Summary:

Hicok begins the poem with a statement and jocular rhetorical question that set the tone and pace: "There are two kinds of people and five hundred / seventy-one thousand, three hundred / ninety-six species of beetle but who's / counting?" Immediately we wonder what are the two types of people and who would take the trouble to write out a species count while also joking about it.

The engagement with the poem continues as we learn about the narrator's platonic friend, an entomologist, freshly returned from the Amazon with a bottled beetle and a raging fever. The narrator, alarmed at her delusional state, rushes her to the hospital ("driving / in a way that proved you can be / in two places at the same time") and good medical care. After several days she has regained enough strength to say one word--jar--which refers to the jar containing her beetle specimen. The narrator restores the jar to her, she recovers and returns to the life she loves, a life in the treetops of the Amazon jungle.

Through the course of the poem, the poet plays with all manner of philosophy and religion. The beetle's body is likened to Michelangelo's image of the finger of God reaching towards Adam. The poet plays with numbers as well, rearranging the numbers of types of people and beetles (and throwing in the number of "delicatessens where you can get a fried- / tuna sandwich on waffles"). This lightness is a disarming way to shed light on the heart of the poem--the narrator's deep caring for the scientist and the scientist's deep caring for her work of discovery.

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West coast dancer John Henry made his life the subject of his final performance. Choreographer Bromberg and film maker Rosenberg collaborate with Henry in the creation of a work for the theatre based on his desire to leave an autobiographic legacy. Filmed during the last few years of Henry's life with HIV/AIDS, the documentary examines the image of self as one individual prepares to separate from body and personhood, and continues after his death.

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In the fall of 1979, Keith Burton, a free-lance journalist, saw the videotape 0105 in a bioethics seminar at Southern Methodist University (see annotation in this database). The structural centerpiece of this 1974 documentary is the interview of a burn patient, Donald "Dax" Cowart, by psychiatrist Dr. Robert B. White at the University of Texas Medical Branch in Galveston. Dr. White had been called in to determine the patient’s competency because of his persistent requests to end the painful treatments, to go home, and to die.

Similar to most viewers of Please Let Me Die, Burton was intrigued by the unanswered questions and the uncertain outcome of the case and ultimately contacted Dax Cowart and his mother, Ada Cowart. Burton invited their collaboration on a follow-up videotape to Please Let Me Die, with the intention of providing "a living record of this man’s struggle for release from pain and despair." [see Keith Burton, "A Chronicle: Dax’s Case As It Happened." In Dax’s Case: Essays In Medical Ethics And Human Meaning, ed. Lonnie D. Kliever. (Dallas: Southern Methodist University Press) 1989: 1].

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Sarah and Peter Bedford are sailing with their parents off the coast of Indonesia when the tsunami strikes. As they attempt to escape, their father breaks his leg. Their mother insists the children run ahead, so they do, up the hills into the jungle. Sarah later finds her mother, dead, on the beach, but not her father. Peter is soon running a fever and Sarah embarks on an arduous overland journey to try to get him help. At the same time Ruslan, an Indonesian boy, has taken his own escape route out of his village, and is looking for his father, along with many who are searching for missing relatives. Ruslan and Sarah recognize one another when their paths cross, as he had waited on her family on an earlier stop in his village. Together, with a few other refugees, they make their way to another village where Peter may be able to receive help in a makeshift hospital. Ruslan is threatened by an additional danger, since his family are partisans in a local conflict, and he is suspected of activity on behalf of the rebels.

At the hospital, lack of personnel and supplies throws Peter's survival into doubt, as well as the prospect of finding the children's father. Eventually Ruslan finds his own father, and Sarah and Peter are rescued by the military and taken to a base where more adequate care may be provided. Once there, Sarah finds herself swarmed by journalists, but realizes that the international attention their own case has incited is lopsided, given the many locals whose stories of loss and suffering are not being told. The story ends with the fates of Peter and their father unresolved; clearly part of the story is that no "end" is in sight, and that it will be a long, long time before anything that looks like "normality" will be restored.

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David Lynch’s The Elephant Man is based on the life of Joseph Merrick (1862-1890), a man who we first encounter in the film as “The Elephant Man” of a freak show, whose physical differences are so frightening to the authorities that the exhibit is closed. An ambitious young surgeon, Frederick Treves (Anthony Hopkins), seeks out Merrick (John Hurt) as a subject for a presentation to the Pathological Society and, taken by Merrick’s intelligence and amiability, arranges for Merrick to have a permanent home on the premises of London Hospital. The film portrays Treves as rescuing Merrick from a wretched existence in the squalid wharf district, where he is beaten savagely and otherwise abused by his sideshow manager, Bytes.

Treves provides Merrick with modest bourgeois comfort in the form of private rooms on the hospital premises. When the London Times publishes a letter from the hospital director describing Merrick’s disfigurement as terrifying and requiring isolation, first a famous actress, then most of London high society seek out Merrick, some to befriend him, others to indulge in spectatorship or the fashion of the day. A hospital porter who has access to Merrick’s room brings drunken revelers to view Merrick for a fee, giving the villainous Bytes the opportunity to kidnap Merrick and spirit him off to Belgium and a desperate existence as an abused and degraded sideshow freak.

