Summary:

One Breath Apart: Facing Dissection is a pictorial and narrative account of gross anatomy class in medical school. The book highlights the educational, moral and metaphysical opportunities anatomy courses afford those who dissect and learn from the cadaver. Educator and thanatologist Sandra Bertman has expanded on her work with medical students previously summarized in her book Facing Death: Images, Insights, and Interventions (see annotation).

Written with the first year medical student in mind, One Breath Apart is a compilation of drawings and writings by students from the University of Massachusetts Medical School between 1989 and 2002 in response to course assignments. The book is dedicated to the professor of the anatomy course, Sandy Marks - of note, the medical humanities module, including assignments and events were integrated into the course. Bertman describes the course and provides a plethora of student work.

Additionally, the book is enhanced by photographs by Meryl Levin, with writings by Cornell-Weill medical students, excerpted from Levin's marvelous study,  Anatomy of Anatomy in Images and Words. Also included is a foreword by Jack Coulehan, who writes of his experience with his cadaver ("We named him ‘Ernest,' so we could impress our parents by telling them how we were working in dead earnest." p. 7) and the lifelong impact of dissection on the student.

Of particular note is the variety of content included in this intriguing volume. Artistry is not a medical school admissions criterion, yet a number of the drawings have design components which are thought-provoking and profound. For example, on page 80 a female doctor adorned with white coat, stethoscope and bag stands beside an upright skeleton. They are holding hands.

Bertman concludes the book with photographs, drawings and text related to the annual spring memorial service for the body donors. The section includes eulogies by students and responses by donor family members. Writes medical student Nancy Keene: "Studying his body provided an opportunity which enhanced my education. But it was the giving of his body, which has remained with me as a lasting memory." (p. 87)

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Summary:

South Africans, Paul and Andrea, are lovers living in France. Paul is fiftyish and white; Andrea is thirty and “coloured.” He has just asked her to marry him. She travels to Provence ostensibly to research sites for a film to be based on Paul’s endlessly forthcoming novel about fourteenth-century plague. But the real reason for the journey is to test her feelings about his proposal—she is leaning to ‘yes.’

As five days roll by, she relives the trajectory of her life: her impoverished parents, her thwarted education, her angry, imprisoned brother, and the previous affair with Brian, a British historian with whom she was captured ‘in flagrante,’ sent to trial, found guilty, and offered prison or voluntary exile. Brian and Andrea left South Africa together, but their relationship eventually crumbled. She had trouble understanding his passion for the past and his love of detail.

In Provence, Andrea avoids places that Paul had wanted her to go, finding strength in solitude and independence. But that feeling is shattered when he asks her to rescue their penniless, black friend, Mandla, an anti-apartheid activist who has been betrayed by a comrade who turned out to be a spy.

Andrea doesn’t like Mandla, his sanctimonious accusations, arrogance, and probing. He is a racist and a male chauvinist, given to violence. But his constant questioning finally unleashes deeper memories of the shocking abuses of her life in apartheid South Africa—memories she has suppressed or attempted to blame on class struggle rather than racial intolerance. She tries to provoke his empathy with the terrible tragedy of the long ago plague. He resists, being concerned far more with the present, but he relents a little and begins to see racism as a plague and walls as feeble, futile attempts to exclude others.

Andrea falls for Mandla, makes love with him near the plague wall, and decides to refuse Paul and return to South Africa. But Mandla rejects a future with her because he wants no vulnerability in his struggle. He is killed in the night by a car. Was the death deliberate? accidental? suicide? Andrea leaves anyway.

In a short second part, Paul writes to Andrea of his own growing doubts about their future together despite his love.

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Summary:

Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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Summary:

On February 16, 2003, readers of The New York Times Magazine came upon Harriet McBryde Johnson's cover story, "Unspeakable Conversations," and a remarkable image of her gazing directly at those readers from her power wheelchair.  Her story memorably recounts her uncompromising, yet civil disagreements with Utilitarian philosopher Peter Singer about nothing less than the value of her life.  That narrative essay is one of eleven stories published in Too Late to Die Young.

