Summary:

Film clips of Cary Grant as the consummate anatomy professor in 0100 (see this database) are interspersed with comments from contemporary gross anatomy students, two medical school faculty intimately connected with dissection and the body donation tradition, and a live body donor. In what ways "yes" and "no" could both be proper responses to the statement, "A cadaver in the classroom is not a dead human being" is the key premise, beautifully presented in the cut-aways, organization, and editing of this piece.

The structure of the film is an as-if dialogue between young dissectors and soon-to-be cadaver (the body donor). Interviews heighten and explore the relationship between the living and the dead--and not just medical students and body donors. The medical students do not speak directly with the future donor, though we see him shaking hands with them, visiting (and speculating on) the spot where his remains will eventually be deposited. The video concludes with a moving annual ritual, the disposition of body donors' cremated remains at sea.

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This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of anesthesia or sedation. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."

It is this power, the fear of this power felt by both the doctor and the patient, and, by extension, the fear of anesthesia or sedation, that form the heart of the poem. The narrator states that he cannot let his own fears about anesthesia and "loss of control get in the way." Instead he accepts the power and control that the patient gives him and "bring[s] him down."

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A stern, old doctor (Victor Sjostrom) is preparing to travel by car to Lund to receive an honorary degree. He has a disquieting dream in which he perceives his own death as the frightening, lonely end to a hollow existence. In the morning, his gruff demeanor is considerably altered by the intimations of mortality. His daughter-in-law (Ingrid Thulin), who has inexplicably been visiting, decides to accompany him to Lund. En route they encounter a trio of mirthful teenagers, a bickering married couple, and grateful patients. They also visit the doctor's mother.

The dream and the journey unleash a recurring flood of memories of youthful summers at the family home among the wild strawberries and of his unrequited love for a beautiful cousin. He learns that his daughter-in-law is pregnant, but his only son is about to repeat his mistakes by rejecting an emotional bond with his wife and his future child in the empty pursuit of professional achievement. The pregnancy is the reason she left her husband to visit his father. At the end, the doctor establishes a small but real rapport with his son and achieves a degree of understanding about his own life.

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The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.

The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.

Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.

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The front cover of this collection shows the outline of Africa completely filled with the names of patients ("Tyra Lynette Deja Nya Rovert Marqui Fatima Terry Alexia Michon Ty . . . ") On the last page, poem #120 consists of an outline of the United States of America, also completely filled with the names of patients, also African. The poems in this collection constitute a journey through these Dark Continents, both of which lie within.

Kelley Jean White stakes out her territory very clearly: "I suppose I embarrassed you / at all those mainline / plastic surgery parties / talking Quaker and poor and idealism" (3). There are no elegant parties, nor plastic surgeons, after page 3. Instead, persons like Shawanda live here: "At seventeen, Shawanda has never spoken. / Her brother easily carries her frail body / into the exam room--37 pounds" (36). And the nine year old girl who delivers her baby by C-section: "The nurses said it was the worst thing / they’d ever seen . . . She took her to her grandmother’s home / to raise. / The man did time / for assault." ("Freedom," 55)

But the poet hasn’t lost hope at all. She is filled with love and humor and imagination: "I dream I’m marrying this guy I used to work with who spent a lot of money on his hair" (73). "I musta been looking pretty down / when I left you today . . . " because the legless man pulling his wheelchair to his favorite begging spot said, "love, you gotta be always looking up . . . I just smiled and looked at / my too big shoe feet" (118).

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The narrator of the story, a former district doctor in Russia, reminisces about his frequent encounters with patients suffering from secondary syphilis ("the speckled rash"). The first case he diagnoses is a 40-year-old man seeking treatment for a sore throat. The doctor recommends the application of a bagful of mercury ointment once a day and a follow-up visit after 6 days, but the man never returns. The physician advises him that his wife needs to be examined also, but she is never seen in the clinic.

The doctor remembers many other cases of secondary syphilis in the community. Except for one young woman, patients seem to have little fear of the disease. Children and even entire families are infected. The physician decides to tackle the widespread venereal disease and to confront the rampant patient apathy in the district.

His weapons include mercury ointment, potassium iodide, Salvarsan (an arsenic compound) injections, harsh words, and warnings about the horrible effects of the disease if left untreated. He opens an inpatient unit to treat patients with syphilis. Now long-removed from that remote medical outpost, the narrator still wonders about the people living there.

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Fifty-two year old Pete, the hospital mailman, suddenly experiences severe abdominal pain. He is evaluated and treated in the emergency room. His diagnosis is acute surgical abdomen, but the exact cause of his pain is still unknown. The surgeon-narrator determines that the severity of Pete's condition mandates exploratory surgery. During the operation, "an old enemy" (18) is encountered--pancreatitis.

Afterwards, the surgeon assures Pete that he will get better. One week later though, the mailman dies. His death has been painful. An autopsy is scheduled, but the surgeon deliberately arrives 20 minutes late. He does not want to view the intact body of his deceased patient. No matter, the pathologist has waited for him to arrive before beginning the post-mortem examination. The pathologist closes Pete's eyelids before starting the autopsy, mindful of how the mailman's "blue eyes used to twinkle" (21) when he delivered the mail everyday.

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Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

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Kirk, a man in his 50s with highly metastasized kidney cancer, presents himself to Dr. Groopman after having been turned away as a helpless case by several respected cancer clinics. He tells Groopman that he is a risk-taking venture capitalist and is willing to take any medical risk on the chance that it will save him. After pondering the ethics of the situation and the nature of informed consent under such conditions, Groopman agrees to treat Kirk. He proceeds to devise a highly risky (and untried) combination of chemotherapeutic agents. The course of treatment is excruciatingly difficult, but the experiment succeeds, and Kirk's cancer goes into complete remission.

Kirk calls it magic, a miracle, and the hospital interns call it a "fascinoma," a case defying normal expectations. Groopman releases Kirk to home and weekly checkups with a local internist, but in doing so he notices that Kirk's mood has mysteriously changed. He has lost the "piss and vinegar" of their earlier contact. Kirk continues to improve physically, traveling and playing golf and even tennis, but Kirk's wife soon reports that Kirk has stopped reading the newspapers he used to devour, which now collect in their driveway.

Several months later some physical symptoms return, and Kirk's cancer is back. A month later he is dead. In talks with Kirk near the end, Groopman discovers that Kirk's brush with death had brought with it a new and sharply negative view of himself as selfish and disconnected from the world and other people. Suddenly all his financial success seemed to him "pointless," and, since his life contained nothing else, it seemed to him a waste, and he felt it was too late to live it over. What Kirk ironically calls "my great epiphany" seems to have undone his doctor's "magic."

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The physician-narrator celebrates his 24th birthday in the company of two midwives and a feldsher (physician’s assistant). They toil in a remote area of Russia where conditions are harsh. The doctor tells the group about a peasant woman who requested a refill of belladonna (an atropine-like drug) that was prescribed for stomach pain the day before. Although the instructions were to take five drops as needed, the bottle was completely empty already. Since the woman had no signs of belladonna poisoning, the feldsher concludes she shared it or maybe even sold it to other villagers.

The group shares other stories about patient mistakes and misguided beliefs. That same night a man comes to the doctor’s house. He is a miller suffering from recurrent fevers. The physician diagnoses malaria and remarks how sensible and literate the patient is. Powdered quinine is prescribed to be taken once a day before the onset of fever. Soon the doctor receives word the miller is dying. The patient has defied the instructions and taken all 10 doses of quinine at one time to expedite his recovery. His stomach is pumped, and he survives the overdose.

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