Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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Mother is set in the 1930's and deals with a woman's difficult life, low self-esteem, and sense of having inherited tragedy and misfortune from her mother. Even though she finally marries, and unexpectedly conceives long after her husband and she had given up trying, her outcome is destined to be unhappy. She goes into premature labor, and gives birth to a stillborn child.

When she finally wakes up, she is weak, and cannot remember anything about the delivery. Her paternalistic physician, her husband, and the hospital staff withhold from her the news that her child has died. One night, in her frustration and need, and believing that her child is in the nursery "in the basement," she searches the basement corridors for her child. Outside the morgue she begins to hemorrhage and despite the efforts of her physician, she dies.

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Summary:

Reade was known for writing "novels with a cause." Here, as in several other of his novels, his cause is the deplorable condition of mental hospitals in the early to mid-nineteenth century. Until late in the century, many considered the mentally ill untreatable. Hospitals were more like prisons than places for treatment. Admission policies were also fairly lax. Reade records a common fear that healthy people would be incarcerated.

In Hard Cash, a father incarcerates his son in order to cover up a crime. The doctors who admit him have a kickback scheme worked out with the hospital--they get money for each patient admitted. Once in the hospital, the hero tries to prove his sanity but finds it impossible to battle against doctors who refuse to look past the diagnosis that caused his admission to his actual mental condition. He also must negotiate with the head of the hospital, a woman who is madly in love with him and refuses to allow him out of her sight.

He cannot prove his sanity and only escapes when there is a fire in the asylum. There is one "good" doctor in the story who refuses to bleed patients, deny them food, or admit the sane to mental hospitals. The other doctors think him a quack, but he saves several lives.

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Summary:

Jordanova posits that medicine and science "contain implications about matters beyond their explicit content." Namely, they have historically made assumptions about women and their relation to science/medicine. Jordanova explores this relation through seven chapters.

Particularly interesting is Chapter Three, "Body Image and Sex Roles." Here Jordanova discusses the wax models used by medical students in the nineteenth century to learn about anatomy. These models were almost always female and sometimes even had flowing hair, pearl necklaces, and other realistic details. Jordanova argues that this gendering was no accident. The route to knowledge is historically associated with looking deep into the bodies of women.

Chapter Five pursues this theme, commenting on how nature is often configured as a female whose secrets will be revealed by masculine science. The final two chapters address twentieth century representations, including the gendered nature of drug advertisements in in-house medical magazines.

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A young man is traveling through France with a companion. They pass near a well-known "Mad House" and decide to visit. His companion introduces him to the superintendent, Monsieur Maillard, then leaves. The superintendent informs the young man that the hospital has given up the system of management it was famous for. Previously, patients were allowed complete freedom. The practice had finally proved too dangerous and Maillard promises to show the young man the alternative system he installed after dinner. He escorts the young man to a banquet table crowded with guests and laden with food.

To the visitor, the dinner guests seem rather mad as they take turns describing and then demonstrating the delusions of patients. But Maillard assures him that the lunatics are locked up; the guests are keepers. Maillard says the new system was invented by Doctors Tarr and Fether. He describes the dangers of the former system used. In one instance, he says, patients rebelled and imprisoned their keepers while they themselves enjoyed the wines and beauty of the grounds.

Suddenly, there is a crash at the boarded-up windows. The visitor thinks it is the escaped madmen. It turns out, however, to be the keepers who were indeed imprisoned by the madmen, tarred and feathered and kept on a diet of bread and water. Maillard, the former superintendent, had gone mad himself and organized the rebellion.

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Condemned to death, Socrates, strong, calm and at peace, discusses the immortality of the soul. Surrounded by Crito, his grieving friends and students, he is teaching, philosophizing, and in fact, thanking the God of Health, Asclepius, for the hemlock brew which will insure a peaceful death. His last words are "a cock for Asclepius!"

