Ward Rounds

Beernink, K. D. (Kenneth Dale)

Last Updated: Apr-25-2022

Coulehan, Jack

Summary:

This is a collection of poems about patients, written by a young physician in the late 1960s. The book is organized around the theme of a hospital ward. Each poem is named for a patient and has the patient’s disease as its subtitle. The poet composed these poems during his own illness when, as he says in the original Introduction, “my patients reappeared to me, and I lived again in my mind all the many emotions we experienced together.” K. Dale Beernick died of chronic myelocytic leukemia at the age of 31 in 1969. In Ward Rounds he recounts his experiences as a medical student and house officer. He uses a variety of forms and techniques, including rhyme, blank verse, haiku, and even one villanelle. The poems vary in quality and impact. Among the best are "Penny Brown" (rheumatic heart disease), "Theodosus Bull" (delirium tremens), "Anonymous" (spontaneous abortion), and "Minnie Freeme" (post-necrotic cirrhosis).

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The First Wave

Heineman, Matthew

Last Updated: Apr-18-2022

Bruell , Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

First Wave documents the early days of the COVID-19 pandemic at Long Island Jewish Medical Center (LIJ) in New York from March through June of 2020. It opens with a graphic scene of a rapid response team trying to save a patient with COVID whose heart has stopped. Despite their efforts, the patient dies. After the team pauses for a minute of silence at the bedside, the grueling work of saving lives continues.

The film follows Dr. Nathalie Dougé, an internist who was born in the Bronx to Haitian parents. Most of her patients are Black, Hispanic or immigrant. Two patients with COVID are essential workers: Brussels Jabon, a Filipino nurse who undergoes an emergency C-section after she is brought to the emergency room, and Ahmed Ellis, a school safety officer with the NYPD. Both have young children and supportive families.

Nurses hold up IPads so families can Facetime with the patients. It’s terrifying and sad for the families to see the patients on screen and not to be present when they are needed the most. It’s emotionally difficult for the healthcare team as well who are the only ones to hold a patient’s hand during these encounters. One nurse describes the effect of holding the phone while family members have five minutes to Facetime with patients, “You become the family member, and it seems like you’re losing your family.”

The emotional toll of losing so many patients, while fearing that they too may contract the virus and bring it home to their own families, weighs heavily on the healthcare teams. They are trained to compartmentalize, to separate work from personal life but their empathetic response to their patients follows them home. “I think about him every night when I go home,” nurse Kelli Wunsch says of Ahmed. “I just want him to do well.”

Scene after scene of teams rushing to resuscitate a patient who has coded are interspersed with more hopeful moments of a reunion between husband and wife, the sound of the song “Here Comes the Sun” when a patient is taken off the ventilator, and the cheerful encouragement of a physical therapist working to help a patient regain enough strength and mobility to be discharged. At times the camera moves outside the confines of the hospital to the outside world: Dr. Dougé alone at home with her dog celebrating her birthday with friends over zoom, eerily empty streets during the lockdown, and families anxiously awaiting news from the hospital. We see bodies taken to refrigerated trucks and people cheering the health workers at 7pm from windows across the city.

In May, when protests erupt following George Floyd’s murder, Dr. Dougé, joins the protest with other frontline workers carrying a sign, “Racism is a Public Health Issue” and ”I Can’t Breathe” scrawled on her surgical mask. Amid the “I Can’t Breathe” cries of the protestors, she relives the myriad times she has heard her patients gasping those words to her just before they are placed on ventilators.

Both Brussel and Ahmed become stable enough to be taken off the ventilator and released from the hospital to return home to their families. Despite their recovery from the acute phase of the illness, it is clear their health remains severely compromised. As the cheers of the staff in the hospital lobby fade, tough work lies ahead for these patients and their families.

