The British author, Eve Garnett (1900-1991) was born in Worcestershire, England, and had a comfortable, middle-class upbringing. She became inspired to write children’s literature after moving to London in the 1920s for art school and witnessing the stark social division and living conditions of London’s poor.[1] These experiences fueled a lifelong mission to bring attention to poverty and to give children from urban, working-class backgrounds stories that reflected their own lives. Her first book, The Family from One End Street, was published in 1937. It is the first of three books about the Ruggles family, consisting of Mr. Ruggles, a town dustman¹, Mrs. Ruggles, a washerwoman, and their seven children, from teenage Lily Rose to infant William. The subsequent books, Further Adventures of the Family from One End Street (1956) and Holiday at the Dew Drop Inn (1962), take place immediately after the first. Set in the fictional English town of Otwell between WWI and WWII, the series describes the adventures and hardships of the Ruggles family with humor and poignancy. 

In the second book, Further Adventures of the Family from One End Street, a measles outbreak is the inciting event that sets the plot into motion. The eldest, Lily Rose, is the first to be stricken as “her head ached, she felt hot and cold by turns” and then she looks in the mirror to find her face is “bright pink, and covered all over with small red spots!” The doctor is called to their small and crowded home, and he advises Mrs. Ruggles, “You can’t keep her here, you know – nowhere to isolate her and no time to look after her if you had; it’s the isolation hospital for measles these days. I’ll have the ambulance round in half an hour and someone to disinfect that room for you. ‘The others?’ no, they certainly can’t go to school, but don’t you worry, they’ll probably all have it in a few days and be off your hands in the hospital too!” 

Management of measles and other infectious diseases was particularly challenging among the urban poor, who lived in crowded conditions. Because the nine Ruggles live in tight quarters in a “very old and very small” house, the remaining six Ruggles children are at risk for catching measles from Lily Rose.² Infection can also easily spread beyond the Ruggles household to the rest of the neighborhood. To help contain the infection, patients were sent to isolation hospitals, which were standalone institutions dedicated to treating infectious diseases in the pre-antibiotic and pre-vaccine era.  

The evolution of isolation hospitals was shaped by public health efforts throughout the 1800s and the medical acceptance of germ theory by the 1880s. The first fever hospital in England opened in 1801.[2] Early fever hospitals were run as private charities for the poor and featured open-planned rooms where patients suffering from different infections were packed side-by-side. These places were mocked as houses of death because someone admitted with a mild case of one fever could catch an entirely different, fatal infection from the patient in the next bed. Over time, laws established public health funding and regulation for isolation hospitals. The Sanitary Act of 1866 gave local authorities explicit power to provide hospital accommodation for infectious disease, a power consolidated by the Public Health Act of 1875.[3-5] Later, the Isolation Hospitals Act of 1893 empowered county councils to build new isolation hospitals where needed, leading to a national network of specialized isolation hospitals designed in accordance with modern germ theory.[3,6] By WWI, there were more than 750 isolation hospitals in England and Wales.[7] These new isolation hospitals emphasized cleanliness and good ventilation, and featured separate wards for different infections.[7] Thus, when Lily Rose develops measles in the 1930s, the doctor recommends she be admitted to a dedicated measles ward of a modern isolation hospital for quarantine and care.³ 

Hypothetically, if Mrs. Ruggles objected to Lily Rose’s hospital stay, the doctor may not have had a pathway to mandate her admission in the 1930s. The Public Health Act of 1936 gave local health authorities a legal mechanism to apply to a justice of peace, who could then mandate the admission of a patient to an isolation hospital if they had a notifiable disease, home isolation was not possible, and they posed a serious risk of infection to other persons.[8] However, measles did not become a nationally notifiable disease in England and Wales until 1940.[9] Before 1940, it was up to individual towns to make measles notifiable and enforce isolation, and Eve Garnett does not specify if such laws existed in Otwell. 

Despite Lily Rose’s prompt quarantine, her younger siblings Jo and Peg also develop measles and are sent to the isolation hospital. Mrs. Ruggles may have been particularly grateful for the supportive care of isolation hospitals in Jo’s case as “the doctor said Jo was a very sick boy, and told Mrs. Ruggles downstairs it was always worse if the spots stayed in, and the sooner Jo was in the hospital the better!” What the doctor is referring to is that the measles rash typically appears 3-5 days after the first symptoms of fever, cough, coryza⁴, and conjunctivitis; if the rash onset is delayed or “the spots stayed in”, it is a signal that the body is struggling to fight the virus. A late, absent, or weak rash is common in immunocompromised, malnourished, and very young children whose immune systems are not fully developed; these patients are at increased risk for severe systemic complications.[10, 11] While Lily Rose is described as a robust 13-year-old girl who only has a “mild attack”, 7-year-old Jo and 5-year-old Peg suffer more serious attacks and have a longer road to recovery. This is especially true as measles is now known to cause immune amnesia, a condition where the virus depletes patients’ pre-existing antibody repertoire, leaving them vulnerable to other infections for two to three years afterward.[12]  

Upon discharge from the hospital, Peg and Jo have clearly lost weight, are still quite weak, and need further treatment. After a conversation with the doctor, worried Mrs. Ruggles updates her husband, “Peg and Jo’s got to be fed up with malt-and-oil when they comes out, and Jo’s that pulled down, the doctor says as six weeks in the country’ll barely set him up”. The oil the doctor recommends to Mrs. Ruggles is cod liver oil, which transitioned from a folk remedy to a mainstream, multi-purpose medical treatment in the 1800s. However, doctors did not know why some patients benefited from cod liver oil until medical research in the early 1900s discovered vitamins and diseases of vitamin deficiency. Cod liver oil was discovered to contain vitamin A in 1913 and vitamin D in 1922.[13,14] And, as discussed in the first part of this MedHum series, the therapeutic value of treating measles patients with vitamin A was demonstrated in 1932.[15] The high caloric content of cod liver oil also helped with malnourishment. Unsurprisingly, children hated the taste of cod liver oil, so malt-and-oil was developed as a commercial pharmaceutical product in the late 1800s, whereby the fishy oil was mixed with thick, sweet malt extract to make it more palatable. Mrs. Ruggles, who has not tasted the malt-and-oil, puts this mixture to the test when she “hold[s] a spoonful out to” suspicious Jo and coaxes him with hopeful reassurances, “It’s not medicine, nor yet oily – more like soft toffee”. She heaves a sigh a relief when he swallows it without resistance, “Thank Heaven he liked it!” 

