Showing 1 - 10 of 428 annotations tagged with the keyword "Pain"

Summary:

Beth Macy has been a newspaper reporter in the Roanoke, Virginia area for three decades. In this book, she provides extensive reporting on the opioid crisis, how it developed and wreaked havoc in Appalachia, and how it grew into a national crisis across the United States.  

“Dopesick” is the colloquial term people who are addicted and addiction medicine specialists use to describe the constellation of wrenching and violent symptoms opioid withdrawal causes. As one of Macy’s subjects describes it:

You’re throwing up.You have diarrhea. You ache so bad and you’re so irritable that you can’t stand to be touched. Your legs shake so bad you can’t sleep. You’re as ill as one hornet could ever be. And believe me, you’ll do anything to make the pain go away.” (p. 41)
As a result, not long after a person is addicted to opioids, drug seeking behaviors are not motivated by the urge for the next and best high, but instead are driven “to avoid dopesickness at any cost” (p. 9). 

Macy divides her reporting into three major parts: 1) the ways Purdue Pharma fueled the explosion of opioid addiction beginning with the introduction of its product Oxycontin in 1996; 2) the ways in which people get addicted to opioids and how they get their supplies; and 3) the ways the U.S. health care system, criminal justice system, Congress, state legislatures, and regulatory agencies have failed in preventing and fixing the addiction crisis. 
 

As a journalist, Macy weaves the stories of individuals into the larger story of the opioid addiction crisis: people who became addicted to opioids and the effect it had on their families, and the stories of health care professionals who pulled alarms about the rapidly rising rate of opioid addiction and tried as best they could to treat addicted patients and protect the public. We read about the Purdue Pharma executives who were blamed and prosecuted for the marketing campaigns that turned localized opioid addiction patterns into a national opioid addiction epidemic. And we read about individual sheriffs, investigators, prosecutors, judges, and community activists who were trying to stem the tide of addition and death. These stories intersect throughout the book.

Embedded among the individual story lines are digressions Macy uses to elaborate on certain aspects of the opioid addiction crisis. She provides historical perspectives on drug addiction, and how this crisis differs from those of the past. She puts an emphasis on how trends in medical practice to liberalize the use of opioids in the management of all types of pain—minor and major, acute and chronic—converged with Purdue Pharma marketing campaigns for its proprietary opioid products. She cites statistics to show how fast the epidemic was worsening, how widely it was spreading across the United States, and how deadly it had become with mortality rates exceeding those of AIDs mortality at its peak. Other digressions cover how illicit opioid supply chains are created and maintained, and how different levels of governments reacted to the crisis. 

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

After a combined twelve years of medical training and working on hospital wards, this British physician leaves the medical profession. Using his diary written during a stint in the National Health Service (NHS) from 2004-2010, he recalls his experiences as a young doctor.

He describes the making of a doctor and a physician's life as "a difficult job in terms of hours, energy, and emotion" (p196) and recounts the overwhelming exhaustion and toll on his personal life. He chooses OB/GYN as his specialty partly because "I liked that in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties" (p32). As for his bedside manner, "I went for a 'straight to the point' vibe - no nonsense, no small talk, let's deal with the matter in hand, a bit of sarcasm thrown into the mix" (p163).

Days are filled with doing prenatal visits, vaginal deliveries, caesarean sections, gynecologic surgeries, and lots of women's health issues. Night shifts are often hellacious as they "made Dante look like Disney" (p5). He must handle emergencies, break bad news, deal with intra-uterine deaths, and once gets sued for medical negligence. The anecdotes are sometimes tender and heart-tugging, other times wacky and gross. Consider this diary entry dated 12 March 2007: "a lump of placenta flew into my mouth during a manual removal and I had to go to occupational health about it" (p92).

The final diary entry chronicles a catastrophe. An undiagnosed placenta previa results in the delivery of a dead baby. The mother is hemorrhaging, requires an emergency hysterectomy, and is headed to the ICU. The author sits alone crying for one hour. For the next six months, he never laughs. He quits medicine and lands a job as a comedy writer and editor for television. Seriously.




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Taking Care of Time

Davis, Cortney

Last Updated: Aug-14-2018
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

In this volume by the esteemed nurse-poet/writer, Cortney Davis, are 43 previously published poems (some revised for this collection), assembled in 3 sections-- the middle section featuring her long poem, "Becoming the Patient," that recounts through 10 shorter poems her time "in the hospital."

