Summary:

A down-and-out attorney, who has become somewhat obsessed with the case of a severely impaired woman who had suffered brain damage during the course of a surgical procedure, presses forward to prove medical malpractice. In the course of developing the case he is opposed by the Bishop of the diocese which owns the hospital in question; one of the most powerful law firms in the city; and, acting as "spy" for the defense team, a beautiful woman lawyer.

Galvin, the protagonist, is encouraged to continue his pursuit of justice by an honest former partner and his own belief in the patient's childrens' right to a settlement. Galvin wins his case by proving that the medical records have been altered.

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The aim of this collage of anecdotes from medical history is largely to entertain, though it is pointedly instructive in its focus on reasons for and results of medical mistakes, misapprehensions, and serendipitous breakthroughs. Gordon's dryly humorous skepticism and general irreverence is balanced by an obvious delight in the intellectual play that characterizes the history of science.

The stories he tells range from Hippocrates to the present with a heavy focus on the 18th and 19th centuries. The book includes a good representative collection of visual art and photography documenting moments in medical history upon which Gordon casts a cold but twinkling eye. Chapter titles such as "Discoveries in the Dark," "Sex and its Snags," "Odd Practices," and "Freud, the English Governess and the Smell of Burnt Pudding" give a bit of the book's flavor.

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Set sometime in the near future, Cast of Shadows has as its protagonist Davis Moore, a successful private practice physician specializing in cloning human babies for infertile couples. Early in the book, Anna Kat, his high school senior daughter, is murdered and raped. (For a while a likely suspect is Mickey the Gerund, a right wing extremist member of the Hands of God with a fascinating grammatical moniker never explained, who shoots cloning physicians, including Dr. Moore, in the abdomen, a short time before his daughter, Anna Kat, is brutally killed. However, Mickey is only a shadow of a suspect and quickly becomes supplanted by another much more likely villain. Mickey goes on to kill, by various methods, dozens of cloning physicians and staff by book's end.)

After a year of unsuccessful detective work, the local police return Anna Kat's belongings, including a plastic vial with the suspected murderer-rapist's semen. In an act never fully explored by Dr. Moore or the author, an otherwise rational and ethical physician surreptitiously uses the suspect's semen to fertilize a married woman patient.

The offspring, a clone of the suspected killer-rapist, is Justin, who becomes a formidable presence in the book. He is very intelligent--at his psychologist's advice, his parents provide him at an early age with advanced reading materials like Plato (hence one of the allusions to shadows, i.e., Plato's cave, in the book's title and referenced directly on page 118 and indirectly on page 208) and other philosophers. By the time he is a senior in high school, Justin has become a dominant player in the affairs of Dr. Moore; Sally Barwick, a private investigator-turned journalist; and the suspected killer-rapist--his origin of the species as it were.

This book has a number of subplots all of which radiate from the initial cloning and the various members of the extended family and professional staff involved in it, some knowingly, most not. There are narrative threads involving the suspected murderer rapist-now-prominent attorney, Sam Coyne; the triangle of Dr. Moore and Jackie, his alcoholic wife, and Joan, his attractive pediatrician associate; Mickey the Gerund's various murderous and obsessional religious activities and reflections; Justin's life in school and involvement with Sally Barwick's investigation of a serial killer called The Wicker Man; and, most especially, the development of Shadow World, a computer game and a virtual replica of the real world--the world as Justin, Sally, Sam Coyne, and Dr. Davis Moore know it.

Since this is a thriller, it would be inappropriate to divulge more of the plot, which is intricate, often a little far-fetched but always engaging, highly readable and more labyrinthine than most medical thrillers.

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Summary:

Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.

He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.

Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.

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Summary:

Selzer tells four stories of surgical loss: a surprise loss on the operating table, the drowning of a sick child in a flood in wartime Korea, the sudden death of a professor due to a perforated ulcer, and the loss of some facial mobility in a young woman following the removal of a tumor in her cheek. As we move from one vignette to the next, the narrator's mood goes from despair to accepting to redeemed, with various forms of love the agent.

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In the beginning of Ann Darby's lovely and enigmatic short story, "Pity My Simplicity," Dr. Peary, whose medical degree came from "The Franklin School of Eclectic Medicine and Surgery" (3), is trying to deliver Orla Hay's sixth baby, a breech presentation. The doctor is weary and perhaps under-trained, but he is vigilant. Orla's sister asks if she might take over trying to tug out the baby. When the doctor glances at the sister's hands--"Fever-breeders, he's sure, and he won't be blamed for fever"--he says no, he'll manage (4). He does manage, and when the child is "wailing a syncopated, newborn wail" the doctor is undone (5). He weeps, hoping his tears will be mistaken for sweat.

