Summary:

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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Warning: this annotation reveals the solution of the novel's mystery. The Moonstone is typically read as one of the first detective novels in British fiction. Published serially in 1868, the novel sets out to identify the thief who steals an expensive gem, the moonstone, from the heroine, Rachel Verinder. Franklin Blake, Rachel's love interest, turns out to be the thief. He stole the gem while under the influence of a dose of opium slipped to him by the local doctor. He has no memory of the deed.

Blake is able to solve the mystery--and win Rachel--with the help of Ezra Jennings. Jennings is also a doctor, but his unorthodox appearance and methods make him a pariah. Jennings is addicted to opium, which he began prescribing for himself to reduce the pain of a chronic illness. He uses his knowledge of the drug to re-create Blake's state on the night the jewel disappeared. Blake again tries to take the jewel and the mystery is unraveled.

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Gerald Wilcox is an otolaryngologist who lives with his wife and daughter in a small town in Montana in 1959. Dr. Wilcox has a weakness for women, alcohol, and, lately, morphine (with which he injects himself about once every six weeks). He enjoys writing in his journal almost every evening yet rarely reviews what he has previously written.

Although high on morphine, Dr. Wilcox repays a debt by making a house call late one night to treat a young boy with mastoiditis. On returning home, the doctor decides to bake a coffee cake for his wife at 5 o'clock in the morning while musing on what will happen to his journals after he dies.

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Sid Elliott is an alcoholic Vietnam veteran who works as an Emergency Room janitor. His lover, Roxanne, is a drug addict. Their relationship deteriorates until Roxanne leaves. After trying to stop a patient from banging her head on the wall, Sid is transferred from the ER down to the morgue. When the body of Gloria Luby, a 326 pound woman, is brought in, Sid decides to try and move her himself, repectfully, rather than rolling her with the help of an orderly. She is too heavy: they fall, and Sid is trapped under her body, his knee smashed. The story ends with Sid in the hospital, after knee surgery, visited by the phantoms of Gloria Luby, his father, and Roxanne.

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The front cover of this collection shows the outline of Africa completely filled with the names of patients ("Tyra Lynette Deja Nya Rovert Marqui Fatima Terry Alexia Michon Ty . . . ") On the last page, poem #120 consists of an outline of the United States of America, also completely filled with the names of patients, also African. The poems in this collection constitute a journey through these Dark Continents, both of which lie within.

Kelley Jean White stakes out her territory very clearly: "I suppose I embarrassed you / at all those mainline / plastic surgery parties / talking Quaker and poor and idealism" (3). There are no elegant parties, nor plastic surgeons, after page 3. Instead, persons like Shawanda live here: "At seventeen, Shawanda has never spoken. / Her brother easily carries her frail body / into the exam room--37 pounds" (36). And the nine year old girl who delivers her baby by C-section: "The nurses said it was the worst thing / they’d ever seen . . . She took her to her grandmother’s home / to raise. / The man did time / for assault." ("Freedom," 55)

But the poet hasn’t lost hope at all. She is filled with love and humor and imagination: "I dream I’m marrying this guy I used to work with who spent a lot of money on his hair" (73). "I musta been looking pretty down / when I left you today . . . " because the legless man pulling his wheelchair to his favorite begging spot said, "love, you gotta be always looking up . . . I just smiled and looked at / my too big shoe feet" (118).

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The unnamed narrator, a physician, notices a surgeon in a "seedy cafe on the edge of town." (73) He learns from the waiter that the shabby man with the "aristocratic demeanor" is "a doctor: Surgeon once" (73). The surgeon hears the narrator call for medical papers and makes his acquaintance. One night soon thereafter the narrator notices that the surgeon, sitting and drinking alone, drains the green syrup of his absinthe "so slowly and pleasurably" (74) that he must be, in fact is, an alcoholic.

