Summary:

This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.

Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.

Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?

One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).

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This large, wide-ranging anthology is subtitled Poems for Men. The editors consider 16 aspects of male life and experience, and present groups of poems illustrating each aspect. Each section is introduced by a few pages of commentary. Representative sections include Approach to Wildness, Father's Prayers for Sons and Daughters, War, I Know the Earth and I Am Sad, Making a Hole in Denial, Anger Hatred Outrage, Earthly Love, and Zaniness.

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Born in 1728 the tenth child in a struggling Scottish farm family, John Hunter was a wayward and unteachable child who spent most of his time outdoors. At the age of 20, with no prospects and having lost his father and 6 siblings, he wrote for help to his older brother William, who was practicing midwifery in London and had just opened England's first anatomy school, one featuring the revolutionary opportunity for students to dissect their own cadavers.

John rode the 400 miles to London on horseback, apprenticed with great success under William, learned dissection, then surgery, and went on to become a supremely gifted anatomist and surgeon, one whose brilliant and tireless experimentation broke with ancient and outmoded medical traditions and established the foundation for modern science-based surgery. (When John arrived in London, the city's Company of Barber-Surgeons had only just dissolved to allow surgeons to organize themselves independently of barbers.)

One of his most important activities in working for his brother--and which continued when he made his own way--was the procuring of cadavers, which because of the customs of the time involved him intimately in the grisly business of grave-robbing.

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This biography begins on April 20, 1995 when the ashes of Marie and Pierre Curie were transferred from their graves in a Paris suburb and re-interred in the Pantheon, thereby placing the Curies among the "immortals" of France. Thus, Marie became the first (and so far the only) woman to be honored in this way. Goldsmith's biography is a straightforward and well-written narrative that eschews hagiography, wordiness, and psychological interpretations.

The story of Marie Curie (1867-1934) is well known. Born into an intellectual but impoverished Polish family, she struggled to obtain a scientific education, first in Poland and then at the Sorbonne in Paris. While a graduate student, she met and married the young chemist Pierre Curie. Together, with essentially no funding and dismal laboratory space, they discovered and characterized radioactivity. Later, on her own Marie discovered and isolated two new elements, polonium and radium. Subsequently Marie and Pierre created the Curie Institute, where Marie was in the forefront in envisioning medical applications of radioactivity and radium.

The story is especially powerful in its depiction of bias against women in science. Marie had to fight for many years to obtain a faculty position at the Sorbonne (unheard of for a woman), or even space to conduct her experiments. When the Nobel Committee awarded its 1903 Prize in Physics, Pierre had to fight to have his wife included in the citation, even though the bulk of the brains and energy behind the discovery of radioactivity were clearly Marie's. Marie was later vindicated when she won her second (and solo) Nobel Prize in 1911 for the discovery of radium.

Obsessive Genius doesn't shy away from Marie Curie's recurrent clinical depressions, which began during her adolescence, nor from her obsessive, hard-driving personality. The book presents an even-handed picture of repeated conflict between her love of her husband and children (one of whom, Irene Joliet-Curie, in 1935 became the second woman scientist ever to win the Nobel Prize); and her passion for her work.

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This concise and well-written biography is meant to be, as Sherwin Nuland tells us, "a guide for the perplexed," for those who may recognize the name of Maimonides and his historical importance to Jewish religion and culture, or who may even have read some of his works, but have no knowledge of the man behind the name. The story begins, as it should, in Medieval Spain with its vibrant Judaeo-Islamic culture, in which the historical relationship between Judaism and medicine developed and later expanded throughout the European and Islamic worlds. Though they were outsiders in both civilizations, Jewish physicians became the most sought after healers in the Christian and Muslim worlds.

Moses son of Maimon (also known as Maimonides and the Rambam, 1138-1204) was born in Cordoba, the cultural and political center of Muslim Spain. He and his family had to flee Cordoba to avoid persecution in 1148. They wandered through Spain until 1160, when they settled in Fez, Morocco. Again fleeing from persecution, Maimonides moved to Fustat, Egypt, when he was 30 years old and remained there for the rest of his life. During these early years, the young rabbi wrote numerous biblical commentaries, culminating in the Mishneh Torah, his great code of Jewish law. Later, he attempted to reconcile faith with reason in another great work, The Guide for the Perplexed, completed in 1190.

Maimonides's specifically medical work is difficult to characterize and evaluate. The traditional historical assessment is that he was "unique in his time in the theory and practice of medicine." Essentially, he practiced Galenic medicine, as transmitted and developed in the flourishing Islamic tradition. We don't know how he acquired his medical knowledge, but by the time he reached Fustat, Maimonides was acknowledged to be a leading physician and in 1190 he was appointed personal physician to the vizier of Egypt. Late in life, Maimonides wrote a number of medical treatises, most importantly his Medical Aphorisms, which presents a coherent, well-organized, and practical medical system based on Galen and Aristotle.

