Summary:

Richard Koslowski, a 32-year-old computer systems supervisor and musician, breaks a tooth when he bites an olive pit. Although the remnant of the damaged tooth is removed during his initial visit to the dentist, Koslowski embarks on a peculiar quest. He longs to find a perfect-fitting dental bridge, to eliminate a mysterious oral pain, and to measure up to the suffering his parents have endured as survivors of concentration camps.

He eventually elicits opinions or treatment from ten different dentists and specialists. Koslowski realizes that he has sustained more than just a cracked tooth. His entire life is now fractured. Koslowski becomes obsessed with his teeth. His girlfriend, Lisa, is a law student who is passionate about women's rights. She travels to Bosnia to interview and assist rape victims. When Lisa returns, she breaks up with Koslowski. His suffering seems so small and his life so insignificant that she can no longer tolerate him.

Koslowski's father is dying of a brain tumor but remains stoic until the end. Koslowski, on the other hand, has a poor pain tolerance. After undergoing multiple dental procedures--tooth extraction, root canals, a series of gum cleanings every week, and finally dental implants--Koslowski ultimately resigns himself to living with the discomfort in his mouth. His "reward" is marriage to a disabled woman, three children, and an ordinary life filled with minor ailments and nuisances.

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This collection contains all the stories in Arthur Conan Doyle's Round the Red Lamp, six additional medical tales (three of which are from the Sherlock Holmes oeuvre), and the published version of "The Romance of Medicine" (1910), an awards ceremony address to the medical students at St. Mary's Hospital Medical School.

Round the Red Lamp (see annotation in this database) received almost universally negative reviews when it was published in 1894. They deplored the fact that Conan Doyle wrote about such "nauseating" and "ghastly" topics. All but one of the stories deal with doctors, disease, or medical practice. (The exception is a gothic tale that has a medical student as its hero.)

For example, "Behind the Times" contrasts the behavior of old fashioned humanistic physicians with that of modern scientifically-oriented physicians; "The Doctors of Hoyland" conveys a very positive image of women physicians; "His First Operation" depicts a first-year medical student fainting in the operating room; and "A False Start" presents a humorous account of Conan Doyle's difficulties in starting his own medical practice.

The three Sherlock Holmes stories are "The Dying Detective" (1913), "The Creeping Man," (1923) and "The Blanched Soldier" (1926). "The Romance of Medicine" is an inspirational essay on professionalism and medical history, somewhat similar in tone to, and contemporaneous with, the essays of William Osler.

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After being struck by a speeding car while riding his bicycle, Paul Rayment suffers extensive damage to his right leg. An above-knee amputation is performed by a young surgeon, Dr. Hansen. Paul is a 60-year-old former photographer who lives in Australia. Divorced and childless, he has no one to assist him with the activities of daily living after he is discharged from the hospital. He refuses a prosthesis. Paul's accident and loss of a limb have triggered a reexamination of his life. He now regrets never having fathered a child. Paul's life is further complicated by three unusual women.

He hires a Croatian lady, Marijana Jokic, as his day nurse and aid. He is attracted to and dependent on the much younger Marijana. Although she is married and has three children, he lusts for her. He offers to act as a godfather for Marijana's children and provide funds for their education. Drago, Marijana's oldest child, lives with Paul for a while. Drago and his father build a customized cycle to convey Paul, but the crippled man doubts he will ever ride it.

Paul has a single sexual encounter with a woman blinded by a tumor. Her name is Marianna. He is blindfolded during the affair and pays her afterwards. A novelist with a weak heart, Elizabeth Costello, intrudes on Paul. The elderly woman is mysterious. She pesters him, occupies his apartment without an invitation, and peppers him with questions. In time, all three females fade from his world, leaving Paul still struggling to adapt to loss and a new life.

