Summary:

In 1921, the twenty-four year-old Scottish medical graduate, Andrew Manson, takes up an assistant’s position in a small Welsh mining town. He is idealistic, but he quickly learns that his training is inadequate and that his hemiplegic employer will never return to practice. Manson must do all the work for a pittance and bad food. He befriends another assistant, the surgeon Phillip Denny, whose fatal flaw is devotion to drink. Together they solve the town’s problem with typhoid by blowing up the sewer.

Manson’s escape comes in a new job in a larger town and marriage to the equally idealistic Christine. She encourages him to continue his studies and to conduct research on the relationship between dust inhalation and tuberculosis. The results include higher degrees and international recognition, but they also bring about the wrath of the town’s antivivisectionists. To add to the gloom, Christine looses a much wanted pregnancy and the ability to have children.

The Mansons leave Wales for London, where Manson hopes to extend his research within a government agency. Quickly disillusioned by bureaucracy, he is lured into society practice and slowly abandons his ideals in exchange for prestige and wealth. Christine is increasingly unhappy, but his response is annoyance with her and an affair with a married woman. When one of his new associates botches an elective operation on a trusting patient, he realizes the colleague is nothing more than a society abortionist and that he and his new friends are little better.

He decides to sell his practice and renews contact with Denny to establish a group consulting practice "on scientific principles" in a carefully chosen Midland town. He also helps the tubercular daughter of an old friend to an unorthodox (but effective) pneumothorax in a clinic run by Stillman, an American who does not have an MD. Just as he and Christine have rediscovered joy in each other and their future together, she is killed in a freak accident. Only days later in the depths of grief, he is brought before the General Medical Council on charges of unprofessional conduct laid by his former associates. He acquits himself brilliantly and leaves with his old friend Denny for work in the Midlands.

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Please note that in order to properly annotate this novel, the novel's surprise ending will be revealed here. Snowman--who used to be called, Jimmy--is a rare survivor of a dreadful catastrophe that seems to have been both the product and the demise of modern science. He lives in a tree, clad in rags, hiding from relentless heat and hoarding his precarious cache of food and alcohol, while he tries to obliterate consciousness and avoid contact with a peculiar race of beings, the Crakers. Through a series of reminiscences as he makes his way back to where he once worked, Snowman's past slowly advances to meet his future.

The world heated up to be uninhabitable desert and genetic engineering created more problems (and species! [pigoons, rakunks, wolvogs]) than solutions. People became increasingly reliant on artificial environments--both internal and external--while their purveyors--drug and technology firms--held ever greater but unthinking power. The world was divided into two: the rich, safe controlled spaces and the dangerous chaotic realm of the poor. Then an epidemic wiped out most of the human race.

Two friends are central to the story: brilliant but inscrutable Crake whose nerdy gift for science had a role in engineering the 'pure' Crakers and the horrifying world that they occupy; and beautiful, seductive Oryx whose regard of knowing innocence heaps scorn upon messy human desire and emotion. They are the Yin and Yang of the "constructed" world. Only at the end, the reader learns that Oryx was murdered by Crake, who was slain by Snowman. It seems that his arduous journey was simply to destroy the history of the events that he had written and left behind.

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A collection of short stories loosely connected to each other by centering on the experiences of four people from their first encounters during medical school and continuing into young middle age.

The first and third stories “Getting into Medical School, Part I” and “Part II,” are about study partners, Fitzgerald and Ming, who have trouble admitting their love for each other until she is accepted to medical school and he is not. Ming teaches Fitzgerald how to prepare successfully by passing along learning tips her physician-cousin provided her in exchange for sex. In the second story, Ming meets fellow students Sri and Chen and drifts away from Fitzgerald. In the third, he wrestles with feelings of rejection and misery as he realizes she has opted for a relationship with the more culturally “appropriate” Chen; however, her study tips pay off in more than one way when he meets Ming’s unsavory cousin at his medical school interview.

Later stories describe clinical encounters with specific cases, one of the most memorable being “Winston,” about Sri’s relationship with a paranoid person; the tale is told alternatively from the doctor’s perspective and the patient’s. in “Afterwards,” Sri must explain to a man’s wife and son, how he died suddenly at a strange hairstylist salon; the news disturbs the family who discover that the supposedly impotent diabetic had been a regular at a sex shop.

Fitzgerald and Chen become emergency physicians. Less settled, Fitzgerald tries several settings, including working for an air ambulance company. His problem with alcohol emerges from deep disaffection and brooding resentment over Ming’s callous rejection years earlier and her subsequent marriage to Chen. The problem begins to threaten his judgement and seriously compromises his health when he falls ill.

