Summary:

Bertie Shields, a second year college student, and Joyce Renfrew, a nurse, are conveying the body of a dead elderly woman to the morgue. After a brief lustful look at Joyce, whose plumpness does not go unnoticed or uncommented upon by either Selzer or Bertie, the latter averts his eyes to the leaner cadaver, going from "pubic woolgathering" to ribbon-spotting; for he notes with increasing meditative pleasure that the corpse is wearing a bright blue ribbon, tied in a small bow and sitting "at the side of her head like a butterfly." (p. 122)

Bertie waxes reflective, wondering who put the ribbon in her hair and when. Joyce, who looks thirty-five to Bertie and who has "heard about" Bertie from "one of the other girls", begins making verbal and then physical advances as they approach the morgue. Just as he has put the unnamed cadaver on her tray and is proleptically about to "slide the tray home," Bertie’s last sight of the cadaver as she is entering "the dark recess" is the "winky blue . . . "--a sight that goes unfinished as he feels Joyce’s hand on his buttocks. The inevitable happens, of course, on the now vacant stretcher.

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This unique "miscellany" of prose from journals and essays, poems, stories, music, paintings (reproduced in black and white), drawings, and cartoons illustrates countless ways that medicine and the arts, in tandem, "stretch the imagination, deepen the sympathy . . . enrich the perceptions" and give sheer, unadulterated pleasure. Organized by Robin Downie, renowned Professor Emeritus of Moral Philosophy at Glasgow University, the anthology is grouped in eight categories: "The Way We Are," "Disease and Mental Illness," "Doctors and Psychiatrists," "Nurses and Patients," "Healing," "Last Things," "Research," and "Ethics and Purpose."

Excerpts include the classic lore [Charles Lamb’s essay, "The Convalescent"; Florence Nightingale’s diary, "Notes on Nursing"; W. H. Auden’s poem, Musee des Beaux Arts (see this database); Theodore Roethke’s poem, In a Dark Time (see this database); C. S. Lewis’s journal, A Grief Observed (see this database); Sir Luke Fildes’s painting, The Doctor (see this database)] and refreshingly new nuggets from John Wisdom’s radio talk, "What is There in Horse-Racing" ("For a game of croquet is not merely a matter of getting balls through hoops, anymore than a conversation is a matter of getting noises out of a larynx,"); Robert Pirsig’s treatise, "Zen and the Art of Motorcycle Maintenance"; physician Roy Calne’s tender sketches of his own patients; composer Richard Wagner’s letter, "Biscuits as Therapy"; Janice Galloway’s novel, "The Trick is to Keep Breathing"; and expressions by patients and artists who happen to be patients of their particular illness experiences.

Lest "commentary be intrusive," except as brief introduction to each section, Downie deliberately omitted them, placing illustrations and extracts so as to provide commentary on one another. (Readers cannot help but be stimulated, however, to rearrange and create their own juxtapositions.)

The section on "Healing" considers not only the expected operations, spiritual healing, traditional cures, music and art as therapy, but also "spells, hope, and mothers." Richard Asher’s essay on why medical journals are so dull (British Medical Journal 23 Aug. 1958), or on whether or not baldness is psychological, and the comic strips of Posy Simmonds (the double entendres of "Medical Precautions," the "Minor Operation" burlesque on Shakespeare’s "All the Ward’s a Stage,") remind us yet again that birthing, aging, illness and dying are not pathological events or mere medical processes, and that the arts and humanities are bountiful reservoirs of moral discourse, inspiration, and renewal.

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The subtitle of this photographic essay is "The Story of a Country Doctor." Berger and Mohr give the reader an imaginative portrait of Dr. John Sassall, an English general practitioner who lives and practices in a remote rural community. The book begins with several stories of Sassall’s work with patients, gradually introducing the man himself and revealing his thoughts about his profession, his life, and the nature of healing.

Berger explores what people in the community think about this unusual doctor who has given up his chance to "get ahead" in the world in order to remain with them. They are sure he is a "good doctor," but what does that mean? How does one judge "goodness" in a physician? Berger comments in an impressionistic way on the nature of Sassall’s relationships with patients--a complex mixture of authority, fraternity, and intimacy.

The latter part of the essay expands its focus to the community as a whole and the nature of contemporary medicine. Throughout the book, Jean Mohr’s photographs serve as indispensable features of the story.

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This poem by physician-poet Mukand transforms what might be unobserved and ordinary into the visible and extraordinary. A frail old woman with a disease of "no cure," probably cancer, is in the waiting room at a hospital or clinic. The narrator, whom we suspect is the second character, as well, a medical student, spins with delicacy a thoughtfully real and imaginative description of the waiting patient.

Readers see her "blue gauze scarf," "her gnarled, polished walking stick," and her pained body, but are provided with, additionally, an imaginary account of the effects of the disease on the woman as she struggles with pain through her final months. When the student enters the waiting room, the woman extends her "brittle" hand, then pulls from her black bag a sealed envelope. When instructed to open it, the student finds a fifty-dollar bill "to help with school." Caught by surprise, he smiles, but leaves the bill in her palm: "It lies in her palm like a / handful of earth picked up, raised / to the sky / as an offering to the spring wind."

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Victorian critic and poet Edmund Gosse was the child of respected zoologist Philip Gosse, a minister within the Plymouth Brethren, a fundamentalist evangelical sect. This memoir of Gosse’s childhood and young adulthood details his upbringing by parents whose faith and literal approach to Scripture directed all their domestic practices.

