Summary:

To escape accusations of plagiarism, Swedish neurosurgeon Stig Helmer (Ernst Hugo Jaregard) has come to work at The Kingdom, a large Copenhagen hospital. He is a surgical butcher with lamentable bedside manners and utter contempt for Denmark, but he resembles his colleagues in his medical positivism and abhorrence of spiritualism. His inadequacies are easily perceived by the hospital staff and resident Dr. Hook (Soren Pilmark), but his fellow consultants celebrate his arrival and make him a member of their lodge.

The malingering spiritualist Mrs. Drusse (Kirsten Rolffes), admitted for a variety of fictitious ailments, discovers The Kingdom is haunted by a little girl murdered there a century ago by her scientist stepfather. Drusse engages the help of her son, who is an orderly, to trace the child's secret.

Tangents to the main plot involve a pathologist, who is so obsessed with obtaining research tissue that he has a cancerous liver transplanted into himself, and the psychopathic medical student son of the hospital director, whose sick sense of humor leads him to mutilate corpses in the hospital morgue. The ending is pure horror.

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This is a long poem, subtitled "A Poem for Three Voices," and originally written for radio broadcast. It consists of three intertwining interior monologues, contextualized by a dramatic setting: "A Maternity Ward and round about." The three women of the title are patients, and each describes a different experience.

The First Voice is a (presumably) married woman who gives birth and takes her baby home during the course of the poem. The Second, a secretary, has a miscarriage, not her first, and the Third, a college student, gives birth after an unwanted pregnancy, and gives the baby up for adoption.

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The action takes place in a mental hospital where Pythagoras is a patient. According to the medical authorities, Pythagoras is a small-time show-biz magician. The patient, however, believes that he is the REAL Pythagoras, the ancient Greek philosopher, mathematician, and mystic. It certainly SEEMS that Pythagoras may have magical powers: when he points to the telephone, it rings; when he raises his hand to the sky, thunder claps.

Dr. Aquillus, the superintendent, has no sympathy with these pranks. The patients believe in his power, but even they sometimes question Pythagoras. For example, in response to the Greek's boast that "I was philosopher, mathematician and magician," one patient says, "You shoulda specialized, buster. You won't get anywhere unless you specialize." At this point Pythagoras responds that it is "difficult to wear both the white coat of science and the magician's purple one. You have to be--very great!" In the end Pythagoras is reduced to Tony Smith and the truth is revealed. Or is it?

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Today, Friday June 5th, I am going to meet the man who killed my father. So begins the narrator of this novel, who is about to drive to New Jersey to visit the physician (now retired) who took care of his father during his final illness 20 years previously. The narrator (Peter Cave), who was an adolescent at the time, is now a physician himself.

Most of the novel is a flashback in which the narrator describes his life during the several days prior to June 5th, "the white life," which is the term he uses for the practice of medicine. We learn, in particular, about his patient George Dittus, a difficult man who definitely doesn't want to play the hospital game. "I need to get home" is the first thing Dittus says. Dr. Cave wants to save the life of this gruff, eccentric man who may well have had a serious heart attack, but at the same time, he tries--sometimes painfully--to respect the patient's desire to be in charge.

Cave's encounter with the retired Dr. Gresser, who remembers the elder Cave as a difficult patient, is surprising--"You know he refused to take the medicines I suggested." Cave is disappointed; he wanted a confrontation with the man who "killed" his father, but, instead, is confronted with the realities of human nature. Back at the hospital, he discharges George Dittus, who disappears into the inscrutable future.

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Perri Klass, who had already written of her medical school education (A Not Entirely Benign Procedure: Four Years as a Medical Student, see this database), took notes, made dashed journal entries, and saved sign-out sheets and other written memorabilia during her internship and residency in pediatrics at The Children’s Hospital in Boston, Massachusetts. Because she is a writer, she looked at her experiences in medical training with an eye towards what stories were happening. This book then is a compendium of stories and essays (some previously published) about Klass’s pediatrics training.

Klass reflects on the difficulties of being a writer and physician: "I have been a double parasite, not only learning off patients, but also writing about them, turning the agonies of sick children into articles, using them to point little morals either about my own development as a doctor or about the dilemmas of modern medicine." (p. 297) But she also notes the benefits of writing during training: "between life at the hospital and with my family, it seemed that all my time was spoken for, and spoken for again. I needed some corner of my life which was all my own, and that corner was writing . . . I could describe the astonishing contacts with life and death which make up everyday routine in the hospital." (p. xvii)

Part of the book concerns issues of women in medicine; Klass debunks the mystique of the "superwoman"--the professional, wife and mother rolled up into one incredible ball of efficiency and perfection--with a month of laundry spilling over the floor. Klass, as a successful writer, struggles with this label and includes an essay on her experiences with a "crazy person" who anonymously and publicly accuses her of plagiarism in the midst of the stress and responsibilities of residency.

