Summary:

The narrator of the story, a former district doctor in Russia, reminisces about his frequent encounters with patients suffering from secondary syphilis ("the speckled rash"). The first case he diagnoses is a 40-year-old man seeking treatment for a sore throat. The doctor recommends the application of a bagful of mercury ointment once a day and a follow-up visit after 6 days, but the man never returns. The physician advises him that his wife needs to be examined also, but she is never seen in the clinic.

The doctor remembers many other cases of secondary syphilis in the community. Except for one young woman, patients seem to have little fear of the disease. Children and even entire families are infected. The physician decides to tackle the widespread venereal disease and to confront the rampant patient apathy in the district.

His weapons include mercury ointment, potassium iodide, Salvarsan (an arsenic compound) injections, harsh words, and warnings about the horrible effects of the disease if left untreated. He opens an inpatient unit to treat patients with syphilis. Now long-removed from that remote medical outpost, the narrator still wonders about the people living there.

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Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

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Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.

Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.

Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."

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When faced with breast cancer and chemotherapy, Catherine Lord chronicles her illness in a literary performance piece by adopting the online persona of Her Baldness--a testy, witty, passionate presence who speaks forthrightly about her fears to a highly selective listserv audience of friends, family, and colleagues. The fragmented, multifaceted format of this autobiographical text includes photos, lists, e-mail narrations of her illness, responses from friends, plus the quick-tempered, no-holds-barred ruminations of Her Baldness on what cancer, chemotherapy, and baldness have meant in her life.

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A husband and wife in Ireland struggle to make ends meet. Corry and Nuala, each 31 years old, have 3 children. Corry works at the joinery. He also carves religious statues on the side. A wealthy English woman is impressed by his artwork and encourages Corry to pursue his craft fulltime. His talent is undeniable, but there is no market for his wooden statues.

Now Nuala is pregnant and Corry is without a job. The English woman's wealth has vanished, and she can no longer help the couple financially. Nuala offers to sell her unborn baby to an infertile couple, Mr. and Mrs. Rynne, who long for a child of their own. Mrs. Rynne is shocked by Nuala's proposition and rejects it. Corry turns down work as an apprentice tombstone engraver but accepts a job working on the roads.

Nuala is angry about the way events have unfolded. She finds solace, however, in the concrete shed that functions as her husband's workshop. As she views the wooden figures of saints, Madonnas, and the Stations of the Cross created by her husband, Nuala concludes, "The world, not she, had failed" (152).

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The physician-narrator celebrates his 24th birthday in the company of two midwives and a feldsher (physician’s assistant). They toil in a remote area of Russia where conditions are harsh. The doctor tells the group about a peasant woman who requested a refill of belladonna (an atropine-like drug) that was prescribed for stomach pain the day before. Although the instructions were to take five drops as needed, the bottle was completely empty already. Since the woman had no signs of belladonna poisoning, the feldsher concludes she shared it or maybe even sold it to other villagers.

The group shares other stories about patient mistakes and misguided beliefs. That same night a man comes to the doctor’s house. He is a miller suffering from recurrent fevers. The physician diagnoses malaria and remarks how sensible and literate the patient is. Powdered quinine is prescribed to be taken once a day before the onset of fever. Soon the doctor receives word the miller is dying. The patient has defied the instructions and taken all 10 doses of quinine at one time to expedite his recovery. His stomach is pumped, and he survives the overdose.

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This book contains 29 short essays by physician-scientist Lewis Thomas, originally published in the early 1970s in The New England Journal of Medicine. The essays center on science, and range in focus from the molecular (e.g., DNA) to the subcellular to the organism to social interactions and all the way up to the search for extra-terrestrial life. Some themes reappear in several essays: science as a grand, engaging enterprise worthy of the brightest minds; communication between organisms creating the intricate dance of the social organism; the relationship of man to both nature and the grand scheme of the universe.

Lewis is fascinated by communication not only at the cellular level, but also at the pheremonal and cerebral level: "Language, once it comes alive, behaves like an active, motile organism" (90). The ant and its colony, as an example of a simultaneous individual and integrated social organism, form a link for Thomas between the enclosed unit of a cell and the complex interactions of a society. Indeed, macro-micro comparisons continue throughout the essays, and even conclude the final essay, "The World's Biggest Membrane," which lauds the atmosphere as protector, filter, and provider: "Taken all in all, the sky is a miraculous achievement. It works, and for what it is designed to accomplish it is as infallible as anything in nature. . . it is far and away the grandest product of collaboration in all of nature" (48).

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This is a collection of 14 contemporary patients' accounts of dealing with their illness or injury. (The patients, four men and ten women, including the editors, are all writers.) Among them the stories cover numerous medical conditions: erythroblastosis, environmental illness, obsessive-compulsive disorder, hip dysplasia, osteoarthritis, hip replacement, H.I.V., Crohn's disease, broken leg, ruptured cervical disc, myelitis, rheumatoid arthritis, paroxysmal nocturnal hemoglobinuria, lupus, alcoholism, multiple sclerosis, diabetic retinopathy, breast cancer, severe facial scarring, and depression. The collection is unified by a focus on selfhood--the recovery, discovery, or reconstruction of the psyche that the editors propose is the deepest form of healing.

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This is a collection of 22 contemporary first-person accounts by survivors of a wide range of life’s woes--some medical, some social, and most of them at least partly emotional. The challenges the writers have faced are too numerous to represent individually in keywords, but they include incest, colonialism, disfigurement, adultery and divorce, obsessive-compulsive disorder, bone marrow transplant, and the death of family members.

All of the authors are writers, a handful of them well-known, and virtually all the works collected here have been published before. They are unified, to use the editor’s words, by the idea that "lifewriting is a passage through grief to knowledge" (she might have added "and to healing").

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Gabriel Garcia Marquez was born in 1928 and is best known in the English-speaking world for his novel, One Hundred Years of Solitude, which appeared early in his career in Spanish (1967) and later in English (1970). He was awarded the Nobel Prize in Literature in 1982 and in 1988 published the novel, 0008 (see annotation), which received considerable attention for its evocative story of love and memory.

Garcia Marquez's autobiography is recent (2002, 2003); it covers the first twenty-seven years of his life in Columbia, ending in 1955 when he is sent as a journalist to Geneva to cover the Big Four Conference for his newspaper in Bogota. Although he remained in Europe for three years after that the book does not cover that period.

Garcia Marquez was born in Aracataca, Columbia in his grandparents' home, the first child in a family that grew to include ten younger siblings. He had a hectic childhood being reared by his parents' large extended family, which included several children sired by his father with women other than his mother.

Finances were always tenuous; when he worked as a journalist he was an important supporter of the family. He received a broad classical education at the Jesuit College in Bogota, where he began his writing career. Later he studied law and journalism but did not finish law school. He read extensively from all genres of literature.

Garcia Marquez's family relationships and personal experiences were traumatic in many ways as was the political situation in Columbia. It was a tumultuous initiation to a life of creative writing. His words quoted on the flyleaf describe the book: "Life is not what one lived, but what one remembers and how one remembers it in order to recount it."

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