Cancer Confidential: Backstage Dramas in the Radiation Clinic

Hayter, Charles

Last Updated: Aug-23-2022

Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Summary:

All the [medical] world’s a stage! In elegant prose, with Felliniesque flights into whimsical metaphor, physician-historian-playwright Charles Hayter describes his encounters with cancer, as a doctor and as a son, and how the experience changed him as a person.

Just as he finishes his residency training as a cancer specialist, his stoic physician father develops cancer. The story of that family illness is interwoven with vivid case histories of patients, recounted personally rather than clinically. These patients display many of the characteristic reactions and behaviors of his own father.

Several other themes are prominent: the losing battle against death – or rather Death--who is a character lurking in the corners of the consultation rooms; the tensions of a son trying to please his difficult parents with advice and understanding that they seem not to want; the bravery of a gay man coming out to his wife and children to find a new place in the world.

These struggles are placed on a background of the nebulous status of radiation therapy, a maligned and misunderstood specialty.

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Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians

Joinson, Carla

Last Updated: Aug-08-2022

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

In 1902, an unusual structure was erected on South Dakota’s windswept prairies. It was not a silo, farmhouse, or barn—buildings that would be perfectly commonplace in that corner of the state. This conspicuously odd edifice, a “two-story building, with its jasper granite foundations,” was called the Canton Asylum for Insane Indians, a first-of-its-kind and federally managed institution based outside of Canton, South Dakota (Joinson 24). The asylum, which operated from 1902 to 1934, was designed to incarcerate and treat Indigenous peoples deemed ‘mad’ by powerful political authorities, such as reservation superintendents and the Bureau of Indian Affairs. According to the historian and disability studies scholar, Susan Burch, the facility “ultimately held four hundred men, women, and children from seventeen states and nearly fifty tribal nations.”

In Vanished in Hiawatha: The Story of the Canton Asylum for Insane Indians, Carla Joinson provides an incisive institutional history of the Canton Asylum, examining the political motivations for its establishment, its different periods of (mis)management, and, ultimately, its demise in the early 1930s due to inspection findings and Indigenous affairs advocacy spurred by John Collier. In writing the book, Joinson seeks to answer her chief research question: “why an institution like this asylum could exist for so many years, and what made it tick as a viable part of the Interior Department” (2). Her research explores the mechanics of institutional longevity, specifically how, despite government inspection reports that revealed appalling evidence of neglect and abuse, the facility remained in operation for over three decades. Joinson’s book also corroborates the staggering fact that many of the asylum’s patients were not, in fact, ‘insane,’ but sent to the institution only so that the federal government could detain and surveil people who may have experienced difficulties with reservation authorities back home. Other Indigenous peoples, such as those with epilepsy and ‘feeblemindedness,’ were also deemed ‘mad’ and in need of medical detention. Many instances of abuse are chronicled: unhygienic conditions, patient restraint, fraudulent diagnoses and misdiagnoses, suicide, and failure to quarantine tubercular patients. Joinson also unearths decades-long dysfunction among the facility’s administration: staff backbiting and high turnover rates, lack of medical treatment, poor medical training and recordkeeping, and refusal to employ translators to communicate with Indigenous patients and understand their different cultures. Vanished in Hiawatha documents that Canton’s patients suffered years of neglect, and those who would have potentially benefitted from psychiatric treatment never received it because the facility was little more than a rural prison for unwanted, troublesome, and chronically ill Indigenous peoples.

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The End of Her: Racing against Alzheimers to solve a murder

Hoffman, Wayne

Last Updated: Aug-01-2022

Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The author’s beloved Jewish mother is a great storyteller. A favorite tale describes how her grandmother was shot dead while sitting on the family’s Winnipeg porch nursing her baby. An accomplished investigative journalist, author Hoffman assumes it is fiction but decides to investigate. He is astonished to discover that, indeed, his great-grandmother was murdered, although the details deviate slightly from the family tradition.

Through official records, the Census, and newspaper accounts he pieces together the circumstances of her life and death and the frustrated search for her killer. In the process, he learns a great deal about his ancestors and the world of Jewish immigrants in early twentieth-century Canada. Eager to share his findings, he is confronted by his mother’s decline into dementia and the poignant difficulties of grasping and reshaping memories, both collective and individual.

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Two Nurses, Smoking

Means, David

Last Updated: Jul-20-2022

Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Two nurses decked in scrubs repeatedly meet outdoors for smoking breaks and banter during the summer and fall months. Gracie, a thin and pale woman, leads an itinerant life as she follows a mobile lithotripsy unit that services "cut-rate hospitals" in New York. She assists with the machine (dubbed "the kidney pounder") that delivers ultrasound energy to smash kidney stones. Marlon, a brawny man and Army vet adorned with a scar on his neck and an arm tattoo, works in the ER at one of the modest hospitals visited by the lithotripsy trailer.

