Summary:

This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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Dr. Slocum leads his readers through some of the high (and low) points of his 34 years of general medical practice in the Hell’s Kitchen neighborhood of Manhattan. The work opens as he and his wife and nurse of as many years close the office they have shared for the last time. Then moving backward for a few chapters, the author discusses briefly his training, including a critical four-month period in Vienna in the year 1932. Slocum was awaiting the results of his Medical board examination and while doing some advance study, experienced first hand the early stages of Nazi activity against Jews in Austria.

After their return to the states and the doctor’s completion of his internship, the young couple located office and home in Manhattan. The remainder of the book is devoted to descriptions of critical events and important professional encounters in more than three decades, organized by chapter, most of which encapsulate a patient and, when present, his or her family.

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Sontag argues against the use of illness as metaphor. She states her main point on the first page of this long essay : "The most truthful way of regarding illness--and the healthiest way of being ill--is one most purified of, most resistant to, metaphoric thinking."

Tuberculosis and cancer serve as her two central examples of the human tendency to use metaphoric thinking about illness. In the 19th century, tuberculosis was considered a disease of passion, of "inward burning," of the "consumption" of life force. Sufferers were thought to have superior sensibility; the illness purified them of the dross of everyday life. The romantic image of the TB sufferer became "the first widespread example of that distinctively modern activity, promoting the self as an image" (p. 29). Metaphoric thinking about TB declined in the early part of the 20th century as the disease succumbed to science and public health measures.

Cancer has now become the predominant disease metaphor in our culture. Cancer is considered a disease of repression, or inhibited passion. The cancer sufferer characteristically suppresses emotion, which after many years emerges from the unconscious self as malignant growth. As in Auden’s poem, Miss Gee, reproduced on page 49, (see annotation in this database): "Childless women get it, / And men when they retire . . . . " Sontag uses the 19th century view of insanity as another example of malignant metaphoric thinking, while metaphor related to syphilis was somewhat more benign. She concludes the essay with an eloquent prediction that, as we learn more about the etiology and treatment of cancer, its metaphorical system will die on the vine. (I wonder if Sontag would consider my "die on the vine" an appropriate metaphor here?)

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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A collection of twenty-six short essays about AIDS from two primary perspectives. Approximately one-third of the essays reflect on this physician-author’s personal response to his identical twin brother’s deterioration and eventual death from AIDS. The remaining essays reflect this pathologist/public health educator’s interest in confronting the epidemic on a societal/cultural level.

The author’s love of nature and gardening provides a sense of continuity throughout the book. The gentle yet strong voice of the author is very moving when sharing his personal experience. His voice, on occasion, becomes pedantic when addressing societal and public health concerns.

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In early nineteenth-century England, Gustine is a "dress lodger" who rents a room and a fraying but elegant robe which she wears to work as a prostitute. The dissolute, violent landlord takes all her earnings and to keep her from hiding the money or stealing the dress, he has her followed by an elderly, sinister-seeming woman, called "the Eye."

Gustine has a baby, born with its heart on the outside of its chest (ectopia)--the beating muscle is covered only in a thin membrane. Gustine loves her child and tries to care for it, in the grinding poverty and filth of the crowded rooming house. She is convinced that the Eye is dangerous.

The young physician, Dr. Henry Chiver, is intent on making his name as a scientific doctor and educator through dissections. Cholera breaks out in the town to challenge his skill; even when confronted with death, however, he perceives an opportunity for research much to the alarm and disgust of citizens who fail to understand the advantages promised by an act of desecration. He is both attracted to Gustine and appalled by her profession; but when he discovers the secret of her child he sees yet another opportunity and his obsession to become a famous researcher makes him lose sight of all that is appropriate.

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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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This film tells the story of Alfred Kinsey (Liam Neeson), the scientist who famously changed his focus in mid-career from the study of gall wasps to the study of human sexuality and through his publications on male and female sexuality (1948, 1953) revolutionized the way we think and talk about sex. Kinsey entered adult life with the classic Boy Scout's view of sex that it was best not to think about it. (He collected a million gall wasps instead.) But under the influence of one of his students, Clara McMillen (Laura Linney), who later became his wife, and listening to the questions some students were asking about sex, he decided to teach a course at Indiana University on human sexuality. "Sexual morality needs to be reformed," he proclaims, and "science will show the way."

