Tuner follows Niki White (played by Leo Woodall), the apprentice of piano tuner Harry Horowitz (Dustin Hoffman), and a tragic genius. Once a gifted pianist, Niki developed hyperacusis—an increased sensitivity to sound that prevents him from playing the piano and requires him to wear hearing protection at all times. After Harry forgets the combination to his safe, Niki teaches himself to open it by listening to the lock’s subtle sounds. When Harry is later hospitalized, Niki begins cracking safes to pay off his mentor’s mounting medical debt.

By the film’s second act, Niki’s increasingly dangerous work jeopardizes both his safety and his relationship with his girlfriend Ruthie (Havana Rose Liu), leaving him to confront the consequences of his actions. When Niki makes amends in the third act, Uri (Lior Raz), the leader of the criminal group in which he has become entangled, viciously beats him. The injury costs him part of his hearing but enables his return to the piano.

Tuner is engaging, beautifully constructed, and emotionally resonant. At the same time, it turns disability into a plot device. Marking director and co-writer Daniel Roher’s fiction debut, the film fully embraces the artistic license afforded by the genre, casting hyperacusis as a superpower rather than focusing on the condition’s often debilitating effects.

To be fair, Niki mentions that, at one point, even the sound of his own voice was agonizing. He is constantly on guard against potentially harmful sounds. When confronted with barking dogs, smoke alarms, air horns, and gunshots, he winces and clutches his ringing ears.

But the impact is fleeting. In real life, exposure to noises like these can permanently worsen hyperacusis. Furthermore, the hearing disorder is not a “superhuman” tool; many individuals with hyperacusis show normal hearing thresholds. For those with milder cases, everyday sounds like a running dishwasher can cause significant discomfort. In more severe cases, even near silence can be excruciatingly painful. One wonders how Niki could tolerate the clicks, clacks, and whirs of piano keys and combination locks (another creative liberty: modern safes are designed to thwart auditory decoding).

As disability studies scholar Rebecca Garden argues, there are “tensions between the lived experience of illness… and the conventions that shape the representations of those experiences in published narratives.” [1] In other words, the demand for drama often precludes verisimilitude, instead favoring a happy ending of triumph over adversity. Niki’s liberation from his condition is narratively satisfying; another, if less commercially successful, film might depict a similar character learning to live with it.

In his seminal text The Wounded Storyteller: Body, Illness, and Ethics (2013), sociologist Arthur Frank enumerates three types of illness stories: restitution, chaos, and quest. The restitution narrative “has the basic storyline: ‘Yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again,’” the chaos narrative “imagines life never getting better,” and the quest narrative “accept[s] illness and seek[s] to use it.”

Tuner follows a kind of restitution storyline: Yesterday Niki was a healthy prodigy, today he cannot perform because he is sick with an exploitable “superpower,” but tomorrow a thief will effectively cure him by rupturing his eardrums. The film also features aspects of the quest narrative; to quote Frank, Niki “returns as one who is no longer ill but remains marked by illness”—that is, no longer hyperacusic but partially deaf. Niki is figuratively reborn with a new purpose, embodying the film’s Spider-Mannish moral logic: “With great power comes great responsibility.”

Despite these quest elements, Niki’s story remains fundamentally a restitution narrative. Frank notes that such narratives are “culturally preferred” and calls for “an enhanced tolerance for chaos.” To that end, future films might engage more directly with the lived experience of hyperacusis. Ultimately, however, Roher’s approach is understandable and even commendable, using the possibilities of cinema to draw attention to some of the challenges of a rare, if romanticized, disability.

[1] Garden, Rebecca. “Telling Stories about Illness and Disability: The Limits and Lessons of Narrative.” Perspectives in Biology and Medicine, vol. 53, no. 1, 2010, pp. 121–135.

Photo credit: Black Bear

“I am we, we are a year, we year, we are rest, we rest.” 

In winter 2024, Sop had a severe relapse of myalgic encephalomyelitis, also called chronic fatigue syndrome (ME/CFS), leaving them housebound in South East London.

That summer, in the days leading up to a friend’s birthday celebration, the artist rested carefully so they would be able to attend. The night before, they started taking what was touted as a “magic” pill for insomnia. They didn’t sleep at all and had to miss the party. But in a sleep-deprived haze, they wrote, as they described in a recent interview [1], “a solidarity rant, a kind of letter to other disabled people stuck indoors.” 

When Shape Arts, a UK disability arts organization, approached Sop with a commission, they decided to adapt the essay into a script for We Year, a mixed-media love letter to others living with energy-limiting conditions. The short film premieres at RestFest—a film festival and virtual space by and for the disability community—as part of a program co-organized by The Remote Body, Resting Up Collective, and Ort Gallery. 

With a poetic voiceover and ethereal soundscape, We Year immerses viewers in a chronic illness flare during a sweltering summer, blending decades-old archival footage from when Sop was well enough to move outside freely with recent phone footage shot at home. Shifting between past and present and between interior and exterior, the experience is at once isolating and unifying, claustrophobic and liberating. 

We Year also features 16mm direct animation, a technique that involves drawing and scratching moving images directly onto film stock rather than recording with a camera. Here, Sop used ink to overlay the orange stress bars from their Garmin watch across the entire film—a constant representation of their body that acts as a symbolic barrier between them and the audience. 

The following interview has been edited for length and clarity. 

When did you begin to think of yourself as an artist? 

I always wanted to be an artist. Even as a kid, when I was asked, “What do you want to be?”, I was like, “An artist!” I honestly have never thought about doing anything else. I grew up in the deep countryside, and there wasn’t much access to contemporary culture, although I was obsessed with music and music magazines. There was this teen music magazine called Smash Hits that I loved, and I made collages and scrapbooks of pop stars. When I was 13, I went to a big retrospective of the massive British artist David Hockney, who just died, and it was the first time that I’d seen contemporary art. It blew my mind, and that’s the first time I remember thinking, “Oh, this is something serious that I want to do.” 

What questions or themes does your art usually explore? 

I find it hard to make work that isn’t about my life and the things that I’m dealing with. What I do always ends up being ultra-personal. That’s not something that a lot of people do, necessarily. The act of living as a chronically ill person means that you have to live in the world in a very different way from people who are not chronically ill. Chronic illness is a fertile area for ideas. You’re living the life and thinking about the life at the same time. If you’re an artist or someone who thinks about things in conceptual ways, you can’t help but try and interpret your life into art-making, projects, or ideas. Everything’s interesting. It’s like living life wonky.

As a chronically ill person,  I can’t do a 9 to 5. I can’t necessarily keep to plans, and I can’t always do basic things, like sometimes even look after myself in a normal  way. The agency that I have is to interrogate what this life means and the challenges that it poses and what is interesting about that. What can I say that’s beyond how I would perhaps describe being sick to a stranger? Like, what’s within that? All of the work that I make—even if it looks not about that—is going to be about that.   

And then the other part of it is that I grew up in the field and was a tomboy covered in mud. My understanding of the world was through nature, and now I’m in a flat without a garden. I can see some trees in the park just over there, but quite often, I’m not well enough to go and hang out in the park. I am pretty obsessed with nature and the fact that I can’t get to it. I can’t really have that life currently.  

