Summary:

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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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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This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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This thorough and fascinating treatment of the politics of anatomy studies in 19th-century America provides a variety of perspectives on the vexed question of how appropriately to study human anatomy while also maintaining respect for the human body and honoring the various, deeply held community beliefs, and attitudes toward treatment of the dead. Sappol seeks, as he puts it, to "complicate the cultural history of medicine in late-eighteenth- and nineteenth-century America. . . by telling it from an anatomical perspective."

That statement of his objectives hardly suggests the startling range of approaches to the topic he takes in the book's nine chapters. These cover such issues as the legacies of belief about the "personhood" of the dead human body; the status of anatomy as both a legitimate and valuable study and also as an "icon of science"; the relationship of dissection and anatomy study to medical status and professionalization; the political tensions engendered by the "traffic in dead bodies" that most often expropriated corpses from marginalized communities; and the relationship of anatomy studies to sexual commerce and sensationalist fiction.

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This gripping narrative traces the history of the efforts to eradicate smallpox in the 1970s, the top-level decisions to keep a few vials of it for emergency purposes in American and Soviet freezers, and the reemergence of smallpox not only as a health threat, but as a potential bioweapon of unequaled destructive power. Preston details maverick natural cases that surfaced after worldwide eradication efforts, how it was discovered that undocumented reserves of smallpox were not only being kept, but researched and possibly "weaponized," and how hotly, in the US, teams of scientists and military intelligence personnel debated funding new smallpox research in the US with a view to developing a new vaccine as a defense.

The ethical issues in those debates are unprecedented in the scope of the possible public health threat and the variables that might make traditional vaccination ineffective against the weaponized virus. As in his previous books on biological threats, The Hot Zone and The Cobra Event (see annotation), Preston follows the work and lives of several key scientists and includes scenes from interviews with a variety of persons involved in confronting the political, ethical, and medical dilemmas posed by smallpox research and efforts to track and control it.

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Max Vigne, the most junior member of a survey group mapping the Himalayas in the 1860s, writes letters to his young wife Clara in England. She has prepared in advance of his journey a series of postdated letters which he keeps in his trunk. When these have been read, Clara sends numbered letter packets which arrive sporadically, out of sequence, if at all, over the months of the expedition. Max struggles to describe and to edit his daily experiences on the mountains which are extraordinary, often terrifying, and disorienting for him.

Separated by time, distance, and experiences, they are slowly and irrevocably estranged. Max discovers that his real scientific passion is alpine botany, and he must decide how to tell Clara that he will not be returning to England after the Survey ends. The exchange of letters ingeniously maps out the complexities between Max's love for his wife and his passion for scientific knowledge, and the wide expanse between them.

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This history play narrates the rise to power through treachery and murder of Richard Plantaganet, Duke of Gloucester and last king of the House of York. Set in England during the Wars of the Roses (1455-1485), the play opens after the Lancastrian King Henry VI and his son Edward have been killed and Richard’s brother has been crowned Edward IV.

In the course of the play, Richard woos and wins Prince Edward’s widow Anne Neville and engineers the murders of his other brother (George, Duke of Clarence), his nephews, his closest advisor, possibly his wife, and other members of the court. He is crowned king but later dies a violent death in the Battle of Bosworth, defeated by Henry Tudor, Duke of Richmond, who will become the first Tudor King Henry VII.

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Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.

Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.

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