Summary:

In 1999, eighteen years after Project HOPE began publishing the journal "Health Affairs," the founding editor, John Iglehart, began a new column: Narrative Matters. This book contains 46 of the 80 essays published to date, and an inspiring foreword by Abraham Verghese. The essays are contained in eight chapters-- "Writing to Change Things: Essays on the Policy Narrative," "Dollars and Sense: Hard Financial Realities," "Bearing Witness: Patient's Stories," "The Maddening System: Frustrations and Solutions," "Trouble in the Ranks: Professional Problems," "Drug Resistance: Battling Undue Influences," "Disparity Dilemmas: Stories on Race and Ethnicity," and "Values and Choice: Stories of Practical Ethics." Familiar voices include those of Fitzhugh Mullan (one of the editors), Abigail Zuger, Howard Brody, Richard Lamm, John Lantos, Danielle Ofri, and Carol Levine. The essays in the first section strike an important cautionary tone, reminding readers that the plural of anecdote too often is taken for policy and that the repetition of anecdote should not be seen as evidence.

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Fifty-something Canadian professor of history and lifelong womanizer Rémy (Rémy Girard) lies in an overcrowded hospital with a fatal illness. Family and friends gather, including Rémy’s estranged son Sébastian (a wealthy financier played by Stéphane Rousseau) from overseas, and Rémy’s ex-wife (Dorothée Berryman) and several previous romantic partners. Rémy and Sébastian fight painfully about Rémy’s philandering, but after a plea from his mother Sébastian decides to make things better for his father, even if they have not been reconciled.

This he does in many ways, most of which involve spending lots of money and many of which are highly irregular or illegal. For example, he arranges to have his father taken into the U.S. for an expensive PET scan that would have required six months’ wait to have free in Canada. And he arranges through Nathalie (Marie-Josée Croze), a childhood friend who is now a heroin addict, to provide a regular supply of heroin to control his father’s pain, which the hospital apparently is not able to do with morphine.

These and other extraordinary measures work for Rémy, and the process of caregiving brings Sébastian and his father closer. (Rémy’s only problem seems to be the feeling that his life has been wasted because he has not left his mark--and he gets help with that, paradoxically, through several conversations with Nathalie.) For his last few days, Rémy and ensemble move to a friend’s lakeside cabin, where the conversation is witty, intellectual, and sexually frank, and the mood upbeat and conciliatory.

In the face of Rémy’s imminent demise, all is forgiven, and others seem to gain insight about their lives. Rémy’s last act is peacefully nodding to a sorrowful Nathalie to begin the series of heroin injections that will end his life. In a final dig at the establishment, the heroin is administered through an IV provided on the sly by a hospital nurse.

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The novel opens with a young surgical nurse, Justine Brent, nursing a mill worker whose arm has been mangled by a carding machine. She soon meets John Amherst, the mill’s assistant manager who works passionately to reform the dangerous conditions at the mill and to improve the living conditions of the workers. Amherst recognizes Justine’s intelligence and sympathy, but he quickly forgets about her when he meets and falls in love with the new mill owner, Bessy Langhope.

The narrative skips ahead three years. John Amherst has learned that his now-wife Bessy has no real interest in his plan to reform the mill, although she initially appeared to be moved by the workers’ misery. In fact, her insistence on luxury, which is funded by the profit from the mills, thwarts his desire to use her controlling interest to make significant changes. The couple encounters Justine, who knew Bessy in school. When the somewhat sickly Bessy invites her to be a private nurse to herself and her stepdaughter, Justine, who is exhausted from “difficult cases,” accepts. Justine attempts to shore up John and Bessy’s increasingly troubled marriage without success. When John is abroad, Bessy has an accident while riding her horse. Paralyzed, in constant pain, and slowly dying, Bessy is attended by a physician who advances his career with the technological feat of keeping Bessy alive, ostensibly until her husband and her father arrive to say their goodbyes. When Bessy begs Justine to let her die, Justine secretly gives her a fatal dose of morphine, an act that the physician suspects.

The narrative skips ahead again to over a year later when Amherst, who has inherited the mills from Bessy, invites her family to celebrate the opening of an emergency hospital he has built in the mill town. Justine, who had stayed on after Bessy’s death as her stepdaughter’s nurse, and Amherst become reacquainted. Their shared social and intellectual interests develop into love, and they marry. The physician who had cared for Bessy and who had, earlier, asked Justine to marry him, had developed an addiction, one that had begun while he was treating Bessy. Beginning to sink into financial ruin, he blackmails Justine. Eventually, Amherst finds out that Justine killed Bessie with morphine and, horrified, rejects her.

