Summary:

What is an atlas? To most people, an atlas is a collection of maps constructed by cartographers who meticulously plot the surface of the earth, inch by inch. In the medical field, we use the word atlas to refer to textbooks of human anatomy, but the endeavor is much the same, and no less painstaking – the human body is quite complex, after all. Though some anatomy atlases are famous for their beautiful depictions of anatomical structures, it is more important that they are accurate. What good would a map be otherwise?  

Yet this quest for accuracy is founded on an inherent dishonesty. Anatomy atlases are supposed to be our guides to the human body, but in reality, they depict the anatomical structures of only a human body. Every person is different, and that goes for their underlying anatomy as well. That being said, these minor variations are fairly unimportant for learners at the novice level. At the same time, one can’t help but feel like these books have been stripped of the key element that defines what it means to be human.  

It is fitting that an artist would be the one to bring light to this issue. Laura Ferguson, Artist-In-Residence in the Master Scholars Program in Humanistic Medicine (MSPHM) at the NYU School of Medicine, has lived nearly her whole life with scoliosis. She saw in her own story the tendency of clinicians to boil a person down to a diagnosis – normal or abnormal. For doctors, this categorization is often necessary. But the artist recognizes that a person is more than just the sum of their parts. Laura saw past the medicalization of her anatomy and cherished the beauty of her curved spine.  

Laura’s arrival at the medical school ushered in a renewed focus on the humanism of medicine, starting with the Art & Anatomy seminar she began in 2009, open to students, doctors, researchers, and all other staff members at NYU Langone Health. In the seminar, students spend 90 minutes a week undertaking illustrations of various anatomical specimens: bones, organs, and even cadavers in the anatomy lab.  

Now almost a decade into this project, Laura has showcased her students’ work in her recent book Art & Anatomy: Drawings, co-edited by Katie Grogan, Associate Director of the MSPHM. Unlike with other anatomy books, the goal for her students was never to be “accurate”; such a word has limited meaning in the world of art. Instead, Laura taught students to observe things that they had never taken the time to see before. Then, she encouraged them to draw what they saw, as they saw it. The result is the compilation of drawings into a different kind of atlas – an atlas of the mind, of creative spirit, and of humanistic expression.

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Author Christie Watson begins her memoir with these words: "I didn't always want to be a nurse." Indeed, the first several pages of the introduction give witness to Christie's many interests, her career starts and stops, and a peek into what she names her "flightiness," including leaving school at age sixteen to move in with her older boyfriend and his four lodgers (page 5).  Then, still sixteen years old, she begins working with the "Spastics Society" helping to assist disabled adults.  This is the first time she sees nurses in action, and one of them offers Christie a suggestion: "You should do nursing. They give you a grant and somewhere to live" (page 6).  At age seventeen, the author enters nursing school--and like most nursing students, she is "terrified of failure." During her health screening blood draw, Christie faints; a nurse suggests she rethink her career.  But Christie persists, graduates, then spends twenty successful years in nursing.  This memoir--densely written, action packed--is her account of her work especially in the Special-Care baby Unit, in the medical ward, and in Accident and Emergency.  The author brings us as well into the cancer ward, pediatric ICU,  and the geriatric ward, painting vivid portraits of her patients and the many acts of kindness she offers them along the way.

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Olivia Laing, a British novelist and writer on cultural and social issues, tackles the phenomenon of loneliness as a pervasive condition that is both a symptom and a cause of malaise, dysphoria and depression. The book is thoroughly referenced and has an extensive, useful bibliography. Laing begins by describing her own loneliness when she moved to New York City. Somewhat reclusive by nature, she spent hours in her apartment, connected to  the outside world through social media, email and Skype. This leads her to examine the nature of loneliness, its causes and impact on the individual. She then turns to the lives and works of artists who specifically dealt with their own loneliness -- as inspiration, subject matter and personal burden: Edward Hopper; Andy Warhol and his assailant Valerie Solanas; the artist and AIDS activist, David Wojnarowicz; outsider artist, Henry Darger; singers Klaus Nomi and Billie Holliday; tech entrepreneur, Josh Harris, and painter Jean-Michel Basquiat. Laing weaves in pertinent research (Klein, Harlow, Bowlby, Ainsworth, Weiss, Turkel) and expertly ties their findings to her subjects’ creative lives. Her section on Josh Harris’ radical social media experiments is a pertinent reminder of technology’s role in fostering loneliness. A recurrent theme is that social isolation “leads to a decline in social sophistication which itself leads to further episodes of rejection.” Among the results, she says, are that lonely people are more susceptible to sickness and more likely to die before their time.  

