Summary:

This is an excellent review of the authors' choices of the ten greatest medical discoveries. They arrived at the ten selected after narrowing five thousand or more possibilities down to one hundred and then finally down to ten based on these three components in the field of medicine: 1) structure and function of the human body, 2) diagnosis of medical conditions and 3) treatment of such maladies. Finally the ten selected were approved by four avid and informed physician collectors of rare and important medical publications.

Chronologically, the anatomical observations of Vesalius come first with his publication of the Fabrica in 1543. Harvey's discovery of the circulation of the blood is considered the single most important discovery. Leeuwenhoek gets credit as the founder of bacteriology, but Koch and Pasteur are included in a discussion of this discovery. Jenner gets his just recognition for introducing vaccination and Roentgen for discovering the X-ray beam.

Crawford Long is recognized for the initial use of surgical anesthesia and Fleming for the discovery of penicillin. More unlikely choices are Ross Harrison for tissue culture, Anichkov for the relation of cholesterol to atherosclerosis and Wilkins, rather than Watson and Crick, for the DNA story.

Each chapter describes not only the discovery but also tells the life stories of the chosen "discoverers" and others who contributed to extension and usefulness of the discoveries. The authors conclude that it is not genius so much as curiosity and the ability to conduct methodological investigations that distinguish these men.

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In this collection Richard Selzer brings together 25 stories from his previous books, along with two new stories, Avalanche (see this database) and "Angel, Tuning a Lute." The unifying theme is the world of medicine and healing, which Selzer explores with a keen eye and compassionate heart. These stories are firmly grounded in the foibles, suffering, and exultation of the human body.

In the Introduction Selzer sketches the path by which he became a surgeon-writer and he indicates the origin of some of the stories. Particularly interesting are the stories that do homage to literary and historical figures; for example, "Poe's Light-house," which grew out of a fragment Edgar Allan Poe wrote in his last delirium, and "The Black Swan," a re-writing of a Thomas Mann novella (Mann's The Black Swan is annotated in this database).

Likewise, the story of how "Avalanche" was written is an interesting tale in itself. Selzer's description of pruning the story from his journal reminds me of Michelangelo's comment that the sculpture already exists in the block of marble. The sculptor merely removes the unnecessary stone. The Doctor Stories contains many of Selzer's tales that have become part of the Literature and Medicine canon; these include, for example, "Tube Feeding," "Sarcophagus," Imelda, Mercy, Brute, and Four Appointments with the Discus Thrower. (See this database for annotations of the latter four.)

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From the mundane to the profound, from the body as physical preoccupation to the body as sacred, the poet explores in 21 highly personalized lines the significance and symbolism of the human body. Washing your feet without giving it a thought means you are in good health; struggling to do it because of overweight is a reminder of mortality. This (any) physical act "should be ritual . . . memorial, meditative, immortal." It conjures up an image of the Degas ballet dancers washing their feet, and then, remarkably, that " . . . they also seemed to be washing God’s feet."

But the creative power of Degas is yet another reminder of the author’s limitations. He is vulnerable, mortal and not creative enough to gain immortality by producing a masterpiece: "It is sad to be naked and to lack talent."

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In The Mysteries Within, Sherwin Nuland takes the reader on a guided tour of selected organs inside the human body. Beginning with the stomach, he progresses along to visit the liver, spleen, heart, uterus, and ovaries. At each point he addresses various historical and contemporary beliefs, as promised in the book's subtitle, "A Surgeon Reflects on Medical Myths." Nuland brings to this endeavor the patented mixture of personal story, elucidation of medical history, and plain old good writing that characterizes all of his books.

For example, he devotes the first three chapters to the stomach. The first consists mostly of a brilliant clinical tale in which a six-week-old baby is found to have a wax bezoar in his stomach. The second and third provide a cogent survey of beliefs about the stomach's function, beginning with Greek humoral theory, continuing through van Helmont and the iatrochemists, and ending with Ivan Petrovich Pavlov and his seminal monograph, The Work of the Digestive Glands.

Van Helmont and his mentor, Paracelsus, appear again and again in later chapters as the earliest champions of the idea that the body runs by means of chemical processes (iatrochemistry). However, as Nuland points out, Paracelsus has left us two different legacies. One is his devotion to chemistry and experimentation, which eventually led to modern biological science. The other is his devotion to alchemy and mysticism, which makes him as well a forerunner of contemporary irrational systems of healing.

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Collegiate Assessor Kovalyov wakes up one morning and discovers that his nose is missing. At the same time in another part of St. Petersburg, Kovalyov's barber finds the nose in his breakfast roll. However, the barber, desiring to disassociate himself from the strange incident, proceeds to toss the nose into the Neva River. A little later, Kovalyov happens to see his nose riding in an elegant carriage and wearing the uniform of a State Councillor (a higher rank than Collegiate Assessor). He demands that the nose give itself up, but is rudely rebuffed.

At first neither the police nor the newspaper offer any help, but later a police officer, who happened to observe the barber throwing an object into the river, returns the lost nose to Kovalyov. However, a new problem arises. How will he re-attach the nose to his face? For this he consults a doctor, who recommends letting nature take its course, "it's best to stay as you are, otherwise you'll only make it worse." Poor nose-less Kovalyov! He becomes the laughing stock of St. Petersburg, until one morning he wakes up and finds his nose re-attached firmly to his face.