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When their young son dies from kidney failure, Stewart and Sharon Mackaney funnel their grief into a business--transporting donated organs for transplant patients. Sharon has put on weight and not cut her long hair since the death of her child, Matthew. The fortyish woman likes to read about vertebrate organs in a worn copy of Gray's Anatomy. She totes a red cooler on her trips crisscrossing the country. Inside of it is a precious organ--a kidney, liver, or pancreas.

Sharon spends lots of time in airplanes, hotels, and bars. Although they continue to share a house, she and her husband have been estranged since Matthew's death three years earlier. Stew suffers from irritable bowel syndrome and chronic flatulence that began at his son's funeral and has not improved a bit despite psychiatric treatment.

Stew and Sharon receive an award for their work as organ transporters. During a speech at the fundraising event, Sharon criticizes the audience for hoarding their kidneys. On returning home, she spends time in Matthew's bedroom and later has a variation of the recurrent nightmare that has plagued her since her son's death. Sharon dreams that her hair is gone, and she rises, unencumbered, until reaching the ozone layer where she is incinerated.

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A screening chest X-ray reveals the presence of a cardiac myxoma in a 72-year-old dictator. His personal physician (fearing for his own life) timidly informs Mr. President about the tumor and the likelihood that it will claim the dictator's life in a matter of months. The physician lacks the training and ability to remove the tumor but recommends Dr. Gala Sampras as the surgeon most qualified to perform the procedure.

Slight problem: Sampras was one of 14 surgeons who "disappeared" in 1992 after criticizing the dictator and his regime. She was imprisoned and abused in a labor camp. Her husband and three children were also removed from society. A bargain is struck. Sampras will do the operation. After the surgery is done, she will be reunited with her family.

The dictator shows Sampras pictures of her family. Although the photos of her children appear to be recent, the picture of her husband seems to have been taken years ago. On the day of surgery, the dictator directs the doctor's attention to the courtyard where soldiers surround her daughter. Sampras realizes the dictator might not survive the operation given the complexity of the procedure and the patient's age. Before succumbing to his anesthesia-induced sleep, the dictator is told by Sampras not to worry, but her every move is closely monitored by his soldiers. The night is likely to be long and hard for the doctor and the dictator.

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Half-waking from surgical anesthesia, a woman named Mary realizes that she has had a breast removed. She immediately begins to imagine how this will affect her already troubled marriage. When she is fully awake, other women on the ward try to comfort her, each with a strategy for bearing up under suffering which Mary finds unacceptable because these strategies represent values about marriage, submissive gender roles, or religion which Mary cannot quite swallow.

Later, talking with her brusque surgeon and her family doctor, Mary learns that the mastectomy may not have been necessary, that the tumor was benign. At the end of the story, husband Matt hustles in to ask: "Well, baby, are you still going to divorce me?"

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A neurosurgeon looks forward to having a day off from work, but a promising Saturday brings only trouble. Henry Perowne is 48 years old and practices in London. Lately, he's concerned about the impending invasion of Iraq. Perowne's views on the situation have changed considerably after conversations with a patient who was tortured and imprisoned in Iraq for no apparent reason. A protest march against the looming war is held on Saturday.

On his way to play a game of squash that morning, Perowne is involved in a car accident on an otherwise deserted street. No one is injured and the two vehicles sustain only minor damage. The owner of the other car is a man in his twenties named Baxter. He is accompanied by two buddies. Perowne refuses Baxter's demand for cash to repair the car so Baxter punches the doctor. Perowne is moments away from a pummeling.

He notices that Baxter has a tremor and an inability to perform saccades. Perowne deduces that Baxter has Huntington's disease. The doctor capitalizes on the fortuitous diagnosis. He speculates that Baxter has kept the neurodegenerative disorder a secret from his sidekicks. When Perowne initiates a discussion about the illness, Baxter orders the cronies away so that he can speak privately to the doctor. The two men desert Baxter, and Perowne escapes in his car, hopeful he can still make the squash game.

