Summary:

Send in the Idiots is a witty and moving tale of reunion, part memoir and part journalistic character study. Nazeer, hailing from a Pakistani family that has lived in the United States, Great Britain, Saudi Arabia and Pakistan, returns to the United States, where he had attended a school for autistic children during his early youth. He tracks down some of those who were also at that school with him, in order to find out how they are doing, what they are doing, and how their autism has affected their lives. He locates three people who were in the same class as he was and goes to visit them; he finds the family of a fourth; and finally sits down and has a slice of cheesecake with their former teacher and principal. Now a civil servant in the English government, Nazeer visits Andre, a computer scientist who makes uses of puppets to facilitate communication; Randall, a bike courier in Chicago and poet; and Chris, a speechwriter in Washington, DC. He then stays with the parents of Elizabeth, who had committed suicide a few years before, and through them finds out about her life, and about how parents may cope in the aftermath of such an awful catastrophe. Finally, he meets with Rebecca, who had been one of their teachers, and Ira, the prinicipal of the school, which has since shut down.

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At fourteen, after marginally consensual sex with a boyfriend, Jane has a baby.  She managed to keep her pregnancy a well-camouflaged secret until late in the process; both family and friends are still reeling from her late-breaking news.  Her mother has died; her grandmother has moved from the tribal reservation to live with Jane, her father (a white Canadian), and Jane's two brothers.  Though the school she attends has daycare for students' babies, Jane finds little emotional support, even among former friends, until a new girl, Dawna, takes an active, unpretentious interest in both Jane and the baby.

With Dawna's and her grandmother's help Jane decides to make the rather complicated arrangements required to allow her to audition for the school play and pursue a longstanding dream of singing and dancing on stage.  She meets with fierce and aggressive competition from a much more privileged girl who does her best to discredit Jane's efforts on account of her unfitness as both a Native American who doesn't look the part, and as an unwed mother who, as one faculty member puts it, shouldn't "parade herself" in public.  Nevertheless, Jane's skill and determination and soul-searching pay off; despite the steep learning curve required to care for a baby and the psychological cost of teen motherhood, she succeeds in making the accommodations and compromises necessary to retrieve old dreams on new terms.

            

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Until their father abandoned the family and moved to California, Toby Malone, his older brother, Jake, and his younger brother Eli have a close, easy relationship with each other and their parents.  After his departure, and their move into a small condo, Jake begins to associate with drug users and dealers.  He becomes secretive, his behavior becomes erratic, and Toby, from whose point of view the story is told, is torn between loyalty to Jake and guilt at keeping secrets from his mother, who, coping with her own losses, is preoccupied and somewhat depressed.

For a while Toby runs interference, finding ways to care for his younger brother, mask the trouble from his mother, and cover Jake's tracks.  His own stability is preserved in part by a comfortable, cordial relationship with an older man in whose store he helps, and who helps him find baseball cards he treasures.  Finally, when Jake is apprehended and sentenced to rehab, Toby is relieved of his conflict and able to enter into a more authentic relationship with all his family members.  This new stage includes releasing pointless fantasies about his father's coming back and rescuing the family from their troubles.

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In four parts this book uses a wide variety of images--caricatures in newspapers, comic books, advertisements, and photojournalism of Life magazine--to explore attitudes to physicians and medical progress in the mass media from the late nineteenth century to the mid-twentieth century. Each section centers on a specific type of image and the analysis addresses change in perception of doctors and their achievements by privileging crucial moments of newsworthy events and discoveries.

Early in this history, the media portrayed doctors as frock-coat wearing fops.  Medical metaphors used in a political context proclaimed these attitudes well. The story of four little boys, bitten by a dog in 1885 and sent to Pasteur in Paris for the newly invented rabies vaccination, is used as a pivot point for a transition in perceptions of medicine: from a clumsy, suspicious craft to a useful, progressive science.

The third section is devoted to the public fascination with the history of medicine in the period from 1920 to 1950, Films, newspaper articles, and comic books chart the insatiable taste for scientific success and medical progress. The last section studies images of progress in Life and other magazines through a meticulous analysis of health-related articles. In this section, Hansen shows how the media participated in educating the public to a definition of science that enjoyed an enthusiastically optimistic spin.

An appendix lists American radio dramas about medical history from 1935 to 1953. A wealth of sources are documented in the notes and the whole is completed with an intelligent index.

 

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South Africans, Paul and Andrea, are lovers living in France. Paul is fiftyish and white; Andrea is thirty and “coloured.” He has just asked her to marry him. She travels to Provence ostensibly to research sites for a film to be based on Paul’s endlessly forthcoming novel about fourteenth-century plague. But the real reason for the journey is to test her feelings about his proposal—she is leaning to ‘yes.’

As five days roll by, she relives the trajectory of her life: her impoverished parents, her thwarted education, her angry, imprisoned brother, and the previous affair with Brian, a British historian with whom she was captured ‘in flagrante,’ sent to trial, found guilty, and offered prison or voluntary exile. Brian and Andrea left South Africa together, but their relationship eventually crumbled. She had trouble understanding his passion for the past and his love of detail.

