Summary:

St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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This tightly researched documentary opens with the tragic auto accident in which Ms. Kowalski is rendered comatose. During the early period of her prolonged hospitalization, tensions arise between Kowalski's domestic partner and the patient's parents, leading to a highly contentious battle for the rights not only to visit, but also to assume long term care responsibilities. As the patient regains consciousness and limited physical and cognitive skills, the drama moves from the hospital and nursing care facility to the courtroom.

For ten years, the battle for custody and the ultimate care of Ms. Kowalski rages. Drawing on trial transcripts, medical records, newspaper archives, and personal interviews, Casey Charles's work brings to life emotions and personalities that dominated the courtroom dramas and illuminates the highly contested judgments emerging from supposedly objective authorities in journalism, medicine, and the law.

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This well crafted story concerns a contemporary woman in her thirties who undergoes significant personal losses; in fact, she seems to lose or lack an identity. Over the years, Kat, an "avant garde" fashion photographer, has altered her image, even her name, to suit the situation and the times. She has had two abortions and "learned to say that she didn't want children anyway."

The story begins when Kat undergoes surgical removal of a rare and peculiar ovarian tumor containing hair, teeth, bones (the clinical term is a dermoid cyst ); Kat dubs it "hairball " and stores it in formaldehyde on her mantelpiece. We learn that Kat's relationship with her married lover is going sour, that he will replace her as creative director at work. She fantasizes that she has given birth to "hairball" who she sees as the "warped child" of their failed relationship. Physical symptoms accompany Kat's growing emotional confusion. Hairball becomes the vehicle for an ultimate bizarre act reflecting Kat's personality disintegration. She has gone from being Katherine to Kath to Kat, to K, to being "temporarily without a name."

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For more than fifteen years, Irish-born Grace Marks has been confined for the 1843 murder of housekeeper, Nancy Montgomery, and her employer, Thomas Kinnear, at their home north of Toronto. Her convicted accomplice was hanged, accusing Grace with his last breath, but her sentence was commuted to life in prison at the last minute. Because of her amnesia and outbursts of rage and panic, she was held in the Lunatic Asylum before being sent to the Kingston [Ontario] Penitentiary.

Beautiful, intelligent, and strangely poised, Grace intrigues worthy townsfolk, spiritualists, and some of her jailers, who grant her the privilege of outside work, believe in her innocence, and strive for a pardon. In looking for medical approbation, they consult Dr. Simon Jordan, a young American doctor who is interested in insanity and memory loss. Without explaining his purpose, he brings her vegetables and other familiar objects, hoping to stimulate recollection of her life.

Interspersed with Jordan's own problems, Grace's story unfolds in her own words, from her poverty-stricken childhood in Ireland and the emigration voyage that killed her mother, leaving her and her younger siblings to a neglectful father, through her short life in service, to the dreadful events of autumn 1843. She has suffered many losses, including the death of her mother to ship fever, and that of her friend and fellow servant, Mary Whitney, from an illegally procured abortion. After many weeks, Jordan abandons his project in frustration and ambiguity. The novel ends years later with forty-six year-old Grace's discharge from prison in 1872, nearly thirty years after the crime.

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Written in 1977, "Rape Fantasies" appears to be a recap of a conversation among several women during their lunch hour, a few of them playing bridge, one--Chrissy the receptionist--reading aloud from a tabloid. When Chrissy asks the question, "How about it, girls, do you have rape fantasies?" the story unfolds with each woman’s response, all retold from the perspective of Estelle, who’s doing her best to deflect the entire conversation by concentrating on her bidding.

The conversation is tragically ironic, moving from woman to woman, Darlene calling the entire subject "disgusting," Greta describing a Tarzan-like scenario, Chrissy describing hers in a bubble bath, when Estelle, ever the voice of reason, reminds them that what they’re describing are sexual fantasies: "Listen . . . those aren’t rape fantasies. I mean, you aren’t getting raped, it’s just some guy you haven’t met formally who happens to be more attractive than Derek Cummins . . . and you have a good time. Rape is when they’ve got a knife or something and you don’t want to" (104).

