Doctors and Other Casualties (review)

Abstract

Book Reviews 319 red as Milwaukie, & some of the light sandstone found in St. Louis. ... There is a pretty park in the central part of the town which is shaded by large trees. Squirrels may be seen running about in them. The principal street is paved with wooden blocks which, having been recently put down, look neat. (p. 97) After his stint as a contract surgeon, Lauderdale returned to New York for duty at Bellevue Hospital and Blackwell's Island, an alms house. He wrote to his sister describing the draft riots in that city in July 1863. Peter Josyph's introduction to this section brings the reader to Lauderdale's later life, his enlistment in the army in 1866, and his duty station in Utah among Mormons, whom he disliked. Throughout these years, the devoted brother shared his experiences in detail with his sister in regular letters. The letters from the D.A. January, however, remain the treasure of the larger collection. The Wounded River is an important work. It shows the significance of the titanic struggle waged in the West during the American Civil War. —Cynthia De Haven Pitcock University of Arkansas Campus for the Medical Sciences Stewart Massad, Doctors and Other Casualties. New York: Warner Books, Inc., 1993. 325 pp. Clothbound, $18.95. Doctors deal with pain and suffering, with the idea of making things better. Doctors, especially during their training, are subjected to pain and suffering in the systems in which they work, systems that reward assertiveness, comparison, and competition. In hierarchical, power-over medical systems, doctors are elevated to positions of power based less on skills at being human than on publications and the competitive drives and inherent aggressiveness this fosters. Reward assertiveness, comparison, and competition, and you also reward those individuals who further dehumanize medicine. Despite the best intentions , few doctors try to make things better, either for doctors in general or for doctors in training. If they do have that intent, they do not know how to change things. 320 BOOK REVIEWS Under such conditions, the vision of healing gets dim. And those who are dedicated to healing suffer, and often leave for more human venues. This conflict has spawned countless volumes of "internship" fiction. A fine addition is Steward Massad's first book, a series of stories about the aptly named "casualties" in the title. Dr. Massad is an obstetrician and gynecologist now working in Chicago. His personal growth toward becoming a casualty took him from upstate New York to the South and then to the Midwest. Along the way, he has kept his vision of healing and struggle and service to humanity alive in his life and in these stories. "Dreams of a Doctor's Wife" is written as a first-person narration told by a woman, a daring conceit that mostly works. She is a wife of an obstetrician who is so busy he can't even be there when she delivers their first child. With her mother to coach her breathing, the baby finally comes: I took a slow breath in and bore down. Very slowly, very gently, my body turned itself inside out, and my world turned to crystal. The baby was pink, smeared with blood and shiny with fluid. It wrinkled up its nose and cried. I dropped back again, exhausted. "I'll be God damned," said a voice in my ear. "That kid's so ugly it's got to be mine." I twisted around. "Yeah," he said, in answer to the question on my face, "it's me. Late again, but better that than never." "Damn you," I whispered, and kissed my husband's hand. "Is it all right?" I asked him. "She's a girl. Otherwise she looks fine." (p. 15) This early scene sets a theme for the book—the main character in many of these stories is a hard-seeming, overworked resident in obstetrics who wants to have a love relationship with his wife—and sometimes girlfriend—but who turns out to be an exhausted, miserable, selfcentered wretch with little idea how to connect and grow in relationship . The best that several of these characters can do is to admit "I'm crazy...