by David N. Moolten, in which the passengers in a trolley car are jolted out of their cocoons by a deranged screaming woman (142).

Space prohibits descriptions of all 100 poems, but each should be read and savored. Some others are particularly memorable. "Carmelita" by D. A. Feinfeld tells of the physician’s encounter with a feisty tattooed prisoner, who ends up with "a six-inch steel shank" through his chest as the physician labors futiley to save him (23). In "Candor" physician-poet John Graham-Pole struggles with having to tell an eight-year old that he will die from cancer (27). Audrey Shafer writes of a Monday Morning when she makes the transition from the "just-awakened warmth" of her naked little son to tend to the patient whom she will anesthetize "naked under hospital issue / ready to sleep" (72).

In "The Log of Pi" Marc J. Straus muses about being asked "the question / I never knew" that he "pretend[s] not to hear" whose "answer floats on angel’s lips / and is whispered in our ear just once" (113). Richard Donze wants to know why "Vermont Has a Suicide Rate" (132). Vernon Rowe remembers the "hulk of a man" who shriveled away from an abdominal wound and begged, " ’Let me go, Doc,’ / and I did" (44).

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A victim of a car accident suffers severe cranial fractures and facial disfigurement. Assuming a passive-aggressive stance toward the medical staff, and carrying on a sarcastic inner dialogue with her surgeon, she creates her own world, to escape and combat the pain. She becomes infatuated with the mystery and power of her own brain.

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This history of western medicine in the nineteenth century chronicles the lives of some men and women who were innovators in the field of medicine. Williams begins the book in the 1700s with the life of John Hunter and his influence on nineteenth century medical practice and research.

The book consists of 16 chapters, many of which, like the one on Hunter are biographic. For example, Williams writes of the contributions, education, and lives of Florence Nightingale, Hugh Owen Thomas (orthopedics), Marie Curie, Joseph Lister, Ignaz Semmelweis (maternal health), Patrick Manson (tropical medicine), Jean-Martin Charcot, and William Conrad Röntgen. Other chapters are more theme-oriented, such as body-snatchers, discovery of anesthesia, homeopathic medicine, blood transfusion, and medical use of spas.

Black and white illustrations, such as Mrs. Röntgen's hand in an X-ray photograph help the reader to appreciate the advances in medical knowledge in the nineteenth century.

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A psychiatrist who is skilled at hypnotism is asked by an oncologist to hypnotize a difficult patient prior to a bone marrow biopsy. The psychiatrist is able to achieve excellent pain relief through hypnotism, much to her own surprise. She is exhausted by the mental energy she has expended in this experience, and is discredited by the oncologist, who doesn't really believe that hypnotism is anything special.

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William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.

Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.

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The narrator recalls a boyhood encounter with Rab, a majestic dog. Rab causes the lad to make friends with his master, James Noble, a simple horse-cart driver. Six years later, James brings his beautiful old wife, Ailie, to the hospital where the narrator is now a medical student. She has breast cancer and the surgeon tells her that it must be operated the following day. James and the dog are allowed to remain nearby.

Ailie endures the operation in brave silence, commanding silent respect from a lively group of students. James nurses her tenderly, but she develops a fever and dies a few days later. Shortly after her burial, he too falls ill and dies. Rab refuses to eat, becomes hostile, and is killed by the new driver.

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