Summary:

A Mexican-American woman has an appointment for her son Jorge to be seen at the Anglo clinic. She insists on keeping the appointment, even though her relatives think she is crazy. She reflects on events in her life--Jorge's congenital heart disease, the fact that she had a tubal ligation after his birth, and that the heart disease might have been a punishment from God. She reflects upon the fact that often people go for clinic appointments, only to find that the Anglo doctors aren't there and another appointment must be made. She carefully selects Jorge's clothes. She takes the crowded bus.

Finally, at the clinic two doctors enter after a long wait. One is a psychiatrist. In this last scene it becomes evident that Jorge has already died. His mother has brought a bundle of Jorge's clothes to the clinic for "his" appointment, still hoping for a miracle. Referring to the psychiatrist, the woman doctor tells the mother, "He will make you better."

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Sapphira was a fashionable young woman in Winchester when she married Henry Colbert, a man beneath her station, and moved to a rugged backwoods village, where they have lived for more than 30 years. Twenty of Sapphira's slaves came with them. This caused somewhat of a sensation among the poor, non-slave owning population of the region, where even to this day the Colberts are admired but not well-liked. Henry successfully took over the village grinding mill, while Sapphira assumed the role of local granddame. They had three daughters, all of whom married and moved away. However, Rachel's husband died, and she returned to Back Creek with her two young children.

Sapphira and Rachel are lay nurses who often visit and comfort the sick. Sapphira appears to do this work out of a sense of noblesse oblige, but Rachel feels empathy for the sick and less fortunate. She sets herself above nobody. Rachel is also an abolitionist at heart (as, to some extent, is her father), but Sapphira is firmly convinced that slavery is not only necessary, but also moral. Henry, a rather ineffectual male presence in this story, has responded to Sapphira's haughty regime by gradually withdrawing. In fact, he has largely abandoned the Big House to live at the mill, which he justifies by claiming the lack of a reliable foreman.

Sapphira suffers from severe dropsy. Her swelling is so bad she can no longer walk. She is jealous of a young slave named Nancy, with whom she believes Henry is having an affair. Much of the novel describes Sapphira's attempts to get rid of Nancy, first by selling the girl in Winchester, and later (when Henry refuses to sell) by importing her ne'r-do-well nephew to rape and destroy Nancy. This doesn't work either, primarily because Rachel takes Nancy under her wing and arranges her escape to Canada via the Underground Railroad.

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This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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This film tells the remarkable story of Vivien Thomas (played by Mos Def), an African-American fine carpenter, who found his way into medicine through the back door and changed medical history. Hired when jobs were in short supply to work as a custodian and sometime lab assistant to Dr. Alfred Blalock (Alan Rickman), a research cardiologist, Thomas quickly becomes an irreplaceable research assistant. His keen observations, his skill with the most delicate machinery and, eventually, in performing experimental surgery on animals, make clear that he has both a genius and a calling.

Though the relationship has its tensions (Blalock, as a Southern white man and a doctor, has some blind spots in the matter of mutual human respect, though he highly values Thomas’s skills) it lasts for decades. The two move their families to Baltimore, where Blalock becomes Head of Surgery at Johns Hopkins and, much to his colleagues surprise and to some of their dismay, brings Thomas in to perform groundbreaking open heart surgery on a blue baby. It is not until after Blalock’s death that Thomas is granted an honorary doctorate from Johns Hopkins, where he continues to work in research until his own retirement.

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A physician is called to visit a sick baby in an apartment in the poorer part of town. When he arrives, the baby is being cared for by a "lank haired girl of about fifteen," the child’s sister. The parents are out. The doctor is intrigued by the young girl’s forthrightness, the "complete lack of the rotten smell of a liar." He notices that she has a rash on her legs. She asks for some medicine to help her acne.

The doctor returns later when the mother is home. She speaks little English. Evidently the child had been in the hospital, but they had brought her home because she was getting worse with hospital-acquired diarrhea. The doctor examines the baby, discovering that she has a congenital heart defect, which is probably responsible for her failure to thrive. The doctor gives advice about feeding and prescribes some cream for the fifteen year old’s acne.

