Summary:

When I had Annina, the narrator says, her first-born child was eight years old, frost covered the geraniums, and something "warm and wet" ran down her legs. She lost her second pregnancy at only nine weeks from a spontaneous abortion. Secretly, she names the tiny girl "Annina" and tucks her inside her heart and mind, where for years she nurtures her, protects her, dresses her, listens to her language, and watches her grow to a daring adventuress, though she is Thumbelina small, and carries a needle for a sword. Annina eventually moves on and the narrator will not dare to ask her to come home.

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Sam and her partner are getting ready to go out. She is due to have a baby soon, and they need to acquire just a few more items to complete the nursery and baby wardrobe. Sam wants a Forever Baby duvet, but realizes that it may be difficult because duvets are large and hard to conceal. Slowly it emerges that her trendy baby supplies are stolen.

Sam stops by the clinic where an assistant makes the mistake of asking if this is her first pregnancy. The glance from a colleague silences her, but Sam notices. She has no baby now but she remembers her little girl who "ought to have kept out of his way" although she was hiding in her duvet.

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A child of a beautiful, talented woman and ambiguous paternity craves learning. Adopted by a Spanish officer and an "uncle" who is a painter, s/he is sent off to Edinburgh as a pedagogic experiment to become James Barry, a male medical student. Barry adores the vivacious Alice, an illiterate but intelligent servant, whom he teaches to read.

Later as a doctor and medical officer, he travels the world to the Crimea, to the Caribbean, to South Africa and America, a scion of society and a good scientist. By happy fortune, he lives in retirement with Alice, who has become a famous actress. The book ends with the scandalous revelation of Barry's femininity when his body is laid to rest.

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This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

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A bedraggled street dog is about to perish in the cold winter night, after having been scalded by boiling water earlier in the day. Suddenly, an elegant man feeds him and takes him home. The dog's savior is a famous and wealthy medical professor who rejuvenates people by hormonal manipulations.

As soon as the dog becomes accustomed to his new life of plenty, he finds himself the subject of a strange experiment--the professor and his assistant implant the testicles and pituitary gland of a dead criminal into the dog's body. After a rocky post-operative course, the dog gradually begins to change into an animal in human form and names himself Poligraph Poligraphovich Sharik. The half-beast-half-man, who gets along very well in the prevailing proletarian society, turns his creator's life into a nightmare--until the professor manages to reverse the procedure.

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This biography, written by a second party in conjunction with the person whose story is portrayed, is the tale of a black lay-midwife working in the southern United States during the mid to latter part of the 20th century. Gladys Milton, mother of seven children herself, is called to midwifery training by the Health Department in a rural county in Florida.

After an introductory chapter that sets the stage for the ultimate challenge to Gladys, the following few chapters follow her through some of the high points of her childhood and early years of motherhood. The remainder of the work describes broadly the career--with its ups and downs--of Gladys as midwife, doing home deliveries and working in the birthing center she has established in her own home. The final chapters deal with the legal efforts and ultimately the hearing in which the Health Department attempts to revoke Gladys's license to deliver babies.

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Martha Hale and her husband are taken by the sheriff with his wife to the isolated home of the Wrights. Hale tells the authorities that on the previous morning he found Mr. Wright strangled to death. Mrs. Wright claimed not to know who killed him. She was arrested and awaiting charges.

Mrs. Hale and the sheriff's wife are to gather clothing and see to her preserves. The men mock women's "trifles" and jokingly caution them not to miss any clues, before they turn to their "more serious" work of finding a motive. In a basket of patches destined for a quilt, the women find a strangled canary. In quilt-like fragments, they piece together the difficult life of the third woman and decide to conceal the evidence that could incriminate her.

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Summary:

The sculptor Ken Harrison (Richard Dreyfuss) is badly injured in a car accident and finds himself in the middle of life permanently paralyzed below the neck and dependent on others for his care and survival. Ken is a strong-minded, passionate man totally dedicated to his art, and he decides he does not want to go on with the compromised, highly dependent life that his doctors, his girlfriend Pat (Janet Eilber), and others urge on him. He breaks up with Pat and fights to be released from the hospital, to gain control of his life in order to stop the care that keeps him alive and unhappy.

His antagonist is the hospital's medical director Dr. Emerson (John Cassavetes), who believes in preserving life no matter what, and so tries to get Ken committed as clinically depressed. Ken's attending physician, Dr. Scott (Christine Lahti), begins with the establishment but gradually moves toward Ken's position.

