Summary:

Dr Bernard Rieux (William Hurt) says good-bye to his ailing wife at the Oran airport in South America. Their only child is dead. She has gone to the distant capital for tests and he plans to join her in a few days. But a mysterious epidemic of rats and what turns out to be bubonic plague breaks out. The city is sealed by draconian authorities who separate family members and drag people from their homes. Rieux decides to stay; months pass and his wife will die before he can see her again.

He befriends two stranded French journalists, Martine (Sandrine Bonnaire) and Tanto (Jean-Marc Harr), who volunteer as aides. They visit Joseph Grand (Robert Duvall) who keeps the cemetery statistics and writes an interminable novel. Tanto and Grand contract the disease but manage to survive under Rieux's care.

Constantly palpating her body in fear, Martine is desperate to flee, even as she strives to evoke passion from the emotionally numb Rieux. She is robbed and incarcerated by Cottard (Raul Julia) an unscrupulous profiteer. As the epidemic wanes, the journalists, the doctor, and Grand are reunited, but in that same instant Cottard shoots Tanto dead. Rieux and Martine are left sobbing in each others arms.

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In his study, Professor Starr examines the evolution of the practice and the culture of medicine in the United States from the end of the colonial period into the last quarter of the twentieth century. His major concerns are with the development of authority, and the Janus image of professionalization as medicine has gained power, technical expertise, and effective modes of diagnosis and treatment and at the same time seems to be getting further from the patient.

At the time of publication, our society had finally begun to take a hard look at the impracticality and the inhumanity of continuing on the trajectory of American medicine developed one hundred years ago. Starr invites the reader to consider the impact of modern stress on the profession and, more intently, on the constituency it is dedicated to serve.

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The threat of biotechnological warfare and/or terrorism is the focus of this carefully researched and riveting novel by the author of The Hot Zone. The term "science fiction" doesn't quite do justice to this tale which lies just to the other side of Preston's usual domain of literary nonfiction. Though the particulars of this story of a genetic engineer who designs lethal virus bombs to thin the population and the counterterrorist group of scientists who attempt to stop him are fictional, the possibilities of such threats are real.

The counterterrorists are a motley and sometimes contentious group of recruits from the FBI, the Centers for Disease Control (CDC), and the U.S. military. Their agendas and methods differ, but the immediate death threat to the unsuspecting inhabitants of New York and Washington D.C. unifies them into an effective if not always efficient team. They discover the virus when five cases appear of what seems to be an acute and horrifying permutation of a rare neurological dysfunction that induces violent seizures and compulsive self-destruction by chewing on one's own flesh. The virus turns out to be a graft that could only have been produced by artificial means.

The search for the "mad scientist" with equipment capable of this sophisticated work takes weeks during which a handful of people have to live with the secret that a potential pandemic could literally explode in a local subway. The resolution, while in some ways satisfying, hardly dispels the uneasy implications which invite readers not only to serious reflection on our collective attitudes toward weapons research and development, but to activism.

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This history of western medicine focuses on British life in the eighteenth century. Williams begins his treatise by wondering if "we realize sufficiently what we have escaped by being alive in the twentieth, not the eighteenth, century." He then catalogues in the subsequent 12 chapters the agonies not only of illness but also of medical treatment in the 1700’s.

Topics are wide-ranging and include blood-letting, parturition, infant malnutrition, rampant infectious diseases, maltreatment of the insane, surgery prior to anesthesia, water therapy, and military medicine. Primary source quotations interspersed in the narrative add to the drama. For example, the deposition of a widower (his wife died while pregnant) is quoted: " . . . Being taken ill of a paine in her right side under her short ribb together with a great difficulty of breathing having but 14 weeks to go with Child Mr Hugh Chamberlen Senr was sent for to take care of her, who thereupon gave her in the space of nine days four vomitts, four purges, and caused her to be bled three times to the quantity of eight ounces each time: Then gave her something to raise a spitting after which swellings and Ulcers in her mouth followed . . . . " (p. 31)

A few medical advances at the close of the century are also described, notably the smallpox vaccine developed by Jenner and the administration of First Aid to wounded soldiers at the frontlines (developed by Larrey). The text is accompanied by black and white illustrations, such as an inside view of Bedlam (Bethlehem Hospital) by William Hogarth (A Rake’s Progress, plate VIII).

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In Book I Oliver Sacks describes his visit to Pingelap and Pohnpei in the Caroline Islands (now a part of the Federated States of Micronesia). On Pingelap (population 700) 5-10% of the people are completely colorblind; i.e. they have a rare hereditary condition called achromatopsia in which the retina has no functional cone cells. Rod cells, which normally provide peripheral and night vision, are their only source of vision. While partial colorblindness is common, achromatopsia is normally very rare. Sacks and Knut Nordby, a Norwegian scientist who is himself achromatopic, examined dozens of achromatopes on Pingelap and in a village of Pingelapese people on the larger Pohnpei.