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The documentary film opens with the filmmaker, Susan Smiley, in search of her mother, Millie, who suffers from paranoid schizophrenia and who, once again, has disappeared into the woefully inadequate public health care system of middle America. Through old photographs and home movies, interviews with family members and health care professionals, and voice-over and direct narration by Smiley herself, the film chronicles the descent of a young, beautiful woman in her twenties into severe and chronic mental illness.

When Millie’s marriage to their father fails, Susan and her younger sister, Tina, are essentially abandoned to endure severe physical and emotional abuse by their mother. As the years unfold, Millie eventually loses her home and embarks on a journey of evictions, arrests, hospitalizations, and homelessness. At what seems to be Millie’s lowest point, warehoused in a nursing home where she is angrily refusing to take any medication, her daughters intervene, petition for guardianship, and navigate the system on behalf of their mother.

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The devoted, and antagonistic, bond between a dramatic, charismatic widow (Shirley MacLaine) and her quietly rebellious daughter (Debra Winger) is the focal point of this film's exploration of a range of human relationships and their changes over time and under various pressures, including that of serious illness. The major focus of the last part of the film is the illness and death of the daughter from cancer and its impact on her mother, her husband and children, and their immediate circle of friends and lovers.

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A variety of figures, all of them Tahitian, sprawl across the wide frame of the painting, each engaged in a particular and significant act. In the center of the image, a man wearing a simple loincloth picks an apple from the top edge of the image. To his right, a nude person examines his or her underarm, two clothed women in the background walk together with their arms around one another, three women sit together around a babe, and a dog looks inward from the exterior of the right edge.

On the left of the apple-picking man, two white kittens play with one another next to a clothed young girl who eats an apple. Behind her lies a goat. In the far background stands a blue religious statue, to the right of which stands a lone fully clothed woman. At the far left of the painting, a dark-skinned unclothed old woman sits with her head in her hands, next to a seated, nubile young woman with firm, full, bare breasts. A white bird sits to their immediate left.

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A 110-ton, 33 foot by 60 foot elliptical sculpture of stainless steel plates welded together with almost invisible seams, polished into a smooth rounded shape like an enormous glob of mercury. It rests in Millenium Park in Chicago, where its organic form has earned it one of those epithets so damningly accurate it becomes an endearing nickname: informally, the piece is called The Bean. The concave shape has a 12 foot high arch, through which spectators can walk into a 27 foot high chamber.

This central curvature is called the "omphalos": omphalos is a term that can mean center or hub, or a raised prominence within the base of an object (its literal meaning here), but also has connotations of a navel or a belly. Like a mercury Henry Moore, this piece refines the human form into its most basic curves: "Cloud Gate" is so titled by Kapoor because it invites the sky and clouds into the city, but it is also a body, kneeling perhaps, with the sky above and the reflected bodies of those walking under it cupped in its belly.

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This is a comprehensive social history of European (or "Western") attitudes toward death and dying over the last thousand years. Ariès organizes his history into five sequential cultural constructs, each of which conveys the meaning of death to the individual and community, as well as the social institutions around death and dying, during a different period of Western history, beginning in the Middle Ages.

Cultural responses to death must begin by acknowledging that death is mysterious and overwhelming; a wild beast; a meaningless monster. Death lurks at the edge of our consciousness, ready to destroy us and demolish whatever meaning we attribute to our lives. In medieval Europe Christianity had domesticated this monster by establishing a comprehensive set of beliefs and practices that Ariès calls the "tame death." Death was merely a transition to eternal life. The individual was understood as an integral part of the community and not as autonomous and isolated. Therefore, death and dying were communal events, supported by specific prayers and practices (i.e. ars moriendi) that "tamed" the unknown.

In the centuries that followed, Ariès's "tame death" evolved through five stages into the radically different cultural conception of death that characterizes Western society--especially in its American form--today. These changes result largely from the gradual replacement of community-oriented personal identity with today's radical individualism; and the gradual sequestration of death to a position behind the scenes, so that dying and death become remote from ordinary experience.

In today's world we encounter "invisible death," a somewhat paradoxical name because its invisibility allows the savage beast free rein. Death is no longer "tame" because we deny its existence so effectively we no longer develop personal and communal resources to give it meaning. Death's invisibility enhances its terror; our culture's loss of spirituality enhances death's meaninglessness.

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