Summary:

"Beautician" is a short poem about a beautician visiting a dead friend in the morgue, her sorrow at seeing her friend dead and not looking her best, even dead, and the beautician's attempts to rectify the situation. It is fifteen lines long, in three stanzas of five lines each, in iambic pentameter with a rhyming pattern of abbab. The rhyming is best described as approximate, e.g., "skill" with "beautiful" with "all".

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Several threads tie together this ambitious, beautifully digressive reflection on eros and logos in the experience of illness and the conduct of medicine and health care, which takes into account what a complex striation of cultural legacies, social and political pressures, and beliefs go into both.  Framing his reflections on the role of unknowing, altered states, inexplicable events, desire, hope, love, and mystery in illness and healing is a fragmented, poignant narrative of Morris’s own experience of watching his wife succumb to the ravages of early Alzheimer’s. 

Her disease is one that leads both professional and intimate caregivers to the same question:  what do you do when there’s nothing left for scientific medicine to do?  Conversations about palliative care are broadening, he points out, and medical education is making more room for the kind of reflection the arts invite and for spirituality as a dimension of illness experience and caregiving.  Guidance in such explorations can be found in ancient literature, especially in the archetypes provided by the Greek and Roman myths.  Morris makes astute and helpful use of his own considerable training in literary studies to provide examples of how eros and logos—complementary contraries—have been conceived and embodied in a somewhat polarized culture and how incomplete health care is when it doesn’t foster the capacity to dwell in and with unknowing, possibility, indeterminacy, and mystery.  Knowing the limits of scientific medicine may, paradoxically, make it better.  Certainly it can help keep our engagements with illness—always relational, always disruptive, most often to some degree bewildering—humane.

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Eric Kandel, the 2000 Nobel Prize winner in Physiology or Medicine, has an abiding interest in art for its own sake, and also in how art can inform his primary work in brain science, especially as both art and science can be understood through reductionism.

My central premise is that although the reductionist approaches of scientists and artists are not identical in their aims—scientists use reductionism to solve the complex problem and artists use it to elicit a new perceptual and emotional response in the beholder—they are analogous (p. 6).  

Kandel’s aim, however, is more than just explaining how reductionism is used in brain science and in modern art. He is also out to show in a larger sense how science and the arts, which now exist as “two cultures,” are more alike than not. 

My purpose in this book is to highlight one way of closing the chasm by focusing on a common point at which the two cultures can meet and influence each other—in modern brain science and in modern art. Both brain science and abstract art address, in direct and compelling fashion, questions and goals that are central to humanistic thought. In this pursuit they share, to a surprising degree, common methodologies (p. 3).   

This slim volume comprises four parts amply supplied with schematics of brain structures and nerve tracts, and with reproductions of modern art works. The two middle parts are concerned with how reductionism applies to brain science and to art, respectively. The introduction places the topic within the context of the two-culture divide. The final part argues that art reduced to a set of core elements (e.g., form, line, color, and light) can add to the understanding of how the brain works, just as brain science reduced to a set of core elements (e.g., top down and bottom up processing of images) can add to the understanding of how art can be perceived and used to evoke certain responses.      

Bottom up processing refers to “universal rules that are largely built into the brain at birth by biological evolution and enable us to extract key elements of images in the physical world, such as contours, intersections, and the crossings of lines and junctions” (p. 22) This inborn circuitry is all that is needed for perceiving figurative art, and as a result produces uniform perceptions among viewers. Top down processing refers to the information the brain needs to perceive images when bottom up processing is insufficient, like in the case of abstract painting. It “incorporates the information our brain receives from the external world with knowledge based on learning from earlier experiences and hypotheses testing.” This includes “people we have seen and known, environments we have been in, as well as memories of other works of art we have encountered” (p. 23). Top down processing thus brings the viewer into the creative process and results in differences in perceptions among individuals of a particular work of art.  

In Kandel’s and many others’ telling, modern art was the response to the advent and expanding use of photography. No longer was figurative painting needed to render life as it is. Artists became free to explore and experiment with other ways to generate perceptions of life. Starting with impressionism and progressing through abstract expressionism and pop art, Kandel describes how painters in particular reduced their art to form, line, color, and light. They invited—demanded—that viewers participate in creating what they perceive. Brain science was able to use these elements also to map places in the brain where this processing takes place and to associate these elements with the different responses they produce. To illustrate these concepts, Kandel features the works of Turner, Monet, Kandinsky, Mondrian, de Kooning, Pollock, Rothko, Morris, and Warhol among others.  

