Summary:

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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Bruno Kamenar is a pale and thin ten year old boy who lives with his stepmother and younger brother in Croatia in 1948. His father, Pero, has just returned home after serving in the Yugoslav Federal Army. With the constant threat of a Soviet invasion serving as a backdrop, Bruno is plagued by frequent nightmares as well as a cough. He finds solace both in drawing and in the company of the family cow.

Sadly, Bruno contracts tuberculosis from the cow's fresh milk. At first he is unable to be treated because the government rejects an offer of free streptomycin from the Swiss. It is only after Pero publicly criticizes his country's refusal of medical aid and becomes a political prisoner that UNICEF physicians arrive at Bruno's home and treat him with streptomycin and PAS.

He recovers and his father is released from prison. As he watches the family cow and its pen incinerated, Bruno is filled with horror and relief by the death of an animal that once provided food and comfort but almost killed him.

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This sketch is teeming with images: in what appears to be a science lab, two researchers stand in the background, surrounded by gray lab equipment; one peers into a microscope. In the bottom of the frame a horse and cow flank three sheep. At the center stands a muscular baby, loosely draped in a white cloth and held up by a nurse in a white apron and cap. To his left stands a rather grim looking doctor, who holds the baby's arm with one hand and injects a vaccine with the other.

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In this extensive review of her experiences in public health and rural and urban medicine, Eva Salber, MD, explores the commonalities and the differences in medical practice among three environments: pre-World War II South Africa, urban America, and the hills of North Carolina. Trained in South Africa, where she and her husband practiced for many years, Salber came to the US during a very difficult political period for whites in Cape Town.

In Boston, she pursued her passion for the plight of the poor and their health issues by studying further public health and running a ghetto clinic. Later, as a member of the Duke University faculty, she established rural health clinics in North Carolina. She describes, in this memoir, the contrasts among the cultures as well as her own difficulty in obtaining the funding and support she needed to carry out her work in each setting.

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Between April 1795 and September 1801, 306 bodies were pulled from the river Seine in Paris. A register of these deaths, indicating, sex, age, hair colour, wounds (if any) and a description of clothing (if any) was kept by two mortuary clerks, Citizen Bouille and Citizen Daude. If witnesses came forward in the days that followed, the names, occupations of the "silent guests" and the witnesses would be added together with the circumstances of the deaths. In most cases the cause of violent death was unknown, or unrecorded--be it "accident, misadventure, suicide, or murder." Bouille and Daude would not speculate.

This artistic documentary uses a male narrator and an eloquent text to present 23 out of the 306 cases: traveling clerks, hearty horsemen, children, mothers, mistresses, aged widows, and a laundress with her little daughter drowned together. These people had lived through the Revolution, the Terror and the early Consultate and it seems reasonable to wonder if the political circumstances they had experienced were somehow connected to their demise. On the other hand, the occupations--tobacco-pouch maker, carter, delivery clerk--invoke the continuity of daily life in the great city despite the political turmoil.

Each case is presented with the site and details of the discovery of the body, followed by a description of the external anatomy as the camera moves slowly and clinically upward over the naked corpse from the feet to head. The shadowy antics of the crude yet sympathetic bureaucrats Bouille and Daude appear throughout, as they retrieve bodies, wash them, label them, and arrange for the witnesses to view them with enforced respect. But we know less about Bouille and Daude than we do about their "guests."

The narrator reminds us how memory rarely survives more than three generations. Who will remember us, he asks, or these actors who lay very still? And as the register ends, the Revolutionary calendar that governed it ended too. These people who no longer exist could be said to have lived in a time that also no longer exists, because it is no longer measured.

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This pocket-sized book contains stories from the home front--poems about patients the nurse-author tends in their apartments and in her clinic. Often, the patients speak, teaching us not only what it's like to be elderly and lonely, but also how to view mainstream healthcare from a different perspective.

Most important, we learn about the courage with which these patients cope with illness and poverty, and how nurses honor their patients' choices through non-judgmental caring. Outstanding poems include "The Language of Hearts," "Passages," "Lower Midline Surgical Scar," "The Screamer in Room 4," and "Home Remedies for the Blues."

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Summary:

Jacob Hansen is sheriff, undertaker, and pastor in the little Wisconsin town of friendship. A Civil War veteran like many of the men in his town, he has seen many faces of death and knows how to balance compassion, prayer, and practicality in the presence of grief. When he recognizes a diphtheria epidemic as one after another the people of Friendship fall ill and die, he has to shoulder responsibility for protecting public health.

This means imposing and enforcing quarantine, extending even to the encampment of religious revivalists at the edge of town who mostly keep their distance and their own ways. Jacob's equanimity falters when his wife and baby daughter succumb; he keeps them alive in his mind and unburied for days, unable to acknowledge his own loss, though he helps others through theirs.

Finally he forces a passing railroad engineer to transport the survivors across the quarantine border into a neighboring town for safety, but the train is sabotaged, wrecked, and the fugitives killed. Jacob survives almost alone to return to what is now a ghost town and cope with the grim fate of survival.

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Summary:

This story is subtitled, "An Artist's Story." The narrator is a landscape artist living on the estate of his friend Belokurov. Nearby is the home of the Volchaninovs, a mother and two daughters. The older daughter, Lydia, is a teacher and social activist. The younger daughter, Zhenya (Missie), is warm and lovable. The narrator insists that Lydia's political and social views are wrong.

"In my opinion," he says, "medical centers, schools, village libraries and dispensaries, under present conditions, merely serve the cause of enslavement. The people are entangled in a great chain, and you are not cutting through the chain, but merely adding new links to it." (p. 223). Lydia replies, "It's true we are not saving humanity, and perhaps we make a great many mistakes; but we do all we can, and--we're right." (p. 224)

The narrator falls in love with Zhenya, who responds to him, but he makes the mistake of telling Lydia, who despises him. The next day Lydia has sent her mother and sister away. The narrator never sees them again, although he still has a faint hope: "I begin to feel that she, too, remembers me, that she is waiting for me and that we shall meet one day . . . ." (p. 231)

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A doctor and a magistrate are driving down a country road in a rainstorm on their way to an autopsy. The doctor says he doesn't notice the weather. "I feel a strange oppressive dread," he says. "It seems to me as if some misfortune were about to overwhelm me." The magistrate scoffs at this. They decide to stop at a country home for the night.

The doctor mentions his foreboding to the pretty widow who lives in the house. When they go to bed, the drunken magistrate, who thinks the widow was flirting with the doctor, encourages his colleague to visit the woman's room. The straightlaced doctor not only refuses, but also prevents his companion from visiting her.

The magistrate blows up in anger and the two men go home. Three days later the autopsy remains to be done. Once again, the two set off to the autopsy, but this time they are waylaid by a tavern and decide to stop and have a few drinks.

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Summary:

This biography of Anton Chekhov features a clear, uncluttered text and benefits, at least indirectly, from the fact that the Chekhov archives (his letters, his family's letters and diaries) are now available to the public. The author, however, does not read Russian; he uses only secondary sources.

Callow's source for the new scholarship--presumably the "hidden ground" indicated in the title--is Donald Rayfield's biography, Anton Chekhov. A Life, published in 1997 (see annotation). The book presents the story of Chekhov's life in a straightforward fashion, but places special emphasis on the writer's relationships with women, and the role of actual people and events as sources for Chekhov's characters and stories.

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