Summary:

Martin Arrowsmith is from a tiny mid-western town. He goes to college and then to medical school in the largest town in the state. He begins to worship Gottlieb, Professor of Bacteriology, one of the few professors who is devoted to pure science instead of lucrative practice. Martin becomes Gottlieb’s assistant and annoys his professors and friends by constantly talking about methodology. He is engaged to Madeline, a rather dull graduate student in English. When he meets Leora, a nurse, he breaks his engagement to Madeline. Martin grows disenchanted with his career, leaves school, and wanders around the midwest. Finally, he marries Leora and returns to school. Now, however, he becomes a disciple of the Dean, Silva, whose science is much less precise and who is devoted to making people comfortable at all costs.

Martin sets up practice after graduation in Leora’s home town. The Swedish and German farmers find him invasive and unwilling to cater to their small-town expectations. When Martin misdiagnoses a case of smallpox, he is forced to leave town. He has by then found a new hero, Gustave Sondelius, who fights plagues abroad and returns to America to lecture. Sondelius finds him a job in a larger town as an assistant to Dr. Almus Pickerbaugh, Director of Public Health. Pickerbaugh writes popular poems against sidewalk spitting and alcohol but does little else. The town loves him. He becomes a senator and Martin takes over the department. He quickly makes enemies of the very people Sondelius pleased. He also returns to research. Between annoying the upper crust with his brusqueness and annoying the farmers by closing their diseased dairies, he is soon drummed out of town.

He is then hired as a pathologist at the Rouncefield Clinic, where he does meaningless, repetitive work. His old mentor, Gottlieb, saves him by getting him a position at the McGurk Institute in New York. The Institute is very rich and gives scientists a chance to work without the interruption of patients or a need for practical application. Martin returns to Gottlieb’s principles and discovers a cure for bubonic plague. The Institute, which is not free from economic interests, sends him off to the tropical island of St. Hubert to test his material and save the population.

Martin is determined to conduct a controlled trial. When his wife and Sondelius both die of the plague, however, he injects everyone, saves the island, and returns to New York. Gottlieb has dementia and can neither blame nor forgive Martin for his lack of scientific aplomb. Martin marries an heiress and briefly lives the rich life he always dreamed of, but finds that his new wife will not let him work. Finally, he joins a friend who has built a laboratory in Vermont and happily returns to research.

 

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A neurosurgeon looks forward to having a day off from work, but a promising Saturday brings only trouble. Henry Perowne is 48 years old and practices in London. Lately, he's concerned about the impending invasion of Iraq. Perowne's views on the situation have changed considerably after conversations with a patient who was tortured and imprisoned in Iraq for no apparent reason. A protest march against the looming war is held on Saturday.

On his way to play a game of squash that morning, Perowne is involved in a car accident on an otherwise deserted street. No one is injured and the two vehicles sustain only minor damage. The owner of the other car is a man in his twenties named Baxter. He is accompanied by two buddies. Perowne refuses Baxter's demand for cash to repair the car so Baxter punches the doctor. Perowne is moments away from a pummeling.

He notices that Baxter has a tremor and an inability to perform saccades. Perowne deduces that Baxter has Huntington's disease. The doctor capitalizes on the fortuitous diagnosis. He speculates that Baxter has kept the neurodegenerative disorder a secret from his sidekicks. When Perowne initiates a discussion about the illness, Baxter orders the cronies away so that he can speak privately to the doctor. The two men desert Baxter, and Perowne escapes in his car, hopeful he can still make the squash game.

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This slim volume dips into "quotable quotes" drawn from literature and historical writings dating back several centuries. The quotes are put forth by physicians, patients, observers of medical issues, and writers of fiction as well as essayists. Each quote is but a few lines. The author, the source, and the date (when known) are provided for each quotation.

Many of these quotations will be familiar to persons who are widely read or who study the literature by and about medicine. Some of the quotes are scatological in the sense that they address issues of bodily parts and functions; others are simply amusing, while many are profound observations. The range is wide and the selections eclectic.

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Professor Sandra Bertman founded the Medical Humanities Program at the University of Massachusetts Medical Center and holds certificates in grief counseling and death education. This handbook outlines how she uses the visual and literary arts to "improve our professional abilities to deal with death and dying." Her premise is that the arts provide a valuable vehicle for exploring and making bearable the prospect and fact of death.

Bertman illustrates her presentation technique (Chapter 2) of juxtaposing dual images around six central themes, here abbreviated: the chosen death; death and afterlife; existential aloneness; loss of control, unmentionable feelings, grief; the land of the sick vs. the land of the well; the moment of death. The book offers dozens of paintings, sketches, and photographs (reproduced in black and white), as well as many literary excerpts. Classic works are represented (David's painting, The Death of Socrates; Michelangelo's sculpture, "Pieta"; Tolstoy's novel, The Death of Ivan Ilyich) but there are many unusual representations as well--greeting card messages, epitaphs, cartoons.

