Summary:

The novel twines several plots together: the love story of Emilia Sauri and Daniel Cuenca; the Mexican Revolution; Emilia's medical practice; the love story of Emilia and Dr. Zavalza.

Emilia Sauri is the daughter of upper-class Mexican parents and is raised in relatively idyllic surroundings. Her father is a pharmacist and she learns his craft through a long apprenticeship with him. Emilia's long-time childhood friend, Daniel Cuenca, becomes her lover as they grow older and their love grows in passion while Daniel's involvement in popular struggle increases.

The Mexican Revolution is brewing and the Sauri's and Cuenca's lives are intertwined and involved in the struggle in various ways. When a wounded fighter is brought to the Sauri's, Emilia takes care of him, her "first patient," and thus begins her thirst for practicing medicine. She studies with Daniel's father, the indomitable Dr. Cuenca ("I leave but one bequest to my children: paralysis of the spine before the tyrant").

Drawn more and more into the struggle, Emilia joins Daniel on the front and practices medicine with the most desperate cases, along with the myriad poor people she meets along the way. Emilia also practices medicine with Dr. Zavalza, and finally marries him, although she never stops loving Daniel.

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The text explores the experiences of a nurse practitioner in an inner city OB-GYN (Obstetrics & Gynecology) clinic and four of her women patients, from a fifteen-year-old homeless pregnant child to a mature woman struggling with cancer. Another of her patients is pregnant and drug addicted; a fourth suffers from pains that come from buried memories of sexual abuse. The stories of all four patients weave in and out of the narrator's own stories about herself, her own health and illness experiences, her own respectful appreciation of the female body.

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The title of this collection of poems recalls the formulaic statement by which a physician introduces a patient's medical problem or chief complaint. For example, "The patient presents with a history of fever, abdominal cramps and diarrhea for the last 24 hours." Or, "The patient presents with a long history of hypertension and diabetes." In this case, though, Dr. White's patients' presentations are poems, rather than chunks of sanitized medical jargon; and, while the patient remains a key character in most of these works, they also present the doctor's story.

Domestic violence, child abuse, and sexual abuse figure prominently in these poems. In "365" (p. 1) a five year old girl presents with "a foul smelling vaginal discharge"; she was a victim of rape. Baby "John Brown" (p. 9) has 47 fractured bones and was "dipped in boiling water" for soiling himself. In "Ironing" (p. 18) a first grade girl has the impression of an iron burned into her thigh. And the two-year-old girl in "Peek" (p. 49) is admitted to the Intensive Care Unit (ICU) with cigarette burns and a liver fracture.

Dr. White also writes of babies left behind by their mothers ("Autumn Angels," p. 3), homeless mothers and children ("Numbers," p. 42), and complex multigenerational family pathology ("Riddle," p. 50). All in all, these stories carry the reader very close to "Looking at the Gates of Hell" (p. 32).

Yet, a still, small voice of calm, maybe even of salvation, can appear in the most unlikely places. In "Belly" (p. 4) the physician lays her face against a baby's belly and "the warm brown skin calms my forehead. / All stiffness melts." In "Maplewood & Greene" (p. 36) she revels in seeing "three little girls on roller skates." And in the Whitmanesque poem called "Oh" (p. 45), she gloriously affirms, "Oh to laughter, oh to sorrow / Oh to a better day, oh tomorrow."

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Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."

Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.

The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.

Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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Dr. Alvord was born to a Navajo father and a Caucasian mother--bilagaana--and felt from the beginning that she was walking the path between two worlds. Her childhood was spent on an Indian reservation and she was very close to her Indian grandmother.

She was fortunate to be able to attend Dartmouth College where there is strong support for American Indians. Actually there were 50 other Indian students there when she enrolled. From there she went to Stanford University for medical school and a surgical residency. This was a very unusual path for an Indian woman.

While in medical school and residency she felt very much separated from her Indian heritage and was glad to start her practice of surgery in the Indian Health Service and eventually to return to the Indian Hospital at Gallup, New Mexico, just fifty miles from the reservation where she grew up. This gave her the opportunity to learn more about Indian medicine and how to care for Indian patients.

While there she met her husband, a considerably younger Caucasian, and had her first child after a problem pregnancy. She sought the help of an Indian Medicine Man during this experience and felt much help from him. This is described very vividly.

Just eighteen years after she left Dartmouth she returned to be the Associate Dean for Minority and Student Affairs and to practice surgery and teach part time. There she hopes to share the Navajo philosophy of a balanced and harmonious life called "Walking in Beauty."

