Summary:

This book represents collaboration between neurologist-poet Jerome Freeman and potter Richard Bresnahan. Thirty-seven black-and-white photographs of ceramic pieces by Bresnahan from the Minneapolis Institute of Arts are interspersed with 56 of Freeman’s short poems. In his introduction Freeman writes, "Richard’s pottery (champions) both our environment and the need to nourish our humanity through cooperation and caring." Likewise, Freeman notes that much of his own poetry "attempts to focus upon caring." As he also points out, "the economy and simplicity of pottery can resemble the spare verbiage and subtlety of successful poetry."

Indeed, Freeman’s poems are simple, direct, and evocative. Many of them, such as "Carrying On" (p. 3), "Ten Year Old with Rheumatoid Arthritis" (p. 17), and "DTs" (p. 49), create images of patients. (However, the 88-year-old arthritis sufferer in "Carrying On" by no means considers himself a patient!) Others evoke more general human responses to severe illness ("Apocalypse," pp. 6-7), or to the threat of illness ("In Defense of the Hypochondriac," p. 15). In the former, Freeman writes of a comatose ICU patient, "All about keep mostly / thinking there’s a mistake / here somewhere." In the latter poem, Freeman concludes, "The worst might / happen. Keep crossing / bridges before you come / to them."

These poems also evoke the landscape and flora and fauna of the Great Plains: "Lake Superior in February" (p. 29), "The Prairie Gentian" (p. 79), and "When Wild Turkeys Come Out of the Woods" (p. 87). But the outside and inside worlds are closely connected. In "Coma Vigil" (p. 59), a poem about a woman in a persistent vegetative state, he begins, "Dawn’s bounty spills over / the rim of sky to spread / across darkened / prairie." Does the woman want to be kept alive in her "coma vigil"? The poem ends, "The time has / come. / Shadows still conceal / easy ways of letting / go."

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This treatise is part of the Madeleva Lecture Series in Spirituality, an annual presentation sponsored by the Center for Spirituality, Saint Mary's College, Notre Dame, Indiana. Margaret Farley's lecture begins with a brief introduction to the successes and failures of the global response to AIDS and HIV both worldwide and in Africa. Her aim is to demonstrate that "compassion needs to be normatively shaped, both as an attitude and as the generator of actions," and that the form compassion and help take must be directed in part by the "real needs" of the individuals involved.

What follows in this brief book is an excellent review of traditional and feminist ethics, from the moral concepts of "individual autonomy," "nonmaleficence," "beneficence," and "distributive justice" to Carol Gilligan's "ethic of care." Farley looks at these and other ethical precepts with a keen eye, and then proposes a blended moral response she calls compassionate respect. Her intelligent, focused discussion of what compassionate respect might encompass includes a look at the role of compassion within various religions and how caregivers might modulate giving, mercy, and love into compassion and care.

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St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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A child of a beautiful, talented woman and ambiguous paternity craves learning. Adopted by a Spanish officer and an "uncle" who is a painter, s/he is sent off to Edinburgh as a pedagogic experiment to become James Barry, a male medical student. Barry adores the vivacious Alice, an illiterate but intelligent servant, whom he teaches to read.

Later as a doctor and medical officer, he travels the world to the Crimea, to the Caribbean, to South Africa and America, a scion of society and a good scientist. By happy fortune, he lives in retirement with Alice, who has become a famous actress. The book ends with the scandalous revelation of Barry's femininity when his body is laid to rest.

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This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.

Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.

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Argan, a fearful but miserly hypochondriac, divides his time between summoning the doctor to care for his ills and trying not to settle the resultant bills. He resolves to marry his daughter, Angélique, to a medical student, hoping to acquire unlimited access to gratis consultation. The chosen fiancé is an unattractive dolt, who would never interest Angélique, even if she were not already in love with clever, handsome Cléante, who poses as her music instructor.

