Summary:

In their introduction to this anthology, the editors write that their goal is "to illustrate and to illuminate the many ways in which medicine and culture combine to shape our values and traditions." Using selections from important literary, philosophical, religious, and medical texts, as well as illustrations, they explore, from a historical perspective, the interactions between medicine and culture. The book is arranged in nine major topical areas: the human form divine, the body secularized, anatomy and destiny, psyche and soma, characteristics of healers, the contaminated and the pure, medical research, the social role of hospitals, and the cultural construction of pain, suffering, and death.

Within each section, a cluster of well-chosen (and often provocative) texts and drawings illuminate the topic. Specifically, literary selections include poems by W. D. Snodgrass ("An Envoi, Post-TURP"), William Wordsworth ("Goody Blake and Harry Gill: A True Story"), and Philip Larkin ("Aubade"); and prose or prose excerpts by Robert Burton ("The Anatomy of Melancholy"), Zora Neale Hurston (My Most Humiliating Jim Crow Experience), Sara Lawrence Lightfoot ("Balm in Gilead: Journey of a Healer"), William Styron (Darkness Visible: A Memoir of Madness), George Orwell ("How the Poor Die"), Ernest Hemingway (Indian Camp), and Paul Monette (Borrowed Time: An AIDS Memoir). (The full texts of the pieces by Hurston, Styron, Hemingway, and Monette have been annotated in this database.)

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In the videotape, She's Finally Free . . ., Joe Cruzan and Christy Cruzan White, Nancy Cruzan's father and sister, tell the story of their eight-year struggle for the right to let Nancy die, after a January 11, 1983 car wreck left her in a persistent vegetative state. The Cruzans see their story as a means of enlightening health care professionals and the community at large about the concerns and frustrations experienced by the families of critically ill patients. After a brief pictorial overview of Nancy Cruzan's life, the remainder of the video presents a chronological series of vignettes/stories told by Christy and Joe Cruzan.

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This anthology frames a rich selection of fiction and nonfiction with astute and helpful introductions to issues in nineteenth-century medicine and the larger culture in which it participated. The fiction is comprised of Mikhail Bulgakov’s The Steel Windpipe in its entirety; Sir Arthur Conan Doyle’s story, "The Doctors of Hoyland" from Round the Red Lamp; and selections from George Eliot’s Middlemarch, Gustave Flaubert’s Madame Bovary, Sarah Orne Jewett’s A Country Doctor, Sinclair Lewis’s Arrowsmith, Thomas Mann’s Buddenbrooks, W. Somserset Maugham’s Of Human Bondage, George Moore’s Esther Waters, Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde, Eugène Sue’s Les Mystères de Paris, and Anthony Trollope’s Doctor Thorne [the full-length versions of many of the above have been annotated in this database]. The nonfiction consists of two versions of the Hippocratic Oath, two American Medical Association statements of ethics, and selections from Daniel W. Cathell’s The Physician Himself (1905).

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This is a harrowing story, told in the first person, of an obsession with food and body image. "One day I will be thin enough", says Josie, the 25 year old anorectic woman who has been hospitalized for life-threatening self-starvation. "Just the bones, . . . the pure, clear shape of me." "One day I will be pure consciousness." The narration spins out in painful detail the pattern of compulsive behavior which pervades Josie’s existence. Her pitifully barren emotional life is revealed as well.

How did it all begin? Flashbacks of significant events invade Josie’s attempts to stop thinking. A shy, awkward adolescent, overly sensitive to casual comments about excess flesh, decides to diet. Josie stumbles non-communicatively through a teen-age sexual initiation to a later affair with her married professor, retreating ever further from her bewildered family.

But why do events take such an extreme turn? The mystery of anorexia nervosa remains. In the hospital, a nurse who has seen everything seems to strike some responsive cord, and Josie begins eating to gain weight. At the end of the novel she’ll soon be released , under supervision, but the outcome is in doubt. "Can I learn to be so present? Can I learn to be so full?" ". . . if I were a body, what would I be?"

