Summary:

This short, anecdotal autobiography begins with the author's birth in Cardiff in 1923 and ends in the mid-1960's when the author had become a successful writer and physician in London. Much of the story concerns Abse's childhood and youth. The theme is self-definition: how did it come about that, like Anton P. Chekhov, the young Dannie Abse chose to devote his life to "chasing two hares" (medicine and writing).

His lower middle-class Jewish parents, especially his father, found no redeeming social value in having a poet in the family. Influenced by his older brother Wilfred (who became a psychoanalyst), Dannie gravitated toward medicine as a career, although he almost fainted when he observed his first surgery.

When Dannie was a student in London, poetry energized his life. He published "After Every Green Thing," his first volume of poetry, while still in medical training (1949). He also met Joan, his future wife, in 1949 and they were married in 1951.

He was assigned to reading chest x-rays while serving his time in the Royal Air Force. Subsequently, Dannie took a part-time job as a civilian in the RAF chest clinic in London and began his dual career as chest physician and writer. Near the end of A Poet in the Family, Dannie describes the death of his father in Llandough Hospital in 1964.

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This is a study of the influence of medicine and medical practice on Chekhov's writing. While the material is presented in a roughly biographical manner, the chapters are thematically organized. In "University Years" the author discusses Chekhov's experience at Moscow University Medical School (1879-1884) and the influence of several of his professors. "Diseases of the Mind" focuses on the play "Ivanov" and several stories that demonstrate Chekhov's keen interest in and understanding of mental disorders, including endogenous depression (Ivanov), neurotic depression or dysthymia (Uncle Vanya), and reactive or exogenous depression(An Attack of Nerves (A Nervous Breakdown)).

The next chapter covers Chekhov's extended trip to Sakhalin Island in 1890. "Tolstoy Versus Science" describes Tolstoy's position that scientific and technical progress lead to moral regression. For several years Chekhov was sympathetic to Tolstoy's ethical position, although he never embraced the older man's opposition to science.

"The Country Doctor" deals with Chekhov's medical and public health work during the years he resided at Melikhovo (1892-1897). The last chapter describes Chekhov's own battle with pulmonary tuberculosis.

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As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.

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This is a tight, short poem that takes its central metaphor from the uncredited quote, ". . . a madman attacked Michelangelo's Pietà with a hammer." The speaker is presumably a physician who, with a pathology report on his desk, contemplates the task before him. He likens himself, as bearer of grim news, to an avenging creature about to assault his patient, the Pietà, with a catalogue of cutting and pounding tools as images for the effect of such news on the recipient. The speaker also reflects on his own anger, the anger he feels about his patient's bad fortune, yet ". . . not wanting to judge / the cracked face of God."

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The austere and homesick Breton doctor, René T.H. Laennec (1781-1826) (Pierre Blanchar) and his religious friend, G.L. Bayle (1774-1816) are caring for the hundreds of patients dying of epidemic tuberculosis in the Necker Hospital of Paris. They conduct autopsies on the dead, but cannot predict the findings before the patients' demise, nor can they offer any treatment.

Laennec's sister, Marie-Anne, arrives from Brittany with news of their brother's death from tuberculosis. He confesses his despair over this devastating scourge to his friend, but quickly realizes that Bayle too is doomed. A distant cousin, the widow Jacquemine Guichard Argou, becomes Laennec's housekeeper and companion in philanthropic work for the sick after he is able to reassure her about her health; she engages the widow of Bayle in the same enterprise.

One day in 1816, Laennec is invited by urchins to hear to the scratching of a pin transmitted through the length of a wooden beam. He is thereby inspired to fashion a paper tube to listen to the chests of his patients. With Jacquemine at his side, he joyously announces that he can hear sounds from inside the chest. Feverish research ensues as he links the chests sounds of the dying to the findings at autopsy.

He turns his wooden, cylindrical stethoscopes on a lathe in his apartment, publishes his findings, and marries Argou. Fame and notoriety follow, as Laennec is able to distinguish fatal disease from minor illness and to predict the need for operations; however, he is ridiculed by jealous colleagues. Suffering now himself, Laennec consults his friend Pierre Louis, who tells him that he has tuberculosis. In the final scene, he returns to his native Brittany only to collapse on the stairs of his beloved home and die.

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The young English doctor, Mary Percy Jackson (M.D. Birmingham 1928), went to practice in northern Alberta for a year. She had been recruited by a philanthropic movement that targeted women doctors: they could be paid lower wages and would also cook and keep house. But she fell in love with the subarctic community, its native peoples, and a certain widowed farmer with two young sons, and stayed for the next seven decades.

Dr. Jackson became the only physician responsible for the well being of aboriginals and settlers in a wide radius of remote territory where winters last more than six months and the only effective mode of transportation was the horse. Married and in relative prosperity, she did not seek payment for her medical work, although she appreciated gifts in kind.

Despite the isolation, Jackson was vigilant about nutrition, vaccination, and tuberculosis control and she kept up with the latest advances in health promotion. She and her husband were active in improving opportunities for education. The film closes with a simple party for Jackson, at the local school named in her honour.

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This essay is told from the perspective of an ophthalmologist who was consulted about a patient who had blurry vision. She is told by his internist that he has cancer but the family does not want him to know it. She plays along with the deception and does not inform the patient that his vision problems are from brain metastases. By serendipity she later learns that the patient knows his diagnosis but is playing along with the deception so as not to hurt his family. She is relieved to finally talk with him openly about his disease and his prognosis.

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A psychiatrist who is skilled at hypnotism is asked by an oncologist to hypnotize a difficult patient prior to a bone marrow biopsy. The psychiatrist is able to achieve excellent pain relief through hypnotism, much to her own surprise. She is exhausted by the mental energy she has expended in this experience, and is discredited by the oncologist, who doesn't really believe that hypnotism is anything special.

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A pediatric intern encounters her first dying child. Her initial response is to care for the child, hold him, and try to comfort him. She is told by her attending physician that this behavior is unprofessional. When she cries in response to her stress and grief, she is told she will never be an effective physician. The narrator then describes how she ultimately came to terms with her impulse to cry at stressful times, and how she interacts with patients in her current practice.

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Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.

For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.

An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.

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