In your bio, you describe yourself as “a torn and crooked leaf, a root embedded in the dirt, a shoot reaching to the sky.” Would you please elaborate on what this means? 

When I wrote that bio, I was making work about my body being the same as the microbiome in the soil. “A torn and crooked leaf” is being chronically ill. “A root embedded in the dirt” is really what it sounds like, within the context of that specific work. And the “shoot reaching to the sky”—my work deals with pretty hefty emotions, but there’s always hope. My life is not a miserable life; it is hopeful, and I do believe there’s something so crucial in being chronically ill that you absolutely have to keep hope alive. It takes a lot of work to do that and to get there. It’s not easy, but it’s super important. If you have this restricted life, you absolutely have to shoot for the sky. Because time just goes on.  

What does working in crip time [2] look like for you? What are your long-term goals as an artist? 

If you’re truly working in crip time, it’s fairly impossible to have long-term goals. You haven’t really got a choice when you work. You can do your very best to carve out time or space. Currently, I have about a couple of hours in the early morning when I can manage to do something. My afternoons and evenings—I simply can’t make work then. If you have such a limited time to make work, the amount of work you make is going to be low. It will have to meet your capacity, and that doesn’t fit well with current art market production timelines or expectations. Sometimes, you can’t make something for a year because the thing that you should be working on—and the thing that is your work—is your health. That’s your full-time job.  

I deeply believe that making in crip time actually is truthful to the world. We would probably all be better off if we did. Really, it means making work to your capacity, and that can mean a lot of things. You don’t need to be ill to make to your capacity. 

It’s a more authentic timeline of meeting yourself where you’re at, rather than forcing yourself to meet arbitrary or toxic timelines. 

You haven’t chosen to have chronic illness—you’re forced into doing that. And I don’t think that’s a bad thing necessarily. Asking what would I like to do for my long-term goals—I find it very hard to answer because, first of all, I live, like, day to day and, second, when I think about what my long-term goals would be, it’s from the perspective of someone without a disability because I currently cannot see how I would be able to do more than what I’m doing unless I had an enormous amount of more support. 

How did you decide which media to work with for this project? 

Films and writing have always been the two mediums I mostly turn to, and actually they’re the most accessible things for me to do now, being housebound. When I was asked to make the film, I just didn’t have it at all in my means to film new work or leave the house, so I had to kind of figure out how to make a new work out of what I had, which was this personal essay I wrote about being stuck inside in the summer. I made the film throughout another summer of being stuck inside. A lot of chronically ill people turn their camera or phone or whatever onto their surroundings, so I had bits and bobs that I filmed. When I started making films, I would just film tons of different stuff. I had my little Hi8 video camera around the whole time, so I had lots of little clips that I hadn’t used, and I didn’t actually think that I was ever going to use them for anything. But that obviously wasn’t enough, and I didn’t really want to make a film which was just a film inside my house—there’s plenty of films like that. I had a whole bunch of old footage from the 90s. I digitized all of these tapes a few years ago, and they looked so great. A lot of that stuff was filmed out of the house, and then there were funny effects that I filmed which made it into the films. There’s a lot of blobs of color, which are actually motorway lights and ended up being this really nice kind of texture, which floated over and broke up some of the images.  

Hi8 and MiniDVs are the two cameras I was using in the past, so I have footage from both of those. And then there was 16mm direct animation. Each section of the film has a different animation running over it, but the animation is quite transparent, so it’s always there. It’s textural and has multiple meanings. And then I commissioned my friend to make the soundtrack. 

Would you elaborate on the meaning of the title of the film? 

The thing that’s turned me on most about this film is the fact that I can try and get “to year” and “yearing” adopted as a new way of describing spending all this time being sick. I think the word “year” is long enough for people to imagine, “Whoa, you are sick for a whole year. That’s a really long, unbearable time.” But then you make it into “yearing,” and then it could be even less than a year, but it’s probably closer to a year or multiple years. Then I was interested in what would happen if the years were then broken up with periods of being well, with relapses included as well.  

I find it really tiresome to have to explain the last five years of my life. So to not have to say, “Well, I was sick for a couple of years, housebound and bedbound, and then I got well again, and then I had a relapse”—it’s just like, “I was yearing.” I would love for it to become part of the lexicon of chronic illness.  

What does it mean to have “We Year” screened at RestFest? 

There’s this informal network of crip friends who work with each other. Not everyone works together, but we all know each other and there’s really close friendships within this group. They’re all small, crip-led organizations that have been made pretty much for the same purpose, which is remote events, screenings, and workshops. I was just really keen to connect and uplift all of these organizations. We created this program together, and I’m really proud of it. It’s been a lot of work, but it’s really nice making things with your friends. The access intimacy side of it all is real. Creating or programming with your friends is a very accessible way of making because we all understand each other and our capacities. I’ve said capacities a million times. 

You need to coin a new term for that as well. 

Okay, I’ll get on that for next time. 

We Year, through July 12 (if you start watching on June 28); RestFest Film Festival. “I am we, we are a year, we year, we are rest, we rest.” 

[1] “Interview with artist-filmmaker Sop + a Special Screening of their New Film.” RestFest, 2026,
https://restfest.substack.com/p/interview-with-artist-filmmaker-sop. 
[2] In her 2013 book Feminist, Queer, Crip, disability scholar Alison Kafer writes, “Rather than bend disabled bodies and minds to meet the clock, crip time bends the clock to meet disabled bodies and minds.” 

DAVID HSU: Tell me a little bit about this half-marathon business. What’s going on with that?

TONY MIKSANEK: I’ve been running for a number of years, which I truly enjoy, and I’ve done ten full marathons, one ultra marathon, and God knows how many half-marathons. But as I get older, I’m leaning more toward the half-marathon as the longest distance I like running.

DH: So how did this one go? Was it good?

TM: Yeah. This one was in Florida. The weather was beautiful. There were about 20,000 people, and it was at Disney World. So you run through the Cinderella Castle, you’ve got all the characters high-fiving you on the course. It’s great. I think I originally got into running as a sort of release from medical practice, where you can be outside, mindful of your surroundings and your breathing and your foot striking the pavement. Since then, it’s become just short of an obsession. A good one, a good obsession. But I’ve often thought about the similarities between running and medicine. The greatest similarity is that both endeavors require a pair of comfortable shoes because you’re on your feet all day practicing medicine. There’s also a rhythm to running, which is a very individual, personalized thing. And, of course, there’s a rhythm to our practice. The flow of taking care of patients and our style in interacting with them. In running, you have to build up a core. We call it a core of mileage that your body gets acclimated to. In practice I think that core is sort of like developing trust in the physician-patient relationship. You have to work on that. You know that saying, “trust is hard to earn but easy to lose?”

DH: Let’s talk a little bit about medical humanities. You mentioned that running was something that you did to put your head in a different space from your regular work. I assume that medical humanities would also be something that gives you a diversion from your regular work. Is that accurate?