By sacrificing their meager savings, Mr. and Mrs. Ruggles are able to follow the doctor’s other recommendation to send Jo and Peg (along with their 12-year-old sister Kate) to stay with Mrs. Wildgoose in countryside for recovery. Throughout the 19^th and early 20^th centuries, sending urban children to the countryside to recover from illness was standard practice; the rationale was plausible in cities plagued by industrial smog, poor sanitation, and overcrowding. When Mrs. Wildgoose meets the children, she says “she could see from the look of Peg and Jo how important [malt-and-oil] was, but mark her words, before the three children had been a week at the Dew Drop Inn, eating the eggs from her ducks and hens, good farm butter, and drinking milk from Mr. Digweed’s cows, they wouldn’t know themselves!” It may be universally agreed upon that eggs and dairy are a more palatable way to consume calories and fat-soluble vitamins than cod liver oil. The children do indeed have a marvelous time at the Dew Drop Inn – their countryside explorations and misadventures make up the core of the book – and they make a full recovery attributed to fresh air, sunshine, exercise, and good food. And when they return home, “How [Mrs. Ruggles] hugged and kissed them all, exclaiming again and again at Peg and Jo’s bright eyes and round, fat, sunburnt faces – so different from the pale, skinny little creatures she had seen off six long weeks ago!” 

Although the book focuses on the children’s perspectives, Mrs. Ruggles’ measles experience is worth acknowledging. She is separated from her children for two stressful months because of measles. She is not allowed to visit them during their weeks in the hospital, as isolation hospitals of the time followed strict quarantine protocols. In fact, the doctor warns Mrs. Ruggles when Lily Rose is first diagnosed, “go down to the hospital this evening if you like but they won’t let you see her.” After Peg and Jo are discharged from the hospital, she sends them to recuperate with Mrs. Wildgoose for six weeks because she cannot afford to take time off of work and she needs to tend to her other four children. No wonder those six weeks felt long, and no wonder she is relieved and overjoyed to see her children healthy again when they return from Dew Drop Inn.  

While the isolation hospital and measles recuperation experience would have been familiar to contemporary readers, it likely feels foreign to readers today. The development of a measles vaccine in 1963 and its implementation in Britain in 1968 – about thirty years after this book is set – dramatically reduced the incidence of measles and contributed to the obsolescence of isolation hospitals.[16] Following the development of highly effective vaccines and antibiotics in the mid-1900s, isolation hospitals were systemically closed or repurposed. Measles was declared eliminated by the World Health Organization in the US in 2000 and in the UK in 2017.[17,18] For a period of time, measles was relegated to a bygone era, just like doctors’ prescriptions for malt-and-oil and country air. However, as vaccination coverage has fallen, measles has returned. The UK lost its measles elimination status for a second time on January 26, 2026, and the US is predicted to follow.[18,19] As a result, Further Adventures of the Family from One End Street is somehow pertinent again in its depiction of measles as a contemporary childhood malady.  

¹ Dustman is a traditional British term for garbage collector, which is considered old-fashioned today. 

² This quote is taken from the first book, The Family from One End Street. 

³ The development of isolation hospitals in the US followed a similar timeframe. In the US, the first isolation hospital was opened in Philadelphia in 1801 following a series of yellow fever epidemics. During the late 19th and early 20th centuries, state statutes across the US codified the mandatory construction of municipal isolation hospitals to control epidemics. Because public health powers are granted to states under the U.S. Constitution’s 10th Amendment, individual towns and state boards of health passed the earliest mandatory measles isolation laws in the late 1800s, and measles became a nationally notifiable disease in 1912. 

⁴ Coryza is the medical term for acute inflammation of the mucous membranes inside the nose, commonly known as a runny nose. It is one of the “three C’s of measles”, a traditional medical mnemonic used to teach medical students the standard early clinical presentation of measles – cough, coryza, and conjunctivitis.  

References 

1. Eve Garnett. Penguin Random House. Accessed September 7, 2026. https://www.penguinrandomhouse.com/authors/9731/eve-garnett/ 
2. Currie MR. Fever Hospitals and Fever Nurses: A British Social History of Fever Nursing: A National Service. Routledge; 2005. Accessed September 7, 2026. https://ndl.ethernet.edu.et/bitstream/123456789/9881/1/1072.pdf 
3. Parsons HF. The Hospital Isolation of Infectious Diseases: I. The History of Isolation. Hospital (Lond 1886). 1913;54(1408):357-358. 
4. Great Britain. The Sanitary Act 1866. legislation.gov.uk. Enacted 1866. Accessed September 7, 2026. https://www.legislation.gov.uk/ukpga/Vict/29-30/90/contents/enacted 
5. Great Britain. Public Health Act 1875. legislation.gov.uk. Enacted 1875. Accessed September 7, 2026. https://www.legislation.gov.uk/ukpga/Vict/38-39/55/contents 
6. Great Britain. Isolation Hospitals Act 1893. legislation.gov.uk. Enacted 1893. Accessed September 7, 2026. https://www.legislation.gov.uk/ukpga/Vict/56-57/68/enacted 
7. Currie MR. Fever Hospitals and Fever Nurses: A British Social History of Fever Nursing: A National Service. Routledge; 2005. Accessed September 7, 2026. https://ndl.ethernet.edu.et/bitstream/123456789/9881/1/1072.pdf 
8. Great Britain. Public Health Act 1936, section 169. legislation.gov.uk. Enacted 1936. Accessed September 7, 2026. https://www.legislation.gov.uk/ukpga/Geo5and1Edw8/26/49/section/169/enacted 
9. Public Health Wales. Measles surveillance and epidemiology. Accessed September 7, 2026. https://phw.nhs.wales/reports/measles-surveillance-and-epidemiology/ 
10. Burrell CJ, Howard CR, Murphy FA. Pathogenesis of virus infections. In: Fenner and White’s Medical Virology. 5th ed. Academic Press; 2017:77-104. doi:10.1016/B978-0-12-375156-0.00007-2 
11. Permar SR, Griffin DE, Letvin NL. Immune containment and consequences of measles virus infection in healthy and immunocompromised individuals. Clin Vaccine Immunol. 2006;13(4):437-443. doi:10.1128/CVI.13.4.437-443.2006 
12. Mina MJ, Kula T, Leng Y, et al. Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens. Science. 2019;366(6465):599-606. doi:10.1126/science.aay6450. 
13. McCollum EV, Davis M. Nutrition classics from The Journal of Biological Chemistry 15:167-175, 1913. The necessity of certain lipins in the diet during growth. Nutr Rev. 1973;31(9):280-281. doi:10.1111/j.1753-4887.1973.tb07065.x 
14. McCollum EV, Simmonds N, Becker JE, Shipley PG. Nutrition classics. The Journal of Biological Chemistry 53:293-312, 1922. Studies on experimental rickets. XXI. An experimental demonstration of the existence of a vitamin which promotes calcium deposition. Nutr Rev. 1973;31(5):158-161. doi:10.1111/j.1753-4887.1973.tb05090.x 
15. Ellison JB. Intensive vitamin therapy in measles. Br Med J. 1932;2(3745):708-711. doi:10.1136/bmj.2.3745.708 
16. Sutherland I, Fayers PM. Effect of measles vaccination on incidence of measles in the community. Br Med J. 1971;1(5751):698-702. doi:10.1136/bmj.1.5751.698 
17. Centers for Disease Control and Prevention. History of measles. Updated April 29, 2026. Accessed September 7, 2026. https://www.cdc.gov/measles/about/history.html 
18. Taylor L. UK loses its measles elimination status. BMJ. 2026;392:s172. doi:10.1136/bmj.s172 
19. Bischops AC, Hulland EN, Patzakis M, Majumder MS. Will the USA lose its measles elimination status? Lancet. 2026;407(10540):1679-1681. doi:10.1016/S0140-6736(26)00466-6

