Summary:

Year after year Dr. Lin Kong returned to his country village from his army hospital post in the city with the intention of divorcing his wife, Shuyu. Except for the conception of their single child, Lin and his wife had no conjugal relationship. Their marriage had been arranged by Lin's parents and his wife had remained in the village and cared for Lin's parents until they died and then raised his daughter, Hua.

In the meantime, Lin had developed a relationship with a military nurse, Manna, in his hospital. Manna pressed him each summer to request a divorce from his wife; each summer he got Shuyu's consent, but she backed down when they appeared in court. Still Manna waited--for 18 years she waited for Lin to be free.

Eventually the waiting ended as the law allowed a divorce without consent after 18 years of separation. Lin moved his former wife and his daughter to the city and he married Manna. The remainder of the tale is that of the new marriage. Lin still waits for something that doesn't seem to exist. Manna also waits for a dream that doesn't materialize. Shuyu and Hua quietly wait in the background for Lin to come to his senses.

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In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.

In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.

Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).

He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.

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Death beds have been around for a long time. Ancient Greeks, Japanese monks, Medieval Christians, and tubercular Victorians all had opportunities to use them. Some folks were witty, some were slow, and some called for a priest when the time came. "And you and I, too, may lie on ours, / the vigilant family in a semicircle, / or the night nurse holding our hand / in the dark, or alone." We cannot avoid the death bed, but what we can hope for is "just at the end / a moment of pure awareness . . . . " [56 lines]

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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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In mid-19th century England, a small group of religious women called the Household of Hidden Stars follow Muley Moloch, an itinerant prophet, across the world to establish a life for themselves in New South Wales. Catherine, Moloch's wife, gives her account of their story many years later in 1898.

Moloch is an illiterate shoemaker-turned-prophet who claims to perform miracles. His goal is to prepare the way for the Second Coming of Christ. To accomplish this, he and his group of 8 or 9 women set out to lead exemplary lives in the wilderness, yet they do not attempt to make converts.

When Catherine becomes pregnant, she and the others think her pregnancy is a miracle. (In reality, Moloch has had sex with her while she was desperately ill and unaware of what was going on.) They name the child Immanuel and believe that he is the Second Coming of Christ.

Muloch considers the local Aboriginal people to be demons and treats them as such. One day he sees Immanuel talking to a "demon" and shoots the man dead. Immanuel, already fed up with all the craziness, runs away. At this point the women finally seize control of their own lives and tell Moloch that he must leave. As the years progress, the women remain together. One by one they die of consumption, until only Catherine and Louisa are left.

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The poems in this collection are elegant, economical, worldly, and humorous. The tone is generally one of amused ruefulness. In "Alcohol" the poet addresses his subject as "the eighth / and shallowest / of the seven seas." He salutes the "nice" people, "on whom depends / the diminishing goodness of the world."

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Bruno Kamenar is a pale and thin ten year old boy who lives with his stepmother and younger brother in Croatia in 1948. His father, Pero, has just returned home after serving in the Yugoslav Federal Army. With the constant threat of a Soviet invasion serving as a backdrop, Bruno is plagued by frequent nightmares as well as a cough. He finds solace both in drawing and in the company of the family cow.

Sadly, Bruno contracts tuberculosis from the cow's fresh milk. At first he is unable to be treated because the government rejects an offer of free streptomycin from the Swiss. It is only after Pero publicly criticizes his country's refusal of medical aid and becomes a political prisoner that UNICEF physicians arrive at Bruno's home and treat him with streptomycin and PAS.

He recovers and his father is released from prison. As he watches the family cow and its pen incinerated, Bruno is filled with horror and relief by the death of an animal that once provided food and comfort but almost killed him.

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This is the story of the ill-fated romance of Marguerite Gautier, a beautiful and brazen young courtesan of Paris, and Armand Duval, her passionate aristocratic lover. After becoming his mistress, Marguerite grows emotionally attached, returning Armand’s love and living with him in the country in order to recover her health.

Estranged from his family and deeply in debt, Armand is confronted by his father who demands an end to the illicit relationship. When Armand defies him, Monsieur Duval convinces Marguerite to release her beloved to secure his future and protect his reputation. Marguerite dies alone and in agony from consumption.

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The story opens on the day that Ridgeon, a prominent research doctor, is knighted. His friends gather to congratulate him. The friends include Sir Patrick, a distinguished old physician; Walpole, an aggressive surgeon; Sir Ralph Bloomfield Bonington, a charismatic society doctor; and Blenkinsop, a threadbare but honest government doctor. Each one has his favorite theory of illness and method of cure. These are incompatible--one man's cure is another man's poison. Nonetheless, they all get along.

A young woman (Mrs. Dubechat) desperately seeks help for her husband from Ridgeon, who has evidently found a way to cure consumption by "stimulating the phagocytes." Ridgeon initially refuses, but changes his mind for two reasons--Dubechat is a fine artist and Ridgeon is smitten with his wife.

When the doctors meet Dubechat, however, they find that he is a dishonest scoundrel. Ridgeon eventually decides to treat Blenkinsop (who also has consumption) and refer the artist to Bloomfield Bonington, this insuring that he will die. In the end Ridgeon justifies his behavior as a plan to let Dubechat die before his wife find out what an amoral cad he actually was. This, in fact, happens and Dubechat's artistic reputation soars.

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Carl Elliott and John Lantos have brought together a collection of 12 essays that explore the complex work and person of Walker Percy. Personal reflections and stories capture the importance of Walker Percy in the lives and work of several of the essayists, while others offer commentaries on various aspects of Percy's life and work. All of the contributors reveal their affection and appreciation of Walker Percy as physician, novelist, and philosopher.

In addition to the editors, the contributors include Robert Coles, who was Percy's friend; Ross McElwee, the documentary filmmaker; Jay Tolson, Percy's biographer; author and historian Bertram Wyatt-Brown; scholars Martha Montello and Laurie Zoloth; and physicians Brock Eide, Richard Martinez, and David Schiedermayer.

The collection covers many topics and themes. Percy's biography is reviewed: the early losses of his father and grandfather by suicide, the early death of his mother, his medical education and subsequent struggle with tuberculosis, his turn from medicine to philosophy and literature, his marriage and conversion to Catholicism, and his long and productive life as a philosophic novelist.

The essays explore Percy as both physician and patient, and how, as diagnostic novelist, he gives us characters and stories that caution about the technologic-scientific worldview that dominates not only medicine but western life. The many wayfarers are discussed, including Binx Bolling from The Moviegoer, Will Barrett from The Last Gentleman, and Dr. Tom Moore from Love in the Ruins and The Thanatos Syndrome. [These novels have been annotated in this database.]

Percy's spiritual and religious views are reviewed, along with his moral concerns about a post-modern world before anyone had coined the term. The problems of isolation, alienation, and struggle for meaning are apparent in all of his works, and many of the essayists explore the connection between his novels and these existential concerns. The importance of Kierkegaard in his work, his theory of language, and his early essays are discussed.

The contributors give examples of how Walker Percy's life and work are incorporated in medical education and the practice of medicine, both in personal and theoretical terms. Percy's work reminds practitioners of the necessity for human connection in the midst of scientific and technologic paradigms that distance practitioner from patient. Likewise, medicine and medical education shaped Percy the novelist, where keen observation and sustained searching for answers are to be found in all of his fiction.

A feminist critique of Percy's development of women characters, reflections on physician characters in Percy's work, his personal struggle with a family history of depression, and his attitudes about psychiatry and psychoanalysis complete the collection.

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