Summary:

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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Brown, anthropologist and Professor of Anthropology of Religion at Drew University, describes the life, religion and healing practices of Marie Therese Alourdes Macena Margaux Kowalski, also known as Alourdes or Moma Lola, a priestess of Voodou, who emigrated to the U.S. from Port-au-Prince in Haiti at the age of 24. What began as an ethnographic research project on immigrant Haitians, turned into a deep personal friendship between Moma Lola and Brown, and a privileged look at the practices and patients of a priestess, and at the socio-cultural lifeworlds of the Haitian community in Brooklyn and in Haiti between 1978 and 1986.

The book presents an intimate description of an alternative healing tradition through a number of perspectives. Brown alternates between a personal, an analytical, and a descriptive narrative of Moma Lola’s own history and her encounters with patients. In some chapters, Brown fictionally reconstructs the patient’s stories, so that the book is part traditional ethnography, and part fiction.

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Veneta Masson’s wonderful collection contains 56 "entries," essays, poems, fragments, and articles about her work as a nurse in an inner-city clinic. Her story is offered not as a neat beginning to end narrative, but as a pastiche of observations that range from commentary on how doctors and nurses approach caregiving, to a poem about Maggie Jones, a patient who changed Masson’s life.

As she follows the growth of the clinic and muses about the professionals and patients who give it life, Masson also talks about nursing: how it was, how it is, and why it’s such an important, and sometimes difficult to define, vocation. Some entries were contributed by Masson’s colleagues, Jim Hall, Teresa Acquaviva, Sharon Baskerville and Katrina Gibbons, but the best are Masson’s own.

This book should be required reading for nursing students, especially entries, "Nurses and Doctors as Healers," A Case for Doctoring Nursing," "Pushing the Outside of the Envelope," "If New Graduates Went to the Community First," "A Good Nurse," "Nursing the Charts," "Tools of the Trade," "Bring Back Big Nurse," "A Ready Answer," "Mindset," "Seven Keys to Nursing," and "Prescriptive Ambivalence." This book, especially for the essays "Nurses and Doctors as Healers," "A Case for Doctoring Nursing," "Prescriptive Ambivalence," and "If New Graduates Went to the Community First," should also be slipped into every medical student’s pocket.

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In the book’s Introduction, Dr. Cleaveland explains his personal need for real and fictional heroes. Seeing himself often as a victim of cruel childhood peers, he sought protectors and savored particularly the exploits of World War II heroes. His heroes, he notes, delivered him safely through childhood and adolescence.

Cleaveland describes seeing a documentary movie about Dr. Croydon Wassel in 1944; Dr. Wassel became his first personal hero. A book about Dr. Wassel was read by Cleaveland many times; later, as an adult, Cleaveland looked for the book again and set out to ascertain its authenticity. From extensive research he found Dr. Wassel to be far more courageous than he had anticipated--"studied, found not wanting."

The author was introduced to the story of Dr. Billie Dyer in 1992 through a collection of short stories. Dyer was a black physician who kept a diary during his eighteen months in service in the U.S. Medical Corp during the First World War. Cleaveland found a copy of the diary in the public library in Lincoln, Illinois and learned more about a new hero.

Other heroes he writes about were Dr. Woodrow Dodson, who served sixty years as a "domestic medical missionary"; and Dr. Lonnie Boaz, a black physician, the son of a victim of a hate crime, who became a well known ophthalmologist, husband, father, civic leader, and reformer after starting out as a painter, janitor, and army medic.

Cleaveland considers some of his patients to be heroes: Vera Gustafson, a World War II nurse whom he interviewed extensively, later adding historical information to her story; Paulette McGill, a childhood diabetic cared for by Dr. Cleaveland for twenty years; and an obese diabetic who became a "universal friend," teaching others about devotion and courage. Other patients were also deemed heroic, each for some special reason.

The longest story, saved till the last, is about Dr. Janusz Korczak, described by Dr. Cleaveland as the most heroic figure he knows of. Korczak was a Polish, Jewish pediatrician who devoted his life to improving the welfare of children in the Warsaw ghetto; he was deported to the Treblinka concentration camp with the children. (A movie that came out in 1990 dramatically tells this story.)

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According to the author's introduction, the most "beautiful and informative images of nursing are found on picture postcards" (xi). He has gathered over 580 full--color postcard images of nursing from 65 nations, documenting nurses' work in peace and war time and documenting, often in breathtakingly lovely images, an important part of nursing's history. Postcards from the years 1893 to 2002 (many of these from the "golden age of postcards," 1907 through World War I) follow nurses from factories to flu wards, from battlefields to mission welfare clinics.

The author has divided his book into seven chapters: "Symbols of Care," "Twentieth--Century Postcard Art," "As Advertised: The Nurse on the Advertising Postcard," "Portraits," "War!" "An American Photo Postcard Album," and "Parade of Nations." Each chapter begins with an intelligent, fascinating explanatory essay by the author, and each chapter ends with copious notes revealing the origins and stories behind the postcards. The book has an extensive bibliography and is well indexed.

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This is an exhibition catalogue for a show of 16 photographers who documented major topics in health over the last century. Carol Squiers, curator of the show, provides ten essays, amply illustrated by photos, on critical topics such as child labor, domestic violence, environmental pollution, AIDS, veterans of war, and aging. Some 80 per cent of the images treat American subjects.

