Summary:

This survey of the history of women in medicine begins in the mid 19^th century and moves forward to the late 20^th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19^th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20^th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20^th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

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Up-and-coming architect, Guy Haines, is traveling to Texas to obtain a divorce from Miriam, pregnant with another man’s child. He has nothing but contempt for her and cannot wait to begin a new life with more sophisticated and loving Anne. On the train, he meets slender, disturbing Charles Bruno, who hates his father. With a lot of booze Bruno goads Guy into confessing his hatred for Miriam. Bruno then proposes a double murder plot, where each would kill the other’s problem.  Appalled, Guy leaves, forgetting his book of Plato.

Not ten days later while vacationing with Anne’s family in Mexico, Guy learns from his anxious mother that Miriam has been murdered. Increasingly tormented that the unstable character on the train may have actually done it, Guy finds his life unraveling as Bruno mails evidence that he is Miriam’s killer, threatens to expose Guy as the instigator, and leaves anonymous letters for Anne. Guy’s work suffers. He drinks heavily and slowly sinks into a state where he realizes his only salvation is to kill Bruno’s father according to the precise plans that have repeatedly been sent. He does.

Guy’s career seems to pick up. But Bruno cannot leave him alone. He turns up uninvited at Guy’s wedding and insinuates himself menacingly into his married life. Guy is miserable, but plays along, aware that he has an impulse to defend Bruno as well as himself. He tells many lies and is wracked with guilt. Anne is worried and suspicious. The two men are bound by their secret, which encompasses a kind of animal attraction rooted in the sensation of having taken a life.

Things could continue indefinitely but for Gerard, the persistent but clever detective who worked for Guy’s father. Having known Bruno for years, he already suspects him of his father’s murder; then he finds Guy’s Plato. To say any more would spoil the gripping conclusion.

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Pseudonymic writer of romantic novels, Edith arrives at her Swiss hotel on lac Leman. She had been sent by friends to extract her from a situation, which at first is not clear.  The month ahead looks bleak and long.

With a keen eye, she observes her fellow guests, almost all female: beautiful, slender Monica with an eating disorder masked as indulgence of her tiny dog; a deaf, lame dowager ousted from her own home by a churlish daughter-in-law; a narcissistic mother and daughter whose amiable but inane conversation slowly begins to engulf Edith. These encounters ought to be fodder for her writing and they lead Edith to contemplate her own relationships with parents, aunts, women, men, and love.

Part of the narrative is conveyed in detailed letters to “dearest David,” letters that, we later learn, are never sent. Edith and David must be lovers, but soon it emerges that he is married and intent on staying that way; their affair is secret – possibly even to David. Even later, the reader discovers that Edith was on the verge of marriage to sensible, kind, older Geoffrey. But at the last minute, she left him literally standing at the altar--to his horror and that of those friends who have since packed her off to Switzerland.

A well turned out, wealthy male guest appears on the scene, Phillip Neville. He guesses Edith’s identity and challenges her to be less romantic and more selfish. He points out the value of marriage in terms of career, social standing, and simple companionship. Then he startles her by proposing. No love exists between them, they both admit. Nevertheless, Edith is on the verge of accepting his offer and his crass, unromantic view of the world, when a tedious, banal observation changes everything. She opts for freedom in romantic solitude.

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This eight-and-a-half-minute video begins with a woman rocking in front of a window and waving her hands. We hear a woman’s voice singing the sound of “e,” almost without melody. The first half of the video follows this woman’s activities: a shot of her hand rhythmically scraping a looped wire against the surface of a door, repetitively stroking a keyboard, batting at the pull chain for window blinds, and bouncing an orange plastic slinky. The woman rubs her face against the pages of an open book and rocks and listens to the sound of the book’s pages as she flips through them.

Halfway through this short video, text appears: “A Translation.” What follows—in the form of a voiceover and subtitle text—is more than a translation of the autistic woman’s actions just observed. It is a manifesto revealing and protesting the assumptions often made about people with autism and how those assumptions have led to institutionalization and the exclusion of people with autism from the category of persons.