It details the older Gosse’s agony as he struggles to reconcile his scientific vocation with his religious faith in the face of the hefty challenges posed by Chambers, Lyell and Darwin’s mid-century hypotheses about the age of the earth and the diversity of its species.

Edmund’s own agony as he realizes his inability to fulfill his parents’ expectations for him in terms of religious vocation is another significant thread. While "father and son" is the primary relationship explored, the early parts of the memoir describe Emily Gosse’s influence on her son, particularly during her illness and death from breast cancer.

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Dr. Forrest Janney, once a prominent surgeon, has given up his practice in the city and retired to his hometown in Alabama due to alcoholism. He runs the local pharmacy and keeps up his medical license, but doesn’t practice. His brother Gene begs Forrest to operate on their nephew, who is comatose from a gunshot wound in the head; he was sent home to die. Other doctors have refused to operate because the bullet is lodged close to a major artery at the base of his skull. Dr. Janney examines the young man. Although Janney declines to operate, citing his drunkenness and tremor, he encourages his family to keep trying to find a surgeon because he estimates a 25% chance of survival if the bullet is removed.

Shortly thereafter, a violent tornado plows through the town, leaving dozens of dead and wounded. Dr. Janney immediately pitches in with several other doctors to treat the wounded and makes supplies from his pharmacy available at no charge. The comatose nephew is also found in the wreckage, barely alive, and in order to give him at least a chance, Janney operates on him, despite being fortified by a heavy dose from his flask.

A few days later, the nephew presumably dies (not clear from the text). A little girl whom Dr. Janney has befriended is sent to the orphanage in Montgomery because her father died in the tornado. Shortly thereafter, Dr. Janney leaves town, after giving his house to his brother and his family. He is on his way to save the little girl from the orphanage.

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An even-handed consideration of the essence of doctoring, this poem packs into a few short lines the paradoxes, frustrations, rewards, and dangers inherent in the profession. It depicts the doctor’s power, skill, humanity, dedication, and sometime arrogance, and the arena in which the work is done--"they are only a human / trying to fix up a human." Sexton warns that arrogance has profound consequences: "If they [doctors] are too proud, . . . then they leave home on horseback / but God returns them on foot."

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Elsa Walsh profiles three women of extraordinary achievement: Meredith Vieira, "60 Minutes" television correspondent; Rachel Worby, conductor for the Wheeling Symphony Orchestra; and Alison Estabrook, chief of breast surgery at Columbia Presbyterian Medical Center in New York. Even though the women represent remarkable levels of success, the in-depth portrayals reveal enormous personal costs to each of the individuals. Their separate efforts to balance professional and personal goals often lead to irreconcilable conflicts and then to questions about burdens placed upon women who refuse to follow imposed expectations and blueprints.

Readers will sympathize with Meredith Vieira’s struggle to overcome high-risk pregnancies and retain her highly visible and highly paid position on the CBS news team. The measures established to prevent previous miscarriages and accommodate her medical needs eventually lead to friction and discord among co-workers and staff. As the following anecdote demonstrates, Meredith refuses to separate her roles as journalist and mother. When the baby is born and salary negotiations begin, Meredith brings her infant son to the Tavern on the Green lunch meeting so that she can nurse the baby on demand. The executives are flabbergasted by her behavior and by her announcement that she intends to become pregnant again.

Rachel Worby’s story concerns the tensions between an artist’s work, milieu, and spirit and those associated with the widowed Governor of West Virginia, the man she agrees to marry. Both are accomplished, he is rich, and the love between them is healthy and strong.

Nevertheless, the worlds they occupy impose divisive expectations. She does not conform to the assumed role of Governor’s wife; it is both difficult and impossible to regulate her bombastic and vivacious personality and style.

The final story centers on Alison Estabrook as she struggles to become the chief of breast surgery in a professional world seemingly intent on placing unacceptable barriers in her way. Readers will anguish over this infuriating account of suppression by a patriarchal system.

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This is another Molière fabliau on the practice of medicine in his 17th Century culture. Sganarelle, the woodcutter turned doctor in spite of himself, is the object of a joke orchestrated by his wife Martine. She determines to punish him for his bad behavior toward her by setting him up as a learned, albeit somewhat eccentric, physician.

Falling for her bait, the stewards of the rich landowner, Geronte, implore Sganarelle to come to the rescue of their master’s daughter, who has become unable to speak. The woodcutter-turned-doctor begins to play the game, and through a series of happenstances and ruses, solves the enigma of the girl’s disability, comes upon a solution, and, in the process, determines that perhaps doctoring is more salutary than cutting faggots.

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The surgeon Jack McKee (William Hurt) carries on an outwardly successful practice while treating his patients with aggressive sarcasm and general disrespect. "There is a danger in becoming too involved with your patients," he warns his residents, reminding them of the surgeon’s credo: "Get in, fix it, get out." Then McKee himself is diagnosed with cancer of the vocal chords, and the doctor discovers patienthood. The process is enormously uncomfortable for him, as he experiences a sharp decline in autonomy and everything that goes with it, and he begins to develop some empathy for those he has always scorned.

Particularly inspiring are several encounters with a coldly professional specialist and a platonic friendship with a young cancer patient named June (Elizabeth Perkins) who is dying because her doctors failed to diagnose her brain tumor. By the end of the film, Dr. McKee is both recovered and converted, and in the last scene is requiring his residents to spend 72 hours as hospital patients as part of their medical training.

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