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America

The Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President by Candice Millard (Doubleday, $27.95, 352 pages)

Imagine that you are in charge of making decisions for a major publisher.   A writer presents you with a new novel based on the following story:  A very young (49-year-old) President of the United States is elected and quickly stalked by a madman.   The president serves only 6 months before he is shot by this crazy person.   As the shooting takes place, one of the men standing alongside the president has been present at three presidential assassinations (although he is in no way connected to the assassins).   The physician in charge of saving the president cannot locate the bullet in the president’s body, and turns to a world-famous inventor for his assistance in creating a new machine that will find it.   Despite their best efforts, the president does not survive and the vice-president – a political hack who is against everything the former president stood for – assumes office.   This new leader throws aside his former supporters, and proceeds to fully implement the dead president’s political agenda.

No doubt you would reject this fictional tale as being beyond the bounds of believability.   And you might be right, except for the fact that this all, in fact, occurred in 1880.   As documented in The Destiny of the Republic, one truly fascinating account of the events surrounding the assassination of President James A. Garfield, and the assumption of the high office by Chester A. Arthur, these events happened.   The genius inventor who attempted to save the life of the president (in the days before x-rays) was Alexander Graham Bell.   The witness to Garfield’s assassination was Robert Todd Lincoln, “…the only man to be present at three of our nation’s four presidential assassinations.”   And President Arthur, a product of the New York State spoils (political patronage) sytem, was to be the man who enacted civil service reform.   Arthur came to be known as the Father of Civil Service, a title that would likely have been Garfield’s, had he survived being shot.  

“Assassination can no more be guarded against than death by lightning, and it is best  not to worry about either.”   James A. Garfield

This is a detailed and moving version of the events surrounding the life and death of James Garfield of Ohio, a man who was very much in love with his wife; a woman who nearly preceded him in death.   Garfield was to die, not from the bullet that lay harmlessly encased in body fat within his frame, but from medical malpractice and incompetence.   In modern times Garfield, like President Reagan, would have survived his  injuries and returned to the White House.

Garfield turned to the doctors closest to him, and asked what chance he had of surviving.   “One chance in a hundred,” the doctor gravely replied.   “We will take that chance, doctor,” Garfield said, “and make good use of it.”

The reader will come to see that Garfield was a very courageous man who suffered at the hands of a medical team that hastened his death.   Alexander Graham Bell and Chester Arthur also come to life as fascinating characters; Bell as an imperfect but well-meaning genius, and Arthur as a man who reluctantly but boldly grew into the role that destiny selected for him.   (Arthur was not born to greatness, but grew into it when the nation desperately needed a leader to fill Garfield’s very large shoes.)

This true story is very cinematic in nature and might well make for an excellent film filled with multiple larger-than-life characters.   Thanks to Candice Millard, it is a story that will not longer be a blip in the history of the United States.   If you know of a young person who is interested in reading about the history of our country, consider presenting this book to him or her as a very valuable present.

Highly recommended.

Joseph Arellano

A review copy was received from the publisher.   The Destiny of the Republic will be released on September 20, 2011.   “What an exceptional man and what an exciting era Millard has brought to elegant life on the page!   After reading The Destiny of the Republic, you’ll never think of James A. Garfield as a ‘minor’ president again.”   Hampton Sides, author of Hellbound on His Trail

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Help!

Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein, M.D. (W. W. Norton; $24.95; 302 pages)

Medical Journalist Randi Hutter Epstein presents an easy-to-understand, yet not patronizing, overview of childbirth across time.   Each of the book’s five parts features some aspect of the cold, unvarnished reality faced by pregnant women and the subsequent delivery of their babies.   The time frame discussed in the book spans the ages; however, the 19th and 20th centuries are Epstein’s primary focus.   Clearly, fads and political movements in these two centuries have had a heavy influence on how childbirth has been addressed.   The ongoing struggle between physicians and midwives for clientele became an ugly smear campaign, never mind that nearly all doctors were male and that they perpetuated ludicrous theories for hundreds of years causing massive harm to their patients.

“In the meantime, doctors were doing what they considered the best medicine.   They believed they were saving lives by luring women away from midwives and into the hospital, where doctors could control the business of babies.   Ironically, what they thought was (the) best medical care was sometimes the deadliest.”

Dr. Epstein conveys her views in a most engaging manner.   She has a very strong sense of irony and makes good use of it.   This reviewer was unaware of the sometimes-bizarre methods employed in the past during delivery, including twilight sleep that wiped out all memory of the childbirth experience.   Never mind that during labor a woman using twilight sleep had to be lashed to the delivery table in order to keep her from falling off while writhing in pain.

There is some overlap among chapters with regard to the material covered.   A reader interested in a particular section of the book will find a comprehensive write-up much like a stand-alone article.   This makes perfect sense because the author is a widely published medical journalist.

There does not seem to be an intended audience for Get Me Out.   Rather, most anyone can benefit from the book, as was the case for this reviewer whose granddaughter was born right after I finished reading it.   By the way, Dr. Epstein has four children of her own which qualifies her on yet another level.

Highly recommended.

This review was written by Ruta Arellano.   A review copy was received from the publisher.

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Angels on Earth

CC Theresa Brown

Critical Care: A New Nurse Faces Death, Life and Everything in Between by Theresa Brown (HarperOne, $14.99, 224 pages)

“Death.   It casts a long shadow in this book, and in these stories.   Even when death is not present it hovers just around the corner, unbidden and unwanted, but waiting nonetheless.”

“People say, why wait?   But really they should say, don’t wait.   Listen when you can, tell the people in your life you love them…”

If doctors are the mortal gods of medicine, then nurses are its angels.   At least that’s the case put forth here by Theresa Brown, a former Tufts University Journalism professor turned Registered Nurse (R.N.).

It seems that Brown and a former close female friend were looking for meaning in their lives when they decided to go to nursing school.   Brown started at Penn but finished at Pitt.   In Critical Care, Brown pulls back the curtain on what she somewhat successfully labels the Science of Nursing.   My mother was an emergency room nurse, so much of what I read in Critical Care sounded familiar and true…  Good hearted nurses are worn down by tough-minded superiors.   These nurses rarely receive praise for medical successes but often are blamed for the failures.   And, they have to clean up stool because “doctors don’t do poop.”

Still, this seemed like a somewhat lightweight survey of a crucial field.   There are some specific problems with the telling.   Brown shows us her empathy in writing about patients like the all-too-young David, who is battling leukemia; and Irene, the Pittsburg television personality who does not realize that she’s dying until she hears her former co-workers talking about her on TV.   But as soon as we become engaged with their lives, Brown’s off describing other things – like a voluntary job change.

Brown also loses track of former patients (some of whom have likely died) and their families.   In this age of the Internet, it’s odd that she did not pursue some basic research to find out what happened to them.   Also, the book begins with multiple pages of acknowledgments which seems distracting before we get to the actual content.

A last flaw is that we do not get to know the author’s husband or daughter.   They remain on the edges of the stage.

What Brown does quite well is to convince the reader of the need to enjoy life (and other people) while good health lasts.   Today’s tiredness may be diagnosed as leukemia or some other energy-robbing disease tomorrow.

Critical Care lets you walk in the shoes of some very ill patients, both young and old.   Yet for a better overview of today’s world of medicine – as practiced on a daily basis – I recommend two books by Dr. Atul Gawande.   The most recent is Better: A Surgeon’s Notes on Performance (2008).   The contemporary classic is Complications: A Surgeon’s Notes on an Imperfect Science (2003).

Recommended.

Joseph Arellano

A review copy was provided by the publisher.

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