Summary:

A college professor who suffers from Tourette's disorder deals with two challenging students in his English 101 class. Having spent years in therapy, Professor Jorge is now fairly content with his life in spite of the frequent vocal and motor tics that he labors to suppress. Allen Ramsey is the freshman prodigy who induces Jorge to reassess the implications of his existence. Anna is an undergraduate who is preoccupied with death. She has a crush on Jorge and leaves a suicide note in his office box.

One day Allen is late for class because he has a seizure. His seizures increase in frequency, but Allen doesn't mind them. He relishes them. Allen acknowledges that "It's as though I can smell my thoughts" during a seizure and "the world just changes" (170). Jorge finds Allen on the campus ground in a postictal state. He summons an ambulance, and Allen is admitted to the hospital.

When Allen returns to class weeks later, he is no longer the same person. With the use of medication and possibly surgery, doctors have abolished his seizures along with his former personality. Allen receives an "Incomplete" grade for the class. The semester's experience has Jorge lamenting Allen's shocking transformation, attempting to convince Anna of life's worth, and mulling the magnitude of his words.

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This great literate novel is the tale of Hans Castorp, the "delicate child of life" whom we first meet at age 23, ambivalently embarking on a career as a ship-building engineer in his home city of Hamburg, Germany. Before beginning his professional work, however, he journeys on what is intended to be a vacation and a pro forma visit to see his tubercular cousin, Joachim Ziemssen, at a sanatorium in the mountain town of Davos, Switzerland. Yet as the train pursues its course through the alpine scenery, Hans and the reader become aware that this is no ordinary journey. The impressionable Hans is transported away from the life and obligations he has known, to the rarefied mountain environment and insular community of the sanatorium.

At first uneasy, he soon becomes fascinated with and drawn to the routine established for the "consumptives" and to the social scene which flourishes there. Ordinary life seems increasingly unreal to him; his perceptions are heightened and he becomes aware of his physical, spiritual, and emotional vulnerability, as well as of his own sexuality. He is greatly attracted to one of the patients, a married woman of Slavic background, Madame Clavdia Chauchat. She reminds him of a schoolboy to whom he had been strangely drawn as a child. The turmoil brought on by this romantic obsession seems even to be reflected in his physical state, which is unstable and feverish.

As his intended stay of three weeks nears its close, the director of the sanatorium advises Hans to stay on to recuperate from a heavy cold, which appears to reveal an underlying case of tuberculosis. Hans is almost relieved at this news, for it provides him with a reason for remaining near Madame Chauchat as well as the opportunity to continue intriguing, profound discussions and cogitation about illness, life, time, death, religion and world view initiated by another patient, Herr Settembrini.

Settembrini is an Italian man of letters and humanist who believes that reason and the intellect must and will prevail, in daily life as well as in world affairs. He is contemptuous of the foolish flirtations and empty talk in which most of the sanatorium inhabitants indulge, and warns Hans repeatedly of the dangers inherent in cutting off all ties to real life and responsibility.

Nevertheless, Hans remains at the sanatorium for seven years, freeing himself from the constraints and conventions of life "in the flatlands" and instead engaging in a prolonged "questioning of the universe." This questioning includes a critical flirtation with death, stunningly described in the chapter, "Snow." Hans does not return home until the outbreak of World War I, in which he fights and survives.

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This story follows John and Aileen Crowley and their three children, the two youngest of whom have a rare "untreatable" genetic disease. Pompe disease gradually degenerates muscle until patients cannot breathe or sit up; it also dangerously enlarges the heart. Determined to try to save his children, John Crowley started up a biotech company to develop an enzyme that would replace the non-functioninging one in his children. Others researchers in other companies were trying different approaches. Everyone made mistakes and created problems along the way.

Finally, in "the mother of all experiments," the four promising drug developments were tested against each other in a double-blind trial. After five years of development, the "special medicine" was finally given to the Crowley children. Daughter Megan, a real fighter and outgoing personality, won over the hearts of the researchers. Interesting conflict of interest issues increase the tension in this race for a cure.

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In this novel, with the help of some friends, Gregor Samsa has survived his seeming death at the end of Kafka’s The Metamorphosis and joined a freak show in Vienna. A little man named Amadeus Hoffnung, who suffers from Werner’s syndrome (premature aging), runs this Chamber of Wonders. The human sized cockroach proves to be a big hit with the public and a good friend for his assorted colleagues, who come to admire his optimism, compassion, and sense of social responsibility. Gregor thrives, except for the festering wound in his carapace (back) that will not heal--the wound made when his father threw an apple at him during his traumatic early life in "Metamorphosis" as a human-turned-insect.

