Summary:

This survey of the history of women in medicine begins in the mid 19^th century and moves forward to the late 20^th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19^th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20^th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20^th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

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Spoiler Alert: The ending of this thriller is revealed in the final paragraph of the summary. The threat of terrorism and the moral code of a physician place Dr. Collin Reeves in a very difficult position. The young American doctor is a specialist in parasitology and tropical diseases. He has trained and worked around the world - London, Kuwait, Brazil, and Africa. He presently practices in Mexico City. The U.S. Embassy refers sick American tourists to him. Dr. Reeves is also a CIA operative who enlisted after 9/11 to fight terrorism. After two years as an employee of the U.S. Intelligenge Service, he is disenchanted and wants out. Dr. Reeves is appalled by the brutal handling of terrorist suspects. It is his job to treat them and keep them alive long enough to obtain information or a confession.

Dr. Reeves loves Mexico, painting, and living day to day. He hates arrogance, disease, and human misery. His boss, Alex Law, is the chief of the CIA station in Mexico. He and his pal, Butch Nickels, have been in the spy business a very long time. Law is an alcoholic. His wife finds a lump in her breast that proves to be malignant. Dr. Reeves and his father (a surgeon practicing in San Francisco) arrange treatment for the woman in California where she undergoes a double masectomy.

Law has some clues that a group of al Qaeda in Mexico are plannning an attack. He worries they intend to bomb a city in California. Law's intuition is pretty good. A husband (Mohammad) and wife (Fatima) from Baghdad are set on revenge. Their young son was killed by an American bomb in Iraq. The husband, a physician, was mutilated by the same bomb. Unaware of her true background and her mission of destruction, Dr. Reeves falls in love with the beautiful woman who calls herself Dolores Rios. At one point, he kills a policeman and wounds another to rescue the woman. When her husband is bitten by scorpions, Dr. Reeves saves his life.

Members of the al Qaeda cell eventually capture Dr. Reeves and some of his friends. They plan to crash a stolen airplane into a California city. Dolores has a change of heart, but her husband is intent on revenge and becoming a martyr. Dr. Reeves offers to accompany the terrorists in exchange for Dolores being left behind. Still recovering from the effects of the scorpion bites, Mohammad figures it might be wise to have some medical expertise readily available. Shortly after take-off, Dr. Reeves manages to crash the plane but he is killed by gunfire in the process. The terrorist attack is averted. When Alex Law locates Dolores, he allows her to go free and start a new life. The doctor would have wanted it that way and Law allows him that much.

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After his divorce and a year of traveling the world with Doctors Without Borders, Orville Rose returns to his home town of Columbia, New York upon learning of his mother's death. He discovers upon his return that in order to receive the benefits of his mother's will he must stay in this "Hudson River town plagued by breakage" for one year and 13 days. What transpires over that time is the heart of this novel which includes Orville's love story with a single mom (who has her own physical breakage), a renewed relationship with his mentor, Dr. Bill Starbuck (the inventor of the cure-all Starbusol who leaves Orville to travel the world with his wife Babette, before returning to town to receive Orville's care as he dies), and the often hilarious account of Orville trying to care for the citizens of Columbia. Thrown into this mix of new and old relationships is the floating presence of his dead mother as well as the in-his-face presence of Orville's boyhood arch-nemesis who now is riding high in Reagan's "Morning in America" as Columbia's candidate for congress.

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This collection of physician experiences, colored by the necessity of the writer to protect  his patients, gives a glimpse into a medical practice of a time past-remembered by some of us, not  known by our younger colleagues.  Dr. Palmer, aka Harry Byrd, takes the reader into a rural setting and  the practice of surgery bounded by the time and the place.  Dr. Byrd, trained in Boston as a surgeon,  chooses to practice in rural Maine and to work with the culture and needs of this environment.  He  treats the reader to a viewpoint of another era of medicine and, at some level, asks the readers to  consider the lost or fading qualities of the pre-tech doctor/patient relationship.

