Summary:

The aged, black nurse, Eunice Evers (Alfre Woodward), testifies before the 1973 Senate hearings into the Tuskegee study. Through a series of lengthy flashbacks, her testimony evokes the 1932 origin and four-decade course of a research experiment to study but not treat syphilis in the black men of Macon County, Alabama. The federally funded project began with the intent to treat the men, but when funds dried up, the project coordinators decided simply to document the course of the disease to discover if blacks responded to syphilis as did whites.

The nurse was deeply attached to the patients and they, to her; a Dixie band named itself "Miss Evers' Boys." Evers and her doctor supervisor (Joe Morton) hoped that treatment would be restored after a few months, but ten years pass. With the advent of penicillin in 1942, her intelligent lover Caleb (Laurence Fishburne) rebelled, took penicillin, and enlisted in the army; the project, however, continues.

Evers is disbelieving when she realizes that the men will not be treated, but she cannot abandon them. Against the advice of her father, she refuses to leave Alabama with Caleb and continues to participate in the lie that encourages the Tuskegee men to remain untreated into the late 1960s. One by one Miss Evers' Boys die or are disabled by the disease.

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In September 1796, 32-year-old Mary Lamb (1764-1847), stabbed her mother to death with a carving knife during an incoherent frenzy. Almost immediately, she became calm and was sent to a madhouse, remaining away from home for months until her grieving and unforgiving father had died. Mary was released into the care of her much younger brother, Charles (1775-1834), soon to be known for his poetry and essays. She never went to prison, but would return to the madhouse many times over the next fifty years. As a result, this life is an interesting exploration of chronic mental disturbance in the early nineteenth century.

Neither Charles nor Mary ever married; they always lived together and professed to be each other's dearest friend. Obliged to eke out a middle class income--she (until her crime) at dressmaking, he in an office--they turned to writing, often together. The Lambs' famous Tales from Shakespear [sic] was written mostly by Mary, but their friend William Godwin under Charles's name as sole author first published it. Mary's other books, edifying texts for young female readers, were published anonymously.

Letters to their many friends reveal Mary's vexation with Charles's drinking and smoking and his concerns over her multiple relapses, which were triggered by being obliged to move house. Charles predeceased his older sister by ten years and she spent the rest of her life in chronic care of a private couple, visiting his grave almost every day.

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Doctors in Fiction. Lessons from Literature is an interesting collection of short essays about fictional physicians by Borys Surawicz and Beverly Jacobson. The authors, one a cardiologist (Surawicz) and the other a freelance writer, discuss more than 30 physicians drawn from novels, short stories, and drama, and representing a fictional time frame from the late 12^th to the early 21^st century.  In each chapter the authors present one or more of these physicians in context, briefly introducing the work, the writer, and a précis of social context.

Dr. Andrew Manson in A. J. Cronin's The Citadel and Dr. Martin Arrowsmith in Sinclair Lewis's Arrowsmith appear in the section entitled "Idealistic Doctors." Other examples of "good" physicians include Tertius Lydgate (Middlemarch), Bernard Rieux (The Plague), and Thomas Stockman (An Enemy of the People).  At the other end of the spectrum are failures and burnt-out cases, like alcoholic psychiatrist Dick Diver in F. Scott Fitzgerald's Tender Is the Night and the debauched abortionist Dr. Harry Wilbourne in Faulkner's The Wild Palms.   

Some of the best examples of fallen doctors appear in Anton Chekhov's stories and plays. Chekhov, a practicing physician himself, well understood the triumphs and tragedies of the medical experience. Surawicz and Jacobson single out Dr. Andrei Ragin, the dispirited medical director of Chekhov's Ward 6 for special attention. They also touch briefly on Dymov, an idealistic physician who dies as a result of diphtheria he contracted from a patient (The Grasshopper); Korolyov, a young doctor who develops an empathic bond with a woman who suffers from chronic anxiety ("A Doctor's Visit"); Startsev, a practitioner who grows to love money more than his patients' welfare("Ionych"); and Astrov, the dedicated proto-environmentalist physician in Uncle Vanya.

