Summary:

This novel is narrated by Katie Carr, who very much wants to be a good person.  She is a physician and a mother of two, and lives with her petulant husband, David.  David is the author of a column in the local newspaper called "Angriest Man in Holloway".  As their marriage falls apart, David undergoes a conversion at the hands of GoodNews, a young guru, and ceases to be sarcastic and angry, embarking instead on an effort to improve the world with acts of kindness.  Katie is forced to consider what it means to be a good person and how that affects whether to salvage her marriage, how to raise her children and how to be the type of physician she always considered herself to be.

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The young pathologist David Coleman (Ben Gazzara) arrives to join a hospital pathology lab. He encounters disorganization and a hostile, cigar-smoking chief, Joe Pearson (Frederic March), who declares his intention to keep working until he dies. Coleman tries to implement a few changes, but his suggestions are overruled.

The film revolves around two cases: possible erythroblastosis in the child of an intern and his wife whose first child died; possible bone cancer in Coleman's girlfriend, student nurse Kathy Hunt (Ina Balin). The infant's problem is misdiagnosed due to Pearson's refusal to order the new Coombs' test recommended by Coleman; the baby nearly dies, alienating the obstetrician (Eddie Albert), a long time friend who now presses for Pearson's dismissal.

Coleman disagrees with Pearson, who thinks that Kathy's bone tumor is malignant, but he opts for professional discretion, defers to the chief, and urges her to have her leg amputated anyway. He discovers that Pearson had been right: the surgery, which he thought unnecessary, has provided her with her only chance of survival. Just as Coleman realizes the enormity of his error, he learns that Pearson has resigned and that he will take over the lab.

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Although the setting is startlingly different, and the care provided is through highly unorthodox means, the healer in this science fiction story experiences in remarkably similar ways the everyday wear and tear of modern medical practice. Snake, a young female itinerant healer, has been asked to save the life of a young boy. Her attempts to do so, and her interactions with the boy, his family and community, and the tools of her trade (the snakes-mist, sand and grass) are detailed in the story. "Professional development" issues that this strong and complex character has to deal with include truth-telling, interfering and ignorant family members, self-sacrifice, and possible reprobation by her peers and teachers.

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Gathered from four years of volumes of the journal, Annals of Internal Medicine, this collection of short prose essays and poetry written by health care providers (largely physicians) covers almost the entire range of the experience of doctoring, from personal illness and illness in the physician’s family, to all the joys and sorrows inherent in practicing medicine. Seventy-three entries make up the collection, which has been divided into six categories: The Doctor Trains and Lives His Life; She Relates to Family and Friends; He Deals with His Own Illness; She Relates to Her Patients; He Confronts Death; They Find Doctors Good and Bad; and Search for a Mentor. The longest essay is less than six pages in length and most of them are two to three pages.

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Amelia Stern is an academic pediatrician in a large city hospital and mother of a bright, young son. She is deeply involved with her patients, including Darren, born with AIDS, and Sara, the malnourished child of anxious parents, both lawyers. As she struggles to answer to the demands of her work for "other women’s children," she neglects her own child and her marriage begins to fall apart. Her husband’s resentment and her own feelings of guilt come to a crisis when her son falls seriously ill while she is at the hospital.

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Summary:

Aurelio Escovar is introduced as a poor dentist without a degree. He is busy polishing false teeth early one morning when the mayor arrives to see him. At first he refuses to see this would-be patient, until the mayor, who has been suffering severe toothache for five days and is desperate, threatens to shoot him. Eventually the dentist lets him in, examines him, and then removes the infected wisdom tooth, without anesthesia.

We realize that the dentist has deliberately made the mayor suffer all this time, and he gives the reason as he pulls out the tooth, saying "Now you’ll pay for our twenty dead men." When the mayor has recovered and wiped his tears, he leaves, telling the dentist to send the bill. When Escovar asks whether to send the bill "To you or the town?," the mayor replies, "It’s the same damn thing."

