Field Guide to Falling Ill: Essays by Jonathan Gleason 

New Haven, CT: Yale University Press, 2026, 256 pages 
ISBN 9780300282948

In these ten exemplary essays, Gleason mingles illness memoir, the challenges of caregiving, and loss (of health and spirit). Disease is portrayed not only as an aberration of the body’s normal homeostasis but also a distinctive event with social, cultural, and possibly historical meaning. Contagions (viruses, prejudices, even love) receive special attention as catalysts of uncertainty, anxiety, and sometimes terror. Spaces – inner, close, distant, and built – are similarly scrutinized. In 1623, the English poet John Donne declared that “the greatest misery of sickness is solitude.” The narrator of the title essay echoes that sentiment, describing “loneliness” as the world’s greatest sorrow. He volunteers as a part-time medical interpreter at a free clinic but suddenly becomes a patient himself with a blood clot in the left arm. These experiences lead to an understanding of the power and limitations of both language and empathy. Other essays explore organ donation, AIDS, mental illness and the demise of large psychiatric hospitals, Tay-Sachs disease and xenophobia, pain, addiction, and the trial of an Ohio doctor charged with multiple counts of murder. Throughout these pages, Gleason points out the hubris of medicine as well as its shortcomings. He writes, “We like to believe we know the vastness of the world, that everything can be explained through our current models of understanding” (p3). At some point (or maybe many times), however, we will all fall ill and become a patient. And that immense world with all its scientific knowledge will dramatically contract to our single suffering body longing to be comforted and cherished by others. 

“An Eye in the Throat” in Good and Evil and Other Stories (pages 57-96) by Samanta Schweblin, translated by Megan McDowell  

New York, NY: Knopf, 2025, 192 pages 
ISBN 9780593803103 

It’s every parent’s nightmare: a serious (and potentially preventable) injury to their child that occurs right in front of them. Here, the setting is Argentina in the 1990’s. Inquisitive two-year-old Elías chokes on a lithium battery from his grandmother’s digital calculator while his father is in charge of watching him play. A visit to the ER and then an appointment with the family doctor the next day offers little reassurance for the parents. On the third day, Elías begins coughing and develops a fever. An operation is performed to remove the lodged battery and repair tissue damage to the esophagus. A tracheostomy is performed, and he undergoes four operations in a span of six years. He is unable to speak. At one point, he mysteriously gets out of his car seat and briefly becomes lost at a gas station. Soon after, a landline phone at home eerily rings each night. When the father answers, there is no voice at the other end. The parents eventually separate. Elías comprehends that all family members are casualties, and with an amazing capacity for empathy concludes, “There is a hole in my throat, a hole in my body that hurts in theirs” (p79). He is enrolled in a special school for deaf and mute children and becomes an outstanding student who is enthralled by language and mathematical physics. Schweblin’s searing story about parental guilt and grieving, failed communication, and the remarkable resiliency of youth is guaranteed to leave you with a lump in your throat. 

A Prescription for Burnout: Restorative Writing for Healthcare Professionals by Carolyn Roy-Bornstein 

Baltimore, MD: Johns Hopkins University Press, 2026, 208 pages 
ISBN 9781421454733 

Burnout among physicians and nurses, accelerated by the emotional and physical crush of the Covid-19 pandemic, continues to be an urgent problem. Causes of burnout among health professionals include an erosion of autonomy, truncated time allotted for patient visits (but increased time required for inputting data into the electronic medical record system), feeling underappreciated, unrealistic expectations from patients and employers, and the daily exposure to the suffering of others. Roy-Bornstein, a pediatrician and a former RN, enthusiastically endorses reflective writing as an effective remedy for dealing with burnout (or perhaps preventing its occurrence). While not a new concept, her discussion includes research on the utility of restorative writing, some commentary on narrative medicine, and most importantly, more than 85 writing prompts (or Rx’s as she refers to them) for reflection and as a kind of therapeutic exercise. Organized into three sections – Addressing Emotional Exhaustion, Countering Cynicism, and Restoring Self-Efficacy – the book addresses issues of vulnerability, self-compassion, self-awareness, resilience, and optimism. There is no doubt that reflective writing can be healing and hopeful. Roy-Bornstein offers a helpful pathway to reducing the risk of professional burnout.  

Vesalius’s illustration, “Skeleton Contemplating a Skull” from Wellcome Collection

DAVID HSU: What are you up to these days? What are you working on?

JACK COULEHAN: In terms of creativity, I’m working on a new collection of poems that I’m editing now. I’m also the book review editor of The Pharos magazine, and that takes up an unexpectedly large amount of time.

DAVID HSU: Do you practice medicine at all anymore?