Further Adventures of the Family from One End Street 
Eve Garnett 
Puffin Books, 1993. Paperback. 256 pages 
Originally published 1956 

Web image generated by Medhum.org based on the original book cover.

At the height of the HIV/AIDS epidemic, on Nov. 30, 1993, Larry Kramer, the late writer and gay rights activist, sparred with Anthony Fauci, then director of the National Institute of Allergy and Infectious Diseases, on a C-SPAN call-in program over the Clinton administration’s response to the crisis. Journalist Steve Scully moderated the conversation, also taking calls from civilians whose questions and comments revealed varying levels of understanding of the disease and compassion for those living with it and their loved ones. 

Daniel Fish’s Kramer/Fauci offers a verbatim staging of this conversation, starring Thomas Jay Ryan as Kramer, Will Brill as Fauci, Greig Sargeant as Scully, and Jennifer Seastone as the various callers. All four listen to the C-SPAN recording through in-ear speakers. 

Kramer casts Fauci as the face of an indifferent bureaucracy committing a genocide by inaction. “Tony, if you start that business about, ‘Science isn’t done that way,’” he says, “I’m going to come down there and slap your face.” 

“All right, Larry, hang on for a sec,” replies the career public servant. “I love you, Larry.” 

They are equal parts allies and antagonists, their genuine affection bubbling through their disagreements and making their complicated relationship [1] especially compelling to watch. What I found less compelling was the machine that releases a tidal wave of bubbles, enveloping Kramer. At one point, Fauci lies near the foam in a Titanic-style “draw me like one of your French girls” pose. If the suds are meant to represent lives lost to AIDS, this image risks reducing an enormous human toll to a theatrical flourish; the absurdism does little to illuminate the government’s inadequate response. Seastone dons roller skates at one point and an inflatable chicken suit at another. Are these props meant to suggest that the titular characters are skating past each other? Playing some game of chicken? 

I am still glad I saw the hour-long production. It offers a different experience from watching Fauci sit in a studio or Kramer appear via video screen. The actors roam in the cavernous venue, putting the audience physically inside the conversation. But there is more to theater than the theater itself or theatricality for its own sake—than paltry props and a bevy of bubbles. 

Kramer indicates that, despite Fauci’s diplomatic, controlled persona, he is privately frustrated by the political and bureaucratic constraints holding back AIDS research. What if we had seen imaginings of Fauci’s anger behind closed doors? What if we had witnessed how the men’s relationship evolved—how Fauci began working with AIDS Coalition to Unleash Power, co-founded by Kramer, to expand access to life-saving experimental treatments, or how Kramer later shouted at a government hearing, “Tony, I have called you a murderer in the past, but you are now my hero”? 

What if the production had used its visual language to evoke the toll of the epidemic rather than providing sporadic spectacle? Panels from the AIDS Memorial Quilt. Stories of the 700,000 Americans who died. The more than 1 million Americans living with HIV today, with Black and Hispanic/Latino Americans and men who have sex with men among those disproportionately affected. 

Otherwise, Fish risks reducing AIDS to a metaphor for COVID-19 and its fallout. Kramer/Fauci should not be relevant only because COVID-19 has reshaped the public’s relationship with science, or because Fauci, three decades later, has once again been called on to defend his work during a plague. It should be relevant because the history it depicts remains unfinished. 

C-SPAN recording of the Kramer/Fauci call-in show  

Fauci remembers Kramer 

[1] Fauci, Anthony. “Anthony Fauci on Larry Kramer and Loving Difficult People.” The New York Times, 4 July 2023, https://www.nytimes.com/2023/07/04/opinion/anthony-fauci-larry-kramer.html.  

Web image generated by Medhum.org

The book has a Biblical quality. The story unfolds in present day Australia, but the atmosphere is ancient and premodern. Wood incorporates a frightening plague of mice who infiltrate every element of the women’s home and terrify the nuns. Also, a woman who knew the narrator in high school and who was the victim of a horrifying adolescent gang attack surfaces unexpectedly. She is now a famous nun charged with returning the bones of a murdered sister to the community for burial. Her sudden appearance unsettles everyone. It all sounds like “A Children’s Bible” by Lydia Millet. But it is unmistakably a tale of adults living today in a world that we recognize. These mythical events play out in the setting of grounded people caught up in regular everyday challenges and missteps – miscommunication between couples, adolescent conflicts, failing to realize unintended slights, evenings spent comforting ill friends. The narrator is surrounded by nuns, neighbors, and friends whose activities and conversation are routine. Against this backdrop, her voice sounds timeless and prophetic.