Justine confesses her act to Bessy’s father and negotiates a deal: She will remove herself from their lives if he allows Amherst to continue his work at the mills. Bessy’s father accepts the deal, and Justine disappears for many months until Bessy’s daughter becomes ill and begs to be reunited with Justine. A family friend explains to Amherst Justine’s arrangement to protect him and convinces him that she has suffered suitable penance. Justine is reunited with Amherst when he celebrates the opening of a gymnasium for the mill workers, a project he credits Bessy with having designed. Justine, who knows that Bessy had in fact designed the gymnasium for her private estate, a project that would have drained the funds for improving the mills, keeps silent and subverts her knowledge to her husband’s perception of the facts.

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Doctor and Doll is part of the collection of the Norman Rockwell Museum in Stockbridge, Massachusetts. The triangular composition depicts an elderly general practitioner seated in a Windsor chair. A little girl is holding her doll out to him, watching intently as the doctor pretends to listen to her doll's heart through his stethoscope. The fact that the little girl comes to his office and stands up before her doctor suggests that she is coming in for a check-up.

The doctor's large black bag on top of the rug by his feet indicates he makes house calls. Behind the two figures is an old-fashioned desk. On top of the desk are several thick volumes, two brass candlesticks, and two pictures. The image on the left may represent a group of doctors in the style of Rembrandt. On the wall we see a large, framed document which has the word "Registration" on it.

The doctor is wearing a dark suit, cravat, and highly polished, black shoes. He turns his head to the right and upwards as he concentrates on his task. His patient, the little girl, is dressed in heavy shoes, stockings, wool skirt, jacket, scarf, and red beret and mittens. She has removed her doll's dress and holds the dress close to her left side with her elbow. The colors of the painting are dark, but the doctor's head with its gray hair, the doll, and the child's serious face are illuminated.

The girl's red beret, mittens, and the doctor's ruddy cheeks and nose give warmth to the picture. Clearly, the doctor is empathetic and kind, and the little girl trusting. Rockwell paints the ideal country doctor taking time to reassure his young patient that he will do her no harm. His gray hairs make him look fatherly.

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Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

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First published in 1991, and available in reprint edition, this is a compendium of selected artworks and excerpts of diverse medical and literary writings from pre-Hippocratic times to the end of the 20th C. Each chapter integrates selections from medical or scientific treatises, with commentaries written by historians, essays by physicians and writers, and prose and poetry by physicians and by patients. The 235 images in this book include illustrations from medical textbooks and manuscripts, as well as cartoons, sculptures, paintings, prints and sketches. The colour illustrations are stunning and copious, and provide a visual narrative that resonates with each chapter of the book.

The first part of the book, Traditional Medicine, includes chapters on Ancient, Medieval, Renaissance, and Enlightenment medicine. These serves as a preamble for the second part, Modern Medicine, which includes art, medicine and literature from the early 19th century to the end of the 20th century.

The chapter “From the Patient’s Illness to the Doctor’s Disease” illustrates the rise of public health and scientific research with excerpts from works by Edward Jenner, John Collins Warren, René Laënnec, and John Snow, together with experience of epidemic diseases described by writer Heinrich Heine in his essay on “Cholera in Paris”. The chapter on “Non-Western Healing Traditions” includes botanical research by Edward Ayensu, a short story by Lu Hsun and the writing and paintings of George Caitlin on North American Indian healing.

In the patient-focused chapter, “Patient Visions: The Literature of Illness,” are stories of sickness by Thomas DeQuincey, Leo Tolstoy, Giovanni Verga, Katherine Mansfield, André Malraux, and Robert Lowell. The chapter which follows, “Scientific Medicine: the Literature of Cure,” provides the medical counterpoint with personal correspondence by Freud, medical treatises by Wilhelm Roentgen and Louis Pasteur, an essay on surgical training by William Halsted, and an excerpt from George Bernard Shaw's play, Too True to Be Good, in which a microbe takes centre-stage.

There are chapters on “Medicine and Modern War,” which includes personal writing by nurses Florence Nightingale and Emily Parsons, and poems by Walt Whitman, and Emily Dickinson, and “Art of Medicine,” with works by Arthur Conan Doyle, Anne Sexton, James Farrell and W.P. Kinsella.

The final chapter, “The Continuing Quest for Knowledge and Control,” contains no medical treatises but rather ends with personal reflections by the writer Paul Monette on AIDS, and by physician-writers, John Stone, Sherwin B. Nuland, Lewis Thomas, Dannie Abse, and Richard Selzer.

