Summary:

Parts of medical history read like detective novels.  The discovery of the source of cholera by Dr. John Snow in London in 1854 is one of those episodes.  The Ghost Map tells the story of Snow's pioneering work in what have now become standard epidemiological methods.  Tracing a cholera outbreak to a local pump in a poor section of London involved many door-to-door visits working with people who weren't always cooperative, incurring the suspicion and/or ridicule of both them and the medical professionals with whom he worked.  In the course of the story the author offers reflections on the organization of cities and on public hygiene.  Snow, an out-of-the-box thinker, also helped develop surgical anesthesia. 

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Bucky Cantor is a young, athletic, Jewish javelin thrower who is acting as a coach for young boys in the sweltering New Jersey summer of 1944. He is ineligible for war service because of his weak eyes.

His coaching efforts are much appreciated by the children and their parents because a polio outbreak is on the rise, and sports help take their minds off their fears of death and permanent illness. One by one, boys fall ill and disappear. Some die. But the games continue in Bucky’s own private campaign against the epidemic.

No one really knows how polio is contracted and spread.

Bucky falls in love with Marcia Steinberg who urges him to leave the city to avoid exposure to the germs. She works at a summer camp in the Poconos far from the city and uses her influence to have him invited to fill a sudden vacancy when the sports instructor is called up to military service. After agonizing over his decision, Bucky accepts the position—admitting that he is running away from fear as much as he is going to Marcia.  He is amazed that no one seems to blame him.

The camp life is idyllic, and he is reconciled to his choice.  But soon one of the boys at camp shows signs of the dreaded illness, and Bucky believes that he must have brought it with him. Then, Bucky himself falls ill and develops a permanent disability that ends his athletic career.

Marcia rushes to his bedside more than willing to continue as his lover and wife, but he sends her away believing that she should not be saddled with a disabled lover. He thinks he did the right thing.

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Mary Sutter has been trained as a midwife by her widowed mother, and has demonstrated an unusual aptitude.  She is an eager learner, but her deepest desire is to be a surgeon.  No medical school will take her, however.  As reports reach her home town of Albany of the escalation toward civil war around Washington DC, and in the wake of a disappointment in love,  she decides to board a train and offer her services to Dorothea Dix as a nurse.  Though Miss Dix refuses her on the grounds of her youth, Mary finds her way into apprenticeship with a surgeon who, as the numbers of injured climb, needs all the hands he can get.  Slowly and grudgingly, he comes to accept her as a competent assistant and, eventually, to teach her as a respected apprentice, and the remarkable companion she has become to him.  She learns surgery in the most grueling circumstances possible, amputating shattered limbs of young men, many of whom die anyway of infection or water-borne diseases.  In the course of her sojourn in Washington she meets John Hay and, through him, President Lincoln, whose compassionate attention she manages to direct to the dire need for medical supplies.  Two men love her not only for her intelligence and courage, but for the passion she brings to the hard-won skill that, though it cannot save her brother from the respiratory illness that is rampant in the camps, or her sister from a disastrous childbirth, saves many lives and makes a wider way for women of her generation who find themselves called to medicine. 

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Zol Szabo, is public health doctor for the Hamilton Ontario region. He is also a single parent to nine year-old, Max, because his wife could not deal with Max’s mild physical disability. He is dating Colleen an attractive woman detective whom he met in the previous novel. The story opens with Zol’s angst over his son’s expensive misuse of a cell phone that he’d been given for safety reasons.

Soon he and his team are investigating cases of diarrhea in a seniors’ residence.  The diagnosis is difficult—but the doctors are confident they know what it is; however, the recommended treatments prove ineffective. Gradually they begin to suspect that the drugs are not working because they might be fake. Even worse, they notice that the people infected are all taking the same arthritis medicine—could that drug be the source of the infection?

In the background an unbending hospital administration and a hostile boss make the situation even worse.

A team of elderly friends who reside in the senior’s home collaborate to help solve the mystery. And of course the son’s cell phone is crucial to the dramatic conclusion.

