Summary:

Frank Eloff, the novel’s narrator, is a white doctor working at a hospital in the former capital of one of South Africa’s now-defunct independent homelands (rural areas set aside by the apartheid government for black "separate development"). The hospital, in its deserted and decaying city, is understaffed and understocked, and there are hardly any patients. Those who do arrive usually need to be taken elsewhere if they need any significant treatment. The homeland’s former leader, the Brigadier, has returned as a criminal gang leader to loot the place, and a white former army commander, now in the employ of the present government, is trying to capture him.

Frank moved to this place when promised directorship of the hospital (and in flight after his wife left him for his best friend), but the previous director has not left yet, and Frank is in a kind of personal and professional bureaucratic limbo. He has a sexual relationship with a black woman who runs a roadside souvenir stall. It is not quite prostitution, not quite a love affair: she is married, speaks little English, and Frank regularly gives her money.

A new doctor, Laurence Waters, arrives. He is fresh from medical school, sent to the hospital in order to complete the rural community service year required by the government of all new physicians. He and Frank become roommates and begin an uneasy friendship. Laurence is an idealist, planning to make heroic changes, but he misunderstands the complex balance of tolerance, cynicism and patience that characterize survival at the hospital, and his well-intentioned efforts, such as trying to end theft from the hospital and to establish a clinic in a local tribal village, lead to disaster. The novel ends with Frank appointed hospital director at last, and things returning to their depressingly ineffective "normality."

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Doebin is an island reserve for Aborigines off the coast of north Queensland. In 1930 the superintendent goes insane after his wife dies. He sets fire to his house, kills his children, and wounds others in a bloody rampage that ends in his being shot by an Aboriginal man. Interestingly, this superintendent was a benevolent dictator who actually appeared to care for the Aborigines, whom he considered childlike and treated in a strict paternalistic manner. In return, his charges respected him and called him "Uncle Boss."

The book tells this story from the perspectives of several different characters and reveals how the events of 1930 influenced their lives and bound them together in mysterious ways. We learn of the influence these events had on the subsequent lives of the island's little community: doctor, matron, schoolteacher, boarding house operator, priest, and Manny Cooktown, the man who shot and killed the madman, Captain Brodie.

Time moves on, things change. World War II comes and goes. On Doebin Island, however, Aboriginal people continue to be treated like prisoners. Benign paternalism is replaced by out-and-out hatred during the reigns of a succession of superintendents, who treat their Aboriginal charges as if they were animals.

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Ian Young spent the summer of 1970 as a medical student working at a hospital in the province of Kabylia in Algeria. He was assigned to the Maternity department, where he worked primarily with two Bulgarian doctors. Most foreign medical personnel in Algeria at the time came from Eastern bloc countries, as "Islamic Socialism" was the official political system in the newly independent (1962) North African country. According to Young, obstetrical care for the mostly Berber women of the area was brutal, disorganized, antiquated, and dangerous.

Dr. Vasilev, the head of the department, is a passive and indecisive man, who spends most of his day reading the newspaper. Once roused from his lethargy, which doesn't happen very often, he demonstrates competence and concern for his patients. His colleague, Dr. Kostov, is an aggressively brutal man who introduces himself to pregnant patients by shoving his fist into their vaginas.

Both doctors excuse their behavior by saying, "We just can't do it here they way we do it in Bulgaria." For the most part, they do not use sterile technique, and although anesthetics are available, neither Kostov nor Vasilev typically use them. The Algerian nursing staff provides at least a modicum of organization and care in this dreadful environment.

At first Young approaches the situation with disbelief and anger. He then attempts to improve the quality of care, first by introducing a flow sheet for obstetrical care, and later by submitting a report on the poor conditions to the hospital director.

Mild-mannered Dr. Vasilev supports him, but no one uses the new flow sheets, and the Director considers the report a personal (and political) affront. Meanwhile, Ian Young presents the reader with a seemingly endless series of fascinating patient cases and interesting stories about hospital personnel, as well as about his excursions to various parts of Kabylia.

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This little novel is the retrospective tale of a childhood event told by the protagonist 40 years later. Family relationships and bonds in conflict with professional and community obligations vie with the shadow of racism and sexual abuse in the doctor/patient relationship for the core tensions in the book. The setting is a small rural community where the pioneer family about which the tale evolves controls the law and the medicine. The boy narrator relates his view of the breakdown of family as its secret--a physician uncle who is suspected of sexually abusing his native-American women patients--becomes a force that demands action from the doctor’s brother who serves as the sheriff.

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In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.

It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.

The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.