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The exquisite young artist, Angélique (Tautou) sends a rose to her lover, the cardiologist Loic Le Garrec (Le Bihan). She is planning a future with him; the only problem is that he is married. But he has promised to leave his wife. Angélique is little troubled that the couple are expecting a baby and when the pregnancy is lost following an accident, she believes the day will be soon.

Her medical student friend, David, worries that she is being used and is appalled by the accumulation of disappointments and slights that Angélique must endure. She falls apart, neglects herself and the home and exotic plants that she has been watching for friends, but when she hears that Loic has been accused of assault by a female patient, she is utterly disbelieving. The patient is found dead and the doctor falls under suspicion.

Rapid rewind, and the movie begins again with the rose, and by repeating a handful of earlier scenes, retells the same events from the perspective of the doctor. He has no idea who is the sender of the rose, and as the flowers, notes, and gifts accumulate he grows more distracted, even angry, and his wife is suspicious.

It emerges that Angélique and Loic have barely ever spoken to each other and that she actually volunteered for house-sitting next door, in order to be close to him. The accident that caused the miscarriage was Angélique’s attempt to kill his wife by running her down with a motor scooter. The patient who charged the doctor with assault was wrongly mistaken by him for the secret admirer; he struck her out of anger and fear. She presses charges against him and pursues him through the courts until she is murdered by Angélique.

But the doctor knows none of that. When Angélique attempts suicide with gas, he saves her life and she is all the more smitten. Gradually the doctor realizes her real identity and the police link her to the murder. She is sent to a psychiatric hospital.

Years pass. Loic and his wife have two beautiful children. Angélique is finally discharged with reassurance that she will be well as long as she takes her medicine. In the final scene, the caretaker moves a large cupboard to find all the pills that she had been prescribed over four years pasted to the wall in a larger-than-life portrait of Loic.

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This memoir chronicles the pre-adolescent and adolescent years of the author, the son of an alcoholic, abusive mathematics professor father and a psychotic Anne Sexton-wannabe confessional poet mother. The only family member who does not abuse the boy in any way is estranged--an older brother with Asperger’s syndrome. Meanwhile, the amount of trauma to which young Burroughs is subjected boggles the mind. Just when one thinks it couldn’t get any worse, it does.

Burroughs, who loves bright, shiny, orderly things, also likes doctors--paragons of cleanliness, virtue and wealth. Unfortunately, his mother’s psychiatrist, Dr. Finch, described as a charismatic Santa Claus-look-alike, is unethical, bizarre and squalid. As Mrs. Burroughs becomes more and more dependent on Finch, she allows her son to be adopted into the crazy Finch household.

This family includes wife Agnes, who copes with her husband’s infidelity by sweeping madly; son Jeff, daughters Kate, Anne, Vickie, Hope and Natalie; grandson Poo; and adopted son, Neil Bookman, who is twenty years older than Burroughs and homosexual. When Burroughs is thirteen, and has told Bookman that he, too, is gay, Bookman forces the boy to have oral sex. They become lovers.

The Finches, meanwhile, exhibit their quirks and weird tendencies in multiple ways. "Bible-dipping" is popular to read the future, as is prophesying by examining Dr. Finch’s turds. A patient with agoraphobia, Joranne, lives in one of the rooms--in fact, she has not left the room in two years. Young Burroughs is allowed to smoke and drink. When Burroughs says he doesn’t want to return to school, Dr. Finch facilitates this desire by giving Burroughs alcohol and pills to fake a suicide gesture, then hospitalizes the boy.

Yet Burroughs manages to befriend a couple of the Finch daughters, and to survive his childhood. The book closes with his departure for New York City and with an epilogue outlining various people’s outcomes. Finch lost his license due to insurance fraud.

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In the Emergency Room at 2 AM, a doctor tries to suture a laceration on the forehead of "a huge black man," brought in by the police. The man groans and strains; he won't hold still. Finally, the doctor becomes so angry that he sutures the patient's earlobes to the mattress. Not only that, he leans over the man's face and grins: "It is the cruelest grin of my life." Then he sutures the man's wound.

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The famed surgeon Douglas Stone flaunts his notorious affair with Lady Sannox, although his professional reputation begins to suffer. One night a mysterious Turk asks him to attend his wife, who has cut her lip on a poisoned dagger. The Turk insists that amputation offers the only hope of recovery. Anxious to pocket the proffered gold, and impatient to get to his mistress, Stone dismisses his professional misgivings. He excises the lower lip of the veiled, drugged woman--only to find that he was tricked into disfiguring Lady Sannox herself. Lord Sannox (disguised as the "Turk") thus gains his revenge, with his wife morally chastised (and forever after in seclusion), and Stone’s "great brain [thenceforth] about as valuable as a cap full of porridge."

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