In the ironically titled “Contact Tracing” both Fitzgerald and Chen contract SARS (the latter from the former) during the (real) 2003 Toronto epidemic. They are isolated in adjoining rooms separated by glass and phone each other for support and discussion. They reminisce about Sri who has died of cancer and muse on the relevance of do-not-resuscitate orders. The outcome is both humorous and surprising.

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Idealistic, nervous, and rigid, Andrew Manson (Robert Donat) takes his first medical job as an assistant to a doctor in a Welsh mining community. The greedy wife of his invalid employer obliges Manson to hand over most of his earnings. But he finds a local kindred spirit in the outspoken Dr. Denny (Ralph Richardson). In a drunken prank, they blow up the town sewer forcing the unwilling government to repair a notorious source of typhoid.

Manson marries a beautiful school teacher (Rosalind Russell) who leaves her beloved classroom to follow him to an even larger mining town. There he is employed by a group practice run on a capitation basis by the miners. In their evenings, the Mansons investigate the problem of chronic cough in miners, linking it to tuberculosis and coal dust--a discovery that they publish. But suspicious miners destroy their laboratory and force them to London and poverty.

A chance encounter with a wealthy hysteric and an old mate (Rex Harrison) raises Manson’s social standing. He opens a Harley Street practice and makes a fortune. His wife regrets the loss of his ideals and the death of his research. She begs him to remember how happy they were in poverty when each day was a noble challenge to take "the citadel" of life. Denny returns to entice Manson into a new group practice funded by community insurance, but Manson flatly refuses. Denny’s accidental death and a blunder by an elite, unethical Harley Street surgeon bring Andrew back to his idealistic senses.

The film closes with his eloquent self defense against charges of irregular practice for having intervened (successfully) in the case of a little girl with tuberculosis. Manson assists as the child is treated gratis with the controversial new pneumothorax operation administered by an American who does not hold a medical degree. Whether or not Manson keeps his license, the audience is confident that his sense of purpose has been restored and that his wife loves him more than ever. He will return both to the comfortably compatible pursuits of research and serving the sick poor.

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As a medical student, Martin Arrowsmith (Ronald Colman) approaches the revered Professor Gottlieb (A. E. Anson) wishing to accelerate his studies into bacteriology research. Gottlieb insists that he complete his clinical training first. But Arrowsmith meets the cheeky nurse Leora (Helen Hayes) and throws over his plans for science in order to earn a marriage-sustaining living as a general practitioner in her native South Dakota.

Assuaging his undying passion for research (in the family kitchen), he takes on the problem of an epidemic of black leg disease of cattle and earns the animus of a veterinarian and the admiration of the Swedish farmers by single-handedly disproving the efficacy of a government serum, developing his own serum, and conducting a controlled trial to prove its worth. His frustrated and unemployed wife--now displaced from her own kitchen--continues to support him, answering always "Yes, Martin. No, Martin. Whatever you say, Martin."

The couple move to New York City where Arrowsmith intends to devote himself full time to science at the side of his old hero Gottlieb in the McGurk Institute (a thinly disguised Rockefeller Institute). In his new laboratory, Arrowsmith utters a prayer for clear vision and humility--a prayer that seems to go unanswered.

Late one snowy night after two years of fruitless work, he discovers that "something" (in the novel, it is bacteriophage) has killed the bacteria he has been incubating. "Is it important, Martin?" asks Leora. He is brutal in his zealous response, his eyes gleaming with the promise of promotion, fame, and fortune. But after days of exhausting labour, he learns that he has been scooped by Felix D’Herelle a (real) researcher at the Pasteur Institute.

Arrowsmith quickly finds a new passion and travels to the Caribbean to conduct research into the effect of a serum on bubonic plague. Gottlieb makes him promise to act like a scientist (not a G.P. or a quack) and to withhold the remedy from half his patients. He tries to convince the colonial authorities of the importance of controlled testing, but is rebuffed with accusations of turning humans into guinea pigs. A black medical graduate of Howard University invites him to a different island where the epidemic is so thick that the people willingly cooperate with the controlled trial.

Leora, who had refused to remain in New York, is now left behind. The film implies clumsily that the now solitary Arrowsmith--ecstatic to be back in the research trenches--has a romantic encounter with Joyce, a beautiful stranded tourist (Myrna Loy). Meanwhile, Leora contracts plague from a cigarette, which has absorbed plague germs from Martin’s sloppy lab technique, and which she smokes because of Martin’s inattention and abandonment. She dies miserably and alone.

