Summary:

Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

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Despite years of trying, Cara Glanzman and her husband, Richard Case, both thirty-four years old, are unable to have a child. In fact she is contemplating getting a divorce, and he has decided that he really doesn't want any children. Everything changes when Cara is raped and becomes pregnant by Derrick James Cooper, also known as the "Reservoir Rapist." Although Cara initially considers having an abortion, she decides to have the baby.

As the pregnancy progresses, Cara discovers herself even as her husband becomes lost and despondent. The couple is greatly aided by a delightful midwife named Dorothy Pendleton. When Cara's large, hairy son is born, Richard is present to assist Dorothy with the delivery. "Wolfman Junior," the son of a monster, seems to be accepted by both his mother and surrogate father.

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Raina is 17, living alternately on the streets with a boyfriend addicted to hard drugs and at home with an abusive mother, also an addict. She has been victimized by a succession of her mother's live-in boyfriends and lost a young brother to an accidental overdose: he swallowed some of his mother's pills while the mother slept and seven-year-old Raina was watching him.

Margaret Johnson is 45, Raina's teacher at an underfunded, overcrowded public school where Raina's life of squalor is more typical than not. Her own story is told in chapters that alternate with Raina's story and with the texts of autobiographical compositions Raina gives her but refuses to discuss. Only when Raina finds herself pregnant, shortly after her boyfriend has been killed in a drug-related accident, does she take Ms. Johnson up on her repeated offers of help.

She lives at the teacher's home for awhile, runs away to her own home, unused to kind treatment and afraid she'll disappoint the teacher and be thrown out, goes to a shelter, has her baby, and finally returns, having nowhere to go. Ms. Johnson, with some hesitation, takes her and the baby in and the three begin to work out a life together, knowing it will involve difficult change, but willing to bet on love against the odds.

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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 story is a letter written by a 24-year-old woman to her niece who was given up for adoption. Bitte Liten, from a close Norwegian family, remembers the summer she was 12 when she was sent away during the last months of her sister's pregnancy to stay with her uncle. Her sister, 15, unwed and pregnant, had found adoptive parents for the child, but Bitte, imagining the pleasures of being an aunt and helping care for a baby, wanted her to keep it.

While at her uncle's, she visits her aging favorite aunt in a nursing home. Her aunt, sinking into dementia, doesn't remember her. This leaves her reflecting on how much of life is memory of the past and dreams of the future. Her period comes that summer for the first time, and with it, a new understanding of adult responsibilities and her sister's predicament.

She writes her sister to tell her she understands her decision and will support her. In return, her sister invites her to be at the hospital the day the baby is born. There Bitte meets the adoptive parents as well as the baby, says hello and goodbye to her little niece, and comes to understand something new and harder about what love looks like. Twelve years later, she records all these memories for the niece who has grown up as someone else's child.

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Summary:

This story takes place late at night in the quiet wards of a hospital. Some of the staff are kidding around about Night Sister Bean, who is supposedly a witch, but is now off-duty because she had an operation. Hilda from Housekeeping is pregnant again.

Since Hilda is unmarried, some of her co-workers come up with the idea of giving her a proper wedding. The Casualty Porter volunteers to be the groom. They just manage to complete the fanciful night wedding when Hilda goes into labor. Her baby is born in an elevator on the way to the maternity ward.

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Summary:

Nick and Fran move into an old house with their family: Miranda, thirteen, Nick's daughter from a previous marriage (her mother has been hospitalized with depression); eleven-year-old Gareth, Fran's son (who was almost aborted); and a toddler, Jasper, the child of both. Fran is pregnant again. Nick tries to hold them together as a family, but must also take care of Geordie, his grandfather, who is dying of cancer at the age of 101.

Geordie believes that what's killing him is a bayonet wound he received in World War I. As his disease progresses, the old man relives the war, especially the battle in which his brother died, with increasing vividness. After Geordie's death, Nick learns that in the battle he had killed his wounded brother who may, he thinks, otherwise have survived.

Geordie tells the story in an interview with a historian working on memory and war, and confesses that he hated his brother. She gently tells him that "a child's hatred" is different, but he--like the novel itself--refuses to see this as mitigation. Geordie's tale resonates both with what Nick learns about the house he bought--in 1904 the older children of the family living there were believed to have murdered their two-year-old sibling--and with Gareth and Miranda's resentment of Jasper, which has near-fatal consequences.

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Most of the thirteen stories in this collection portray interactions among pension guests in a German spa town; a few represent the lives of the town's permanent residents. The minor health problems (mostly digestive ailments, or unspecified "internal complaints") of the guests are not the crux of the plot but rather what gives it its texture. Talk about eating, "internal complaints," sexuality, body image, and pregnancy is the vehicle through which people try to relate.

Most of the stories are about failed communications: between men and women, for example, or between German and English people. Several stories are narrated in the first person by a young Englishwoman whose bodily and marital status (ill? pregnant? married or not?) are pointedly ambiguous.

Two stories represent childbirth from "outsider" perspectives. In "At Lehman's," a virginal serving girl sees her mistress's pregnancy as an "ugly, ugly, ugly" state; later, her sexual explorations with a young man are interrupted by her mistress's screams in labor. In "A Birthday," a man waiting for his wife to give birth focuses on his own suffering rather than hers. "The Child-Who-Was-Tired" follows a child-servant through a day of repeated abuses to body and spirit that culminates in infanticide.

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Summary:

This is a long poem, subtitled "A Poem for Three Voices," and originally written for radio broadcast. It consists of three intertwining interior monologues, contextualized by a dramatic setting: "A Maternity Ward and round about." The three women of the title are patients, and each describes a different experience.

The First Voice is a (presumably) married woman who gives birth and takes her baby home during the course of the poem. The Second, a secretary, has a miscarriage, not her first, and the Third, a college student, gives birth after an unwanted pregnancy, and gives the baby up for adoption.

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