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This volume nicely supplements the few other anthologies of literature on medical themes currently available in that it covers a wider historical span. Selections from the Bible, Giovanni Boccaccio, William Shakespeare, Rabelais, as well as 18th-century writers including Pepys, Daniel Defoe, Malthus, Schiller, and Goldsmith provide an array of historical touchstones that offer windows onto medical and literary history and points of comparison for the larger selection of works from the 19th and 20th centuries.

The selections are mostly short--averaging around 10-12 pages. Each is introduced with lively, often witty, comments by Gordon, whose popular Doctor in the House series was adapted for stage and screen in England, and whose associations with the medical world include an editorial position on the British Medical Journal as well as a wife and two children who are physicians. Many of the selections focus on the figure of the physician viewed variously from the viewpoints of patients, other physicians, and him or herself.

Selections from novels by three Victorian women doctors as well as selections from several physicians’ diaries provide unusual additions to a useful collection of excerpts from well-known literature including works by Scott, John Keats, Jane Austen,George (Marian Evans) Eliot, George Bernard Shaw, Hardy, Aldous Huxley, Sir Arthur Conan Doyle, Sinclair Lewis, F. (Francis) Scott Fitzgerald, Waugh, Orwell, and more recent and popular fiction, up through Erich Segal.

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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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David Moray is a wealthy physician in his fifties who lives in a Swiss villa, where he indulges his passion for collecting art. He is contemplating a relationship with the stylish yet impoverished Frida von Altishofer, but an idle comment overheard at a party brings an intoxicating memory from his youth. As an idealistic medical student, he once loved and planned to marry Mary Cameron, a simple, highland lass. But first, David had to take a long sea voyage as a ship doctor to recover from tuberculosis; there he met pouting but provocative Doris, and her hopeful parents.

The prospect of a fabulous income in the family’s drug business makes him abandon Mary and a medical practice. He marries Doris but within a short time she is permanently committed to an asylum. The family semi-apologizes for not having told him of her illness. David compensates for his miserable marriage with material possessions that are a proxy for self esteem, until Doris dies and sets him free.

The overhead remark sends him back to Scotland only to discover that his jilted Mary, who had married a minister, is now dead. Her daughter, Kathy, is a nurse and the very spit of her mother. He falls in love all over again. Kathy will not marry him unless he returns to practice and joins her and her uncle as missionaries in Africa. Full of good intentions, he agrees. But he does not tell Kathy about Mary, and he forces himself on her against her will.

When he assimilates the very real dangers of mission work, he simply fails to show up for the appointed rendezvous; he will marry Frida and keep his cherished possessions instead. Told bluntly by Frida of the marriage and of her mother’s past, Kathy drowns herself. David must identify her body. He then hangs himself from a Judas Tree.

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This collection of sixteen Chekhov stories brings together in one volume many of Chekhov’s finest tales about doctors. The chronologically-arranged collection includes the famous novella, Ward 6, as well as such shorter classics as An Awkward Business and A Doctor’s Visit. In all sixteen stories, the doctor is a major figure, often at the center of a moral conflict.

Robert Coles , in his thoughtful forward, notes that Chekhov raises the "big questions" about "the meaning and purpose of life and the manner it ought to be conducted (and why)." Himself the editor of William Carlos Williams’s doctor stories, Coles recognizes and honors the comparison between Chekhov’s and Williams’s works and their dual careers as physician-writers. Jack Coulehan, in his introduction and comments, provides interesting biographical information on the great Russian writer as well as insightful interpretations of each story.

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Dr. Forrest Janney, once a prominent surgeon, has given up his practice in the city and retired to his hometown in Alabama due to alcoholism. He runs the local pharmacy and keeps up his medical license, but doesn’t practice. His brother Gene begs Forrest to operate on their nephew, who is comatose from a gunshot wound in the head; he was sent home to die. Other doctors have refused to operate because the bullet is lodged close to a major artery at the base of his skull. Dr. Janney examines the young man. Although Janney declines to operate, citing his drunkenness and tremor, he encourages his family to keep trying to find a surgeon because he estimates a 25% chance of survival if the bullet is removed.

Shortly thereafter, a violent tornado plows through the town, leaving dozens of dead and wounded. Dr. Janney immediately pitches in with several other doctors to treat the wounded and makes supplies from his pharmacy available at no charge. The comatose nephew is also found in the wreckage, barely alive, and in order to give him at least a chance, Janney operates on him, despite being fortified by a heavy dose from his flask.

A few days later, the nephew presumably dies (not clear from the text). A little girl whom Dr. Janney has befriended is sent to the orphanage in Montgomery because her father died in the tornado. Shortly thereafter, Dr. Janney leaves town, after giving his house to his brother and his family. He is on his way to save the little girl from the orphanage.

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