Summary:

Patrimony relates the final illness and death of Philip Roth's father, Herman Roth. It begins as a misdiagnosis of Bell's palsy, which is eventually diagnosed as a brain tumor. Further tests reveal that it is cancer, operable only with great effort and little promise of cure or even significant palliation. The family (including Herman) decides against surgery and remains in close contact with him until his death.

Roth recounts his father's increasing weakness and helplessness, his own emergency quintuple bypass surgery, and his dreams of his father speaking to him from beyond the grave. Writing this book, he concludes, is the natural and necessary process in bearing witness to his father's life and death.

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This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.

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The author comments initially that most physicians become involved in the stories of their patients' lives--as witnesses, chroniclers, and players. He uses as an example the story of a physician's role in the death of Anton P. Chekhov. Another interesting example is the book, A Fortunate Man (see this database), the story of an English country doctor who matures in the profession and comes to recognize the task of the doctor as one to help his patients feel recognized.

Dr. Verghese believes that all patients seen by physicians are in the midst of a story that begins the moment they walk through the portals of a hospital or a clinic. He sees the challenge as engaging the patient and the family in finding an "epiphany," even if that epiphany is simply the understanding that there is nothing more that can be done medically. In his conclusion he says that as physicians we should be ministers of healing, storytellers, storymakers, and players in the stories of our patients and ourselves.

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The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.

Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.

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Winter investigates the process by which Freudian psychoanalysis became legitimized within modern Western culture and internalized as a kind of "psychological common sense" (4). She argues that Freud's adoption of the Oedipus myth allowed him to draw on the cultural status of classical scholarship and claim the universality of the tragic theme for his own project. She traces how Freud worked to establish an institutional infrastructure for psychoanalysis, to establish it as a profession. His analysis of culture and society represents another strategy in establishing and extending the importance of psychoanalysis: the claim that psychoanalysis powerfully illuminates not only the workings of the human brain (the domain of psychiatry, psychology, and neurology) but also the functions of society (the analytic domain of anthropology and sociology).

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Rosenberg, a surgeon and bench research scientist, has an epiphany fairly early in his clinical career: a patient with widespread cancer determined to be terminal, returns to the clinic sometime later, apparently disease-free without medical treatment. The scientist wonders if this patient's body could have tapped into some immunological or genetic healing pool. After having formulated the question, the author takes the reader through the trials and tribulations of framing, trying, failing, retrying and failing again to determine a way to test and prove how this phenomenon could have happened.

Over the many years of experimental work in the laboratory and on the wards of the National Cancer Institute, Dr. Rosenberg presents in a fashion largely accessible to the lay public a glimpse into this process. The work covers nearly three decades of the author's struggle to better understand and to develop new treatments for malignancies.

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Subtitled "The Story of a Gifted Young Obstetrician's Mistake and the Psychologist Who Helped Her," this is an absorbing account of a young female physician's torment following the difficult delivery of a baby who was soon thereafter diagnosed with cerebral palsy. "Doctor Amelia" seeks counseling after she has taken an indefinite leave of absence from her practice and faculty position. The book intertwines reconstructed counseling sessions in the voice of the doctor-patient, with the therapeutic strategy and personal reflections of her therapist, author Dan Shapiro.

The obstetrician enters therapy because she has lost confidence in her professional abilities. Once deeply engaged in her chosen profession, she has lost her enthusiasm for it and feels "numb." Her marriage is under strain. When asked if she is suicidal, she hesitates and then denies she is. Shapiro thinks there may be trouble ahead, and so does the reader. Gradually, Doctor Amelia reveals the incident that triggered her changed emotional state. She had delayed performing a cesarean section on a patient who was in extended labor and whose baby was showing deceleration of its heartbeat rate. A few weeks later, the baby's pediatrician informed Doctor Amelia that the baby had cerebral palsy and now the baby's parents are filing a lawsuit.

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This treatise is part of the Madeleva Lecture Series in Spirituality, an annual presentation sponsored by the Center for Spirituality, Saint Mary's College, Notre Dame, Indiana. Margaret Farley's lecture begins with a brief introduction to the successes and failures of the global response to AIDS and HIV both worldwide and in Africa. Her aim is to demonstrate that "compassion needs to be normatively shaped, both as an attitude and as the generator of actions," and that the form compassion and help take must be directed in part by the "real needs" of the individuals involved.

What follows in this brief book is an excellent review of traditional and feminist ethics, from the moral concepts of "individual autonomy," "nonmaleficence," "beneficence," and "distributive justice" to Carol Gilligan's "ethic of care." Farley looks at these and other ethical precepts with a keen eye, and then proposes a blended moral response she calls compassionate respect. Her intelligent, focused discussion of what compassionate respect might encompass includes a look at the role of compassion within various religions and how caregivers might modulate giving, mercy, and love into compassion and care.

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Intended for both the general public and medical professionals, Reel Psychiatry is a comprehensive catalogue of mainstream films that accurately portray psychiatric conditions. Robinson combines his "two passions: teaching psychiatry and watching films" to create a classroom resource for medical educators who want to use film to teach the diagnosis and treatment of psychiatric disorders and a critical compendium for anyone else who has more than a passing interest in cinematic works that dramatize the personal experience of patients and professionals grappling with mental illnesses.

The book is organized in three sections: primary psychiatric disorders such as schizophrenia, depression and bipolar disorder; personality disorders and mental retardation; and substance-related disorders and general medical conditions. The general symptoms and associated features of each condition are first set forth and then followed by descriptions of individual films that depict those symptoms and features.

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When Dan Shapiro was 20 years old and a junior in college, he was diagnosed with "nodular sclerosing Hodgkin's disease." Thus began a five-year ordeal of chemotherapy, radiation treatments, and a bone marrow transplant that failed. But this memoir, which recounts diagnosis, treatment, and two relapses, is more than a narrative of illness. Woven in and out of the subjective experience of physical and emotional trauma is the author's life as an adolescent, a family member, a young man who falls in love with the woman who eventually becomes his wife, a graduate student learning to be a clinical psychologist.

Sequences of ordinary life are carefully juxtaposed with sections on illness and treatment, emphasizing the author's determination to incorporate his illness into his life, all part of one continuous fabric. Even though disease was enormously disruptive, "[l]ife doesn't stop when something horrible happens" (158). Part of that life was a mother who decided to grow marijuana plants in her backyard ("Mom's Marijuana") so that her son would have an antidote for the terrible nausea that accompanied his chemotherapy. It is Mom who learns in a waiting room conversation that it might be advisable for Dan to bank his sperm for the future-- and who then proceeds to make the arrangements. As the memoir ends, Dan's mother finally disposes of the dry marijuana leaves that have been hanging in her attic for several years.

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