Estelle then describes her rape fantasy where she deflects her attacker by squirting juice from a plastic lemon in his eyes ("You should hear the one about the Easy Off Cleaner"), but also includes the one where "this short, ugly fellow comes up and grabs my arm . . . [and] I say, kind of disgusted, ’Oh for Chrissake,’ and he starts to cry," which prompts a wave of sympathy in Estelle (106). And there are more, each with Estelle warding off her attacker through outsmarting him ("I’ve just found out I have leukemia"), or talking him out of it.

As the narrative continues, the reader becomes aware that Estelle is addressing someone in addition to the reader--"I hope you don’t mind me holding my nose like this . . . " (107) and that person is probably a man (twice Estelle says, "But I guess it’s different for a guy"). As the story ends, we realize that Estelle all along has been in a bar, speaking to a man she has just met, worrying about the possibility she will be raped by him. "Like, how could a fellow do that to a person he’s just had a long conversation with, once you let them know you’re human, you have a life too, I don’t see how they could go ahead with it, right?" (110). We are left wondering whether all these "conversations" are Estelle’s deliberate inventions, her way of trying to control a potentially dangerous social interaction.

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Summary:

The sensible Anne Elliot encounters the now-successful Captain Frederick Wentworth, eight years after she was reluctantly persuaded by family and friends to reject his suit as imprudent. He now courts the headstrong Louisa Musgrove instead of Anne. Louisa severely injures her head while frolicking with him, jumping down steps to the sea at Lyme, and requires a lengthy recovery nearby with his friends the Harvilles and Captain Benwick. While Captain Wentworth seems devoted to the injured girl, Anne’s friends are convinced that Anne has interested Captain Benwick and Anne’s cousin Mr. Elliot. But when Louisa and Captain Benwick fall in love, Captain Wentworth is free, and he and Anne are reconciled.

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Summary:

Note: I try not to reveal too much here. Nevertheless, I urge you to read the book first. I would not want the magic of reading this book to be diminished by too much foreknowledge--no matter when the book is initially opened.

Harry Potter and the Order of the Phoenix is the fifth book in a planned series of seven (see Harry Potter and the Sorcerer's Stone for an introductory summary). Harry is now fifteen years old. The opening chapter, "Dudley Demented," features a return of the Dementors (see Harry Potter and the Prisoner of Azkaban), who had been sent to Harry's neighborhood in Little Whinging to deliver their soul-sucking kiss. In order to repel the Dementors and save himself and his bullying cousin Dudley Dursley from the kiss's death-in-life, Harry uses magic. This transgression from rules on underage wizardry leads to Harry's near expulsion from his school, Hogwarts, and a trial by the full court, the Wizengamot, led by Cornelius Fudge, in the Department of Mysteries of the Ministry of Magic.

Headmaster Albus Dumbledore, concerned with Harry's safety as well as with leading the resistance efforts (The Order of the Phoenix) against the resurgent evil Lord Voldemort, not only prevents Harry's expulsion, but also organizes the guard for Harry's transfer from the Dursley home to the ancient house of Harry's godfather, the wonderfully moody and complex Sirius Black. Sirius, like Harry's parents, would risk anything for his godson, but the relationship is charged by Sirius' goading of Harry to be more cavalier like James Potter--Harry's father and Sirius' best friend--and by Sirius' antipathy towards being imprisoned in his ancestral home, filled with reminders of his pureblood wizard family.

These include a portrait of his raging, hate-filled, deceased mother and a malevolent house elf, Kreacher. Communication between Harry and Sirius is a key theme in the book, as Harry looks to Sirius for guidance on the tribulations of adolescence and to satiate Harry's continued craving for information about his father. Harry's emotional tether is short in this novel, and runs the gamut from frustration and envy that his two best friends, Ron and Hermione, were made prefects of Gryffindor House, to despising two teachers (potions teacher Snape, of course, and the new venomous, officious Defense of the Dark Arts teacher, Dolores Umbridge) and finally to absolute fear and hatred of Voldemort, his mortal, yet intimate, enemy.