Argan's wife, however, plans to send Angélique to a convent, removing her from the line inheritance. At the urging of the sensible servant Toinette, he feigns death to test his wife's affection only to discover her contempt. Again with the help of Toinette, the young lovers convince Argan to liberate himself from the twin tyrannies of his ailing body and his grasping physicians by becoming his own doctor. The play closes with the physicians' lively examination of Argan and his entry into the profession, full of musical pomp and pidgin Latin.

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In Edinburgh 1879, the famous actress Hermione Clery and her young lover are brutally murdered. A young man, Alan Lambert, stands accused of the crime, arrested after an expensive chase across the Atlantic. His brother, Graeme, appeals to Dr. Joseph Bell, professor of surgery and one of a dynasty in Scottish academic medicine. At first reluctant, Bell agrees to investigate the case and engages his medical student Arthur Conan Doyle in the task.

The story is told from Doyle's imperfect perspective. Beset by many obstacles from the police, the courts, and the Lambert family, Bell's investigation reveals a string of errors, including police sloppiness, suspicious evidence, and corruption in both government and law enforcement. On the day of the planned execution, Bell identifies the true killer and his motive, saving Lambert from wrongful death.

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The sculptor Ken Harrison (Richard Dreyfuss) is badly injured in a car accident and finds himself in the middle of life permanently paralyzed below the neck and dependent on others for his care and survival. Ken is a strong-minded, passionate man totally dedicated to his art, and he decides he does not want to go on with the compromised, highly dependent life that his doctors, his girlfriend Pat (Janet Eilber), and others urge on him. He breaks up with Pat and fights to be released from the hospital, to gain control of his life in order to stop the care that keeps him alive and unhappy.

His antagonist is the hospital's medical director Dr. Emerson (John Cassavetes), who believes in preserving life no matter what, and so tries to get Ken committed as clinically depressed. Ken's attending physician, Dr. Scott (Christine Lahti), begins with the establishment but gradually moves toward Ken's position.

The film ends with the judge at a legal hearing deciding that Ken is not clinically depressed and that he thus has the right to refuse treatment and be discharged. In the last scene, Ken lies in a hospital bed framed by his own sculptural realization of the forearm and hand of God from Michelangelo's Creation of Man.

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Following the death of an aphasic hermit woman in the woods of North Carolina, it is discovered that she is survived by a daughter (Jodie Foster), a young woman who lives by herself as a kind of wild child, speaking a private language, and intensely fearful of human contact. The authorities decide that she must be normalized for her own good, but Dr. Jerry Lovell (Liam Neeson) disagrees, arguing that, although different, she is fine and has not asked for help. He insists on getting her informed consent before treatment. A judge agrees to give Lovell three months to observe the woman, whose name turns out to be Nell, and find evidence that she should not be treated against her will.

Lovell recruits a partner, psychologist Paula Olsen (Natasha Richardson), and together they set up an observation base on a houseboat with a view of Nell's cabin. From there Lovell makes a series of attempts to win Nell's confidence and understand her language. (Olsen for much of the film mainly represents a set of professional values more conservative that Lovell's unconventional therapeutic moves--which, for example, make her suspect that he is sexually attracted to Nell. Her own sexual presence, while downplayed, serves to defuse this potential.)

Lovell wins Nell's confidence (she calls him her "guardian angel") and the secrets of her speech and wounded psyche (a twin sister died young, and Nell has apparently at least witnessed sexual abuse). Following a court hearing in which Nell speaks in her own defense, the world gets word of her case and journalists descend on her remote cabin on foot and by helicopter.

Fearing that civilization will destroy Nell, Lovell arranges to have her hospitalized as the least available evil. However, when he finds her drugged, he sees that hospitalization is no solution, and he carries Nell out of the hospital and back to her cabin. He tries to make her understand that he is not her guardian angel.

The film switches to a warmly-lit lakeside scene five years later, when all problems seem to have been solved. Lovell and Olsen, who are married with a little girl, and several other sympathetic characters are picnicking with Nell near her cabin, and Nell is shown entranced and somehow emotionally fulfilled in being with the child, who is the age at which her twin sister died.

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