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When poet and writer Amy Nawrocki was nineteen years old, a college student returning home after her freshmen year, she suffered a sudden and mysterious illness.  She was transformed, in an eye-blink, from an active young woman to a bed bound and comatose patient.  "There is nothing to embellish--I got sick, I fell into a deep sleep, I woke up.  No fairy tale" (page 3).  Months of her life went missing: this brief and lovely memoir is her attempt to reconstruct those hours and those experiences.  She begins with reflections on journal entries written before her illness began, giving the reader (and herself) a persona, a personality, a living breathing young woman who already writes, who lives in her head, and who always felt "totally comfortable" in her body (page 3). Then we lose her, as she lost herself.  She re-visions the story of her months of suffering and recovering from encephalitic coma through the various medical records and family memories she gathers in order to reconstruct the missing pieces of her life. "The coma girl has detached herself from me. I have to dream her up or rely on what others saw, eye witnesses who had to detach themselves in a different way" (page 21). Coming back into life after a serious illness is a strange and often prolonged journey.  Nawrocki writes, "Waking up took as long as sleeping" (page 33).  And in this waking up time, she begins to see who she was (or how she looked to others) during those blank months. "The images still frighten me. My face was a mess; hair cropped short, puffed up without styling, ragged, like I just woke up. My eyes seemed empty but weirdly wild" (page 35). During her recovery, the author begins journaling again. "In my college notes, I focused on the art of reflection; after the illness, I wanted mainly to observe" (page 42).  And in recovery, she begins to build memories once again. She lists her recollections during weeks in rehab, and she remembers "the final trip home, a cake decorated with blue and yellow icing waiting for me" (page 45).

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In 1632, at the age of only 26, Rembrandt finished a large (85.2 in × 66.7 in) oil painting that was destined to become one of his best known works and certainly one of the linchpins in the nexus between the graphic arts and the medical humanities. "The Anatomy Lesson of Dr. Nicolaes Tulp" depicts the dissection of the flexor tendons of the left arm of a cadaver by the eponymous doctor while an attentive audience of his peers, identifiable members of the medical and anatomical community of early 17th century Amsterdam, looks on. Nina Siegal's novel tells her imagined back story of this richly illustrated anatomy lesson which, once you read her captivating novel, will make you ask yourself, as I did, why no one has thought fit to do so heretofore.

Using multiple first person narrators, Siegal examines the characters (some historical, others wholly fictional) and events leading up to the anatomy lesson and Rembrandt's artistic rendering of it. Inventing a life for Aris Kindt (born Adriaen  Adriaenszoon), the historically real career criminal whose recently judicial hanging provides the body we see in the painting, Siegal provides him with Flora, a lover who is carrying his illegitimate child at the time of his public - and quite raucous - hanging. Growing up in Leiden, in the same neighborhood as Flora and Rembrandt himself, Kindt was the physically and emotionally abused son of a leather worker and, in Siegal's imagination, a petty but persistent thief hanged for his inveterate and irremediable life of crime. As was the custom of the day, his body was legally assigned to an anatomist for public dissection. With a non-linear narrative, organized into brief chapters entitled for body parts, Siegal traces the beginnings of three of the protagonists - Kindt, Flora, and Rembrandt. She constructs  how their lives intersect not only before, during and after the hanging, but also in more philosophical strokes, namely the medical, theological and artistic tapestry on which this image rests. There are several minor characters, like Tulp and his family; Jan Fetchet, the "famulus" responsible for securing and preparing Kindt's body immediately following the hanging; and even René Descartes, who seems to have been in town during this momentous occasion pursuing his own polymathic research, which included anatomy at the time.  Siegal adds a few reports dictated by a fictional modern- day conservator offering her interpretation of many of the details of Rembrandt's masterpiece, details that serve to highlight aspects of Siegal's narrative, such as the possible artistic re-implantation of Kindt's amputated right hand.

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In this remarkable anthology, 51 women and men describe their nursing school experiences, from initial fears and anxieties to increasing confidence and appreciation of the profession.  Jeanne Bryner, in her Introduction, explains how she and Cortney Davis deliberately sought a diverse group of nurse-writers, from recent nursing graduates in their twenties to seasoned veterans in their nineties.  Their collection includes different races, nationalities, social and economic classes, and education levels.  What the contributors have in common besides being nurses is that they are gifted writers able to capture in poetry or prose the transforming moments of their lives. Nursing students reading this anthology will recognize many kindred souls, struggling with the same uncertainties and apprehensions, wondering how they will ever accomplish all this, but also gaining command of the profession, relishing its special rewards, valuing patients as their ultimate teachers. All readers will understand what is so special about nursing .