The poems in the surrounding sections describe in beautiful and intimate detail her patients' lives and the call to and practice of nursing. Featured throughout are battles won and lost-- with disease, with the medical staff, and as the title-- taking care of time-- suggests, the finitude we all face. No matter the difficulties of hospital life-- whether as practitioner or patient-- its familiarity  provides grounding and comfort in these poems as, for example, heard through the speaker of "First Night at the Cheap Hotel" who tells us:

"Being here is like being sick in a hospital ward
without the lovely, muffling glove of illness.
In hospital, I would be drowsy, drugged into a calm
that accepts the metal door's clang,
the heavy footfall right outside my door.
All these, proof of life,
and there would be a nurse too, holding my wrist,
counting and nodding, only a silhouette in the dark" (p.67)

And if sometimes the experiences and images become too hard to bear, the skillful nurse-poet can, as Cortney Davis does in "On-Call: Splenectomy," "tame them on page” (p.52).

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Summary:

In this remarkable anthology, 51 women and men describe their nursing school experiences, from initial fears and anxieties to increasing confidence and appreciation of the profession.  Jeanne Bryner, in her Introduction, explains how she and Cortney Davis deliberately sought a diverse group of nurse-writers, from recent nursing graduates in their twenties to seasoned veterans in their nineties.  Their collection includes different races, nationalities, social and economic classes, and education levels.  What the contributors have in common besides being nurses is that they are gifted writers able to capture in poetry or prose the transforming moments of their lives. Nursing students reading this anthology will recognize many kindred souls, struggling with the same uncertainties and apprehensions, wondering how they will ever accomplish all this, but also gaining command of the profession, relishing its special rewards, valuing patients as their ultimate teachers. All readers will understand what is so special about nursing .




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Every Note Played

Genova, Lisa

Last Updated: Apr-10-2018

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is a dramatic and moving story about a concert pianist who, at 45 years of age, suddenly and inexplicably, has ALS, and also equally about his ex-wife Karina, who takes on his care throughout his slow, inevitable, and lethal decline. As many readers know, ALS (Amyotrophic Lateral Sclerosis). or “Lou Gherig’s disease,” hardens the motor nerves so that, progressively, there is no more control of muscles throughout the body. Not many readers know, however, the difficult path such patients and their families must pursue. This sensitive and detailed novel takes readers powerfully into the world of ALS, a disease for which there is today no cure.                                                                                      

Obsessed with his musical career and international travel, Richard has paid little attention to Karina and their daughter, Grace, and he has had affairs with other women. Karina has deceived him about her inability to bear more children. Because of their move from New York City to Boston, Karina, also a gifted pianist, has lost a possible career in jazz and now gives piano lessons to unpromising students. 

The first several chapters alternate between Richard and Karina. Although divorced from him, she brings him, now an ALS patient, back into the home they once shared. Various nurses, doctors, and other specialists try to explain the difficult future that includes certain loss of body functions, but Richard and Karina are slow to comprehend these. Despite their denial, they are forced to come to terms with Richard’s progressive decline and, finally, death.     
          
Richard loses the ability to use his hands, then his arms. He needs a special machine to breathe at night. Soon he has paid caregivers for parts of the day; these include a cheery and admirable man named Bill. No longer able to eat, Richard has a feeding tube. Later he needs a hospital bed. Also a Head Mouse to work his computer. Also an elaborate wheelchair. With unresolved issues in the past, Richard and Karina are emotionally apart—even with feelings of hate and rage—even while she cares for him.  

Karina’s walking partner Elise, a teacher, helps her stay sane. Karina travels to New Orleans with Elise and her class and finds her interest in jazz reawakened. No longer able to breathe even with assistance, should Richard go on to mechanical ventilation that will require 24-hour care at enormous expense? A choice is made. Richard dies, with various resolutions before and after his death.  

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Summary:

Dr. Monika Renz’s work with dying patients is unusual if not unique in the way she appropriates and applies insights from Jungian depth psychology, practices available in patients’ faith traditions, and musically guided meditation to invite and support the spiritual experiences that so often come, bidden or unbidden, near the end of life.  An experienced oncologist, Dr. Renz offers carefully amassed data to support her advocacy of focused practices of spiritual care as a dimension of palliative care, but is also quite comfortable with the fact that “neither the frequency nor the visible effects of experiences of the transcendent prove that such experience is an expression of grace” because “unverifiability is intrinsic to grace.”  Still, her long experience leads her to assert not only that “grace” can be a useful, practical, operative word for what professional caregivers may witness and mediate but also that affirmation and support of patients’ spiritual, religious, or transcendent experiences in the course of dying can amplify and multiply moments of grace, which manifest as sudden, deep peace in the very midst of pain, profound acceptance, openness to reconciliations, or significant awakenings from torpor that allow needed moments of closure with loved ones.  Describing herself as “an open-minded religious person and a practicing Christian,” she reminds readers that God is a loanword, whose basic form in Germanic was gaudam, a neutral participle.  Depending on the Indo-Germanic root, the word means “the called upon” or “the one sacrificed to . . . .”  Openness to the divine in both patients and caregivers, Dr. Renz argues, can and does make end-of-life care a shared journey of discovery and offer everyone involved a valuable reminder that medicine is practiced, always, at the threshold of mystery.

