Summary:

A victim of a car accident suffers severe cranial fractures and facial disfigurement. Assuming a passive-aggressive stance toward the medical staff, and carrying on a sarcastic inner dialogue with her surgeon, she creates her own world, to escape and combat the pain. She becomes infatuated with the mystery and power of her own brain.

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As the title explains, the painting depicts Rene Laennec, French physician and inventor of the stethoscope, in a hospital room, his ear pressed to the chest of a male patient, who is sitting up in his bed. In his left hand he holds an early model of the stethoscope. Three other figures appear to the back and right: one is likely another physician, another is a sister/nurse.

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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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Charlie Gordon is a young man with an IQ of 68 who has a job at a box factory and attends night classes in an effort to improve himself. A (very fictional) experimental brain operation becomes available that promises to triple intelligence (it has already done so for a mouse named Algernon), and Charlie excitedly decides that he wants to give it a try. The story consists solely of Charlie's diary entries from the time he hears about the operation through the operation and his dramatic increase, and subsequent decrease, of IQ.

Charlie's increased intelligence opens up to him the understanding of everyday things that had been beyond his grasp, and at his peak he soars to the level of genius, ironically identifying the flaw in the scientific work of the two scientists who developed the operation he has undergone, and thus destroying their careers as their shallow research destroys the life that had been his.

Among the everyday things Charlie understands for the first time is the fact that two of his male co-workers have regularly taken advantage of his retarded state to make fun of him, sometimes roughly. Charlie also becomes self-conscious more generally, which makes it impossible for him to stay in the place where he has been so degraded, even after his formerly misbehaving pals become sympathetic.

At the end of the story he has fallen back to his original level of intelligence--and may continue to decline, if we take the suggestion from the fate of his fellow subject, Algernon, who rises, falls, and then dies. Charlie has only a dim memory of having done something important. His self-esteem is strong, however, and he decides to leave his familiar world and find a place where people won't know about his embarrassment.

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Sidney Winawer is a New York physician specializing in gastrointestinal cancers. When his wife, Andrea, is diagnosed with stomach cancer, he is made to see his own work from a new perspective, that of the patient and her family. The experience gives him new insights into aspects of health care he had not considered before, such as the alienating effects of some hospital routines on patient and family, the patient's need to find hope from any source, regardless of its intellectual provenance, and, encouragingly, the life-enhancing effects on his family as they join Andrea in her determined struggle to prolong and enrich whatever time remains for her.

For the first time, Winawer explores alternative and complementary approaches to cancer treatment, including meditation, antioxidant therapies, hyperthermia, and other attempts to stimulate the immune system. At first resistant, he comes to recognize the need for the terminally ill and their families to have access to as many resources as possible, and eventually it becomes his "mission" to emphasize the need for practitioners of conventional medicine to learn as much as possible about integrative medicine.

An interesting subplot is the story of Dr. Casper Schmidt, Andrea's psychiatrist, whose remarkable knowledge of new treatments for terminal illness is explained when he dies of AIDS. As another physician led by personal experience of disease to explore beyond the boundaries of conventional therapies, Schmidt forms an illuminating counterpoint to Winawer himself.

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Dr. Tom More, from Love in the Ruins (see this database), now middle-aged, returns to Feliciana after spending two years in prison for selling prescriptions of Dalmane and Desoxyn at a truckstop. On his return to his psychiatric practice, More observes that two of his former patients are acting strangely. In his own words: "In each there has occurred a sloughing away of the old terrors, worries, rages, a shedding of guilt like last year's snakeskin, and in its place is a mild fond vacancy, a species of unfocused animal good spirits." (21)

More observes that his wife Ellen and his children have also undergone some mysterious personality change. More, the scientist-physician, with the help of his cousin Dr. Lucy Lipscomb, launches a search for the cause of these and other observations. More and Lucy discover that John Van Dorn, head of the computer division of the nearby Grand Mer nuclear power plant and Dr. Bob Comeaux, director of the Quality-of-Life Division of the Federal Complex overseeing euthanasia programs, are involved in social engineering, releasing Heavy Sodium into the water supply to "improve" the social welfare.

Throughout the novel, Dr. Tom More returns several times to evaluate and talk with Father Rinaldo Smith, a parish priest who has exiled himself to a firetower overlooking the vast pine forest of Feliciana. More has been asked by Comeaux, who sits on the probationary board overseeing More's return to practice, to declare Father Smith crazy, so that Comeaux can take over Father Smith's hospice and put it to better use. The conversations between More and Father Smith contain the philosophic and moral themes that support the plot and action of the novel.

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In 1984 Handler was a moderately successful 23 year old New York City actor, when he developed acute myelogenous leukemia. Strongly supported by his girlfriend and family, Handler underwent induction and, later, consolidation chemotherapy at Sloan-Kettering Memorial Hospital, where he also began his long experience (the "comedy of terrors" or, perhaps more appropriately, the "tragedy of errors") of a harsh, hostile medical environment populated by arrogant physicians, condescending nurses, and a host of unhelpful minor characters.

Handler carries us briskly through his first remission, the impact of his illness on his family and personal relationships, his experience with nonconventional healing (Simonton Cancer Center), his return to work on Broadway, his relapse, and the agony of a second round of induction chemotherapy at Sloan-Kettering.

Subsequently, he goes to Johns Hopkins Hospital to undergo the rigors of an autologous bone marrow transplant. At Hopkins he discovers to his surprise a medical setting far different from Sloan-Kettering: communicative, compassionate physicians and a patient-centered healing environment. Even the two hospitals' sperm banks reflect this radical difference in approach.

After surviving his transplant and a subsequent round of serious infections, Handler resumes his life. He realizes that most of the time nowadays he is not in touch with the sense of joy and gratitude for each moment that the illness taught him. Yet, these feelings exist below his consciousness; sometimes he steps through "a little doorway near the floor of my consciousness" and experiences his life in a simpler, more profound way.

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William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.

Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.

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In his study, Professor Starr examines the evolution of the practice and the culture of medicine in the United States from the end of the colonial period into the last quarter of the twentieth century. His major concerns are with the development of authority, and the Janus image of professionalization as medicine has gained power, technical expertise, and effective modes of diagnosis and treatment and at the same time seems to be getting further from the patient.

At the time of publication, our society had finally begun to take a hard look at the impracticality and the inhumanity of continuing on the trajectory of American medicine developed one hundred years ago. Starr invites the reader to consider the impact of modern stress on the profession and, more intently, on the constituency it is dedicated to serve.

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This study explores the history of physician-patient relationships, especially as it relates to the ascendancy of science in medicine. The book begins by describing traditional physician-patient relationships in the 18th century. The focus, however, is on the "modern" doctor (beginning in the 1880's) and the "postmodern" doctor (beginning in the 1950's).

The author describes the transition from modern to postmodern doctor and a corresponding transition from modern to postmodern patient. A "sympathetic alliance" between physician and patient was essentially a development of the modern period (1880's - 1950's).

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