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Summary: This very welcome poem concerns "twelve older men in shirt sleeves," a group of men with prostate cancer. The narrator, one of the men in this "private brotherhood" suggests the difficulty and reluctance of many men to recognize out-loud their mutual circumstances: "Ever notice how no one parks / in the Cancer Center zone." This line sets the tone; the men are vulnerable and afraid. From time to time they gather for support from one another and from the meeting's scheduled speaker. The reader has little difficulty imagining the collective angst and the grasping of hope shared by the participants leaning together in their mutual storm.

Any expectation of supportive discourse is shattered by this evening's guest speaker, a careless surgeon, who strides confidently into the room with his tray of slides. The remainder of the poem demonstrates a worst-case scenario:

I interrupt his gay delivery,
"What about orgasm...?"
"Forget orgasm," he grins,
"You don't have a prostate."

Some smile nervously and bravely ask questions that really matter. Each time the physician exhibits his caustic brand of insensitivity. The narrator, surely expressing the feelings of his colleagues, wants only to "drive / this witch doctor from the room."

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Dr. Paul Brand, who grew up son of English missionaries to South India, achieved world renown for his research on leprosy and related research on the dynamics of pain. This book, one of several of his reflections on physiology, combines autobiography, stories of research, and reflections on pain and pain management. The three topics roughly correspond to three discrete sections.

It opens with a story of the early death of a child with a rare neurological dysfunction that made her insensitive to pain. Brand's long work with victims of leprosy in India and then in Carville, Louisiana, gave him wide exposure to the consequences of life without adequate pain. Having spent 27 years in India, 25 years in England, and 27 years in the U.S. before writing this retrospective, many of his reflections include observations about cultural variables in perception of pain, how pain is communicated and managed, and how people deal philosophically with the problem of pain.

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This scholarly study examines "what it meant to ’talk of diseases’ in the second half of the nineteenth century" (2) and how discourses of health and illness were a vehicle for exploring individual and social identities, including gendered, racialized, and national identities. Narratives of physical illness are not simply artifacts of Victorian medical culture, Vrettos argues, but offer examples of the pervasive "master narratives" that shaped Victorian middle-class culture.

Individual chapters focus on the ill female body as an expressive text with variable legibility (and on nurses as privileged readers of ill bodies); "nervous illness" and the role of narrative in reconstructing the self; "neuromimesis" or neurotic imitation of disease; and the "politics of fitness and its relation to imperialist ideology." Vrettos discusses fictional works by Louisa May Alcott, (Hospital Sketches; see this database) Charlotte Bronte, George Eliot (Middlemarch; see this database), H. Rider Haggard, Henry James, Bram Stoker, and Harriet Beecher Stowe.

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The protagonist, Anderson, has a skin cancer growing dangerously close to one of his tear ducts. An aging "idler and playboy," he has spent too many years in the sun (67). Anderson consults and promptly becomes infatuated with his facial plastic surgeon, Dr. Kim, "who turned out to be a woman, a surprisingly young Korean-American who even in her baggy lab coat evinced considerable loveliness" (67). Anderson is fascinated with Dr. Kim's body, her visible pregnancy, her way of moving and speaking, and her face. He enjoys the "bliss of secure helplessness" of the surgery itself, performed by Dr. Kim and two female nurses who "rotate[]" around him conversing as they work (67).

While successful, the surgery leaves a small bump on his face that Anderson asks Dr. Kim to correct surgically. The second surgery achieved, Anderson returns a third time for the much more ambitious project of tucking his somewhat saggy eyelids. His goal, however, is not just to tighten slack skin but to make his lids look like Dr. Kim's, "with an epicanthus" (69). The six-hour surgery is both successful and satisfying to Anderson--until he sees a photo of Dr. Kim's husband.

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The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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This DVD, a documentary of a medical student retreat to a museum, illustrates an approach to cultivating empathic understanding in medical students and residents by using the visual arts.  Florence Gelo, D.Min, created the arts program and the video. She is Behavioral Science Coordinator, Family Medicine Residency, Drexyl University College of Medicine. Students observe closely four paintings and are encouraged to experience their feelings about what they are seeing, and to express those feelings. The paintings are Prometheus Bound (Peter Paul Rubens 1618), Massacre of the Innocents (Pacecco de Rosa 1640), Rachel Weeping (Charles Wilson Peale 1618), and The Agnew Clinic (Thomas Eakins 1889; see annotation in this database).

Prometheus Bound is a disturbing scene of an eagle ripping the liver out of Prometheus. Students comment on the nakedness. the vulnerable position and the helpless expression on the face of this strong man, and on the eye contact between the eagle and Prometheus. In Massacre of the Innocents Dr. Gelo calls our attention to the faces of the mothers, helpless to save their children from the swords. In Rachel Weeping Gelo asks the students if they noticed the vials of medicine before the days of allopathic medicine.  Did they notice the one tear dropping from Rachel's face? (Peale added the medicine vials and his wife weeping to the original portrait of his infant daughter Margaret who died of smallpox.)