In 1923, as a result of an life-changing encounter with Ludwig Wittgenstein, and in the context of growing anti-Semitism in Central Europe, Gregor flies (literally) to New York, where he takes up residence and soon runs into Mr. Charles Ives, the composer and insurance executive, who gives him a job as an actuary. The novel describes Gregor’s subsequent adventures over the next 20 years--as a surprise witness at the Scopes trial, as the subject of Ives’s famous "Insect" Piano Sonata, and finally as the confidant of Franklin Delano Roosevelt and member of his "brain trust." Along the way, Gregor contributes greatly to the science of risk analysis and management.

In 1943, at the president’s request, Gregor joins the atomic bomb project in Los Alamos, New Mexico, where he serves as risk analyst and all-around moral questioner during the bomb’s development. Finally, Gregor Samsa, having survived 30 years as an insect, becomes physically ill as the old apple-infection turns to septicemia; and he becomes existentially ill, as he confronts the implications of nuclear warfare. He decides to commit suicide by placing himself among the instruments at Ground Zero of Trinity site, vaporizing in the explosion of the first atomic bomb; indeed, "Gregor’s was the most expensive assisted suicide in history." (p. 458)

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The story of a woman artist's slow decline into dementia and death as told through the eyes, words, and reflections of her philosophy professor son. Through his memories of their 1950s life together, he reconstructs a speculative analysis of her early married life with his soil-scientist, Russian-immigrant father.

The one older brother becomes a neuropathologist who investigates the very disease that slowly strips their mother of herself. Their father tends to her growing needs at the family farm, but he dies suddenly and she must be placed in an institution where one nurse alone seems to respect her dignity.

The brothers' rivalries and misunderstandings are recapitulated in their different responses to their father's death and their mother's illness: the physician retreats to scientific explanations of the "scar tissue" in her brain; the philosopher looks for evidence of personhood and for reassurance that death should not be feared. His obsession with his mother's condition stems from a deeply felt sense of guilt; it destroys his marriage and condemns him to depression, hypochondria, and shame as he creates and diagnoses the same illness in himself, long before it can be detected by doctors.

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Augusto and Michaela Odone (Nick Nolte and Susan Sarandon) are the adoring parents of a bright little boy who inexplicably develops alarming behavioral problems, after they return from working in the Comoro Islands. A series of investigations results in a diagnosis of adrenoleukodystrophy (ALD), but the boy rapidly deteriorates into a bed-ridden, inarticulate state. Frustrated by the medical profession's inability to help, Augusto and Michaela embark on an odyssey of salvation, studying lipid metabolism, promoting international conferences, and trying to disseminate their findings to other parents.

Their insights lead them to experiment with at least two effective therapies, one of which is erucic acid (Lorenzo's oil). Michaela feels guilt as well as grief, when she understands that the X-linked disease is passed from mother to son. In an effort to keep Lorenzo at home, she refuses to admit the extent of his disability, alienates her family, dismisses nurses, and assumes most of the care herself, nearly ruining her own health and her marriage. The film ends hopefully with tiny signs of recovery in Lorenzo. The credits roll over the faces and voices of happy, healthy-looking boys who have been taking Lorenzo's Oil.

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In four parts this book uses a wide variety of images--caricatures in newspapers, comic books, advertisements, and photojournalism of Life magazine--to explore attitudes to physicians and medical progress in the mass media from the late nineteenth century to the mid-twentieth century. Each section centers on a specific type of image and the analysis addresses change in perception of doctors and their achievements by privileging crucial moments of newsworthy events and discoveries.

Early in this history, the media portrayed doctors as frock-coat wearing fops.  Medical metaphors used in a political context proclaimed these attitudes well. The story of four little boys, bitten by a dog in 1885 and sent to Pasteur in Paris for the newly invented rabies vaccination, is used as a pivot point for a transition in perceptions of medicine: from a clumsy, suspicious craft to a useful, progressive science.

The third section is devoted to the public fascination with the history of medicine in the period from 1920 to 1950, Films, newspaper articles, and comic books chart the insatiable taste for scientific success and medical progress. The last section studies images of progress in Life and other magazines through a meticulous analysis of health-related articles. In this section, Hansen shows how the media participated in educating the public to a definition of science that enjoyed an enthusiastically optimistic spin.

