Summary:

Margaret Hale is raised in fashionable Harley Street along with her cousin Edith, but when Edith marries, Margaret returns to Hampshire County in the South of England to live with her mother and her father, a country clergyman. The pastoral life she has imagined is quickly disrupted by her father's confession that he is no longer able to remain true to the Church of England and will leave his position to become a tutor of adult learners in the northern manufacturing town of Milton. The traumatic relocation is exacerbated by Mrs. Hale's diagnosis with a "deadly disease" (probably cancer) soon after the move.

Margaret takes charge of most of the practical aspects of the move and then assumes charge of her mother's illness, acting as an intermediary between the doctor and her parents. As well as learning more about her own family's servant, Dixon, who has been with her mother since her girlhood, Margaret becomes friendly with textile worker Nicholas Higgins and his daughter Bessy, who is dying of consumption (tuberculosis) from inhaling textile dust. The Milton workers' activism and independence appeal to Margaret; she rethinks both class and labor relations as a result, including charitable relationships. Her strong opinions and actions bring her into conflict with the family of John Thornton, a factory owner and self-made man who is also one of her father's students.

When Margaret shields John from a stone thrown by a striking worker, however, he avows his love for her. A series of obstacles to the relationship include Margaret's initial rebuff of John and her dishonesty about her exiled brother's secret return to his mother's deathbed. Before the ending brings John and Margaret back together--as well as calming the tension between workers and factory owners--Margaret experiences not only the deaths of almost everyone she loves, but also the suicide of one of the striking workers.

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James Lang was diagnosed with Crohn's disease in 1996, when he was twenty-six years old. Five years later, however, a particularly severe bout with Crohn's, including a hospital stay, dramatically changed his relationship to the disease. Lang's memoir explores his ongoing relationship to Crohn's disease, both in the context of medical reassessments and diagnostic adjustments and in relation to his personal and professional development in his first year as a tenure-track professor of college English.

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Claire, Rachel, and Allison Barber share the trauma of having lost both parents in a strange and sudden accident. The youngest, Claire, and the oldest, Rachel, also share their late mother's migraine headaches. The novel's focus is Rachel's disappearance and Claire's search for her through North America, Europe, and Mexico. By herself and eventually with the help of Rachel's friend and sometime lover, a massage therapist named Brad Arnarson, Claire traces the steps of Rachel's professional (as a freelance science journalist) and personal meetings with researchers and health practitioners who work on migraines.

Initially, Claire's search is motivated by concern for Rachel and intensified by fears that Rachel's worsening migraines may have caused her to take desperate action. Her need to find Rachel is inevitably intertwined, however, with her own migraine experiences and with her drive to individuate within her family and her longterm relationship with her partner Stefan.

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The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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This DVD, a documentary of a medical student retreat to a museum, illustrates an approach to cultivating empathic understanding in medical students and residents by using the visual arts.  Florence Gelo, D.Min, created the arts program and the video. She is Behavioral Science Coordinator, Family Medicine Residency, Drexyl University College of Medicine. Students observe closely four paintings and are encouraged to experience their feelings about what they are seeing, and to express those feelings. The paintings are Prometheus Bound (Peter Paul Rubens 1618), Massacre of the Innocents (Pacecco de Rosa 1640), Rachel Weeping (Charles Wilson Peale 1618), and The Agnew Clinic (Thomas Eakins 1889; see annotation in this database).

Prometheus Bound is a disturbing scene of an eagle ripping the liver out of Prometheus. Students comment on the nakedness. the vulnerable position and the helpless expression on the face of this strong man, and on the eye contact between the eagle and Prometheus. In Massacre of the Innocents Dr. Gelo calls our attention to the faces of the mothers, helpless to save their children from the swords. In Rachel Weeping Gelo asks the students if they noticed the vials of medicine before the days of allopathic medicine.  Did they notice the one tear dropping from Rachel's face? (Peale added the medicine vials and his wife weeping to the original portrait of his infant daughter Margaret who died of smallpox.)

Two physician speakers, Horace DeLisser, and Rhonda Soricelli provide additional commentary about how engagement with a painting is similar to engaging with a patient, and how learning technology-focusing on the scientific and the medical- detracts students from learning to look at the big picture and the humanistic side of medicine.  Traditional medical education does not teach doctors to be present to patients, to sit by their sides, to listen and invite dialogue of suffering and to not deny those aspects of what it means to be ill.  Dr. DeLisser further acknowledged his personal struggles with feelings of frustration, anger and grief when patients died in the ICU.  The importance of talking about the vulnerability of physicians, the concerns about what else they might have done, propelled him to develop Grieving Rounds.

A cancer survivor contrasts a "callous" physician's response to her care with  another physician who exemplified someone who has the expertise not only around the disease, but  has the ability to acknowledge the whole person and offer his companionship to be there to the very end: "...what we're going to do is....We'll take this step by step."

