Summary:

Journalist Jonathan Eig traces the life of Lou Gehrig, one of the finest first basemen that major league baseball has ever known. Gehrig played as a tremendously reliable and powerful hitter for 17 seasons with the New York Yankees, the only team for which he played, many of them with Babe Ruth; he starred in 7 World Series games, playing on 6 championship teams. Gehrig's consecutive game streak of 2130 games, part of the reason for his nickname Iron Horse, was only broken recently, in 1995, by Cal Ripken, Jr. of the Baltimore Orioles.

Born June 19, 1903, Gehrig was only 35 years old when he developed the symptoms of amyotrophic lateral sclerosis, a neurodegenerative disease of vicious and progressive muscle wasting. He died June 2, 1941, quietly, at home. A relatively unknown disease at the time, amyotrophic lateral sclerosis, or ALS, soon became known as "Lou Gehrig's disease."

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An overthrown Latin American ruler, Mr. President, is exiled to Martinique. The 73-year-old man develops a peculiar pain in his ribs, lower abdomen, and groin. He travels to Geneva, Switzerland in search of a diagnosis. After extensive medical testing, he is informed that the problem resides in his spine. A risky operation is recommended to relieve the pain.

The President meets a fellow countryman, Homero Rey, who works as an ambulance driver at the hospital. Homero schemes to sell an insurance plan and funeral package to the sick man, but the President is no longer wealthy and lives frugally. He is reduced to selling his dead wife's jewelry and other trinkets to pay the cost of his medical expenses and operation.

Homero and his wife, Lázara, grow fond of Mr. President. They provide financial assistance and care for him after he is discharged from the hospital. The President returns to Martinique. His pain is unimproved but no worse either. He resumes many of his bad habits and considers going back to the country he once ruled, only this time as the head of a reform group.

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Two couples drink gin and discuss the meaning of love. Mel McGinnis, a 45-year-old cardiac surgeon, does most of the talking. As an example of bona fide love, Mel describes an elderly couple he treated in the hospital. They were severely injured in a motor vehicle accident and, despite great odds, managed to survive. What bothered the old man the most during his lengthy recovery was his inability to simply look at his spouse.

Mel’s wife, Terri, provides her own case of real love. She previously lived with a man named Ed who professed his affection for Terri the entire time he was beating her. After she left him for Mel, Ed attempted suicide--first by ingesting rat poison and later by shooting himself in the mouth. Terri insisted on being in the room when Ed died.

The other couple at the table, Nick (the narrator) and his wife, Laura, also think they know what true love is, but they have difficulty articulating its essence. After the gin has finally run out and the room gets dark, Nick is acutely aware of the sound of his heart and everyone else’s too.

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When Ben Nowak reached the age of fifty, his primary care physician for the past fifteen years, Dr. Ellen Parrish, began performing annual digital rectal examinations on him. Ben is still embarrassed by the female physician checking his prostate gland. He finds the younger Dr. Parrish attractive and available. She divorced her husband because the man was abusive.

Dr. Parrish's office receptionist happens to be the wife of Ben's friend, Jerry, who works at a landfill and brings home cases of expired beer. Once, Jerry found a dead newborn baby in the landfill. Dr. Parrish informs Ben that his prostate has gotten larger. The tests she orders come back "inconclusive" so additional tests are done. Ben concedes that he might have prostate cancer, but rationalizes that things could be "a hundred times worse" (29).

When his second set of test results are normal, Ben grasps that it is likely a temporary reprieve; he is only fine "until the next time" (34). He drives to the site of an illegal dump. The trunk of his car contains ten cases of expired beer (courtesy of Jerry). At the dump, he proceeds to drink one bottle of beer from each case and smashes the other twenty-three.

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In 17th Century Dutch depictions of "scenes from everyday life," the so-called genre paintings, the single most popular medical representation is the "Doctor's Visit." Among the most comical and complex are those of Jan Steen, who painted at least 18 works with this theme. Typically the patient is a young female, often suffering from a variety of illnesses related to love, either "love sickness," erotic melancholy, or pregnancy. [See relevant paintings by Steen at the Web Gallery of Art: "The Doctor and His Patient," "Doctor's Visit," and "Love Sickness," at http://www.wga.hu/frames-e.html?/welcome.html. Select "S" from Artist Index, scroll down for Steen, select "Page 1".)