Two of the most striking figures in Doctors in Fiction arise from contemporary popular novels, although their fictional lives take place in an earlier time. The first is Dr. Adelia Aguilar, the protagonist of several mystery novels by Ariana Franklin. Aguilar is a graduate of the University of Salerno and serves as a forensic consultant to King Henry II of England in the 1170s. The other is Dr. Stephen Maturin, well known to millions of readers as the particular friend of Captain Jack Aubrey in  Patrick O'Brian's series of novels about the British navy during the Napoleonic Wars. Maturin is not only a famous physician and naturalist, but also a British undercover intelligence agent.

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Ott opens her treatment of the cultural, social and economic evolution of tuberculosis in the U.S in the mid-nineteenth century, although she refers back to antecedent historical events. The study follows how the evolving principles of bacteriology were applied to a syndrome the medical world did not recognize as having a single etiology. Tuberculosis did not fit the epidemiologic patterns of epidemic diseases as recognized by public health specialists.

Ott focuses heavily on the economics of the illness, as well as on its changing social status. Her final chapter examines the contemporary meaning of the disease as it once again is heralded as a public health problem in the U.S.

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This is the wrenching history of the development, evolution, and eventual obsolescence of the leper colony established in 1866 on the isolated and only sometimes accessible peninsula on the Hawaiian island of Molokai--and the lives of the people who were exiled there to die over a period of more than 100 years. The tale opens with the declaration by the Board of Health that all persons proven (or strongly suggested) to be afflicted with leprosy be exiled immediately to the site on Molokai.

The author dramatically describes the selection and separation of the exiles from their families and the tortuous and sometimes deadly sea voyage to their primitive new homeland. Mixed with the public policy and the individuals who made and implemented it, are the descriptions of the hospital in Honolulu where diagnoses and dispositions were rendered, as well as the poignant personal stories of the "detainees." The reader follows the colony from the arrival of its first 13 patients in 1866, through its peak population of 1,144, to its residual 28 in 2003.

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This volume belongs in the category of cross-cultural studies of medicine and the humanities. Its main audience is scholars of nineteenth-century American psychiatry and culture. The author divides his study into six chapters, each with a topic, including the simultaneous emergence of nineteenth-century public debate about improving the treatment of insanity and the movement to abolish slavery; cultural activities in asylums directed toward humanizing the patients; bardolatry in British and American medical circles; discussions of Emerson, Hawthorne, Poe, and Melville in the context of their literary and personal relationship with madness; a chapter on captivity narratives and popular novels by former female and male patients; and an epilogue.

Unlike today, "In mid-nineteenth-century America, the condition of the mentally ill seemed to demand-and to a large degree received-national attention and the full creative energy of a group of dedicated reformers" (p. 2). Reformers linked the emancipation of slaves with curing the delusions of the insane. Slaves and the mentally ill had in common deprivation of their civil liberties; however, the difference was that white mental patients could be expected to grow up eventually, whereas black slaves would always remain children, and hence could not be trusted with the right to vote, own property, or sign contracts.Some causes of insanity were deemed to be the individual's reaction to the stress of modern life, too much freedom and choice, religious fervor, masturbation, or excessive study. In their aggressive attempts to remake patients into proper gentlemen and ladies, the new asylums promoted cultural activities such as reading selected texts, theater performances and writing.

Most asylums housed males and females in approximately equal numbers; cultural activities for females stressed piety, fashion, and domestic activity while men could comment on politics, the temperance movement, and opposition to women's rights. Reiss refers to the French model of using cultural activities in asylums, f.ex., Philippe Pinel's staging of plays to educate patients, and Marquis de Sade's theater performances at Charenton. He ends with a discussion of patient narratives that depict some horrific abuses tolerated in nineteenth-century asylums; the degree of these abuses is familiar to us from One Flew Over the Cuckoo's Nest (see film annotation).