 

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The Island is a collection of three stories sharing a similar setting (Italy) and populated by several characters who are outcasts. In the title story, the relationship between residents of an island and its medieval monastery, the Certosa, decays over time. When a talented stonemason is accidentally injured, his damaged senses are replaced by pain and suffering. His struggle and sacrifice, however, ultimately result in redemption for all those who inhabit "The Island."

In the eighteenth century, a 20 year old leper is condemned to live the remainder of his life in a tower fittingly known as the Tower of Fright. Although befriended by a stranger, the occupant of "The Tower" must nevertheless endure solitude, and he does so with the patience and grace of a saint. With the backdrop of a plague, "The Second Coming" is a medieval tale that recounts the torture of a doubting priest, an unknown pilgrim’s participation in a miracle, and the death of a pope.

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Leprosy looms large in this story about transformation and loss set in post World War II Japan. A nineteen-year-old pearl diver notices a numb red spot on her forearm. Later on, another blemish appears on her lower back. These two lesions are manifestations of a mild case of leprosy. Her infection will be arrested by medication and never get any worse. The girl is forcibly transported to the Nagashima Leprosarium, an island where she will spend the rest of her life except for a few brief excursions and one extended "escape" at the age of sixty-four.

Despite the introduction of new and effective drugs--Promin (sulphone) and dapsone--authorities still fear allowing the leprous patients to return to society. Inhabitants of the sanatorium are admonished on arrival that their past is erased. Each individual must begin a new life and select a new name. The protagonist chooses the moniker Miss Fuji. She is a kind and sensitive young woman who eventually functions as a nurse and caregiver for the other patients incarcerated in the sanatorium. As a punishment, Miss Fuji is required to attend abortions and dispose of the dead fetuses.

As the decades pass, conditions on the island improve. The number of residents with leprosy still living there dwindles from about two thousand people to six hundred. Even a bridge connecting Nagashima to the mainland is constructed. It no longer matters. Emotional and psychological barriers remain. When Miss Fuji has an opportunity to create a new life for herself away from the sanatorium, she still returns to the place and the people that have been her home and family for so many years.

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John Ames narrates this story in the form of a lengthy letter to his young son. Ames is a 76-year-old minister suffering from angina pectoris and heart failure. He has spent almost all of his life in Gilead, a small town in Iowa. His first wife died during childbirth along with a baby girl. Ames remarried a younger woman who is now 41. They have a son almost 7 years old.

Because Ames believes his death is close at hand, he pens a missive to the boy. Its purpose is to teach his son about all the important things in life Ames may not be around to share with him. During the course of composing the letter, Ames reflects upon his own existence. He recalls the experiences of his father and grandfather who were also ministers.

Reverend Ames likes to think, read, and pray. Born in 1880, he has lived through three wars, the Great Depression, a pandemic of influenza, and droughts. His hope is that his young son will grow into a brave and useful man.

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Subtitled "Tuberculosis and the Social Experience of Illness in American History," the book chronicles the medical and societal treatment of tuberculosis in the United States from the perspective of individuals who suffered from the disease. The author includes illness narratives derived from letters and diaries of the afflicted; her analysis spans the period in American history from the nineteenth through the first half of the twentieth century.

The book is divided into four sections. Part I, "The Invalid Experience: New England Men, 1810-60" and Part II, "The Female Invalid: The Narrative of Deborah Vinal Fiske, 1806-44" reveal an interesting contrast in the medical/societal treatment of tubercular men and women, and the resulting differences in their lives as "consumptives." Whereas men were expected to seek a cure by embarking on sea voyages and other travel, women remained at home and sought to control the disease by adjustments in domestic life. For men this meant major disruption and even change of career along with a sometimes exhilarating change of scene; for women it meant relentless anxiety and elaborate coping strategies.

Part III, "Health Seekers in the West, 1840-90" describes the role of cure-seekers in the westward migration and demonstrates how the culture of the time, an optimistic faith in nature and in the economic promise of the newly settled western territories, was reflected in the treatment regimen for tuberculosis. Interestingly, much of the promotional effort to bring "consumptives" west was initiated by physicians who were themselves tubercular.

The final section, "Becoming a Patient, 1882-1940," moves into the modern era with the discovery of the tubercle bacillus, public health measures, and the illness narratives of people who were confined in sanatoriums. Rothman points out that this period marked a transition away from the patient’s ability to understand and determine his/her treatment to one more like the current one in which the medical establishment is the authoritarian "expert."

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This beautiful poem appears in a section called "Sequence, Sometimes Metaphysical." It is a penetrating rendering, at one and the same time, of "pure despair" and of transcendence; of the curse and simultaneous exaltation of heightened awareness; of the personal experience of "madness," "my shadow pinned against a sweating wall," "the edge is what I have," and of a more profound soul-searching that contemplates union with nature and with God: "I climb out of my fear / The mind enters itself, and God the mind, / And one is One, free in the tearing wind."

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