 

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The author takes us on a highly colorful autobiographical tour of his medical career - his personal life never enters this account - from a classical medical education in Paris as a young expatriate Swede (he remains expatriate the entire book) to his internal medicine practice in France, including a tour of Naples as a volunteer during the cholera epidemic of 1881 and his finally settling in Italy. There are also anecdotes - many of them side-splitting and told with uncommon skill - about conducting a corpse back to Sweden, a truly thrilling journey to Lapland,  encounters with the legendary Charcot, his return to San Michele whence the book begins with a mythopoetic retelling of his first visit there, and his last years at San Michele as patron of a community (both local and international) and as collector and explorer of the nearby Mediterranean.        

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In the eighteenth century, Europe began to take stock of the horrific infant mortality in foundling homes and hospitals. Infant feeding and care became a major preoccupation for charities and philanthropic doctors. Some organized systems of wet nurses in the communities and institutions to provide for motherless children. 

At the same time, syphilis was becoming a serious problem in newborns. The sexually transmitted disease, which swept the continent following the voyages of Columbus, was known to affect babies born to infected mothers. Since the early sixteenth century, doctors had been convinced that mercury was of benefit.

Founded in 1724, the Vaugirard Hospital of Paris was the city’s home for orphans. By 1780 it had made room for mothers with syphilis and their children.  Sometimes the mothers died, or well-off families would abandon their sick children. Healthy wet nurses were engaged to feed these babies.

Eventually, the wet nurses were viewed as a technology—a vehicle--for administering mercury to the babies through their milk. Many of these healthy women fell ill, either from the mercury or by infection from their charges. Nevertheless, the practice continued into the nineteenth century. The wet nurses did not know (or were not told) that the children were infected. The physicians in charge of this experiment also attempted unsuccessfully to vaccinate the wet nurses against syphilis. That experiment also spread the disease.

Remarkably, some wet nurses brought suits against the doctors or the birth families. Occasionally they won damages, and finally the law was changed to offer greater protection.

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Zol Szabo, is public health doctor for the Hamilton Ontario region. He is also a single parent to a seven-year-old, Max, because his wife could not deal with Max’s physical disability. But Sol thinks there is hope for Max in an injection of a miraculous new substance called “Endotox” that may loosen the contractures of his arm. Soon he his investigating a cluster of variant CJD (mad cow) cases that may be related to Endotox. But they also seem to be connected to the grocery store where Sol does his shopping. The products that all victims had in common were an imported candy and a sausage, both Max’s favorites.

Conspiracy theories about corrupt pharmaceutical companies and the antics of a pair of unethical mink farmers lead the investigation in many different directions, all personally threatening to Sol because of the health of his son or the ire of his boss. Pressure from his superiors to avoid publicity cramps Sol’s freedom. He seeks help from an attractive woman detective who, of course, sticks with him to the terrifying (and satisfying) conclusion.

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The theme of this book of poems is life in a time of deadly plague. The author depicts his world ravaged by illness. Some of the poems are quiet love songs for others, for the world and its delights, a world turned upside-down by the ravages of AIDS. Many of the poems are elegies for friends who have died in the epidemic.

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Professor Samuel D. Gross of Jefferson Medical College is demonstrating an operation for osteomyelitis of the femur in the surgical amphitheater in 1875 in this highly dramatic, powerful scene. Light glints off his forehead, and his visage is stern, calm, and surrounded by a halo of gray-white hair. The bloody fingers of his right hand hold a blood-tipped scalpel. He appears to have just made an incision and is turning away to demonstrate his work.

To the surgeon’s left is the patient, lying in right lateral decubitus position, with exposed leg and buttocks. Assistants are retracting the wound, further dissecting within it, and holding the patient’s legs. Blood is on their hands, instruments, and the patient’s leg. The patient’s face is obscured by the chloroform soaked towel that the anesthetist is using to administer general anesthesia. The white of this towel and the operating table’s sheet are the only other bright white values besides the surgeon’s head in this mostly dark painting.

Adding to the drama is the stricken pose of the patient’s female relative--to the surgeon’s right. For charity cases, a family member was required to be present during the surgery. She averts her head and raises her hands, clenched in a claw-like fashion, to block her view.

In the gallery are variously interested and disinterested observers--mostly medical students--in casual poses and dimly seen. The exception is the artist’s self-portrayal--he is studiously drawing in the front row. Dr. Gross’s son (also a surgeon) is standing in the entry tunnel.

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