Summary:

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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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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This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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This film tells the remarkable story of Vivien Thomas (played by Mos Def), an African-American fine carpenter, who found his way into medicine through the back door and changed medical history. Hired when jobs were in short supply to work as a custodian and sometime lab assistant to Dr. Alfred Blalock (Alan Rickman), a research cardiologist, Thomas quickly becomes an irreplaceable research assistant. His keen observations, his skill with the most delicate machinery and, eventually, in performing experimental surgery on animals, make clear that he has both a genius and a calling.

Though the relationship has its tensions (Blalock, as a Southern white man and a doctor, has some blind spots in the matter of mutual human respect, though he highly values Thomas’s skills) it lasts for decades. The two move their families to Baltimore, where Blalock becomes Head of Surgery at Johns Hopkins and, much to his colleagues surprise and to some of their dismay, brings Thomas in to perform groundbreaking open heart surgery on a blue baby. It is not until after Blalock’s death that Thomas is granted an honorary doctorate from Johns Hopkins, where he continues to work in research until his own retirement.

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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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This is the first full-length collection by pediatrician and international health physician Roy Jacobstein. These 40 poems engage a wide range of topics, settings, and tones, but all demonstrate the same fine craftsmanship and strong voice.

Among the most engaging of Jacobstein’s poems are those dealing with memories of childhood and adolescence. Consider, for example: “Mr. Gardner in 10th grade told us there was no purpose / to mitochondria, only function.” (“Atomic Numbers,” p. 5). Or, “What transgression made fat Mr. Handler / drop his towel, his gloves, everything… to chase you from one end / of Fullerton to the other?” (“The Lesson,” p. 30) The poet displays a delightful sense of humor in pieces like “Bypass” (p. 36) and “Squid’s Sex Life Revealed in USA Today” (p. 59). Poems with explicit medical themes include “Pre-Med” (p. 6), “Admissions” (p. 8), and “What It Was” (p.11).

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The young pathologist David Coleman (Ben Gazzara) arrives to join a hospital pathology lab. He encounters disorganization and a hostile, cigar-smoking chief, Joe Pearson (Frederic March), who declares his intention to keep working until he dies. Coleman tries to implement a few changes, but his suggestions are overruled.

The film revolves around two cases: possible erythroblastosis in the child of an intern and his wife whose first child died; possible bone cancer in Coleman's girlfriend, student nurse Kathy Hunt (Ina Balin). The infant's problem is misdiagnosed due to Pearson's refusal to order the new Coombs' test recommended by Coleman; the baby nearly dies, alienating the obstetrician (Eddie Albert), a long time friend who now presses for Pearson's dismissal.

Coleman disagrees with Pearson, who thinks that Kathy's bone tumor is malignant, but he opts for professional discretion, defers to the chief, and urges her to have her leg amputated anyway. He discovers that Pearson had been right: the surgery, which he thought unnecessary, has provided her with her only chance of survival. Just as Coleman realizes the enormity of his error, he learns that Pearson has resigned and that he will take over the lab.

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Witty Ticcy Ray tells the story of Dr. Sacks’s treatment of a 24-year-old man with disabling Tourette’s syndrome. The first half of the essay is mainly medical-historical, with some technical language. When Sacks first tries treating Ray with a minute dose of Haldol, Ray finds that even that low dose too effective. It breaks up the rhythms that have determined his life since the age of 4, and he doesn’t like it. Later, a second trial using the same dose succeeds, Sacks believes, because Ray had by that time accommodated mentally to a change in self-image.

Still, over time Ray missed his old wildness and speed, and he and Sacks agree on a compromise: During the week, Ray takes Haldol and is the "sober citizen, the calm deliberator." On weekends, he is again "’witty ticcy Ray,’ frenetic, frivolous, inspired"--and a talented jazz drummer. This, according to Ray, offers Touretters an acceptable artificial version of normals’ balance between freedom and constraint.

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Twain paints a picture of an all female family of four: Margaret Lester, widow; her 16 year old daughter, Helen; and Margaret’s extremely proper twin maiden aunts, Hannah and Hester Gray, aged 67. It is a household in which "a lie had no place. In it a lie was unthinkable. In it speech was restricted to absolute truth, iron-bound truth, implacable and uncompromising truth, let the resulting consequences be what they might." With this background, Twain sets up a perfect scenario of hide-bound morality only to turn it on its head, an iconoclastic trick for which he is deservedly well known.

The doctor caring for the mother and daughter, suffering from typhoid, cuts the aunts’ pietistic morality about lying to shreds, demonstrates the shallow logic and inconsistency of it and predicts they will lie in a greater fashion than they can imagine. True to form, Twain has the aunts go to great lengths to falsify the condition of the critically ill daughter to the mother to prevent the truth from worsening her condition. The title derives from the final lines of the story when an angel of the Lord comes to their house and delivers the judgment for all their lies, a judgment the reader is asked to guess: Was it Heaven? Or Hell?

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The author lists 173 twentieth century physician-writers, including both well-known and relatively obscure figures. The roster features each author’s dates, nationality, gender, year of medical degree, medical specialty, and his or her literary genre (fiction, poetry, drama, and non-fiction). The information about each author is documented by a reference to source material. The article also contains tables indicating (1) the percentage of physicians in the United States who were published physician-writers by decade from 1930 to the present; (2) a breakdown of physician-writers by medical specialty; and (3) literary genres by medical specialty.

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