Summary:

At the age of 42, Barbara Rosenblum learns, after several misdiagnoses, that she has advanced breast cancer. This book, co-written by Rosenblum, a sociologist, and her lesbian partner, Sandra Butler, a feminist writer and activist, is a record of their lives together from the diagnosis until Rosenblum's death three years later. Early on, Rosenblum decides that her dying will be exemplary and self-conscious, and she and Butler use their writing as a way to create an illuminating examination of their lives over those three years.

The book's title is accurate; the writing takes the form of alternating meditations by two women, on the effects of cancer on their relationship, their work, their families, and their social, political, and spiritual beliefs. Especially significant are the differences between their voices, and the differences between the experience of the person who is dying and that of the person who is going to have to survive and grieve. The writers bravely explore the conflicts between them as well as their profound bonds.

After a mastectomy and eighteen months of chemotherapy, Rosenblum has a very brief respite, followed by liver and lung metastases, and prolonged further chemotherapy. A few months after ending treatment, she dies at home.

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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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Alison, 39 years old, is twice-divorced, with three children, on the verge of moving in with a man called Bobby. Her breast is sore and she is afraid it's cancer. Her mother tells her it's more likely she's pregnant. She says she uses contraceptives; her mother tells Alison that she was conceived when a condom broke.

Alison considers abortion, recalling her last pregnancy. Having given birth to a child with Down's Syndrome who died at three months, she had had amniocentesis and was told that she was carrying twin boys, both normal. When the twins were born, though, one turned out to be a girl. One twin, it seemed, had been tested twice. Although the female twin did not have Down's Syndrome, Alison began at that point to worry about luck and the uncertainty of medicine (and of life).

So now, pregnant again, she asks her mother what she should do, and is told to "trust to luck." But she is afraid that her luck has run out and she must take control for herself. A scan shows that she is carrying twins again. Only now does her mother tell her that she is in fact a twin, that her sister had Down's Syndrome and died shortly after birth--in fact, her mother admits, the midwife "did away with" her. (The euphemism carries the senses both of euthanasia and of murder.)

Hearing this, Alison decides she wants to have an abortion right away. Her doctor, thinking the problem is that she wants only one child, gives her the option of selectively terminating one fetus and carrying the other one, but tells her she wouldn't be able to choose which to keep and which to abort. She rejects the idea, imagining how she'd tell the surviving twin about her decision later on, and decides instead to "have them both and trust to luck."

As she leaves the clinic, she begins to bleed and miscarries. Later her mother tells her that she, too, once miscarried twins, and tells Alison she'll have better luck next time, because of the bleeding: "Blood, " her mother says, "is the libation the God of Chance requires."

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Frank is an emergency medic and ambulance driver working night shifts for Our Lady of Mercy hospital in Hell's Kitchen, New York City. The novel begins with Frank's resuscitation of an elderly man called Mr. Burke, who has had a heart attack, and ends a couple of days later with Mr. Burke's death in the hospital. Frank is haunted by the patients he has failed to save, some of whom inhabit his experience like kinds of ghosts.

Most insistent is a teenage girl called Rose who died during an asthma attack, in part because Frank was unable to intubate her in time. He is also unable to forget his marriage, which ended because of the deadening effects of his work. And now Frank is also haunted by doubts about the value of restoring life.

He has successfully started Mr. Burke's heart, but the man is brain dead. Frank thus watches as Mr. Burke's family is first given hope and then must learn that there is none. Frank almost falls in love with Mr. Burke's drug-addicted and disillusioned daughter, Mary, perhaps seeing in her an opportunity for a mutual restoration to health.

But when her father finally dies--when the attending realizes that the patient's struggle hasn't been the "survival instinct" but rather a "fight to die"--she blames Frank, who recognizes that his purpose is not simply to keep people alive (or to bring them back from the dead), but rather that "saving lives" means preserving their value, somehow, in his memory. He walks away from the hospital, and when he gets home, Rose--her ghost, and Frank's own symbol for all the patients he hasn't resurrected--is waiting there, to forgive him.