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Paula Henning (Franka Potente) is a brilliant medical student from Munich, who comes second in the Robert Koch competition winning a place at the prestigious Heidelberg medical school. Medicine is a family tradition, but Paula has little respect for her father's boring suburban practice. Instead, she takes inspiration from her dying grandfather, an academic doctor, who celebrates her decision.

En route to Heidelberg she meets the stunningly beautiful and highly sexed Gretchen (who stood first in the competition) and David, a 22 year-old lad with cardiomyopathy and multiple piercings. Gretchen is interested in partying; Paula is serious, studies all the time, and ignores fellow student Caspar (Sebastian Blumberg) who strives for her attention. When David appears on the dissecting table with no obvious cause of death and "rubbery blood," Paula begins investigating. She determines his death is due to Promidal--a drug developed by The Anti-Hippocratic Society (or "AAA!").

This clandestine group engages in unethical anatomical research on living subjects to "better" the human race. Her classmates scorn her conspiracy theory, but she is drawn deeper into the mystery when Gretchen disappears only to reappear as a perfectly dissected, plasticized cadaver. Paula nearly succumbs to the same fate with her lover, Caspar (who turns out to be an incognito history student writing his thesis on the AAA! ). The ending is happy, although Paula must reckon with the discovery that her venerated grandfather was a member of the "AAA!".

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The first poem in this chapbook ("Sonogram") contains two images of a small, mysterious life (the fetus imagined as a "white boat on whiter water" and as a "tiny orca") in the midst of the coldly technical medical world. This juxtaposition is characteristic of B. A. St. Andrews's poems in this small collection. In most of them, she uses disciplined and sparkling language to explore the interface between modern medicine with its impersonal machinery and the irreducible mystery of life.

Some of the images are simply breathtaking. For example, in "A Dying Art: Room 309," a terminally ill artist lies in bed, surrounded by "plastic bags that hang / like udders dripping pigment / into her." In a love poem called "The Body of Science," the poet confesses, "Each time your voluntary / muscles make contact / my involuntary ones / contract." And at the end of "Alzheimer's," she observes, "She stood at the big bay / window screaming but he never / heard what it was she never said."

The four poems entitled "Your Breast a Unicorn" consider the fate of breasts attacked "at consolation's center" by "one aberrant cell metastasized." These learned, wise, and witty poems are, in my opinion, among the very best of the breast cancer genre.

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Art Myers is not only an art photographer but also a physician who specializes in preventive medicine and public health. Having experienced breast cancer in members of his own family, including his wife, he began to see the disease in a new light and undertook this photographic project to show that for a woman, the loss of part or all of her breast need not be a threat to her being.

In addition to the artistic nude photographs of thirteen different women from a variety of backgrounds there are meaningful personal vignettes and beautiful poetry by Maria Marrocchino. Some of the photographs show women with significant others. The women present their bodies and themselves with humor, sadness, vulnerability and honesty.

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Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider's view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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Summary:

Levin, a social documentary photographer, immersed herself with the Class of 2001 in the anatomy course at Weill Medical College of Cornell University. Her photographs of cadavers, students and instructors are prefaced by a foreword by physician-writer Abraham Verghese. He describes the rite of passage of anatomical dissection: "The living studying the dead. The dead instructing the living." (p. 9)

Interspersed with the full-color images are journal entries by 11 medical students and several artistic anatomic illustrations by 3 of the students. The journal entries and photographs are organized temporally, from the introduction to the dissection lab to the final exam and student-organized memorial service. The end of the book includes the interests and brief biographies of the 11 students and a final dedication by Levin of the book to those who donated their bodies: "I have never before witnessed a gift that is honored, respected, and consumed so completely."

The photographs are not for the squeamish. For example, the double amputee pelvis prosection on page 102, or the multiple images of flayed skin, bits and pieces, or limbs tied to supports provide an insider’s view of an anatomy course. Many of the images show the living in motion: translucent images of students in time-lapse swirl near the static cadavers. Other images conjure the once-upon-a-time personhood of the dead: pink fingernail polish on a female cadaver or a heart palmed by a student. The intensity of the student experience is well documented, as is the relaxed atmosphere that inevitably develops as students become accustomed to the experience of dissection.

The student journal entries are sensitive and thoughtful. Students comment on the intersections of daily living, home life, and their own bodies and bodily functions with what they are learning in the classroom. Particular discomfort regarding certain dissections, such as the pelvic region, are acknowledged. Even though students note growing immunity to the dissection experience, such comments reflect insight into professionalism and defense systems. Gallows humor and uneasiness with such humor is explored by Rebecca (p 62) after she sings "New York, New York" to the roomful of cadavers. Forensic clues about the cause of death for a particular cadaver renew the sense for students that this was once a living, feeling person.

The intense, long hours required for understanding and memorizing the material are clearly evident, but ultimately, these students realize they are given a truly special opportunity: "I began to love learning the material just for the sake of learning. Anatomy no longer felt like a burden, but rather a gift." (David, p. 119) Relationships explored include those of student with cadaver (particularly respect/disrespect, ownership and protection), life with death, and those who have had the experience of dissection with those who never will.

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