JACK COULEHAN: No, actually, I retired about 12 years ago now, but I do still teach medical students as a volunteer. It’s a class that I began back when I started at Stony Brook in 1991. It’s called Medicine in Society, and it’s a first-year seminar course that deals with human, social, and interpersonal issues in medicine. We use a lot of literature and film in that and so I’m still a group leader. We also have a master’s degree program in medical humanities, and I teach a course in that. So I still keep my hand a little bit in teaching.

DAVID HSU: Given that you’re doing all this work in the humanities, what do you think about the relationship between medicine and the humanities?

JACK COULEHAN: You know, that’s a surprisingly difficult question for me, because I’ve always had this kind of love/hate relationship with the term medical humanities, because I think it doesn’t quite capture the problem or the issues that we’re trying to address and what we do. In a lot of my work, I tend to cite a piece that Rafael Campo wrote in JAMA in 2005, entitled “The Medical Humanities, For Lack of a Better Term.”  What I’ve really always thought is that what we’re trying to do is to teach students and ourselves, really, to become more reflective and more thoughtful…[Campo] used the terms reconnection, renewal, and meaning. . I think we’re not necessarily encouraged in our profession to become aware of our own needs, to become reflective, thoughtful, to become focused on the personhood of patients and so on. And so I think, through discussion, through examples in literature, film, etc., we can really try to address these issues. I guess the term medical humanities is fine as a placeholder, but I wish there was a better term for it. But, aside from reflecting on the name itself, those are the things I think we’re trying to address in medical humanities. 

When I started in this business, pretty long ago, I was thinking about [medical humanities] mostly in terms of becoming a better doctor by improving one’s empathic skills and reflecting on the patient as a person. But as time has gone on, I’ve become more aware that I think it’s really something that makes you a better person and also more able to cope with the stresses and the challenges of modern medicine. So, I think it works both ways.

DAVID HSU: What are your criticisms of the way medicine is practiced now, since people aren’t doing all this [reconnection, renewal, and meaning]?

JACK COULEHAN:  First of all, I think medicine has to be understood in our current overall culture of increasing subspecialization and focusing on narrower and narrower fields [of practice], using more and more technological instruments, tools, and machines. Also, medicine is more and more controlled by larger interests that are not necessarily oriented towards the primary values of medicine.  There are virtually no constraints on the use of technology, the focus is entirely on disease, on narrow perspectives on disease.  

What I’m saying is that all this detracts from the ability necessary to see the patient in terms other than as an object that has a disease or a person who has a specific problem that needs to be addressed.

Just to give my personal examples, when you get to be 81 years old, as I am, you have a lot of opportunities to experience being a patient. I saw a cardiologist a couple of weeks ago who is an older cardiologist, and he was what I would call an ideal physician. He does interventional cardiology, he’s a professor, well-published, and yet his approach, I would consider to be very therapeutic–very positive, trusting and good eye contact. He wasn’t looking at the computer. He was just a genuine person, genuinely interested. I’ve also gone to a urologist who was just the reverse. Equally specialized in the same medical system, but one who was all about the particular issue, the particular organ, and the particular thing that’s happening to that organ.

It’s possible, you know, when you start talking about the kind of values and the kind of stresses that modern physicians are under, the first response you get is that, “Oh, yeah, that’s great. That’s what we should do.”  But you know, we only have 15 minutes [and] we have to deal with the EMR, etc. But that belies the fact that there are physicians out there who are very good at actual doctoring and others who aren’t, and I think that’s because, well, let’s say, look at those two things on a spectrum…I would say that there is the opportunity, even in today’s world, to help students keep their belief, which most of them have, I think, when they begin, that doctoring is really interested in persons. And I think we could increase the percentage of physicians who feel that way and practice that way.

DAVID HSU: I’m curious because you mentioned that you’re 81. You’ve been around the medical system for decades. How has the system changed from when you first started in it until now? Is it getting worse, or has it always been like this?

JACK COULEHAN: Well, that’s tough. I definitely think it’s worse, but I also think it’s romanticism, you know, to look back and say, “Oh the good old days.” 

I graduated from medical school in 1969 and graduated from my residency and fellowship in 1975. Those were the days when I was learning to take a history. Taking a history–that’s another phrase that I dislike. But we had a little black book, that had 100 or 140 questions to ask in it. There was no concept of medical interviewing, nor the  teaching of it. I had the feeling that a lot of the values of good doctoring were kind of implicit and not necessarily taught in those days.

And so we’ve gone through a whole phase of learning that the medical interview is a therapeutic tool, and now I think we pay a lot of lip service [to it], but I don’t know that we necessarily carry it from its place in the curriculum to its place in the clinic or the hospital.

