Summary:

Although the setting is startlingly different, and the care provided is through highly unorthodox means, the healer in this science fiction story experiences in remarkably similar ways the everyday wear and tear of modern medical practice. Snake, a young female itinerant healer, has been asked to save the life of a young boy. Her attempts to do so, and her interactions with the boy, his family and community, and the tools of her trade (the snakes-mist, sand and grass) are detailed in the story. "Professional development" issues that this strong and complex character has to deal with include truth-telling, interfering and ignorant family members, self-sacrifice, and possible reprobation by her peers and teachers.

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This lively volume of medical history chronicles the forms of suffering, illness, injury, and treatment endured by the members of the Lewis and Clark expedition of 1805. Beginning with three chapters of political and medical history to set the context, the story follows the adventures of the extraordinarily fortunate "Corps of Discovery" among whom Lewis was the most trained in the medicine of the time (having studied in preparation for the trip under Dr. Benjamin Rush of Philadelphia), and he only an amateur. Even professional medicine of the time was approximate and largely ineffectual, limited mostly to purgatives, opiates and laudanum for pain relief, bleeding, and topical applications of various compounds or herbal substances.

The story chronicles the main events of the trip based on the extensive journals of Lewis and Clark as well as other historical account, maintaining focus in each chapter on the medical incidents including gastrointestinal distress from parasites and contaminated water; effects of overexposure like hypothermia and exhaustion; infections from wounds and scratches; syphilis; dislocations; muscular spasms; mosquitoes and other insect bites; snakebites and other animal attacks.

Along the way Peck pauses to explain the rather rudimentary medical theories upon which treatments were based, the effects of particular known treatments, and what Lewis and others likely knew, guessed at, or didn’t understand about lead, mercury, opium, and certain herbal substances they used. He speculates about the contexts of their medical decisions and offers occasional contemporary analogies to help readers imagine the circumstances and tradeoffs the explorers faced.

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The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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The New Medicine and the Old Ethics, in Albert Jonsen’s own words, is a "secular aggadah." Jonsen explains that one Talmud reviewer defined aggadah as "a magical rabbinic mode of thought in which myth, theology, poetry and superstition robustly mingle" (4). The book begins with a personal essay entitled "Watching the Doctor." Jonsen establishes his premise that the moral history of Western medicine is best understood as a paradox between altruism and self-interest, a paradox alive and well entering the 21st Century.

He then takes the reader on his "secular aggadah," blending history, myths, and stories that trace important moral developments in the practice of Western medicine. In "Askelepios as Intensivist," we learn of the early Greek values of competence in shaping medical practice. Through the influence of the Church in the medieval period, Western medicine incorporates the value of compassion through the Biblical Good Samaritan, struggles with problems of justice in the care of the poor, and further elaborates the meaning of benefit.

In "The Nobility of Medicine," Jonsen describes the contribution of Sir William Osler and other knighted medical men of the 19th Century who established the ethics of noblesse oblige in the medical profession. He traces this noble tradition to the medieval Knights Hopitallers of Saint John of Jerusalem, a group of religious who provided hostels for pilgrims to the Holy Land and cared for the sick. With essays on John Locke and Jeremy Bentham, Jonsen brings us to the 20th Century and the play of individual rights and utilitarian values in the moral life of Western medicine.

In the final essays, Jonsen describes the mingling of these traditions as a means to establish a moral frame for Western medicine in our current times where technology and science have achieved and threatened so much. Ethics, he argues, "is disciplined reflection on ambiguity" (130). In the last essay, "Humanities Are the Hormones," Jonsen brings his "secular aggadah" full circle.

He argues that the paradox of altruism and self-interest that runs through the moral history of Western medicine must continually be vitalized and examined through the Humanities. The Humanities are "the chemical messengers that course through the complicated institution of medicine and enable it to respond to the constantly changing scientific, technological, social, and economic environment" (147).

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This volume nicely supplements the few other anthologies of literature on medical themes currently available in that it covers a wider historical span. Selections from the Bible, Giovanni Boccaccio, William Shakespeare, Rabelais, as well as 18th-century writers including Pepys, Daniel Defoe, Malthus, Schiller, and Goldsmith provide an array of historical touchstones that offer windows onto medical and literary history and points of comparison for the larger selection of works from the 19th and 20th centuries.