This is an extraordinary book. It is not an easy read but a rewarding one that would be meaningful to any doctor trying to become a better care provider. For example, there is an intense effort underway to incorporate quantitative rigor into medical practice. With that as the point of departure, absent evidence to support one treatment over another, it might seem that restraint would be the best path for a doctor to follow. But illness calls for action. And if doctors are honest, they will acknowledge that errors are made in the course of action that they choose. Patients can be injured and their deepest hopes may be ignored. There is plenty of room for misunderstanding and hurt in both directions — patient to doctor, doctor to patient. How does a thoughtful, mature doctor manage this inescapable burden?

Wood’s novel speaks to doctors who have to address mistakes and conflicts every day in their practice. The setting is religious, but the scope is human. She does not offer an evidence-based one-size-fits-all solution to the chaos of life. The interdependency of people and the connectedness of people and nature are central features of the book and key to its emotional integrity. With that backdrop, she has created a narrative that sensitively details the burden of pain and despair when people cannot get past these challenges. This is balanced by the serenity that is achieved when people honestly confront their mistakes and receive forgiveness for misdeeds. The individual stories in the novel vary and the outcomes differ. The endings are often imperfect and reflect our human limitations. But there are moments of deep connection between characters, a willingness to accept how life played out. The feelings that are created are real and genuine. And they speak to doctors.

This is the season in the Jewish annual calendar when one is commanded to take stock of one’s life and conduct. The underlying theme is atonement, to frankly acknowledge personal flaws and misdeeds and seek forgiveness from that one has hurt. The religious framework is an opportunity to address mistakes of the past and map a path to a healthier more moral future. Ideally, it builds on true memory to create a new future history for our personhood. I would recommend Wood’s book as a human companion text to traditional Jewish prayer books. It is a challenging read, unsettling in its directness, and implacable in its honesty. It is an irreplaceable guide to genuine forgiveness, acceptance, and compassion, whether or not you are a doctor, regardless of your faith.

Stone Yard Devotional
Charlotte Wood 
Riverhead Books, 2023, 293 pp 

Web image generated using the original book cover.

In Christopher Nolan’s adaptation of The Odyssey (2026), this entire sequence is conspicuously absent. Waking up on the beach, Matt Damon’s Odysseus only sees Athena, played by Zendaya. Zendaya’s Athena reappears at times in the story, watchful and from afar, such as during conversations. On the beach, Athena is seen in the distance, and Odysseus is stoic. There is no court of Alcinous. Athena’s inclusion also stands out against the rest of the film in that she is the only god personified. As has been criticized by Emily Wilson, the translator of the popular 2020 translation of The Odyssey that Nolan took inspiration from, it is a godless film ¹. Rather, the gods are often vaguely referenced in terms of evoking natural phenomena (e.g., the storms in the distance representing Zeus). So why then does Athena appear time and time again, wordlessly watching?

To understand Athena’s role in the film, it is useful to return to earlier interpretations of the poem. The story of The Odyssey is many things, not the least of which is a story of post-traumatic stress disorder (PTSD). Jonathan Shay’s (2002) Odysseus in America: Combat Trauma and the Trials of Homecoming has most authoritatively used the original text as a framework to understand the poem through the lens of PTSD. Shay argues that Odysseus’ mistrust, lying, explosive violence, and emotional concealment mirror the real-world symptoms seen in combat veterans. He further argues that unlike Odysseus, for whom the titular odyssey of 10 years acts to process his trauma, modern soldiers go from the battlefield to civilian life via a quick plane ride, removing the ability to process trauma. Yet, Nolan’s film refines this allegorical parallel to PTSD beyond the original poem. Many of these qualities Shay touches upon, including the mistrust, lying, and emotional concealment, have been stripped from Odysseus in Nolan’s version, rendering him an “uncomplicated man,” per Emily Wilson. Yet, a new trait, core to PTSD, is introduced: avoidance.

Understanding Nolan’s The Odyssey as allegorical for PTSD fundamentally alters how several scenes are read. For much of its runtime, it feels far removed from the commentary on PTSD of the original poem; Odysseus seems unbothered by the passage of time. Contrarily, it also diverges from the poem in directly calling attention to Odysseus’ role in the Trojan War, which remains relatively implicit in the original poem. The film’s third act reconciles this contradiction by rendering the film’s past events as an exercise in avoidance of trauma. It is only in the finale of the film that the function of these visions of Athena is revealed. Odysseus finally tells the story of his sacking of Troy, and in it, the desecration of a statue of Athena is juxtaposed with the execution of an innocent Trojan, played by Zendaya. This parallel invokes Quran 5:32 (“Whoever kills a soul unless for a soul or for corruption . . . he had slain mankind entirely”) and other religious traditions holding that to kill an innocent is equivalent to killing a god. Simultaneously, it recontextualizes the recurrent appearances of Athena across the film as a type of living embodiment of the guilt that Odysseus holds with him. Athena never intervenes in the film as gods do in Homer’s original poem; rather, she watches, materializing at exactly the moments Odysseus would otherwise be flooded by memory of Troy. This parallels the sense of being watched that trauma survivors describe (Sims & Sims, 1998). While in Homer’s original poem Odysseus breaks down in recounting his journey, in Nolan’s film, instead, he remains stoic while seeing Athena in the distance, avoiding the memories of the war.

So, returning to Book 6 of The Odyssey, Odysseus cries on the beach, overcome by trauma. But in the film, something just as characteristic of PTSD occurs. Odysseus sees Athena, analogous to the innocents he killed in the Trojan War, and he looks away. He avoids reckoning with the regret that comes with such a vision. In Nolan’s The Odyssey, no gods remain to offer Odysseus solace from PTSD. Rather, Athena, the only god that remains, serves only as a reminder for him of his combat trauma.

Footnote:
1, https://www.lrb.co.uk/the-paper/v48/n14/emily-wilson/an-uncomplicated-man

References:
Shay, J. (with Internet Archive). (2002). Odysseus in America: Combat trauma and the trials of homecoming. New York : Scribner. http://archive.org/details/odysseusinameric0000shay

Sims, A., & Sims, D. (1998). The Phenomenology of Post-Traumatic Stress Disorder: A Symptomatic Study of 70 Victims of Psychological Trauma. Psychopathology, 31(2), 96–112. https://doi.org/10.1159/000029029

The Odyssey
Director: Christopher Nolan
Universal Pictures, 2026: RT 2hr 52 min
Web photo courteous of Universal Pictures

Felix is a gifted director at an Ontario theatre festival. He plans an exciting new interpretation of The Tempest but is unfairly ousted from his beloved position by a jealous and inadequate rival. Worse, he is haunted by grief over the loss of his daughter, Miranda who died twelve years ago. 