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This is the story of an adult brother and sister whose lives are indelibly marked by the deaths of their parents, killed in a car accident when the children were young.  Set in the small town in upstate NewYork where they grew up, the film centers on a visit by Terry (Mark Ruffalo) to his older sister Sammy (Laura Linney). Portraying the vicissitudes of their relationship, the film traces the effects of loss on these two compelling individuals.

The film opens uncoyly with the scene of the parents' fatal car accident. Beneath the credits we watch the church-funeral, the two small children clutching hands while a Minister addresses the assembled.  

When the story picks up, we are introduced to the lives of the now adult siblings.  Sammy is still living in their parents' home, working in a local bank branch office and raising her son Rudy, a somber eight-year old who is becoming curious about his estranged father.  Rudy, at eight, is the age Terry was when their parents died. Sammy is a reliable, loving mom, but otherwise her life appears constricted.

We find Terry, the younger brother who is now twenty-five years old, saying goodbye to a much younger girlfriend; he is leaving to borrow some money from his sister, whom he hasn't seen in two years.  Terry, endearing but irresponsible, is leading a marginal existence, broke and unemployed, no fixed address.

A long restaurant reunion scene between the siblings reveals the texture of their relationship. We see that Sammy adores and worries about Terry; he is the light of her life.  Terry conveys restless discomfort with his sister's expectations, experiencing her concern for him as a burden.  He reveals that he has been out of touch because he was in prison for a while, and that he needs to borrow money to pay for a girl's abortion.

After learning that his girlfriend has attempted suicide, Terry sends her the money and decides to stay with Sammy for a while. In small increments, Terry and his nephew Rudy warm up to one another.  Meanwhile Sammy's life takes an unexpected turn as she begins an affair with her controlling, married boss (Matthew Broderick); this begins just after an old flame of hers resurfaces with a marriage proposal.  Neither relationship provides her much nourishment. Without easy answers, the film helps us connect the dots between Sammy's unsatisfying relationships with men and her adaptation to loss and to becoming the caretaking elder sibling.  

Terry's visit goes wrong when, after a series of small irresponsible dealings with Rudy, Terry takes it upon himself to introduce the child to his estranged father, resulting in an ugly scene.  Sammy, distraught, asks her brother to leave, as he "doesn't know how to be around an eight year old."  The film ends with their farewell as they wait for Terry's bus out of town. Terry doesn't know where he is heading or when he'll be back. The scene presents a remarkable exchange of feelings as Terry comforts Sammy, telling her it's always good to know that she "is back here rooting" for him, and assuring her that "everything will be all right -comparatively."   Sammy cannot draw him into her world or her life, and every parting with him feels permanent. They find their childhood connection in this scene--and the camera follows each of them for several beats after they separate, Terry on the bus and then Sammy driving to work.  We feel them slowly absorbing the violence of severing--going back into themselves.  Have they affirmed that in fact they can count on one another or reminded themselves (and us) that nothing can be counted on?

A surprise element in the movie is the character of Father Ron, a Minister played by writer-director Kenneth Lonergan.  Sammy turns to the minister for guidance, seeking advice about her brother.  In two surprising scenes, Father Ron injects into the narrative a sweetly earnest note regarding faith and finding meaning in our lives. 

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The unusual title is borrowed from Nathaniel Hawthorne's story, "The Custom House," to suggest a shift in fortune when immigrants "strike their roots into unaccustomed earth."  Set almost entirely in the United States (the unaccustomed earth), eight separate stories are connected most obviously by cultural dissonances affecting characters who are Indian or have Indian parents.  Three of the stories, however, are linked by a strong narrative connection that is unexpected, profound, and unforgettable.

For Indian readers, the narratives describe complexities about migration patterns, cultural issues, alienation, and generational differences. The stories deal with well-educated children of immigrants who become offspring their parents barely recognize.  For other readers, the stories reveal situations about families and customs that are strangely familiar, especially those stories dealing with relationships between parents and children.
 
