Marchalik D, Jurecic A

Sept 2015

 

This piece introduces "From Literature to Medicine" - a new monthly column that explores medically relevant themes through a literary lens, beginning with a focus on contemporary fiction, essays, and memoir. 

Krishnan L, Marchalik D

Sep 2018

Although an enduring subject of art, music, and literature, it was not until the 1990s that medicine concluded that one can succumb to a broken heart. Japanese physician Hikaru Sato characterised the first case reports of Takotsubo cardiomyopathy, a cardiac response to acute emotional stress. The condition was poetically dubbed the “broken heart syndrome”.

There is perhaps no greater writer of heartbreak than Emily Brontë. 

Aronson L, Marchalik D

Jun 2018

Do traits like positivity, stubbornness, and hard work affect longevity? One study of Italian nonagenarians and centenarians suggested that the answer is yes. Researchers reported that, despite their declining physical health, this group of older Italians continued to control their social lives and refused to stop working the land. Their “exceptional longevity”, the authors suggested, was intimately linked to “a balance between acceptance of and grit to overcome adversities”, and a commitment to their purpose in life.

A similar portrait of acceptance and grit can be found in Ernest Hemingway's The Old Man and the Sea. The novella opens on the 85th day of Cuban fisherman Santiago's fishless streak. Old and unlucky, he is left to fish in solitude.

Marchalik D, Jurecic A

Sept 2015

In her essay collection On Histories and Stories, A S Byatt depicts the 1994 bombings of Sarajevo during which a group of theatre workers came together to launch a project called Scheherazade 2001. As bombs were falling from the Bosnian sky, stories by European writers were simultaneously read aloud and broadcast in theatres in Sarajevo and across Europe—a quixotic and unyielding act of resistance. Having “pitted storytelling against destruction”, fiction against reality, their struggle made use of a long tradition of Balkan folklore. Scheherazade 2001, like its namesake, one of the world's most famous storytellers, used storytelling to ward off death until the stories themselves became an unlikely antidote to catastrophic and uncontrollable events. The use of stories as a coping mechanism functions as the central theme of Téa Obreht's The Tiger's Wife (2010)...

Jurecic A, Marchalik D

Oct 2015

Empathy has become a hackneyed term in medicine. It's generally understood that a physician's ability to sense and understand the feelings, thoughts, and experiences of patients is valuable in clinical encounters, but questions remain. Is it always beneficial for doctors to feel and display empathy? What happens when doctors and patients have different expectations about how and when empathy is expressed? Can empathy really be taught and learned in medical schools? Such questions will never yield to quick and easy answers. The untidy complexity of empathy can be frustrating to physicians and educators, but its ambiguities are gold for an essayist. In her 2014 literary essay collection, The Empathy Exams, Leslie Jamison brings a new voice, energy, and insight to the topic...

Marchalik D, Jurecic A

Nov 2015

 

In 1981, a group of 17 macaques known as the Silver Spring Monkeys became the most famous research animals in the USA when Alex Pacheco, an undercover college student and animal rights activist, infiltrated the laboratory of psychologist Edward Taub to expose the experiments that took place inside. In his research on neuroplasticity, Taub severed the afferent ganglia to certain limbs while immobilising the limbs that were neurologically intact in an attempt to train the macaques to use the appendages that lacked neural feedback. While the subsequent legal case against Taub for animal cruelty sparked the expansion of various animal rights organisations in the USA, Taub's research also gave birth to a valuable therapy for patients with stroke known as constraint-induced movement therapy...

 

Marchalik D, Jurecic A

Jan 2016

 

Samuel Shem's satirical novel House of God (1978) placed a magnifying glass on the callousness of medical training and hospital life. Although he exaggerated the toxic nature of the physician–patient relationship, he captured startling elements of hospital culture, such as physicians' use of phrases like “lol in nad” (little old lady in no apparent distress) and “gomer” (get out of my emergency room)—terms that are still a part of the medical lexicon...

Jurecic A, Marchalik D

Feb 2016

 

When Oliver Sacks died in August, 2015, the medical and literary worlds lost one of their most curious and ebullient interdisciplinary writers, a man who could see the poetry in neuroscience and a role for biography in medical practice. There have been many tributes to Sacks and his career, but more remains to be said about his major contributions to literature in the late 20th and early 21st centuries...