In this painting, the doctor looks with concern at his patient, a young girl, dressed in silk and leaning on a table, as he takes her pulse. Behind her stands a smirking young man who holds a holds a herring in one hand and two small onions in the other. At her feet is an opened letter, alongside a bowl with a piece of burnt ribbon, and a heating box filled with coals, known as a brazier. Behind the physician, a woman playing a harpsichord smiles at the young girl. Behind her, a maidservant beckons a tall, dark, and handsome young man in a red cloak to enter the room.

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When a cousin is scheduled for major surgery, Richard and Joan Maple volunteer to donate blood. They have been married for nine years. During their drive to the hospital, the Maples argue about Richard's behavior at a party. The intern who performs the phlebotomy is clumsy and rough. He needs three attempts to successfully insert the needle into Richard's vein.

Richard and Joan occupy beds at right angles during the procedure and their blood is taken simultaneously. While watching the blood flow from his wife's arm, Richard experiences deep tenderness for her. An elderly man arrives and chats with the intern. Because Richard has never donated blood before, the three others in the room (Joan, the doctor, and the old man) all expect him to faint, but Richard never does.

The Maples have lunch afterwards. When the check arrives, Richard discovers he has only one dollar in his wallet. He and Joan must both pay. That's how marriage usually works.

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This is a collection of two dozen case studies, written for non-medical readers, of patients with right-brain disorders. The chapters are divided into four groups: "Losses," dealing with loss of memory, cognition, and proprioceptive sense; "Excesses," with tics and other cases of overabundance; "Transports," with seizures and various "dreamy states," and "The World of the Simple," concerning mental retardation. In every case, Sacks focuses on the interior or existential world of the patient as the foundation of diagnosis and treatment. Sacks argues that this approach is appropriate for the right hemisphere, which compared to the left is less dedicated to specific skills and more dedicated to a "neurology of identity."

Sacks openly proposes these studies as a corrective to the field of neurology, which has tended to focus on the left hemisphere and therefore, he argues, has wound up treating patients solely in terms of specific deficits, often to their detriment. In "the higher reaches of neurology," and in psychology, Sacks argues, disease and identity must be studied together, and thus he recommends that neurologists "restore the human subject at the centre" of the case study. Sacks warmly recommends music, story-telling, and prayer as therapies that work by ignoring physiological defects and speaking to the patient's spirit or soul.

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When a wealthy man falls victim to incapacitating attacks of vertigo, a young doctor decides that the problem and solution both reside in the patient's head. Gierke is an eccentric widower in his forties who remarries. While honeymooning in Italy with his 17-year-old bride, he collapses after looking down from the heights of a bell tower. Gierke becomes paralyzed by a fear of future attacks of vertigo and eventually stops walking.

Multiple physicians evaluate him without success. Finally a neurologist, Dr. Hugo Spitz, is consulted. He wants to try psychoanalysis but the patient has become extremely introverted. Spitz interviews all Gierke's relatives and even hires private investigators. The doctor devises a theory that Gierke murdered his first wife by pushing her off a mountain and then inherited her fortune.

Spitz reasons that Gierke's vertigo is the result of repressed feelings of fear and guilt. After confronting Gierke with the explanation, Spitz orders his patient to stand. Gierke walks without experiencing any dizziness. Immediately after the doctor exits the house, there is a loud sound and Gierke's dead body, fractured in multiple places from a fall, is found at the bottom of the staircase. Spitz deduces it was suicide.

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This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?

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In four lengthy chapters, the biographies of Haydn, Mozart, Beethoven, and Schubert are carefully presented. Special attention is given to health, both physical and psychological, throughout life and at its end. Autopsy information is included. In particular, the author emphasizes the impact of illness on the composers' relationships with family members and doctors, and on their musical composition.

Evidence is derived from a wealth of primary sources, often with long citations from letters, poetry, musical scores, prescriptions, diaries, the remarkable "chat books" of Beethoven. Neumayr also takes on the host of other medical biographers who have preceded him in trying to retrospectively 'diagnose' these immortal dead.

Late eighteenth- and early nineteenth-century Vienna emerges as a remarkable city of musical innovation and clinical medicine. The composers' encounters with each other link these biographies. Similarly, many patrons, be they aristocrats or physicians, appear in more than one chapter, such as the Esterhazy family and Dr Anton Mesmer.

The disease concepts of the era, prevalent infections, and preferred therapies are treated with respect. Rigid public health rules in Vienna concerning burial practices meant that ceremonies could not take place in cemeteries and may explain why some unusual information is available and why other seemingly simple facts are lost.

Biographical information about the treating physicians is also given, together with a bibliography of secondary sources, and an index of specific works of music cited.

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