The duo exchange numerous stories about patients they have cared for and eventually details about their own private life including personal hardships. A bond develops and deepens between these two people who "were both damaged, somehow lost" (p50). Their growing relationship is accompanied by physical attraction and culminates later in a night of love-making followed by mutual weeping.

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The Death of Innocents: A True Story of Murder, Medicine, and High-Stakes Science

Firstman, Richard; Talan, Jamie

Last Updated: Jul-14-2022

Palusci, Vincent

Primary Category: Literature / Nonfiction

Genre: Longform journalism

Summary:

The Death of Innocents offers an unbelievable but true tale that fulfills the promise of its tagline: Murder, medicine, and high-stakes science. Following prosecutor Bill Fitzpatrick in Onondaga County, New York, journalists Richard Firstman and Jamie Talan unravel the tale of Sudden Infant Death Syndrome, otherwise known as SIDS, in upstate New York in the 1970s. They first reveal the details of the case of Stephen Van Der Sluys, a father convicted of murdering his child for insurance money, establishing that parents don’t always have the best interests of their children at heart; this then lays the groundwork for the story of the successful prosecution of a mother whose children’s deaths had been considered as the basis for the theory of prolonged apnea as the cause of recurrent SIDS. With the prodding of Fitzpatrick, the prosecutor in nearby Tioga County then investigated and called in a slew of local and state investigators and national experts. Waneta Hoyt confessed to and was convicted of the murders, upending the research based on the prolonged sleep apnea theory, millions of dollars of NIH-funded research, and the careers of several research scientists. Although nurses and other pediatricians questioned Waneta’s maternal attachment and even suggested that the deaths were not natural, their voices went unheard. Politicians like Walter Mondale and Ronald Reagan jumped onto a bandwagon led by parents angry that the federal government had not done more to find out why their babies had died without explanation. National conferences on SIDS were held where theories were expounded based on published cases starring the “H” children. And commercial interests entered the stage as apnea monitors, which had never been used at home, became an unproven (and lucrative) recommendation for parents to prevent SIDS.

In addition to Waneta and Tim Hoyt and their five children (who ranged in age from 1 to 28 months) who were murdered between 1965-1971, there is a cast of characters out of a Hollywood script. The leading player is Alfred Steinschneider, MD, PhD, a pediatrician and researcher at Upstate Medical University in Syracuse, New York. Others include Drs. Michael Baden, Milton Halpern, Janice Ophoven and Marie Valdes-Dapena. Pediatric luminaries such as Abe Bergman, Jerold Lucey, Frank Oski, and even T. Berry Brazelton played roles.

The book takes us through the story using court and medical records, interviews, television and audio recordings, conference notes, publications and other publically available information, some of which the authors painstakingly retrieved and obtained through the Freedom of Information Act. We hear the sad story of Waneta and Tim, from high school sweethearts to life partners in rural poverty, and of their family members who tried to help but were often rebuffed. The story takes us to early pregnancy and early death, with inadequate evaluations, lack of autopsies or of more than cursory investigation, and wishes to not upset the Hoyts or their community with insinuations of murder. We hear about the years after the deaths, with the Hoyts’ attempts at adoption, mental health treatment and eventually their confession to heinous acts. We also hear about Steinschneider’s rise, fall and eventual ostracism by the medical community.

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Behold the Dreamers

Mbue, Imbolo

Last Updated: Jul-05-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In the basement of the apartment building where I live, down the hall from the small exercise room, there are two plain wooden bookcases. Each one has five shelves, and they are filled to overflowing with books that people have finished reading and that are now available for the taking. The books cover the gamut of fiction to history to self-help and everything in between. Under pressure to unclutter our apartment, I have added about 30 books to this library. The books do not come with any recommendation and so there is no way to know if the original owners liked the book or got rid of it because they could not get passed the first chapter. I am a frequent borrower. About two weeks ago, I scanned the shelves again and on one of the lower shelves, I noticed this book by Imbolo Mbue. I remembered that one of her books had been selected by the editors of the New York Times as one of the Best Books of the year 2021 so I picked up this earlier book. Two weeks later, I am here to report that I am glad I did.