The selections are mostly short--averaging around 10-12 pages. Each is introduced with lively, often witty, comments by Gordon, whose popular Doctor in the House series was adapted for stage and screen in England, and whose associations with the medical world include an editorial position on the British Medical Journal as well as a wife and two children who are physicians. Many of the selections focus on the figure of the physician viewed variously from the viewpoints of patients, other physicians, and him or herself.

Selections from novels by three Victorian women doctors as well as selections from several physicians’ diaries provide unusual additions to a useful collection of excerpts from well-known literature including works by Scott, John Keats, Jane Austen,George (Marian Evans) Eliot, George Bernard Shaw, Hardy, Aldous Huxley, Sir Arthur Conan Doyle, Sinclair Lewis, F. (Francis) Scott Fitzgerald, Waugh, Orwell, and more recent and popular fiction, up through Erich Segal.

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Mrs. Tucker, Her Daughter Emily and Dr. Duff features Raymond Duff, M.D. as the storyteller. Dr. Duff was a pioneer in neonatology and produced many scholarly works in that field. One of his areas of research was grief and bereavement. However, his interests and this story go well beyond "grief resolution" to an exploration of the boundaries of the clinician-patient relationship.

The pseudonymous Tucker family and Dr. Duff share together a number of deaths and their aftermaths over a short period of time. In recounting the lessons learned from and privilege of being a part of the Tucker family "drama," Ray Duff reminds viewers "that although there inevitably is loss in what they encounter through their work in the health professions, there also is hope."

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This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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The contents include dramatized versions of the following classic stories, many of them in this annotated in this database: William Carlos Williams’s A Face of Stone, The Girl with a Pimply Face, The Use of Force, (annotatd by Felice Aull and by Pamela Moore and Jack Coulehan), Old Doc Rivers, Richard Selzer’s Fetishes, Imelda, and Whither Thou Goest, Susan Onthank Mates’s Ambulance, and Laundry, Pearl S. Buck’s The Enemy, Arthur Conan Doyle’s Round the Red Lamp, Katherine Anne Porter’s "He”; Mary E. Wilkins Freeman’s "A Mistaken Charity”; Margaret Lamb’s "Management”.

All but the last three stories enjoy separate entries in this database. Porter’s story is of a family who copes with a handicapped son. Freeman’s describes how local do-gooders move elderly sisters from their dilapidated home. Lamb writes of an aging African American woman living on social security in dangerous surroundings.

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Jack Coulehan’s fourth poetry collection brings together new and previously published poems in a well-organized and handsome volume. As a reader who has long followed this author’s career, I found some of my favorite poems here (Irene, "Lima Beans," "For Oysters Only," "Six Prescriptions," "Sir William Osler Remembers His Call on Walt Whitman," "Cholera," and Medicine Stone) as well as compelling newer work: "The Shoe," "Work Rounds: On Lines by Tomas Transtromer," "Definitions," and "Decatur in Winter."

The collection is divided into three sections: the first presents poems about "doctoring" and, a Coulehan trademark, poems from a patient’s point of view; the second is a remarkable assembly of Coulehan’s poetic commentaries on Chekhov’s life and writing; the third features poems about a variety of personal relationships.

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Dr. Slocum leads his readers through some of the high (and low) points of his 34 years of general medical practice in the Hell’s Kitchen neighborhood of Manhattan. The work opens as he and his wife and nurse of as many years close the office they have shared for the last time. Then moving backward for a few chapters, the author discusses briefly his training, including a critical four-month period in Vienna in the year 1932. Slocum was awaiting the results of his Medical board examination and while doing some advance study, experienced first hand the early stages of Nazi activity against Jews in Austria.

After their return to the states and the doctor’s completion of his internship, the young couple located office and home in Manhattan. The remainder of the book is devoted to descriptions of critical events and important professional encounters in more than three decades, organized by chapter, most of which encapsulate a patient and, when present, his or her family.

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