Summary:

Many of the poems in this volume bring historical figures to life; these include figures as varied as "Wallace Stevens, Walking," "The Death of Shelley," "Rembrandt's Head," "Immanuel Kant," and "David Hume and the Butterfly." Some, such as "The Miracle," "Dr. Beaumont's Miraculous Hole," and "The Corpse in the White House," focus on specifically "medical" aspects of history. Dr. Young also includes a number of poems that arise from his own experience as a practitioner; e.g. "The Rodeo Queen," "The Medusa," and "Night Call."

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Although he could be a court physician in Macedonia, Hippocrates has returned to the island of Cos, at least temporarily, to take over his dead father's practice. He is summoned to the villa of a wealthy citizen to consult on the fits of a daughter of the house. Using precise clinical observation, he diagnoses hysteria instead of epilepsy. Then, he relates the girl's psychological problems to the neglect of her selfish and adulterous mother, Olympias, who prefers her handsome, athletic, but rather dense (and as it turns out, illegitimate) son, Cleomedes.

A marriage is to be arranged with Cleomedes's obsession, Daphne, the exquisitely beautiful and intelligent daughter of a physician from Cnidus. But Daphne falls in love with Hippocrates, and he with her. In between solving clinical problems, including a real case of epilepsy, a botched abortion, and a broken hip in his own grandmother, Hippocrates is led along a tangled path of intrigue, seduction, and false accusations.

A fire destroys the medical library of Cnidus, killing Cleomedes, who, for once in his life had risen to heroism in attempting to save an invalid woman and her son. When the newly orphaned child reveals that Olympias and her old lover have committed arson, Olympias leaps from the highest wall to her death. Hippocrates is now free to marry Daphne. Adopting the child as their own, they return to the island of Cos.

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In early 1847, the young Quebec city doctor, Lauchlin Grant, struggles to extract a living from his boring practice and pines over his childhood sweetheart, Susannah. She is now the wife of a prominent journalist, Arthur Adam Rowley, who has charged Lauchlin with her care, while he travels in Europe to report on the ghastly potato famine in Ireland and his predictions for its effects on immigration.

Even as Rowley's letters are read at home, waves of starving Irish land at Grosse Ile in the St. Lawrence River where thousands are ill or will sicken of ship fever (typhus), and die. Lauchlin is called to help at the quarantine station. Of the hundreds in his care, he rescues only Nora. Having lost her family, Nora decides to remain as a nurse, because she is now immune.

Lauchlin sees Susannah only once more, learning that she too cares for victims of typhus, which is also ravaging the mainland, despite the quarantine. He senses her unspoken love for him and, filled with an inner peace, returns to Grosse Ile, only to contract typhus and die. Nora takes the doctor's belongings to Susannah's home, hoping to meet the woman whose name he had mumbled in his delirium. Instead, she finds Susannah's newly returned husband dreading the loss of his now dying wife.

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Osler’s famous essay was first delivered as a valedictory address at the University of Pennsylvania School of Medicine in 1889. Osler urges the graduates to develop two qualities or virtues. First is the "bodily" virtue of imperturbability or "a judicious measure of obtuseness." This means the outward expression of calmness and coolness, even under difficult circumstances. This virtue suggests that physicians should be relatively "insensible" to the slings-and-arrows of patient care, always maintaining a degree of detachment from their patients.

The complementary "mental" virtue is aequanimitas, which is the personal quality of calmly accepting whatever comes in life. These virtues, however, should not lead to "hardness" in dealing with patients. Osler also urges his students and colleagues to develop the other gentlemanly virtues of courage, patience, and honor.

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Scarlett writes about the tradition of medicine in a recognizably British (Canadian) voice. He presents a definition of a profession that features social responsibility and duty to serve others, and notes that "an organized profession does not seek to advance the money-making feature of professional activity." Scarlett identifies seven "pillars" (principal qualities) of the physician, or any other professional: technical skill, social responsibility, knowledge of history, knowledge of literature and the arts, personal integrity, faith that there is some meaning and value in life, and "the grace of humility."