He begins doing statistical research on individual sexual behavior, training his interviewers to be open and neutral as they encounter a very wide variety of behaviors. He also encourages them to experiment sexually among themselves, and later even to participate in sexual encounters filmed for research purposes. Naturally, not everyone accepts this readily, and there are problems between Alfred and Clara, among the research assistants, and eventually between the whole project and Indiana University and the Rockefeller Foundation.

Rockefeller withdraws its support, complaining that Kinsey is preaching in public, and Clara tearfully complains that some social restraints are needed to keep people from hurting each other. The assistants struggle with the ties between sex, which is part of the experiment, and love, which is not. Kinsey continues striving, but with much reduced means. The film ends with video clips of interview subjects speaking strongly about the benefits that Kinsey's revolution has brought to them, one woman concluding: "You saved my life, sir!"

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James and Elizabeth Morison and their two sons, 13-year-old Robert and 8-year-old Peter, called by his nickname, Bunny, live in a town in Illinois. It is 1918, the end of World War I.

The first third of the novel is narrated from Bunny's point of view. His mother, to whom he is deeply attached, lets him know that she is expecting a new baby. Her vivacious sister, Irene, separated from her husband, arrives for dinner. There is talk about the influenza epidemic, and Bunny remembers that on Friday a boy at his school fell ill. Later that evening, Bunny develops a high fever and is put to bed with the flu.

The second part of the book is from Robert's point of view. Bunny is seriously ill. The schools have been closed because of the epidemic and Robert is not allowed to go and play with his friends. His boredom is alleviated when a sparrow gets into Bunny's room and he is allowed to use a broom to drive it out. To his horror he realizes that, while he was fetching the broom, his mother had gone into Bunny's room and sat on the bed, even though the doctor had said she must stay away for fear of infection.

Bunny recovers, and the boys are sent to stay with their Aunt Clara while their parents travel by train to Decatur where Elizabeth will have the baby. At Aunt Clara's they learn that both parents have contracted the flu, and then that, after giving birth to a boy who will live, Elizabeth has died.

The last part of the book is from James's point of view. Returning home without his wife, he is certain that he will be unable to live in the house or take care of his sons. He decides that Clara and her husband should raise his children. Irene arrives and disagrees, telling him that the dying Elizabeth had told her she did not want this. Irene has meantime almost reconciled with her husband (as a small child, Robert had a leg amputated after being run over by the husband's buggy). Irene now tells James that she has decided instead to stay with him and help raise her nephews.

The novel ends with Elizabeth's funeral. The doctor has reassured Robert that he was not responsible for his mother's illness, though James continues to be haunted by the possibility that if he had chosen a different train, they would have avoided infection. At the same time, he recognizes Elizabeth's ordering and determining power, and how it will continue to shape his and his sons' lives.

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In 1918, the lives of ordinary Americans are disrupted by two cataclysmic events--an epidemic of influenza and World War I. Lydia Kilkenny is a young woman who works in a Boston department store. She falls in love with Henry Wickett, a sensitive and sickly man who is enrolled in medical school but has little enthusiasm for becoming a doctor. After marriage, Henry drops out of medical school. He tries to enlist in the army but is rejected.

Henry turns his attention to "Wickett’s Remedy"--a tonic accompanied by a handwritten letter emphasizing hope and encouraging recovery. Lydia designs the product’s label and concocts the placebo (based on ingredients revealed to her in a dream). The Remedy is an unsuccessful business venture for the couple.

A businessman named Quentin Driscoll likes the taste, however, and sells the Remedy as a beverage (QD soda). Although Driscoll promises to share future profits from the sale of the soda pop with Henry and Lydia, he fails to honor the agreement. QD soda eventually becomes quite popular, but Lydia never reaps any of the financial gain.

Influenza claims the lives of the two most important men in Lydia’s life--her brother, Michael, and her husband, Henry. She feels helpless and decides to volunteer at the local hospital where she cares for patients with the flu. Lydia realizes that she wants to become a nurse and signs up for a Public Health research project investigating how influenza is transmitted. Unfortunately, none of the test subjects (Navy deserters) contract the flu during the study, but a promising young doctor dies of influenza and pneumonia. Lydia later marries one of the men she meets during the research project.

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