Summary:

Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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A memoir of raising a daughter with autism and an anthropological and historical investigation into autism around the world, Unstrange Minds: Remapping the World of Autism draws upon Grinker's own experiences, those of families of children with autism in the United States, Korea, India and South Africa, and a variety of experts and caregivers.  Putting the story of autism into a historical, anthropological, and personal context, the book deals with hot-button topics - the question of an autism epidemic, of etiology, of treatments - with a careful, patient approach.

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Send in the Idiots is a witty and moving tale of reunion, part memoir and part journalistic character study. Nazeer, hailing from a Pakistani family that has lived in the United States, Great Britain, Saudi Arabia and Pakistan, returns to the United States, where he had attended a school for autistic children during his early youth. He tracks down some of those who were also at that school with him, in order to find out how they are doing, what they are doing, and how their autism has affected their lives. He locates three people who were in the same class as he was and goes to visit them; he finds the family of a fourth; and finally sits down and has a slice of cheesecake with their former teacher and principal. Now a civil servant in the English government, Nazeer visits Andre, a computer scientist who makes uses of puppets to facilitate communication; Randall, a bike courier in Chicago and poet; and Chris, a speechwriter in Washington, DC. He then stays with the parents of Elizabeth, who had committed suicide a few years before, and through them finds out about her life, and about how parents may cope in the aftermath of such an awful catastrophe. Finally, he meets with Rebecca, who had been one of their teachers, and Ira, the prinicipal of the school, which has since shut down.

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In four parts this book uses a wide variety of images--caricatures in newspapers, comic books, advertisements, and photojournalism of Life magazine--to explore attitudes to physicians and medical progress in the mass media from the late nineteenth century to the mid-twentieth century. Each section centers on a specific type of image and the analysis addresses change in perception of doctors and their achievements by privileging crucial moments of newsworthy events and discoveries.

Early in this history, the media portrayed doctors as frock-coat wearing fops.  Medical metaphors used in a political context proclaimed these attitudes well. The story of four little boys, bitten by a dog in 1885 and sent to Pasteur in Paris for the newly invented rabies vaccination, is used as a pivot point for a transition in perceptions of medicine: from a clumsy, suspicious craft to a useful, progressive science.

The third section is devoted to the public fascination with the history of medicine in the period from 1920 to 1950, Films, newspaper articles, and comic books chart the insatiable taste for scientific success and medical progress. The last section studies images of progress in Life and other magazines through a meticulous analysis of health-related articles. In this section, Hansen shows how the media participated in educating the public to a definition of science that enjoyed an enthusiastically optimistic spin.

An appendix lists American radio dramas about medical history from 1935 to 1953. A wealth of sources are documented in the notes and the whole is completed with an intelligent index.

 

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Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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On February 16, 2003, readers of The New York Times Magazine came upon Harriet McBryde Johnson's cover story, "Unspeakable Conversations," and a remarkable image of her gazing directly at those readers from her power wheelchair.  Her story memorably recounts her uncompromising, yet civil disagreements with Utilitarian philosopher Peter Singer about nothing less than the value of her life.  That narrative essay is one of eleven stories published in Too Late to Die Young.

They make the case that philosophers and others have incorrectly imagined Johnson's life, and the lives of others with chronic and disabling conditions, as burdensome and not worth living.  Born with a degenerative neuromuscular disease, Johnson grew up in a family that appreciated her; she practiced law in her native Charleston, South Carolina, and became nationally known for her disability activism.  Still, she encountered a world filled with people who feared her condition.  Fear, she found, led them to assume that disability inevitably brings suffering and to use that assumption to justify acts that would prevent her birth.

Her stories, conversationally and often humorously, ask readers to question why they burden some people with calls to justify their lives or to assure the world that they experience pleasure.  Each story recounts an episode that reveals the pleasures Johnson experienced as an active agent in the world.  She ran for a county office, represented her state at a Democratic National Convention, stood her ground for free speech and against Secret Service tactics when President Reagan spoke at her law school, protested Labor Day Week-end telethons, traveled to Cuba to cover a disability conference for a magazine, advocated for clients in employment discrimination cases, and made many, many friends.

