Summary:

As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.

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This is one of three of Poe's tales that deal with mesmerism, an increasingly common practice of the early nineteenth century. This tale evolves around a young gentleman of Virginia, who has developed a rapport, a dependent relationship centered on mesmerism, with a physician who had been converted to the practices of Mesmer.

One day, after taking his usual morning dose of morphine, the gentleman leaves for his daily walk in the Ragged Mountains. He returns with the tale of a bizarre foreign encounter in which he dies from a snake bite to the temple.

As the "dead" man tells his tale, the doctor confirms that it was not a dream despite the fact that the subject seems quite alive. Within a few days the gentleman is dead, presumably because of the accidental application to his temple of a poisonous leech. The twist at the end of the tale, which includes allusion to reincarnation, will not be revealed here.

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Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.

Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)

Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.

However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.

She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)

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The narrator describes his chronic illness of two or more years duration. He likens his former good health to "an island / going out of sight behind you." His days are filled with visits to the doctor, medicine, and a loss of interest in "wanting to make love . . . . " He describes going through stages: feelings of being punished, which generate "an enormous effort to be good"; anger; fear of death; "a lake of grief"; "neurotic vigilance"; and finally, "only a desire to be done." In the end, he is still en route.

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Anne Finger, a writer and disabled activist whose childhood polio left her with a disability, tells the story of her pregnancy, her birth experience at home and in the hospital, and the serious health problems her newborn son experienced.

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This is a tight, short poem that takes its central metaphor from the uncredited quote, ". . . a madman attacked Michelangelo's Pietà with a hammer." The speaker is presumably a physician who, with a pathology report on his desk, contemplates the task before him. He likens himself, as bearer of grim news, to an avenging creature about to assault his patient, the Pietà, with a catalogue of cutting and pounding tools as images for the effect of such news on the recipient. The speaker also reflects on his own anger, the anger he feels about his patient's bad fortune, yet ". . . not wanting to judge / the cracked face of God."

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An older pregnant woman hesitantly knocks on a closed door. Everything in her pose suggests fatigue and a kind of dignified resignation. Her head is bowed in the direction of her pregnant belly. Perhaps this is one of many pregnancies in this working-class woman's life. The title of the drawing tells the story: she has come to the doctor for a pre-natal visit.

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This is the third volume of poetry by Bamforth, a physician and scientific translator who practices in Strasbourg, France. Open Workings is precisely that--the poet opens various ideas, places, and events and shows us their inner workings. But we find that the workings are not what we expect.

Some of these poems (e.g. "Between the Rhins and the Machars," pp. 20-23) evoke Scottish folk tales and traditions. "The Fever Hospital" (p. 33) alludes to William Carlos Williams's famous poem "Spring and All," which begins, "By the road to the contagious hospital . . . " Several are set in a mining town in the Australian outback. In "A Clear Thought" (p. 39) Bamforth recalls the "scorched mesas / and camel-track droppings / of overland Australia" where he and his wife, "two transients, / (we) were crossing a language / bigger than its markers." The long sequence (30 poems) called "Doing Calls on the Old Portpatrick Road" provides a richly textured view of the life and interactions of a country doctor, one of whose patients asks, "Why do you call it failure now my heart breaks?" (p. 64)

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Like the train images in the last two stanzas, this poem is a train of thoughts about medicine, doctors, and patients' relationships to doctors, medicine and illness. The poem begins with the narrator's (presumably the poet's) Chinese doctor writing a prescription in Chinese. The poet begins daydreaming about the characters, and this leads to a soliloquy about daydreaming and illness and the slower pace of the ill, hanging "suspended in the wallpaper" of waiting rooms.

A recollection of the poet's "lady doctor" and his infatuation with her leads to a revelation of his desire to have illness and suffering, just to be with her. He philosophizes "suffering itself is medicine / and to endure enough will cure you / of anything." He decides he'd like to suffer like his mother, who seemed to not only accept, but also relish, the sick role of the weak, dependent state.

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This essay is told from the perspective of an ophthalmologist who was consulted about a patient who had blurry vision. She is told by his internist that he has cancer but the family does not want him to know it. She plays along with the deception and does not inform the patient that his vision problems are from brain metastases. By serendipity she later learns that the patient knows his diagnosis but is playing along with the deception so as not to hurt his family. She is relieved to finally talk with him openly about his disease and his prognosis.

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