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Brown, anthropologist and Professor of Anthropology of Religion at Drew University, describes the life, religion and healing practices of Marie Therese Alourdes Macena Margaux Kowalski, also known as Alourdes or Moma Lola, a priestess of Voodou, who emigrated to the U.S. from Port-au-Prince in Haiti at the age of 24. What began as an ethnographic research project on immigrant Haitians, turned into a deep personal friendship between Moma Lola and Brown, and a privileged look at the practices and patients of a priestess, and at the socio-cultural lifeworlds of the Haitian community in Brooklyn and in Haiti between 1978 and 1986.

The book presents an intimate description of an alternative healing tradition through a number of perspectives. Brown alternates between a personal, an analytical, and a descriptive narrative of Moma Lola’s own history and her encounters with patients. In some chapters, Brown fictionally reconstructs the patient’s stories, so that the book is part traditional ethnography, and part fiction.

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According to the author's introduction, the most "beautiful and informative images of nursing are found on picture postcards" (xi). He has gathered over 580 full--color postcard images of nursing from 65 nations, documenting nurses' work in peace and war time and documenting, often in breathtakingly lovely images, an important part of nursing's history. Postcards from the years 1893 to 2002 (many of these from the "golden age of postcards," 1907 through World War I) follow nurses from factories to flu wards, from battlefields to mission welfare clinics.

The author has divided his book into seven chapters: "Symbols of Care," "Twentieth--Century Postcard Art," "As Advertised: The Nurse on the Advertising Postcard," "Portraits," "War!" "An American Photo Postcard Album," and "Parade of Nations." Each chapter begins with an intelligent, fascinating explanatory essay by the author, and each chapter ends with copious notes revealing the origins and stories behind the postcards. The book has an extensive bibliography and is well indexed.

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This is an exhibition catalogue for a show of 16 photographers who documented major topics in health over the last century. Carol Squiers, curator of the show, provides ten essays, amply illustrated by photos, on critical topics such as child labor, domestic violence, environmental pollution, AIDS, veterans of war, and aging. Some 80 per cent of the images treat American subjects.

Lewis Wickes Hine's photographs of child labor are dramatic and disturbing; these document children in coal mines, cotton mills, glass works, etc. in the first part of the 20th century. The Farm Security Administration sponsored photographers (including Dorothea Lange) to represent the New Deal Health Initiatives. Topics include farm labor, poverty in the South and Southwest, and inoculations. W. Eugene Smith created a photographic essay for Life magazine about Maude Callen, an African-American nurse-midwife in 1950s rural South Carolina.

Donna Ferrato documented domestic violence in the U.S. in powerful, personal shots, including a series of an actual attack. David T. Hanson created triptychs about environmental pollution: one panel shows a map of the area, a middle panel gives descriptive text, the last panel is an aerial shot in color. Eugene Richards spent time in the 1980s in Denver General's Emergency Room. Eleven black and white photos show the turmoil and drama.

Gideon Mendal documented HIV/AIDS in several African countries. Lori Grinker took photos of army veterans (some without hands) but also noncombatants harmed by war, including children. Ed Kashi presents images of aging Americans, rich and poor, urban and rural. Sebastião Salgado provides photos of vaccination in Africa and Asia.

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The novel is set in Washington, DC in April, 1865. At fourteen, Emily is sole caretaker of her mother who is dying of tuberculosis. Her neighbor, Annie Surratt, is her best friend, though their mothers have been estranged for some time. Both families have deep roots in the South. Annie’s brother, Johnny, an object of Emily’s romantic fantasies, has recently left on a secret mission. The war is nearly over. Emily’s uncle Valentine, a physician, wants to take custody of her after her mother dies, but because her mother has also felt estranged from him, Emily resists. Still, after her mother’s death, she does go to live with her uncle, and learns that he (with his two assistants, one of whom is a woman who is 1/8 African American) has a lively practice among the poor and the African Americans who have flooded the streets of Washington since the emancipation.

Valentine is called to Lincoln’s bedside the night of his assassination, and participates in efforts to track down John Wilkes Booth and his accomplices, one of whom appears to have been Johnny Surratt, who has escaped to Canada. In the course of her time there Emily discovers that her uncle and his assistant are involved in elaborate, marginally legal, schemes to obtain bodies for study at the medical college. Emily, at first horrified by this discovery, comes to recognize the good that comes of anatomical studies and to sympathize with her uncle’s efforts to bring about legislation making the acquisition of bodies for medical research easier. Annie’s mother is hanged as an accomplice in the Booth conspiracy, Annie leaves town, and Emily comes to understand a great deal more about the harsh terms on which life must be lived in times of national crisis and ideological warfare. The story ends with her growing interest in medicine as a possible career path.

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