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‘The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians’

Expanded News Release, with Excerpts

First Anthology of Great Literature Suggested by Physicians

Companion Volume to ACP Poetry Anthology, ‘In Whatever Houses We May Visit’

The title of the first anthology of great literature that has inspired physicians pays homage to the great physician Sir William Osler (1849-1919), a bibliophile who wrote the first modern English-language medical textbook to be written by a single author -- and sprinkled it with references to classical literature. “The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians” -- just released by ACP Press, the book publishing program of the American College of Physicians -- alludes to Dr. Osler’s habit of reading for the last half hour of the day. Osler encouraged physicians and medical students to do the same.

The book’s editors, Michael A. LaCombe, MD, MACP, and Christine Laine, MD, MPH, FACP, dedicate “The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians” to all physicians who aspire to Osler’s reading routine. In the book’s introduction they encourage readers to, “Start with ‘that last half hour’ of Osler, and progress to a lifetime of reading.”

Through 37 stories and essays Drs. LaCombe and Laine share a collection of great literature suggested by physicians around the world. The book is a distillation of those selections, with some additions from the editors. “There are many literary anthologies in print, but this is the very first and only anthology composed of great literature suggested by physicians who read, combining excerpts from prose that has held meaning for them, that they turn to for inspiration and introspection in the course of a busy professional life,” said Dr. LaCombe.

Most of the stories and essays have medicine as a theme or in the background, but the book is designed to be accessible to medical and nonmedical audiences. It features both award-winning and lesser-known writers, in literary styles that range from an ancient writing from Plato, to a modern short story by Alice Walker, a learned essay from Sir Thomas More, to science fiction story by Ursula Le Guin.

The book opens with a passage by Luther Standing Bear, a Lakota Sioux, that begins, “These stories were the libraries of our people. … There were calamities, discoveries, achievements, and victories to be kept. … Then there were stories of pure fancy in which I can see no meaning. … ” The book’s five chapter titles parallel this passage: Achievements, Discoveries, Calamities, Victories, and Pure Fancy.

“The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians” shares writings that express medical ideals and realities, the devastation of death and illness, the miracle of healing, and the netherworld of remission. Reflections of the physician’s role in society and as an observer of the human body and spirit are seen throughout the book.

Ernest Hemingway, whose father was a physician in Illinois, writes of a boy accompanying his doctor-father to a difficult birth in “Indian Camp.” Marie Curie tells of her husband’s sacrifices to science in an excerpt from “Pierre Curie.” In a passage from “Life on the Mississippi,” Mark Twain wonders, “What does the lovely flush in a beauty's cheek mean to a doctor but a 'break' that ripples above some deadly disease.” Jean-Dominique Bauby, who suffered a stroke at age 43 that left him with Locked-In Syndrome, contrasts the once-enjoyable soaks in the tub with the weekly hospital ritual in “Bathtime.” Bauby dictated his book, “The Diving Bell and The Butterfly,” and died shortly after its publication.

“The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians,” closes with Ursula Le Guin’s “The Ones Who Walk Away from Omelas.” Of that tale, Drs. LaCombe and Laine wrote, “It is the hope of the editors that this story will haunt caring physicians everywhere.”

“The Last Half Hour of the Day” includes selections by Raymond Carver, Victor Hugo, Thomas Jefferson, Doris Lessing, Sinclair Lewis, Pablo Neruda, Frank O’Connor, Edgar Allen Poe, and others. Physician voices include those of Anton Chekov, Susan O. Mates, Sir William Osler, Oliver Sacks, Richard Selzer, Lewis Thomas, Abraham Verghese, and Abigail Zuger. The biographies appended at the end of the anthology give suggestions for further reading.

“The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians” is the companion volume to “In Whatever Houses We May Visit: A Poetry Anthology for Physicians,” edited by Dr. LaCombe and Thomas V. Hartman, and published in August 2008 by ACP Press. For “In Whatever Houses We May Visit,” Dr. LaCombe again turned to physicians to contribute the poems that they have found most meaningful in their daily lives. “In Whatever Houses We May Visit” features the work of both well-known and emerging poets, both physicians and non-physicians, in nearly 200 poems about illness and healing, doctors and patients, and a wide range of related subjects. Emily Dickinson; William Carlos Williams, MD; Rafael Campo, MD; Maya Angelou, and Philip Larkin are among the poets whose works are included.

To order “The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians,” visit ACP Press at www.acponline.org/acppress. The list price is $34.95; ACP members pay $24.95. The hardcover book has 350 pages. The product number is 330371800; the ISBN-13 number is: 978-1-934465-09-7.

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Michael A. LaCombe, MD, FACC, MACP, is a writer who has practiced internal medicine and cardiology for over 30 years in rural Maine. He is former director of cardiology at Maine General Medical Center in Augusta. He is the author of “Medicine Made Clear: House Calls from a Maine Country Doctor.” Dr. LaCombe is associate editor of the On Being a Doctor, On Being a Patient, and Ad Libitum sections of Annals of Internal Medicine. He is editor of the compilations “On Being a Doctor,” first and second editions, and, with Dr. Laine, is co-editor of “On Being a Doctor 3.”