Marchalik D, Jurecic A

Apr 2016

 

In his 2015 New Yorker article, “Gene Hackers”, science writer Michael Specter described the mixture of excitement and uncertainty that followed the successful cloning of Dolly the sheep in 1997: “scores of journalists (including me) descended on Edinburgh, and wrote that the achievement, while wondrous, also carried the ominous implication that scientists had finally pried open Pandora's box”. In Greek mythology, of course, Pandora raised the lid of a jar she was told not to open and released death and other evils into the world. By the time she was able to close the lid, only hope remained inside. In 1997, what was released into the world was the possibility of human cloning...

Jurecic A, Marchalik D

May 2016

 

Physicians who pick up Ian McEwan's The Children Act may be intrigued by its focus on legal cases involving medicine and ethics, but the book is really a character study of High Court judge Fiona Maye. She is a specialist in family law who is bound by the UK's Children Act to hold the welfare of children as her paramount concern. Like many physicians, Fiona grapples with the emotional difficulties of a job that requires making decisions about the lives of others...

Marchalik D, Jurecic A

Jun 2016

 

The art of medicine has always involved a bit of artifice. The Hippocratic Corpus, the original medical code, warned physicians not to reveal poor prognoses to their patients lest they extinguish their hope. Although medical care has continued to advance, the palimpsest of the Hippocratic mandate has remained visible in professional rules of conduct. Thomas Percival, credited with drafting the first code of medical ethics (1803), believed in benevolent lying as a way to instil optimism in patients...

Jurecic A, Marchalik D

Jul 2016

 

Charles Bock's Alice and Oliver opens with a young mother, Alice Culvert, walking down a Manhattan street carrying her infant daughter when a coughing fit brings up blood. Soon she is in a hospital with neutropenic fever and is diagnosed with acute myeloid leukaemia. She decides to endure years of agonising treatments on the chance that she might live to raise her daughter...

Jurecic A, Marchalik D

Aug 2016

 

Emily St John Mandel's novel, Station Eleven, belongs to a long tradition of plague narratives, dating back to Giovanni Boccaccio's Decameron (c 1351), a collection of 100 tales told by ten young Florentines who have fled to a villa outside the city to escape the Black Death. Mandel's contemporary novel opens on a snowy night in early 21st-century Toronto during a performance of William Shakespeare's King Lear. In the fourth act, the actor playing Lear suddenly collapses from what seems to be a heart attack. By the next day, the people of Toronto begin dying in a viral apocalypse...

Jurecic A, Marchalik D

Oct 2016

 

Few stories from neuroscience have grabbed the public imagination more than that of an American amnesiac known in published research only by his initials, HM. In 1953, when Henry Molaison was 27 years old, neurosurgeon William Scoville did a medial temporal lobotomy to alleviate his epilepsy. After the operation, Molaison could no longer form long-term memories. For the next five decades he lived in a perpetual present, while research on his brain transformed the understanding of memory...

Jurecic A, Marchalik D

Dec 2016

 

At the beginning of Paul Kalanithi's memoir, When Breath Becomes Air, he appears to be a doctor at work, scrolling through CT scan images on a hospital computer: “the diagnosis was obvious: the lungs were matted with innumerable tumors, the spine deformed, a full lobe of the liver obliterated”. The story takes an unexpected turn when he adds, “This scan was different: it was my own”. 15 months before the end of his neurosurgery residency, Kalanithi was diagnosed with lung cancer. He died less than 2 years later...

Marchalik D, Jurecic A

Jan 2017

 

The Metamorphosis begins with one transformation already having taken place: Gregor Samsa awakens from a terrible dream to find himself in the shape of a giant insect. His disfigured body, a metaphor for disease or disability, repulses his family. They elect to keep him locked away until he dies in isolation, unrecognisable and useless. In Kafka's short story, the transformations caused by illness do not only affect the sick person, and the real monsters do not always appear monstrous...