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This is the familiar story of Victor Frankenstein, a scientist obsessed with his desire to penetrate the secret of life and create a "perfect" creature. The novel is actually a series of stories within stories. The outermost is the tale of Walton, a young captain who sails toward the North Pole in hopes of discovering a northern passage to the New World; he is obsessed with penetrating the "dangerous mysteries" of the north. His ship comes upon the mortally ill Dr. Frankenstein, adrift on an ice floe. Most of the novel recounts the strange tale Frankenstein tells Walton as he lies dying on the ship.

In the book's center is the monster's own story, as told to Frankenstein. At the moment he gives his creature the spark of life, Frankenstein is overwhelmed with the ugliness and unnaturalness of his creation. He abandons the creature, who then begins to pursue him to seek acceptance, and when that is not forthcoming, to seek revenge, eventually killing all those who Frankenstein loves.

The creature yearns for love and acceptance, but all are horrified by him. At first Frankenstein agrees to create a mate for him -- "I am malicious," the creature explains, "because I am miserable." But at the last minute he reconsiders, horrified at the implications of possibly creating a superhuman race. After the creature kills Frankenstein's friend Clerval and his beloved Elizabeth, the doctor begins to pursue him throughout Europe and eventually to the Arctic, where Walton encounters them. After the creature is satisfied that Frankenstein is dead, he takes his leave forever, "soon borne away by the waves, and lost in darkness and distance."

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Summary:

The film covers two days in the life of Frank Pierce (Nicolas Cage), a burned-out EMT (emergency medical technician) working the socio-economic underside of Manhattan. From the beginning, Frank is upset because recently all his patients have been dying on him, and he is haunted throughout by the hallucinated ghost of Rose, a young woman who collapsed on the street and died, apparently because he could not intubate her correctly.

Frank is highly stressed, he has no life outside his work, and he is self-medicating with alcohol. He tries to quit, but his boss keeps him on by promising time off in the future. In the film's first action, Frank does manage to miraculously resuscitate Mr. Burke, a heart-attack victim, but the patient winds up in the hospital with a very bad prognosis, so even that "saving" works against Frank.

Frank has encounters with numerous patients, many of them street people whose lives are out of control, some of whom are ER (Emergency Room) regulars, such as the demented young Noel (Marc Anthony). He also deals with (and is dealt with by) several highly idiosyncratic EMT partners in his ambulance rounds (John Goodman and others). Frank gets to know Mary Burke (Patricia Arquette), the daughter of the heart-attack victim, and they tentatively move toward being a couple who might help each other survive their lives.

Near the end, Frank, who knows Mr. Burke had tried to tear out his tubes during a brief moment of consciousness, and who feels he has been getting pleading messages from him to end his agonies, surreptitiously takes him off life support long enough for him to die. The physician who responds to the code decides not to attempt resuscitation of this patient who had already been resuscitated 14 times that day. Frank goes to tell Mary that her father has died (but not how), and exhaustedly falls asleep on her breast, apparently having forgiven himself because he has in some sense finally "saved" Mr. Burke.

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Summary:

Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.

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Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:

From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.

The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.

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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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Summary:

The author of this memoir is a poet and writer who developed systemic lupus erythematosis (SLE) during her first year at the University of Pennsylvania. Initially, her condition was difficult to diagnose, which led to her first negative encounters with physicians and the health care system. Later, Ms. Goldstein developed unusual neurological manifestations of SLE. Once again, she had trouble convincing her doctors that her symptoms were not only real, but also disabling. She was fortunate enough to come across a few good physicians who respected her as a person and earned her trust.

Despite her chronic illness, Ms. Goldstein thrived throughout college and graduate school. She approached each new challenge with such a positive attitude that some of her doctors considered her emotionally unstable. (I guess they thought it would be more "normal" for her to lose hope and turn herself into an invalid.) Her graduate work in literature focused on the new field of literature and medicine.

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