Summary:

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 is a fourth year medical student dealing simultaneously with the rigors of medical training and the difficulties of living with diabetes. She has discovered that when she tries to interact with patients she over-identifies with them. When she reads about diabetes in medical textbooks, which present a rigid equation for balancing diet, exercise, and insulin need, she tries to adopt this approach to her personal diabetes management, convincing herself that emotions, fatigue, stress and other factors have no effect on her diabetes control. When this biomedical approach fails, she feels deep shame and frustration.

Only over time does she develop the confidence to realize that it is not shameful to admit one's personal needs even in medical training, that disease is a part of all humans and is not an enemy, that she need not be defined solely by her disease (or her profession), and that blurred boundaries between doctors and patients are not as dangerous as she was first led to believe.

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Summary:

A nephrologist is named in a lawsuit after serving as a consulting physician in a diabetes case. The diabetic patient had had a serious infection and later his leg was amputated; he apparently felt the doctors neglected the seriousness of his condition. When the dialysis unit treating this patient requests to transfer his care to the author, whose unit is in the patient's home town, the author is uncertain what to do.

The author is angry about the law suit, and his colleagues counsel him to refuse to take this patient. But after realizing that the lawsuit was merely a reflection of the patient's suffering, and that he needs the same compassion and care as any other human being, the author agrees to accept the patient. The author discovers that his patient is a meek, gentle man; over time, he helps him come to terms with his illness, his disability, and his approaching death. Eventually the patient drops his malpractice suit.

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Summary:

This poem is in the voice of a faith healer who calls upon the reader to witness the marvels of God's healing power, a holy power that shows the terrible evil embodied in the theory of evolution: "Darwin's demon apes of hell / howl the name of blasphemy." The narrative centers on a young boy with diabetes, whose father brings him to be healed. He and his father prayed and their faith grew strong; "he threw away the pills, those ugly / relics of his doubt-- / and the boy cried out, rejoicing!"

Later, though, during the night, the boy became ill again and begged his father for the pills. But the congregation prayed and the father's faith held . . . and the boy died. The healer rejoices, though, because "he is not dead--the boy / only sleeps in the Lord." The healer believes the child died because " Darwin's great beast" rose that night and "passed his hand over the boy's / sick faith."

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