Summary:

A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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Gulliver's Travels consists of four voyages, each of which involves Gulliver ending up on a distant shore where he encounters its strange and wonderful inhabitants. The first voyage finds Gulliver stranded on Lilliput after a shipwreck. Here, he is neatly captured by the famous Lilliputians, "human Creature[s] not six inches high" (5). Gulliver is a source of fear and awe to them, and participates somewhat helpfully in the Lilliputian war against Blefuscu, a lengthy conflict that has arisen between the big-enders and little-enders (depending upon which side of a boiled egg one must crack in order to eat it). Court intrigue and resentments, including the accusation of adultery with a Lilliputian, soon require of him that he escape an assassination attempt.

He returns to England, only to set off again on another voyage. A storm, a longboat journey to fetch water, and abandonment by a terrified crew, leaves him in Brobdingnag where he is captured by giants "as Tall as an ordinary Spire-steeple." (65). Gulliver becomes something of a pet, amusing and entertaining the Brobdingnagians with his exploits and size, competing with the royal dwarf and endearing himself to these massive people. While in transit to the Frontiers, a giant eagle captures him in his travel-box (imagine a carrier with holes punctured in the top to transport a small pet) and drops him into the ocean, where he is rescued by more familiarly-sized humans.

The third voyage finds Gulliver captaining a ship until conquered by pirates, who set him off on a longboat, where he makes his way to Laputa, Balnibari, Glubbdubdrib, Luggnagg and Japan. He encounters the flying island of Laputa, the never-dying Struldbrugs (who nevertheless age and become decrepit), and the Academy of Lagado, with its - to use modern vernacular - "fringe scientists". After returning to England by way of Japan, and somehow still restless, he commences a fourth voyage, again as a captain but this time a mutinous crew abandons him in the Land of the Houyhnhnms, populated by the rational race of horses and the putrid yahoos.

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This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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This film tells the remarkable story of Vivien Thomas (played by Mos Def), an African-American fine carpenter, who found his way into medicine through the back door and changed medical history. Hired when jobs were in short supply to work as a custodian and sometime lab assistant to Dr. Alfred Blalock (Alan Rickman), a research cardiologist, Thomas quickly becomes an irreplaceable research assistant. His keen observations, his skill with the most delicate machinery and, eventually, in performing experimental surgery on animals, make clear that he has both a genius and a calling.

Though the relationship has its tensions (Blalock, as a Southern white man and a doctor, has some blind spots in the matter of mutual human respect, though he highly values Thomas’s skills) it lasts for decades. The two move their families to Baltimore, where Blalock becomes Head of Surgery at Johns Hopkins and, much to his colleagues surprise and to some of their dismay, brings Thomas in to perform groundbreaking open heart surgery on a blue baby. It is not until after Blalock’s death that Thomas is granted an honorary doctorate from Johns Hopkins, where he continues to work in research until his own retirement.

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The novel is set in Washington, DC in April, 1865. At fourteen, Emily is sole caretaker of her mother who is dying of tuberculosis. Her neighbor, Annie Surratt, is her best friend, though their mothers have been estranged for some time. Both families have deep roots in the South. Annie’s brother, Johnny, an object of Emily’s romantic fantasies, has recently left on a secret mission. The war is nearly over. Emily’s uncle Valentine, a physician, wants to take custody of her after her mother dies, but because her mother has also felt estranged from him, Emily resists. Still, after her mother’s death, she does go to live with her uncle, and learns that he (with his two assistants, one of whom is a woman who is 1/8 African American) has a lively practice among the poor and the African Americans who have flooded the streets of Washington since the emancipation.

Valentine is called to Lincoln’s bedside the night of his assassination, and participates in efforts to track down John Wilkes Booth and his accomplices, one of whom appears to have been Johnny Surratt, who has escaped to Canada. In the course of her time there Emily discovers that her uncle and his assistant are involved in elaborate, marginally legal, schemes to obtain bodies for study at the medical college. Emily, at first horrified by this discovery, comes to recognize the good that comes of anatomical studies and to sympathize with her uncle’s efforts to bring about legislation making the acquisition of bodies for medical research easier. Annie’s mother is hanged as an accomplice in the Booth conspiracy, Annie leaves town, and Emily comes to understand a great deal more about the harsh terms on which life must be lived in times of national crisis and ideological warfare. The story ends with her growing interest in medicine as a possible career path.

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The young pathologist David Coleman (Ben Gazzara) arrives to join a hospital pathology lab. He encounters disorganization and a hostile, cigar-smoking chief, Joe Pearson (Frederic March), who declares his intention to keep working until he dies. Coleman tries to implement a few changes, but his suggestions are overruled.