The wife of Socrates can be seen grieving alone outside the chamber, dismissed for her weakness. Plato (not present when Socrates died) is depicted as an old man seated at the end of the bed. The pompous "medical celebrity"--as Tolstoy might describe him, were he one of Ivan Ilyich's five consults (The Death of Ivan Ilyich, see this database)--is pontificating on his rounds about the pharmacological details of the medication.

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Summary:

Humphry Clinker is an epistolary novel, a collection of letters, that charts the adventures of a family group traveling through Britain. The head of the family is Matthew Bramble, a gouty old man, who is constantly writing his doctor with his complaints and visiting areas supposed to be good for his condition. He is accompanied by his niece, Lydia, who is in love with a poor man, Wilson. Her brother, an Oxford student, also comes along, as does Bramble's unwed sister, Tabitha. Tabitha's maid, Winifred Jenkins, accompanies her.

The group travels to Bath, London, Edinburgh, and the Scottish Highlands. Along the way, they meet Humphry Clinker, a dull-headed creature who becomes devoted to Matthew Bramble, even saving his life. He turns out to be Bramble's illegitimate son. Lydia's lover is discovered to be the son of a wealthy man who is Bramble's friend; they are finally happily married.

Tabitha marries Lismahago, an eccentric captain. Winifred Jenkins joins the festivities by marrying Clinker. Relieved of the feminine presence and bother in his life, Bramble recovers his health, writing to his doctor that from now on he will go hunting rather than write letters.

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Summary:

Four men sit drinking in a British tavern. There is a sick man in the house and a famous London doctor has been summoned to treat him. When one of the men, Fettes, hears the doctor’s name, Wolfe Macfarlane, he wakes suddenly from his drunken stupor and rushes to see the doctor’s face. He recognizes and threatens the doctor, who flees. Doctor Macfarlane and his accoster, Fettes, had studied medicine together under a famous--but unorthodox--anatomist.

They were in charge of obtaining bodies for dissection. Fettes regularly received and paid for corpses late at night from the men who robbed graves for them. One night, the body of a woman he knew was brought to his door; he was certain that she had been murdered but he said nothing. One day he met Macfarlane at a tavern. He was being strangely heckled by a man named Gray. The next night, Macfarlane showed up with Gray’s body and demanded payment for it. He had evidently murdered the man. Fettes was shaken but acquiesced. Soon the body was dissected, so the evidence of murder was gone.

Later, Fettes and Macfarlane were sent to a country church yard to exhume a recently buried woman. They sat their package between them as they traveled back. Suddenly, they perceived a change in the body. Unnerved, they got out a light and uncovered the face of the corpse. It was Gray.

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Summary:

Frank Gresham is the squire of Greshambury Manor in the fictional county of East Basetshire. His wife is the aristocratic Lady Arabella, daughter of Earl de Courcy. Because Lady Arabella's and her husband's tastes are more expensive than their means, Gresham goes heavily into debt and has to sell part of his property to the uncouth, but extremely wealthy, Sir Roger Scatcherd.

Thus, it is determined by Lady Arabella that their son, Frank Gresham Jr., must marry an heiress to restore the family fortunes. Doctor Thomas Thorne is the senior Gresham's close friend and advisor. Doctor Thorne is a bachelor who has raised his niece Mary as if she were his own daughter. In reality, she is the illegitimate daughter of Sir Roger's sister and the Doctor's brother. (Sir Roger had killed Henry Thorne in a fit of passion over his sister's shame; the Doctor sent Scatcherd's sister to America; and Scatcherd served time in prison before going from rags to riches in the railroad contracting business.)

The novel tells the story of the apparently hopeless romance between Mary Thorne and Frank Gresham; and Gresham's mother's attempts to have him marry into a wealthy family. Ultimately, both Sir Roger and his reprobate son, Sir Louis, die of complications of alcoholism. It then turns out that Mary Thorne is sole heir (as the "eldest child" of his sister) to Sir Roger's fabulous fortune. Eventually, Frank and Mary marry and establish their home at Boxall Hill, which is actually built on the land that Gresham had sold to Scatcherd.

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