But there’s no question that it’s gotten worse [although] the technological advances are just so incredible. I remember at some point, as a student, you have this idea that the CT scan will give the answer, or the lab result will give the answer. The patient’s story is secondary. And I remember some instructors saying, no, no, wait a minute, you should know 80% of the time what the answer is before you even request the test. The test is not meant to be, the be-all, end-all of everything, but, definitely, that is the case now. Even within practice, every advancement that happens in technology kind of nudges us closer to thinking of the computer as a solution for everything.

Let’s say, one patient comes in with chest pain or nausea. I think the tendency now is to focus on those symptoms, to think of what disease might cause them, and to do various tests, rather than sitting down with the patient and trying to understand what their situation is.

DAVID HSU: You mentioned this earlier, and I wanted to follow up on this little comment you made about how the practice of humanities and writing has a self-care component to it, and that as you’ve practiced it more, it’s helped you handle stress and different challenges. Can you elaborate a bit about this?

JACK COULEHAN: As a high school, college, and even a medical student, I had this inexplicable urge to write poetry, which I did. It’s pretty juvenile. But anyhow, I did it. Then of course, I gave it up because I was a doctor. I was practicing, I was doing research, etc. And in my mid-40s, I was reaching, I think, what you might call burnout. That might be a little too dramatic, but I felt that there was something missing in my life, in my career, and I happened to have a patient who was a professor of poetry at the University of Pittsburgh, where I was teaching at the time. And one thing led to another, and she encouraged me to start writing again. And I did, and I found very quickly that by writing about…my experiences in medicine, I was able to…work through them and understand my reactions better, and so I think that poetry is a reflective practice that in a sense provides occasion for you to grapple with experiences, issues that have been troubling you, or that on the other hand have been very happy. It can work both ways.

Getting back to medical humanities, I think what we’re trying to do in medical humanities is to stimulate that kind of process in young physicians or young clinicians, whether it’s through poetry, through writing journals, through just meeting in small groups…that kind of thing…and to use not only personal experiences, but literature, poetry, film, etc. as stimuli for that.

DAVID HSU: Let’s wrap up with what you would like to see medhum.org do? How would you like to see it grow in the months and years to come? What type of topics or articles do you want us to tackle? 

JACK COULEHAN: I like the concept of being provocative. I’d like to encourage people to come in through material that’s kind of leading edge. I’d like to see people have conversations, comments and so on.

DAVID HSU: Thank you, Jack for participating in “Meet the MedHum Editors.”   It’s been a pleasure to speak with you.

Written by Jack Coulehan on Medhum.org (View All)

Alphonse Daudet and Intractable Pain

26.05.2026 449

Children Who Remember Former Lives 

6.04.2026 8912

The Anatomist by Frederico Andahazi

17.02.2026 509

Rethinking Medications by Jerry Avorn

20.01.2026 644

The Word Is an Instrument of Healing 

16.12.2025 699

Stuck By Heidi J. Larson 

3.11.2025 628

Alive: Our Bodies and the Richness and Brevity of Existence by Gabriel Weston 

Boston: David R. Godine, 2025, 304 pages 
ISBN 9781567928235 

The physician experience, medical history, motherhood, anatomy, and worries about her diseased mitral valve are tenderly sutured together by ENT surgeon Weston in her exploration of “the poetry of the body.” In thirteen chapters, she eloquently contemplates “the strange, unbridgeable gap that exists between the body science describes and the one each of us is living inside right this moment” (p194). In describing the anatomy of bones, brain, breasts, genitals, gut, heart, kidneys, liver, lungs, skin, and womb, Weston writes with a wit and intense curiosity reminiscent of popular science writer Mary Roach. But the book’s splendor arises from its attention to the art of doctoring. Weston notes how good physicians require a kind of “bifocal vision” that allows them to see the generalities of the human body but also the unique details of an individual patient. She extols empathy and elevates vulnerability: “We are not separable from those we care for, just as our strength is not separable from our vulnerability” (p263). Melding science and sentiment, mixing professional life with personal life, Weston enlivens anatomy and pays homage to the physician-patient relationship.  

