Summary:

Tracy Kidder met Paul Farmer in 1994 when the former was writing an article about Haiti. They next met again in 1999 but it was only when Kidder expressed an interest in Farmer and his oeuvre that Farmer emailed him back, writing "To see my oeuvre you have to come to Haiti" (17). Kidder did just that, following the peripatetic workaholic Farmer to Peru, Russia, Boston, and wherever Farmer flew, which is anywhere there is poverty and disease, especially infectious disease.

In Mountains Beyond Mountains (MBM), Kidder chronicles Farmer’s childhood, medical school years (almost a correspondence course with Farmer’s frequent trips to Haiti), his founding of Partners in Health (PIH) and the construction of the medical center in Cange, Haiti, where "Partners in Health" becomes Zanmi Lasante in Creole.

The story of Farmer’s crusade for a more rational anti-tuberculosis regimen for resistant TB; his political struggles to wrestle with drug manufacturers to lower the price of these and medicines for HIV; his charismatic establishment of a larger and larger cadre, then foundation of co-workers; the story of Jim Kim, a fellow Harvard infectious disease specialist; Farmer’s marathon house calls on foot in Haiti; endless global trips punctuated by massive email consultations from all over the world; and gift-buying in airports for family, friends and patients--these are fascinating reading. In the end one is as amazed and puzzled by the whirlwind that is Paul Farmer--surely a future Nobel Peace Prize laureate like Mother Teresa--as Tracy Kidder was and grateful to have the opportunity to read about it by such an intelligent writer.

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This book, designed to accompany an exhibition "on the frequently Excessive & flamboyant Seller of Nostrums as shown in prints, posters, caricatures, books, pamphlets, advertisements & other Graphic arts over the last five centuries," displays and comments on 183 illustrations associated with the art of quackery. As the title suggests, Helfand surveys the graphic material of quackery of England, France, and America during the modern period, although most of the material dates from the eighteenth and nineteenth centuries. In his introduction, Helfand discusses the uncertain boundaries between "regular" (now termed allopathic) physicians and their "irregular" or "empiric" counterparts--quacks.

Through the mid-nineteenth century, many practitioners of both sorts relied on pharmaceutical agents like mercury, antimony, and opium; developed trade symbols and packaging; and flaunted the honorific "Dr." and their affiliation with science. Many patients visited both regulars and irregulars, who might consult with each other. Some physicians even prescribed quacks' proprietary preparations. Helfand also notes differences, such as irregulars' lack of medical training, exaggerated advertising, refusal to disclose the contents of their products, and use of entertainment and sometimes even religion in their "medicine shows."

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In this account of early practitioners and advocates of 'inoculation,' or the use of tiny amounts of smallpox contagion to induce a mild case of smallpox and immunity, author Carrell weaves prodigious historical research with fictionalized dialogue to create a tale of two prominent figures: Lady Mary Wortley Montagu of London and Dr. Zabdiel Boylston of Boston. Both Lady Mary and Boylston suffered scarring from smallpox, and, by living in the early 18th century, both witnessed the devastation of epidemics in terms of public health and private loss.

Both were also aware of the use of inoculation to prevent severe disease in Turkey (Lady Mary visited with her ambassador husband) and in Africa (on the advice of Cotton Mather, Boylston interviewed Africans, slave and freemen, living in Boston). Both faced formidable challenges and risked personal security to promote the use of this technique. Both proved their belief in the technique by the inoculation of their own children. And both, perhaps, met. At the behest of the Royal Society, Boylston traveled to London, witnessed numerous inoculations, and presented his Boston experience to the Society.

The book also chronicles the natural course of the disease, its various symptoms, forms and popular treatments, and the political impact of smallpox on the royal families of Europe and business interests in Boston. The medical research of various doctors is detailed. In particular, selected Newgate prisoners were offered pardon in return for participation in an experiment conducted by Mr. Maitland, who also inoculated Lady Mary's children. These experiments were used to test the safety and efficacy of inoculation prior to royal inoculation.

Ultimately, detractors of inoculation ceased their vitriolic attacks, as the risks of inoculation were proven to be far lower than exposure without such protection. The success of inoculation paved the way for Edward Jenner, often called 'the father of immunology,' to successfully use cowpox to induce smallpox immunity later in the 18th century.

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Aaron Raz Link was born a girl, named Sarah, and loved as a daughter. Twenty-nine years later, after inner turmoil, deep thought and relentless examination of how society views gender, Sarah became Aaron, a gay man. This starkly open and moving book describes, in Aaron's words and then in his mother's words, both the costs and the rewards of this journey.

The book is divided into two sections: the longer, beginning section is Aaron's, an intense rendering of what might be called an inner dialogue: Aaron talking to himself about his place in a gendered world; Aaron talking to society about the role of men and women; and Aaron talking to us, the readers, as if we were his close friends, gathered around him as he revealed his life.

The second section belongs to his mother, Hilda Raz. In musing, episodic scenes, she writes about herself as Sarah and then Aaron's mother, about her own work as a poet and editor, and most poignantly about losing her breast to cancer.