Struggling financially, he accepts a low-paying position to promote literacy in a local prison—and hits upon the idea of using his newfound but incarcerated protégés to mount his long-planned Tempest. The project encounters financial difficulties that begin to seem insurmountable, as his hostile rival assumes an influential government position. 

Moments of hilarity abound. For example, Felix convinces hardened criminals that they might crave and compete to portray such unlikely roles as the ethereal sprite, Ariel, or even the enslaved, monster, Caliban (Hag-seed), with whom the prisoners feel a special connection. Felix forbids swearing, except those oaths used by Shakespeare and the prisoners delight in creating a glossary of antiquated expletives, which they apply to everyday life. The “Correctional Players” embrace digital technologies, and choreography and plan to video their performance. Bringing a meaningful project to his initially uncomprehending, new friends becomes a reward in itself, inviting him to reconsider and move beyond his previous losses.

The result exceeds all expectations, helps to heal his grief, and with its unorthodox staging provides a delicious revenge. 

Hag-Seed
Margaret Atwood 
Penguin Random House, 2017: 320 pages 

AI image created with prompts by MedHum.

Literally thousands of books have been written about Pompeii, scholarly tomes and novels, from Edward Bulwer-Lytton to Robert Harris. It has also inspired operas, fictional movies, documentaries, and entrepreneurial tours. Does the world need yet another book about Pompeii? The answer is “Yes!”

The Buried City is the elegantly translated and beautifully illustrated work, originally published in German, written by the site’s most recent director. Born in 1981, educated in classical studies at Berlin’s Humboldt University, Zuchtriegel came to Pompeii in 2021 from his position, further south, at the UNESCO World Heritage Site of Paestum. His selection benefited from a 2015 change in Italian regulations that finally allowed foreigners to take up prestigious museum jobs. That did not stop 140 professors and curators signing a petition against his appointment – too young, too inexperienced, they claimed. One wonders if they also objected to his German nationality. (Since 2023, the regulation change is being walked back under the right-wing Meloni government.) But Zuchtriegel does not tell us that miserable story until near the end of his book, more with bemusement than rancor.

Some of Zuchtriegel’s critics complain that his enthusiasm for communicating the archeological finds to a wider public is facile popularizing; and they fret over his desire to grant greater access to the sites for risking damage to ancient stones or injury to visitors. He believes that if the public purse supports digging into the past though archeological endeavor, then the public deserves to know, understand, and contemplate the findings in a way that allows for human connection. That agenda welcomes the multidisciplinary approach to interpretation that goes beyond the bare findings of stones and bones to include written sources and the technological traditions of farming, cooking, and building.

His book is a captivating blend of history, guide, and memoir. Each chapter explores the interpretation of a recent discovery that evokes life in those fateful days and connects it to our own reality. A series of frescoes brings alive Roman interpretations of Greek myths. The small size of dwellings invites a reconsideration (upwards) of estimates of the city’s population and the vast number of casualties. A slave bedroom speaks of the fear and daily suffering of those who were unable to flee. A pre-eruption grave with an intact skeleton challenges assumptions about changing burial and religious practices. The looting of the site in the immediate aftermath of the disaster made an impact on what is found and not found now.

Pompeii reminds us that mass casualties are a terrifying yet constant feature of human existence. Wikipedia offers a list of natural disasters by chronology and death toll. Volcanoes, earthquakes, tornados, and tsunamis cannot be prevented, but now many can be predicted, warnings provided, relief prepared. But other “unnatural” disasters result from deliberate human action, especially in war; a disturbing realization that led two doctors – a Russian (Evgeny Chazov) and an American (Bernard Lown) — to create the International Physicians for the Prevention of Nuclear War. They reasoned that medicine could do nothing faced with the mass casualties of an atomic bomb; medicine must therefore prevent it.

Humanity is also responsible for climate change. As I write, Nepal is grappling with a sudden flash flood that has suffocated several villages with thousands missing and dead, buried in dense mud and clay, just as the victims of Pompeii were entombed in volcanic rock. Will the lost eventually be recovered as plaster casts in some remote archeological future? Could this disaster have been predicted and lives saved, as some are now suggesting? And in connecting the horror of two thousand years ago to our own time, will we use our growing understanding of those brutally arrested lives to fully embrace our responsibility to adapt to and restore the waning health of our planet?

The Buried City: Unearthing the Real Pompeii
Gabriel Zuchtriegl
Translated by Jamie Bulloch, University of Chicago Press, 2025. 

Destruction of Pompeii and Herculaneum from Wiki Commons

I learned of Lawlor’s book in an engaging essay in a recent issue of The New Yorker. She is Henry Waldgrave Stuart Professor of Philosophy at Stanford University. The review was intriguing and a book only 213 pages long sounded plausible. I am here to confirm that it is a beautifully written book, one that does not pull punches and that does not hide behind academic terminology. It is of the moment and I hope it gets wide circulation and readership.

Let me explain why. The force driving Lawlor’s book is to analyze the relationship between rational and reasonable thinking and to make the case for restoring value and prestige to the second cognitive style. Lawlor addresses the difference in multiple contexts – in law, in personal identity, and social values. Rational man has had several names including Homo economicus and has been studied in clever models such as the response to the Prisoner’s Dilemma (read the book for details). She points out that greater emphasis was traditionally placed on being rational, namely, making intellectually valid decisions about ourselves and the world around us. Reasonableness was dismissed as a lesser virtue, one that was poorly defined and incapable of promoting good behavior.

The book is rich in stories. Lawlor starts the book with a court case that occurred in Louisiana in 1992. A 16-year old Japanese exchange student was invited to a Halloween party but unfortunately went to the wrong house. After a confused and ominous exchange with the owner, even though the student started walking away from the door, the owner of the house became anxious for his safety and well-being and fatally shot the student. A criminal jury acquitted the homeowner and considered the shooting a reasonable response to a perceived threat to life. A driver in Ohio is issued a summons for exceeding 85 miles per hour in his vehicle, above the reasonable limit. Governor Pataki and Mayor Guliani argued whether it was reasonable for the mayor to violate the standing law and run again as a candidate for another time after the September 11^th attack.