The film revolves around two cases: possible erythroblastosis in the child of an intern and his wife whose first child died; possible bone cancer in Coleman's girlfriend, student nurse Kathy Hunt (Ina Balin). The infant's problem is misdiagnosed due to Pearson's refusal to order the new Coombs' test recommended by Coleman; the baby nearly dies, alienating the obstetrician (Eddie Albert), a long time friend who now presses for Pearson's dismissal.

Coleman disagrees with Pearson, who thinks that Kathy's bone tumor is malignant, but he opts for professional discretion, defers to the chief, and urges her to have her leg amputated anyway. He discovers that Pearson had been right: the surgery, which he thought unnecessary, has provided her with her only chance of survival. Just as Coleman realizes the enormity of his error, he learns that Pearson has resigned and that he will take over the lab.

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This lively volume of medical history chronicles the forms of suffering, illness, injury, and treatment endured by the members of the Lewis and Clark expedition of 1805. Beginning with three chapters of political and medical history to set the context, the story follows the adventures of the extraordinarily fortunate "Corps of Discovery" among whom Lewis was the most trained in the medicine of the time (having studied in preparation for the trip under Dr. Benjamin Rush of Philadelphia), and he only an amateur. Even professional medicine of the time was approximate and largely ineffectual, limited mostly to purgatives, opiates and laudanum for pain relief, bleeding, and topical applications of various compounds or herbal substances.

The story chronicles the main events of the trip based on the extensive journals of Lewis and Clark as well as other historical account, maintaining focus in each chapter on the medical incidents including gastrointestinal distress from parasites and contaminated water; effects of overexposure like hypothermia and exhaustion; infections from wounds and scratches; syphilis; dislocations; muscular spasms; mosquitoes and other insect bites; snakebites and other animal attacks.

Along the way Peck pauses to explain the rather rudimentary medical theories upon which treatments were based, the effects of particular known treatments, and what Lewis and others likely knew, guessed at, or didn’t understand about lead, mercury, opium, and certain herbal substances they used. He speculates about the contexts of their medical decisions and offers occasional contemporary analogies to help readers imagine the circumstances and tradeoffs the explorers faced.

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Schiebinger’s historical analysis looks at the role of women and female nature in modern science in four places. These are: institutional organizations (when and how did medical schools and fraternities allow or disallow female participation?), individual biographies (who were trendsetters in the history of science?), scientific determinations of female nature (how did scientists decide what makes woman woman?), and cultural meanings of gender.

Chapter Seven is an especially disruptive chapter, analyzing drawings of female skeletons at the turn into the nineteenth century. Earlier, female skeletons had been drawn in the same way as male skeletons. At this point, however, they became thin-boned and wide-hipped. Sexual difference became far more central.

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The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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The New Medicine and the Old Ethics, in Albert Jonsen’s own words, is a "secular aggadah." Jonsen explains that one Talmud reviewer defined aggadah as "a magical rabbinic mode of thought in which myth, theology, poetry and superstition robustly mingle" (4). The book begins with a personal essay entitled "Watching the Doctor." Jonsen establishes his premise that the moral history of Western medicine is best understood as a paradox between altruism and self-interest, a paradox alive and well entering the 21st Century.

He then takes the reader on his "secular aggadah," blending history, myths, and stories that trace important moral developments in the practice of Western medicine. In "Askelepios as Intensivist," we learn of the early Greek values of competence in shaping medical practice. Through the influence of the Church in the medieval period, Western medicine incorporates the value of compassion through the Biblical Good Samaritan, struggles with problems of justice in the care of the poor, and further elaborates the meaning of benefit.

In "The Nobility of Medicine," Jonsen describes the contribution of Sir William Osler and other knighted medical men of the 19th Century who established the ethics of noblesse oblige in the medical profession. He traces this noble tradition to the medieval Knights Hopitallers of Saint John of Jerusalem, a group of religious who provided hostels for pilgrims to the Holy Land and cared for the sick. With essays on John Locke and Jeremy Bentham, Jonsen brings us to the 20th Century and the play of individual rights and utilitarian values in the moral life of Western medicine.

In the final essays, Jonsen describes the mingling of these traditions as a means to establish a moral frame for Western medicine in our current times where technology and science have achieved and threatened so much. Ethics, he argues, "is disciplined reflection on ambiguity" (130). In the last essay, "Humanities Are the Hormones," Jonsen brings his "secular aggadah" full circle.

He argues that the paradox of altruism and self-interest that runs through the moral history of Western medicine must continually be vitalized and examined through the Humanities. The Humanities are "the chemical messengers that course through the complicated institution of medicine and enable it to respond to the constantly changing scientific, technological, social, and economic environment" (147).

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