Summary:

Sir Luke Fildes's eldest son Phillip died Christmas morning, 1877. He was attended by Dr. Murray, who directed all of his attention and care to the patient during the child's fatal illness. This unswerving dedication impressed Fildes.

Ten years later, when Sir Henry Tate commissioned Fildes for a painting to exhibit in what was to become the Tate Gallery, Fildes was given freedom to choose the subject matter. Fildes immediately decided to depict this scene of a family physician holding a bedside vigil by a seriously ill child. However, the painting was not begun for four years, and then only at the urging of Tate.

The shade of a lamp is tilted so as to bestow light on the two central figures: the physician, and especially, the recumbent child. The physician faces away from the bottled medicine and cup on the table and directs his gaze fully on the child. He is dressed neatly and sits calmly, patiently, resting his bearded chin on his hand.

The small child is central in the picture, in a white nightshirt on a large white pillow and covered with pale blankets. The makeshift bed consists of two unmatched dining room-type chairs. The child's hair is tousled and the left arm flung out, with hand supinated and beyond the edge of the pillow. Nonetheless, the child rests quite peacefully, as the pose appears quite natural.

To the right and rear of the painting are the parents. They are placed in such deep shadows that it is frequently difficult to make out these figures in reproductions. The mother sits at a table and hides her face in her clasped hands. The father stands beside her, with a comforting hand on her shoulder, as he gazes at the physician.

The painting is set in the interior of a small cottage. Rafters are low, furniture simple. Colors are muted; earth tones predominate. Although the majority of the light comes from the lamp, a bit of light also enters from the recessed window near the mother.

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This is an anthology of poems written by physicians from ancient times through the early part of the 20th century. It includes a great variety of work: poems by well-known physician-writers like Oliver Goldsmith, John Keats, Oliver Wendell Holmes, Sir Arthur Conan Doyle, and William Carlos Williams; poems by distinguished physicians who are not usually remembered as creative writers, such as Edward Jenner, Erasmus Darwin, S. (Silas) Weir Mitchell, and Sir Charles Sherrington; and others by currently little-known physicians.

In the Preface, the editor admits that the genre of "medical poetry" may not have very high standards. For example, she quotes one author as saying that it is generally "poetry in quotation marks and much of it is feeble stuff." However, poetic expression that arises from clinical experience has dignity and value insofar as it reflects "the spirit of helpfulness which gives to the medical profession its value to humanity." The last quotation is attributed by the editor to William Osler, although she cites no reference. Interestingly, the medical professor as reflected in this anthology is entirely male; of 110 poets represented, not one is a woman.

In an "Afterthought" the physician-poet Merrill Moore comments further on the theme of mixing medicine and poetry, presenting the literary equivalent of some insipid "pearls"; for example, "The way he writes is possibly a little different" and "the physician-poet does not quite reach the peaks of spiritual elation and emotional release . . . that a Byron or a Shelley achieves." Profound, huh?

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The author provides a historical review of physicians who became famous practicing a profession other than medicine. Most of the article focuses on physician-writers, beginning with Francois Rabelais, and including both well-known and obscure figures. There are extensive comments on Louis-Ferdinand Celine, Gottfried Benn, Friedrich Wolf, Mikhail Bulgakov, Oliver Goldsmith, Anton P. Chekhov, Arthur Schnitzler, W. (William) Somerset Maugham, Sir Arthur Conan Doyle, Oliver Wendell Holmes, William Carlos Williams, among others. The most complete discussion (5 pages) is devoted to Sir Arthur Conan Doyle.

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Kirklin, a physician and Lecturer in Medical Humanities at the Royal Free and University College Medical School, and Richardson, a historian and associate at the Wellcome Trust Centre for the History of Medicine, are both educators in medical humanities in London. This well-written and concise volume focuses on "the role of the humanities in medical education" and is aimed at "those wishing to integrate medical humanities into their own teaching, and learning." (p. xv) The chapters are written by a variety of educators with a wide range of backgrounds, including artist, medical student, writer, nurse, surgeon and philosopher.

At least two stimuli are cited as reasons for the development of this book: (1) the 1993 publication by the General Medical Council of Tomorrow's Doctors which recommends the inclusion of medical humanities in the required curriculum for undergraduate medical education in the UK and (2) a national conference, "The healing arts: The role of the humanities in medical education" in London, March, 2000. The rationale for such a book is delineated in several prefatory statements including remarks by Professors Sir David Weatherall and Sir K. George M. M. Alberti (Alberti is the president of the Royal College of Physicians). The book concludes with recommendations for further reading, schemata for undergraduate and graduate degrees in medical humanities at University of Wales, Swansea, and an index.