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Every Last Breath: A Memoir of Two Illnesses

Jacobson, Joanne

Last Updated: Apr-11-2022

Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Five years into writing about her mother’s slow decline from a respiratory illness, Joanne Jacobson was diagnosed with a rare, life-threatening blood disease. That discovery dissolved the illusion that she and her mother had separate fates. “How could I continue writing about my mother as though I were observing her from outside the circle of Illness?” Jacobson asks (27). She can’t. And Every Last Breath becomes, as its subtitle discloses, “A Memoir of Two Illnesses.” Doubling its concern, Jacobson’s memoir in essays becomes a richer, more urgent, and ironic revision of her original project.

With writerly attentiveness, perceptive intelligence, and some impatience, the four opening essays witness the negotiations that Florence Jacobson makes with her body, her environment, and her psyche. From a distanced perspective, Jacobson wonders at her mother’s courage and stubborn animal will to go on. Her mother’s slow pace and reluctance to let go—of her possessions, her habits, her life—initially frustrate and puzzle Jacobson. She even expresses impatience with the constant sound of her mother’s oxygen pump filling the apartment, the inconvenient bulk of the oxygen canister, the tangles of tubing connecting the machine with her mother’s nostrils.

As Jacobson’s diagnosis closes the distance she perceived between herself and her mother, it ignites the memoir’s transformative insight. It’s first articulated at the end of the essay titled “Mirror Writing” and it sustains the rest of the memoir. Realizing that her mother might outlive her, Jacobson writes: “. . . I can no longer pretend that the ragged approach of death is likely to be smoothed by nature’s grace, or by the natural order. So long as I believed I was writing about my mother, I was able to hold mortality at a distance . . . Now in the mirror of my mother’s aging face I see myself” (29). In “Dead Reckoning,” when Jacobson learns that her blood is starved for oxygen, she hears her “own lungs fall into the thrumming motor’s pulse” of her mother’s respirator. Revising her response to the technology, she writes that it is “the sound of death being pushed mechanically away that is audible to me now—steadily asserting its nearness . . .” (63-4). Jacobson’s descriptions of her hospitalizations and treatments (“Written in Blood,” “If My Disease Were an Animal”) take her on solo flights toward her new understanding of herself and the “call to the imagination” that her experience issues (59). Jacobson’s elegant and vulnerable rendering of her efforts to survive pain, uncertainty, and terrifying treatments register her own courage and will to go on.

The final essays bring the shared destinies of daughter and mother together. Jacobson thinks of them as “invisibly entwined, cellular,” as she recalls that mothers’ bodies can absorb their fetuses’ cells (88). In “Book of Names,” Jacobson’s closing essay, she and her mother read out the names in Florence’s heavily edited address book, tracking the alterations in the circumstances of those whose lives she’s shared. It invokes the lists in Genesis. Begotten. Then gone.

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Tangles: A Story About Alzheimer's, My Mother, and Me

Leavitt, Sarah

Last Updated: Mar-07-2022

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

Sarah Leavitt’s graphic memoir, Tangles: A Story About Alzheimer’s, My Mother, and Me, narrates and vividly illustrates the pain and difficulty of caring for a loved one with Alzheimer’s disease. Leavitt’s memoir shares her family’s experiences nursing their mother, Midge Leavitt, for six years following her diagnosis at the early age of 52. “I created this book,” Leavitt explains, “to remember her as she was before she got sick, but also to remember her as she was during her illness, the ways in which she was transformed and the way in which parts of her endured” (Leavitt 1). The memoir’s spare, black-and-white panels trace her mother’s deterioration from the first, seemingly innocuous symptoms (such as misremembering conversations and forgetting to unplug an iron) to the debilitating and tragic manifestations of Alzheimer’s, such as confusion, behavioral changes, aphasia, and ultimately, the inability to recognize loved ones. As greatly painful as these experiences were for Leavitt, she singles out from the murk and monotony of caregiving moments that inspire laughter, introspection, and gratitude. Early one morning, Leavitt’s mother wakes her to admire a fresh, “glittering” snowfall (86). On another occasion, Leavitt illustrates a rainstorm. Instead of keeping dry, her mother wants to stand in the downpour: “So finally we let go of her. She stuck out her tongue to taste the rain” (78). For Leavitt, humor brings, if not understanding, comfort when the stifling presence of her mother’s suffering goes momentarily unfelt. Caregiving also stirs recollections about her mother’s personality. Leavitt remembers, for instance, her mother’s love of Granny Smith apples: “She ate the core and stem and everything, crunching loudly” (23). She remembers her mother’s love of nature, “. . . plants, worms, rocks, soil. She did not seem separate from it as most people did” (93). Her mother also adores the poetry of E. E. Cummings and Robert Frost and Aretha Franklin’s music. Leavitt does not allow suffering to efface her mother’s personality, providing a poignantly moving account of how caregiving shapes memory and deepens family love in unexpected ways.