An appendix lists American radio dramas about medical history from 1935 to 1953. A wealth of sources are documented in the notes and the whole is completed with an intelligent index.

 

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Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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At the request of a German editor, Charles Darwin (1809-1882) began his autobiography at the age of 67. His granddaughter and editor, Nora Barlow, tells us that he revised it over several years.

Darwin remembers little about his mother who died when he was 8, but talks at length about his forceful physician father, who measured 6 foot 2 inches, and weighed over 336 pounds. His father's success guaranteed that Charles would never have to work for a living. Darwin was a naughty boy schooled in humaneness and manners by his loving sisters. Early on, he showed a passion for collecting, mostly beetles, but also coins, shells, and minerals. He hated boarding school; he enjoyed running in the open air and shooting snipes with his dogs. He quotes his father's characterization of him as a young boy: "You care for nothing but shooting, dogs, and rat-catching, and you will be a disgrace to yourself and all your family" (28).

As a medical student at Edinburgh University, he witnessed operations without anesthesia which caused him to revolt against his father's wish that he become a doctor; he couldn't take the sight of blood.  At Cambridge, he found most of his classes and professors dull, except for his botany professor, John Stevens Henslow, his mentor and hiking companion. The paternal plan for him to become a clergyman foundered at Cambridge, as Darwin questioned the Thirty-nine Articles of the Church of England.

From 1831, he sailed with Capt. Fitz-Roy on board  The Beagle for 5 years and 3 days (again, against his father's wishes). He quarrelled with  Fitz-Roy whose mood swings required Darwin's tact. They disagreed about slavery, FitzRoy defending it, and Darwin abominating it. He carried Lyell's Principles of Geology with him, read Milton, and collected numerous specimens which he sent back to Britain.

28 months after his return, Darwin married his cousin, Emma Wedgwood. The marriage was happy and produced 10 children.

In the chapter on his religious beliefs, Darwin gives 4 reasons for believing the Old Testament to be false; as he has studied the laws of nature, he has ceased to believe in miracles. He rejects Bishop Paley's argument for intelligent design: "Everything in nature is the result of fixed laws" (87). The Christian god is cruel, as he causes innocent animals to suffer and condemns non-believers to hell. Darwin confesses he does not understand "the mystery of the beginning of all things" (94), calling himself an agnostic. He outlines the great Victorian men he has known, though his ill health has long  prevented him from traveling or seeing friends. He discusses his publications, including Origin of Species, stating he did not care whether he or Wallace got the credit for the theory of evolution. He attributes his success to his moderate abilities. He has been methodical, industrious, and commonsensical.

The appendix includes Darwin's list of pro and con arguments about marriage, Mrs. Darwin's papers on religion, and a short chapter on his illnesses.

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In the early Eocene period, a small horse (Eohippus) accidentally dies in the depths of a lake. Over time, the body of the mare decays. Heat and pressure convert the remains of the animal into oil. Thousands of feet beneath the surface of Utah and millions of years later, that oil is tapped. As it travels through a pipeline, a nearby worker is injured. As a result of the accident, the man loses part of his arm.

The worker, Djamolidine Hasanov, was born in Azerbaijan. Before coming to the United States, he changed his name to Jimmy Nash. As a boy, he loved to bicycle. As an adult in America, his pastimes include drinking beer and writing haiku. After he is injured at work, Jimmy becomes a drifter and lives off his disability benefits.

The oil derived from the matter of the prehistoric horse continues its journey through time and space. It is refined into gasoline and transported to a gas station in Austin, Texas. On June 23, 1975, some of that gasoline is pumped into the tank of a Ford Pinto. One drop of the fuel comes from the once-pumping heart of the ancient equine.

The car is driven by Clarissa Sanders, a college student who is enthralled by biology and genetics. Later that day, she picks up a hitchhiker on a highway leading to San Antonio. The man has an accent and is missing his lower right arm. Jimmy Nash shares some LSD with Clarissa. He even drives her automobile. On the same day, Clarissa inhales some soot particles emitted in the car's exhaust fumes. They contain a carcinogen - benzapyrene. Thirty years later, she is diagnosed with metastatic adenocarcinoma of the lung. Three months after receiving the diagnosis, Clarissa dies.

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