Lewis Wickes Hine's photographs of child labor are dramatic and disturbing; these document children in coal mines, cotton mills, glass works, etc. in the first part of the 20th century. The Farm Security Administration sponsored photographers (including Dorothea Lange) to represent the New Deal Health Initiatives. Topics include farm labor, poverty in the South and Southwest, and inoculations. W. Eugene Smith created a photographic essay for Life magazine about Maude Callen, an African-American nurse-midwife in 1950s rural South Carolina.

Donna Ferrato documented domestic violence in the U.S. in powerful, personal shots, including a series of an actual attack. David T. Hanson created triptychs about environmental pollution: one panel shows a map of the area, a middle panel gives descriptive text, the last panel is an aerial shot in color. Eugene Richards spent time in the 1980s in Denver General's Emergency Room. Eleven black and white photos show the turmoil and drama.

Gideon Mendal documented HIV/AIDS in several African countries. Lori Grinker took photos of army veterans (some without hands) but also noncombatants harmed by war, including children. Ed Kashi presents images of aging Americans, rich and poor, urban and rural. Sebastião Salgado provides photos of vaccination in Africa and Asia.

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The description on the cover of this collection of essays states that it is "candid firsthand accounts of the profound experiences that transform medical students into doctors". It is edited by a woman breast surgeon (Susan Pories) who teaches students in the Harvard Medical School Patient-Doctor Course; a MD/MBA candidate (Sachin Jain) who anticipates a career as a clinician , scholar and activist; and a psychiatrist (Gordon Harper) who is director of the Patient-Doctor III course at Harvard. The short forward is by physician-writer Jerome Groopman. The 44 essays are divided into sections by theme: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. I found it helpful to read the short biographies of each student in the back of the book, before reading that student's essay.

The diversity of the essayists is very wide which makes for a broad look at many important issues. There are several subjects that we tend to avoid (student response to the nude body, the presence of students when end of life decisions are being made, the tensions between caring for a patient and having to do something which causes pain, trying to think of patients a people as well as complex biomedical problems). One of the editors wishes that the book will help people understand the working of the hospital and the many ways in which new doctors learn. The book is certainly a personal look at the teaching hospital from the students' view.

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Having remarried after a long and partly happy life with a woman who bore him three sons, novelist Campbell Armstrong lives in rural Ireland with his second wife. He learns that his first wife, who works in Phoenix, has advanced lung cancer and, with his second wife’s blessing, goes to spend time with her and their grown sons. In the course of that trip, he reflects on their life together, their romance, his alcoholism and its effect on their family, their move to the U.S., their losses, and the remarkably enduring affection between them and, surprisingly, between the first wife and the second.

Completely surprising all of them, a daughter his first wife gave up for adoption, who has searched for years for her birth mother, shows up in the months before Eileen’s death and makes the trip to Phoenix to meet her birth mother. Her appearance turns out to be a gift to the whole family. She assuages decades of sorrow and longing in both her and her mother’s hearts. She herself has cancer, not as advanced as her mothers. Both she and her mother work in health care professions. Much psychological and spiritual healing is accomplished between them in the short time they have before Eileen’s death several months later.

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The novel is set in Washington, DC in April, 1865. At fourteen, Emily is sole caretaker of her mother who is dying of tuberculosis. Her neighbor, Annie Surratt, is her best friend, though their mothers have been estranged for some time. Both families have deep roots in the South. Annie’s brother, Johnny, an object of Emily’s romantic fantasies, has recently left on a secret mission. The war is nearly over. Emily’s uncle Valentine, a physician, wants to take custody of her after her mother dies, but because her mother has also felt estranged from him, Emily resists. Still, after her mother’s death, she does go to live with her uncle, and learns that he (with his two assistants, one of whom is a woman who is 1/8 African American) has a lively practice among the poor and the African Americans who have flooded the streets of Washington since the emancipation.

Valentine is called to Lincoln’s bedside the night of his assassination, and participates in efforts to track down John Wilkes Booth and his accomplices, one of whom appears to have been Johnny Surratt, who has escaped to Canada. In the course of her time there Emily discovers that her uncle and his assistant are involved in elaborate, marginally legal, schemes to obtain bodies for study at the medical college. Emily, at first horrified by this discovery, comes to recognize the good that comes of anatomical studies and to sympathize with her uncle’s efforts to bring about legislation making the acquisition of bodies for medical research easier. Annie’s mother is hanged as an accomplice in the Booth conspiracy, Annie leaves town, and Emily comes to understand a great deal more about the harsh terms on which life must be lived in times of national crisis and ideological warfare. The story ends with her growing interest in medicine as a possible career path.

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At seven months, Remy, daughter and second child of Heather and Lon Davis, is hospitalized with a seizure that, after several days of agonizing uncertainty, is traced to a brain tumor. This narrative of her diagnosis and treatment, told by her mother and very much from her mother’s perspective, is not only a chronicle of a medical event, but, perhaps more centrally, of a spiritual awakening in the mother’s life. From a person uncertain about and largely indifferent to prayer, faith, and spirituality, Ms. Davis becomes, over the course of her daughter’s treatment, convinced of the presence of God, the power of prayer, and the availability of grace in precisely those circumstances that threaten life and lifestyle and bring individuals face to face with their deepest fears and deepest needs.

A series of “coincidences” makes her more and more aware of how little she controls in the grueling process, and how much of comfort, relief, and unexpected aid comes as unsolicited gift from un expected places. The child recovers, unlike several others the mother encounters during her weeks of witnessing hospital life. The mother emerges profoundly different for the experience, and clearer in her purposes as a writer and, eventually, a teacher.

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