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The End of Days

MacLaverty, Bernard

Last Updated: Feb-28-2022

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Autumn in Vienna, 1918. Menace circulated in the air itself and fear was rampant as a global pandemic and a World War raged. Egon, an artist, and his wife Edi, six months pregnant, had enough money to live on but hardly any opportunities to spend it. Shortages of coal for heat and flour for bread were continuous. Edi has suddenly become very ill - trouble breathing, loss of appetite, exhaustion, fever, and explosive coughing that produces blood. It is the Spanish flu and pneumonia.

Egon devotedly cares for his sick wife despite her warning, "You will get it from me" (p111). Soon she is unresponsive. As Egon listens for a heartbeat with his ear against Edi's motionless chest, he can only auscultate the distant, faint beat of his unborn child's heart that is quickly silent. He tragically describes Edi's corpse: "Her body being both cradle and coffin, within a minute" (p128). Egon feels compelled to make multiple sketches of his dead wife.

Before long, Egon experiences harsh bouts of coughing, fever, and chills. He becomes remorseful about the drawings he made of Edi and burns them in the kitchen stove. Egon gazes at the fire, knowing he too will die shortly but aware that he will be survived by all his other artwork.

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Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe

Poe, Edgar Allan; Hawthorne, Nathaniel

Last Updated: Jan-25-2022

Field, Steven

Primary Category: Literature / Fiction

Genre: Anthology (Short Stories)

Summary:

Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe is one in a series of books called Literature and Medicine dedicated to the exploration and explication of the intersection of the two titled disciplines. This volume, edited by L. Kerr Dunn, looks at the short stories (mostly—it includes one sonnet) of Nathaniel Hawthorne and Edgar Allan Poe from the viewpoint of each author’s use of, and in some cases experiences with, doctors, diseases, and the medical profession. The volume begins with an Introduction that situates the writings within the medical and social milieu of the period (the authors were contemporaneous) and illustrates the way in which the tales reflect the times.

The stories are grouped by author and arranged chronologically. Among the nineteen entries included are “The Minister’s Black Veil,” “Lady Eleanore’s Mantle,” “The Birthmark,” and “Rappaccini’s Daughter” for Hawthorne, and “The Black Cat,” “The Fall of the House of Usher,” “Berenice,” and “Some Facts in the Case of M. Valdemar” for Poe; each entry is preceded by a brief introduction and followed by discussion questions. An extensive list of scholarly references closes out the volume.

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Daughter

Davis, Cortney

Last Updated: Jan-17-2022

Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Davis, a nurse practitioner, chronicles her daughter’s life, illness and death at age 54 from cancer. The book consists of three sections, with poems unevenly divided such that of the 30 poems, only one rests in section II. Titled Windmill, this poem forms a fulcrum between the relationship of mother and daughter to one of mother and ill daughter. The windmill is a small gift from her daughter – a reminder of Kansas where the daughter, her husband and children live, thousands of miles from Davis. The collection begins with her ‘soon-to-be born daughter’ (page 15) and ends with The Sacrament of Time, dated months before her daughter’s death from, at this point, a widely metastatic breast cancer. The final poem holds within it an entire world – the birth of the daughter, the fraught frantic mother-to-be pleading for help, the birth of a healthy baby girl, the wonder of the new addition to their family, the travel with the newborn to home, and a reflection on what poems can and cannot do. “Poems cannot // save us, Amichai said, but all I have are these poems” (page 58).

