Showing 1 - 10 of 276 annotations tagged with the keyword "Spirituality"

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This intelligent and compelling book invites us to evaluate the losses pertaining to “modern death” and to consider better ways—whether from the past or in the future—to care for the dying, their families, and all care-givers.   
            
Some chapters, such as “How Life (and Death) Were Prolonged,” are historical, describing changes in inoculations, living conditions, and medical care that extended the human life span but also changes in dying, now often prolonged by technology. Another chapter, “How We Learned Not to Resuscitate,” relates how CPR, initially lauded and popularized, is now widely understood as futile care, especially in older people. Warraich discusses various attempts to define death (brain-based, heart-based, American Bar Association, Harvard Criteria, Uniform Determination of Death Act, even NASA) and some of the issues that still remain. 
 

Other chapters are more physiological:  “How Cells Die” explains natural processes of cell death (necrosis, autophagy, and apoptosis). Most non-medical readers haven’t heard of these and perhaps some medical personnel as well. Unaware of them as regular and usual processes, we resolutely expect people to live some four-score and ten, perhaps even more. The next-to-last chapter, “When the Plug is Pulled” discusses “terminal sedation” (a legal dosage that eases pain but is not strictly speaking euthanasia or murder) and statutes that allow for assisted death and removal of life-sustaining machines. The Nancy Cruzan case and others illustrate many difficulties. (Cruzan was in a persistent vegetative state and supported by a feeding tube. A 1990 U.S. Supreme Court 5-4 decision allowed the removal of the tube.) Warraich argues further for “patients’ right to demand and acquire the means to end their suffering with the aid of a physician” (p. 263).              

Lack of resolution of these difficulties leads to problems for families of the dying and all medical personnel attending them, especially in ICU situations. Living wills are often of no help and “the end of life has become a battleground” (p. 211).
He argues that surrogate roles for decisions at the end of a life often do not represent what the patient actually wanted because the surrogate's values may be different from the patient's and family members may not reach agreement on decisions. He concludes, “All in all, overinvolved family and underinvolved doctors unsurprisingly make for a particularly caustic combo” (p.214).                      

In “When Death Transcends” we read that spiritual and religious matters are often ignored in medical settings. Such resources, however, “may be the only means that patients have of finding comfort” (p. 148). Warraich surveys various religions, including his own, Islam. This is one of the longest chapters in the book and carefully considers the wide range of faiths people have and the regrettable lack of training for doctors in this area.
           

Warraich concludes, “Death needs to be closer to home, preceded by lesser disability and less isolation” (p. 278). For deaths to be “truly modern,” we need to push past taboos and misunderstandings about death. 

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction — Secondary Category: Visual Arts /

Genre: Memoir

Summary:

Devan Stahl’s opening essay in this unusual book explores the tension between her lived experience of being diagnosed with multiple sclerosis (MS) in her twenties and her physicians’ biomedical descriptions of it. While that tension is a familiar theme in patients’ narratives, Stahl’s approach is fresh and generously collaborative. Stahl, a bioethicist, focuses her brief narrative on her uneasy hours inside MRI machines and with clinicians who read the images. Stahl encouraged her sister, artist Darian Goldin Stahl, to transmute her physicians’ diagnostic tools into printmaker’s works, which bring personal meaning and sisterly solidarity to Devan’s experience. Devan then invited Darian and four humanities scholars to write reflective commentaries on her narrative, Darian’s images, and the commentaries themselves. The result is a richly layered, multi-vocal reflection on what Devan Stahl has accepted as “the dark gift of bodily frailty” (xxvii).

Darian Stahl’s prints were inspired by the drawings of Renaissance anatomist Andreas Vesalius that the sisters admired. Unlike their modern counterparts, the older images placed bodies in humanly built and natural environments that are rich with metaphor and theological implications. Darian’s photographic silkscreened and stone lithographic prints, some of which accompany her essay, imaginatively relocate her sister’s MRI scans in domestic spaces that suggest both Devan’s present state: her spine captured in a glass kitchen jar. And her future: a ghostly figure (actually Darian’s) at the base of the staircase that Devan will someday have trouble climbing. Making art became an act of caregiving.

The scholarly essays affirm that a single diagnosis can set in motion processes of interpretation in the context of family, community, academic discipline, and culture. But in this context, they too are expressions of caring for Devan. Literary and health humanities scholar Therese Jones writes that Stahl’s narrative “testifies to [her] hope of transcending or at least managing the alienation and incoherence of a disrupted life” (49). Literature professor Kirsten Ostherr links the Stahls’ collaborative projects with the patient empowerment movement, where creative expression offers one way to resist “the technomediated patient narrative” (71). Two of Devan Stahl’s theological studies professors contribute the remaining essays. Ellen T. Armour believes that the Stahls’ projects suggest the value of engaging the medical humanities in pastoral practice and vice versa, especially to challenge biomedicine’s claims to mastery and its “disavowal of vulnerability” (89). Jeffrey P. Bishop, who is also a physician, understands a patient’s position within the asymmetric power of medicine. Yet he also resists “the power ontology that animates so much of the West” (102). He offers instead a vision of accepting “the dark gift” of the fragility of the body, which can be both humbling and liberating (105). Viewing one of Darian’s images, he writes, “calls me out of myself” (105).

