Summary:

The novel twines several plots together: the love story of Emilia Sauri and Daniel Cuenca; the Mexican Revolution; Emilia's medical practice; the love story of Emilia and Dr. Zavalza.

Emilia Sauri is the daughter of upper-class Mexican parents and is raised in relatively idyllic surroundings. Her father is a pharmacist and she learns his craft through a long apprenticeship with him. Emilia's long-time childhood friend, Daniel Cuenca, becomes her lover as they grow older and their love grows in passion while Daniel's involvement in popular struggle increases.

The Mexican Revolution is brewing and the Sauri's and Cuenca's lives are intertwined and involved in the struggle in various ways. When a wounded fighter is brought to the Sauri's, Emilia takes care of him, her "first patient," and thus begins her thirst for practicing medicine. She studies with Daniel's father, the indomitable Dr. Cuenca ("I leave but one bequest to my children: paralysis of the spine before the tyrant").

Drawn more and more into the struggle, Emilia joins Daniel on the front and practices medicine with the most desperate cases, along with the myriad poor people she meets along the way. Emilia also practices medicine with Dr. Zavalza, and finally marries him, although she never stops loving Daniel.

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Set in 19th-century Japan, the film’s action centers on the experience of the young doctor Yasumoto (Yuzo Kayama) in his work as an intern at a hospital-clinic for the poor run by the experienced and wise Dr. Kyojo Niide (Toshiro Mifune), nicknamed "Red Beard." Coming from a wealthy and influential family, and fresh from a Western-influenced medical education at Nagasaki, Yasumoto had believed he was on the path to become physician to the shogun (equivalent to a king).

He is initially insulted and deeply unhappy with conditions at the distinctly inglorious clinic. The poverty and suffering (and smell) of the clinic’s patients disgust him, and he tries his hardest to get fired. The mysterious Red Beard, however, is extremely patient, and simply waits. While he waits, we see Dr. Yasumoto slowly being converted as he is brought into close contact with the suffering in the lives of several patients.

Initially rebellious and emotionally unable to watch patients die or assist in surgery, Yasumoto gradually becomes a seasoned and enthusiastic member of the clinic’s medical team and announces that Red Beard is his idol. At the end, when Yasumoto is actually offered the position of physician to the shogun, he refuses, in order to continue his work at the clinic.

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In this rich opening chapter of his work on the Nazi doctors, Lifton lays out the groundwork for answering the question of how German doctors became the agents of Hitler’s vision of the purified Aryan race, sterilizing involuntarily several hundred thousand citizens with a variety of mental and physical deficiencies. His answer, in brief: a romanticized genetics coupled with total political control.

Amazingly, the Nazi medical atrocities were carried out not against the opposition of Germany’s medical establishment, but with its approval. (Of course, there were individual dissenters, the more vocal of whom were removed from positions of authority or put to death). Nazi leaders worked hard to convert medical people to the official position. This was accomplished partly by force, but also partly by metaphor, as the normal language of medicine was used to hide the unethical nature of what doctors were being asked to do.

Individual patients were replaced by the racial term "Volk," meaning the (Aryan) people, and their rights were superceded by their doctors’ new duty to assure the health of this collective political idea. According to Nazi publicity, the Aryan race was in grave danger of "Volkstod," of dying out, because its genetic pool had been contaminated both by the transmission of inherited genetic defects and by the "foreign invasion" of Jews and their intermingling with members of the "superior" Aryan race.

To save their new patient, German doctors were expected to carry out the sterilizations, medical experiments, and, later, the euthanasia required by Nazi doctrine, which, in the words of one Nazi writer, declared that "misery can only be removed from the world by painless extermination of the miserable." Doctors were urged not to worry about ethical issues, because Nazi medicine was "nothing but applied biology."

In these ways, says Lifton, Hitler’s racial policies were ’medicalized’ and their evil made less obvious. Those who went along were billed as the "saviors of mankind," the "alert biological soldiers" whose actions would restore the purity of the Aryan race. Jewish doctors were not invited, of course, their research having been officially discredited in the mid-1930s, Lifton tells us, and their medical licenses revoked in 1939--in spite of the fact that they made up half the doctors in some large cities.

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Cosima Nolinas (Codi) trained as a physician, but decided during her residency to give up medicine. As the novel opens, she is returning to her hometown, Grace, Arizona, to teach high school biology and care for her physician father, Doc Homero, who is suffering from Alzheimer's disease. Her younger sister, Hallie, has just left for Nicaragua to help with agricultural development. Codi's journey back to where she grew up reinforces a sense of aimlessness which she attributes to the death of her mother when she was three years old, to the miscarriage of an unwanted pregnancy when she was fifteen, and to her father's remoteness. She intends her stay to be temporary.

But gradually she is drawn into the community. She restarts a relationship with Loyd [sic] Peregrina, the Native-American father--though she never told him--of the child she lost in high school. She joins the town's struggle against a mining company that has polluted the town's water supply and now plans to dam the river. As her father's condition deteriorates, she learns more about the history of his connection with the town and, by examining the results of a life-long study he has done on a genetic anomaly affecting children born to second-generation inhabitants of Grace, she learns that her own hereditary background is far more deeply rooted in the town than she had known.