Scarlett critiques the medical profession in two ways. First, physicians are not skeptical enough and willing enough to correct their errors. Secondly, professional qualities have declined "at the hands of the scarcely literate pushing public . . . . " As a result of this, some physicians now believe that "all this rhetoric about the essential nobility of the medical profession is a load of old rubbish" (p. 129).

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This novel was inspirational for several generations of pre-medical and medical students. It follows the hero, Martin Arrowsmith, from his days as a medical student through the vicissitudes of his medical/scientific career. There is much agonizing along the way concerning career and life decisions. While detailing Martin’s pursuit of the noble ideals of medical research for the benefit of mankind and of selfless devotion to the care of patients, Lewis throws many less noble temptations and self-deceptions in Martin’s path. The attractions of financial security, recognition, even wealth and power distract Arrowsmith from his original plan to follow in the footsteps of his first mentor, Max Gottlieb, a brilliant but abrasive bacteriologist.

In the course of the novel Lewis describes many aspects of medical training, medical practice, scientific research, scientific fraud, medical ethics, public health, and of personal/professional conflicts that are still relevant today. Professional jealousy, institutional pressures, greed, stupidity, and negligence are all satirically depicted, and Martin himself is exasperatingly self-involved. But there is also tireless dedication, and respect for the scientific method and intellectual honesty.

Martin’s wife, Leora, is the steadying, sensible, self-abnegating anchor of his life. In today’s Western culture it is difficult to imagine such a marital relationship between two professionals (she is a nurse). When Leora dies in the tropics, of the plague that Martin is there to study, he seems to lose all sense of himself and of his principles. The novel comes full circle at the end as Arrowsmith gives up his wealthy second wife and the high-powered, high-paying directorship of a research institute to go back to hands-on laboratory research.

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This story concerns the death of a child and failures of communication. Scotty, an eight year old, is hit by a car on his birthday. His mother had ordered a birthday cake but "there were no pleasantries between" her and the baker. Scotty is hospitalized, unconscious, and the cake is forgotten. Dr. Francis reassures the anxious parents that all will be well when the boy wakes up.

The baker phones the parents’ home in the dead of night (when he does his baking) because the cake hasn’t been picked up, but they can’t figure out who he is or what he wants. At the same time the doctors and staff can’t and won’t answer their questions about why Scotty isn’t waking up. Dr. Francis comes to the hospital to check the child, looking tanned, meticulously dressed, as if he has just been out for the evening- he has a life outside of the hospital, but the parents have none. When they do run home, separately, to take a break, the baker torments them with his mysterious late-night calls. Their confusion and isolation deepen. The child dies-"a one-in-a-million circumstance."

The mother finally realizes that it is the baker who has been calling and tracks him down, enraged. She unleashes all of the anger which she had been unable to express to the doctors. The baker is stunned to learn about the child’s death; he begs forgiveness and offers them warm delicious cinnamon rolls. "Eating is a small, good thing in a time like this" and they are comforted.

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William Osler served as one of Walt Whitman’s physicians from 1884, when he moved to Philadelphia to become Professor of Medicine at the University of Pennsylvania, until 1889, when he left Philadelphia for Baltimore. Osler was introduced to Whitman by a mutual friend, Dr. Richard Maurice Bucke, Whitman’s avid disciple and biographer. After his stroke of 1873, Whitman suffered from recurrent episodes of illness (perhaps small strokes?). Osler first paid a call to Whitman’s home in Camden at Bucke’s request and subsequently visited him on numerous occasions.

Published in this book for the first time is Osler’s unfinished 1919 manuscript for a lecture recounting his relationship with Whitman. Much of the book is a gloss on this short manuscript. The book actually deals as much (or more) with the remarkable figure of Richard Maurice Bucke, Whitman’s spokesman and the developer of a theory of "cosmic consciousness," as it does with the two title characters. In sum, Whitman respected Osler, but did not particularly like his sunny, optimistic bedside manner. Osler respected Whitman, but for the most part did not like his poetry. (Leon, however, discovered some handwritten notes on Osler’s copy of Leaves of Grass that suggest Osler grew in his later years to appreciate Whitman’s poetry.)

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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