The forces of globalization have created and accelerated shifts that can seem staggering to all parents intent on preserving cultural patterns and traditions. Whether Indian or not, most parents experience a sense of alienation while watching their children flourish in a world that increasingly appears unfamiliar and foreign.

Not surprisingly, the stories concern strains and challenges affecting mixed relationships and/or mixed marriages and stresses on disapproving and disappointed parents, while others focus on children succumbing to drugs and alcohol(for the latter, see annotation of "Only Goodness").  All deal with some kind of emotional loss, but provide connections to feelings experienced by children and their parents in life's quiet and more kinetic negotiations.
 
The first story is about Ruma, a well-educated woman who lives in Seattle with her work-alcoholic American husband, and child, Akash.  Generational and cultural contrasts are revealed in overt and more subtle ways when her recently widowed father arrives for a short visit. Even though Ruma's complete assimilation into her non-Indian home as well as her on-going worries about her father's loneliness are major considerations, another story thread is spun, one that quietly reveals the father's thoughts about himself and a new relationship made recently during a vacation in Europe. Ruma's assumptions about her father, his loneliness, his possible dependency on her, and the Seattle vacation as a possible signal for relocating to her household turn out to be entirely wrong. 
 
The last three stories follow a boy, Kaushik, and girl, Hema, into adulthood.  In the first story, "Once in a Lifetime," Hema recalls her first memory of Kaushik when he was 9 and she was 6. The occasion was a farewell party for Kaushik's parents who were returning from the United States to live in Calcutta. The mothers, who grew up in Calcutta, but met in Cambridge, Massachusetts had become very close and were saddened by this separation.

Seven years pass before Kaushik‘s parents return to the Boston area and stay with Hema's family. Hema found the now 16-year old young man appealing, but brooding and totally uninterested in her. Even though Hema expected Kaushik to be Indian-like in behavior, he was more Americanized than she was. That the family had flown first-class shocked Hema's conservative family as did their new smoking and moderate drinking habits.

After a long search, and to the relief of Hema's parents, Kaushik's family found a  modern house on the North Shore.  Before they moved to their new home, Kaushik surprised Hema with confidential information-- his family had left India to seek treatment in Boston for his mother's breast cancer.  All medical efforts had been unsuccessful and his mother had only a short time to live.  Hema promised to keep this disclosure secret and grieved for the woman she had come to admire and love.
 
The second story in the link, "Year's End," is narrated by Kaushik.  With the opening line, "I did not attend my father's wedding," readers know that Kaushik‘s mother has died.  His father, in Calcutta for a visit, had married Chitra, a woman with two young daughters, and all would be returning to the North Shore house to live. Most of the chapter recounts the ordeal of the mother‘s dying, Kaushik‘s tremendous sense of loss, and the loneliness experienced by him at Swarthmore College.  No mention is made of Hema by the desolate narrator except to remember he had hated every day spent under her parents' roof, but later had come to think of that time with nostalgia.  

"Going Ashore" brings Hema and Kaushik together in Rome where she has a study grant and a visiting lectureship and he is on vacation from his work as an award-winning photo journalist.  Hema's parents have arranged for her to marry Navin in Calcutta.  Navin has accepted a teaching position at MIT. Until her unexpected reunion with Kaushik and the intense love affair that follows, neither had experienced any real connection with another person.  The story about them in Rome seems to represent an independence from the cultural forces that have shaped their lives, but this independence is short lived.  Ultimately, she is unable to set aside the expectations imposed by her parents.  The consequences of their final separation are more than any reader might imagine.

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New York is the setting for thirteen linked stories that profile a long line of curious and sometimes loony doctors who are passionate about medical science but often lack common sense and good judgment. Beginning with Dr. Olaf van Schuler in the seventeenth century and continuing over more than 300 years with generations of his descendants (the Steenwycks), missteps and madness loom large in this inquisitive and peculiar medical family.

Most of these doctors share common goals: They strive to eliminate pain. They attempt to expand the scope of medical knowledge. They seek the soul. In their quest for cures and enlightenment, many of these physician-scientists, their relatives, and patients embrace off-beat diagnostic techniques or unproven remedies: phrenology, magnetism, bloodletting, hypnosis, radium-emitting apparatus, electrical shocks, and lobotomy.

