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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Sunday, November 20, 2005

    Second Hand Book Reviews: I know this is a cheap way to do book reviews, but sometimes when you hear about a book that sounds interesting, you just got to pass it along. And some weeks, the book review section is the best part of the medical journals. So here are some recently reviewed books from prestigious medical journals.

    Bleed, Blister, And Purge: A History Of Medicine On The American Frontier is written by a retired pathologist and catalogues the medical theories and techniques used in the American West from the native Americans to Lewis and Clark and beyond. Sounds like it may be more a series of vignettes than a comprehensive history, though:

    Bleed, Blister, and Purge is easily accessible to general readers as well as to health care workers. It comes across almost like an impressionistic painting: there are lots of stories and facts, but the reader has to mentally assemble the parts into an image of frontier medicine. It would not likely be used as a text for a medical history course, but it might be useful in a course on frontier sociology. For $15, Steele‚s book is a bargain, with nuggets of enjoyable information on almost every page.

    It might be good for browsing.

    A more traditional study in the history of one specific disease of long ago, The Great Mortality : An Intimate History of the Black Death, the Most Devastating Plague of All Time looks at the effect of the Plague on the developing Western world, and sees parallels for our time:

    Western society is getting older and, as Kelly points out, "Post-Black Death society was an old society." There were not enough young adults to tend the infrastructure, and thus, "there were hulking pockets of survivors surrounded by untended fields, unmended fences, ...over everything was the oppressive sound of silence."

    The Black Death occurred in the mid-14th century and it spread across the whole Eurasian continent - from China to the British Isles. And this was a time before easy transportation and comingling of populations. Another new book, 1491, suggests that the native Americans who lived in North America when the mass European immigration began in the 17th century were actually the straggling survivors of a devastated civilization. From the Amazon review:

    To many of those who were there, the earliest encounters felt more like a meeting of equals than one of natural domination. And those who came later and found an emptied landscape that seemed ripe for the taking, Mann argues convincingly, encountered not the natural and unchanging state of the native American, but the evidence of a sudden calamity: the ravages of what was likely the greatest epidemic in human history, the smallpox and other diseases introduced inadvertently by Europeans to a population without immunity, which swept through the Americas faster than the explorers who brought it, and left behind for their discovery a land that held only a shadow of the thriving cultures that it had sustained for centuries before.

    Might they, too, have suffered from the Black Death?

    A different kind of medical history is presented in Attending Children - the history of the development of a medical heart and mind:

    In the five stories of part 1, Mohrmann relates her encounters with seven children whom she cared for during her residency. All but one died in the hospital. What unfolds is a remarkable exposition of how the author developed her listening skills from attending to children with terminal illnesses. The honesty and clarity with which Mohrmann examines her lack of skill, for example, in giving bad news to families, is exemplary. As an intern, Mohrmann assisted in a code during which the child died. She was sent to inform the family:

    They were sitting together on the sofa holding hands. I stood in front of them and said, "We‚re still working on him, but he isn‚t responding to what we‚re doing."His mother looked up at me for a long five seconds and said, "Are you trying to tell me that my baby is dead?""Yes," I said. "I‚m sorry." Then I left them and went back to Joel‚s bedside.I did not know until she asked me that that was what I was trying to say. After all, my colleagues had used the same circumlocution: nothing‚s working. I had not yet translated that euphemism for myself; Joel‚s mother did it for me, and I knew she was right. I was horrified, then as now, that I had forced her to tell me that her child was dead.

    Becoming a doctor is much more than grappling with facts and figures. You're forced to grapple with your soul, too.

    posted by Sydney on 11/20/2005 07:50:00 AM 0 comments


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