Summary:

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)

View full annotation

Summary:

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.

View full annotation

Summary:

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.

View full annotation

Summary:

In this documentary film about euthanasia in the Netherlands, a man--Kees van Wendel de Joode--with amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) requests death in his home, to be performed by his doctor, Wilfred Sidney van Oijen. The film mostly consists of what appear to be unscripted discussions between Kees, his wife Antoinette, and the doctor; however, there are also interviews with the doctor and views of the doctor seeing other patients. The film shows the doctor performing euthanasia: we watch him inject a barbiturate and then a muscle relaxant and we see him supporting Antoinette during the bedside deathwatch.

Kees has had a rapid deterioration of his ability to function: he is unable to move his legs and right arm, he can no longer speak coherently, and he is having difficulty swallowing. His wife cares for him in their Amsterdam apartment. The film documents the legal requirements for euthanasia in the Netherlands: Kees's repeated requests for euthanasia, confirmation that he has an incurable disease, the second opinion doctor's visit, and reporting the death to the municipal coroner and public prosecutor.

The film's strength lies in the sensitive treatment of the impact of this request on the patient, his wife, and especially on his doctor. Dr. van Oijen is an introspective man who cares for his patients--he makes house calls, explains medical terms to his patients, touches his patients, and asks what they are concerned about. He allows his patients (Antoinette is, in many ways, his patient too) to weep and be emotional.

The religious and moral dimensions of euthanasia are explored mostly with the doctor, who does not view himself as a wanton killer, but rather a doctor whose duty includes the alleviation of suffering. The film concludes with a voice-over stating the doctor will not sleep this night, but still has a clinic full of patients awaiting him in the morning.

View full annotation

Summary:

In response to hearing the dehumanizing proclamation that "bed number 12 has died," the narrator attempts to restore dignity to the life of a fellow patient by placing him, his illness and his death into a fictive framework. Having only very few clues to work with, the narrator eventually discovers that his story about the patient has for the most part missed the mark. He gains some solace in the end, however, for at least he made the attempt to understand a fellow sufferer's life and death, an act the doctors and nurses were unwilling to do.

View full annotation

Summary:

The film opens with a bird's-eye sweep over the frieze of a post-engagement battlefield--mud, strewn with bodies and shards of machinery, all iron grey and relieved only by rare patches of crimson blood. Psychiatrist William Rivers (Jonathan Pryce) treats shell-shocked soldiers in the converted Craiglockhart Manor. He is obliged to admit the poet and decorated war hero, Siegfried Sassoon (James Wilby), because his military superiors prefer to label the much-loved Sassoon's public criticism of the war as insanity rather than treason. Rivers is supposed to "cure" the very sane poet of his anti-war sentiments.

At the hospital, Sassoon meets another poet, Wilfred Owen (Stuart Bunce), equally horrified by the war although he, like Sassoon, believes himself not to be a pacifist. A secondary plot is devoted to the mute officer Billy Pryor (Jonny Lee Miller) who recovers his speech, his memories, and a small portion of his self-respect through the patience of his doctor and his lover, Sarah (Tanya Allen). Vignettes of other personal horrors and the brutal psychological wounds they have caused are presented with riveting flashbacks to the ugly trenches. Sassoon, Owen, and Pryor return to active service. The film closes with a dismal scene of Owen's dead body lying in a trench.

View full annotation

Summary:

In her poem, "Dehiscence," Amy Haddad speaks in the voice of a nurse tending a suffering patient. The patient has "come unstitched," and, seen through the nurse's eyes, the patient's wounds are devastating: fistulas "connect bowel, liver, pancreas"; the "stench is overwhelming," telling everyone, caregiver and patient alike, that medical science has failed, that no more can be done.

Moved by her patient's suffering and her own inability to help, the nurse does what she can. She washes the patient, changes the soiled sheets, removes the dirty dressings and replaces them with clean gauze and tape. "Done," she says. Stepping back, looking from a distance, she can no longer see the patient's wounds. She "is caught," as all caregivers have been at one time or another, in "the illusion" of the patient's "wholeness."

View full annotation

Summary:

Jose is a patient who exhibits all the classical symptoms of autism. The caregivers in his institution treat him dismissively, as though he is stupid. Sacks notices, however, that, given a pencil, Jose draws not only with amazing accuracy, but with a quality of liveliness in his representations that betokens close, insightful, and even empathetic observation and awareness. As he encourages Jose to draw, he finds his drawings diagnostically helpful, and powerful evidence of an active interior life to which they provide a valuable link.

View full annotation

Summary:

Mattie, recently divorced from Nick, the father of her two children, is coping with the aftermath of divorce, functioning as a single parent, feeling ambivalence toward Nick who still shows up and sometimes stays the night, and becoming aware of her own attraction to other men. Her mother, an aging social activist, lives nearby with her lover and companion who copes with the mother’s insistent personality and mood swings better than Mattie. Her brother, Al, also lives nearby and fills in some of the father functions for Mattie’s children.

In the background is the story of Mattie’s father, now dead, much loved by both Mattie and Al, who, as it turns out, fathered a child now living in the community by a young girl about Mattie’s age. The mother of the child lives in the squalor of near homelessness at the edge of town. This disclosure, Mattie’s blossoming friendship and eventual romance with the man who comes to repair her house, and Mattie’s mother’s descent into dementia are the three main threads of plot in this story of pain, forgiveness, and healing in family life.

View full annotation

Summary:

Alexei Laptev, the middle-aged son of a wealthy Moscow industrialist, is on a prolonged visit to a provincial town where he is helping to care for his sister Nina, who is recovering from a cancer operation. Nina’s husband has abandoned her and their two young daughters for another woman. Unexpectedly, Laptev falls in love with Yulia Sergeyevna, the doctor’s 22-year-old daughter. Laptev is an unattractive, but good-hearted man; Yulia, though beautiful, is bland and immature. She eventually accepts his offer of marriage, though she is somewhat repulsed by him as a person. Yulia is neither attracted by his money, nor by his social position; she just feels badly about disappointing him and, moreover, looks forward to living in Moscow, where life is more exciting.

Once married, both Yulia and Alexei suffer. She hates his family and friends, and feels no affection for him. Meanwhile, Alexei remains head over heels in love with her. Nina dies of her cancer, and the little girls come to live with them for a while. Eventually, Yulia finds her own group of friends, who consider her foolish for not taking on a lover. Yulia and Alexei have a baby, who becomes the center of Yulia’s life, until the child dies of diphtheria.

Time passes. The family business turns sour. Alexei’s bother Fyodor goes mad and has to be put into an asylum. And in the last scene, Yulia greets her depressed husband with tenderness: "You are precious to me. Here you’ve come. I see you, and I’m so happy I can’t tell you. Well, let’s talk." (p. 328)

View full annotation