Summary:

This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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Summary:

The 22 short stories in this volume are lively, economically written accounts of medical and epidemiological investigations over a thirty year time span from the mid-1940's to the late 1970's. Similar to the "clinical tales" Oliver Sacks (see this database) and others have more recently popularized, these stories are full of medical detail interspersed with dialogue, and are narrated in the manner of popular mysteries.

Even technical medical problems are made comprehensible to a lay audience without oversimplification. "Eleven Blue Men," the opening story details an investigation of eleven simultaneous cases of cyanosis traced to a particular salt shaker. "The Orange Man" traces the investigation of a rare case of carotenemia-lycopenemia. "The Dead Mosquitoes" recounts a strange outbreak of reactions to organic-phosphate poisoning traced to a batch of blue jeans. All the stories are notable for the relative rarity of the cases on record.

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This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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Set in Padua "very long ago," this is the story of a "mad scientist" working in isolation on a completely unethical (at least by modern research standards) experiment involving poisonous plants. A young student of medicine observes from his quarters the scientist's beautiful daughter who is confined to the lush and locked gardens in which the experiment is taking place.

Having fallen in love with the lovely Beatrice, Giovanni ignores the warning of his mentor, Professor Baglioni, that Rappaccini is up to no good and he and his work should be shunned. Eventually, Giovanni sneaks into the forbidden garden to meet his lover, and begins to suffer the consequences of encounter with the plants--and with Beatrice, who dwells among them and has been rendered both immune to their effects and poisonous to others.

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A devoted scientist, in a brief step from his laboratory pursuits, marries a beautiful woman with a single physical flaw: a birthmark on her face. Aylmer becomes obsessed with the imperfection and his need to remove it. The tale evolves around his progressive frenzy to use his scientific skills to render his bride perfect and the faith of his submissive wife that the union can survive only if he accomplishes his goal. The author tells us that Aylmer "had devoted himself, however, too unreservedly to scientific studies . . . " and, in the secrecy of his laboratory he prepares the potion for Georgiana which results in the disappearance of the birthmark and the death of Aylmer's experimental subject.

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Summary:

Frankenstein's monster is speaking. "Bigger than the best, but not the best," he will do anything, he will not rest until "the earth is rid of that Creator / who dared to make a thing without a soul." He tells us that he is "the dark body . . . / made . . . to symbolize your dread." He warns us that he is not really something exterior or alien--we can find him in our sons and daughters, even in ourselves: "While you disperse in every dark theater / in streams of light, inside you I am whole."

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