Summary:

A physician stands in the laundry, folding her baby’s diapers, and thinks about Mr. Dantio, who died of wildly metastatic cancer. She reflects on the development of her relationship with Mr. Dantio during the time that she was pregnant. Toward the end, he developed a lung infiltrate, maybe a type of pneumonia. There was a chance that a biopsy might have helped--perhaps he had a treatable infection--but she recommended against it. Now she wonders about this decision. She wonders also about what the other physicians think of her: "you don’t really want to be a doctor anyway, you must be conflicted to have a child . . . . " She remembers seeing Mrs. Dantio in the supermarket shortly after her husband died, and crying with her. She asks herself: Will I ever be a REAL doctor, "because in moments of great stress I revert to my native tongue."

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A medical student at Lincoln Hospital in the south Bronx is called to the Emergency Room, where a gang war is going on. She plunges through fighting bodies in the waiting room to reach the treatment area, where she is enlisted to ride an ambulance with a critically injured and intubated patient. During the trip, the ambulance jerks, the tube comes out, and the student tries but fails to ventilate him with mouth-to-mouth respiration. At the other hospital, she is turned away from the cafeteria because her clothes are blood-soaked. The patient dies. Although she feels terrible, her friend Marie, a practical nurse, comforts her with a touch of ordinary love, a photo of her new grandchild.

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Twelve contemporary stories set in Rhode Island and New York City. Major themes include the pain of cultural dislocation and cross-cultural experience ("Theng," "Shambalileh," "My German Problem"); human frailty and self-deception ("Sleep," "Juilliard"); and the personal and moral dimensions of medical practice. See the separate annotations for Laundry, The Good Doctor and Ambulance--three stories which are particularly relevant to Literature and Medicine.

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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The poem depicts a fiercely wild and free woman who meets an untimely death in a motorcycle accident. The anatomy student views the cadaver as more than just "thirty-one-year-old female flesh," and fantasizes about what her life (and death) must have been like.

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As you are now, so once was I; Prepare for death and follow me. The novel's advisory epigram prepares readers for the realities of aging and death which affect both narrator and reader. Following surgery, Caro Spencer is delivered to Twin Elms, a nursing home in a rural New England setting. While this intelligent woman requires only short-term care, she is deposited, permanently, in an understaffed, sub-standard care facility by relatives unwilling to add her minor but time-consuming difficulties to their own.

It is not a pretty setting. The staff is overworked and demeaning, especially to the new resident who is well-educated and accustomed to better circumstances. The nursing home routine is careless of individual differences and needs, and set up to strip away autonomy and dignity through petty and cruel indignations.

Caro is able to survive by keeping a secret diary for observations, reflections, and interpretations; ultimately, this alone sustains her. While the voice is that of an elderly woman (as we are now), the journal is for us, those still able to manage their lives, but unable to predict or control end-of-life events.

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Sea Creatures is Dr. Vernon Rowe's first collection and contains forty-eight poems divided into two sections: "Creatures of the Inland Seas" and "Out Far and In Deep." The poems are succinct and focused. Much of the imagery is derived from nature, as in the title poem, where the poet-neurologist-helicopter pilot likens his descent through the sky to a dive into a deep and ancient ocean. Poems in the first section are directly related to the poet's life as a physician; works such as "Paralyzed" "Brahms' First, First Movement" and "Wasted" are empathic portrayals of patients.

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This 14 line poem deals with a physician's compassion for a hopelessly ill patient ("An apparatus not for me to mend--") and his participation in active euthanasia. The patient, Annandale, was "a wreck . . . and I was there." The narrator asks the reader to view himself or herself "as I was, on the spot-- / with a slight kind of engine." (This "engine" is a hypodermic needle.) He concludes, "You wouldn't hang me? I thought not."

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The narrator observes that we all, from the worm to the brontosaurus, have excrement. As she cleans the horses' stalls of "risen brown buns," she contemplates that sparrows will come to pick "redelivered grain" from the manure, that mushrooms will "spring up in a downpour" from it, that "However much we stain the world," shit indicates that we go on.

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