Summary:

In The Mysteries Within, Sherwin Nuland takes the reader on a guided tour of selected organs inside the human body. Beginning with the stomach, he progresses along to visit the liver, spleen, heart, uterus, and ovaries. At each point he addresses various historical and contemporary beliefs, as promised in the book's subtitle, "A Surgeon Reflects on Medical Myths." Nuland brings to this endeavor the patented mixture of personal story, elucidation of medical history, and plain old good writing that characterizes all of his books.

For example, he devotes the first three chapters to the stomach. The first consists mostly of a brilliant clinical tale in which a six-week-old baby is found to have a wax bezoar in his stomach. The second and third provide a cogent survey of beliefs about the stomach's function, beginning with Greek humoral theory, continuing through van Helmont and the iatrochemists, and ending with Ivan Petrovich Pavlov and his seminal monograph, The Work of the Digestive Glands.

Van Helmont and his mentor, Paracelsus, appear again and again in later chapters as the earliest champions of the idea that the body runs by means of chemical processes (iatrochemistry). However, as Nuland points out, Paracelsus has left us two different legacies. One is his devotion to chemistry and experimentation, which eventually led to modern biological science. The other is his devotion to alchemy and mysticism, which makes him as well a forerunner of contemporary irrational systems of healing.

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Narrative competence is important for effective health care practice. By "narrative competence" I mean mastering a wide array of narrative skills, ranging from active listening and empathic responding in the client-practitioner interaction to reflective writing about one's professional experience. In the author's first book (The Therapeutic Potential of Creative Writing: Writing Myself, see this database), she explores the potential of creative writing as an aspect of therapy, and also presents some introductory writing skills. This book overlaps somewhat in covering the background for reflective practice, but focuses in considerably more detail on skill building.

Near the beginning of the book, Bolton presents a clear summary of "The Principles of Reflective Practice" (chapter 2). Recognizing that therapeutic writing is often accomplished in a group setting, the material on "Group Processes and Facilitation" (chapter 4), "The Creation of a Team" (chapter 5), and "Assessment, Evaluation, Mentoring and Values" (chapter 6) serves to introduce the last 100 pages of the book, which address specific writing skills, beginning with "How to Begin Writing" (chapter 8).

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In this book Robert Coles elucidates the nature of moral leadership by presenting a series of narratives about moral leaders. These are individuals who have made significant contributions to the author's moral development, mostly through personal interaction, but in some cases through their writings or their influence on other people.

The subjects include public personages like Robert Kennedy, Dorothy Day (of the Catholic Worker), Danilo Dolci (a Sicilian community organizer), Dietrich Bonhoeffer, and Erik Erikson; writers who have influenced Coles, such as Joseph Conrad and Ralph Waldo Emerson; and "ordinary" persons whom he encountered over the years in his studies of the moral lives of children.

The "ordinary" person category is most extraordinary. Coles draws heavily on personal interviews that reconstruct the courageous narratives of people like Andrew Thomas, a young Mississippian who worked on the voter registration project during the summer of 1964; Donita Gaines, one of the first black teenagers to "integrate" an all-white high school in Atlanta in 1961; and Albert Jones, a parent who volunteered to drive the school bus that carried black children in 1967 from Roxbury to a previously all-white school in South Boston.

However, the clearest and most powerful narrative that emerges from this book is that of the author himself, as he develops from young, socially conscious child psychiatrist to a middle-aged man seeking to understand what it means to be a moral leader in today's world.

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Summary:

The author first presents an introduction and rationale for the concept of using creative writing as therapy, either self-prescribed or as part of professional treatment. She then provides practical guidelines for starting a journal (Chapter 3), and for beginning to write poetry, fiction, and autobiography (Chapter 7).

The text includes an accessible introduction to images and metaphors--aspects of the craft--as well as to methods of capturing dream material (Chapter 6) for use in one's creative writing. The later chapters present therapeutic writing in various contexts--as group work (Chapter 9), or in various institutional settings (hospital, nursing home, hospice, and prison). There are examples of therapeutic writing, especially poetry, throughout the book.

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This is a scholarly book and the author, who is an exceptionally good writer, has gone to great lengths to search out original source material, much of which has not been examined by previous authors. Instead of retelling Elizabeth Blackwell's story she relates in some detail that of Sarah Adamson Dolley, another important pioneer woman physician who was the third woman medical graduate in America. She also was one of the eight founding members of the earliest society of women physicians in the United States.

The book also details the period in the late eighteen hundreds and early nineteen hundreds which was referred to as "maternalist medicine," when women began to pursue their careers in public health. After being "sidelined" in the first half of this century, the numbers of women physicians began to slowly increase, greatly aided by the new women's movement and the equal opportunity era.

Dr. More does an excellent job of bringing together the history of women physicians with the history of medicine from 1850 until the present. Her descriptions of women physicians' lives and problems are evenly presented and make interesting reading. The evolution of medical education in general is also well described. Her conclusion is not unexpected--that the greatest obstacle facing women practitioners today is the need to accommodate the demands of childbearing and child rearing with their professional lives.

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Written by surgeon and renowned author Sherwin B. Nuland, this book offers both a detailed look into the workings of the human body and a glimpse into the heart and work of the author. Furthermore, it is also a philosophical treatise on the wonder of human life and the beauty of "animal economy." As a human biology text for the layman, the book explicates the major organ systems of the human body, such as the nervous system (including the sympathetic nervous system), the cardiovascular system, the gastrointestinal tract, the immunologic and hematologic systems (including coagulation, cell lines, lymphatics), and the urogenital system (including reproduction and childbirth).