Eventually, the other members of the freak show free Merrick and send him back to London, where, in a dramatic chase scene, he is pursued by an angry mob until the police arrive. Treves is summoned and reinstalls Merrick in his rooms at the hospital. Merrick is then celebrated by society when he attends his first theater performance. That night, he arranges himself to be able to sleep lying down, like a “normal person,” a position he knows will lead to his asphyxiation due to the size of his head, and he dies.

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This is a collection of 91 poems on medical topics by medical students, physicians in training, and attending physicians; two are Canadian and the rest American. The poems are organized by six traditional groups of medical training and advancement in the profession: Medical Student, First Year; Medical Student, Second Year, Medical Student, Clinical Years; Intern; Resident; and Attending. There are no sections for pre-meds, retired doctors, or other programs (naturopath, chiropractor).

The editors have done a good job of picking well crafted and evocative poems. A dozen have been previously published. For the most part, the poems are short, easily fitting on one page. Almost all are in free verse, although there is one group of haiku, one prose poem, and an impressive sequence of ten Shakespearean sonnets “Breughel at Bellevue” by Anna Reisman.

Many poems treat dramatic moments in training: the anatomy lab, first gynecological exams, physician-patient relationships, especially when a patient is gravely ill or dying. Several poems in the first three sections comment on the differences between the normal social world and the intense medical world of the hospital. Throughout there are references to the pressures of high-tech, unfeeling medicine. Indeed Jack Coulehan sounds this theme in his introduction; he writes that "steadiness and tenderness" are both needed in medical practice.

 

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Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)

Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.

Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.

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An already depressed second year medical student, Deborah, finds herself even more confused about the meaning of life after her aunt sustains a head injury and is in critical condition. Auntie Jenny’s convertible car collides with a utility pole and the impact ejects the woman (who was not wearing a seatbelt) onto the concrete road where she smacks her head. Five days later, Jenny remains in a vegetative state and connected to a ventilator. Deborah’s mother and Auntie Sal keep vigil over their unresponsive younger sister.

Deborah has been slacking – missing classes, sleeping a lot, and uninterested in most activities she formerly enjoyed. Previously she has suffered from insomnia and has fifteen barbiturate sleeping pills remaining. She questions the medical librarian as to how the drug works and the physiologic effects of an overdose. In the seventh grade, Deborah was hospitalized and out of school for one month with unexplained abdominal pain. In retrospect, her mother now admits that Deborah was likely suffering from depression as a child but no diagnosis was made and no treatment provided.

Jenny’s medical status remains unchanged. Deborah’s mother gives her an ultimatum: “You’ve got to make up your mind. The living or the dead” [p 119]. Deborah envies Jenny. No more worries about finding answers to important questions. Survival itself seems to be out of her control. Jenny’s fate rests in the hands of her close relatives who confer with the doctor about whether to continue artificial life support or “pull the plug.”

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A collection of short stories loosely connected to each other by centering on the experiences of four people from their first encounters during medical school and continuing into young middle age.

The first and third stories “Getting into Medical School, Part I” and “Part II,” are about study partners, Fitzgerald and Ming, who have trouble admitting their love for each other until she is accepted to medical school and he is not. Ming teaches Fitzgerald how to prepare successfully by passing along learning tips her physician-cousin provided her in exchange for sex. In the second story, Ming meets fellow students Sri and Chen and drifts away from Fitzgerald. In the third, he wrestles with feelings of rejection and misery as he realizes she has opted for a relationship with the more culturally “appropriate” Chen; however, her study tips pay off in more than one way when he meets Ming’s unsavory cousin at his medical school interview.

Later stories describe clinical encounters with specific cases, one of the most memorable being “Winston,” about Sri’s relationship with a paranoid person; the tale is told alternatively from the doctor’s perspective and the patient’s. in “Afterwards,” Sri must explain to a man’s wife and son, how he died suddenly at a strange hairstylist salon; the news disturbs the family who discover that the supposedly impotent diabetic had been a regular at a sex shop.

Fitzgerald and Chen become emergency physicians. Less settled, Fitzgerald tries several settings, including working for an air ambulance company. His problem with alcohol emerges from deep disaffection and brooding resentment over Ming’s callous rejection years earlier and her subsequent marriage to Chen. The problem begins to threaten his judgement and seriously compromises his health when he falls ill.

In the ironically titled “Contact Tracing” both Fitzgerald and Chen contract SARS (the latter from the former) during the (real) 2003 Toronto epidemic. They are isolated in adjoining rooms separated by glass and phone each other for support and discussion. They reminisce about Sri who has died of cancer and muse on the relevance of do-not-resuscitate orders. The outcome is both humorous and surprising.

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A saxophone-playing, divorced psychiatrist, Dr. Denis, is baffled by the unexplained arrival of a new patient in his mental hospital. The highly intelligent newcomer, called Rantes, has extraordinary gifts and spends long hours in the yard facing southeast, where he claims to receive communications from his home planet. He is visited by the saintly Beatriz, who works in a church, and Denis asks her questions about Rantes.

The bond between the three people begins to transgress the ordinary boundaries between doctor and patient, and culminates in an excursion to a concert in the park. Charmed by Beethoven's "Song of Joy," Rantes instigates generalized waltzing and takes over from an inexplicably obliging conductor. Back in the asylum, the other patients feel the vibrations emanating from Rantes' concert and engage in a good-humored romp. The doctor is reprimanded for the embarrassing situation, and begins to doubt the integrity of the psychiatric enterprise. A weakened Rantes dies after electroshock therapy and the film ends in ambiguity.

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