2017 L&H DISCUSSION SCHEDULE - Facilitator Notes

Book: The Door by Magda Szabo

Facilitator: Mark Matheson, D.Phil.

Magda Szabo’s novel The Door is set in post-war Hungary. Szabo published the novel in 1987, and she died at 90 in 2007. The central relationship in this autobiographical novel is between a successful writer (the narrator) and her housekeeper, Emerence. The two women have a complicated life together over a period of twenty years. We might expect that much attention would be paid to the Soviet-bloc communism of the period, but more relevant contexts are Eastern-European Christianity, which the narrator embraces and Emerence rejects, and ancient Greek epic and myth, which influence the narrator’s perceptions in general and her specific attempts to understand Emerence. Medicine enters the story: in the latter part of the novel Emerence is hospitalized, and the doctors and those who know her attempt to deal with the difficult issues she raises as a patient. One is her right to choose death, which she fiercely maintains, and this issue leads to an estrangement between her and the narrator. These two women characters are very different but somehow deeply bonded, and the novel explores the many contrasts they represent, including the folkloric past with modern consciousness and a mythic (even heroic) sensibility with everyday domesticity and practical civic-mindedness. The narrator asserts that the bond she has with Emerence is one of love, and the novel is a sustained exploration of authenticity in human relationships both “official” and personal.  

Book: Becoming Nicole by Emily Ellis Nutt

Facilitator: Rachel Borup, PhD

Wayne and Kelly Maines adopted identical twin boys and named them Wyatt and Jonas, but from the very beginning, it was clear to everyone that one of the twins was markedly different from the other.   Almost as soon as he could talk, Wyatt was insisting he was a girl stuck in the body of a boy.  Becoming Nicole:  The Transformation of an American Family is a moving account of a transgender girl’s coming of age and her conservative, blue collar family’s struggle to first accept her identity and then champion it in a landmark court case.  Pulitzer Prize-winning author, Amy Ellis Nutt takes readers inside the lives of each of these remarkable people. 

Book: The Gene: An Intimate History by Siddhartha Mukherjee

Facilitator: Rachel Borup, PhD 

 Dr. Siddhartha Mukherjee's 2011 book, The Emperor of All Maladies:  A Biography of Cancer won a Pulitzer Prize and ignited a new generation's passion for cancer research. His 2016 book, The Gene: An Intimate History, generated equal interest in the expansive and controversial field of genetics. Mukherjee impressed many in the University of Utah community with his brilliant and eloquent discussion of the ethical dilemmas in genetics in his 2016 Tanner Lecture on Human Values. Please join us as we dive into The Gene and discuss the questions this book raises about the history and future of genetic research.

Book: When Breath Becomes Air by Paul Kalanithi

Facilitator:  Susan Sample, PhD, MFA

Since its publication in 2016, nine months after the author died, When Breath Becomes Air has remained on The New York Times bestseller list and deservedly so. The memoir by Paul Kalanithi, a 36-year-old neurosurgery chief resident at Stanford University diagnosed with Stage 4 lung cancer, is, in a word, elegant. Kalanithi’s prose is graceful and sophisticated as he writes to understand and make meaning of his transformation from promising doctor to terminal patient. Ever the ambitious scientist, Kalanithi’s discussions of statistics, the application of probability theory to medical practice are equally pleasing in their precision and simplicity. He challenges us as readers to think about the interplay of scientific knowledge and existential authenticity, the role the humanities plays—or can--in the practice of medicine. The popularity of When Breath Becomes Air, according to the neurosurgeon’s widow, Lucy Kalanithi, a general internist at Stanford, is due to “people’s hunger” to talk about the questions Paul raised: “What are we doing to help each other live and die well? What should we be talking about that we’re not?” We can begin, and end, with these questions as well.

Wed, Aug 2

(Please NOTE date change to 1st Wednesday of Month in August)

Book: Benediction by Kent Haruf

Facilitator: Susan Sample, PhD, MFA

Benediction is the final novel in Kent Haruf's trilogy—Plainsong and Eventide, the previous two--set in fictional Holt, Colorado, a small town on the high plains outside Denver. (No need to be familiar with the earlier books.) Often, rural towns are associated with stability and tradition; thought of as places unaffected by time and contemporary trends. Benediction, though, is a novel about change. From the outside world, Berta Mae's granddaughter moves in after her mother dies from breast cancer; she doesn't know her father. A new minister and family are reassigned from Denver where he spoke in support of a gay colleague. Change comes from inside as well when "Dad" Lewis is diagnosed with cancer. Not only are the lives of his wife and daughter affected; so, too, are relationships between neighbors, church members, and the community. Dad's impending death becomes a confluence, bringing people, their memories and their hopes, together.

Haruf, described as "the most muted master in American fiction," takes on large existential questions that arise at the end of life. No answers are given. Yet, the title Benediction--"blessing"—seems like an honest response to the changes the community undergoes. As you read, consider how peace and imperfection, dignity and regret can co-exist. Also, think about the portrayal of Dad Lewis. Does his experience as a hospice patient seem realistic? Would you recommend this novel to a cancer patient, family member, or caregiver? Why or why not?    

Book: Taking Turns by MK Czerwiec

Facilitator: Gretchen Case, PhD

MK Czerwiec’s new graphic memoir Taking Turns: Stories from HIV/AIDS Care Unit 371, uses poignantly hand-drawn pictures and words to share Czerwiec’s experience as a nurse on one of the first hospital wards dedicated to the care of patients caught up in the AIDS epidemic of the late 20th century.   Czerwiec manages to tell not only her own story, but those of many of her co-workers and patients as well, based in large part on oral history interviews.  The graphic, or comic, format used in this book is part of a growing trend in telling stories of health care. 

