Summary:

This documentary video follows the making of an opera, based on the illness experiences of four Australians who have been diagnosed and treated for cancer. Their feelings about these experiences are translated into music (with lyrics) as they work closely with music therapist/composer, Emma O'Brien. As the three women and one man tell their stories of physical debility and emotional pain, the music therapist asks them to think in terms of color (they choose purple, black) and tones and rhythms that she plays for them on the piano.

When the narratives and their musical representations have evolved sufficiently, trained singers take on the roles "written" for them by the four former patients; the latter continue to be intimately involved in the opera's production, directed by David Kram. At the end of the project, which is also the conclusion of the film, the opera is performed in front of an audience (with musicians playing instruments, singing, and dramatic enactment) and the four people whose illness experience is performed take their bows together with the singers.

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After being struck by a speeding car while riding his bicycle, Paul Rayment suffers extensive damage to his right leg. An above-knee amputation is performed by a young surgeon, Dr. Hansen. Paul is a 60-year-old former photographer who lives in Australia. Divorced and childless, he has no one to assist him with the activities of daily living after he is discharged from the hospital. He refuses a prosthesis. Paul's accident and loss of a limb have triggered a reexamination of his life. He now regrets never having fathered a child. Paul's life is further complicated by three unusual women.

He hires a Croatian lady, Marijana Jokic, as his day nurse and aid. He is attracted to and dependent on the much younger Marijana. Although she is married and has three children, he lusts for her. He offers to act as a godfather for Marijana's children and provide funds for their education. Drago, Marijana's oldest child, lives with Paul for a while. Drago and his father build a customized cycle to convey Paul, but the crippled man doubts he will ever ride it.

Paul has a single sexual encounter with a woman blinded by a tumor. Her name is Marianna. He is blindfolded during the affair and pays her afterwards. A novelist with a weak heart, Elizabeth Costello, intrudes on Paul. The elderly woman is mysterious. She pesters him, occupies his apartment without an invitation, and peppers him with questions. In time, all three females fade from his world, leaving Paul still struggling to adapt to loss and a new life.

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This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."

In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).

In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."

During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.

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This is a comprehensive social history of European (or "Western") attitudes toward death and dying over the last thousand years. Ariès organizes his history into five sequential cultural constructs, each of which conveys the meaning of death to the individual and community, as well as the social institutions around death and dying, during a different period of Western history, beginning in the Middle Ages.

Cultural responses to death must begin by acknowledging that death is mysterious and overwhelming; a wild beast; a meaningless monster. Death lurks at the edge of our consciousness, ready to destroy us and demolish whatever meaning we attribute to our lives. In medieval Europe Christianity had domesticated this monster by establishing a comprehensive set of beliefs and practices that Ariès calls the "tame death." Death was merely a transition to eternal life. The individual was understood as an integral part of the community and not as autonomous and isolated. Therefore, death and dying were communal events, supported by specific prayers and practices (i.e. ars moriendi) that "tamed" the unknown.

In the centuries that followed, Ariès's "tame death" evolved through five stages into the radically different cultural conception of death that characterizes Western society--especially in its American form--today. These changes result largely from the gradual replacement of community-oriented personal identity with today's radical individualism; and the gradual sequestration of death to a position behind the scenes, so that dying and death become remote from ordinary experience.

In today's world we encounter "invisible death," a somewhat paradoxical name because its invisibility allows the savage beast free rein. Death is no longer "tame" because we deny its existence so effectively we no longer develop personal and communal resources to give it meaning. Death's invisibility enhances its terror; our culture's loss of spirituality enhances death's meaninglessness.

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The son of a poor widow, François Burnens is overwhelmed with his good fortune when he is hired to assist the gentleman-scientist, François Huber. Blind since the age of 19, Huber studies bees, helped by his wife in his observations at their Geneva home. Now expecting their second child, the couple realizes that she must concentrate on the family. Through Burnens's diary, from 1785 to 1794, the young man grows as a scientist, a writer, and a human being. Charles Bonnet and other scientists visit in person or in citation.

The domestic drama of the home plays against a backdrop of the menacing turbulence in nearby France. Burnens' admiration, respect and pity for Huber keeps him in the modestly-paid employ for nine long years. But his fascination with an artistically talented young woman shows him that his situation as a valued servant must come to an end.

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This tale is a fantasy in which a mountain climber falls into a strange and isolated society of non-seeing persons--claimed to have been in existence for fifteen generations and cut off from the rest of the world by an earthquake. The interloper decides quickly that "In the country of the blind, the one-eyed man is king."