TM: Most of my career was spent as a small town, rural area, solo family practitioner in a former coal mining town with a population of right around 8,000 people. So medical humanities, for me, for most of my life, has always been an individual thing. I read and tried to be involved in whatever peripheral way I could with medical humanities. And I did and still do derive a lot of satisfaction, enjoyment and learning from reading great literature. We can debate what the adjective “great” means when it applies to literature, but I feel there’s so much to gain from literature. When a patient comes into our office, they usually want to tell us a story. Sometimes they’re reluctant, but usually they want to tell us a story. And my belief is that most people, to be healed, need to tell that story. But equally important is they need somebody who is invested in listening to that story, that confirms their importance. and the validity of their illness or what they’re going through. And I think literature is a really great tool to help us learn how to listen intently to patients, more fully understand their stories of life and illness, and to enhance our empathy.

So again, my entry into medical humanities is probably unlike most of the people on our MedHum group. It’s mostly been kind of a solo route for a long time. Currently I’m an associate editor and a book editor for the Journal of Medical Humanities. I don’t know how far back you go with your practice, but once upon a time, the American Family Physician Journal, the AFP, had a regular column called “Diary from a Week in Practice.” And there were four contributors. I was one of them. I guess I was the token rural small-town doctor, because there was somebody from an urban practice and somebody from an academic practice. I forget what the fourth one was. And so we would take turns writing a column that was basically a chronicle of a week of practice like “what were the highlights, what were the lowlights.” I think that was important for me, because at the time, that was probably my version of reflective writing, even though it was produced in a form that would be published. You know, being a doctor is tough, albeit a wonderful, often joyful, profession. Running gave me an opportunity, I think, to kind of put myself in a place where I can sustain joy and the dedication that was required, especially being a small-town doctor where your patients are your neighbors. You run into them at church or the grocery store. The land is the connecting fabric for a small-town doctor. I mean, your kids’ friends are almost always your patients. So it’s a very vivid, organic, dynamic relationship.

DH: How big was your practice? How many patients did you have?

TM: I practiced in our town for a little over 30 years, as a solo family physician, 24/7, unless it was time for vacation or a meeting. And then, you know, I had an agreement with a couple other physicians for coverage if we were gone, but it was a very full practice. The only thing I didn’t do as a family physician was OB.

I loved to make house calls. I used to make them in my Jeep Cherokee. And I’ll never forget the first house call I made. I brought my nurse with me because I was new to town, and I didn’t really know where the address was. And we pulled up in front of this very, very small, weathered house. And I remember as they opened the door to let us in, the floor was dirt. It was a dirt floor. And having been born and raised in Chicago and then later some of the suburbs, I was dumbfounded. That was really my experience — people that were really struggling to make a living. But the dirt floor was, I mean, it sounds like an oxymoron, but it was clean. And the home was well-kept. There were a lot of eye-opening experiences being in a small town.

DH: What’s the name of the town?

TM: Benton. Illinois. Wonderful town. Great people.

DH: How did you stumble across the humanities and arts connection to medicine? Was this something that you were aware of as a student or at some point as you started working you started to realize that novels had something to do with your job? How did you make that connection working solo?

TM: I’ve always been an avid reader, as I think most physicians are. And actually, I got a head start because our medical school, the medical school I attended and where I am now a volunteer faculty in the Department of Medical Humanities, was one of the first medical schools in the country to actually have an independent medical humanities department. So as a student, I was already interested in medical humanities. I guess as a prelude to that, as an undergraduate student at the University of Chicago, we had what they called a core curriculum when that was not a popular thing. Every student, no matter what your major was, had to have competence in basically all the major disciplines. So, if you were going to be a biochemistry major, you still had to take the History of Western Civilization, Art Appreciation, etc.

I’ve always been involved with literature. Once upon a time, JAMA and the New England Journal had book review sections, and I did book reviews for those two journals. The sad thing is, they haven’t had a book review section for a number of years now. There’s no interest, I presume? I don’t know. They just kind of vanished in the night. So, during my early years of clinical practice, I was writing reviews mostly for JAMA. They would send me all kinds of books, some of which were very peripherally connected with medicine. And so I think maybe when they had a book that looked interesting, they would say, “well, we’ll just send it to Tony.” Which was great. But that was in the days even before internet. I remember I would be sitting at my kitchen table with a typewriter typing these reviews to mail to JAMA or New England Journal. And it was kind of wild. But life was so much simpler then, too, on the other hand. Anyway, I would say that medical school, a love of literature, getting involved in book reviewing from early in my career was kind of the springboard for me, into medical humanities.

DH: Can you give us a few medical humanities book titles that we can spotlight for the audience?

TM: One book that I really was impressed by was Do No Harm. There’s an aphorism in medicine, “do no harm.” That’s the title. And it was written by a neurosurgeon in England by the name of Henry Marsh. It’s a beautiful book because like the very best memoirs, he presented his vulnerability as an individual and as a physician, a surgeon, so beautifully. You couldn’t help but be moved by his sincerity. In fact, he had a line, I’m paraphrasing it, but the line was something like, “I am a vessel for my patients to pour their misery into.” And you know, on the one hand you can say, “well, that sounds a little pontificating, a little arrogant,” but on the other hand, it’s like, “isn’t that part of the job description?” So that would be one: Do No Harm. Another by a physician author is Cutting for Stone.

DH: By Abraham Verghese.

TM: He’s out at Stanford and he’s written a lot. The Tennis Player, and others, but Cutting for Stone is one of these lengthy novels that you’re reading and you’re like, “this author’s all in.” He’s not saved any good stuff for another book. It’s just all there. So that’s another one I would recommend to people.

I’m also a very big fan of Richard Selzer because first of all, most are short stories or short essays you can read in a single sitting. I’ve met him a number of times and he admits that he lies, because these are not true stories necessarily, and they may have had their genesis in some kernel of truth. So there is a lot of exaggeration and hyperbole but there’s still something that he’s able to successfully impart to the reader about a doctor’s vulnerability. When I trained, we were told to suppress our emotions and have clinical detachment. You can’t survive if you get too involved with your patients. And of course there is truth to that. It can get to the point where you lose yourself in someone else’s situation and it’s not healthy for you or them. But I think we’re in a renaissance of saying, “Okay, maybe you can’t be too empathetic, but it’s okay to be vulnerable.” We’re not superheroes. I still struggle with that.

I had a lot of older folks in my practice who were huggers. Early on, I was always like taking a step backwards as they were lunging toward hugging me. But then my nurse, in her wisdom, said, “You know, they need to hug you.” That’s how they’re acknowledging your value to them and what you mean to them. I’ve done a lot of thinking about vulnerability and physicians. What is the optimum amount of being vulnerable? In the old days, if we had a very difficult situation, we would just go in our office, close the door, and have a cry. I mean, we would weep. We would never think of demonstrating our sorrow in front of a patient or something. And I think that comes from the training back then. But as you know, there’s no template for being a good physician. And it’s kind of a learning experience for all of us.

DH: It has something to do with how to be a good human being.

