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In
Print Sherwin
B. Nuland '55MD "Each of our internal organs has a personality of its own, and a mythology too," writes Sherwin B. Nuland, clinical professor of surgery, and in his latest exploration of the inner workings of the human body, the author of the National Book Award-winning How We Die deftly melds scenes from the operating room with a history of medicine and ideas. The result should satisfy fans of ER and Chicago Hope as well as readers interested in the development of the science of healing. In what has become a Nuland trademark, the surgeon opens many of his chapters with an account of a memorable operation he participated in, such as the removal of a bizarre growth in an infant's stomach -- it turned out to be wax -- and the correction of a heart valve defect with a fingertip, a procedure "where a single maneuver might either cure or kill a patient, all within a period of a few seconds." Especially gripping is his story about an emergency liver surgery, the successful outcome of which he attributed to "dumb luck." Chance might only favor the prepared mind, as Louis Pasteur once noted, but nothing in Nuland's education and experience prepared him for what he confronted in 1961 when he opened up a patient injured in a car crash. The surgeon confronted a liver so badly lacerated that he and his assistant felt they had no choice but to remove the torn section. The problem, said Nuland, "was that we did not know how . . . I would have to make up the operation as I went along." It was a race against time. It was a race against ignorance, for liver surgery was then in its infancy. But Nuland's patient had "dumb luck" on her side, for the traffic accident that injured her liver had torn it in a way that provided a "road map" which suggested how to remove the damaged section. "Without the guidance of luck, I might have become irretrievably lost in the complex network of vessels and ducts within the liver's substance, and been unable to extricate myself and my patient," he said. Nuland then uses these operating room tales as an introduction to how such organs as the stomach, liver, spleen, heart, and uterus function, and to how we've managed over time to come by our knowledge. The theories and discoveries of such important figures as Galen, Empedocles, Paracelsus, William Harvey, Jean Baptiste van Helmont, and others are well represented, and many of the details about older beliefs about the body -- the connection between the "wanderings" of the uterus and hysteria, or the notion that removing one's spleen improved running speed, among them -- are fascinating. Through this history, Nuland shows the rise of the scientific method. "A single word embodies the entire foundation of Western medicine," he notes. "That word is see." But while this story represents the triumph of science, Nuland is careful not to reject the role of the ineffable in healing. "The red body paint and extravagant headdress of the primitive healer have been replaced with the white coat and the rattles and rods with the stethoscope," he writes. "Until recently, the doctor was a magician. He is one still."
William
Sloane Coffin '49, '56BD The profusion of "Big Tasks To Do" lists would seem to indicate that people are thinking about achieving monumental goals in the Year 2000 and beyond, but the Reverend William Sloane Coffin is not quite so optimistic. "Everyone is in danger of succumbing to what de Tocqueville called 'paltriness of aim,'" says Coffin. As an antidote, the feisty preacher, his 1960s-style passion and beliefs untouched by either age or complacency, presents a collection of speeches and sermons that address some of the most pressing issues among humanity's unfinished business. Just as one can't judge a book by its cover, so should a reader avoid assessing a volume by its size. In a mere 81 pages, Coffin offers, with eloquence and good humor, plenty to chew on -- "an abundance of wisdom in an economy of words." Typical is a speech Coffin delivered at the 1996 inauguration of the president of Ripon College in Wisconsin in which he considered "The Spiritual and the Secular: Can They Meet?" Arguing in the affirmative, Coffin noted that "most churches and colleges in this country were once wed. Then most got divorced, the colleges pleading mental cruelty. But apart, they're not faring well. The religious communities -- Jews, Moslems, Christians -- need the intellectual rigor of the academic community, while many college professors and students are perishing alive for want of spiritual nourishment." Nowhere, however, is there a suggestion that we return to some mythical version of the "good old days." Rather, Coffin, moved no doubt by the Biblical dictum to beat swords into plowshares, calls on both warring camps to get together, talk, and learn. "For the sake of the planet as for that of honest scholarship, wonder/reverence and knowledge must find each other, re-wed, and stay married," he says. Whether Coffin is considering "The Politics of Compassion," homophobia, "The Authority of the Bible," self-righteousness, war, or "Civility, Democracy, and Multiculturalism," there's a strong appeal to form new kinds of communities. "Caring, I believe, is what civility is all about," he explains. "If we reunite freedom and virtue by caring ceaselessly for one another, for our multicultural communities, nation, and planet. then our democracy, presently stalled, will once again feel the advance of hope." U.S. democracy will also be able to get on with its most important millennial task. In the last century, "we Americans have created a world for some of us," says Coffin. "It's time to create one for all of us."
Leonard
Barkan '71PhD Glenn
Fleishman '90
and Jeff Carlson, with Neil Robertson and Agen Schmitz Archer
Mayor '73 Sally
M. Promey '78MDiv Kim
Sichel '86PhD Jonathan
Spence '65PhD, Sterling Professor
of History
Nicholas
Christakis '84 F. J.
Chu '77 John
R. Hall '68, with Philip D. Schuyler and Sylvaine Trinh Jeff
A. Johnson '74 Max
Page '88, Lecturer in History Martin
Shubik, the Seymour H. Knox Professor of Mathematical Institutional
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Yale
Alumni Magazine, PO Box 1905, New Haven, CT 06509-1905. USA.
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