Summary:

This history of western medicine focuses on British life in the eighteenth century. Williams begins his treatise by wondering if "we realize sufficiently what we have escaped by being alive in the twentieth, not the eighteenth, century." He then catalogues in the subsequent 12 chapters the agonies not only of illness but also of medical treatment in the 1700’s.

Topics are wide-ranging and include blood-letting, parturition, infant malnutrition, rampant infectious diseases, maltreatment of the insane, surgery prior to anesthesia, water therapy, and military medicine. Primary source quotations interspersed in the narrative add to the drama. For example, the deposition of a widower (his wife died while pregnant) is quoted: " . . . Being taken ill of a paine in her right side under her short ribb together with a great difficulty of breathing having but 14 weeks to go with Child Mr Hugh Chamberlen Senr was sent for to take care of her, who thereupon gave her in the space of nine days four vomitts, four purges, and caused her to be bled three times to the quantity of eight ounces each time: Then gave her something to raise a spitting after which swellings and Ulcers in her mouth followed . . . . " (p. 31)

A few medical advances at the close of the century are also described, notably the smallpox vaccine developed by Jenner and the administration of First Aid to wounded soldiers at the frontlines (developed by Larrey). The text is accompanied by black and white illustrations, such as an inside view of Bedlam (Bethlehem Hospital) by William Hogarth (A Rake’s Progress, plate VIII).

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This story takes us to the fictional town of Port William, Kentucky where the traditions of family, farming, and freedom blend in a durable wholeness and wholesomeness of place. It is to this place that Burley Coulter is returned by his kin to die. In what turned out to be a mistaken expression of compassion, Burley's family took him to the doctor when, after eighty-two years, he fell ill. But then seeing him lying in the "mechanical room" of a hospital, attached to a life support system, his family conspires quietly and heroically to kidnap him so that he can die in his beloved woods.

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Cora is a fourteen year old girl who lives in Oklahoma, probably during the early part of this century. She has had to assume the work of child and home care after the death of her mother earlier in the year. As she learns these new tasks she compares herself to her mother.

Her worst fear is of butchering time, when she has to hear the squeals of the pig being butchered and smell the fat as it is made into lye soap. After she carries food to her father and brothers in the field, her father pursues her and rapes her, telling her she is the woman in the family now. At the end of the story, butchering time is no longer her greatest fear.

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The conflicting experiences of puberty for girls is the subject of this poem. A girl's bodily self awareness coincides with society's devaluation of a girl's sexuality. The conflicts between innocence, dirtiness, sexuality, and learning "to love yourself again" constitute the complexity of coming of age for young women.

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A young woman, Rachel, denies that she has an eating disorder, despite the concern of her boyfriend, Taylor, and her therapist, Karina. We see her complex system of denial, self-control, and isolation as the people who care about her most become more concerned and frustrated. Finally, through the confrontation of a beloved former professor, her therapist, and through meeting a physician whom she trusts for the first time, she begins to recognize her problem. She concludes, "I am only half here, and I don't know where I've gone."

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A teenager with a large, classic, Jewish nose, decides to get a "nose job." She has seen how her aunt blossomed after getting her nose fixed, and believes her life would improve too. It does. But as she grows older, and begins to appreciate her Jewish identity as well as the need to learn to look inside, not outside, for one's personal value, she wonders about the rightness of her action. Clearly, her self esteem improved; she did learn to like herself for the first time. Still, if she had a daughter with a big nose who wanted to be fixed, what would she advise her?

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The narrator of this poem describes all the kinds of things that disrupt your life when you experience PMS (premenstrual syndrome): impatience, dissatisfaction, irritability, temper, feeling overwhelmed. You notice that others avoid you, your doctor tries to treat your symptoms, and everyone sympathizes with those around you for how difficult you are making their lives. In the end, though, how does a woman know that her PMS-related perceptions aren’t really the accurate ones, that her temporary unhappiness isn’t really justified, or that her everyday comforts aren’t illusions?

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In the past, the father has tried to help the child cope with earache by showing him how the ear works, providing a visual image of the ear's anatomy from the encyclopedia. It didn't help the pain. Now that the father is chronically ill, his adult son tries to help, but cannot (even with an encyclopedia that purports to contain the entire world) produce a visual image, or metaphor, to explain the illness, or "what brought us here." Instead, he gives his father a Walkman, hoping that the music will "help him pass the hours in dialysis."

The son can see his father's blood, circulating in the dialysis machine (just as the father helped the son visualize what was happening in his sore ear), but the son cannot feel (or see, or hear--or, even though he's a poet, find a metaphor to convey) what it is like to be his father. This isolation is ironically emphasized by the son's gift: because of the Walkman, the father falls asleep "to a music I can't hear / And for which there is no metaphor."

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In the past, "tuberculosis" was a taboo word. The poet reviews the disease's many names and its history. John Keats said, "Bring me a candle, Brown. / That is arterial blood, I cannot be deceived / in that color. It is my death warrant."

For centuries so many died of tuberculosis; physicians were so impotent to help. Now, a patient accepts the fact that his chest x-ray has cleared as unremarkable, "as his right / and is right."

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This thoroughly researched book helps us understand John Keats's life and work in terms of his medical training. Goellnicht argues that, contrary to some critics' view that Keats was "anti-scientific" or "anti-intellectual," Keats incorporated much of the knowledge gained from his six years of medical training into his poetry.

The book begins with a chapter of biographical information about Keats, emphasizing the nature of medical training in the early nineteenth century, but includes Keats's self-diagnosis of tuberculosis. The heart of the book consists of four chapters, organized by scientific topic, which relate the specifics of Keats' s medical training to his writing: Chemistry, Botany, Anatomy and Physiology, and Pathology and Medicine.

Excerpts of Keats' poetic and epistolary writing are examined in each of these chapters in light of Keats' scientific and medical knowledge. For instance, in the chapter on Botany, the uses of specific botanical species in his writing are examined in terms of what was known of materia medica (see annotation for Ode on Melancholy. Furthermore, the author explores Keats's interest in plants and trees as metaphors for life, such as his interest in "the flower as a vital, but passive, being that exists in a state akin to negative capability."

The author concludes the book with a summary statement about each of the chapters (e.g., " . . . from pathology he adopted the approach of viewing aspects of life, in particular love and poetic creativity, in terms of morbid and healthy states . . . ") and also the caveat that the book is not meant to in any way diminish other profound influences on Keats, such as his interactions with other Romantic poets. Goellnicht notes, however, that Keats himself united the worlds of medicine and poetry in his poem, "The Fall of Hyperion," in which he describes the poet as a physician.

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