However, incident after incident proves him wrong in a society that no longer knows the word "see" and operates perfectly effectively and happily with the other finely tuned senses. Virtually imprisoned, and relegated to serfdom, the visitor begins the acculturation process of learning to live with his own disability--vision. Eventually he falls in love and gains permission to marry if he will agree to have his eyes, which have been deemed the cause of his irrational outburst, removed. His decision and its outcome make up the climax of the story.

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What will the members of an isolated community do to attract a doctor? What won't they do? Ste-Marie-la-Mauderne is a microscopic fishing village on the rocky north shore of Quebec, just where it meets Labrador.

The fishery is declining, people are leaving, and the welfare payments, doled out by the pretty postmistress, Eve (Lucie Laurier), are humiliating. Ste Marie wants to diversify. All it needs to attract a plastic-bottle factory is a bribe of $50,000 and a doctor. They get a lucky break when a Montreal cop, who hails from Ste-Marie-la-Mauderne, stops the speeding plastic surgeon, Dr. Christopher Lewis (David Boutin), on his way home from a cricket match.

Now, the village has one month to convince the worldly young man that he wants to stay forever. The mayor, Germain (Raymond Bouchard), and several friends set out to make Dr. Lewis feel as welcome as possible. They embark on a collective effort to teach the francophone fishers how to play cricket. They flood the clinic with bogus ailments, they take Lewis fishing, they charm him with five dollar bills left nightly by a garden gnome, they force themselves to listen to incomprehensible jazz, and they bug the doctor's telephone to ascertain his tastes and commitments, broadcasting the intimate details of his faltering relationship with sultry Brigitte back in Montreal.

Eventually, Dr Lewis splits up with Brigitte, because she has been "dishonest" and he chooses to stay in Ste Marie because they are "genuine." The crisis arises near the end, when the townspeople realize that in order to keep Dr. Lewis for any time at all, they must own up to the charade of deception and offer to let him go.

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Author Horace Davenport is a retired professor of physiology who had a distinguished career in medical science. This book reflects his more recent interest in the history of medicine and physiology in the 19th and 20th centuries. The best summary of this transcription with commentary resides in the author's own introductory paragraph, paraphrased here: From 1899 to 1900 fourth year medical students at the University of Michigan doing their medicine and surgery rotations attended a diagnostic clinic twice a week with George Dock, A.M., M.D., professor of theory and practice of clinical medicine. Dr. Dock had a secretary make a shorthand record of everything that was said at these clinics by Dock himself, the patients, and the students.

The clinics and recording of the interactions continued until the summer of 1908 when Dr. Dock left Michigan for a position at Tulane. The typed transcripts of these sessions fill 6,800 pages. This book is Davenport's distillation and, on occasion, clarification of these documents. In these transcriptions resides not only a view of the practice of academic medicine at the turn of the 20th century, but also a glimpse at one clinician's interpretation of clinical material in his own time.

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As James Morris, the author was the dashing journalist who covered the first successful ascent of Everest in 1953 for The Times of London; a member of the elite and quintessentially male 9th Queen's Royal Lancers ("famous for their glitter and clublike exclusivity"--p. 27); the husband who married Elizabeth, fathering several sons. But, as the writer says in the first sentence of the book, "I was three or perhaps four years old when I realized that I had been born into the wrong body, and should really be a girl. I remember the moment well [James was sitting beneath his mother's piano], and it is the earliest memory of my life."

Realizing he was a member of a tangled (a favorite word of the author) group of transsexuals, James felt himself trapped in a conundrum of gender (he felt and considered himself female) versus sex (he was genotypically and phenotypically male). "To me gender is not physical at all, but is altogether insubstantial; it is soul, perhaps, it is talent it is the essentialness of oneself" (25). (Morris goes on to quote C. S. Lewis's Perelandra.)

After some fruitless interactions with the medical profession, Morris travels to Casablanca in the summer of 1972 to undergo sex-changing surgery and becomes Jan Morris. Unlike many if not most transsexuals, post-operatively Morris fared quite well emotionally and has, to date, been quite happy with the change (see below). Jan Morris's writing is as humorous and eloquent as James Morris's was. She describes (magazines like Rolling Stone and publishers like Random House and thousands of readers have never cared what gender or sex was holding the pen) how life changed in clubs, restaurants, and in taxi-cabs, where Jan met the first man to kiss her, post-surgery, "in a carnal way" (151). (Morris records that "all I did was blush.")

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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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