In prose that is atmospheric and evocative, Darby brings us into scene after scene as Dr. Peary's evening unfolds: the delivery, then home to his child and his wife, who tells him, only after he eats his dinner, that Alma Pine down the road "isn't 'faring' well" (8). Just as Orla and her sister expected the doctor to save the baby, both Alma Pine's husband John and Dr. Peary's wife expect him to figure out what's wrong with Alma. "And you waited to tell me?" Peary asks his wife (9).

In the final and longest scene in the story, Peary hurries to attend to Alma, a woman dying of tetanus. About to enter her room, Peary laments that he's never grown "callous to this moment," the second when he enters the lives of his patients (12). He walks in to find Alma writhing in her bed and her husband glowering nearby. "Quiet! Look what you've done," the husband accuses (12). The doctor nods, accepting guilt.

Later, he thinks, he will write in her chart words that describe her state but cannot cure. At the story's end, he gives Alma "the morphia, the one centigramme dose he always carries with him" (14). As he gives Alma this dose, he never looks at her husband, "which is fine because John Pine cannot bear to look at him" (14).

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The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.

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The young and upwardly mobile engineer, Joshua Jeavons, is obsessed with finding a solution to the water problems of 19th-century London. He spends almost every spare moment drawing and re-drawing maps of his precious drainage plans destined to save the city from the stench of effluent, which everyone believes is the source of cholera. His boss, Augustus Moynahan, is unimpressed with Joshua's plans, but allows him to continue analyzing sewers and drains. They work in conjunction with a master plan of coercive bureaucrats, led by Edwin Sleak Cunningham and manipulated by private interest.

Joshua has married the boss's daughter, Isobella, who had seemed more than eager to have him over her father's objections; however, she rebuffs all his physical attentions and the marriage is unconsummated. Brimming with sexual need and self-pity, Joshua continues a sporadic liaison with a friendly prostitute, all the while resenting what he decides must be his wife's infidelity.

When Isobella vanishes on the night of a disastrous dinner party, Joshua's fortunes plummet. He is reduced to poverty and shame, as he replaces his first obsession with the quest for his lost spouse--to reclaim her or kill her, he knows not. But his contact with urchins and beggars brings him to discover the real causes of pollution and disease--both environmental and moral.

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A young art student falls off a ladder and literally lands into the arms of a middle-aged doctor. Daisy Whimple is a poor, homeless woman with multiple body piercings. She has volunteered to decorate the Gynae Ward of the hospital where she had once been a patient undergoing surgery for a complicated abortion.

Dr. Damian Becket is an obstetrician and gynecologist. He is a lapsed Catholic who is separated from his wife. Becket is interested in modern art and attracted to an art historian, Martha Sharpin. The hospital has a collection of medical antiquities in need of cataloging. Some of the pieces are treasures but others are horrible relics. Martha is in charge of organizing the collection, and Daisy is paid to assist her.

Because she has nowhere to live, Becket invites Daisy to stay at his apartment. They make love every night for one week until she leaves. While attending an art exhibit, Becket and Martha spot a sculpture of the goddess Kali. The figure is comprised of artifacts "borrowed" from the hospital's collection including prosthetic arms, antiquated instruments, and body parts. It is designed by Daisy.

The sculpture is not the only unexpected thing created by Daisy. She is pregnant by Becket. Daisy requests an abortion but he insists that she have the baby. The pregnancy is almost miraculous given the damage done to Daisy's fallopian tubes from her previous abortion. It turns out to be a difficult delivery and Becket must perform it since he is the most qualified obstetrician at the hospital. The baby is a healthy girl. The newborn child radically changes the lives of Daisy, Becket, and Martha, yet the three of them have no clue what to do next.

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Summary:

Dr. McKechnie begins his overview of the history of the practice of medicine in British Columbia with records of Coastal Native practices encountered by the first explorers of the Northwest Territory in the 18th century. This opening section of the work contains interesting folklore regarding some of the methodologies and medicinals utilized, and terminates in descriptions of the rites surrounding the initiation of a new Shaman.

Moving forward in time, the author explores the early naval medicine of the seamen and their captains, including the early intermingling of the explorers with the Coastal Indians. The plagues of smallpox, measles, syphilis, and tuberculosis attributed to the arrival on the western continent of organisms to which the natives were not immune are covered briefly.

The third portion of the book is devoted to the changes in medical practice on this particular frontier as the emerging science of the 19th century moved gradually westward. The final chapters cover the century of the great world wars and the progressive advances in medical science as they affected the residents and physicians of British Columbia.

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