Codi's narrative is interspersed with her father's confused but illuminating memories of her childhood, and with the letters she receives from Hallie, who has always been the motivated and determined sister. When Hallie is kidnapped and then murdered by the contras, Codi's first response is to run away once more, but in laying her sister to rest and telling Loyd about their lost child, she realizes that she has found her home and--in her fierce and practical education of the new generation of Grace adolescents--her purpose.

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As much about the abusive treatment of women, and the clash of traditional and contemporary mores as it is about the HIV/AIDS pandemic, this beautifully crafted novel tells the story of a nineteen-year-old Mosa (for mosadi--woman) who has already lost two brothers to AIDS. The reader is caught up in the mega-deaths and non-mention of the dreaded acronym, AIDS, as the story unfolds. At their brother’s gravesite Mosa’s one remaining living brother is halted as he shovels in the final loads of earth: "All around him were fresh graves . . . He looked at the not fresh, fresh graves, and noted the dates of birth. Young people who had died prematurely . . . He had known about their long illnesses, their deaths and their funerals." (p. 20)

The author is the first (and only) female judge of the High Court of Botswana and a human rights activist. She is internationally renowned for bringing about the Dow Case, which challenged Botswana nationality laws; she argued successfully for revisions allowing women to pass their nationality on to their children.

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Ian Young spent the summer of 1970 as a medical student working at a hospital in the province of Kabylia in Algeria. He was assigned to the Maternity department, where he worked primarily with two Bulgarian doctors. Most foreign medical personnel in Algeria at the time came from Eastern bloc countries, as "Islamic Socialism" was the official political system in the newly independent (1962) North African country. According to Young, obstetrical care for the mostly Berber women of the area was brutal, disorganized, antiquated, and dangerous.

Dr. Vasilev, the head of the department, is a passive and indecisive man, who spends most of his day reading the newspaper. Once roused from his lethargy, which doesn't happen very often, he demonstrates competence and concern for his patients. His colleague, Dr. Kostov, is an aggressively brutal man who introduces himself to pregnant patients by shoving his fist into their vaginas.

Both doctors excuse their behavior by saying, "We just can't do it here they way we do it in Bulgaria." For the most part, they do not use sterile technique, and although anesthetics are available, neither Kostov nor Vasilev typically use them. The Algerian nursing staff provides at least a modicum of organization and care in this dreadful environment.

At first Young approaches the situation with disbelief and anger. He then attempts to improve the quality of care, first by introducing a flow sheet for obstetrical care, and later by submitting a report on the poor conditions to the hospital director.

Mild-mannered Dr. Vasilev supports him, but no one uses the new flow sheets, and the Director considers the report a personal (and political) affront. Meanwhile, Ian Young presents the reader with a seemingly endless series of fascinating patient cases and interesting stories about hospital personnel, as well as about his excursions to various parts of Kabylia.

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Dr. Conley became, in 1991, the center of media attention when she publicly declared her reasons for resigning her position as Professor of Neurosurgery at Stanford University: a hostile work environment due to the sexism of the male professor promoted first to acting chair, then chair of her department. This book is her story, but as she notes in the introduction, it is "one of many that could be told by women doctors across the country, about this institution [Stanford University] and many others like it."

Dr. Conley has been a remarkable pioneer in academic medicine: in 1975, she became the first female faculty member at Stanford in any surgical department. She was immediately elected the first female chair of the faculty Senate. She has led an active, innovative research team investigating the immunology of brain tumors. She is the first female tenured professor of neurosurgery in the country.

The book offers behind-the-scenes views of the anatomy lab and medical school, residency and sleep deprivation, the operating room and hospital medicine, and, above all, the political parrying and power struggles in academic medicine, particularly in the dean's office. In a bold move, Conley uses the real names of top administrators and those who had previously been identified in the media--not only concerning her issues, but also those involved with scandals that were unfolding concurrently in other departments.

Because of the circumstances surrounding her resignation and subsequent rescindment of the resignation, she became aware of many instances of sexism, gender discrimination and harassment, not only in academia, but throughout hospital and research environments. Her current position within the University and Veterans Affairs hospital enables her to be a strong voice for women's issues. This book chronicles her personal journey and acknowledges the support of her husband, parents, mentors, and friends along the way.

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This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.

Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.

Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)

As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.

Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.

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The description on the cover of this collection of essays states that it is "candid firsthand accounts of the profound experiences that transform medical students into doctors". It is edited by a woman breast surgeon (Susan Pories) who teaches students in the Harvard Medical School Patient-Doctor Course; a MD/MBA candidate (Sachin Jain) who anticipates a career as a clinician , scholar and activist; and a psychiatrist (Gordon Harper) who is director of the Patient-Doctor III course at Harvard. The short forward is by physician-writer Jerome Groopman. The 44 essays are divided into sections by theme: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. I found it helpful to read the short biographies of each student in the back of the book, before reading that student's essay.

The diversity of the essayists is very wide which makes for a broad look at many important issues. There are several subjects that we tend to avoid (student response to the nude body, the presence of students when end of life decisions are being made, the tensions between caring for a patient and having to do something which causes pain, trying to think of patients a people as well as complex biomedical problems). One of the editors wishes that the book will help people understand the working of the hospital and the many ways in which new doctors learn. The book is certainly a personal look at the teaching hospital from the students' view.

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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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