Summary:

Dr. Andrey Yefimych Ragin has for many years been the superintendent of a town hospital. A solitary man who pursued a medical career to please his father, he feels superior to the people who live in the provincial town, none of whom engage in intellectual or aesthetic pursuits. Initially, Ragin was conscientious about his duties at the hospital, but after a while he withdrew his interest and energy. Now he sees only a minimal number of patients and leaves the rest to his assistant, Sergey Sergeyich.

Ragin has developed the philosophy that, since "dying is the normal and legitimate end of us all," there is no point in trying to cure patients or alleviate suffering. The endeavor is futile. While Ragin accurately observes deficiencies in the hospital and in the surrounding society, he does nothing to try to remedy them. Instead, he withdraws to his apartment and spends his time reading.

At one point, Ragin accidentally finds himself in Ward 6, where the lunatics are kept. One of them, Ivan Dmitrich Gromov is a well-educated paranoid man who engages Ragin in conversation. Ragin is so taken with this stimulating interchange that he begins to visit Ward 6 daily to debate with Gromov. Since the doctors never visit Ward 6, this is considered very peculiar behavior. Based on this new evidence of incompetence, the town council decides to fire Ragin from his position.

Ragin then goes on an extended tour with his one friend, Mikhail Averyanych, the postmaster. But when he returns, he behaves more strangely than ever. Finally, the new superintendent, Dr. Khobotov, tricks Ragin into visiting Ward 6, whereupon they incarcerate him as a lunatic. Shortly thereafter, Ragin has a stroke and dies.

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This is a collection of 23 stories, five of which take the form of "letters" in which an older physician (not surprisingly, a surgeon) gives advice to an imaginary young surgeon. However, every one of the stories "fits" as a tale that might be told in such a letter--assuming the author was a wise and gifted writer, in addition to being a surgeon.

The book begins with the gift of a physical diagnosis textbook on the occasion of the young doctor's graduation ("Textbook") and ends with a reflection on "your first autopsy" ("Remains"). Among the other stories are Imelda (see annotation), Brute (see annotation), Toenails (see annotation), Mercy (see annotation), "A Pint of Blood," "Witness," "The Virgin and the Petri Dish," and "Impostor."

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Winter investigates the process by which Freudian psychoanalysis became legitimized within modern Western culture and internalized as a kind of "psychological common sense" (4). She argues that Freud's adoption of the Oedipus myth allowed him to draw on the cultural status of classical scholarship and claim the universality of the tragic theme for his own project. She traces how Freud worked to establish an institutional infrastructure for psychoanalysis, to establish it as a profession. His analysis of culture and society represents another strategy in establishing and extending the importance of psychoanalysis: the claim that psychoanalysis powerfully illuminates not only the workings of the human brain (the domain of psychiatry, psychology, and neurology) but also the functions of society (the analytic domain of anthropology and sociology).

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The title The Body in the Library suggests medicine (the body) as seen through literary eyes. True enough, this collection of stories, poems, essays, and excerpts from longer works is subtitled "A Literary Anthology of Modern Medicine." However, as Iain Bamforth points out in his introduction, nowadays we are more concerned with "the library in the body" (p. xxiv); that is, we believe the truth of human illness can be found by biochemical tests and positron scans, rather than by storytelling. In this anthology Bamforth uses literature itself to document this change in perspective. Beginning with "The Black Veil" (1836), an early sketch by Charles Dickens, Bamforth recounts the recent history of medicine as seen by poets and writers, many of whom were (and are) physicians themselves.

Part of the anthology consists of material already annotated in this database. This includes stories (e.g. Conan Doyle’s "The Curse of Eve" from Round the Red Lamp, Kafka’s A Country Doctor, and Williams’s Jean Beicke); excerpts from novels (e.g. "The Operation" from Flaubert’s Madame Bovary, "The Fever Ward" from Camus’ The Plague, and "Doctor Glas" from Hjalmar Soderberg’s novel, Doctor Glas); and essays (e.g. Virginia Woolf’s On Being Ill and John Berger’s "Clerk of Their Records" from A Fortunate Man).

However, most of the selections have not previously been noted in this database, nor do they appear in other recent anthologies. Iain Bamforth has discovered some wonderful "new" material on the medical experience. This includes several poems by the German physician-poet Gottfried Benn (pp. 151-153); and a brief piece by neurologist-writer Alfred Döblin ("My Double," pp. 177-179), in which the physician Döblin and the writer Döblin describe their respective "doubles" in rather detached and negative terms.

Another delight is the series of selections from Miguel Torga’s diary (pp. 256-278); Torga (1907-1995) was a provincial Portuguese medical practitioner for 60 years. Among the other pieces are short excerpts from plays by Georg Buchner, Jules Romains, and Karl Valentin; and poems by Weldon Kees, W. H. Auden, Philip Larkin, Dannie Abse, Robert Pinsky, Miroslav Holub , and Thom Gunn.

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Rosenberg, a surgeon and bench research scientist, has an epiphany fairly early in his clinical career: a patient with widespread cancer determined to be terminal, returns to the clinic sometime later, apparently disease-free without medical treatment. The scientist wonders if this patient's body could have tapped into some immunological or genetic healing pool. After having formulated the question, the author takes the reader through the trials and tribulations of framing, trying, failing, retrying and failing again to determine a way to test and prove how this phenomenon could have happened.