In "The Siblings," a doctor performs a lobotomy on his sister. She dies a few months after the operation. In "The Story of Her Breasts," a woman develops rheumatoid arthritis that may or may not be caused by her silicone breast implants. She also experiences guilt and worry after encouraging her 18-year-old daughter to undergo breast augmentation. In "The Baquet," hope is undeniable and a miracle cure is mesmerizing. In the book's final story, "The Doctors," two physicians - a father and his daughter - grapple with their strained relationship and the man's progressive deterioration that might be due to Creutzfeldt-Jakob disease.

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Job, a prosperous but god-fearing man, is stricken with a series of misfortunes, losing his goods, his sons, and his health all as a result of a wager between God and Satan about whether or not a "perfect and upright" man will remain thus under relentless misfortune (1:1). As he sits in ashes, covered with boils, a group of friends come to mourn with and comfort him, sitting beside him for seven days and nights in complete silence "for they saw that his grief was great" (3:13).

Job proves a good bet by never following his wife's advice to "curse God and die," but he does deliver a series of lamentations and questions about his condition, countering his friends' theories about the possible causes (unacknowledged sin, primarily) for his troubles and finally asserting his desire to speak directly to God and ask Him the reason that a good man has been burdened with a host of sorrows (2:9). Job's friends, including a fourth speaker, Elihu, who was probably added into the text by a later writer, reprove him angrily.

God appears suddenly and speaks to Job from within a whirlwind, ending Job's complaints with his chastening response. Rather than offering a rationale for Job's suffering, God reminds him of the limitations of a human perspective. Ultimately God rewards Job and reprimands Job's friends.

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Based on the memoir by British writer Blake Morrison, who is played in the film by Colin Firth, the story unfolds through Blake's eyes.  Blake's father Arthur (Jim Broadbent) is rapidly dying of cancer, cared for at home by Blake's mother, Kim (Juliet Stevenson).  Blake's parents are both physicians.  Blake is extremely ambivalent toward his father and reluctantly goes back to his childhood home to visit the dying man.  As his father lies dying Blake hashes out within himself his conflicted feelings toward his father -- long-standing anger, contempt, guilt, occasional grudging admiration.  The film flashes back and forth between the present and Blake's memories of the past.

As seen through Blake's eyes, his father is bombastic, overbearing, a deceiving and self-deceiving individual.  Blake recalls numerous instances where his father called him "fathead," barged unannounced into his room, humiliated him in front of others, competed with him for the attention of young women, and disparaged his choice of career as a writer.  Blake is deeply wounded by the knowledge that his father has been carrying on a romance with Aunt Beaty (Sarah Lancashire ) behind his mother's back -- although his mother is painfully aware of the infidelity.  In addition to recalling various humiliating and annoying situations with his father, Blake is enveloped in memories of his first sexual relationship with the family's maid and even makes a brief pass at her in the present, after his father's funeral.  He is so fixated on his obsessions -- with his first love and with his father -- that when his wife speaks with him on the telephone, he is distant and hostile toward her.
 
Blake's mother nurses her dying husband while Blake hovers in the background, hoping for an opportunity to talk to his father while he is still lucid, in what is bound to be a futile attempt at having a revelatory discussion about their fraught relationship -- such a discussion is bound to be futile because Arthur does not admit to his faults and even as he is on his deathbed, seeks reassurance from his wife that they had a happy life together.

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Summary:

This collection of physician experiences, colored by the necessity of the writer to protect  his patients, gives a glimpse into a medical practice of a time past-remembered by some of us, not  known by our younger colleagues.  Dr. Palmer, aka Harry Byrd, takes the reader into a rural setting and  the practice of surgery bounded by the time and the place.  Dr. Byrd, trained in Boston as a surgeon,  chooses to practice in rural Maine and to work with the culture and needs of this environment.  He  treats the reader to a viewpoint of another era of medicine and, at some level, asks the readers to  consider the lost or fading qualities of the pre-tech doctor/patient relationship.

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