Summary:

Set in contemporary Boston, this medical thriller not only gets the reader's blood moving, but also raises some important ethical questions: How do corporate interests influence the judgment and character of physician researchers? To what length should older persons go to slow down the aging process? How does one's lifework of health care fit in with obligations to one's family?

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This memoir is DeBaggio's first-person account of his early experience of Alzheimer's disease and its effect on his life and the life of his family. The book is a collection, in loosely narrative form, of the author's diagnosis of early-onset Alzheimer's; brief excerpts from his journal; excerpts from the medical literature on the disease; and memories from his past that he wants to commit to paper before he can no longer recall them. He documents his struggle simply to write the book, as it becomes more and more difficult to sustain thoughts or find the words to express what he wants to say.

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Written by a medical historian who is also a physician, The Breast Cancer Wars narrates how breast cancer diagnostic methods and treatments have developed from the early twentieth century. More significantly, the book describes the debates and controversies that permeated this evolution and the ways in which not only clinicians and researchers, but, increasingly, women patients/activists shaped how we view, diagnose, and treat breast cancer today.

Individual chapters explore the influential (and ultimately contested) radical mastectomy procedure of William Halsted, the development of the "war" against breast cancer as a full-blown campaign developed and conducted within the public media and consciousness of the United States as well as within medical practice and research, the intertwined development of feminism and breast cancer activism, the "fall" of the radical mastectomy, and the continuing controversies surrounding mammography and genetic testing as modes of early detection and risk assessment. Lerner draws on a range of primary sources including texts from the archives of the American Cancer Society, the papers of doctors and patients, and advertisements from popular and professional magazines throughout the century.

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This is an excellent review of the authors' choices of the ten greatest medical discoveries. They arrived at the ten selected after narrowing five thousand or more possibilities down to one hundred and then finally down to ten based on these three components in the field of medicine: 1) structure and function of the human body, 2) diagnosis of medical conditions and 3) treatment of such maladies. Finally the ten selected were approved by four avid and informed physician collectors of rare and important medical publications.

Chronologically, the anatomical observations of Vesalius come first with his publication of the Fabrica in 1543. Harvey's discovery of the circulation of the blood is considered the single most important discovery. Leeuwenhoek gets credit as the founder of bacteriology, but Koch and Pasteur are included in a discussion of this discovery. Jenner gets his just recognition for introducing vaccination and Roentgen for discovering the X-ray beam.

Crawford Long is recognized for the initial use of surgical anesthesia and Fleming for the discovery of penicillin. More unlikely choices are Ross Harrison for tissue culture, Anichkov for the relation of cholesterol to atherosclerosis and Wilkins, rather than Watson and Crick, for the DNA story.

Each chapter describes not only the discovery but also tells the life stories of the chosen "discoverers" and others who contributed to extension and usefulness of the discoveries. The authors conclude that it is not genius so much as curiosity and the ability to conduct methodological investigations that distinguish these men.

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The narrator, Latimer, begins the story with a vision of his death, which he attributes to a heart attack. He explains that, always sensitive after a childhood eye affliction and his mother's death, the further shock of a "severe illness" while at school in Geneva enabled him to see the future, and to hear others' thoughts--an experience which he describes as oppressive. He is fascinated by his brother's fiancée, Bertha, the only human whose thoughts are hidden from him, and whom he marries after his brother dies in a fall.

The marriage falters after Latimer eventually discerns Bertha's cold and manipulative nature through a temporary increase in his telepathy. When Latimer's childhood friend, the scientist Charles Meunier, performs an experimental transfusion between himself and Bertha's just-dead maid, the maid briefly revives and accuses Bertha of plotting to poison Latimer. Bertha moves out, and Latimer dies as foretold.

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In The Mysteries Within, Sherwin Nuland takes the reader on a guided tour of selected organs inside the human body. Beginning with the stomach, he progresses along to visit the liver, spleen, heart, uterus, and ovaries. At each point he addresses various historical and contemporary beliefs, as promised in the book's subtitle, "A Surgeon Reflects on Medical Myths." Nuland brings to this endeavor the patented mixture of personal story, elucidation of medical history, and plain old good writing that characterizes all of his books.