Over the many years of experimental work in the laboratory and on the wards of the National Cancer Institute, Dr. Rosenberg presents in a fashion largely accessible to the lay public a glimpse into this process. The work covers nearly three decades of the author's struggle to better understand and to develop new treatments for malignancies.

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In 1768 the young, feeble-minded King Christian VII of Denmark sets off on a prolonged tour of European capitals. His "handlers" determine that he needs to have a doctor along to help fend off, and to treat, the King’s frequent bouts of "agitation." Therefore, they appoint Johann Friedrich Struensee, a German physician from Altona, as the Royal Physician. Christian and Struensee develop a close bond; when the trip is over, the Royal Physician stays with the King and becomes a permanent fixture at the Danish court.

Christian is unstable and childlike. He enjoys playing games, but is totally uninterested in his beautiful young English wife, Caroline Mathilde. She becomes pregnant the first time he visits her, but he never sleeps with her again. Meanwhile, the King’s ministers actually run the government, even though he is theoretically an absolute monarch.

When Struensee, who is an Enlightenment intellectual, enters this ménage, he decides to reform the State by getting King Christian to agree to a series of enlightened new laws. Having won the King’s ear, the Royal Physician proceeds to rule Denmark for several years and to institute many of the reforms proposed by Voltaire and the other Enlightenment philosophers. Struensee also begins a tender, prolonged, and obvious love affair with the queen, who subsequently bears him a daughter.

The end of this story is not difficult to predict. Aggrieved members of the aristocracy manipulate the king to strip Dr. Struensee of his power and have him executed for adultery with Queen Caroline. She and the baby girl are shipped back to her home in England. The new Prime Minister retracts all of the reforms enacted by Struensee. And the demented king lives on in the fiction of his absolute power.

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Summary:

St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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In 1822, a young Canadian paddler named Guillaume Roleau is near death after suffering a gunshot wound to the stomach. His recovery is dramatic and scientifically important. The injury has resulted in a traumatic fistula--a porthole between the outside world and Guillaume's abdominal cavity and organs. The treating physician, Dr. William Barber, immediately recognizes the incredible opportunity for medical research and conducts a lengthy series of experiments on the process of human digestion.

Guillaume--patient, research subject, and guest in the doctor's cabin--is rowdy and frequently uncooperative. He continues to participate in the grisly experiments at least partially out of affection for the physician's wife, Julia, who helps nurse him back to health as well as providing emotional sustenance.

Julia ultimately makes a large, uncredited contribution to Dr. Barber's research. At her husband's request, she has sexual relations with Guillaume so that the unreliable man will remain with the doctor until the experiments are all completed. The efforts of this tragic trio result in a landmark textbook on gastrointestinal physiology authored by Dr. Barber and Julia's illegitimate son, Jacob, sired by Guillaume Roleau.

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For more than fifteen years, Irish-born Grace Marks has been confined for the 1843 murder of housekeeper, Nancy Montgomery, and her employer, Thomas Kinnear, at their home north of Toronto. Her convicted accomplice was hanged, accusing Grace with his last breath, but her sentence was commuted to life in prison at the last minute. Because of her amnesia and outbursts of rage and panic, she was held in the Lunatic Asylum before being sent to the Kingston [Ontario] Penitentiary.

Beautiful, intelligent, and strangely poised, Grace intrigues worthy townsfolk, spiritualists, and some of her jailers, who grant her the privilege of outside work, believe in her innocence, and strive for a pardon. In looking for medical approbation, they consult Dr. Simon Jordan, a young American doctor who is interested in insanity and memory loss. Without explaining his purpose, he brings her vegetables and other familiar objects, hoping to stimulate recollection of her life.

Interspersed with Jordan's own problems, Grace's story unfolds in her own words, from her poverty-stricken childhood in Ireland and the emigration voyage that killed her mother, leaving her and her younger siblings to a neglectful father, through her short life in service, to the dreadful events of autumn 1843. She has suffered many losses, including the death of her mother to ship fever, and that of her friend and fellow servant, Mary Whitney, from an illegally procured abortion. After many weeks, Jordan abandons his project in frustration and ambiguity. The novel ends years later with forty-six year-old Grace's discharge from prison in 1872, nearly thirty years after the crime.

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Emiko a child survivor of Hiroshima, is now a documentary filmmaker. She has horrific memories of August 1945 when she lost her parents and little brother, and of the years of painful operations and homesickness in America where she was sent to restore her mutilated face. She is hoping to interview Anton Böll, a scientist who had fled Germany to work on the Manhattan project.

Böll contends that he had been unaware of human rights abuses; he left Europe because the Nazi regime had cramped his scientific style. As a consequence, his mother was imprisoned and killed. During the war, he met his Austrian-born Jewish wife, Sophie, at a displaced persons camp in Canada. Sophie had lost her whole family, but she does not speak of them and he does not ask.

Briefly they knew happiness, but soon Böll left for work on the bomb and on to Hiroshima in its aftermath. Their marriage would never be the same. For the rest of his life, Böll justified his involvement as a "dream" turned "nightmare" emerging from the imperative demands of a virtuous science. When Emiko approaches him, he hesitates. He does not want to risk blame. But his dying wife knows that absolution for unacknowledged guilt is what he craves.

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