Nuland intertwines dramatic stories of his surgical patients with the systems review. For instance, the book begins with the near death of a woman by hemorrhage from a ruptured splenic artery aneurysm. Another dramatic story involves the near death of a young diabetic woman from bacterial overgrowth in the gut. The reader also hears the patients' versions of their illness experiences--Nuland gives direct quotes from what they have said or written about their experiences. Through it all, Nuland expresses his awe and wonder at the workings and capabilities of the human body.

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The author, a Canadian physician-historian-educator, blows the dust off the shelves of medical history with this fascinating text designed for medical students, educators, and those with an interest in history of medicine. Duffin begins this survey of the history of Western medicine with a glimpse at a pedagogical tool designed to spark the interest of even the most tunnel visioned medical students: a game of heroes and villains. In the game, students choose a figure from a cast of characters selected from a gallery of names in the history of medicine.

Using primary and secondary sources, the students decide whether the figures were villains or heroes. The winner of the game is the student who first recognizes that whether a person is a villain or hero depends on how you look at it. This philosophy imbues the entire book, as this treatise is not a tired litany of dates, names and discoveries, but rather a cultural history of the various times in which medical events occurred.

The book is organized by topics which roughly follow a medical school curriculum: anatomy, physiology, pathology, pharmacology, health care delivery systems, epidemiology, hematology, physical diagnosis and technology, surgery, obstetrics and gynecology, psychiatry, pediatrics, and family medicine. The last chapter, entitled "Sleuthing and Science: How to Research a Question in Medical History," gives guidance to formulating a research question and searching for source material. Fifty-five black and white illustrations are sprinkled throughout the book, as well as 16 tables.

Direct quotes from historical figures, such as Galen and Laennec, as well as excerpts from writings of eyewitnesses of events, anecdotes and suggestions for discussion, appear in boxes within the chapters. Many of the chapters contain discussion about the formation of professional societies. Each chapter ends with several pages of suggested readings and the third appendix delineates educational objectives for the book and individual chapters. The other two appendices list the recipients of the Nobel Prize in Physiology or Medicine, and tools for further study, including titles of library catalogues, and resources in print and on-line.

Although the book is a survey covering multiple eras and topics, each chapter contains choice tidbits of detail. For instance, the chapter on obstetrics and gynecology includes the story and photograph of Dr. James Miranda Barry, the mid-nineteenth century physician, surgeon and British military officer, who was discovered to be a woman at the time of her death. The impact of the stethoscope on the practice of medicine is explored in depth in the chapter, "Technology and Disease: The Stethoscope and Physical Diagnosis."

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This work touches upon a wide range of issues, more or less closely related to the trauma surrounding, the management of, and the aftermath of sustaining a serious burn. Divided into three sections, the work first defines burns not only on a biological basis, but as distinguished psychologically and historically from other forms of physical trauma.

In Part II the authors explore ancient myths and then images from modern culture that they contend define social perceptions about the meaning of being a burn victim. The final section poses problems that remain in the technique of burn management in its most holistic sense. An extensive bibliography/filmography completes the book.

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Poetry is a natural medicine . . . Poetry helps us feel our lives rather than be numb. So begins John Fox, a Certified Poetry Therapist whose aim in this book is to help the reader see the profound relationship between creativity and healing, and to nudge the reader gently into making his or her own poems.

Fox grounds his work in narrative--stories of suffering persons who were able to transform their experience by writing poems. He illustrates the text with the poems of these persons, as well as those of well-known poets from King David to Lucille Clifton.

Fox carries the reader from the silence that leads to poetry (Chapter 1, "Heart, Who Will You Cry Out To?") through the elements that go into writing (Chapter 3, "Poetic Tools For Your Healing Journey") to writing about specific situations, such as illness, loss, and death (Chapter 6, "When God Sighs"). Each chapter includes a number of suggestions and exercises.

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This book concerns the care of dying persons. Hospice care provides a multidisciplinary approach to caring for the whole person, including his or her physical, emotional, social, and spiritual needs. Often, however, discussion about hospice or palliative care tends to focus almost exclusively on relieving physical symptoms. Kearney tells us a number of dying patients' stories. Some die at peace, in seeming fulfillment. Others die in great distress, with what Kearney calls "soul pain," a deep existential anguish that is not relieved by symptom control or social support.

Kearney proposes two complimentary models to describe what occurs in dying persons whose "soul pain" is relieved. For the first, he recounts the Greek myth of Chiron. The wise centaur Chiron suffered from an incurable arrow wound inflicted by Hercules. Chiron learned that if he would be willing to sacrifice his immortality on behalf of Prometheus, he would be freed from his suffering. After he did this and descended into the underworld, Zeus raised him to the heavens, where he became a constellation.

Thus, the mythological model has a hero who is wounded, struggles, makes a choice, then descends into the depths, and finally returns transformed. The second, psychological model portrays the mind as having a surface rational part (where the ego resides) and a deep symbolic and intuitive part (where the "deep center" resides). The relief of "soul pain" lies in choosing to reject the ego's resistance and "letting go" to get in touch with the deep center.

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