The film ends with the judge at a legal hearing deciding that Ken is not clinically depressed and that he thus has the right to refuse treatment and be discharged. In the last scene, Ken lies in a hospital bed framed by his own sculptural realization of the forearm and hand of God from Michelangelo's Creation of Man.

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When Alice Sebold, author of the best-selling novel, The Lovely Bones (see this database), was completing her freshmen year at Syracuse University, she was assaulted and raped. Years after the fact, Sebold wrote this memoir about the rape and its aftermath. The book's title, "Lucky," is explained in the prologue: the police told Sebold that she was lucky to have escaped the fate of another girl who had been murdered and dismembered in the same spot. In point of fact, Sebold, a virgin before the rape, was in a sense murdered, since life as she had known it would never be the same: "My life was over; my life had just begun" (33).

In crisp, lively prose the author takes us relentlessly through the details of her rape and the police inquiry that followed. We learn also that the narrator had suffered from a poor body self-image, loved to spend her time reading, had day-dreams of becoming a poet. We learn about her family--a mother prone to severe panic attacks and a professorial father who hid behind his books, an older sister who helped Alice take care of their mother. The family was considered by neighbors to be "weird."

After the rape, Sebold felt even more isolated and "Other." She could not bring herself to tell her family, who tip-toed around her, all of the horrendous details of the assault. She realized that all who knew her were aware she had been raped and were uneasy in her presence. Her father could not understand how she could have been raped if the assailant's knife had dropped out of reach.

In spite of everything, Alice returns to Syracuse, taking poetry workshops with Tess Gallagher and a writing workshop with Tobias Wolff. Incredibly, she spots her assailant one day on the street near the college. The author notifies the police, the assailant is later arrested, and Alice agrees to press charges and to be a witness at the trial. Neither her father nor her mother have the stomach to come to the trial, but Tess Gallagher accompanies her. The account of the trial is detailed, agonizing, and fascinating.

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In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer argues that "the traditional western ethic has collapsed" as we enter "a period of transition in our attitude to the sanctity of life" (pp. 1). The book begins with the tale of Trisha Marshall, a twenty-eight year old woman, who in 1993 was seventeen weeks pregnant when a gunshot to her head left her in an intensive care unit, her body warm, her heart beating, a respirator supporting her breathing. However, she was brain dead.

Her boyfriend and her parents wanted the hospital to do everything possible so that the baby would be born. The ethics committee of the hospital supported the decision. For the next 100 days, Trisha Marshall continued to be supported in the ICU until her baby was delivered by cesarean birth. After a blood test showed that the boyfriend was not the father, and after three weeks in the intensive care unit, the baby went to live with Marshall's parents.

Singer uses this introduction to pose the many ethical questions that are raised because of medicine's ability to keep a "brain dead" body warm for an extended period of time. "How should we treat someone whose brain is dead, but whose body is still warm and breathing? Is a fetus the kind of being whose life we should make great efforts to preserve? If so, should these efforts be made irrespective of their cost? Shall we just ignore the other lives that might be saved with the medical resources required?

Should efforts to preserve the fetus be made only when it is clear that the mother would have wanted this? Or when the (presumed?) father or other close relatives ask for the fetus to be saved? Or do we make these efforts because the fetus has a right to life which could only be overridden by the right of the pregnant woman to control her own body--and in this case there is no living pregnant woman whose rights override those of the fetus?" (pp. 17-18).

In the chapters that follow, Singer argues that whether western society will acknowledge it or not, we have, in our actions and decisions, moved to an ethic where "quality of life" distinctions trump "sanctity of life" positions. Yet, many continue to raise the "sanctity of life" position when it is clear that our legal and ethical positions in western society have embraced the "quality of life" stance. For Singer, this paradox results in an incoherent and illogical approach to the ethical challenges presented by modern medicine.

Throughout his book, Singer presents evidence for his argument through ethical and historical analysis of brain death, abortion, physician assisted suicide and euthanasia, organ donation, and the nature of persons. For those uncomfortable with Singer's position on "infanticide," this book allows one to follow Singer's argument and his recommendations in the last chapter for a coherent approach to these "quality of life" decisions.

He closes his book with the recommendation that a new ethic should embrace five new commandments to replace the old "sanctity of life" commandments. His commandments are: 1) Recognize that the worth of human life varies; 2) Take responsibility for the consequences of our decisions (in end of life care); 3) Respect a person's desire to live or die; 4) Bring children into the world only if they are wanted; and 5) Do not discriminate on the basis of species.

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