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In recent years, relations between patients and physicians in America have undergone a dramatic change. The growing acceptance of natural childbirth, support groups for patients with serious illnesses, health maintenance organizations, and hospices for a "happy death" among family and friends is part of a redefinition of medical practice and reformulation of the field of medical power. No longer is medical practice confined to "taming the beast" of death and fighting the diseases observable in the human body. The modern practitioner is now a manager of the living, taking an ecological view of the patient as a "whole person" in a network of relationships.

Medicine and the Management of Living questions how it has been possible for the patient to change from a silenced specimen observed in the clinic to a person whose subjective experience of illness is important to medical practice and discourse. Arney and Bergen ask, What incited the demand that medicine take the whole person, including the patient's presentation of his or her illness, into consideration? And in whose terms are patients speaking about themselves? The authors argue that the inclusion of patients' experiences in medical discourse that has come about since the 1950s is not so much a result of a "patient rebellion" as an activity preciptated by the medical establishment itself. Drawing inspiration from the work of Michel Foucault, Arney and Bergen examine the structure of medical power, contending that new social technologies like support groups make the patient's subjectivity available for medical evaluation, judgment, and manipulation.

 Throughout this sensitively written discussion, the authors vivify the issues they raise with excerpts from many sources—the writings of a poet dying of cancer, the comments of doctors pondering their own fatal illnesses, and excerpts from popular magazines, medical journals, and sociological studies. They examine the changing role of the medical profession through history, using a modern advertising image and woodcuts from Vesalius's Renaissance anatomy text to show the symbolic portrayal of health and medicine. Their wide-ranging concerns lead the reader through such topics as teenage pregnancy; the historical treatment of medical anomalies like hermaphrodites and the "elephant man" (John Merrick); and literary representations of illness in Sartre, Chekhov, and Brian Clark's recent Broadway drama, "Whose Life Is It Anyway?"

In a provocative yet thoughtful way, Medicine and the Management of Living points the way for a radical reassessment of medical power and the medical establishment.

The personal odyssey of a man with a disability, this passionate book tries to tell as well as analyze what it is like to have a disability in a world that values vigor and health. Zola writes, "Missing Pieces is an unraveling of a social problem in the manner of Black Like Me. Like its author, I, too, am a trained social observer, but for me 'passing' was not an issue. For I already have the stigmata of the disabled—the braces, the limp, the cane—though I have spent much of my life denying their existence." The author started out in the role of a social scientist on a seven-day excursion to acquaint himself with an extraordinary experiment in living—Het Dorp, one of the few places in the world designed to promote "the optimum happiness" of those with severe physical disabilities. Neither a medial center nor a nursing home, Het Dorp is a village in the western-most part of the Netherlands. What began as a sociological attempt to describe this unusual setting became, through the author's growing awareness, what can only be called a socio-autobiography. Resuming his prior dependence on a wheelchair, the author experienced his own transformation from someone who is "normal" and "valid" to someone who is "invalid." The routine of Het Dorp became his: he lived in an architecturally modified home, visited the workshops, and shared meals, social events, conversation, and perceptions with the remarkably diverse residents. The author confronts some rarely discussed issues—the self-image of a person with a chronic disability, how one fills one's time, how one deals with authority and dependence, and love and sex. Missing Pieces offers striking insights into an aspect of the human condition shared by nearly 30 million Americans. It is must-read for the general reader, as well as for the rehabilitation counselor, social worker, or social scientist.