They make the case that philosophers and others have incorrectly imagined Johnson's life, and the lives of others with chronic and disabling conditions, as burdensome and not worth living.  Born with a degenerative neuromuscular disease, Johnson grew up in a family that appreciated her; she practiced law in her native Charleston, South Carolina, and became nationally known for her disability activism.  Still, she encountered a world filled with people who feared her condition.  Fear, she found, led them to assume that disability inevitably brings suffering and to use that assumption to justify acts that would prevent her birth.

Her stories, conversationally and often humorously, ask readers to question why they burden some people with calls to justify their lives or to assure the world that they experience pleasure.  Each story recounts an episode that reveals the pleasures Johnson experienced as an active agent in the world.  She ran for a county office, represented her state at a Democratic National Convention, stood her ground for free speech and against Secret Service tactics when President Reagan spoke at her law school, protested Labor Day Week-end telethons, traveled to Cuba to cover a disability conference for a magazine, advocated for clients in employment discrimination cases, and made many, many friends.

Feeling exhilarated rather than confined by her wheelchair, she bears witness, perhaps unexpectedly, to another pleasure:  "the simple delight of movement."  She writes of maneuvering around Charleston, "I zoom through chaotic swarms of tourists, zip around the raggedy sidewalks . . . loop around every inconveniently placed garbage can, with maximum speed and also with style and grace" (252).  But her stories also describe her wheelchair stumbling over incompatible surfaces, one of which sends her to an emergency room far from home.  This episode also brings moments of grace, this time with the ER staff.  After learning who she is, they Google her on-line profiles and writings.  Delighting in their patient with unpredictable needs, they place print-outs of her electronic portfolio in her chart.

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Summary:

In the 1527 sack of Rome, undiscplined troops of the Holy Roman Emperor rape, pillage, and destroy. The beautiful couresan Fiammetta Bianchini opens her house to the marauders, inviting them inside for food and comfort. The act gives her household a moment’s reprieve. Her golden tresses savagely shorn, she swallows her jewels and escapes north to her native Venice in the company of her servant and companion, the dwarf, Bucino Teodoldi.

Arriving with almost nothing, they set about establishing a reputation and securing backers. The small company is helped by Fiammetta’s friend and admirer the satirist and poet, Pietro Aretino. Her portrait is painted by his friend, Titian.

Clever and loyal to a fault, Bucino frets over finances and willingly engages in subterfuges that mesmerize their audiences. Fiammetta accepts the attentions of tedious but wealthy admirers in exchange for a house and status. She comes to rely on a blind woman healer, called La Draga who supplies medicine and cosmetics. Bucino is suspicious and jealous, but he tolerates the competition grudingly. He too has many ailments, including headaches and arthritis, because of his deformity.

Suspense swirls around a banned book, a Jewish shopkeeper, and La Draga’s mysterious origins in the glass-making town of Murano.

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Summary:

Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Summary:

This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Summary:

Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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Summary:

Kaplan Publishing has recently released several anthologies aimed at a nursing audience or perhaps at a reading audience that wants to know more about what nurses think and feel about their professions.  This anthology, a collection of poetry and essays, looks at the various reasons these authors went into nursing in the first place, how nursing changed them, and why they either stayed the course or went on to other pursuits.  As the editors say in the Introduction, "nursing abounds with experiences that can either reinforce our vocational commitment or cause us to reconsider it" (p. xi).

In the first section, "The Calling," poems and essays examine "the idealistic reflections of those aglow with nursing's promise of intimacy and connection" (xii).  Here we meet student nurses with a true calling who are "living, breathing and sleeping nursing" (p.5), and students who are sure they are going "to murder someone" (p. 6).  Like most professionals, nurses often have mentors, and those mentors--"brisk, frank, fast, sometimes sharp" (p. 30)---are honored in this section as well.  Readers, upon completing this section, will be moved and cheered by the poems and essays that reflect the romance of nursing and the intense drive that many nurses have to give of themselves to others. 