TM: Yes, exactly. And I think the whole point of medical humanities, as I alluded to earlier, is about that soul, that spirit of medicine, which is not just about how we practice medicine and interact with other people, but also with being self-aware of who we are, what we can offer, what our strengths and our weaknesses are, and trying to embrace both. Understanding that there are things we don’t do as well as we’d like, things we could do better. But again, it goes to that understanding of our vulnerability and accentuating our strengths and trying to minimize our weaknesses, while understanding that all human beings are some unequal combination of both.

DH: Switching gears a little, as a retired family physician, what’s your view of medicine today? Is it pessimistic? Is it optimistic? Do you think we’re moving in the right direction or are things worse than they were back when you were going through it?

TM: I think medicine is a completely different enterprise now than it used to be. I remember the joy of holding a paper chart and writing my notes with a pen on paper. I think my notes were adequate or good, but they had just the right amount of information that was necessary. There was nothing superfluous when you had to write your own note because you had a certain amount of time that you wanted to get the note done in. And I understand the utility of the electronic health record and its portability. But I think there’s something about looking a person in the eyes, giving them 100% attention, and even though back in the day I used to scribble down some notes so I wouldn’t forget certain things, 90% to 95% was just one-on-one. And then after the visit, I would write the note in the chart, or later I had the ability to dictate a note, which was great. So I think the electronic health record, on balance, has been a detriment to the practice of medicine.

Also, the amount of time you spend with a patient has become very restricted. For example, I was very cognizant of people waiting in the waiting room. Back at my peak, I was seeing 30 to 35 people a day in the office. In addition, I admitted and cared for all my patients requiring hospitalization. The local hospital that we have, 50 beds, still does not have a hospitalist. And so you had to make rounds. You took care of people in the ICU. You saw your patients in the ER. It was a full-service experience for patients and the physician. It was hard. There’s no question. But there was something very gratifying about being able to do all those things right and being a small-town doctor. People just called you at home. We had one rule in the house, and the rule was that as a family — we had three children — we would all have dinner together and that one hour was just for us. What happened with the kids during the day at school and their activities and how work for my wife went. And I just remember laughing and laughing, but we carved out that time. But otherwise, it was all hands on deck all the time. SoI think medicine is different. Whether it’s better or worse, I don’t know.

I really do feel sad that we’ve become such a technological profession. You hear students saying, “Well, what’s the point of trying to listen to a murmur? We’ll just get an echocardiogram.” Back in the day, you relied on your clinical acumen and you formulated your differential diagnosis. And then you thought, “well, what is the most likely diagnosis?” And then you would do testing to support that diagnosis or refute it and move on. And now I feel it’s like people immediately get tested.

We used to have to listen to people. You probably have the same experience. I think all medical students do. You have some wise professor that says 90%, 80%, 85% of the time, the patient will tell you exactly what’s wrong. You just have to listen to them. You may have to nudge them a little bit to give you more information. But now I don’t know that we’re giving people enough time to tell us what is really wrong with them before we kind of take the leap to do these tests. And I think, unfortunately, patients are getting so comfortable with the notion of getting tests that that is all they want. I’ve had patients that say, “Well, can we do a CAT scan? Can we do this or that?” Of course we can do it, but tests come with risks. False positives, incidentalomas, radiation exposure in some cases and so on. So on balance I’m going to say, although it was not Nirvana or Eden back in the day, and we had our own issues and problems, it seemed closer to the aim of healing.

DH: Well said. What would you like to see MedHum do in the coming months and years?

TM: I think what I would like to see is just MedHum continue on its trajectory and grow to become a go-to resource for people interested in medical humanities or just people that are curious about medicine in general. I would like to see the website continue to grow and become a valued resource where people, if they’re interested in the depiction of medicine in the humanities and in the culture of medicine, they can read articles, they can listen to podcasts. There’s a lot of interesting material on the website already. I think as we grow and expand and include more contributors, the possibilities are limitless for what it can become.

DH: That was great. I had a good time. We should do this again.

TM: Me too. We’ll look forward to talking again.

Posts Written by Dr. Tony Miksanek

Book ReviewVideo

Do No Harm: Stories of Life, Death, and Brain Surgery by Henry Marsh 

06.16.26 105

Biblioscopy

Biblioscopy: A Glimpse of New and Upcoming Books 

03.02.26 1237

Book ReviewFocus

The End of Days by Bernard MacLaverty 

11.03.25 513

Book ReviewLitmedVideo

Tell Her Everything by Mirza Waheed

10.20.25 691

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The trajectories of tuberculosis (TB) and opera met in the mid-nineteenth century most notably with the production of La Traviata in 1853, and then La Bohème near the century’s end. With eminent scholars Linda and Michael Hutcheon, we talk about how these trajectories converged and how these resulting two operas then brought attention to the medical effects of the infection and the sociocultural influences on its spread. We also discuss how the discovery of germ therapy during the time between the staging of these operas affected the way social behaviors changed accordingly, that is, from understanding TB as hereditary to understanding it as infectious. We play audio clips from parts of the operas pertinent to perspectives provided. 

A big thanks to Drs Linda and Michael Hutcheon who in addition to providing their expertise and perspectives during the podcast, also contributed ideas for the production. 

Links
– The combined bio for Linda and Michael Hutcheon.
– The New York Metropolitan Opera on-demand video service where you can get access to high-quality video productions of La Traviata and La Bohème among many other operas and performances. (There could be a 7-day free trial available).
– Homer Simpson performing as Rudolpho in La Bohème singing Oh Dio! Mimi!
– We covered the effects of TB as an aesthetic ideal of beauty during the nineteenth century as represented in paintings earlier in episode 5.

Audio Credits
La Traviata
Preludio (National Philharmonic Orchestra; Richard Bonynge cond London Records 1979)
Prendi, Quest’È L’Immagine (Orchestra of the Opera House, Rome; Tullio Serafin cond; Victoria de los Angeles (Violetta); EMI Records Ltd 1960; digitally remastered 1992)

La Bohème
O Soave Fanciulla (Berlin Philharmonic; Herbert von Karajan cond; Mirella Freni (Mimi); Luciano Pavarotti (Rudolfo); Rolando Panerai (Marcello); London Records 1972)
Si. Mi Chiamono Mimi (ibid)
Mimi È Una Civetta (ibid)
Mimi È Tanto Malata! (ibid)

La Bohème photo from wikicommons

Zauner was 25 when her mother was diagnosed with an aggressive, late-stage, mid-life cancer. Zauner was a rebellious child, resentful of Umma’s version of tough love. Growing up the lone Asian student in her Oregon community, she felt both othered at school and an outsider among her mother’s Seoul relatives when she visited them each summer. Just as she was beginning to appreciate her Korean heritage and understand her mother’s love, she learned about Umma’s diagnosis.   