In Devan Stahl’s final reflection on her colleagues’ commentaries and her sister’s art, she concludes that sharing her experience has revealed both a “power in submission” and her responsibility to other patients (112). Her discovery leads her to a “new image” of herself and acceptance of Bishop’s observation: “Flesh calls the self into question” (115, 103).

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Annotated by:
Thomas, Shawn

Summary:

What is an atlas? To most people, an atlas is a collection of maps constructed by cartographers who meticulously plot the surface of the earth, inch by inch. In the medical field, we use the word atlas to refer to textbooks of human anatomy, but the endeavor is much the same, and no less painstaking – the human body is quite complex, after all. Though some anatomy atlases are famous for their beautiful depictions of anatomical structures, it is more important that they are accurate. What good would a map be otherwise?  

Yet this quest for accuracy is founded on an inherent dishonesty. Anatomy atlases are supposed to be our guides to the human body, but in reality, they depict the anatomical structures of only a human body. Every person is different, and that goes for their underlying anatomy as well. That being said, these minor variations are fairly unimportant for learners at the novice level. At the same time, one can’t help but feel like these books have been stripped of the key element that defines what it means to be human.
 

It is fitting that an artist would be the one to bring light to this issue. Laura Ferguson, Artist-In-Residence in the Master Scholars Program in Humanistic Medicine (MSPHM) at the NYU School of Medicine, has lived nearly her whole life with scoliosis. She saw in her own story the tendency of clinicians to boil a person down to a diagnosis – normal or abnormal. For doctors, this categorization is often necessary. But the artist recognizes that a person is more than just the sum of their parts. Laura saw past the medicalization of her anatomy and cherished the beauty of her curved spine.  

Laura’s arrival at the medical school ushered in a renewed focus on the humanism of medicine, starting with the Art & Anatomy seminar she began in 2009, open to students, doctors, researchers, and all other staff members at NYU Langone Health. In the seminar, students spend 90 minutes a week undertaking illustrations of various anatomical specimens: bones, organs, and even cadavers in the anatomy lab.  

Now almost a decade into this project, Laura has showcased her students’ work in her recent book Art & Anatomy: Drawings, co-edited by Katie Grogan, Associate Director of the MSPHM. Unlike with other anatomy books, the goal for her students was never to be “accurate”; such a word has limited meaning in the world of art. Instead, Laura taught students to observe things that they had never taken the time to see before. Then, she encouraged them to draw what they saw, as they saw it. The result is the compilation of drawings into a different kind of atlas – an atlas of the mind, of creative spirit, and of humanistic expression.

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Summary:

Citing numerous studies that might be surprising to both lay and professional readers, Dr. Rakel makes a compelling case for the efficacy of empathic, compassionate, connective behavior in medical care.  Words, touch, body language, and open-ended questions are some of the ways caregivers communicate compassion, and they have been shown repeatedly to make significant differences in the rate of healing. The first half of the book develops the implications of these claims; the second half offers instruction and insight about how physicians and other caregivers can cultivate practices of compassion that make them better at what they do.  

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joy: 100 poems

Wiman, Christian

Last Updated: Jun-12-2018
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Anthology (Mixed Genres)

Summary:

"joy: 100 poems," edited by poet and editor Christian Wiman, is a collection of 100 poems that examine, in various ways, the state of consciousness we call "joy."  The poets represented here are for the most part well known, as are many of their poems.  But, happily, there are poems here that seem new, especially when viewed through the lens of "joy." 

A brief list of the poets, chosen at random, includes Galway Kinnell, Donald Hall, Lucille Clifton, Josephine Miles, Sylvia Plath, Richard Wilbur, Sharon Olds, Wallace Stevens, Yehuda Amichai, W.B. Yeats, Stanley Kunitz, and Thom Gunn.  Poems, again chosen at random, include "Plumbing" (Ruth Stone), "Tractor" (Ted Hughes), Laundromat" (Lorine Niedecker), and "Unrelenting Flood" (William Matthews)--titles that at first glance might not suggest "joy."


The book begins with an excellent twenty-eight page introduction by Wiman in which he discusses the various shades of joy we might encounter in our lives, examines closely some of the poems represented, and briefly comments on his selection process. 