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The film enters late into the lives of Anne and Georges, a Parisian couple apparently in their 80s, apparently long married, and apparently retired music teachers. Maybe they still teach music, and maybe they still play, based on the important place a grand piano is given in the grand living room of their apartment. Their daughter, Eva, is a working musician and is married to one as well. When Georges and Anne sit together in the living room, the controls to the stereo system are never more than an arm’s length away. This family is serious about music; they love music. But, their love of music is not the love of the movie title, “Amour.” Amour is the love between Anne and Georges, and the forms this love takes. 

We first see the amour of Georges and Anne in their quotidian activities. They eat breakfast together at the small table in the cramped kitchen. They sit across from one another—or one of them lies down on the adjacent couch—and read to each other from the paper or talk about various subjects, like music. They have been doing this for decades, and probably would for decades more, but that isn’t likely, and we see why soon. 

While having their breakfast one morning, Anne becomes unresponsive to Georges while looking him straight in the eye. She eventually comes to and goes about her business as if nothing happened and doesn’t know what Georges is talking about when he describes the incident. She probably had a transient ischemic attack—a warning that a stroke may be coming—and as a result, had surgery to clear an occlusion from her carotid artery to prevent a stroke from actually occurring. However, something goes wrong in the hospital and Anne suffers a stroke there nevertheless. She returns home with some paralysis on her right side. The form of amour changes. Now the quotidian activities involve Georges administering care to Anne: he sees to her toilet, washes her hair, cuts her food, reads her newspaper articles, and helps her walk from one spot to another in the apartment when he’s not pushing her in a wheelchair. During a moment when Georges and Anne are in their customary chairs in the living room, Georges says to her, “I’m so pleased to have you back.” To which Anne responds, “Please never take me back to the hospital, promise?” 

But when Anne has another stroke, Georges takes her back to the hospital. She returns home having lost most of her ability to move at all, she can only eat or drink with considerable difficulty even with assistance, she can’t communicate verbally to any extent, and she wets herself. Georges adds feeding her and exercising her arms and legs to his established routines of bathing her, reading to her, and telling her stories. Amour has taken the shape of getting her through the days with great effort and later with help from nurses.  

Anne wants no more of her life despite Georges’ efforts and pleas. His daughter argues with him about the care her mother needs. The nurses can’t administer care to Anne in a way he expects. Anne does not want her daughter to see her as she is. She cries out for her own mother. She won’t take water or food. She is in pain. Georges is left with only options that test the extreme boundaries of amour.

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This entertaining and wide-ranging book discusses the importance of the human foot and many related topics. There are five alliteratively named chapters.  

1. Destiny
Drawing on anthropological research, Rinzler discusses the deep history of humans and their primate ancestors. Our bipedalism—our upright stance—preceded our large brain, making possible a larger diet and working well with our bodies as they evolved away from other primates. She discusses the idealized ratios of Leonardo’s Vitruvian man. Leonardo considered our foot as “a masterpiece of engineering and a work of art” (p. 6).  

2. Disability
Rinzler discusses historical senses of disability, notably clubfoot. She mentions various people with a clubfoot:  Joseph Goebbels, Sir Walter Scott, King Tut, Cludius I, Dudly Moore, Kristi Yamaguchi, and Mia Hamm; the last are two successful athletes. Rinzler reviews the history of surgical approaches, many of which were harmful. X-ray and sonography provided new insights, and genetics may have further promise, given that families and ethnic groups often have higher instances of clubfoot.  

3. Difference
This chapter describes the anatomy of the foot, bones, arches, tendons, and on as well as artistic representations and, of course, ballet and other forms of dance. A footprint is as individual as the much-used fingerprint. In Nazism and the American south, a flat foot was discriminated against as Jewish or Negro. Various treatments have been proposed for flat feet.  

4. Diet
Gout has been known since antiquity, but only in modern times has the underlying biochemistry and, now, genetic heritage been understood. The chapter mentions many famous names of people who suffered from gout. rheumatism, or corns. The closing pages discuss pharmaceutical approaches.  

5. Desire
The foot as sexual symbol: Rinzler discuss folklore (Cinderella’s slipper), pheromones, and Biblical topics: God’s feet, footwashing, and feet as symbols for sex and urination. Foot fetishism can be understood in terms of the lavish sensory innervation that links to our brain. Discussion mentions the bound feet of China, the folktale The Red Shoes, also Fifty Shades of Grey, Sex and the City, and Judy Garland’s red shoes in The Wizard of Oz

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Citing numerous studies that might be surprising to both lay and professional readers, Dr. Rakel makes a compelling case for the efficacy of empathic, compassionate, connective behavior in medical care.  Words, touch, body language, and open-ended questions are some of the ways caregivers communicate compassion, and they have been shown repeatedly to make significant differences in the rate of healing. The first half of the book develops the implications of these claims; the second half offers instruction and insight about how physicians and other caregivers can cultivate practices of compassion that make them better at what they do.  

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