However, most of the book is about being a new doctor--the terror, the patients, the procedures, the other doctors and staff. She writes of first nights in the Neonatal Intensive Care Unit, delivery room crises, adolescents with chronic illnesses, and her struggles as a sleep and time deprived mother.

She addresses difficult issues: moral dilemmas, suffering, loss, the rape and abuse of children, children with AIDS. Throughout the book is a concern for the patient’s experience, as well as the doctor-in-training’s experience. After her first night on call caring for very premature infants she notes: "Maybe my first patient and I have more in common than I realized: we are both too immature to be out in the world, but with a lot of help, we may just make it." (p. 15)

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This book is a sequence of poems about Frank Goldin, a middle-aged biochemist who is admitted to a mental hospital, Elmhurst, with the chief complaint, "I hear a thousand voices and must respond to each." In the first poem Goldin confesses his sins, but simple confession doesn't get to the root of his dilemma, the existential ambiguity that plagues him.

During Goldin's dark night of the soul, his scientific self struggles with the mysterious longing within. Dr. Hudspeth, the Elmhurst psychiatrist, directs his support to the part of Goldin that says, "I am the restless biochemical cycle / that pours out glutathione in buckets." In essence, just straighten out the chemicals and you'll get better.

Throughout the book Goldin waits for his wife Helen to visit Elmhurst, but she never appears. He ruminates over the matter of confessing that he had an affair with a woman named Da-ling during a professional meeting in Osaka. If he confesses, if Helen comes, Goldin hopes that things will return to the way the way they used to be.

However, the mysterious side of Goldin is looking for something else. He has visions of the ancient Rabbi Yehuda of Smyrna, who asks, "Why do we not even know how to ask a question properly?" After several weeks Goldin leaves Elmhurst with the feeling that he has made progress, but not in any discernible direction. Goldin concludes that he should be grateful, but he asks, "to whom?"

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Anne Finger, a writer and disabled activist whose childhood polio left her with a disability, tells the story of her pregnancy, her birth experience at home and in the hospital, and the serious health problems her newborn son experienced.

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This history of western medicine in the nineteenth century chronicles the lives of some men and women who were innovators in the field of medicine. Williams begins the book in the 1700s with the life of John Hunter and his influence on nineteenth century medical practice and research.

The book consists of 16 chapters, many of which, like the one on Hunter are biographic. For example, Williams writes of the contributions, education, and lives of Florence Nightingale, Hugh Owen Thomas (orthopedics), Marie Curie, Joseph Lister, Ignaz Semmelweis (maternal health), Patrick Manson (tropical medicine), Jean-Martin Charcot, and William Conrad Röntgen. Other chapters are more theme-oriented, such as body-snatchers, discovery of anesthesia, homeopathic medicine, blood transfusion, and medical use of spas.

Black and white illustrations, such as Mrs. Röntgen's hand in an X-ray photograph help the reader to appreciate the advances in medical knowledge in the nineteenth century.

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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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Dr. Pensack writes in the first chapter of his memoir: "Through a lifetime I have been in the process of dying, consistently surprised when reminded that life is appallingly brief, and briefer still for me. The prospect of an early death has amounted to little more than embarrassment and loneliness, even though the routine of living can be, and usually is, just one goddamn thing after another. A new heart was somehow supposed to be my bloody-red carpet of victory." (p. 7)

At age 4, Pensack's mother died of IHSS, Idiopathic Hypertrophic Subaortic Stenosis--now known as HCM, Hypertrophic Cardiomyopathy, a genetically inherited, progressive disease of heart muscle that results in early death. At age 15, Pensack receives the terrible news of his own fate--the disease afflicts both Pensack and his older brother--and thus launches a life of near death experiences, numerous hospitalizations, early experiences at the National Institutes of Health with early investigators of the disease, pursuit of his own medical training and eventual specialty training in psychiatry, marriage and children, and ultimately, the waiting and eventual transplantation of a younger man's heart into his chest at the University of Colorado Health Sciences Center when Pensack was 43.

Raising Lazarus tells of Pensack's journey through much of this, including his descent into madness, his fury and anger with medical colleagues, his poignant relationship with the heart surgeon who eventually performs the transplant, and the importance of his family in his refusal to die. While much of the book tells of the events leading to the transplant and post-operative period of Pensack's life, the reader learns of Pensack's early losses, including the death of his mother, and how these experiences shape the values of a gutsy and determined survivor, a man who continually returns to the struggle.

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