Later, the doctor’s wife and his colleagues comment on the baby’s family: they’re no good, they’re crooks, he’ll never get paid. In the end he does go back to the apartment. The baby looks a little better and the girl’s face is a little clearer.

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Max, who has lost his wife after a long life and career together as circus acrobats, reluctantly retires to an assisted living home. There he finds unexpected friendship first in his neighbor, Lettie, a widow who has a gift for uncomplicated kindness, and Alison, a thirteen-year-old he meets when he gives juggling and stunt lessons at the local junior high. The unhealed ache of his wife's slow death from cancer makes Max skittish about opening his heart to either of them, though Lettie offers him patient companionship and Alison, full of adolescent restlessness, unfocused intelligence, and need, desperately wants something of the grandfatherly good humor and wit she finds in Max.

Alison's mother is pregnant with a long-delayed second child and the distance she feels from her parents drive her to lengthy novel-writing and to rather pushy efforts to make Max her special friend. For him, she learns to juggle. She cuts class to visit him, and to go out for sodas with Lettie. Alienated from peers she finds silly, the old people touch a place in her that needs love. After a heart attack, Max comes home with newly raised defenses, and retreats from the budding friendship with both women.

But when Alison runs away to a circus he refused to attend with her, and then to Penn Station, Max goes with her parents and finds her on a hunch. Found, she clings to him like a small child, and he finds himself full of a long-resisted love. On the way home, however, he succumbs to a heart attack. In the final chapter, Lettie helps Alison begin the long, difficult process of accepting mortality, grief, and the possibility of eventual healing from a loss of a kind she finds herself still unable fully to articulate to anyone she believes will understand.

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George, a strong introverted African-American man and Guilio, a delicate and flighty Italian man, have been lovers for many decades. Guilio's deteriorating heart condition strains their relationship. Guilio is haunted by childhood death fantasies and George becomes frustrated trying to help him to deal with his illness and his fears. In the end, however, George is comforted by Guilio, who has sensed his pain and grief over being the surviving partner.

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Williams's autobiography recounts his life from his first memory ("being put outdoors after the blizzard of '88") to the composition of "Patterson" and a trip to the American West in 1950. The book's 58 short chapters epitomize the writer's episodic and impressionistic style, presenting a series of scenes and meditations, rather than a narrative life story.

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Subtitled "New and Selected Medical Poems," this volume includes poems on illness and healing from Downie's three previous collections, along with several new poems. A longer piece called "Learning Curve Journal" serves as a framework for the book.

Beginning with the desperate voice he hears on his first night as a "suicide line" volunteer, the poet reveals the shape of his own medical learning curve, moving poem by poem from "Orientation" through the realm of "Patient Teaching" and "Teaching Rounds" to "Pronouncing Death." Among the many strong poems in this collection are "Diagnosis: Heart Failure," "Louise," "Sudden Infant Death," "Wishbone," "Living with Cancer," and "Ron and Don."

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Howard Carter very skillfully weaves together the various meanings that the heart holds for us--biological, medical, psychological, cultural, and spiritual. He does so through four patients that he interviewed when he was appointed to a distinguished professorship in medical humanities in a joint program of St. Patrick Hospital and the University of Montana, in Missoula.

Each of the sections of the book focuses on one of the patients who suffers, respectively, from a prototypical heart problem: a young man with congenital defects who undergoes successful surgery; a middle-aged woman with a viral illness who learns how to live with her chronic heart condition; a middle-aged man whose blocked coronary arteries are cleared, as is the stress in his life; and an old man who turns to spiritual matters as he faces heart failure.

What contribute significantly to the uniqueness of this book are the essays that Carter provides at the end of each Patient Section. They are the vehicles for the synthesis of the patient stories, the scholarly look at how "we have largely lost the anchoring image of the heart" in American society, and his very poignant personal reflections about life in (or at least near) the wilderness of Montana. (See Solid Footing, Higher Ground -Third Essay as an excellent example of his skillful and moving writing.)

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