In Book II Sacks takes the reader to Guam where he investigates (with his friend John Steele, a neurologist who lives on the island) the neurological disease called "lytico-bodig." The "lytico" form of this disease is a progressive paralysis similar to amyotropic lateral sclerosis, while the "bodig" form resembles parkinsonism. Both appeared in Guam after the Second World Way and now seem to be dying out. However, no one has ever determined their cause.

Sacks tells the story of his visit, while also discussing various hypotheses that have been considered and discarded over forty years of study. The last section of the book describes a trip to Rota, a small island north of Guam, where Sacks visits a forest of cycad trees and discusses his life-long fascination with these primitive plants.

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Showalter identifies clusters of syndromes, or mini-epidemics, which she suggests represent late-twentieth century manifestations of the entity which was called hysteria in nineteenth century western culture. Opening with the history of psychiatry's involvement in hysteria in the time of Charcot and Freud, she traces the replacement of hysteria or conversion reaction by modern hysterical analogues such as: chronic fatigue syndrome, recovered memory, Gulf War syndrome, multiple personality syndrome, satanic ritual abuse, and alien abduction.

In separate chapters she examines each of these entities--how it presents, how it fits into her theory of mass hysteria as a cultural response to the millennium, and how it is being handled by health care professionals. Showalter contends that "Redefining hysteria as a universal human response to emotional conflict is a better course than evading, denying, or projecting its realities." (p. 17)

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In his introductory notes, Pritchett calls his book a "biographical and critical study." The author presents Chekhov's life chronologically, while at each stage concentrating on the relationships between life events and art, particularly with regard to the incidents and characters that find their way into Chekhov's stories. A typical chapter begins with the events of a given period and then presents lucid analyses of several stories or plays written during that time.

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In early 1847, the young Quebec city doctor, Lauchlin Grant, struggles to extract a living from his boring practice and pines over his childhood sweetheart, Susannah. She is now the wife of a prominent journalist, Arthur Adam Rowley, who has charged Lauchlin with her care, while he travels in Europe to report on the ghastly potato famine in Ireland and his predictions for its effects on immigration.

Even as Rowley's letters are read at home, waves of starving Irish land at Grosse Ile in the St. Lawrence River where thousands are ill or will sicken of ship fever (typhus), and die. Lauchlin is called to help at the quarantine station. Of the hundreds in his care, he rescues only Nora. Having lost her family, Nora decides to remain as a nurse, because she is now immune.

Lauchlin sees Susannah only once more, learning that she too cares for victims of typhus, which is also ravaging the mainland, despite the quarantine. He senses her unspoken love for him and, filled with an inner peace, returns to Grosse Ile, only to contract typhus and die. Nora takes the doctor's belongings to Susannah's home, hoping to meet the woman whose name he had mumbled in his delirium. Instead, she finds Susannah's newly returned husband dreading the loss of his now dying wife.

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This novel was inspirational for several generations of pre-medical and medical students. It follows the hero, Martin Arrowsmith, from his days as a medical student through the vicissitudes of his medical/scientific career. There is much agonizing along the way concerning career and life decisions. While detailing Martin’s pursuit of the noble ideals of medical research for the benefit of mankind and of selfless devotion to the care of patients, Lewis throws many less noble temptations and self-deceptions in Martin’s path. The attractions of financial security, recognition, even wealth and power distract Arrowsmith from his original plan to follow in the footsteps of his first mentor, Max Gottlieb, a brilliant but abrasive bacteriologist.

In the course of the novel Lewis describes many aspects of medical training, medical practice, scientific research, scientific fraud, medical ethics, public health, and of personal/professional conflicts that are still relevant today. Professional jealousy, institutional pressures, greed, stupidity, and negligence are all satirically depicted, and Martin himself is exasperatingly self-involved. But there is also tireless dedication, and respect for the scientific method and intellectual honesty.

Martin’s wife, Leora, is the steadying, sensible, self-abnegating anchor of his life. In today’s Western culture it is difficult to imagine such a marital relationship between two professionals (she is a nurse). When Leora dies in the tropics, of the plague that Martin is there to study, he seems to lose all sense of himself and of his principles. The novel comes full circle at the end as Arrowsmith gives up his wealthy second wife and the high-powered, high-paying directorship of a research institute to go back to hands-on laboratory research.

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For forty years, James Langstaff (1825-1889) practiced medicine in a small town near Toronto. He witnessed the advent of anesthesia, antisepsis, new drug remedies, germ theory, and public health. Chapters are devoted to his management of surgery, obstetrics, and diseases, especially in women and children, his finances, and his role and that of his suffragist wife in the political and social fabric of their community. A reformer and temperance advocate, Langstaff was quick to adopt medical innovations, but slow to abandon familiar practices.

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