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The narrator suffers from depression and a pain in the right side beneath his ribs. Surgery will be performed at his home by Dr. Haddon and Dr. Mowbray, but the narrator worries that he might die during the operation. During an afternoon nap on the day before surgery, he dreams of death and resurrection. Chloroform is administered prior to the operation, but the narrator continues to be aware of everything taking place.

He can see into the minds of the surgeons and learns that Dr. Haddon is afraid of inadvertently cutting a vein. Almost on cue, the vein is slashed and hemorrhaging occurs. The narrator has a near-death experience associated with an extraordinary clarity of perception. He senses movement upward - beyond his body, beyond the town, and beyond the world. He believes his soul is streaming through space past the solar system and nearby constellations.

His impression of absolute serenity is eventually replaced by a sensation of loneliness. All matter becomes condensed into a single point of light, then a fuzzy glow, and finally the image of a colossal hand clenching a rod. A faint sound punctures the silence followed by a voice proclaiming, "There will be no more pain" (63). He awakens and sees the surgeon standing next to the rail of the bed. The narrator has not only survived the operation, but his pain and melancholy are vanquished.

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Summary:

This novel spans one day in the life of a London neurosurgeon, Henry Perowne. It is set on a specific day, Saturday, February 15, 2003, when mass demonstrations were held in London protesting the coming war on Iraq. This actual historical and geographical context colors the fictional narrative, told entirely from the point of view of Perowne, who wakes in the early hours of the morning to see a burning aircraft descending towards Heathrow. Although this turns out not to be a terrorist attack, as Perowne at first fears, it sets up the book's atmosphere of foreboding and the powerful contrast between dangerous world events and Perowne's essentially happy family.

The Perownes are all talented and successful and fond of each other. Henry's wife, Rosalind, is a media lawyer; their son, Theo, a blues guitarist; and their daughter, Daisy, a published poet. This Saturday's highlight is to be a family dinner, where it is expected that Daisy and her grandfather, John Grammaticus, a famous poet, will reconcile after an argument.

Henry is on the way to his morning squash game when he is involved in a minor car accident with a dubious character named Baxter. He escapes theft and a beating by realizing that Baxter suffers from Huntington's Disease. He tells Baxter the diagnosis and offers hope of a non-existent treatment, shifting the power base of the encounter from brawn to brain and humiliating Baxter in front of his cronies. (This part of the novel was published in the New Yorker as a short story, The Diagnosis. See the annotation in this database for a more detailed account.)

Henry then plays an aggressive game of squash with Jay Strauss, his American colleague, and they discuss the Middle East and the impending war. He buys seafood at the market for the evening's dinner, and he goes to the nursing home to visit his mother, Lily, who has multiple-infarct dementia. He listens to his son's band, goes home and cooks dinner. He argues with Daisy, his daughter, just come from the protest march, about the coming war.

When the family is gathered for dinner, Rosalind returns from work and Baxter and his henchmen force their way into the house. They threaten Rosalind with a knife, break Grammaticus's nose, and force Daisy to strip, at which point Perowne realizes his daughter is pregnant. Then Daisy recites poetry--Matthew Arnold's "Dover Beach"--and, unlikely as it is, the effect of the poem is to distract Baxter enough that Perowne is able to lure him upstairs with the promise of more information on treating Huntington's, and he and Theo then throw Baxter down the stairs. Baxter is taken away in an ambulance, and later Perowne is called in to operate on his brain. The novel ends with Perowne back in bed with his wife.

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Summary:

This slim volume dips into "quotable quotes" drawn from literature and historical writings dating back several centuries. The quotes are put forth by physicians, patients, observers of medical issues, and writers of fiction as well as essayists. Each quote is but a few lines. The author, the source, and the date (when known) are provided for each quotation.

Many of these quotations will be familiar to persons who are widely read or who study the literature by and about medicine. Some of the quotes are scatological in the sense that they address issues of bodily parts and functions; others are simply amusing, while many are profound observations. The range is wide and the selections eclectic.

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