If the first section details the many ways unconditional love for a child unfolds, through wonders of babyhood, delights of childhood, the harsh lessons of adolescence, and the successful launch, the final section underscores how deep that love runs. As the cancer illness progressed during the pandemic, issues of separation became more acute. Davis marks the numbers affected (illness and death) by coronavirus (SARS-CoV-2, COVID-19) during the pandemic, as her poems follow her daughter’s cancer. These numbers, along with brief quotations from her daughter’s scans and reports, lend a contrast to the evocative imagery and experience of illness in a loved one. Medical mistakes are chronicled as well (see What a Terrible Mistake).

The collection is dedicated to Davis’ daughter and her daughter’s children. Even the title, Daughter, calls to her, as if addressing her daughter directly. The title also serves to universalize the parenting of a daughter, even as the particulars of this family are detailed.

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The King's Anatomist

Blumenfeld, Ron

Last Updated: Jan-03-2022

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Brussels mathematician Jan van den Bossche, (fictional), single, and fifty years old, is devasted to learn of the death of his lifelong friend, the brilliant (and very real) anatomist Andreas Vesalius. Companions since childhood, shorter, sturdy Vesalius was the outgoing exuberant leader of the duo, snubbing authority, taking risks, and seizing every opportunity to explore the anatomical structure of animals and humans. He constantly dragged the quiet, shy Jan in his exploits.

News of Vesalius’s death sends Jan in two directions. First, he wanders back through many memories: their lives and travels together to Paris, Leiden, Padua, Spain; the rise of Vesalius’s fame in anatomy, medicine, and surgery; and his odd departure from academe to serve foreign crowned heads in France and Spain. Second, it propels him forward on a journey to his friend’s grave on the Greek island of Zante (now Zakynthos), in an effort to comprehend why the notorious skeptic would have embarked on a religious pilgrimage in the first place. Jan realizes that he can forgive Vesalius almost everything, including the theft by marriage of his beloved Alice. But he is incapable of pardoning the bewildering manner of his death.

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Nervous System

Meruane, Lina

Last Updated: Dec-13-2021

Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ella needs time for finishing her doctoral dissertation on black holes she has been writing for years and thinks an illness could provide the time: “Just enough to take one semester off, to not have to teach all those planetary sciences classes to so many distracted students whom she had to instruct evaluate forget immediately (p. 6). Before she can decide which illness would best suit her purposes, a mysterious illness finds her.

A sudden cramp shoots down the spine and then, stillness... (p. 9)

An unbearable stinging had settled into her shoulder neck ember... (p. 10)

She felt an invisible wound wrapping her up and suffocating her... (p.10)

A slight numbness that starts in the shoulder and extends along the arm to the elbow until it reaches the back of her right hand, the fingers where it all started. (p. 12)

Inflammatio. In flames. En llamas. Ardor without romance. (p. 10)

Quickly, then, the story shifts from Ella’s dissertation odyssey to her diagnostic odyssey. As she makes her way along this journey during the first chapter, other characters come into the picture: El, Ella’s long-term boyfriend and forensic scientist, is one. The others in her family history are “the Father,” “the Mother,” “the Brother,” and “the Twins”—none are ever named (neither, really, is Ella or El because they are “she” and “he,” respectively in Spanish). Except for the Twins, each of the subsequent four chapters center on one of these characters and how they figure into the family history. Just as in the first chapter, the stories are told through and around the health challenges each character faced; all harrowing, many life-threatening, and some metaphorical.

Ever present in these histories is the story of Ella’s birth mother,“genetic Mother”. She died giving birth to Ella. Ella’s stepmother, “the Mother,” is called at different times, “the volunteer Mother,” “the replacement Mother,” and “the living Mother.” The Brother, alternatively known as “the Firstborn,” shares with Ella her birth mother and was born nine years before her. The Twins, known separately as “the Boy Twin” and “the Girl Twin,” came after the Father remarried. Another dimension shaping the stories is both the Father and the replacement Mother work as practicing physicians.