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From Fish to Philosopher

Smith, Homer

Last Updated: May-17-2018
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Most students of biology are well aware of our humble beginnings as puny, single-celled lifeforms. The mechanism of our remarkable transformation was famously described by Charles Darwin in his groundbreaking text On the Origin of Species, published in 1859. In many respects, Darwin’s magnum opus was just the opening chapter of a much broader discussion of how we humans have taken our current form. Darwin elucidated only a general process of adaptation and evolution in the face of environmental pressures. He left his successors with the more onerous task of applying this rule to the tortuous history of human evolution.

Rising to the occasion nearly a full century later was Homer Smith, a prominent kidney physiologist who spent much of his life and career as the Director of Physiological Laboratories at the NYU School of Medicine. Dr. Smith shares his account of our evolutionary history in his 1953 book From Fish to Philosopher. In the book, he posits that organisms must have a system for maintaining a distinct “internal environment” in order to have any sense of freedom from the perennially dynamic external environment. He guides the reader through the various biological filtration devices that have come and gone over the eras, culminating with the fist-sized organs dangling next to our spines.


The book is often billed as a detailed treatise on how modern-day mammalian kidneys have arisen from their more primordial forms – a fair assessment, especially given the author’s background. But this book offers readers something much more ambitious in scope than a rehashing of his work in renal physiology. For example, the first chapter of the book, “Earth”, highlights geological milestones that molded the early environment of the first known lifeforms. In Dr. Smith’s words,

“the history of living organisms has been shaped at every turn by earth’s vicissitudes, because every geologic upheaval, by causing profound changes in the distribution of land and sea, has had profound effects on the climates of both, and hence of the patterns of life in both” (pp. 9).

By the final chapter, “Consciousness”, he has begun to ponder questions of metacognition and learning. He marvels at how our complex nervous system has allowed classical pianists to balance the rigidity required for technical prowess, and the fluidity required for creativity. This is not a textbook about our kidneys. From Fish to Philosopher is a story of mankind’s genesis, told through the existential musings of a physiologist who left no stone unturned.

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One Crimson Thread

O’Siadhail, Micheal

Last Updated: Apr-19-2018
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

This collection of 150 sonnets takes us through the journey from the writer’s wife’s diagnosis with Parkinson’s, eventually complicated by dementia and overmedication, to her death and his early days of grieving.  Married for over 40 years and close companions, their successive separations deal new blows as they happen: She goes into skilled nursing care, gets lost in delusions, and becomes more frail and erratic, finally succumbs after a fall and a short period in a coma.  The writer draws on biblical metaphors and threads memories of their earlier life together in fleeting images so that the reader is left to infer from glimpses a rich and happy marriage that, he reflects, prepared them—but not enough—for this going.  

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Second Bloom

Krugovoy Silver, Anya

Last Updated: Dec-05-2017
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

These poems are not a cancer chronicle, but the experience of living with cancer is threaded through them in a way that illustrates beautifully how awareness of illness may permeate daily life, but is foregrounded and backgrounded, reshaped and revisited in shifting ways as it takes its course.  They encompass moments in family life, moments in the hospital, moments of spiritual longing and awareness of loss.  Together they offer a record of accommodation, acclimation, and complex acceptance.

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Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians.   Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few. 

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334).
  The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185)  The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor. 
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field.  Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul".
 Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151) 

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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Augustown

Miller, Kei

Last Updated: Oct-03-2017
Annotated by:
McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Set in the loosely fictionalized Jamaican town of Augustown (“loosely,” as it bears a strong resemblance to August Town, which was absorbed over time into the expansion of Kingston), the novel spans three generations of a single family.  The novel moves back and forth easily through different moments in time, from the birth of Rastafariansim in 1920 under British colonional rule, through the post-colonial division of the island and its citizens into turbulent threads, to the present day of 1982, where the same tensions run strong as ever.  

Ostensibly a family novel, the story centers on Ma Taffy, her niece Gina, and Gina’s son Kaia, and it boils down to several key moments in their lives.  But these moments are brief in the overall bulk of the novel, the majority of which is devoted to the fleshing out of the world that permits – and, as we ultimately realize, requires – that such moments come to pass.  There is the miracle of the preacher Alexander Bedward, who, as seen through the eyes of Ma Taffy, could have literally floated up to the Heavens; the comically doomed marriage and foiled aspirations of schoolteacher Emanuel Saint-Josephs; the errand run by Soft-Paw, a young gang member; the second chance that comes before the well-to-do Claudia Garrick; the friendship of Clarky and Bongo Moody, and their run-ins with the police.  As Miller moves between these characters, the forces pushing Ma Taffy, Gina, and Kaia to their conclusion become clearer and harder to resist.
 

Despite the complexity of the novel’s structure, Miller easily weaves all of the component parts together.  The result is absorbing and affecting, a novel that is as much a family drama as it is an exploration of the legacy of colonialism, religion, class conflict, and violence.

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