The novel is a moving story of two families whose fates get intertwined in the year 2008. One family is a couple, Jende and Neni Jonga, with their 6-year-old son. They have recently come to the United States from Cameroon. They chose to try their luck in New York in the hope of escaping the dreary life that they see in their future if they stayed where they were. The other family, Clark and Cindy Edwards, is a wealthy couple living in a posh apartment on the upper East Side of Manhattan. They seem to have it all -- health , wealth, and the freedom to do whatever they want. Clark is a high-level executive at Lehman Brothers, and he interviews Jende for a job as his chauffeur in the opening chapter. Jende gets the job, and it is a game changer for the Jongas. It gives Jende the self-confidence that he is a traditional provider for his family and allows Neni to enroll in school and actualize her goal of becoming a pharmacist. For both of them, they can feel more comfortable with the idea of a growing family. They have received their ticket to the American dream.

However, while the Edwards are the picture of success to all who see them at the glamorous parties and fund raisers they host and attend, there are cracks beneath the surface of their dream life. Clark is working 16-hour days to try to stave off the imminent bankruptcy of Lehman and the financial collapse that will follow in its wake. Cindy is a psychologically traumatized person who struggles to keep her family whole and provide a loving and safe haven for her two sons. Ultimately, Clark is forced to leave Lehman and take up a job at Barclays Bank. His wife suspecting infidelity ultimately succumbs to drug and alcohol abuse. The Jendes lose their financial footing and are forced to confront the question -- where will they be best able to live wholesome lives of meaning and self-worth? They have to decide whether to persevere and try to make things work in New York or whether to return to their native country, Cameroon. The book ends with a question from the Jongas’ older son to his parents, “Home?” Mbue artfully asks this same question to her readers.

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Editing Humanity

Davies, Kevin

Last Updated: Jun-28-2022

Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

Editing Humanity explores the history, biology, sociology, and ethical import of CRISPR (“clustered regularly interspaced short palindromic repeats”), the major new DNA technology indicated in the book’s subtitle, “The CRISPR Revolution and the New Era of Genome Editing.” Using CRISPR, researchers can manipulate the DNA of animals, plants and microorganisms with extremely high precision. In particular, scientists now have the potential to customize the human genome.

What is CRISPR? To quote Davies, “CRISPR is a small subsection of the bacterial genome that stores snippets of captured viral code for future reference, each viral fragment (or spacer) neatly separated by an identical repetitive DNA sequence.” (p. 23) When the cell is reattacked by a virus, an RNA copy of that virus’ stored “signature” forms a DNA-splitting complex that destroys the incoming virus. In 2012, Jennifer Doudna, of the University of California, Berkeley, and Emmanuelle Charpentier, of the Max Planck Institute, Berlin, demonstrated that CRISPR could be engineered to edit any gene. One could, for example, replace a disease-causing mutation in any DNA segment with the healthy variant, thus preventing genetic disease.

The author, Kevin Davies is a geneticist and science writer whose previous books include Cracking the Genome and DNA: The Story of the Genetic Revolution. In Editing Humanity, he discusses an array of actual and potential applications of CRISPR technology, including human disease prevention by altering susceptibility of animal vectors, improving farm productivity, and even resurrecting extinct species. However, the most powerful and controversial topic is genetic manipulation of the human embryo. Davies devotes several chapters to the cautionary tale of the young Chinese scientist He Jiankui who engineered the world’s first gene-edited babies, and the scandal and disgrace that followed. (He was convicted in China of “illegal medical practice” and sentenced to prison.)

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Crying in H Mart: A Memoir

Zauner, Michelle

Last Updated: Jun-23-2022

Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

While Michelle Zauner’s remarkable memoir is an expression of her profound grief after her mother died, her story simultaneously reflects on her complicated relationship with the woman she called Umma and with her own Korean-American identity. The H Mart of the title, an Asian grocery chain, provided the ingredients for the dishes that suffused their relationship, her identity, and her grief. Food and memory animate the memoir itself.

Zauner was 25 when her mother was diagnosed with an aggressive late-stage, mid-life cancer. Also the only daughter of a white American father, Zauner was a rebellious child, resentful of Umma’s version of tough love. Growing up the lone Asian student in her Oregon community, she felt both othered at school and an outsider among her Seoul relatives. Just as she was beginning to appreciate her Korean heritage and understand her mother’s love, she learned about Umma’s diagnosis.

The first half of the memoir exuberantly brings to life scenes from Zauner’s childhood and her brief post-college years in New York City, interrupted by her dedicated caregiving. Attempting to save her mother, Zauner at times overwhelmed her with her native foods. “I would radiate joy and positivity,” Zauner pledged. “I would learn to cook for her—all the things she loved to eat, and I would single-handedly keep her from withering away” (69). Her optimistic culinary efforts produce a poetry of exacting descriptions of the flavors and textures and preparation of those foods. It’s grimly ironic that the chemotherapy her mother endured wiped out her ability to taste or digest Zauner’s loving offerings of health.