In the end, Kandel is asserting—hoping—that reductionism in art will serve brain science because it will show “how we process unconscious and conscious perception, emotion, and empathy.” (p. 188). And, that reductionism in brain science will help artists “enhance traditional introspection with the knowledge of how some aspects of our mind work” (p. 189).

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In Karel Schoeman’s novel, Another Country, Versluis, an affluent and educated Dutchman diagnosed with tuberculosis, immigrates to Bloemfontein, South Africa, to convalesce. Bloemfontein in the 1870s, located within the remote interior of the Free State, is little more than a dusty outpost populated by first- and second-generation German, Dutch, and English inhabitants. As the novel quietly unfolds, Versluis’s tenuous recovery, and subsequent regression, are punctuated by his observations of the community’s struggle to both preserve and break from European culture to form a distinct South African identity.   Whereas Versluis cherishes his familiar Dutch customs and courtesies, here, in Bloemfontein, he must adapt to the community’s irregularities and gaucheries. Nevertheless, he is regularly astonished by the town’s culture of insouciance—a lack of punctuality, etiquette, and municipal orderliness; its sometimes frowzy fashions; disregard for conservatism; and ease among poverty, violence, and isolation. His observations, however, are not the mordancies of a snobbish European, but a wrestling with his sense of profound alienation as a precariously ill man living abroad in a strange country.   Informed that his case is terminal, Versluis resigns himself to the inescapable state of his life. With fresh sensibility, he embraces life in Bloemfontein, becoming more receptive to its people and daily life. Particularly, for Versluis, the veld—with its rocks, dust, succulents, and solitude—takes on a potent and portentous symbolism, as an immutable and implacable presence (and emptiness), much akin to the illness that is killing him. Within this ponderous flux of change, of a gradually evolving Africa, Versluis peacefully comes to terms with his imminent death.

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This engaging memoir describes Pearson's medical training at the University of Texas Medical Branch (UTMB) on Galveston Island from 2009 to 2016. During these years her personal values become clear, and she finds fault in her training, in medicine as practiced in Texas, and even in her own errors in treating patients.

Having left a graduate writing program, Pearson took a "postbac," a year of pre-med courses in Portland, Oregon. She interviewed at medical schools "all over the country" and writes satirically about them; she concludes "nothing out of Texas felt quite right," having lived there and done her undergraduate work at University of Texas at Austin. She's a Spanish speaker with a working-class background. When her classmates provide the annual “white-trash”-themed party, she wonders, “do I go as myself?” (p. 21).

Pearson's education continues on three tracks: the formal UTMB courses in medicine, a simultaneous Ph.D. program at the Institute for the Medical Humanities at the University of Texas, and her volunteer work at the St. Vincent's Student Run Free Clinic. The Ph.D. program is off-stage, not mentioned, but the St. Vincent's Clinic becomes pivotal to her development as a doctor and a moral person.

As for medical school, she finds the relentless "truths of biochemistry and anatomy" so reductive that the suffering of people and surrounding politics seem "not to matter at all" (p. 70). Among the politics are: the lack of safety nets for poor people, the use of uninsured (including prisoners) for students to practice on, failures to extend Medicare, pollution (notably from the oil industry), losses of charitable care, and income disparities that include crushing poverty for many. Something of a rebel, she writes that medical school "felt like junior high" (p. 44). She does enjoy the "clinical encounters" with real patients.

St. Vincent's, by contrast, was “a relief.” Her pages sparkle with her conversation with clinic patients, some homeless, all poor, and all suffering. She reports--confesses, she even says--her errors that had consequences for patients. She writes that errors are an unavoidable part of medical education, but that it's wrong that they should routinely happen to the poorest members of society.  

Chapter 8 discusses depression, which she felt after the second year. She writes about high rates of suicide among medical students and doctors; indeed a close friend killed himself during the "post-doc" year. Because some states require doctors to report psychiatric care, some doctors avoid such care. This consequence “drives a suicide-prone population away from the help we may need" (p.92).

The last two years are the rotations through specialties: surgery, dermatology, trauma, rural medicine, neurology, internal medicine, and so on. These are clearly and insightfully described. In one case (internal medicine), she allows the reader to see the irony of a doctor providing hair removal by laser, diet foods, and Botox treatment for wrinkles, “a pure luxury transaction” (p. 183).

Pearson describes the storms, hurricanes, and floods that hit Galveston Island, also the pollution from the oil industry that causes a “cancer belt” along the Louisiana and Mississippi coasts (p. 104). At last she finishes her program, understanding that her identity is simultaneously a person, a physician, and a writer (p. 248). 