The editors, however, are no Polyannas.  They know that a student's illusions and dreams will run right smack into reality.  While the rewards will certainly be many, the discouragements will be present as well.  The fact that both experiences---the highs and the lows---can occur within a single day is reflected in the collection's second section, "The Reckoning."  Here the realities of death, exhaustion, burnout and doubt are faced full on.  Some of the works in this section are by nurses who have chosen to leave the profession:  "Brazil, the new hospital.  We have no water.  Doctors protest poor facilities by refusing to see patients and sitting in their cars outside in the parking lot" (p. 81), writes Veneta Masson as she traces her career from 1958 to 1998 when she decides to leave nursing and "use my hands to write and to bless" (p. 84).  While some have chosen to leave, other nurses have found ways to survive: "Nursing allowed me to help my mother die; my music has helped me live" (p. 88) writes Colleen O'Brien, and Fr. Robert J. Kus writes about his dual roles, priest and nurse, how they balance and enhance one another (pp. 102-110).  The works in this section remind readers of the sacrifices caregivers must make every day.  As Jo Ann Papich writes, "Please appreciate your nurse while you still have one" (p. 99).

Section Three, "Reincarnation," tells of the "informed commitment that arises after sustained trial" (p. 165).  Here nurse-writers talk about survival and the oddly comfortable balance between stress and transcendence that comes, at last, after many years in nursing.  In "Why I Like Dead People," Sallie Tisdale takes a wry look at death, nursing homes and their "cockeyed logic" (p. 175).  Anne Webster, in "Slow Night in the E.R." talks about doing what you must do to help others even when you "can't do it," when you "stand outside the curtain, shaking" until the patient asks, "Are you there?" (p. 186-7).  Kathryn Gahl, in "The Reason Nurses Write Mostly Poetry" says it's because nurses "convert heart sounds // and hard words into art before the next patient / arrives, hemorrhaging, counting on that nurse / to flow like a pen, bleed for both of them" (p. 195).  And in the book's final essay, "I'm Staying," Shirley Stephenson offers a series of lovely statements about why she, and others, might continue in the frustrating, tiring, challenging and miraculous profession of nursing.  "Because I have been in the bed, and beside the bed. Because I have waited. Because I believe any one of us could face the circumstances of those for whom we provide care, and we're much more similar than different. Because this is where the rhythm is loudest---yes this yes this yes this yes this" (p. 246).

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Summary:

Clever, investigative journalist Stephanie Delacourt is sent from Paris to the mythical Santa Varvara to cover police inspector, Northrop Rilsky, in his quest to solve a series of high profile murders with political overtones. The back of each victim is “signed” with a carved figure 8 (or infinity?). At the same time, the distinguished historian Sebastian Chrest-Jones (CJ) disappears. Unbeknownst to everyone but the reader, he has just murdered his Chinese mistress, who is pregnant with his child.

Anxious that CJ has come to harm, his wife appeals to Rilksy, drawing on the connection that he is a step-relation of the missing man. She has been conducting an affair with CJ’s assistant who soon becomes another corpse signed with an 8. Suspicions fall on CJ.

Distracted from the murders she was to cover, Stephanie becomes increasingly involved in CJ’s historical research on the first crusade and the twelfth-century Anna Comnena, considered Europe’s first woman historian. In tracing the connections that CJ has drawn between Anna Comnena and one of his own (and Rilsky’s) ancestors she “derives” his obsessions and his likely whereabouts.

Late discovery of mistress’s corpse offers bizarre genetic clues about the identity of the serial killer and the paternity of the child, again tying the two mysteries into one. A thrilling climax is set in monastery of Notre Dame du Puy en Velay.

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