The first half of the memoir exuberantly brings to life scenes from Zauner’s childhood and her brief post-college years as a musician in New York City. Surprisingly, without hesitation, she paused her makeshift career and flew west to care intensively for her mother. Attempting to heroically save Umma, Zauner zealously learned to prepare the native foods they shared. “I would radiate joy and positivity,” Zauner pledged. “I would learn to cook for her—all the things she loved to eat, and I would single-handedly keep her from withering away” (69). Her optimistic culinary efforts produce a poetry of exacting descriptions of the flavors and textures and preparation of those foods. It’s grimly ironic that the chemotherapy her mother endured wiped out her ability to taste or digest Zauner’s loving offerings of health.  

The second half turns from living with Umma to living without her. Wishing to sustain her bond with her mother as Zauner grieved, she continued preparing her Korean family’s recipes. Walking down H Mart’s redolent aisles released “waves” of sorrow that mark the enduring ebb and flow of her grief. Unsuccessful with conventional therapy, she found cooking the best form of self-care: “Every dish I cooked exhumed a memory. Every scent and taste brought me back for a moment to an unravaged home. Knife-cut noodles in chicken broth took me back to lunch at Myeong Dong Gyoja . . . The kalguksu so dense from the rich beef stock and starchy noodles it was nearly gelatinous. My mother ordering more and more refills of their famously garlic-heavy kimchi” (212-213). An image of abundance in the midst of loss.

Zauner’s detailed descriptions of cooking and consuming invite readers to her table, reminding us—as previous celebrated writers have—of the power of the senses to evoke memory and the power of food to strengthen human bonds. Food also powers Zauner’s self-understanding and the unexpected transformational love for her mother: “The culture we shared was active, effervescent in my gut and in my genes, and I had to seize it, foster it so it did not die in me . . . If I could not be with my mother, I would be her” (223-224).  

Zauner’s writing is itself active and effervescent. Through her grief, she holds a steady, unflinching gaze on cancer and death. As she writes candidly about her family, Zauner is critically reflective about her own life. Her writerly achievement is the immediacy of her felt experiences, her grief and her joys made palpable. “Let me feel this,” she courageously writes, dismissing her Korean family’s admonitions to withhold tears (202). An unforgettable image of the process of loving transformation that Zauner experienced unfolds in her description of making the Korean staple kimchee. It is a slow, exacting process of fermenting cabbage that at first strikes her as “controlled death” because “[l]eft alone, a head of cabbage molds and decomposes. It becomes rotten, inedible. But when brined and stored, the course of its decay is altered. Sugars are broken down to produce lactic acid, which protects it from spoiling. Carbon dioxide is released and the brine acidifies. It ages. Its color and texture transmute. It exists in time and transforms. So it is not quite controlled death, because it enjoys a new life altogether” (223). 

As if miraculously, a few years after Umma died, Zauner’s itinerant music career took on a new life. The band she has fronted, Japanese Breakfast, recorded the album Psychopop with a song she wrote about her mother, “In Heaven.” Then they toured the U.S. and South Korea. Although her mother was skeptical about a musical career, Zauner imagined that Umma would be “glad that I had finally found a place where I belonged” (233). 

Crying in H Mart: A Memoir
Michelle Zauner

Publisher Alfred A Knopf
Place Published New York
Edition 2021
Page Count 239

Web photo by Portuguese Gravit

Most chapters are titled after a medical condition (exceptions are “Hubris” and “Melodrama”). Some of the headings are familiar – Trauma, Infarct, Aneurysm, Meningioma. Other chapter titles flaunt delicious medical terminology that mingles the mysterious and the poetic with nomenclature such as Angor animi, Neurotmesis, Photopsia, and Anaesthesia dolorosa.

Included are riveting accounts of both mundane and seemingly miraculous patient outcomes. One success story involves a pregnant woman losing her sight due to a brain tumor that compresses the optic nerves. Her vision is restored with an operation performed by the author. Her baby is born healthy too. But tales of failure and loss – malignant glioblastomas that are invulnerable to any treatment, operative calamities including bleeding of the brain, paralysis, and stroke – are tragically common. The author describes his humanitarian work in the Ukraine. He admits his aggravation with hospital bureaucracy and is frequently frustrated by England’s National Health Service.

Sometimes the shoe falls on the other foot, and the doctor learns what it is to be a patient. He suffers a retinal detachment. He falls down some stairs and fractures his leg. His mother succumbs to metastatic breast cancer. His three month old son requires surgery for a benign brain tumor.

As his career winds down, the author grows increasingly philosophical. He acknowledges his diminishing professional detachment, his fading fear of failure, and his less-hardened self. He becomes a sort of vessel for patients to empty their misery into. He is cognizant of the painful privilege it is to be a doctor.

The title of Do No Harm is spot-on. After all, this commandment is a crucial caution to all doctors. And for neurosurgeon Marsh, it signifies the restraint he must exercise in his medical decision-making. His approach to the doctor-patient relationship features a gentle medical paternalism that incorporates plenty of honesty and kindness. He writes about his struggle (and occasional clumsiness) with breaking bad news.

His professional life is portrayed as paradoxical – constant anxiety and contagious confidence, phases of futility and strings of inspiring operative accomplishments. The gift of forgiveness, how uncertainty tortures doctors, and the process of dying are significant topics for Marsh. In the last few decades, there has been a proliferation of medical memoirs. Do No Harm rises above them all. The book informs doctors that it’s okay to be vulnerable and fallible, as long as they are also compassionate, truthful, and caring. 

Primary Source Do No Harm: Stories of Life, Death, and Brain Surgery 
Publisher Thomas Dunne Books/St. Martin’s Press 
Place Published New York 
Edition 2015 
Page Count 288 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database.   
Web image by Medhum.org.

John O’Connor, whom I happened to interview on May 5, explores a similar dynamic unfolding amid today’s psychedelic renaissance—a movement rife with magical thinking that he sees as something of a religious revival—in his delightful and enlightening new book A Short, Strange Trip: An Untold Story of Magic Mushrooms, Madness, and a Search for the Meaning of Life in the Amazon. 

Some Westerners are appropriating sacred plants while divorcing them from the traditions that gave them meaning—“colonizing them in reverse,” as American ethnobotanist Glenn Shepard puts it (p. 211). For example, ayahuasca use, despite widespread belief, may not date back thousands of years. Instead, O’Connor argues that the practice “rarely existed where Indians remained isolated from Western meddling” (p. 222). Its expansion beyond the Río Napo began relatively recently with Jesuit missions in the early 17th century and later accelerated through 19th-century rubber camps along the major river systems of the Amazon Basin. Through Western tourism, ayahuasca has come to be portrayed as “an ancient ritual for slaking our insatiable thirst for Indigenous salvation and/or for increasingly extravagant highs” (p. 223). 

During our meeting, O’Connor told me he does not “think there’s ultimately harm in appropriating a plant if you find it therapeutic, useful, or even life-saving—which a lot of people are reporting these drugs can be.” 

At the same time, he said, “we need to have an honest, good-faith conversation about where these drugs come from, what their actual Indigenous uses are, and what they are.” 