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This Way Madness Lies was published in partnership with London’s Wellcome Collection for the exhibition “Bedlam: The Asylum and Beyond,” which ran from September 2016 - January 2017 and was curated by Mike Jay and Bárbara Rodriguez Muñoz. It is a book that was meant to accompany the exhibition, yet which, by virtue of the substantial text and reproductions, can stand alone.  

The book traces the history of treatment of the mentally ill by following the colorful story of Bethlem Royal Hospital from its antecedents in the Middle Ages up to the present.  Its sway over the public imagination evidenced by its appearance in everything from Jacobean Drama to “Sweeney Todd,” Bedlam has truly attained archetypal status.  An archetype, yet also a real functioning hospital.  Sections of the book entitled “Madhouse,” Lunatic Asylum,” and “Mental Hospital” chronicle the facilities designed respectively during the 17th/18th, 19th, and 20th centuries, and explain how they reflect changing notions of madness in each era.   

The first structure was visually grand but lacked a foundation, a metaphor for what was going on inside: “a façade of care concealing a black hole of neglect” (p. 39).  It became a tourist attraction along the lines of the zoo, with nothing preventing the public from gawking at and taunting the inmates.  While its replacement gave the impression of being more functional, conditions proved equally squalid.  On the other hand, 19th-century Europe and the United States saw asylum reforms, as well as the medicalization of madness as an “illness” and the ascent of psychiatry as a branch of medicine.  Finally, in 1930, the buildings still in use in Monks Orchard, a suburb of London, were constructed.

By contrast, we learn about treatments elsewhere, most notably Geel, Belgium.  There, for centuries, as an alternative to being warehoused in psychiatric hospitals, the mentally ill have been successfully boarding with townspeople.   

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Set in the loosely fictionalized Jamaican town of Augustown (“loosely,” as it bears a strong resemblance to August Town, which was absorbed over time into the expansion of Kingston), the novel spans three generations of a single family.  The novel moves back and forth easily through different moments in time, from the birth of Rastafariansim in 1920 under British colonional rule, through the post-colonial division of the island and its citizens into turbulent threads, to the present day of 1982, where the same tensions run strong as ever.  

Ostensibly a family novel, the story centers on Ma Taffy, her niece Gina, and Gina’s son Kaia, and it boils down to several key moments in their lives.  But these moments are brief in the overall bulk of the novel, the majority of which is devoted to the fleshing out of the world that permits – and, as we ultimately realize, requires – that such moments come to pass.  There is the miracle of the preacher Alexander Bedward, who, as seen through the eyes of Ma Taffy, could have literally floated up to the Heavens; the comically doomed marriage and foiled aspirations of schoolteacher Emanuel Saint-Josephs; the errand run by Soft-Paw, a young gang member; the second chance that comes before the well-to-do Claudia Garrick; the friendship of Clarky and Bongo Moody, and their run-ins with the police.  As Miller moves between these characters, the forces pushing Ma Taffy, Gina, and Kaia to their conclusion become clearer and harder to resist.  

Despite the complexity of the novel’s structure, Miller easily weaves all of the component parts together.  The result is absorbing and affecting, a novel that is as much a family drama as it is an exploration of the legacy of colonialism, religion, class conflict, and violence.

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The exhausted narrator has just undergone 3 vessel coronary artery bypass graft (CABG) surgery. While grateful for surviving his "cabbage" operation, he is acutely aware how different he seems from his previous self. He gets a roommate sent from The Scrubs, a prison facility located next to the hospital, who has been jailed for grievous bodily harm with a sentence of 8 years. Now the prisoner is pretending to have a heart attack, hoping doctors will keep him for a few days for tests.

The two men exchange information and banter. The convict wants details about what it feels like to have a heart attack. The narrator wants to know what it's like to be in prison (The answer is "Boring."). They pass time imagining they are vacationing on a Mediterranean beach. The criminal has a knack for making his roomie laugh - a welcome, but painful sensation after open-heart surgery.

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The opening of the documentary Fixed: The Science/Fiction of Human Enhancement is meant to startle. A young woman (disabled performance artist Sue Austin) in a motorized wheelchair fitted with transparent plastic fins gracefully glides underwater around seascapes of coral and populations of tropical fish. The scene dislodges expectations about what wheelchairs can do and where they belong. It creates what for many are unlikely associations among disability, wonder, joy, freedom, and beauty. Watching Austin incites questions about what this languid and dreamy scene might have to do with human enhancement, which more predictably brings to mind dazzling mechanical, chemical, or genetic interventions that surpass the ordinariness of a wheelchair and extend human capacities. But this gentle scene opens the way for the film’s conversations about the ethics and meanings of human enhancement that emphasize perspectives by people with disabilities.  