Harry's scar pains him almost continuously now that Voldemort has returned in the flesh, and also now that Harry has dreams and visions of Voldemort's actions. With this ability, Harry envisions himself as a snake and witnesses the wounding of Ron's father, Arthur Weasley. This episode leads to two visits to the wizard hospital: St. Mungo's Hospital for Magical Maladies and Injuries. The reader is deliciously informed that the personnel in green robes are not doctors ("those Muggle nutters that cut people up" p. 484), but rather Healers: wizards and witches who passed a large battery of tests in a range of subjects to qualify for such training.

The hospital is a mix of the mundane (the irritable receptionist) and the arcane (patients suffering from bizarre spell damage). Mr. Weasley's recovery from the nearly lethal snake bite suffers a minor setback when Trainee Healer Pye (not the Healer-in-Charge, Hippocrates Smethwyck) tries some "complementary medicine . . .

[an] old Muggle remed[y] . . .

called stitches . . . " (pp. 306-7). The loving Mrs. Weasley, whose temper is notorious and hence humorous, shouts at her husband that even he "wouldn't be that stupid" as to allow his skin to be sewn together. (p. 307)

While in the hospital, Harry and his friends encounter schoolmate Neville Longbottom visiting his parents, who suffer dementia caused by dark magic performed by one of Voldemort's Death Eater followers. Mental illnesses prove far more difficult to remedy than bodily injuries and maladies. Indeed, late in the book, Madam Pomfrey, the Healer at Hogwarts, wisely advises that "thoughts could leave deeper scarring than almost anything else." (p. 847) As Dumbledore, the embodiment of sagacity, states, memories of old hurts, slights and abuses, make "some wounds run too deep for . . .

healing." (p. 833)

Other medically related items include the Skivving Snackboxes--an assortment of magical treats and their antidotes concocted to fake various illnesses in order to skip classes, and Umbridge's detention punishment which results in the painful etching of the required written phrases on the back of the hand of the miscreant student.

Professor Snape is charged with teaching Harry the subtleties of mind-reading (Legilimency) and its prevention (Occlumency), in an effort to prevent Voldemort's use of Harry's mind. "The mind is a complex and many-layered thing," says Snape, and hence the mind cannot be read like a book. (p. 530) Harry's failure at these lessons leads to the denouement of the book and ultimately to the loss of someone very dear to him. After the inevitable confrontation between Voldemort and Harry, Dumbledore gently coaches Harry through his guilt and anger to teach him about destiny, love and death.

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In 1869, national and medical attention was focused on a poor family in Wales. The daughter, twelve year-old Sarah Jacob, was bedridden with a strange ailment characterized by paralysis, staring fits, and anorexia. Yet she did not waste away. On the contrary, she seemed to survive comfortably with only few drops of water daily. Credulous folk came to visit, knowing that such abstinence had been the practice of many Christian saints; they would leave a few coins as an offering, although the family protested that money had never been requested. Others claimed it was a hoax.

Eventually the doctors and vicars became curious. An initial investigation upheld the family’s position that the girl did not eat. A more rigorous second investigation was designed by medical professors from Guy’s Hospital in London and carried out by trained nurses who sat knitting at the bedside. It resulted in the girl’s death.

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Summary:

A child of a beautiful, talented woman and ambiguous paternity craves learning. Adopted by a Spanish officer and an "uncle" who is a painter, s/he is sent off to Edinburgh as a pedagogic experiment to become James Barry, a male medical student. Barry adores the vivacious Alice, an illiterate but intelligent servant, whom he teaches to read.

Later as a doctor and medical officer, he travels the world to the Crimea, to the Caribbean, to South Africa and America, a scion of society and a good scientist. By happy fortune, he lives in retirement with Alice, who has become a famous actress. The book ends with the scandalous revelation of Barry's femininity when his body is laid to rest.

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Summary:

This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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