Feeling exhilarated rather than confined by her wheelchair, she bears witness, perhaps unexpectedly, to another pleasure:  "the simple delight of movement."  She writes of maneuvering around Charleston, "I zoom through chaotic swarms of tourists, zip around the raggedy sidewalks . . . loop around every inconveniently placed garbage can, with maximum speed and also with style and grace" (252).  But her stories also describe her wheelchair stumbling over incompatible surfaces, one of which sends her to an emergency room far from home.  This episode also brings moments of grace, this time with the ER staff.  After learning who she is, they Google her on-line profiles and writings.  Delighting in their patient with unpredictable needs, they place print-outs of her electronic portfolio in her chart.

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Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Medicine and religion cross paths in the examination of miracles and the canonization process of Roman Catholic saints. The author of this book, a medical historian and hematologist, compiles an impressive amount of data procured largely from four trips to the Vatican Secret Archives. She reviews 1,400 miracles from the time period 1588 to 1999 and discovers that 95% of these phenomena involve the healing of a physical illness. The author scrutinizes the nature of these miracles and investigates the dynamics and beneficiaries of them.

Medical expertise plays a central role in the substantiation of miracles. After all, miracles that involve healing imply a failure of medical treatment. Over the centuries, any physician providing testimony about the occurrence of a possible miracle must address two issues. The doctor must confirm the hopelessness of a patient's prognosis. The doctor must admit that the positive outcome of the case is nothing short of astonishing. The text is adorned by some splendid and strange paintings that illustrate people requesting or receiving miracles. It profiles celebrities in the history of the canonization process such as Prospero Lambertini (Pope Benedict XIV) and Paolo Zacchia.

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This study sets forth the mystery of scurvy  which devastated the British Navy during the eighteenth century. Among several diseases common on board, including yellow fever, typhus, or typhoid fever, syphilis, tuberculosis, and dysentery, scurvy was the most devastating. Caused by a lack of vitamin C, scurvy’s symptoms appear as swollen and bleeding gums, livid spots on the skin, and prostration. Untreated, the illness results in agonizing death. When Commodore George Anson’s flagship, Centurion, sailed from Plymouth in 1741, rounded Cap Horn and returned to Britain, his ship carried home only two hundred of the two thousand men he set out with. A deadly combination of voyages lasting a year or more, unhealthy conditions on board, including malnutrition, filth, crowding, ignorance about basic facts of biology, as well as inexperienced sailors pressed into crewing on ships managed by violent officers using harsh physical punishment resulted in millions of deaths at sea from the age of Columbus to the nineteenth century, when scurvy remedies were finally found.

Bown credits three men with discovering a solution to the mystery of scurvy: a surgeon, James Lind (1716-1794), sea captain James Cook (1728-1779), and a  physician, Gilbert Blane (1749-1843). Lemon juice had been known to prevent and cure scurvy since the 17^th century, but 18^th century medical men disregarded empirical knowledge in favor of the theory of humours.

James Lind entered the Royal Navy as a surgeon’s mate in 1739 under appalling conditions similar to those described by Tobias Smollett in Roderick Random (1748). He initiated a two-week controlled experiment where he separated the afflicted sailors into 6 groups who each received a different diet: cider, vitriol, vinegar, sea water, oranges and lemons, and nutmeg paste. The group receiving the oranges and lemons obtained the best results. Lind published his treatise on scurvy in 1753. However, he was unable to explain the causes of scurvy and why oranges and lemons led to its cure.

James Cook circumnavigated the world 3 times. On his lengthy voyages, he stopped for fresh fruits and antiscorbutics wherever he could, as he noticed these kept the seamen free of scurvy. Cook showed that scurvy was curable, but not why.

During the War of American Independence, Gilbert Blane served as a physician on board several warships in the British Navy. He instituted a diet of fresh fruits and better hygiene on board ship. He published Observations on the Diseases Incident to Seamen, in which he advocated using oranges and lemons to cure scurvy. He advised that lemon juice be mixed into the sailors’ grog.

The British Navy encountered an historic ordeal in 1805 with the Battle of Trafalgar. Admiral Nelson, commander of the British Navy, had nearly died from scurvy in 1780. Now he faced Napoleon Bonaparte and the French fleet. Bown argues that the near- elimination of scurvy on board their ships contributed mightily to the British victory.

A timeline, from 1492 to 1933, concludes the volume. Recommended readings, a bibliography and an index are provided.

 

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This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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