Regan Brashear’s film features interviews with and footage of people living with disabilities as they move in varied ways through their environments—home, workplace, airport, therapy lab, city street. Photographs, news footage, and performances by mixed-ability dance companies complement their stories. We also hear from a transhumanist, academicians, and activists. Together they express a wider range of views about human enhancement than seems possible in an hour-long film.  

Often contrastive views are paired or clustered. For instance, double amputee Hugh Herr, Director of MIT’s Biomechtronics Group, brags that his carbon-fiber and other prosthetic legs will outperform the biological legs of aging peers. His lab develops robotic limbs controlled by biofeedback, and he intends to end disability through mechanical technologies. Gregor Wolbring, a biochemist and bioethics scholar who was born without legs, regards himself as a version of normal and rejects being fixed. “I’m happy the way I am!” he exuberantly proclaims. Rather than strive for normalcy through restorative technology, Wolbring urges acceptance of imperfection.  

Altogether, the interviewees raise questions about how to respond to differences among human bodies: focus on corrections toward achieving a concept of “normal”? accept diversity? extend human potential? The interviews call out underlying assumptions about disability that influence our answers. Do we assume that disability is an aberration that should be erased? A condition located in individual bodies? A condition brought about by unaccommodating social and built environments? Or, as disabled journalist John Hockenberry proposes, “a part of the human story”?

Fixed also asks what the social and ethical consequences of pursuing enhancements might be. Do they equalize opportunity? Do they misplace priorities by channeling attention and resources away from basic health care and ordinary, essential technologies, such as reliable, affordable wheelchairs? Are biological, chemical, and mechanical enhancements indispensible opportunities to extend human experience, as transhumanist James Hughes claims? Do we have an ethical responsibility to enhance, whether to correct or extend?                                                                                               
Hockenberry mentions that we already enhance. Think of eyeglasses, telescopes, hearing aids. People with disabilities, he points out, are typically the first adopters of technologies, such as computer-brain interfaces, that are destined for wider use. Archival film footage of warfare during this discussion reminds us what many of those uses have been. Should we worry, he asks, about using people with disabilities as research subjects? Or should we say with recently paralyzed Fernanda Castelo, who tests an exoskeleton that braces her body as it moves her forward: “Why not”?  

Considering whether we should trust technology to create equality or treat each other equally in the presence of our differences, disability rights attorney Silvia Yee poses the film’s most vital question: “Which is the world you want to live in?” While Fixed gives a fair hearing to disparate answers, the closing image is suggestive. A woman in a motorized wheelchair offers a lift to someone struggling to push a manual chair uphill. She invites him to grasp the back of hers and they roll forward together.

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In this wonderful short story, author Jeanette Brown describes a woman’s first visit to an alternative medicine healer. The woman has a persistent cough. Unhappy with the "five seconds per visit your doctor lavishes on you after your two-hour wait in his sterile lobby," she has taken her yoga instructor’s advice and made an appointment with a tall, olive-skinned man whose voice is "low and soothing" and whose manner is slow, relaxed, and personal.The woman, whom the healer diagnoses as "the roadrunner, a busy fidgety type," alternates between interest, skepticism and dismay. She cracks jokes; he doesn’t laugh. He recommends diet, exercise, no caffeine, and colon cleansing. She mentally rolls her eyes until, his hands massaging her foot, she feels her stomach lurch, a twinge in her armpit and begins to think of her body as "a human pinball machine." Whenever her self-defensive, rational, traditional beliefs almost propel her off the exam table and into her clothes, the healer "nails" her, reading her personality and her lifestyle exactly.Well into the visit, she realizes she hasn’t coughed once. Then, when she’s the most relaxed, incense wafting, his hands kneading all tensions from her back, her mind registering "this is bliss," her esophagus becomes blocked. Sitting up, she coughs, and the healer confronts her. "You have something to say," he insists, and she counters with "You expect me to believe all this mumbo-jumbo?" He tells her she swallows her feelings, and when she coughs again a "feather? A butterfly?" escapes from her mouth and disappears.When the healer pats her back and asks her to cough once more, she can’t. Taking her hands, he declares her "cured." At the story’s end, still not quite able to admit that this strange physician has helped her, yet knowing that he has, the woman struggles to count out his fifty dollar fee, finally dropping a handful of bills onto his bench, "hoping he won’t be offended by a tip."

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