To write the book, which explores humanity’s broader relationship with psychedelics, from ancient religion to modern medicine, O’Connor worked with the Uitoto people to retrace an expedition undertaken some 50 years ago. Into the Colombian rainforest—home to begonias as red as blood and butterflies as wide as hubcaps—ventured scientific researcher Dennis McKenna and his older brother Terence, the visionary whose “tangled beard hung like an oriole’s nest past his chin” (p. xix). Weary of the war on drugs and fueled by utopian fantasies, Terence’s army of psychonauts sought a legendary hallucinogen that would turbocharge their DNA and “hasten a return to our preindustrial and preliterate past” (p. 284). 

In reality, Terence and his disciples did not transform into “eternal hyperdimensional beings” or travel via “flying saucers of the mind… ‘into the plenum of being’” (pp. 94, 30). Nor did they propel “human evolution forward to its next stage” by connecting to “the mind of nature itself” (pp. 284, 11). But they did experience auditory and visual hallucinations that led them, in a manner not unlike schizophrenia, “to adopt a new narrative interpretation of the world” (p. 95). 

Armed with the spore prints they’d brought back from La Chorrera, the McKenna brothers were “among the first, if not the very first, to successfully cultivate magic mushrooms at home, sparking a major leap forward in psychedelic history” (p. 202). In 1976, they published Psilocybin: Magic Mushroom Grower’s Guide; this April, half a century later, President Donald Trump signed an executive order expediting research into the therapeutic benefits of psilocybin and other substances of its ilk. 

O’Connor mentioned that one such mind-altering drug, ibogaine—made from the root of a Central African shrub—has shown promise in treating post-traumatic stress disorder and substance use disorders. 

“That’s great,” he told me, “but it also has a habit of slowing people’s heart rates considerably,” among other life-threatening side effects.  

“People are diving into these treatments as if there are no potential risks,” O’Connor, who teaches journalism at Boston College, added. “They don’t work for everyone—they’re not a magic bullet.” 

The remainder of the interview, which follows, has been edited for length and clarity.  

Why did you choose Terence as the focal point of the book? 

I hadn’t heard of him, and I pride myself on knowing about eccentric, overlooked weirdos from the psychedelic ’60s and ’70s. I was doing a lot of retail therapy online during the pandemic, as were many folks, and I came across his book, True Hallucinations (1989), totally by happenstance. I hadn’t known anything about it, bought it, and put it on the shelf for two years.  

I finally opened it one day and started reading. I had some preconceived ideas without really knowing anything about Terence or his subject. I thought it was probably some hippie-dippy thing about machine elves, and it sort of is that, but that’s not all it is. It’s a great narrative and just fascinating—it just captured me. 

Terence postulated that psilocybin mushrooms “played a crucial role in human evolution, giving our remote ancestors a jolt in language and cognition” and “turning Homo erectus into Homo sapiens.” While there’s nothing in the fossil record to support Terence’s “stoned ape theory,” according to anthropologist Laura Weyrich, advances in proteomics and DNA-sequencing technology could potentially indicate whether ancient hominids at least ate psychedelic mushrooms.  

How plausible do you think stoned ape theory is? 

When I first began looking into it, I was like, “Oh, this is so ridiculous.” I was embarrassed to ask these various paleoanthropologists, archaeologists, and researchers about it. I was like, “Oh my God, I can’t ask this, but I have to.” But it turns out that, as a thought experiment, many of them also found it interesting. It’s not something that I think is ultimately really provable. You could find some tangential scientific evidence, but you’re probably never going to get a smoking gun. 

Terence had a lot of theories—some relatively sane-seeming, like the stoned ape theory, and some completely batshit theories that have no basis in science or reason. But I sometimes liken him to Sigmund Freud, or maybe some of the kookier analytic philosophers, where you read it, it sounds kind of good, and then you get to the end and think, “Well, that’s probably 95 percent bullshit, but it still enriches my worldview.” I feel more enriched for having read it. That doesn’t mean it’s true, and I don’t put much credence in it, but it’s fun to entertain, and I do think it enriches the way I think about the human mind and human possibility. 

You also mention how “what drove [you] to write this book was in part a procession of deaths and their aftermaths” you and your wife endured starting in 2019. Would you elaborate on that? 

About a year into writing the book, my son, who was four at the time, fell ill unexpectedly, out of nowhere. He was in and out of the hospital during those days. It really brought us face to face, for the first time as parents, with real suffering and grief, and with being totally out of control when it came to finding a remedy for him. There was just no help to be found anywhere. I started thinking about grief and suffering, and how much of it was around us.  

Then there was this kind of cascade of deaths—just a lot coming at once over the span of a couple of years. It made me wonder what psychedelics, at least on a therapeutic level, potentially have to offer people: some relief.  

Another thing: My father was, weirdly, at the same time, starting to consider psychedelic-assisted therapy to treat his depression and longstanding addiction to alcohol. Maybe a year before, I’d given him Michael Pollan’s book, How to Change Your Mind: What the New Science Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence (2018). Because my dad had been in and out of therapy, rehab, and 12-step programs for many years, I was like, “I don’t know if you’ve heard of this, but I’ve been reading about non-traditional approaches to treating alcohol addiction, including psychedelics.” I don’t think he ever read it, but it did start a conversation between us. 

What surprised you most while researching the book? 

Reading Terence, I hadn’t realized that psilocybin mushrooms were not indigenous to La Chorrera—that they were essentially a foreign import [1], and not something used by the people there, certainly not by shamans. 

Another revelation was what “shamanism” actually looks like in the Colombian Putumayo. Terence talked a lot about this sort of psychedelic shamanism. A lot of people do today, too. But it’s just not at all what it seems to be. The Indigenous perspective on and use of things like ayahuasca, or yagé, and other psychedelic plants—at least in the Putumayo, where Terence and Dennis spent much of their time—is vastly different from how I think they’re generally understood or used in the U.S. These substances were generally not used for healing. Until European contact with Indigenous peoples throughout the Amazon Basin, ayahuasca was mostly used in the hunt—to have luck in finding animals—or sometimes to find lost objects or communicate with family members or other tribe members over long distances. But it was definitely not a therapeutic application. That’s starting to shift a little bit now, though, because of this strange sort of cross-pollination that happens so often in history where it’s now being fed back into an Indigenous context. 

I think I went into the book as something of a Terence fanboy. I cooled on him a bit once I spoke with Colombian anthropologists and ethnobotanists and realized how taken out of context many of his proclamations were on psychedelics and the “shamanic” experience. But, by the end, I sort of warmed to him again because I realized that his ultimate project, I think, was really about human wellness and flourishing. I think that’s what he wanted ultimately, even if he went about it in a strange, myopic way focused almost exclusively on the psychedelic experience through psilocybin mushrooms. That’s where I part ways with him. I think the best place from which to grapple with grief, loss, and suffering is through love, tenderness, and compassion—not through machine elves at the end of history, which was, more or less, Terence’s take. 

I was also interested in your discussion of “diagonalism”—what scholars William Callison and Quinn Slobodian characterize as the social-distress-born alliances between the far left and the far right uniting wellness gurus, anti-vaxxers, and conspiracy theorists. 