The nine chapters in this volume combine pedagogic philosophy, citations for literature and art and how to encourage reflection about these selections, tools for encouraging student creativity, reproductions of art and literature generated by students or patients or used by teachers for discussion, and some practical advice about teaching medical humanities and its, at times, uneasy connection to the rest of the curriculum. Each chapter reflects the individual contributor's area of expertise and experience. For example, in "Fostering the creativity of medical students", the authors Heather Allan, Michele Petrone (who painted the striking cover art), and Deborah Kirklin provide useful guides for teaching creative writing and art production by students studying cancer and genetic disease.

In a particularly insightful chapter, "Medical humanities for postgraduates: an integrated approach and its implications for teaching," Martyn Evans describes the challenges of developing a full-fledged interdisciplinary program for graduate as well as undergraduate studies in Wales. He addresses concerns about "bolt-on" versus integration of medical humanities in the curriculum, risks of superficiality, and how such studies may transform the culture of modern medicine. Several chapters address a theme (such as "clinical detachment" or understanding the patient's perspective) and include topic-specific sources and guidelines.

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Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Narrated in the first person, the transforming events of Peter's life as a 15 year old are told years later. The opening paragraphs set the scene: "the older brother who went off to school" leaving "the brilliant . . . mother . . . bereft"; the father, "son of a bankrupt Hudson Valley apple grower"; "the darkening drift and dismay of my parents." Into this family unease steps the local veterinarian, Dr. Mason, whom Peter assists during after-school hours, and who is a sometime dinner guest in his parents' home.

Dr. Mason not only tries to persuade Peter to go into a medical profession, ignoring Peter's interests (writing poetry, reading about mountain climbing) but self-importantly insists on "offering [him] lessons in nothing less than all of life" (63). Dr. Mason, we learn, is singularly unqualified to dispense such lessons. He is, at least in Peter's eyes, overbearing and insensitive in his interactions with the owners of the pets he treats, and perhaps even unethical in his professional decisions. Then, Peter discovers, his mother is having an affair with Dr. Mason (who is also married). It is the burden of this knowledge that drives the narrative.

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The first full-length collection of poetry by a Canadian medical social worker who cares for cancer patients and their families. The "longing" of the title expresses the human yearning for love, knowledge, completeness, and healing.

Many of these poems deal with the process of revealing the inner workings of the world (and the inner truth of persons) through photography; see "Darkroom: 1," in which, "I watched you emerge / take on form / and intensity." X-ray photography, of course, takes this one step further, allowing us to see the insides of bodies.

The long last section of the book includes 24 poems that deal explicitly with illness and health care. Among the best of these are "Worker Classification: Material Handler," "Hand to Mouth," "Wishbone," and a sequence of short poems called "Post-Mortem Report."

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This is a collection of humorous sketches first published in 1850. They purport to describe the youthful experience (and antics) of an elderly "swamp doctor" named Dr. Madison Tensas. In fact, they are the work of Henry Clay Lewis, a young Jewish-American doctor who, after graduating from the Louisville Medical Institute in 1846, set up practice in MADISON County, Louisiana, along the banks of the TENSAS River.

The Introduction of this edition, written by Edwin T. Arnold, locates Henry Clay Lewis and his work within the context of 19th Century "South and Southwest Humor," and briefly discusses each piece. One of his major points is that the swamp doctor's "odd leaves" contain a dark, almost Gothic strain, thoroughly mixed in with their humorous and prankish sensibility. (Perhaps "lack of sensibility" would be a better phrase to use to describe these sketches.)

The first brief sketch compares characteristics of the "city physician" with the "swamp doctor." After this, we follow the growth and development of "Dr. Tensas" from childhood through medical school and into his practice in the swamp country of Louisiana. Among the more notable sketches are "Getting Acquainted with the Medicine," in which the student's preceptor conceals his bottle of whiskey by labeling it "tincture of arsenic"; "The Curious Widow," in which the student prepares a gristly surprise for his snooping landlady; "Being Examined for My Degree," which demonstrates the comic vagaries of oral examinations; "My First Call in the Swamp," in which the newly minted doctor cures his first patient (more or less); and "How to Cure Fits," which presents a novel and efficient treatment for hysterical disorders.

If you want to find some genuine clinical wisdom in this book, look no further than "My First Call in the Swamp," where the author observes, "if you wish to ruin yourself in the estimation of your female patients, hint that the disease they are laboring under is connected with hysterics" (p. 146).

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A young doctor, recently assigned to a country hospital, is fraught with anxiety, especially over his lack of experience with obstetrical problems. One night the midwives call him; a woman is having a difficult labor. The fetus is presenting in a transverse position. The doctor must reach internally and “turn it around by the foot,” as Anna Nikolaevna, the seasoned midwife, reminds him.

The doctor has never performed this procedure. He buys time by going back to his room to consult the textbook (under the pretext of going for cigarettes). Finally, he can't avoid it any longer. He performs the rotation. It works! Both mother and baby are saved.

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