Ella’s prominence in each chapter makes her our witness to El’s recovery after an explosion rips through his mass grave excavation site, and his many surgeries for separate gastrointestinal troubles; the Mother’s aggressive and brutal breast cancer treatment; the Firstborn’s recurring bone fractures (an “osseous enigma”); and the Father’s bleeding ulcers and life-threatening hemorrhagic complications from prostate surgery.

The author, Lina Meruane, structured the book in a somewhat unconventional form. She delineates sections within each chapter with asterisks centered on the page (“***”), and these sections rarely comprise more than two paragraphs. Dialog is neither separated from other text nor signaled with quotation marks. The text moves back in forth in time, from here to there in place (presumably somewhere in South America), and sometimes takes the form of pensées rather than plot narrative. But, overall, the book moves towards resolving some mysteries surrounding family history.

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The Problem of Alzheimer’s

Karlawish, Jason

Last Updated: Nov-29-2021

Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In a 1976 Archives of Neurology essay, the neurologist Robert Katzman successfully argued for relabeling “senility” as “Alzheimer’s disease.” He urged rejecting various forms of dementia and senility as common consequences of aging, and accepting them as a disease requiring all the attention any other important disease deserves. Now medicine and society had a problem—"The Problem of Dementia,” the famed physician Lewis Thomas called it in a 1981 essay published by the popular magazine Discover, and he noted that, suddenly, “a disease of the century” had arisen (p. 3).

Forty years on, Jason Karlawish thinks there is still a problem, but in keeping with Katzman’s call, he refers to “The Problem with Alzheimer’s.” Based on the history he covers and the experiences he shares in this book, nothing of much significance has occurred since “The Problem of Dementia” became the “The Problem of Alzheimer’s.”

Karlawish is a physician who cares for people with Alzheimer’s and a researcher delving into “issues at the intersections of care, ethics, and policy” (p. 5). He draws on his experiences in this book, which he describes as “the story of how once upon a time, Alzheimer’s disease was a rare disease, and then it became common, and then it turned into a crisis.” Karlawish wants to answer why during the time between Thomas’ essay and the year 2010, “nothing really changed,” and how that could be the case in “the richest and most powerful nation.” (p. 6) He tells this story in four parts.

The first part concentrates on efforts clinicians and researchers were making following Thomas’ call to distinguish Alzheimer’s disease from normal aging, other dementia types (e.g., frontotemporal, Lewy body), and precursor syndromes (e.g., minimal cognitive impairment). They were looking for definitive clinical patterns, imaging studies, diagnostic tests, and pathologic markers for the disease.

In the second part, Karlawish goes back in time to when Alois Alzheimer first found what are known today as “plaques” in the brain of a patient who had an early onset of severe, progressive dementia. He traces the attention this finding drew to eventual advances in imaging and biochemistry aimed at diagnosis. Karlawish also covers how a cascade of events over the decades following Alois Alzheimer’s finding disrupted the pursuit of a pathophysiological basis for dementia. These events included the rise and dominance of Freudian psychology; followed by two world wars; the cold war; the overshadowing of AIDS; Medicare political and funding constraints; tussles among patient advocacy groups; loss of asylums where care and research had coexisted; clinical failure of the first drug; and the continued debate over whether dementia is a consequence of aging or is a disease.

Karlawish moves on in the third and fourth parts to cover what “we will have to learn to live with the disease so as to improve the lives of persons...to provide the care they need to live well at home...and repair the broken system” (p. 171). Success in his view requires integrated biological, psychological, and social components. He reports the progress on each of these three fronts: some failed approaches continue to fail (such as drugs targeting amyloid); some psychological interventions show promise (though at times causing moral tension); some of the social configurations engineered for Alzheimer’s patients, families, caregivers, and society have produced triumphs and some disasters. He has much to say about why and how this search must go on, but with some much-needed course corrections.

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