For example, he devotes the first three chapters to the stomach. The first consists mostly of a brilliant clinical tale in which a six-week-old baby is found to have a wax bezoar in his stomach. The second and third provide a cogent survey of beliefs about the stomach's function, beginning with Greek humoral theory, continuing through van Helmont and the iatrochemists, and ending with Ivan Petrovich Pavlov and his seminal monograph, The Work of the Digestive Glands.

Van Helmont and his mentor, Paracelsus, appear again and again in later chapters as the earliest champions of the idea that the body runs by means of chemical processes (iatrochemistry). However, as Nuland points out, Paracelsus has left us two different legacies. One is his devotion to chemistry and experimentation, which eventually led to modern biological science. The other is his devotion to alchemy and mysticism, which makes him as well a forerunner of contemporary irrational systems of healing.

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Sleep is a much sought-after prize in this novel. Bonnie Saks is a 39 year old woman whose life has spiraled out of control. Already divorced and the mother of two young boys, she is tormented by insomnia. Her life is further complicated when she discovers she is pregnant and struggles to complete her unfinished dissertation on American literature.

Ian Ogelvie is a 29 year old psychiatrist and sleep researcher experimenting with a breakthrough drug known as Dodabulax that greatly enhances REM sleep. While Ian helps Bonnie sleep, she in turn provides him with a wake up call of sorts. Ultimately, Bonnie becomes uneasy with the changes triggered by her blue pills. Despite suffering a miscarriage, her life becomes more tolerable and her insight much clearer.

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Sam Daniels (Dustin Hoffman) and his wife (Rene Russo) are both working for a federal infectious disease laboratory, but their marriage is on the rocks. A mysterious lethal illness, remarkably like Ebola fever, breaks out at various sites in America, all eventually connected to a pet shop that received a monkey from an illegal smuggling operation. Most cases are immediately isolated and contained, but a town in California develops an epidemic of the new disease.

The lab is called in and the military enforces a strict quarantine that divides families and prevents anyone from leaving the area. One worker dies quickly and Sam's wife falls ill. The crass General Donald McClintock (Donald Sutherland) is convinced that the nation can be saved only by the annihilation of the town by a gigantic bomb.

A plane sets out on the gruesome mission. Meanwhile, Hoffman leaps from a helicopter onto the cargo ship where the sailor-smuggler has just died leaving a photo of the monkey carrier. Sam makes a televised appeal for help locating the cute but dangerous, little monkey; a terrified mother responds and the creature is snatched from the arms of her child.

With military snipers in hot pursuit, Sam returns to the town, radioing the baffled bomber pilots with a barrage of reasons why they should ditch their mission of destruction. He puts the tiny monkey to work producing anti-sera and vaccines, which--in only a matter of minutes!--rescue the town, his wife, and his marriage. The pilots disobey orders and dump their bomb in the sea.

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Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.

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Some interesting and very odd characters (including a few scientists and researchers) inhabit the eleven short stories in this collection. In "Concerning Mold Upon the Skin, Etc.," Anton van Leeuwenhoek creates his first microscope and becomes so absorbed by the invisible worlds revealed to him that he neglects his own family. "Nowhere" is the tale of an old anatomy professor who aspires to spice up the curriculum by obtaining a corpse for his students to study. "Tumbling" recounts the difficult life of a young woman understandably haunted by the possibility that she may inherit Huntington’s chorea from her father and her inspired liberation of over one thousand laboratory mice.

In "Chloroform Jags," a professional midwife self-experiments with chloroform "not to escape time but to dissolve time." Other stories describe the execution of an elephant; the murder of a physician who happens to be an important figure in the French Revolution; a woman with a talent for insomnia who has not slept for six months; a psychoanalyst and his patient; an eighteenth century blind beekeeper; and Dorothea Dix, an early advocate for the humane treatment of the mentally ill.

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