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After several years as a firefighter, Paul Austin decided to return to school and become a doctor.  Both his training as firefighter and a somewhat late start at medical school gave him an unusual perspective on his selected specialty-emergency medicine.  The book chronicles a wide variety of surprises, learning moments, and challenges from his years in the emergency room.  These are interspersed with vignettes about the interrupted home life of an emergency physician rotating into night duty three to four times a month.  The pace is lively and the stories confessional in the best sense-rich with reflection on what he has learned, often at great cost to his resilient wife and three children, one with Down syndrome.  A strong theme in the book is the importance of developing strategies for sustaining humanity and compassion even under intense pressure to be quick, clinical, and detached. 

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A Place Called Canterbury by social historian Dudley Clendinen, former New York Times national correspondent and editorial writer, provides readers with an intimate and revealing account of aging in a particular place at a particular time--Canterbury Tower in Tampa, Florida. The story about the author's mother, Bobbie--and so many others--begins in 1994, a few years after the death of James Clendinen, Bobbie's husband of 48 years, and known to the community as the progressive editor of the Tampa Tribune. Although she had been "falling apart, a piece here, a piece there...collapsing vertebrae...bent, frail, and crooked...subject to spells and little strokes...." (p. xii),

Bobbie Clendinen was in reasonably good health. Nevertheless, her grown son and daughter did what most children their age do--they worried. When she finally agreed to move from the home where she had lived for twenty-nine years to Canterbury Towers, room 502, two bedrooms, two baths ($88,000 in cash, $1505 each month), Clendinen and his sister were relieved. She would be cared for and safe in "the small, cream colored, obsessively well-run geriatric apartment tower and nursing wing...across a broad boulevard from an arm of Tampa Bay" (see book cover).  And, so many of her old friends were already established residents!

Clendinen was fascinated by his mother's new circumstance and by what he came to regard as the new old age. As a writer, he could not resist the opportunity before him. Although he lived in Baltimore, he could come and go, but over the twelve-year period of his mother's residence--three in the Towers and nine years in the hospital wing--he spent more than 400 days as a live-in visitor, observer, listener, interpreter. This unusual arrangement provided Clendinen with a close-up view of a 21st Century phenomenon, the comings and goings of aging people in the final setting of their lives.

Canterbury is a well-run camp and life there is a soap opera. Between his exchanges with the witty rabbi and the former jitterbug champs, the enthusiasm generated by a nudity calendar proposal (declined) and the geriatric bib enterprise (thriving), the inhabitants provided Clendinen with an abundance of riches. Whether at lunch in the dining room overlooking the Bay, over daily drinks at 5pm, or in bed in the health center, everyone of this Greatest Generation had a story to tell. This ethnographic page-turner, with its cohort of named characters--the Southern Belle, the Rabbi who escaped the Holocaust, Emyfish, the ageless New Yorker, Lucile, the warm-hearted Fundamentalist, the raunchy Atheist, the crusty Yankee, the horny widower, and the maddeningly muddled Wilber--reads like fiction. Whether rich or poor, married or widowed, Clendinen listened as they spoke and in doing so became a trusted friend and chronicler of small and great events in their collective lives: childhood, Depression, World War II, medical advancements, healthcare costs, 9/11. Because Bobbie Clendinen spent so many years in the hospital wing, much of the story describes the kind of care and staff standards that we would hope for all--including ourselves. Mrs. Clendinen died at age 91.

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As a father of three boys and a friend of the famous doctors Erik Erickson and Robert Coles, Rockwell had plenty of opportunity to study doctors interacting with patients. Before the Shot is one of his humorous doctor-patient scenes. Published as a Saturday Evening Post cover, March 15, 1958, this oil painting depicts a doctor's examination room with the male physician and his young male patient standing with their backs to each other. In the foreground the young boy stands on a chair in his undershirt. He grasps his belt and pants around his buttocks and leans forward toward the wall, his nose up against one of his doctor's framed diplomas. On the chair are his coat, hat, and scarf. His heavy shoes are on the floor. The doctor stands behind him facing the window and holds a syringe in his hand. The walls of his office are hospital green; the floor grey and white linoleum tile. The dominant color is green. It is daytime.