The Land in Winter by Andrew Miller 

London: Sceptre, 2024, 384 pages 
ISBN 9781529354270 

Andrew Miller’s remarkable 1997 debut novel Ingenious Pain chronicles the complex life of an 18^th century highly skilled English doctor incapable of feeling pain. Twenty-seven years and many novels (Oxygen, Pure, The Optimists) later, Miller’s latest book spotlights a main character who also happens to be an English physician – but this flawed human being hurts (especially emotionally). Eric Parry is a 36-year-old country doctor having an extramarital affair with a married woman while his wife Irene is pregnant. Next door to their cottage is a farm owned by Bill Simmons and his pregnant wife Rita who suffers from mental illness and enjoys reading science fiction. It is winter (December, 1962 – January, 1963) and for a time the rural community is paralyzed by a brutal blizzard. Happy endings are in short supply here. One of the pregnant women has a miscarriage while sitting on the toilet. Characters get injured. Some patients die. Eric’s infidelity is exposed. Still, compassion and empathy occasionally sprout amidst the bleakness and the cold. Irene is cognizant that her husband’s work is hard as he “had to deal with people’s suffering all day” (p55). Eric excels at examining patients with a manner that “calmed” them. Secrets, loneliness, belonging, complicated personal relationships, and poor decision-making are essential elements of the plot. The story asks readers to contemplate whether virtuousness is a necessary requirement to be a “good doctor.” 

Doc or Quack: Science and Anti-Science in Modern Medicine by Sander L. Gilman 

London: Reaktion Books, 2025, 320 pages 
ISBN 9781836390152 

Bloodletting and purging (“heroic medicine”) employed for a wide array of diseases. Laetrile (a chemical present in apricot seeds) used for treating cancer. Hydroxychloroquine and Ivermectin prescribed for COVID-19. Spanning centuries, the list of wacky, ineffective, and sometimes dangerous remedies for illness is quite lengthy. In this standout history of scientific medicine from the mid-19^th century to the present, Gilman navigates “the ever-shifting boundary between good medicine and quackery” (p15). He reviews the rise of allopathic medicine that resulted from “following the science” as discovery and knowledge migrated from the laboratory to the bedside. He writes about the model of the physician-healer, the placebo effect (along with the morality of deception), superstitions (of both doctors and patients), and the faddish nature of medical practice. Gilman is rightly concerned about physicians experiencing burnout and patients feeling disconnected from their doctors in truncated office visits. He wonders if empathy and efficacy can coexist in contemporary healthcare. Three “case studies” are presented: peptic ulcer disease, the development of ophthalmic surgery, and acupuncture for back pain. A thoughtful study of historically “good” and “bad” medicine and the occasional blurring between the two. 

Additional recommended books published in 2025: 

The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains
by Pria Anand 

The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker
by Suzanne O’Sullivan 

Web photo by Bermix Studio 

At one point Ragin accidentally visits Ward #6, the mental ward, where he encounters Ivan Gromov, a brilliant patient, and strikes up a conversation with him.  Gromov, who carries a diagnosis of paranoia, loves life passionately.  His passion attracts Ragin, whose sensibilities are blunted by the emotional numbness from which many physicians suffer.  Ragin is attracted to Gromov like a moth to a candle. He begins to visit Ward 6 daily to debate with Gromov. Since the other doctors never visit Ward 6, this behavior is considered very peculiar. 

Ragin yearns to feel something, anything, even to experience suffering, rather than to remain suspended in his emotionless cocoon.  He develops an obsession that only suffering can redeem him.  This obsession makes him even more dysfunctional, a situation which allows a junior doctor to have him fired as hospital director and, ultimately, admitted to Ward #6 as mentally ill.  Once Ragin has become a patient, a “nobody,” the ward orderly hits him, thereby giving him the opportunity to suffer.  Shortly thereafter, he has a stroke and dies.

Enormous demands and poor working conditions contribute to Ragin’s predicament, but Chekhov suggests that Ragin’s character is also deficient.  Something is missing.  He experiences a sense of futility and numbness.  Is this an inevitable consequence of medical practice?  Or is he particularly vulnerable to burnout?  The deeper theme in “Ward No. 6” is Ragin’s failure to live an authentic life, to discover a sense of wholeness and meaning in his existence.  It is possible that Ragin’s early enthusiasm for hospital practice disguised the fact that he never came to terms with his own needs and values.  

Lady With Lapdog and Other Stories
Anton Chekhov
David Magarshack (Ed.)
London, Penguin Books, 1964.

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database (Litmed).

Reviews of Chekhov’s Stories

Cold Eye, Warm Heart: Medicine and Anton Chekhov  

Jack CoulehanAug 6, 2025

An Awkward Business by Anton Chekhov 

Jack CoulehanJun 11, 2025

The Grasshopper by Anton Chekhov

Jack CoulehanMay 11, 2025

Ionych by Anton Chekhov 

Jack CoulehanMar 11, 2025

A Doctor’s Visit  by Anton Chekhov 

Jack CoulehanMar 11, 2025

Ward No. 6 by Anton Chekhov

Jack CoulehanMar 11, 2025

A Nervous Breakdown by Anton Chekhov 

Jack CoulehanFeb 11, 2025

Enemies by Anton Chekhov

Jack CoulehanJan 11, 2025