In Provence, Andrea avoids places that Paul had wanted her to go, finding strength in solitude and independence. But that feeling is shattered when he asks her to rescue their penniless, black friend, Mandla, an anti-apartheid activist who has been betrayed by a comrade who turned out to be a spy.

Andrea doesn’t like Mandla, his sanctimonious accusations, arrogance, and probing. He is a racist and a male chauvinist, given to violence. But his constant questioning finally unleashes deeper memories of the shocking abuses of her life in apartheid South Africa—memories she has suppressed or attempted to blame on class struggle rather than racial intolerance. She tries to provoke his empathy with the terrible tragedy of the long ago plague. He resists, being concerned far more with the present, but he relents a little and begins to see racism as a plague and walls as feeble, futile attempts to exclude others.

Andrea falls for Mandla, makes love with him near the plague wall, and decides to refuse Paul and return to South Africa. But Mandla rejects a future with her because he wants no vulnerability in his struggle. He is killed in the night by a car. Was the death deliberate? accidental? suicide? Andrea leaves anyway.

In a short second part, Paul writes to Andrea of his own growing doubts about their future together despite his love.

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Summary:

Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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Late in the twentieth century, the young doctor Goodheart fails in a city practice and accepts a salaried position in the country.  Even there his difficulties persist. A challenging patient—the Reverend Pastor--refuses a tiny muscle biopsy that would not only confirm the diagnosis of trichinosis, but establish the doctor’s reputation. “I would rather die than let myself be skewered alive!” the pastor shouts (p. 11).

Deeply discouraged Goodheart wanders into the country at twilight, sighing, “If only there were a means of making the human body as transparent as jelly fish” (p. 13). Suddenly a woman appears in a blaze of light. She is “Electra the spirit of the twentieth century” (p. 15). She gives the astonished doctor a box and bids him open the lid. The nearby tree immediately becomes “as transparent as a jelly fish” (p.17). Next the box, judiciously aimed, illuminates the inner workings of a frog.

Goodheart applies his box to the ailing pastor and sees parasites teaming throughout his body. Then he effects a dramatic cure with helminthotoxin made from the worms themselves—a treatment that had been invented sometime during the century.

The box proves to be a simple electrical device, easily replicated. Declining financial recognition, to the vexation of his wife, Goodheart communicates the workings of the box to the world with no mention of Electra. But fame and riches flow his way and he dies in old age an honored man.

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Two months after he starts writing poetry, the narrator collapses. The maid finds him on the floor. An ambulance arrives at the scene. Two EMT's - Mike and Bob - check the condition of the novice poet. Their assessment includes the patient's orientation, his chief complaint, his favorite form of poem (the sonnet), and the last time he used iambic pentameter. Mike reads the poet's unfinished villanelle that remains stuck in a Smith Corona typewriter. The EMT deems it awful. The ambulance crew generates a list of possible diagnoses that includes an aneurysm in the language center of the brain and (more plausibly) writer's block. The duo decide that the narrator requires evaluation in the hospital for bad poets. All of their ambulance patients receive supplemental oxygen during transport. Every poet additionally gets a copy of verse by Rainer Maria Rilke to read during the trip.

The hospital for bad poets is a teaching hospital. A swarm of medical students participate in the evaluation of the narrator. His working diagnosis is "chronic acuteness." A young physician, Dr. Krupp, takes charge of the case. He also reads the narrator's incomplete poem and agrees with the opinion of Mike the EMT. The poem stinks. Dr. Krupp listens to the narrator's breath sounds and commands him to recite poetry during the examination. The physician announces, "Poetry is the equivalent of ventilation. Poets breathe for one another, they breathe for all of us" [p 147]. Dr. Krupp decides that the narrator's problem is serious enough to warrant hospital admission for one week's worth of observation. The doctor then scurries off to treat another poet whose situation is much more serious than the narrator's.

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Thirteen-year-old Matilda lives on a south Pacific island with copper mines. Rebels and other more official warriors are tearing the place apart. A blockade has made resources scarce and communication impossible; fathers are absent at distant work. Along with everything else, the local school collapses. 

Mr. Watts, the only island white man, offers to take over the education of the children, but he has no experience, few materials and just one book: his treasured copy of Charles Dickens’s Great Expectations. He begins reading a few pages every day. Captivated by the story, the children repeat it to their mothers when they go home each night.  

Matilda believes that she loves Mr. Dickens more than anyone else and she is both bemused and irritated by her stern mother's suspicion of the strange, possibly godless, white man and her feigned disinterest in Pip. Parents are invited to the school to pass on their own expectations about learning. Students accept these moments with pride and embarrassment.

The political chaos deepens, homes are destroyed, and the book vanishes. But Watts (nicknamed Mr. Pip) turns the loss to advantage by helping the students to recover fragments in a lengthy effort of collective recollection.

The ever menacing warriors return. Little more than frightened children in an incomprehensible conflict, they indulge in senseless brutality and killing. With courage absorbed from her mother, Matilda escapes, rediscovers her father, and finds a scholarly future—a life she embraces because of Mr. Dickens and Mr. Pip.

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Summary:

This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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