Lawlor’s book begins with the standard view, namely that a rational person is “logical, smart, and unemotional” while a reasonable person is “honest, kind, and fair.” But her central thesis is that this characterization overstates the value of rationality and misrepresents the importance of reasonableness to meaningful interpersonal interactions and the stable function of society. She assembles a wide selection of psychological data and real and theoretical circumstances to redefine the meaning of reasonableness and to identify its key components. She makes a compelling case that to be reasonable means to be sensitive to the needs and views of others, be willing to recalibrate one’s own view in response to the concerns of others, and to be willing to change your course of action if pressed by someone who thinks differently from you. These are not features that are generally invoked when describing a rational person and she makes the claim that this indicates that reasonableness is more important than rationality in grounding society.

The link to the current political environment is clear and acknowledged. Without mentioning any names, Lawlor vividly chronicles how loss of reasonableness is the underlying defining feature in our polarized argumentative world. The fact that political parties articulate programs that fail to account for the needs of the other and the inability to acknowledge any value to the views of others are signs of rampant unreasonableness. It is unclear whether reasonableness has a biological basis and whether it was favored by evolution. But anyone reading the news or monitoring the policy objectives of the current administration cannot escape the notion that reasonableness is a “misunderstood” and clearly undervalued virtue.

One gap in Lawlor’s narrative is medicine. She does not have a chapter on reasonableness in patient care. To me this is an area in need of attention. A case can be made that the movement towards evidence-based medicine is a move to incorporate more rationality into medical care. To be sure, incorporation of the patient voice and patient-related outcomes in the assessment of treatment efficacy is a sign of attention to the other and recognition of the need for reasonableness. But I fear that this information may be prone to quantitative analysis that undermines a genuine commitment to listen to the patient and treat that person on their own individual terms. Clinical research is urgently needed to learn whether exciting novel therapies are being utilized in a reasonable way, namely with genuine attention to the needs of the patient, a willingness to change the plan if the clinical course does not meet expectations, and a realization that medical care is just one component in the total scope of social wellbeing. That research team would be wise to include Lawlor as a consultant.

In closing, books often have an impact because they are read by a receptive reader at just the right moment time. In the beginning of May, I was on vacation with my wife. After a day biking and hiking, I accidentally fell and suffered a head injury. I lost consciousness for two days and needed to be hospitalized in an unfamiliar place for six days. On my return to New York, I was cared for by wonderful people and I think, or should I say I hope, that I am getting back to “normal.” But one thing was clear to me. I am not sure how I usually think and behave but over the last two months, I am sure I was not as reasonable as I should be. But one good and reasonable decision I made was to read this book. It has helped me appreciate what I lost and offered guidance about what I should pay attention to as I get back to myself. I cannot think of higher praise for any philosophy book.

Being Reasonable: The Case for a Misunderstood Virtue
Krista Lawlor
Harvard University Press, 2026. 213 pp 

Web image by Medhum.org.

Five Little Peppers and How They Grew by Margaret Sidney is an early example from 1881. This book describes the daily life of the hardworking Pepper family and how they remain cheerful and loving despite challenges associated with 19^th century poverty. The Pepper family consists of widowed Mrs. Pepper or “Mamsie,” 11-year-old Ben who voluntarily takes on the mantle of “man of the house,” patient and selfless 10-year-old Polly, impulsive and food-loving 9-year-old Joel, gentle and conscientious 7-year-old Davie, and beloved baby of the family 3-year-old Phronsie.

Children’s literature during this era was heavily instructional and used relatable characters and stories to teach morals and values to young minds. Illness was rarely just a biological event; it was a test or demonstration of character. In a chapter aptly titled “Trouble for the Little Brown House,” the first challenge that the Pepper family faces is measles.

Notably, this book highlights the ophthalmologic symptoms and sequalae of measles, as first Phronsie, then Ben, Polly, and Joel all catch the infection. Common early symptoms of measles include conjunctivitis and photophobia, which occur before the obvious rash. Ben and Polly, the hardworking older siblings who earn money for the family by chopping wood and sewing respectively, are each in initial denial of infection because they understand the financial repercussions this will have on the family. But the historic reader understands the warning signs when Ben and Polly report visual complaints. Ben tries to reassure Polly by saying, “I’m all right; only my head aches, and my eyes feel funny,” alluding to the itchy and gritty sensation of conjunctivitis, before he becomes bedridden. The narrator describes Polly’s struggles more vividly, “An awful feeling made her clutch the back of a chair, but she managed somehow to get into her clothes, and go groping blindly into the kitchen. Somehow, Polly couldn’t see very well. She tried to set the table, but ‘twas no use.” Polly’s initial visual impairment can be attributed to severe photophobia, leading to blurry vision.

Modern day readers may not know that the measles virus can result in serious vision-threatening complications. It can cause deeper structural damage starting with keratitis – a painful inflammation or infection of the cornea, the clear front surface of the eye, which manifests as blurred vision and intense tearing. If keratitis is left untreated or a secondary bacterial infection occurs, corneal scarring can permanently impair vision. In rare instances, measles can also cause retinopathy and optic neuritis leading to blindness. The severity of eye damage from measles is heavily linked to nutrition. The virus actively depletes body stores of vitamin A. In low-income populations where vitamin A deficiency is already common, measles is more likely to cause permanent childhood blindness.

The Peppers live in poverty and hunger. Mrs. Pepper makes a meager income sewing “sacks and coats” for a local store and “had hard work to scrape together money enough to put bread into her children’s mouths, and to pay the rent of the little brown house.” There is never enough food to go around. Their main source of calories are coarse brown bread and unappetizing cornmeal mush, neither of which contain meaningful amounts of vitamin A. However, the generosity of the parson’s wife, Mrs. Henderson, helps protect some of the Peppers from blindness. Mrs. Henderson gives the Peppers “a little pat of butter,” which Phronsie and Ben put on their bread. Dairy, like milk and butter, is an excellent source of vitamin A. And later, Mrs. Henderson sends over “a little bird delicately roasted,” which Joel consumes with delight. Poultry and gamebirds are another good source of vitamin A.