The latter approaches the narrator and begins elaborating a complicated theory of time and how it is an internalized, organically controlled, locus in the brain, no different "from an ordinary brain cell" (77). As such, he, the surgeon, proposes to cut it out, imagining, grandiloquently, vast seas of gratitude washing up on his shore as he frees humanity of the "silent madness of mortality" (78). The surgeon ends with a toast to absinthe, "a drug to be taken orally, and which is useful against time, temporarily. . . . We won’t be needing it much longer, since the surgical method’s both radical and excellent. Cheers, my dear colleague!" (78-79)

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The events in Dry follow those in Burroughs's memoir of his bizarre childhood, Running with Scissors (see this database). Burroughs, at 24 years old and with no formal education beyond grade school, works in the high pressure advertising world of Manhattan. He's also an alcoholic, and his addiction definitely interferes with his work. Fortunately for Burroughs, he is not fired, but rather, his boss and co-workers set up an intervention. Burroughs--after telling his best friend, Pighead, who is HIV positive; his drinking buddy, the undertaker Jim; and his abusive, alcoholic father, of the plan--leaves for an inpatient rehabilitation program in Minnesota designed for gay people.

Thus begins Burroughs journey to sobriety. A journey that is replete with temptation, relapse (not only with alcohol, but also crack cocaine), love, success, loss, and grief. Burroughs experiences hallucinations, coma and life-threatening withdrawal. But ultimately, Burroughs achieves the title of his memoir. What he reveals is that, for an addict, remaining clean and dry is hard work. This daily, moment-by-moment work forces the addict to examine what is truly precious in life.

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21 Grams tells three stories that interlock in many ways, and it treats a wide variety of subjects, as the above keywords suggest.

Nevertheless, at the center of the film, and driving its action, is Paul (Sean Penn), a man in his middle years who gets a critically needed heart transplant and then sets out to discover, against the conventions of anonymous donorship, exactly whose heart he has inherited.

Paul’s quest brings him into close and complex contact with the other two main characters and their stories--Cristina (Naomi Watts), the grieving widow of the man whose heart Paul now has, and Jack (Benicio Del Toro), a reformed ex-con who now runs his life, and his family, by strict Christian dictates, and who is, through an accident, responsible for the death of the heart donor.

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For three weeks the narrator has been working as a clerk in the emergency department. His good friend, Georgie, is a hospital orderly. Both men abuse drugs, and Georgie steals them from the hospital. The ER staff includes Nurse (an overweight woman who shakes) and the Family Service doctor (a physician with limited competence who is not well-liked).

At 3:30 A.M., a man named Terrence Weber arrives at the ER. He has a hunting knife stuck deep in his eye. Ironically, his other eye is artificial. Weber's wife apparently tried to blind him because he ogled the woman next door. The doctor immediately decides the situation is beyond his expertise and calls for an ophthalmologist, neurosurgeon, and anesthesiologist.

Meanwhile Georgie is prepping Weber for surgery. The drugged-up orderly, who cannot even tie his shoe at this point, somehow removes the knife by himself. Weber's vision is fine. Later on, the narrator and Georgie get lost while driving around in a pick-up truck without headlights. The truck runs over a jackrabbit on the road. Intent on making rabbit stew, Georgie cuts the animal open with the hunting knife he had earlier removed from Weber's eye. The rabbit is pregnant with eight miniature bunnies inside her.

Georgie decides to save the babies. Unfortunately the narrator forgets about the rabbits and accidentally squashes them to death. At the end of the story the two men encounter a hitchhiker who has gone AWOL from military service. Georgie promises to take him to Canada.

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Intended for both the general public and medical professionals, Reel Psychiatry is a comprehensive catalogue of mainstream films that accurately portray psychiatric conditions. Robinson combines his "two passions: teaching psychiatry and watching films" to create a classroom resource for medical educators who want to use film to teach the diagnosis and treatment of psychiatric disorders and a critical compendium for anyone else who has more than a passing interest in cinematic works that dramatize the personal experience of patients and professionals grappling with mental illnesses.

The book is organized in three sections: primary psychiatric disorders such as schizophrenia, depression and bipolar disorder; personality disorders and mental retardation; and substance-related disorders and general medical conditions. The general symptoms and associated features of each condition are first set forth and then followed by descriptions of individual films that depict those symptoms and features.

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