Book: The Patient Will See You Now by Eric Topal

Facilitator: Mark Matheson, D.Phil.

Eric Topol is a cardiologist, professor of genomics, and director of the Scripps Translational Science Institute in La Jolla, California. He makes large claims and predictions about medicine in his 2015 book The Patient Will See You Now: The Future of Medicine is in Your Hands.   In political terms, Topol believes that medicine is still paternalistic, especially in the doctor-patient relationship, but sees this era coming to an end, a process of change accelerated by the digital revolution. Smartphones and big data mean that patients will be less reliant on doctors, and their independence will continue to increase as new networks of medical information are created. Topol likens hand-held internet access combined with open information systems to the invention of printing in 15^th-century Europe, a technology that helped bring about numerous social and political disruptions. The coming of massive, open, on-line medicine means that patients will be increasingly in charge of their own medical care, including making their own diagnoses. This technological revolution is also rendering traditional medical education obsolete. Topol thus makes many broad assertions about the future of medicine, and the reader is left to evaluate his provocative theses. There should be no shortage of topics for us to take up in our discussion.

Book: A Man Called Ove, by Fredrik Backman

Facilitator: Gretchen Case, PhD

The eponymous protagonist of Frederik Backman’ novel A  Man Called Ove is an apparently cantankerous and unpleasant older man who has a rich life story and is capable of unexpected friendships.  This book explores preconceived notions about aging and death, questioning what is most important to people as they age, and how cultural differences matter at all stages of life.  

Book:The Finest Traditions of My Calling:  One Physician’s Search for the Renewal of Medicine, by Abraham M. Nussbaum 

Facilitator: Susan Sample, PhD, MFA

Abraham Nussbaum adopts a line from the Hippocratic Oath as the epigraph to his memoir: “May I always act so as to preserve the finest traditions of my calling….” It provides a context for the title he chose, The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine. Equally telling, however, are the two words he did not include. In order to reimagine medicine for the twenty-first century, the University of Colorado psychiatrist chooses not “to preserve” traditions. Rather, he critically examines how physicians have been traditionally educated and calls into question recent efforts at reform that he believes have mechanized the practice of medicine. “Call him a medical millennial questioning a past,” writes Abigail Zuger in The New York Times, who finds his writing “stronger for its frequent uncertainty” and “as notable for its process as its conclusions. The reader can actually watch him think.” Nussbaum, chief education officer for Denver Health, thinks a lot about what the role of the physician could be--scientist, technician, author, gardener, witness, and servant—so physicians can better help patients “seek health.” He looks for inspiration to other physician-writers whose work we’ve discussed in recent years, including Abraham Verghese, Paul Farmer, and Victoria Sweet. As you read The Finest Traditions of My Calling, consider how he syntheses ideas to argue that the renewal of medicine can be found in community and cultural spaces where the focus is on human relationships. Is this is even possible?

Wed,
March 8

Book:  Eleven Hours by Pamela Erens

Facilitator: Rachel Borup, PhD

Pamela Erens’ Eleven Hours is a spare, short, and intense novel that takes place in the maternity ward of a New York City hospital.  It is told from alternating points of view:  that of Lore, a woman who shows up at the hospital pregnant and alone, and Franckline, the Haitian maternity nurse who takes care of her and is hiding her own pregnancy.  At first the two women are guarded and suspicious of each other.  But over the harrowing eleven hours of Lore’s labor, they come to trust and admire each other.  The book examines the emotional bonds that can develop between a patient and care provider in the brief, but powerful span of eleven hours.

Wed, February 8 

UU Hosp Large Conf Rm W1220

Book: The Wonder by Emma Donoghue

Facilitator: Gretchen Case, PhD

Emma Donoghue’s novel is based on historical incidents of “Fasting Girls" and set in mid-nineteenth century Ireland, but the central questions of this mystery are quite modern: What happens when religious beliefs and health care practices are at odds? What responsibilities does science have to the investigation of miracles? The complex characters include a child on a tenant farm, apparently surviving for months without eating, and the Florence Nightingale-trained nurse sent to prove that the child is a fraud.

Book: The Warden by Anthony Trollope

Facilitator: Mark Matheson, D. Phil

Anthony Trollope was a prolific Victorian novelist. The Warden, published in 1855, was his first genuine success. In it Trollope tells the story of the Rev. Septimus Harding, a kindly churchman who serves as the warden of a “hospital” or home for the elderly, supported by the English Church, in the cathedral town of Barchester. The quiet of the town is disturbed by the reforming spirit of the mid-nineteenth century, and there is a challenge to the Church’s management of the charitable trust that supports the hospital. Over time, the value of the property included in the trust has increased very considerably, and the annual stipend of the warden has accordingly grown into a handsome sum. Modern reformers believe that these funds should be distributed instead among the twelve old men who live at the hospital, and the case is taken up by a young doctor in the town and the leading national newspaper. The Rev. Harding is vexed by this development, and in his goodness he wants to see the issue and his own conduct from all sides. As the critic Owen Chadwick has said, Trollope’s interest is in “the relationship of the individual to moral conduct when he or she is entangled in the toils of public institutions.” And here is where the Rev. Harding’s case might well be ours: how are we to act and make decisions in the complex institutions in which we live and work, as these institutions undergo the struggle between tradition and reform, engage in allotting large sums of (often public) money to various projects and individuals, and become subject to the scrutiny of a not always well-informed press? Henry James admired The Warden, and he said of it that an authorial “motive more delicate, more slender, more charming, could scarcely be conceived. It is simply the story of an old man’s conscience.” We look forward to discussing the novel with you and finding possible connections between the institutional life of a Victorian hospital and the twenty-first century medical complex.