Summary:

Sapphira was a fashionable young woman in Winchester when she married Henry Colbert, a man beneath her station, and moved to a rugged backwoods village, where they have lived for more than 30 years. Twenty of Sapphira's slaves came with them. This caused somewhat of a sensation among the poor, non-slave owning population of the region, where even to this day the Colberts are admired but not well-liked. Henry successfully took over the village grinding mill, while Sapphira assumed the role of local granddame. They had three daughters, all of whom married and moved away. However, Rachel's husband died, and she returned to Back Creek with her two young children.

Sapphira and Rachel are lay nurses who often visit and comfort the sick. Sapphira appears to do this work out of a sense of noblesse oblige, but Rachel feels empathy for the sick and less fortunate. She sets herself above nobody. Rachel is also an abolitionist at heart (as, to some extent, is her father), but Sapphira is firmly convinced that slavery is not only necessary, but also moral. Henry, a rather ineffectual male presence in this story, has responded to Sapphira's haughty regime by gradually withdrawing. In fact, he has largely abandoned the Big House to live at the mill, which he justifies by claiming the lack of a reliable foreman.

Sapphira suffers from severe dropsy. Her swelling is so bad she can no longer walk. She is jealous of a young slave named Nancy, with whom she believes Henry is having an affair. Much of the novel describes Sapphira's attempts to get rid of Nancy, first by selling the girl in Winchester, and later (when Henry refuses to sell) by importing her ne'r-do-well nephew to rape and destroy Nancy. This doesn't work either, primarily because Rachel takes Nancy under her wing and arranges her escape to Canada via the Underground Railroad.

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Karen Newman traces the visual depictions of the pregnant female body, the fetus, and obstetrical illustrations from the 9th century to the present in western culture. These images, in which the fetus looks baby-like or even adult and in which the female body is truncated or mythologized, have supported the anti-feminist rhetoric where the fetus or embryo is privileged with full human rights. Even in the fetal studies by Leonardo da Vinci (Studies of the Fetus), which were far more accurate than any prior or concurrent renditions, the roles of the uterus and placenta are de-emphasized and the uterus is simply a vessel, "almost a Fabergé egg."

Analysis and critique of medical art history is of relevance for today's society: "Early obstetrical illustration, Bologna's Museo ostetrico, and eighteenth-century anatomical sculpture and engraving are not merely antiquarian esoterica; rather, they constitute crucial political knowledge for the present." In fact, the book begins and ends in the 20th century.

In the first section, a close analysis of the Lennart Nilsson fetal photographs in Life Magazine "Drama of Life Before Birth" (1965) reveals that not only the photo captions, but also the manipulations of the specimens during and prior to photography (all the pictures but one were ex utero), were designed to proclaim and reinforce "fetal personhood." A similar conclusion is reached at the end of the book, when images from the current, widely used obstetrical text and from new imaging procedures are examined.

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This is a play about gullibility, evil, and jealousy. Iago, the embodiment of evil intent, resents not having been promoted. In the opening scene, he announces his intention to avenge the wrong done him by Othello and Cassio. He devises elaborate schemes to turn Othello against Cassio by implicating Cassio in tryst with Desdemona, Othello's bride.

The scapegoating plan works and in a jealous rage Othello smothers his beloved. When he learns he has been duped, Othello kills himself. The author of the tragic deaths, Iago, is ordered by the new general, Cassio, to torture and execution.

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In a rural town in Louisiana in the late 1940's a poorly educated young black man, Jefferson, is in the wrong place at the wrong time: he is in a liquor store with two friends when they murder the white storekeeper. Jefferson is unfairly convicted of murder and sentenced to the electric chair by a white judge and jury.

His defense lawyer, in trying to stave off the death sentence, labels him a "hog"--and it is this label that Jefferson's godmother wants disproved. She enlists the help of the narrator of the novel, Grant Wiggins, the plantation schoolteacher.

Wiggins agrees to talk with Jefferson only out of a sense of duty--he is an unhappy, angry man who dreamt of escape from his impoverished youth yet returned to his hometown after a university education to teach in the same one-room parish school he attended. Despite humiliation at the hands of the white sheriff, Jefferson's lack of cooperation, and his own sense of futility and uncertain faith, Wiggins forges a bond with Jefferson that leads to wisdom and courage.

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Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."

Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.

The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.

Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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Dr. Robert Weiss passes through the town of Sankt Vero in the Tirol and rents a room from the Lukasser family. During the night, the Lukasser's son, Niki, develops acute appendicitis; the visiting doctor operates right there on the kitchen table, saving the boy's life. Years later, when war rages in Europe, the Jewish doctor returns to Sankt Vero and knocks on the Lukasser's door. He tells of soldiers forcing men, women, and children into railroad cars, and how he himself--he who had saved Niki years before--needs asylum.

To hide Dr. Weiss, Mr. Lukasser boards him up in a small room in the back of the hayloft, a space one meter wide and three meters high. For two years, the doctor exists in this box. Niki and his friend, a blind girl named Sigi, bring Dr. Weiss food once a day and, for ten minutes or so, they stay and talk. Sustained by Niki and Sigi's lives--the stories of their discoveries of sexuality, cruelty, and love--the doctor survives.

Although Sigi is blind, she has the insight to recognize and try to alleviate the doctor's growing depression by encouraging him to tell his own stories. It is through these stories and through the doctor's observation of Sigi and Niki's blossoming adolescence and struggles with morality that we experience both the doctor's confinement and the powerful conflicts and transformations that rage behind the doors of Sankt Vero.

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This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Edgar Drake, a forty-one-year-old English piano tuner, accepts a commission from the 1886 British War Office to tune an Erard grand piano located in a colonial military outpost in Mae Lwin commanded by Surgeon-Major Anthony Carroll. Edgar leaves the squalor, fog and drizzle of London, as well as his middle class life and his wife Katherine, childless for eighteen years, for a journey by boat, train, carriage and horse to the exotic, intoxicating beauty of Burma.

En route, Edgar is surrounded by stories--a tale by the deaf Man With One Story, rumors about the legendary, eccentric Carroll's peace-making with the local Shan via music and cultural exchange, and socio-historical treatises about the Burmese, internecine wars, and British imperialism. The journey becomes a search for the meaning of home and purpose in Edgar's life. It is an adventure far beyond his prior imaginings and dreams.

The clash of cultures, British and Burmese, civilian and military, wealthy and poor, rule-bound and individualistic, is explored throughout the text. For example, a tiger hunt led by several British officials ends in disaster. Edgar meets Burmese culture on both grand and personal scales: street theatre; appealing, poverty-stricken children; the garb and cosmetics of various tribes; and, ultimately, the allure of Khin Myo, an educated Burmese woman who guides him to Mae Lwin and Carroll.

Carroll, a renaissance physician with a Victorian fervor for botanical and medicinal classifications and investigations, asks Edgar to assist him in his clinic. Common infectious diseases are diagnosed and treated by this forward-thinking physician, and he also performs finger amputations on the mangled hand of a boy without benefit of anesthetic. Other maladies are treated with local remedies and prayer. Meanwhile the delirium of malarial fever descends on Edgar.

Edgar does finally meet and treat the ailing, badly out-of-tune Erard piano. Edgar's expertise is required--his aural excellence and perfect pitch, his delicate yet callused hands, and his willingness to be innovative in the repair of a bullet hole. But what Edgar cannot be prepared for--intrigue and deceptions, fascination with the lush beauty of Burma, and his own shifting priorities and secret longings--is ultimately what sets his fate.

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A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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