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In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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Middlemarch is a middle-sized country town typical of rural British life in the early nineteenth century. George Eliot (born Mary Ann Evans) was part of the realist school that dominated Victorian literature. She tried to create a true representation of the real, historical lives of ordinary people.

The novel has a vast number of characters and events but most of the plot centers on two couples: Dorothea and Casaubon (later Will Ladislaw) and Rosamond and Lydgate. Dorothea is an intelligent, vigorous woman, eager to improve the lives of her friends and the poor. She is determined not to marry any of the local, mindless squires but to devote herself to godly work.

Soon, however, she is introduced to Casaubon. Casaubon is an aging, ugly scholar, but Dorothea is attracted by his learning and agrees to marry him in hopes of helping him in his work. Their marriage is unhappy and cold. It is contrasted to Dorothea’s growing relationship with Will Ladislaw, a distant relative of Casaubon. Where Casaubon is cold, Will is passionate. Casaubon senses the kinship between his wife and Will and adds a codicil to his will insisting that if Dorothea and Will marry after his death than Dorothea must give up Casaubon’s house and money.

Shortly thereafter, Casaubon does die, and Dorothea is outraged upon hearing of the codicil. She does not recognize her feelings towards Will as feelings of love. By the end of the novel, however, the two confess their feelings and Dorothea gives up her earthly possesssions to live happily.

The plot developed around Lydgate and Rosamond is of particular medical interest. Lydgate is a new kind of medical practitioner. At the beginning of the nineteenth century, the traditional medical order, consisting of physicians (like modern consultants), surgeons, and apothecaries, was being replaced. New well-schooled general practitioners could perform all these functions.

When Lydgate arrives in Middlemarch with his modern techniques and visions of building a modern hospital for the poor, the medical establishment greet him with jealousy and suspicion. Lydgate’s practice therefore develops very slowly. His marriage to Rosamond, a woman used to a rich lifestyle, quickly depletes his savings.

Facing bankruptcy and the loss of his disappointed wife, Lydgate receives an unexpected loan from Bulstrode, a wealthy landowner. Soon after, Bulstrode is charged with murder and Lydgate is accused of having a hand in it; Middlemarch sees the loan as a payoff. Disgraced, Lydgate cannot fight back. He becomes a doctor who toadies to the wealthy and abandons his revolutionary dreams. He dies at 50.

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The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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This poem, written in five sections of free verse, begins with the speaker remembering the old steel bridge he used to drive over on his way to work. He describes how the gaps between the steel beams had given him access to the world beyond the bridge: he had been able to see the river bank and railroad tracks and, most importantly, the people down there, "wild dangerous men" living near the edge of the river.

The poet next describes the new bridge, with its smooth speedy surface and solid concrete sides concealing the view. He then steps back and reflects: "what now?" He compares the engineer making the bridge with his own writing, "diminish[ing] the homeless to a poetic abstraction," and asks where this leaves him. Both bridge and abstraction, he implies, take the life, untidy and dangerous but valuable, out of his experience of crossing the Missouri.

He cannot view the material for his poetry now, unless he were to stop, back up the traffic, and risk his life climbing the walls of the bridge, and even then he does not know what he would say, because the new bridge has made him realize something about himself: "I am partly the leech come to feed, / yet I cannot waver from my groove." As a poet, he needs access to the lives of others, an access he likens to parasitism. But his career, the work to which he is going, requires him to speed on across the bridge without pausing.

He now elaborates on his distance from the world of the homeless people (and, by implication, all the other material for his poetry), saying that he has "safely bled away the guilt, / and pity and compassion," from his involvement or complicity in the meaning of his material, and "channeled it" into the poem. The leech image is now applied to the poem which, once filled with those ambivalent emotions, becomes separate from the poet and attaches itself instead to the reader, who now becomes the one feeding on the "dark spurt of old blood," the horrifying riches of which the speaker has rid himself.

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