However, selfless Polly saves the butter and bird for her siblings and ends up being most at risk for permanent vision loss. She develops very painful eyes, suggesting keratitis, and the doctor pronounces that “her eyes are very bad” and warns, “You will be blind!” if she doesn’t take care. Although the author attributes Polly’s illness severity to eye strain from sewing to earn money for the family, it is medically more likely due to vitamin deficiency. The therapeutic value of vitamin A in treating measles was not discovered until 1932 – 51 years after the publication of this book – when British physician Joseph B. Ellison found that administering vitamin A extracts roughly halved the death rate of hospitalized children suffering from measles [1]. Studies establishing the role of vitamin A in reducing blindness in children with measles did not occur until the 1980s [2,3].

Because moralizing 19^th century children’s literature rewards the virtuous, Polly ultimately makes a full recovery. However, reality is not so kind. Even today in the 21^st century, an estimated 15,000 to 60,000 children are blinded by measles every year globally [4]. The World Health Organization recommends that children in low income and developing regions diagnosed with measles receive immediate, high-dose oral vitamin A [5]. This simple, low-cost intervention protects the cornea and has successfully saved the eyesight of millions of infected children [6]. And, those who are vaccinated against measles are spared the risk and need for intervention completely.

[1] https://pubmed.ncbi.nlm.nih.gov/20777111/
[2] https://pubmed.ncbi.nlm.nih.gov/8486934/
[3] https://pubmed.ncbi.nlm.nih.gov/3492298/
[4] https://pubmed.ncbi.nlm.nih.gov/14998696/
[5] https://www.who.int/news-room/fact-sheets/detail/measles
[6] https://pubmed.ncbi.nlm.nih.gov/24407830/

Original Publication: The story was originally serialized in an 1880 edition of Wide Awake, a children’s magazine and later published in a hard cover edition.

Dover Publications, 2006. 224 pages

Web image by Medhum.org

The Sick Child

The sick child is thought to be the artist’s sister. She is not a child but rather a young girl who is lying down or seated, with a blanket over her lower body and she faces a woman who is seated beside her, clutching the child’s left hand. We cannot see the woman’s face – it is turned down as she is bent over in apparent grief. While the painting’s title names the girl as the subject of the painting, it is the grieving woman and her attention to the girl that is particularly striking.

Death and the Child

Death and the Child depicts the anguish of a child who has been confronted with the corpse of her mother lying in bed. The child faces the viewer, hands pressing against her ears – she cannot bear to “hear”/ absorb what she has encountered; her face has an expression of fear and despair

Death in the Sickroom

In Death in the Sickroom several adults are scattered about, some standing, one woman sitting in the foreground; behind her another woman stands facing us. In the back of the room a figure sits on a chair, a blanket draped over her lap – presumably this is Munch’s sister. With his back to the wall an elderly man has both hands pressed to his chest. These individuals have come to help and mourn but they are isolated from each other, which adds to the grimness of the scene.

Image credits: wiki commons

Painting with Empathy: The Expressionist Art of Edvard Munch with Curator Øystein Ustvedt

Russell Teagarden 12.28.23 2130

Edvard Munch’s emotional portrayal of illness and suffering offers profound insights for health professionals and…

Far less dramatic—not even in the same league, but disturbing in its own way—is the record of psychoanalysis during the Third Reich (psychoanalysts were not involved in the two programs mentioned above). Psychoanalysis, pejoratively referred to as “the Jewish science” by the Nazis, was of course created by Sigmund Freud in Vienna. One of the early and seminal centers of treatment, research, and training was the Berlin Psychoanalytic Institute, founded in 1923 (it grew out of the Psychoanalytic Polyclinic, a free clinic founded three years before) by Max Eitingon, who was the director. Many of the faculty, including Eitingon, were Jews; several were also socialists.

When the Nazis came to power in 1933, the Institute’s days were clearly numbered; not only because psychoanalysis was considered “Jewish” and so many psychoanalysts were Jewish, but also because its goals of individual growth, self-knowledge, and independence were directly antithetical to the mindset that a totalitarian government wanted to impose. Freud was now anathema, a new language of “Aryan” terms for analytic principles was devised, all Jews were purged, and the focus of psychoanalysis in Berlin shifted to the furthering of Nazi ideology: treating “war trauma” in soldiers and SS men, prioritization of and obedience to a totalitarian mindset, “reorienting” dissidents towards approved National Socialist thinking, conversion therapy as a treatment for homosexuality, and the like. The talking cure was to be weaponized for state purposes.

Seven months after Hitler seized power, Freud wrote to a colleague in England, “Berlin is lost…” Eitingon was forced to resign and fled Germany and was replaced by two Aryan analysts as co-directors. Three years later the Institute was subsumed into the German Institute for Research and Psychotherapy, known as “the Gӧring Institute,” with a new director, Matthias Gӧring, cousin of Reichsmarshall Hermann Gӧring.

The Institute’s excuse for collaborating with the regime was that it was the only way to “save” psychoanalysis and permit its survival; Freud himself had early on counseled accommodation as necessary to accomplish this end. What the Institute learned was that there is no accommodation short of full cooperation in a totalitarian state. But what was the toll of compromise on the men and women left in the Institute?

This was the history of psychoanalysis under the Nazis, which has been reviewed in a number of scholarly works¹. The novelist Stephen O’Connor has set himself a different task: to examine the life of a fictional non-Jewish German psychoanalyst as it played out against the background of Berlin and the Berlin Psychoanalytic Institute before and after the Nazi seizure of power in January 1933. His new novel, We Want So Much to Be Ourselves, follows its main character, Günter Zeitz, from his initial meeting with Sigmund Freud in 1924 through the years of the Third Reich and beyond. Günter will be our avatar, our surrogate participant through whose eyes we will watch things play out, during the heyday of psychoanalysis and through its suppression. However, the novel is not primarily about the destruction of German psychoanalysis, but about Gunter during the destruction of German psychoanalysis. Günter will be Exhibit 1 in the case for the acute and lingering effects of trauma.