The work includes a few illustrations, the most important being an engraving from a painting by Tony Robert-Fleury titled: Pinel Freeing the Insane (1876). (Yale University). Philippe Pinel (1745-1826) was a French pioneer in the humane treatment of mentally ill patients. A Director of Bicêtre Hospital in Paris, he is depicted as a heroic physician, liberating, mostly female, patients there. However, scholars have shown that only 10 of the 270 patients were chained, and that Pinel '"accepted the traditional use of chains to restrain the violent insane as a matter of course"' (p. 160). Reiss's point is that the revolutionary nature of Pinel's treatment of the insane has been exaggerated.

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The index finger of his left hand touching the thumb of his right, the young Jesus sadly debates a mob of arrogant, self-righteous scholars. The mood is ominous. The doctors are challenging him, thrusting their sacrosanct doctrines at the fresh pure voice of the youth. They are so cemented into dogma that Jesus's moral and ethical message is an affront to their hard-held authority. Citing their previous books as "gospel," they have completely ignored his message--that one must live by the spirit, rather than the letter of the law.

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Written by a psychiatrist and historian, American Melancholy: Constructions of Depression in the Twentieth Century looks at how culture, politics and, in particular, gender have played a role in the development of a diagnosis.  Hirshbein moves between several different worlds, showing how they intercalate and, indeed, are very much part of the same world: psychiatric nosology and cultural attitudes to the gendered expression of emotion and feelings, medication trials and magazine advice to women about how they should deal with the blues, the relations between treatment paradigms and how society views suffering.

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During  the Dutch Golden Age, religion and medical science were combined in people's minds to the extent that illness, especially plague, was seen as a punishment from God. In the minds of  many Dutch seventeenth-century Calvinists, God was vengeful and often angry with the sinner. As Matton shows in this fictional monologue of an illiterate peasant woman, Hendrickje Stoffels (1626-1663), when plague swept through the city of Amsterdam, the afflicted person had three ways of fighting the disease: prayer, folk remedies, and the ministrations of the plague doctors. But for Hendrickje, prayer held first place.Hendrickje Stoffels modeled for several Rembrandt works. She was one of the three most important women in the life of Rembrandt Harmenszoon van Rijn (1606-1669).

He was first married to Saskia van Uylenburgh, who bore him 4 children. Only Titus,their son, survived. As Saskia lay dying of tuberculosis, Rembrandt hired Geertje Dircx  (c.1610-1656) as Titus's wetnurse. She became Rembrandt's lover. Hendrickje entered his household and began a relationship with the painter in the late 1640s. As Geertje was being forced out of the home, Rembrandt started paying her an annuity; later, she sued Rembrandt for breach of marriage contract. He had her removed to a prison/insane asylum. Hendrickje bore him a daughter, Cornelia (1654),the only one of his five children to survive their father.

The book begins when Hendrickje is 23 years old and Rembrandt 42. Matton's book cover shows Rembrandt's painting, Hendrickje Bathing (1655). This and several other paintings of his lover illustrates Rembrandt's passion for Henrickje who  devoted her life to the artist, to Titus, and Cornelia. We read the experiences articulated by the deeply religious Hendrickje as she moves around Rembrandt's home and studio, and the streets of Amsterdam. She thinks that  cats and dogs, not rats, carry the plague.  She notices wounded war veterans with open sores in the streets, lepers, and public whippings and executions. She is obsessed with the worms that live in the body and cause plague and death. Cherries also cause the plague.

In 1654, the City Fathers summon her, pregnant, accusing her of whoredom--hence the title of the book. She endures an admonition and is banished from the Lord's Supper. She becomes Rembrandt's common law wife. We witness the home birth of Cornelia and observe Hendrickje breastfeeding her. She watches Rembrandt and his pupils at work in the evil smelling studio where his assistants boil rabbit skins to make glue for the paints. Hendrickje composes medications she has learnt about  from a midwife in her home town of Bradevoort, but she cannot cure the plague. A comet streaks across the sky to announce an outbreak in Amsterdam. Rembrandt goes bankrupt, and Hendrickje feels Rembrandt's tears on her face as she suffers a horrific death from plague, clinically rendered by the author.

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Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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