I was just reading an article by the American political scientist Francis Fukuyama; he calls it this horseshoe meeting of the minds—this ideological vortex where people with otherwise totally divergent political opinions are meeting in the middle on certain issues. The far left, the Make America Healthy Again movement, the Multidisciplinary Association for Psychedelic Studies—even just the friendship between [MAPS founder] Rick Doblin and former Texas Governor Rick Perry [co-founder of the nonprofit Americans for Ibogaine], who had one of the most conservative legislative agendas in recent memory. That friendship seems genuine—and maybe even necessary to advance these drugs beyond their current legal status. 

In 2023, MAPS hosted the world’s largest psychedelic conference, which you describe as laden with snake oil pseudoscience and lacking in diversity, equity, and inclusion. Almost a year later, an FDA advisory panel rejected MDMA-assisted therapy for PTSD, citing safety concerns and questions about data validity. Critics alleged that MAPS’ drug development arm failed to disclose data showing sexual misconduct by therapists and increased suicidality among trial participants. A former MAPS volunteer called MAPS an exploitative and abusive cult that functions “more like a religious movement than a scientific organization.” Similar concerns emerged at The Johns Hopkins Center for Psychedelic and Consciousness Research. An ethics complaint accused founding director Roland Griffiths of “acting as a ‘spiritual leader’ rather than a scientist” and influencing participant outcomes through religious symbolism. 

Additionally, a Columbia psychiatrist reviewing the field noted a relatively high rate of  irritability, anxiety, insomnia, and other adverse events, and called for more “rigorous assessment” of psilocybin-assisted therapy.  

How do we balance the potential of psychedelics to promote empathy and well-being with the risks? 

Terence said a lot of completely bullshit things about psychedelics—even dangerous things at times. You see that in the movement today, where a lot of these wild, unsubstantiated claims are being made about drugs that, yes, have real healing potential for many people, but for others, such as my father, don’t work at all—and arguably cause more harm than good. 

We should be sane and sober about this. We can champion these drugs while still having a lucid conversation about their efficacy, limitations, and safety concerns. 

[1] One of my favorite passages from the book is “Darkly gilled, with distinctive golden halos and pink veils around slender stems the color of bruised flesh, they were easily identifiable as Psilocybe cubensis… Likely brought to the Americas by Spanish missionaries via the dung of zebu cattle—rangy saltwhite beasts with enormous, scythe-like horns—Psilocybe did especially well in the humid pastures of La Chorrera. Amazonian shamans, who knew more about psychoactive plants than anyone on earth, had no use for these foreign imports. To Terence, however, they were living manifestations of the divine” (p. xx). 

A Short, Strange Trip: An Untold Story of Magic Mushrooms, Madness, and a Search for the Meaning of Life in the Amazon 
John O’Connor 
New York: Sourcebooks 
2026 

Tooker depicted waiting for a more specifically governmental bureaucracy in his painting, “The Government Bureau.” In that painting, the waiting people are reproduced several times to emphasize their anonymity, and the multiple bureaucrats peer out from frosted windows with only their eyes and noses visible — bringing to mind the concept of the “medical gaze” promulgated by the French philosopher,  Michel Foucault.

In another Tooker painting, “Ward,” he renders patients’ anonymity and a sense of abandonment in the hospital setting–with government bureaucracy invoked by the American flags hanging on the wall.

Image Credit
The Waiting Room, George Tooker, 1959. Collection of the Smithsonian American Art Museum. Image used for educational and critical commentary purposes.

George Tooker documentary videos from Columbus Museum

The short story follows a woman who has been sent by her physician to a colonial mansion in the country as treatment for postpartum depression. The woman, who remains nameless, is constantly dismissed and belittled by her husband, who is also a physician. He speaks to her patronizingly and ignores her protestations that the “treatment” she is being given is making her worse instead of better. She is told not to think, and not to write, and her husband believes that since he sees no reason for her suffering, it does not exist. She is kept upstairs in the mansion’s nursery, isolated behind bars and gates that she believes to be there for children’s safety, when in actuality they function to keep her imprisoned. As time passes, the woman believes that she perceives something in the wallpaper and becomes convinced that it is a trapped woman. She believes the woman is confined behind bars within the wallpaper, which mirrors the trapped feelings that she herself is experiencing living day in and day out inside the confines of the nursery. Her desire to help the woman escape, which mounts to a frenzy, is reflective of her own desire to be free from the nursery and the rest cure.

Throughout the story, the titular wallpaper functions almost as another character as it’s brought to life in the narrator’s mind. She contrasts the vitality of the wallpaper with the “dead paper” upon which she is writing the journal entries that make up the narrative. Her fascination, and disgust, with the wallpaper drive the story as she investigates its pattern and condition, and then ultimately determines that there is someone living within it. The narrator’s disdain for the paper is obvious in her descriptions; for instance, in her first mention of the wallpaper, she writes “I never saw a worse paper in my life” (p. 793). She later writes that the print was “One of those sprawling flamboyant patterns committing every artistic sin” (p. 793). On the topic of its hue, she writes that “The color is repellent, almost revolting; a smouldering unclean yellow…a dull yet lurid orange in some places, a sickly sulphur tint in others” (p. 793). For all of her disgust with the wallpaper, and its damaged and torn condition, she still finds herself fascinated by it, and this fascination turns into obsession, which later turns into madness.

“The Yellow Wallpaper” works so effectively because it allows the reader to step into the mind of a woman as she is driven to madness. The structure of the story, which is told in an epistolary format, adds to the reader’s affiliation with the narrator as there is an intimacy in reading her journal entries and being in on the secret that she is writing against her husband’s orders. This affiliation helps to build empathy between the reader and the narrator, which contributed to the concern that I felt for the woman when she slowly lost her mind. If the story helped to save people, as Gilman hoped, it did so because it made them see the human being at the center of the “illness” and “treatment,” forcing them to understand what truly happens when you isolate someone and take away their ability to do what brings them joy. We bear witness as the woman loses her mind, leaving us with an intimate picture of what the rest “cure” could truly do to someone’s psyche. Instead of viewing postpartum depression solely as a condition to be treated, “The Yellow Wallpaper” makes readers realize that there is a person at the center whose needs and voice deserve attention.

In a patriarchal era in which women’s voices and lived experiences were ignored in favor of what the men around them deemed to be “best,” “The Yellow Wallpaper” offers an important and valuable perspective – that of the woman herself. By placing the female patient’s voice at the forefront of her story, Gilman gives her narrator the agency that had previously been stripped from her, to tell the story of her postpartum depression and how the prescribed treatment drove her to madness instead of restoring her health. It is a reminder to each of us that the voice of the patient is of paramount importance in any instance in which an embodied condition is being treated. When we ignore the patient, and what they need, they are lost, pushed to the background, and left to disappear into their own metaphorical wallpapers.

Works Cited
Gilman, Charlotte Perkins. “The Yellow Wallpaper.” The Norton Anthology of American Literature, edited by Nina Baym and Robert S. Levine, W.W. Norton & Company, 2012, pp. 804.