As the novel opens we meet Günter corralling Freud on a street corner in Vienna and asking him to take him on for analytic training, which will consist largely of Günter’s personal analysis, and Freud agrees. In the doctor’s waiting room Günter meets another patient, Josine Rosen, a Jewish woman, and shortly thereafter they begin an affair. It becomes clear that Josine is troubled; she has already had a suicide attempt, and is subject to bouts of depression, but Günter is in love and within a year they marry and soon thereafter have a daughter, Hannah. Despite their ongoing disputes about some aspects of Freud’s “death force” theory, Freud recommends Günter for a position at the prestigious Berlin Psychoanalytic Institute, which he accepts. Over time, the course of true love does not exactly run smooth; Josine is unstable, and the National Socialists are increasing in power and presence in Germany, posing a problem for her as a Jew. Günter and Josine will separate and reunite several times and draw others into their story as their world descends into a very rigidly structured type of chaos. How they all navigate this personal and professional turmoil determines the rest of their lives.

Meanwhile, we listen in as the analysts at the Institute discuss the increasingly dangerous situation, and how to respond. They initially dismiss Hitler and his “gang of toothless throwbacks” (p. 127) as upstarts with no political base and no future (as does much of the German public) until 1933, when it becomes apparent that this is no longer the case. In 1936, after Matthias Gӧring assumes the directorship, new rules for psychoanalysis are introduced; complying with these changes is clearly the only way the Institute will be allowed to continue to function. Some analysts flee, some accommodate, and some join the resistance.

However, the novel is really Günter’s story. Günter is eminently likeable; he is a bright, engaged and engaging character pursuing his academic dream who genuinely wants to mitigate human suffering. We watch him grow from the sheltered son of a country doctor to a confident teacher and practitioner, and we watch him fall in love, repeatedly, almost as though he is “feeling his way” in this world of emotions. When the Institute is taken over and its direction changed Günter finds himself in a moral quandary: he is horrified by National Socialism but feels unable to do anything about it. Can there be a small degree of accommodation, to allow him to continue to help those who need help, or is accommodation a slippery slope which ends in a betrayal of self and principles? Silence or resistance? We watch with him as he tries to keep his professional life intact as his personal life begins to unravel. When he is forced to treat Dr. Gӧring’s nephew, an SS lieutenant recently returned from a murderous detail in the East, he reaches his personal Rubicon.

Günter is an everyman caught in the gears of a machine, and the kernel, the gist, of the novel, is a question: how does one go on living one’s life in a system gone mad, and what are our responsibilities to others and ourselves? How do you go to work and go home to your family, how do you love and hate and gossip and drink your coffee and read your newspaper and pick up your paycheck and go to a movie, when you are convinced that a great evil is being perpetrated, that you are told to be part of it, and that any false step on your part might bring that evil down upon you? When it is your country and your countrymen and your colleagues doing it? What is the personal cost, the cost to yourself, and to your self, when—if— you come out on the other side of the madness?

The other characters, and their interplay, are handled carefully and realistically. Josine is a large and critical part of the story. She is clearly—and sadly—damaged, and her behavior is too erratic for us to “like” her, although she engenders tremendous sympathy . She is a tragic figure and we feel for her, although this is not always easy. The student analyst Elke Weber, who becomes a critical participant in the story, is drawn realistically and sympathetically. Hannah will become important as a character in her own right later in the book. The other characters in the novel, including some of the historical figures, are drawn simply but cleanly and expressively; the reader feels that they know them, if only briefly.

We Want So Much to Be Ourselves is well-written, engaging, and suspenseful. O’Connor’s narrative successfully summons up both the atmosphere in the world of psychoanalysis in the 1920’s and Nazi-era Berlin’s anxiety and paranoia in the 1930’s. The reader who has some familiarity with the history of Weimar and Nazi-era Germany will note a rare factual slip², but nothing that is critical for plot development or that takes away from the pleasure of the reading experience; such are the pitfalls of writing historical fiction. When we reach the last hundred pages or so—the postwar years—the narrative tempo speeds up, and near the very end the novel becomes telescoped into a series of rapid-fire moments in the protagonists’ lives, seeming more an epilogue than a continuous part of the novel; this is the section that catalogues the aftermath. Life hobbles on, though one might wish for a more leisurely unwinding of the tale.

We Want So Much to Be Ourselves asks how a person of moral integrity can function in what the German philosopher and psychiatrist Karl Jaspers has called a Verbrecherstaat, a “criminal state”—not simply a state that occasionally commits crimes, but a state which has been transmuted entirely into a criminal enterprise—and what the price of that functioning, of complicity or resistance, might be. It portrays profoundly human characters who live through societal trauma, from which it is possible to emerge, but rarely to emerge unscathed, and emphasizes the role of connection for moving forward and healing. Importantly, it reminds us that patient care does not exist in a vacuum or a pure state, divorced from the society that surrounds it, and that when it is co-opted and weaponized by political considerations, things go very bad, very fast.

We Want So Much to Be Ourselves
Stephen O’Connor
Bellevue Literary Press, New York 2026: 496 pages
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¹The history is complicated…and contested; see Geoffrey Cocks’ “The devil and the details: psychoanalysis in the Third Reich,” in Psychoanalytic Review, 88 (2), 2001; Zvi Lothane, “The deal with the devil to “save” psychoanalysis in Nazi Germany” Psychoanalytic Review, 88(2), 2001; and Cocks’ review (in Psychoanalysis and History 3(2), 2001) of James and Eileen Goggin’s Death of a Jewish Science—Psychoanalysis in the Third Reich, among others. The Goggins feel that psychoanalysis was “destroyed” under the Nazis, while Cocks notes significant continuities in the discipline through this period, although his analysis includes psychoanalysis and psychotherapy.

²At one point one of the characters is said to have been arrested by the police and “…got off the train at Theresienstadt and went straight to the gas chamber…” (p. 425) While the person narrating this event is admittedly unsure that the prisoner went to the gas chamber, the fact is that they could not have; there were no gas chambers at Theresienstadt. In another example, a patient of the Berlin clinic is referred to as a “Leninist” who was a member of “the DKP.” The author is presumably referring here to the German Communist Party, known as the DKP, or Deutsche Kommunistiche Partei. However, the DKP was only founded in 1986. The Communist party in Germany during the Weimar Republic and (though it was rapidly outlawed) in the Third Reich was the KPD (Kommunistiche Partei Deutschlands).

Web image by Medhum.org based on the original book cover.