On page 86 Aaron says, "A stereotype is a kind of camouflage; the eye finds what it expects to find, and passes over details." Throughout this book we are asked to look at, directly but never sensationally, our bodies' organs, our gender "details," not only as functional anatomy but as symbols of identification.

In both sections, I felt pulled along on this journey, both as someone invited and as someone looking on, an emotional voyeur, and in both sections I observed the unflinching honesty of the authors' revelations. But it in was this final section, the mother's story, that I felt most keenly the love between the two authors. It is this love that becomes the strength of the narrative, the ground on which this incredible story unfolds.

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The narrator is a woman who lives alone in a rural area of Puget Sound. She is a writer, an observer, a spiritual thinker. "Each day is a god, each day is a god, and holiness holds forth in time" begins her musings about the first of three days. But on day two, a catastrophe occurs: a small plane crashes and a seven-year-old girl’s face is "burned off" as she is carried away from the explosion in her father’s arms.

The narrator had met the girl once before, at a neighbor’s farm, and had formed a connection--they looked alike and the girl playfully tormented the narrator’s cat with a dress-up game. The narrator imagines the girl in the hospital, imagines her future life as a nun with no face, and ultimately imagines a gentler future in which the girl’s face is restored, she is married and the narrator has assumed the function of the nun for her.

Throughout, the narrator wrestles with the hard questions of life: why are we here; why do horrible things happen; what is the relationship of God and the world; where is God and what is he doing? She is angry: "Do we need blind men stumbling about, and little flamefaced children, to remind us what God can--and will--do?"

A Christian, she seeks answers in her wide-ranging theology, and seems to find an inroad in the idea of "Holy the Firm"--a substance lower than salts and minerals, below the earth’s crust, in touch with "the Absolute." The narrator hence posits that "Holy the Firm" allows for an unbroken circle between God, Christ, and the created world.

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As an anthropologist with training in comparative biology, Jablonski is particularly interested in the natural history of humans: how did humans evolve to gain the varied appearances we see today? In particular, she investigates how our skin developed into a covering that is unique among animals in three ways: (1) it is naked--effectively hairless--and sweaty, (2) we come in a wide array of colors (not just the traditional four), and (3) we use our skin as a surface for decoration, a "social placard," which we cover or bare at will, and on which we put make-up, tattooes, scarifications, and piercings, all ways of expressing cultural and personal values.

Our ability to sweat allowed us to cast off the usual mammalian fur coat and to be active even in the heat of the day (when many creatures take shelter). Humans, therefore, could do more and be more as thinkers, builders, and social creatures.

As to our color variations, Jablonski argues that the main root of modern humans came out of East Africa; these people were black, because a lot of melanin in their skin was the best way to avoid too much ultraviolet radiation, although some is needed to create Vitamin D. As humans migrated to the north and the south, Darwinian selection favored lighter skin pigmentation in order to use the lower levels of sunlight.

Jablonski writes, "Dark skin or light skin, therefore, tells us about the nature of the past environments in which people lived, but skin color itself is useless as a marker of racial identity" (p. 95). And, noting an irony: "Naturally dark people in many parts of the world are increasingly seeking ways to lighten their skin, while the naturally light-skinned are trying to find new ways to darken theirs" (p. 159).

We often take our skin and all its functions for granted; our consciousness can change quickly, however, if we experience a skin disease, a sunburn, or a thermal burn (see Carter and Petro, Rising from the Flames: The Experience of the Severely Burned). Jablonski discusses a variety of illnesses, including burns, dermatitis, and skin cancers. Other topics include the importance of touch, how skin relates to emotion and sex, and experiments in artificial skin, useful for covering patients with severe burns.

Jablonski presents a dozen color plates, 44 figures, and maps to enliven her text.

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Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)

Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.

Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.

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This slim volume is Calvin Trillin’s tribute to his wife Alice, not only his muse and his first and most critical reader but also a figure well known to his readers. First written as a long essay in The New Yorker, the book is a slightly expanded version that chronicles their relationship, their family life, her many and varied interests, her illness—lung cancer—that first appeared in 1976, and her death in 2001 waiting in the heart failure unit of a hospital, her heart having been damaged by the radiation treatment 25 years before.

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This is the first of several autobiographies written by Donna Williams. In this she describes her earliest memories and experiences of being autistic through to her late twenties and the writing of the autobiography itself. Her account begins with descriptions of personality characteristics understood to be typical of people with autism. Contrasting her highly visual nature--a fascination with patterns and color and seen or imagined spots of light--with her difficulty understanding language and formulating it, Williams’s narrative is an account of neurological difference within a family that responded to it with impatience, anger, and violence.

She describes her fear of other people and how she learned to communicate primarily through objects, attaching to things and their symbolic meanings more easily than to people and language. As a means of managing her fear of people and her encounters with sometimes abusive family members and partners, Williams developed alternative personalities. She would perform those different personalities when she wanted to socialize or if she needed to protect herself. Williams develops relationships, some exploitative and some comforting to her, and finds ways to do well in aspects of school and work. The autobiography ends with a discussion of her first draft of the narrative itself providing a means for diagnosis. Initially thinking she has schizophrenia, Williams experiences a revelation when she realizes she is autistic.

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