Summary:

Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

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When Ruth's unfaithful and unappreciative husband Bobbo calls her a she-devil, she decides to appropriate that identity with a vengeance and take a different spot in the power relations of the world. She wants revenge, power, money, and "to be loved and not love in return"(49). Specifically, Ruth wants to bring about the downfall of her husband's lover, Mary Fisher, a pretty, blonde romance novelist who lives in a tower by the sea and lacks for neither love nor money nor power.

Ruth commences her elaborate revenge by burning down her own home and dumping her surly children with Mary and Bobbo. She continues on a literally shape-shifting quest in which she changes identities; gains skill, power, and money; and explores and critiques key sites of power and powerlessness in contemporary society, including the church, the law, the geriatric institution, the family home, and (above all) the bedroom.

By the end of the novel, Ruth achieves all four of her goals in abundance. Her success, however, raises complex ethical questions, not only because she uses the same strategies of manipulation and cruelty of which she was a victim, but also because of the painful physical reconstruction of her body that is the tool of her victory.

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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

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This sketch is teeming with images: in what appears to be a science lab, two researchers stand in the background, surrounded by gray lab equipment; one peers into a microscope. In the bottom of the frame a horse and cow flank three sheep. At the center stands a muscular baby, loosely draped in a white cloth and held up by a nurse in a white apron and cap. To his left stands a rather grim looking doctor, who holds the baby's arm with one hand and injects a vaccine with the other.

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Dividing the background expanse of red from yellow, and surrounded by a halo, three apples--green, red, and purple, four yellow papyrus blossoms, and a snake held between the fingers of the artist's hand, a disembodied head appears caricature-like in this self-portrait.

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A medical instrument kit from the year 2450 is transported back in time and falls into the possession of old Dr. Full, a retired physician and drunkard who had been expelled from the medical association for milking patients. The futuristic instruments are awe-inspiring and virtually operate themselves. The discovery of the black bag restores Dr. Full's self-worth and dedication to healing.

A street-wise woman, Angie, realizes the value of the medical instruments and their origin. She forces Dr. Full to accept her as a partner. The two of them soon establish a successful medical practice. When Dr. Full decides to donate the instrument kit to the College of Surgeons, Angie murders him.

While demonstrating the safety of the medical bag to a patient, Angie plunges the futuristic surgical scalpel into her own neck, confident it will do no harm. Meanwhile, authorities in the future learn that the medical bag is missing and deactivate it just prior to Angie's demonstration. She slits her own throat. By the time the police arrive, the contents of the black bag had already rusted and are decomposing.

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Carl Elliott and John Lantos have brought together a collection of 12 essays that explore the complex work and person of Walker Percy. Personal reflections and stories capture the importance of Walker Percy in the lives and work of several of the essayists, while others offer commentaries on various aspects of Percy's life and work. All of the contributors reveal their affection and appreciation of Walker Percy as physician, novelist, and philosopher.

In addition to the editors, the contributors include Robert Coles, who was Percy's friend; Ross McElwee, the documentary filmmaker; Jay Tolson, Percy's biographer; author and historian Bertram Wyatt-Brown; scholars Martha Montello and Laurie Zoloth; and physicians Brock Eide, Richard Martinez, and David Schiedermayer.

The collection covers many topics and themes. Percy's biography is reviewed: the early losses of his father and grandfather by suicide, the early death of his mother, his medical education and subsequent struggle with tuberculosis, his turn from medicine to philosophy and literature, his marriage and conversion to Catholicism, and his long and productive life as a philosophic novelist.

The essays explore Percy as both physician and patient, and how, as diagnostic novelist, he gives us characters and stories that caution about the technologic-scientific worldview that dominates not only medicine but western life. The many wayfarers are discussed, including Binx Bolling from The Moviegoer, Will Barrett from The Last Gentleman, and Dr. Tom Moore from Love in the Ruins and The Thanatos Syndrome. [These novels have been annotated in this database.]

Percy's spiritual and religious views are reviewed, along with his moral concerns about a post-modern world before anyone had coined the term. The problems of isolation, alienation, and struggle for meaning are apparent in all of his works, and many of the essayists explore the connection between his novels and these existential concerns. The importance of Kierkegaard in his work, his theory of language, and his early essays are discussed.

The contributors give examples of how Walker Percy's life and work are incorporated in medical education and the practice of medicine, both in personal and theoretical terms. Percy's work reminds practitioners of the necessity for human connection in the midst of scientific and technologic paradigms that distance practitioner from patient. Likewise, medicine and medical education shaped Percy the novelist, where keen observation and sustained searching for answers are to be found in all of his fiction.

A feminist critique of Percy's development of women characters, reflections on physician characters in Percy's work, his personal struggle with a family history of depression, and his attitudes about psychiatry and psychoanalysis complete the collection.

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This work touches upon a wide range of issues, more or less closely related to the trauma surrounding, the management of, and the aftermath of sustaining a serious burn. Divided into three sections, the work first defines burns not only on a biological basis, but as distinguished psychologically and historically from other forms of physical trauma.

In Part II the authors explore ancient myths and then images from modern culture that they contend define social perceptions about the meaning of being a burn victim. The final section poses problems that remain in the technique of burn management in its most holistic sense. An extensive bibliography/filmography completes the book.

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This story draws attention to subtle ramifications of organ transplantation for the survivor(s) of the donor as well as for the organ recipient. Also at issue is coming to terms with the sudden death of a loved one. Hannah, a woman in her thirties, finds that three years after the violent death of her husband, she is still caught, "unable to grieve or get on with her life . . . . "

The physician in charge had persuaded her both to allow life-support to be terminated for her brain-dead husband, and to agree to organ donation. "That way your husband will live on." Seven different people are the living recipients of his organs. To Hannah, it seems that her husband is both dead and not dead, an intolerable situation.

She becomes obsessed with trying to meet the person who received her husband's heart. This will be the means by which she can re-connect to the living and achieve closure--she will hear and feel her husband's heart in the chest of the recipient, her ear "a mollusc that would attach itself . . . and cling through whatever crash of the sea." At the end of the story, Hannah has succeeded in her quest and the man who is the heart's recipient, at first suspiciously hostile, has become Hannah's co-conspirator and protector.

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