Marchalik D, Jurecic A

Jan 2017

 

The Metamorphosis begins with one transformation already having taken place: Gregor Samsa awakens from a terrible dream to find himself in the shape of a giant insect. His disfigured body, a metaphor for disease or disability, repulses his family. They elect to keep him locked away until he dies in isolation, unrecognisable and useless. In Kafka's short story, the transformations caused by illness do not only affect the sick person, and the real monsters do not always appear monstrous...

Marchalik D, Jurecic A

Mar 2017

 

In his 2003 interview with Rolling Stone, Steve Jobs, the co-founder and former CEO of Apple Inc, praised the digital revolution by remarking that technology has “brought the world a lot closer together, and will continue to do that”; but he also warned that, “there are downsides to everything; there are unintended consequences to everything”.

In recent decades, technology has transformed medical research, diagnosis, and treatment in extraordinary ways. Amid so many successes, it may seem strange to focus on the “downsides”. Yet on occasion, it is worth casting a critical eye on medicine’s use of technology and the potential unanticipated effects...

Jurecic A, Marchalik D

Apr 2017

 

Christine Montross wrote her first memoir, Body of Work: Meditations on Mortality from the Human Anatomy Lab, when she was still a medical student. In it she described the process of dissecting a cadaver with a poet's attention to detail and metaphor. When her female cadaver inexplicably lacked an umbilicus, for example, she and her lab partners named her Eve. Anatomy lab became for her, as for many medical students, an initiation into the complicated emotional work of being a doctor. She learned to contain her emotions without becoming indifferent...

Jurecic A, Marchalik D

May 2017

 

Mend the Living begins with the steady beat of 20-year-old Simon Limbeau's heart as he rouses himself before dawn for a surfing trip with friends. The early pages of this novel by French writer Maylis de Kerangal celebrate Simon's physical vigour and his emotional exuberance—his heart, both literal and figurative. De Kerangal describes him slipping onto the back of his first wave: he is euphoric, able “to grasp the whole explosion of his own existence, and to conciliate himself with the elements, to integrate himself into the living”...

Jurecic A, Marchalik D

Jun 2017

 

In 2018, Mary Shelley's Frankenstein: or the Modern Prometheus will turn 200 years old. Shelley published the novel in 1818, 2 years after she began to write it during a visit to Lake Geneva with the poets Percy Bysshe Shelley and Lord Byron and the physician-writer John Polidori. The weather was unusually cold and wet, and after days of rain confined them to the house, they amused themselves by competing to write the best horror story. The 18-year-old Mary Shelley had prodigious competition; Polidori would publish The Vampyre in 1819....

Marchalik D, Jurecic A

Jul 2017

 

The world of medicine is often defined by the tragedy of illness that can be unexpected or long anticipated. In some cases, when a diagnosis is certain, there are clear explanations; yet often there are not. For many patients and families, it is such unexplained tragedies that can be the hardest to reconcile...

Jurecic A, Marchalik D

Sept 2017

 

Roxane Gay's Hunger: A Memoir of (My) Body is about obesity, but it is nothing like those books that celebrate more typical memoirs about the triumph of will over waist size. Gay writes instead about how, why, and when she became “super morbidly obese”, while also criticising conventional attitudes about weight. 

Marchalik D, Jurecic A

Mar 2018

 

In January, 2018, UK Prime Minister Theresa May appointed a ministerial lead on loneliness “to address the loneliness endured by the elderly, by carers, by those who have lost loved ones—people who have no one to talk to or share their thoughts and experiences with”. Social psychologist Jean Twenge offers a different perspective on modern loneliness for a generation that has grown up staring at digital screens. This generation, she argues, is “on the brink of the worst mental-health crisis in decades [and] much of this deterioration can be traced to their phones”. Are we all—young and old—more alone than ever?

Khullar D, Marchalik D

Feb 2019

In science, we tend to hail solitary geniuses. Often, however, scientific breakthroughs are born not of individual insight but synergistic collaboration. Sometimes one stands on the shoulders of giants. Sometimes, the giants sit in the cubicle next to you. Or, as Michael Lewis writes in his 2016 book The Undoing Project, in the same room: door closed, lost in conversation, laughter spilling into the hallway.

Lewis chronicles the deep, curious, and ultimately fraught friendship between two Israeli psychologists — Daniel Kahneman and Amos Tversky.