Originally published by The New England Magazine, Boston, 1892

Image Credits
Illustration for ”The Yellow Wall-paper” by Joseph Henry Hatfield, 1892 from Wiki Commons
Book cover by Small, Maynard & Company, 1901 from Wiki Commons
Web image from Medhum

Film ReviewVideo

Obsession and “The Yellow Wallpaper” 

Rudy Malcom May 29, 2026

The film highlights the peril of love that demands possession.

Two hidden stories by two famed authors written decades apart in two countries eventually became widely known. One, Anton Chekhov’s, At the Pharmacy, was translated into English in 1998, about one-hundred years after it was published in Russia. The other, Raymond Chandler’s, It’s Alright–He Only Died, was unearthed from its unpublished state by Strand Magazine in 2018, about sixty years after it was written. Though written in different times, and using different scenarios, both stories warn of the barrier money creates to urgent and necessary health care, and of the corrosion in professionalism it causes in providers. They tell of what was to become a defeating feature of Western health care because of financial incentives, social prejudices, and human folly.

Six Kopecks or Your Life

Peter Constantine reached back from the 1990s into the 1880s to assemble a translated anthology of some Chekhov short stories not available to English-speaking audiences. Among the chosen stories in The Undiscovered Chekhov: Thirty-Eight New Stories, is At the Pharmacy.

The story begins when Egor Alexeyitch Svoykin becomes sick. His physician prescribes medicine that a pharmacy would need to prepare. Svoykin felt some relief being in a large Russian city during the late nineteenth century that would have pharmacies he could count on. This feeling of relief dissipated just after entering the pharmacy and coming before the imperious pharmacist there. 

The pharmacist eventually raises his head from a newspaper, looks at the prescription, shouts instructions to his assistants, and then returns his gaze to the newspaper while at the same time informing Svoykin the prescription will be ready in an hour. Svoykin is the only person waiting at such a late hour as it was, and he was deteriorating.

His mouth was on fire; there was a drawn-out pain in his arms and legs; foggy images tumbled about like clouds and shrouded human figures in his heavy head. He looked as if through a veil at the pharmacist, the shelves of jars, the gas burners, and the cabinets. The monotonous pounding in the marble mortar, and the slow ticking of the clock seemed to him to be coming not from the outside but from inside his head. (p. 129)

When Svoykin reports to the pharmacist that he is becoming feverish and feeling weaker, “the pharmacist “remained stock-still and, leaning his head farther back, kept on reading his newspaper. He didn’t respond to Svoykin with word or movement—it was if he hadn’t heard him.” (p. 130) When Svoykin subsequently approaches the pharmacist pleading with him to hurry the prescription, the pharmacist again brushes him off saying, “It’ll be ready soon enough…excuse me, but there’s no leaning on the counter.” (p. 131)

The next half hour was “unbearable” before the prescription came and then made more so by the dubious rituals the pharmacist performed in adorning the prescription container. The pharmacist charged one ruble and six kopecks, but Svoykin was short the six kopecks. 

Under the circumstances…I would be grateful if you would let me bring you, or maybe send you, the six kopecks tomorrow…

I’m sorry, we don’t accept credit here.

What am I supposed to do?

Go home, get the six kopecks, and then you can have your medicine.

But…I’m having difficulty walking, and I don’t have anyone I can send…

That’s your problem.

pp. 132-133

Svoykin returned home, though with difficulty. The Kopecks were there on the table, but his illness kept him from returning to the pharmacy.

Just Drunk

Strand Magazine is a source for “unpublished works by literary masters.” The October-February (2017-2018) issue includes an unpublished Raymond Chandler short story. Chandler wrote crime fiction for the most part, and the stories usually involved the fictional detective, Phillip Marlowe. This story, however, written between 1956 and 1958, is about a person brought to a hospital emergency room and denied service for financial and social reasons.

As the story opens, a man who has been hit by a truck is brought into the emergency department at General Hospital. He arrives just before shift change and so the admitting clerk is already annoyed about having to assess him. The clerk checks the patient’s pockets for the required $50 deposit and finds nothing, so she could now send the patient to the county hospital, and that would be that. But, before she initiates the transfer, she asks a passing private attending physician to look at the patient. He sees that the patient is dirty, smells of alcohol, and would cost a lot to work up. Mindful of an admonition from a major donor that the “hospital is not run for charity,” the physician surmises the patient is “just drunk,” and agrees the patient should be moved to the county hospital. Off the patient goes.   

The next day, the same admitting clerk at General Hospital gets a call from the county hospital. She’s informed that the patient they transferred had a head injury requiring surgery, and that the patient had $4,000 in a money belt inside his undershirt. The patient couldn’t be saved, however, because of the delay involved in the transfer to the county hospital. “It’s all right—he only died.”

Fast Forward

If they could have foreseen the current time when they wrote these stories, 140 years ago for Chekhov and 70 years ago for Chandler, they would have realized that the scenarios they created became commonplace and institutionalized in many ways.

Pharmacists may not go unseen behind a newspaper as Chekhov’s pharmacist did, but they may be buried under insurance company paperwork or piles of prescriptions needing to be filled. And certainly in a few situations, perhaps only independents, do pharmacists have ways to cover costs when patients are short on cash, credit, or insurance coverage. They are very likely to send patients away to get money even when they are very sick.

Hospital personnel do not now actually reach into the pockets of unconscious patients to see if there’s enough cash for admission as Chandler conjures in his story, but he would see them still check for money in the form of insurance cards or proof of sufficient financial means. He would also see that the scenario he described in which patients without money get transferred to county hospitals had progressed to a degree that people are moved around among different health care providers based on health care insurance plan coverage or lack thereof. But the poor treatment of patients in need of emergency care can even occur in the “right” hospitals when they are held for hours to days in hallways or holding wards for beds to become available.

Scenarios such as these can and have been addressed to varying degrees through government welfare programs, regulatory requirements, technology advances, and professional practice standards among other responses. The two stories, though, also expose human folly not so amenable to these actions. What can be done about the pharmacist who won’t put the newspaper down to address the needs of a person seeking help for an acute illness? What can be done about the physician who after a cursory evaluation brushes off an unconscious patient as “just drunk?”

Chandler makes an attempt at addressing the human folly he and Chekhov reveal by describing how it fails humanity on both professional and personal levels, and in shaming the character, who is ostensibly standing in for those behaving as this doctor in the story did.

All he had done was disgrace himself as a person, as a healer, as a saviour of life, as a man required by his profession never to turn aside from anyone his long–acquired skill might help or save…Why should a doctor in such circumstances be better than other men? The answer is simply, that if he isn’t, he is not a doctor. The $4,000 would have made quite a difference in this case, wouldn’t it?  Should it?  

Chekhov and Chandler are perhaps hoping that those in the care of others will exhibit more humane and professional behaviors when they ask themselves many decades later: “Am I a doctor?”“Am I a pharmacist?” “Am I a human being?” Would it make a difference? Should it?

Notes

Title image:
A young girl waiting for a pharmacist to make up a prescription.
Photogravure, 1912, after J. Jendrassik, 1896
Licensed under the Creative Commons Attribution 4.0 International

End image:
Nurse Aide Rocky FordHospital CO
Mennonite Church USA Archives, No restrictions, via Wikimedia Commons