In addition, some groups with whom she works (for example, medical students studying Gross Anatomy) have submitted their own drawings and commentary. These are shown in Chapter 3, along with written responses to a follow-up Death Attitude Questionnaire. Responses are from junior and senior high school students; college students; medical students; graduate nurses; hospice volunteers.

Chapter 4 gives suggestions for how to use images and texts and for how to approach discussions of loss and grief. The course syllabus for "Dissection, Dying, and Death," taught with Gross Anatomy, is appended, and there is an extensive bibliography.

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This is the meticulously researched and beautifully constructed catalogue for a 1999 exhibition at the Duke University Museum of Art. Over one hundred items originally produced to serve the science of medicine were culled from the history of medicine collections in four North Carolina institutions: Duke, East Carolina University, University of North Carolina at Chapel Hill, and Wake Forest.

Covering a wide range of time periods, media, and nationalities, the exhibit was coordinated by Suzanne Porter, librarian and curator of the History of Medicine Collections at Duke University Library, and Julie Hansen, an art historian. Martin Kemp, Professor of Art at the University of Oxford, supplies a foreword to the catalogue.

The rich and unusual yield of materials is grouped thematically rather than chronologically in five sections: "Art and Anatomy," "The Surgical Arts," "The Doctor's Practice," "Obstetrics and Gynecology," and "Non-Western Medicine." All images and objects are accompanied by historical information, biographical detail, thoughtful analysis, and precise description.

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This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?

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Film clips of Cary Grant as the consummate anatomy professor in 0100 (see this database) are interspersed with comments from contemporary gross anatomy students, two medical school faculty intimately connected with dissection and the body donation tradition, and a live body donor. In what ways "yes" and "no" could both be proper responses to the statement, "A cadaver in the classroom is not a dead human being" is the key premise, beautifully presented in the cut-aways, organization, and editing of this piece.

The structure of the film is an as-if dialogue between young dissectors and soon-to-be cadaver (the body donor). Interviews heighten and explore the relationship between the living and the dead--and not just medical students and body donors. The medical students do not speak directly with the future donor, though we see him shaking hands with them, visiting (and speculating on) the spot where his remains will eventually be deposited. The video concludes with a moving annual ritual, the disposition of body donors' cremated remains at sea.

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The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.

The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.

Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.

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Physician and poet Rafael Campo sometimes gives poems to his patients, tucking them in with educational materials and prescriptions. He knows that poetry can be therapeutic for both patient and caregiver, and in this beautifully organized and executed book he tells readers why and how poetry can enhance healing.

The chapters (in which Campo ponders questions such as: Is poetry necessary for survival? How does poetry locate us inside the experience of illness? Why is poetry therapeutic?) follow the arc of illness itself. In Chapter 4, "Inklings," Campo discusses how not-yet-diagnosed symptoms of sickness may be revealed in poetry, the patient "divining" signs of illness "from the clues discernible in a sentient relationship to the world around us" (p. 52).

In following chapters ("Diagnosis," "Treatment," "Side Effects," and "End of Life"), he expertly unfolds, through brilliant poem analysis, how "At every station of the disease experience, poetry has suggested an ulterior discourse that, as it accumulates, forms a composite picture of a humane idea of wellness" (p. 127). In other chapters ("Daniel," "Clara," "Sunny," "Eduardo," and "Mrs. Twomey") he discusses how poetry has changed and informed his clinical and personal interactions with patients.

Fully aware that poetry is not a "cure" for illness and that relationships between patients and caregivers are not always ideally sympathetic, Campo demonstrates how, nonetheless, poetry can be a valid healing modality. In the "Afterword," he urges readers to imagine poetry "as a metaphor itself for the process of healing" and "to experience it through the stories and voices of real people who have themselves called upon it as they faced illness" (p. 188), and he states his wish to see "non-poet physicians use this book with their own patients and medical trainees" (p. 190). An excellent "Further Reading" appendix provides wide-ranging selections for further study.

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The House of God is a chronicle of Roy Basch's internship year at a prestigious Boston teaching hospital, also known as The House of God but clearly modeled after the Harvard-affiliated Beth Israel Hospital. Cycling through various medical disciplines, Roy and his peers learn medicine from the eccentric, irreverent, yet oddly compassionate Fat Man, whose 13 Laws of the House of God cynically summarize the harrowing and often demeaning hospital practices and rituals reflected in both the doctor-patient relationship and in the residency experience itself.

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