Two physician speakers, Horace DeLisser, and Rhonda Soricelli provide additional commentary about how engagement with a painting is similar to engaging with a patient, and how learning technology-focusing on the scientific and the medical- detracts students from learning to look at the big picture and the humanistic side of medicine.  Traditional medical education does not teach doctors to be present to patients, to sit by their sides, to listen and invite dialogue of suffering and to not deny those aspects of what it means to be ill.  Dr. DeLisser further acknowledged his personal struggles with feelings of frustration, anger and grief when patients died in the ICU.  The importance of talking about the vulnerability of physicians, the concerns about what else they might have done, propelled him to develop Grieving Rounds.

A cancer survivor contrasts a "callous" physician's response to her care with  another physician who exemplified someone who has the expertise not only around the disease, but  has the ability to acknowledge the whole person and offer his companionship to be there to the very end: "...what we're going to do is....We'll take this step by step."

 

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A Doctor's Story of Friendship and Loss, this book is, in a sense, a sequel to Verghese's earlier memoir, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (see this database). The Tennis Partner tells the parallel stories of Verghese's disintegrating marriage as he establishes new roots in El Paso, Texas and of his new deep friendship with a (male) medical student who shares his passion for tennis. Both men are struggling to re-establish order in their personal lives: Verghese, in easing himself out of a dying marriage while trying to maintain a close relationship with his two sons; David (the tennis partner), in remaining drug-free and successfully completing medical training, which had been interrupted by his addiction.

Verghese, an experienced physician trained in infectious disease and an expert on AIDS treatment, relishes his role as David's mentor; David, a former tennis "pro," enjoys teaching Verghese how to play better. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other, seeking solace in a difficult time. Through it "we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost." (339)

While the reader suspects that David must have a drug problem because the Prologue to the book, narrated in the third person, describes a "young doctor from El Paso" in drug treatment, Verghese the biographer has no inkling of the problem until one-third into his first person narrative. He is shocked, but in some ways the bonds of their friendship are strengthened. Each has only the other as a confidant.

David, however, has another addiction: women. The friendship becomes increasingly complicated as Verghese tries to remain both supportive and objective. Eventually David resumes "using" and Verghese must decide how to respond, both professionally and on a personal level. The turmoil in both lives ends tragically for David and causes profound grief in Verghese.

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Before Jamie Weisman went to medical school and became a physician she wanted to be a writer. As she struggled to make a career out of writing, she was forced to acknowledge that the obscure, life-threatening condition that had plagued her since adolescence could not be factored out of her plans. Writers don't have easy access to affordable health insurance and her monthly intravenous infusions of antibodies and interferon were very expensive. Yet they were essential to fend off infection, for she had an immune system malfunction.

Of course, finances were not the only reason that Weisman decided to go into medicine. As is often the case, her own experience of illness was an important motivating factor, as was the fact that her father, of whom she is very fond, was a physician. This memoir describes significant stages of Weisman's illness, her interaction with the physicians she consulted, and the issues she grapples with as she pursues her life as a physician, wife, and mother (she graduated from Emory University's school of medicine in 1998 and practices dermatology).

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Editor Helman is a physician and anthropologist as well as a published author of short stories, essays, and a medical anthropology textbook. For this anthology he has selected short stories, case studies, memoir and novel excerpts whose purpose is "to illustrate different aspects of [the] singular but universal relationship" between doctors and patients (1). In the introduction he discusses how these selections illustrate storytelling in medicine; the unique experience of individual illness; differences between fast-paced contemporary technological specialized medicine, and an older more leisurely medicine where the physician employed all his/her senses to diagnose illness, doctors made house calls, and patients recovered over time, or died.

The anthology is subdivided into three parts: "Doctors," represented by the work of Mikhail Bulgakov, Franz Kafka, Sir Arthur Conan Doyle, and Rachel Naomi Remen; "Patients," represented by authors Renate Rubenstein, Ruth Picardie, Rachel Clark, Clive Sinclair, W. (William) Somerset Maugham, and O. Henry; and "Clinical Encounters," with work by Oliver Sacks, Cecil Helman, William Carlos Williams, A. J. (Archibald Joseph) Cronin, Anton P.Chekhov, and Moacyr Scliar. (In total there are 16 selections.) Each piece is preceded by a paragraph of biographical information about its author and an introduction to the text.

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Vicki Forman's twins, Evan and Ellie, were born in 2000 at twenty-three weeks' gestation.  Fetuses could legally be aborted up to twenty-four weeks, but rules regulating treatment of extremely premature babies differed from one hospital to another.  Daughter of a doctor, Forman knew how slim were the chances of survival and how great the chances of serious disability if either of the twins did survive.  Grieving, but realistic, she and her husband asked for a DNR order, but learned that such orders did not strictly apply to the situation of children like their twins.  Instead, the line between  the parents' authority and the doctors' remained blurry and decision-making vexed not only by technical and emotional complications, but by conflicting legal guidelines as they made their way through many months of hospitalization and home treatment of their surviving son.

Ellie, the daughter, died at four days.  Evan lived for eight years with disabilities that completely reorganized family life, and required constant monitoring, management of equipment, and careful orchestration of parental relationship to their older child, Josie, and their special-needs child.  Much of the narrative covers the period of hospitalization during Evan's early months and the negotiations between parents, physicians, and other caregivers.  It also touches on Forman's own emotional responses to the strenuous learning curve required of a parent who suddenly finds herself with a special-needs child.

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