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Christine Laine, MD, MPH, FACP, is an internist, researcher, and medical educator. She is vice president and senior deputy editor of Annals of Internal Medicine, which is published by the American College of Physicians. Dr. Laine is affiliated with Jefferson Medical College in Philadelphia, where she is a clinical associate professor of medicine in the Division of Internal Medicine. She is active in the international medical journal community and is vice president of the Council of Science Editors.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 126,000 internal medicine physicians (internists), related subspecialists, and medical students, residents and fellows. Internists specialize in the prevention, detection and treatment of illness in adults.

Notes to Editor: For interviews or review copies, contact Lynda Teer (lteer@acponline.org; 215-351-2655) at the American College of Physicians. Additional quotes and references readily available. ACP Press also publishes “Post Mortem: Solving History’s Great Medical Mysteries,” and “The Quotable Osler,” among other titles in clinical medicine and the medical humanities.


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EXCERPTS (7) from “The Last Half Hour of the Day: An Anthology of Stories and Essays That Have Inspired Physicians”:

You have erased from the calendar of human afflictions one of its greatest. Yours is the comfortable reflection that mankind can never forget that you have lived. Future nations will know by history only that the loathsome small-pox has existed and by you has been extirpated.
-- from “Letter to Edward Jenner,” Thomas Jefferson

What does the lovely flush in a beauty's cheek mean to a doctor but a 'break' that ripples above some deadly disease. Are not all her visible charms sown thick with what are to him the signs and symbols of hidden decay? Does he ever see her beauty at all, or doesn't he simply view her professionally, and comment upon her unwholesome condition all to himself? And doesn't he sometimes wonder whether he has gained most or lost most by learning his trade?
-- from “Life on the Mississippi,” Mark Twain

“Isn’t it curious that doctors don’t believe in God?” he asked me. “But if there is no God, who do you speak to when your patient is doing poorly? And who is it you are whispering to when you are about to stick the subclavian vein, or send home the LP needle, or spark the lifeless heart?
If there is no God, then why is it that patients who are prayed over seem as a group to do better? If there is no God, why is there beauty in the world? If I have learned one thing in forty years of medicine, it is that there is a higher power, and great things unknown to me.”
-- from “Last Words,” J.P. Featherstone, MD (1913-1996)

I know there are many scared eyes like mine opened now at 3:46 A.M. Eyes that are listening. There is a set in room 416. Another set in room 412. Another set of opened, scared eyes that should be shut and dreaming in room 411. But all of the eyes, those that can open if there is not too much morphine or Demerol in them, all those sets of eyes in the hospital beds are listening to this, to him. Or were.
-- from “Okay, So I’m in This Bed,” Tony Gramaglia

Medicine arose out of the primal sympathy of man with man; out of the desire to help those in sorrow, need and sickness.
-- from “The Evolution of Modern Medicine,” Sir William Osler (MD)

I had two interns to supervise that month, and the minute they sat down for our first meeting, I sensed how the month would unfold.
The man's white coat was immaculate, its pockets empty save for a sleek Palm Pilot that contained his list of patients.
The woman used a large loose-leaf notebook instead, every dog-eared page full of lists of things to do and check, consultants to call, questions to ask. Her pockets were stuffed, and whenever she sat down, little handbooks of drug doses, wadded phone messages, pens, highlighters and tourniquets spilled onto the floor.
The man worked the hours legally mandated by the state, not a minute more, and sometimes considerably less. He was seldom in the hospital before 8 in the morning, and left by 5 unless he was on call. He ate a leisurely lunch every day and was never late for rounds.
The woman got to the hospital around dawn and was on the move for the rest of the day. Sometimes she went home when she was supposed to, but sometimes, if one of her patients was particularly sick, she would sign out to the covering intern and keep working, often talking to patients' relatives long into the night.
-- from “Defining a Doctor, With a Tear, a Shrug and a Schedule,” Abigail Zuger, MD

Do you remember when we first met, and you complained that you itched, and it was flea bites and you had headaches, and it was because your wife yelled at you and you yelled at her, and you would call me in the middle of the night, and I would jump when the phone rang, my husband would groan and roll over in bed, one of the girls would start to cry, and the page operator said with a clothespin clipped on her nose Mr. Salvadore Dantio for you Dr. Martin and I would wake up and you would say, Doctor, that you doctor? Listen, I can’t sleep for the itching. And there was nothing wrong with you and I hated you, but in the morning you would say, I’m sorry sorry, things get so bad in the middle of the night and what could I do but laugh, because it’s true.
-- from “Laundry,” “The Good Doctor,” Susan O. Mates, MD


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*Sir William Osler, advice to medical professionals on the importance of reading:

“Before going to sleep read for half an hour, and in the morning have a book open on your dressing table. You will be surprised to find how much can be accomplished in the course of a year.” -- Bedside Library for Medical Students, from “Aequanimitas”

“With a half hour’s reading in bed every night as a steady practice, the busiest man can get a fair education before the plasma sets in the periganglionic spaces of his grey cortex.” -- The Medical Library in Post-Graduate Work. British Medical Journal, 1909, Vol. 2, pp. 925-8.

“Every day do some reading or work apart from your profession. I fully realize, no one more so, how absorbing is the profession of medicine; how applicable to it is what Michelangelo says: ‘There are sciences which demand the whole of a man, without leaving the least portion of his spirit free for other distractions’; but you will be a better man and not a worse practitioner for an avocation.” -- The Student Life, from “Aequanimitas”


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Osler published “The Principles and Practice of Medicine” in 1892. (Other medical texts had been published by multiple authors and in other languages at the time.) It sold more than 500,000 copies and was translated into six languages to become the world’s standard medical textbook for more than 55 years.

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