The second half turns from living with Umma to living without her. Wishing to sustain her bond with her mother as Zauner grieved, she continued to prepare her Korean family’s recipes. Walking down H Mart’s redolent isles generated “waves” of sorrow that mark the enduring ebb and flow of her grief. Unsuccessful with conventional therapy, she found cooking a preferable form of self-care. “Every dish I cooked exhumed a memory. Every scent and taste brought me back for a moment to an unravaged home. Knife-cut noodles in chicken broth took me back to lunch at Myeongdong Gyoja . . . The kalguksu so dense from the rich beef stock and starchy noodles it was nearly gelatinous. My mother ordering more and more refills of their famously garlic-heavy kimchi” (212-213). As if miraculously, a few years after Umma died, Zauner’s itinerant music career ignited. The band she has fronted, Japanese Breakfast, recorded an album, Psychopop (with a song she wrote about her mother, “In Heaven”). Then they toured the U.S. and South Korea. Although her mother was skeptical about a musical career, Zauner imagined that Umma would be “glad that I had finally found a place where I belonged” (233).

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Wild Boy

Dawson, Jill

Last Updated: Jun-15-2022

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Young doctor Jean-Marc Itard is serving in the Paris home for deaf-mute children. When a “wild boy” without speech is found near a village in Aveyron, France, Itard accepts the challenge of educating him. Many senior colleagues, including Philippe Pinel, opine that it will be impossible, even when Itard determines that the boy is not deaf. The lad, now named Victor, seems to be about ten years old, but his small size owing to malnutrition may be deceptive; he quickly reaches puberty. Helped by the care and empathy of the home’s housekeeper, Madame Guérin, and Julie, her daughter, Victor learns to perform several domestic tasks but manages to speak only a few words.

His situation is a mystery. Caregivers marvel at how he had been able to survive alone in the woods for several years. They wonder if he ran away from an abusive home, or if he was deliberately abandoned because of his disability. A crisis emerges when a woman appears claiming to be his relative. Itard eventually abandons the effort to educate Victor, but he is allowed to continue living with the Guérins.

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The Inkblots

Searls, Damion

Last Updated: Jun-14-2022

Madsen, Danielle

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Damion Searls’ The Inkblots: Hermann Rorschach, His Iconic Test, and the Power of Seeing is a comprehensive history of Rorschach’s life and an overview of the use and influence of his psychiatric test over the past century.

Rorschach grew up in Switzerland, the son of a widowed middle school art teacher who would die while Rorschach was a teenager after suffering from years from neurological disease caused by lead paint exposure. Rorschach debates whether to study drawing and become a teacher or attend medical school and pursue a career in neurology. The book follows his career across three countries after choosing to do the latter, until he becomes a practicing psychiatrist at a rural Swiss institution. It traces his psychiatric influences—Bleuler and then Jung as professors while at the University of Zurich and Freud via their influence—as well as his artistic ones—Ernst Haeckel, the pre-modernist galleries of Zurich, then Russian Futurism. It also provides an overview of the field of psychiatry at the time: schizophrenia was considered an unremittable condition named dementia praecox, psychiatric institutions included patients with tertiary syphilis, and increasing neurologic knowledge and psychiatric techniques improved diagnostics but not treatments.

The earliest inkblots of Rorschach’s are temporary creations made with a local schoolteacher and administered to patients and pupils, formulated as one of dozens of strategies to gain insight into people. Rorschach’s patients see much in these inkblots, but the schoolboys little, and the experiment is abandoned. He returns to the idea a decade later, with greater stress placed on the image. He requires that they look organic rather than made, imply movement, and have multiple foreground/background interpretations. After creating a set of ten products, he starts to categorize results. He codes whether the answers are seen in the whole image or a detail; whether they are based on form, color, or movement; whether the figures seen in the image are well- or poorly-defined; and how many and what category of answers are seen. The coded results enable Rorschach to give accurate blind diagnoses and he begins to gain traction in psychiatric community. However, he dies before his inkblots become popular.

The book follows the test as it travels to America and gains acclaim with psychologists. It is used in clinic and hospitals and becomes a standard part of psychology training. The inkblots are part of military personnel assessments and scientific studies. They are referenced in criminal trials and family court. They are applied in anthropology and education. They show up on movie posters and in fashion shows and become a household name. As it details these broad applications, the book explains the battle over how the test should be given and whether analysis of the results should be open-ended interpretation or a standardized scoring method. It also details society’s constantly shifting belief as to whether psychological testing is a valid diagnostic tool.

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