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This is a collection of approximately 45 pathographies-essays, memoirs, biography, autobiography, poems, and reflections on illness experiences -grouped loosely into four categories of related subject matter. These categories are: Illness and Identity: Dynamics of Self and Family; Concealing Illness, Performing Health; Agency and Advocacy; Medicine at the Margins. The majority of the pieces are written by non-health care academics about their experiences with a wide variety of illnesses. A few have been written by or with health care professionals.

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Body of Work is a cleverly crafted memoir - or, rather, the first chapter of a memoir - of the author's medical school experience at Brown University School of Medicine in Providence, Rhode Island. Ms Montross relates the chronological course of her team's dissection of a female cadaver with no discernible umbilicus and whom they therefore name Eve. (She neglects to comment on Eve's ribs and whether she has the normal complement or a supernumerary, more masculine, rib.) As she and her team of four (later three as one student drops out of school) proceed with the orderly dismantling of Eve, bone by bone, nerve by nerve and blood vessel by blood vessel, she uses this experience as a springboard to analyze her and her team's emotional reactions to the often unnatural process of deconstructing, literally (at times with a saw), a former person now cadaver, as well as the gradual, almost imperceptible acculturation that transmogrifies medical students into doctors. In fact, she devotes the final pages to this metamorphosis and what it means to the person undergoing the transition from caring student to detached physician, and whether one can retain enough caring, while remaining sufficiently detached to function as one must as a clinician, to become both a whole person and competent physician: "How much of becoming a doctor demands releasing the well-known and well-loved parts of my self?" (page 209)

Although it primarily revolves about the axis of her gross anatomy (cadaver dissection) course, the author's narrative includes tangents that have variably relevant relationships to this course, e.g., a trip to Italy to inspect first hand the anatomy theater of Vesalius in Padua and the Basilica of St. Anthony; another trip to the anatomical wax sculptures museum in Bologna, where the author also observes the "incorrupt corpse of Santa Caterina" in a "small church called Corpus Domini" (pages 223-224); interspersed histories of the traffic of corpses for dissection, including the infamous Burke and Hare story; some flash-forwards to her second and third years; and a prolonged narration of the final illnesses of her grandmother and grandfather. This last bit of family history is worth the price of the book alone. Despite the apparently incongruous collection of such asides, the author makes it work smoothly, if not seamlessly.

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This book consists of a series of "found poems" abstracted from transcripts of interviews that Loreen Herwaldt conducted with 24 writers who had previously published accounts of their illnesses. Dr. Herwaldt, an infectious disease specialist at the University of Iowa, began her investigation into the personal experience of illness after having read Mary Swander's Out of this World: A Journey of Healing and Reynolds Price's A Whole New Life, both of which revealed a negative dimension of medical care. These books initiated an "unexpected turn" (p. 1) in Dr. Herwaldt's life, culminating in a sabbatical year during which she interviewed a wide array of writers, intending to investigate the texture and dynamics of their experience of medical care by textual analysis of interview transcripts.

However, as a result of a further (and fortunate) insight, the author decided to abstract and arrange these texts into "found poems" that have "a concentrated emotional power that the unedited stories did not." (p. 5) Among the authors whose stories of illness appear in these poems are Arthur Frank (see The Wounded Storyteller ), Nancy Mairs (A Troubled Guest: Life and Death Stories), Richard Selzer (Raising the Dead), Oliver Sacks (A Leg to Stand On), Mary Swandler (The Desert Pilgrim: En Route to Mysticism and Miracles), and Christina Middlebrook (Seeing the Crab: A Memoir of Dying). In most cases Dr. Herwaldt has crafted two or more poems giving voice to different aspects of the subject's experience. For example, Richard McCann (pp. 82-90) speaks about loving his primary care physician, why patients can't talk to doctors, what he needs from a doctor, and being labeled as a patient with hepatitis C (cf. "The Resurrectionist").

The author includes a section on "How to Use This Book" (pp.9-20) that summarizes her experience utilizing these poems in medical education settings and provides helpful hints for teaching them.

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