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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:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In this follow-up to his masterful memoir Do No Harm, British neurosurgeon Henry Marsh must deal with old age and retirement after nearly four decades as a doctor. Stepping down engenders mixed feelings, and he confesses to "longing to retire, to escape all the human misery that I have had to witness for so many years, and yet dreading my departure as well" (p17).

Marsh keeps busy by spending time in Nepal training young doctors and operating. He also makes visits to the Ukraine to perform surgery and teach. He has a fondness for creating things and purchases a fixer upper cottage that he struggles to repair. Marsh recounts previous neurosurgical cases, mostly patients with brain tumors. He remembers the distress at being sued by patients. He reveals his own admission to a psychiatric hospital as a young man. Regrets, both personal and professional, are confessed.

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Summary:

This powerful—even disturbing—book examines the state of Louisiana, a home of the Tea Party, multiple polluting industries (oil, chemicals), environmental degradation, bad health for all, including children, and politics and economics that favor corporations not local business. 

In Part One, “The Great Paradox,” sociologist Hochschild interviews locals, attends civic events, sits in cafes, and listens to stories. Bit by bit she understands that right-leaning people believe in Republican notions of less governmental regulation despite suffering from the ill effects of living in “red” states, even individual counties, that are the most polluted in the U.S. (pp. 79-80).  She calls this disparity “the great paradox.” Locals call a portion of the Mississippi between Baton Rouge and New Orleans “Cancer Alley” (p. 62), but there is no popular demand for control of pollution.

Part Two, “The Social Terrain” discusses history. Earlier, Louisiana had economies of fishing and farming in tune with the landscape. New industries, including Big Oil changed all that, with promises of jobs and wealth for all—neither of which occurred, because oil is largely mechanized, and wealth went to corporations, some headquartered in other countries. Further, there was not just pollution but also large sinkholes and the BP Horizon blow-out of 2010. Problems of on-going pollution were ignored by the Press, especially Fox news, and the “Pulpit” (evangelistic Christianity) took the longer view, urging continued human exploitation of nature, patience for ultimate rewards, and the hope that “the rapture” would ultimately save the most worthy Christians.

Part Three is “The Deep Story and the People in it.” Hochschild formulates an unspoken but motivating narrative of values in Louisiana. This metaphoric story represents deep feelings, including urges for a success that is always thwarted. In the story, there is a long line of white, Christian people, mostly male, often with limited education, waiting in line patiently to climb a hill. On the other side is a good job, wealth, security, and reward for the long waiting. Tragically, there are “line cutters,” symbolized by President Obama and other blacks who had various preferments, but also women, also immigrants, also refugees, even the brown pelican, the Louisiana state bird that needs clean water and fish to survive. The people in line feel betrayed. Where is progress toward the American Dream? Fair play? There is hatred toward the line cutters, and loyalty toward the similar people in line and the industries that will save them. Pollution is unfortunate but a necessary cost.

“Going National” is the fourth part. Hochschild reviews the plantations of the South that not only brutalized slaves but also caused poor whites to move to non-productive land, while the wealthy always improved their lot. People from the North were (and are) suspect, with policies of integration, abortion, gun control, etc. The North cut in line. People in Louisiana became “strangers in their own land” and therefore glad to support not only Governor Bobby Jindal (who “left the state in shambles,” p. 232) but also Trump who would “make American great again.” The “strangers” have gone national in the U.S. and even in some other countries. Hochschild drafts two short “letters,” one to the liberal left and the other to the Louisiana people. She suggests that the two polarized groups have more in common than they currently imagine.  



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Torremolinos

Simpson, Helen

Last Updated: Sep-25-2017
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The exhausted narrator has just undergone 3 vessel coronary artery bypass graft (CABG) surgery. While grateful for surviving his "cabbage" operation, he is acutely aware how different he seems from his previous self. He gets a roommate sent from The Scrubs, a prison facility located next to the hospital, who has been jailed for grievous bodily harm with a sentence of 8 years. Now the prisoner is pretending to have a heart attack, hoping doctors will keep him for a few days for tests.

The two men exchange information and banter. The convict wants details about what it feels like to have a heart attack. The narrator wants to know what it's like to be in prison (The answer is "Boring."). They pass time imagining they are vacationing on a Mediterranean beach. The criminal has a knack for making his roomie laugh - a welcome, but painful sensation after open-heart surgery.

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