 

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In "Life Support," a mother must make a difficult decision: whether or not to consent to heart surgery without anesthesia for her critically ill newborn who is on a ventilator. Her instincts and reason contradict each other, and she isn’t sure which to believe. She wants to let the child die naturally in her arms, but this will not be allowed in this particular institution. She feels distant from her husband and from the doctors, and believes that her sudden transformation into the guardian of this child presumes far more knowledge and ability than she possesses.

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In this short poem (11 lines) the writer sees a whole world in the microscope: among the cells, a world of dreams and suffering, of courage and death.

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The narrator carries hothouse orchids as a gift to a friend in the hospital. When he gets there, he feels out of place, not having expected "barricades / against infection, the doors’ / pneumatic psshh . . . . " He regrets that his gift flowers are tame, when "the room / cried out for wildness." The place is sleek, efficient, and antiseptic. His friend--who is not described in the poem--"would never rise / from the motored bed." Who could blame the narrator for looking away? Or for wishing that he could have brought a gift of wilder, more glorious flowers? (40 lines).

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A surgical resident named Thor Bitterbaum happens to be in attendance when the fatally wounded President John Kennedy arrives at Parkland Hospital in Dallas. He immediately remembers the work of a scientist who had performed some successful cloning experiments. In the twinkling of an eye, he locates a liquid nitrogen container and freezes a sample of the President’s tissue. He then locates G. K. Kellogg, a multimillionaire who is willing to foot the bill to clone President Kennedy. Kellogg’s plan is to reproduce the major events of Kennedy’s life so that his "son" has essentially the same experience as JFK and grows up to be elected President of the United States.

Not surprisingly, some things go wrong with the plan, but, in general, the whole bizarre scheme works out as G. K. and "Uncle" Thor intend it to. Joshua Francis Kellogg, the cloned child, eventually learns his origin, rebels against his "father’s" plan, blows his cover by writing a book about his experience, but ultimately becomes a successful politician just as G. K. had envisioned.

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May the Lord Jesus Christ bless the hemophiliac’s motorcycle, the smell of knobby tires . . . This long-lined incantation of a poem takes the reader from the motorcycle raceway to the Kanawha River to the "oak tops on the high hills beyond the lawns" and, finally, to the hospital wards and the writer’s elderly roommate, who reads his grandson’s Bar Mitzvah speech. Isn’t it dangerous for the hemophiliac to ride in motorcycle races when even "a mundane backward plunge on an iced sidewalk" can bring him to the hospital bed and the "splendor of fibrinogen and cryoprecipitate"? Of course, but why not do so anyway!

This poem is a psalm, a paean of praise and gratitude to God--gratitude for oaks, and hills, and catbirds, and star clusters. "I want to hymn and abide by, splendor of tissue, splendor of cartilage and bone." The poet is also listening--listening for the presence of God in the silence: "may He bless our listening and our homely tongues."

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Elizabeth Mann, the daughter of a world famous fertility specialist whom she despises, hasn’t quite made it into medical school. She runs away to London, where she can revel in an orgy of self-destructive behavior, while working as a freelance writer for a travel guidebook. She soon develops two obsessions. In an obscure medical museum she encounters the skeleton of Jonathan Wild, a famous 18th century criminal who met his death by hanging. During the same museum visit, she runs across Gideon Streetcar, a young fertility specialist who once worked with her father. Though Gideon is "happily" married, he and Elizabeth soon begin a torrid affair.

Elizabeth’s obsession with Jonathan Wild grows when, through Gideon, she obtains a copy of the criminal’s second wife’s memoir. Through it, she learns that his first wife, who died in childbirth, was named Elizabeth Mann. She develops a scheme to obtain DNA from Wild’s skeleton and use it in association with an experimental cloning procedure to become pregnant with the 18th century criminal’s child (clone).

When the 25 year old Elizabeth reveals that her father tied her tubes when she was 16, after having aborted her fetus--a "slut," he called her--Gideon agrees to attempt in vitro fertilization with her eggs and his sperm. He transfers two blastocysts, plus one of the supposedly cloned Jonathan Wild cells. She becomes pregnant. Soon thereafter she returns to the USA when her father has a massive heart attack and she, apparently, has an opportunity to go to medical school.

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