Crazed with remorse, Arrowsmith abandons his scientific principles and allows the entire population to be treated with the serum after all. The epidemic is arrested. But Martin knows that his success does not justify his scientific sin. Still grieving for Leora, he returns to New York to much fanfare, but is unable to find absolution from Gottlieb who has just had a stroke. He runs out on his lover, his institute, and a press conference to join a friend who is establishing a Walden-like institute dedicated to pure research in Vermont.

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During the Nazi occupation of Paris, the deranged doctor Petiot (Michel Serrault) abuses the trust implied by his profession to "help" frightened Jewish citizens. By day, he conducts his clinic and supports his family with a kindly obsession. By night, he leads his victims from a metro-station rendezvous to his apartment, their worldly possessions dragged in a trailer behind his bicycle. He then administers a "vaccine" and locks the now poisoned refugee in a room to face an agonizing death alone.

The doctor takes the possessions of his victims, and dismembers and incinerates their corpses in a makeshift crematorium in his basement. In March 1944, the nauseating black smoke betrays his activities; however, the now notorious doctor vanishes, abandoning his wife and son. Following the war, he is living incognito as a soldier pursuing war criminals and collaborators. But he is identified by his fascination with the Petiot case and his handwriting. In the final scene, dozens of people stand at a long table silently sorting through clothing, jewelry, books, seeking belongings of their loved ones who became the doctor's victims.

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To the "people on the pavement," Richard Cory looked like he was on top of the world. The narrator of this 16 line poem (four a, b, a, b rhyming stanzas) tells how Cory was physically good-looking, well-dressed, humane, and very rich ("yes, richer than a king"). Yet "Richard Cory, one calm summer night, / Went home and put a bullet through his head."

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Subtitled Women Novelists of Color and the Politics of Medicine, this book draws on novels by eleven women to illustrate how physical and emotional states of health and illness are linked directly to social justice. The book is divided into two parts. The first five chapters deal with individual characters, their illnesses, and sometimes their healing: Toni Cade Bambara's The Salt Eaters, Paule Marshall's Praisesong for the Widow, Gloria Naylor's The Women of Brewster Place: A Novel in Seven Stories, Leslie Marmon Silko's Ceremony, Toni Morrison's Beloved and The Bluest Eye, Louise Erdrich's Tracks, and Sapphire's Push are among the works Stanford uses to examine women who have become ill because of broken ties to their histories and communities, because of racial hatred, or because of domestic and sexual violence (see this database for annotations).

The second part of the book finds novels examining medicine itself. Stanford uses Ana Castillo's So Far from God, Gloria Naylor's Mama Day (annotated in this database), Leslie Marmon Silko's Almanac of the Dead: A Novel (annotated in this database), and Octavia Butler's Parable of the Sower and Parable of the Talents again to raise connections between patients and social conditions but also to ask questions about bioethics and uncertainty, medicine and epistemology, and how medicine might resist dehumanizing trends through the "myriad possibilities of communitas" (218).

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As editor Judy Schaefer writes in her introduction, this collection provides "the rare opportunity to read both the poem and the poet's commentary." It is somewhat like a good poetry reading, where we get to hear about the events, thoughts, feelings and contexts that have stimulated the poem. Often the writer's commentaries have a richness of their own, complementing the poetry but not necessary to it. Also the commentaries describe some of the writing process the nurse poets go through in creating the poem. The fourteen nurse poets in this volume have all published their work in journals and anthologies, but this is the first collection to include commentaries along with the poems.

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Richard Selzer’s memoir is subtitled “A Doctor Comes of Age.” The book is structured around childhood memories, interspersed with stories from more recent times. Selzer’s father, a general practitioner in Troy, New York, serves as the focal point for most of his early memories--a commanding figure of warmth and goodness in his son’s life: “If I have failed to describe father… it is because none of his features did him justice. I should have had to mention wings in order to do that.” (p. 152)

While his father brought science into Selzer’s life, his mother represented the world of art. She was an amateur singer with a “small pure soprano voice” (p. 15), as well as being the doctor’s wife. After the doctor’s death from a massive heart attack when Selzer was 12 years old, his mother had numerous suitors, at least some of whom she eventually married. When he went to college, she began a life-long practice of writing her younger son (Selzer has an older brother William) weekly letters, including such advice as “Rise and flee the reeling faun,” “You do not take enough chances” and “You must learn to be absurd.” (p.227)

Toward the end of Down from Troy, Selzer writes of his parents, “Of all the satisfactions of my life, the greatest is that I have at last fulfilled each of their ambitions.” (p. 251) This is in reference to his having practiced both surgery and writing. He goes on to enumerate the many unexpected similarities between the two professions. The book ends with a narrative that brings together narrative and medicine, the story of a retired surgeon who reaches out to help a young man dying of AIDS.

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