Showing 1 - 10 of 381 annotations tagged with the keyword "Cross-Cultural Issues"

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and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor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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How to Visit a Healer

Brown, Jeanette

Last Updated: Sep-08-2017
Annotated by:
Davis, Cortney

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In this wonderful short story, author Jeanette Brown describes a woman’s first visit to an alternative medicine healer. The woman has a persistent cough. Unhappy with the "five seconds per visit your doctor lavishes on you after your two-hour wait in his sterile lobby," she has taken her yoga instructor’s advice and made an appointment with a tall, olive-skinned man whose voice is "low and soothing" and whose manner is slow, relaxed, and personal.The woman, whom the healer diagnoses as "the roadrunner, a busy fidgety type," alternates between interest, skepticism and dismay. She cracks jokes; he doesn’t laugh. He recommends diet, exercise, no caffeine, and colon cleansing. She mentally rolls her eyes until, his hands massaging her foot, she feels her stomach lurch, a twinge in her armpit and begins to think of her body as "a human pinball machine." Whenever her self-defensive, rational, traditional beliefs almost propel her off the exam table and into her clothes, the healer "nails" her, reading her personality and her lifestyle exactly.Well into the visit, she realizes she hasn’t coughed once. Then, when she’s the most relaxed, incense wafting, his hands kneading all tensions from her back, her mind registering "this is bliss," her esophagus becomes blocked. Sitting up, she coughs, and the healer confronts her. "You have something to say," he insists, and she counters with "You expect me to believe all this mumbo-jumbo?" He tells her she swallows her feelings, and when she coughs again a "feather? A butterfly?" escapes from her mouth and disappears.When the healer pats her back and asks her to cough once more, she can’t. Taking her hands, he declares her "cured." At the story’s end, still not quite able to admit that this strange physician has helped her, yet knowing that he has, the woman struggles to count out his fifty dollar fee, finally dropping a handful of bills onto his bench, "hoping he won’t be offended by a tip."

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Songs from the Black Chair

Barber, Charles

Last Updated: Sep-08-2017
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Subtitled "A Memoir of Mental Interiors," this book is both an exploration of self and a search for reasons that led to the suicide of the author's friend, Henry, when both were of college age. But there is more. As the memoir unfolds, we learn that since childhood, the author experienced episodes of inexplicable, preoccupying, repetitive thoughts and behavior patterns--much later diagnosed as obsessive compulsive disorder (OCD). And finally, Barber discusses being drawn to work with mentally retarded people in a group home, and the mentally ill homeless at Bellevue Hospital in New York City.Growing up in an intellectual New England family with a tradition of sending its sons to Andover (a prestigious prep school) and Harvard, Barber was expected to continue the tradition, and so he did. At Harvard, however, Barber found himself disintegrating into obsessive thinking, unable to concentrate, near suicidal. He withdrew from Harvard, went back to his small town, hung out with his friends Henry and Nick, washed dishes in a local restaurant, took courses at the local college. Obsessive thinking continued to torment him.In desperation, he dropped out of college again, quickly finding a position as a "childcare worker" in a local group home. The author believes this step was the turning point that led eventually to effective treatment of his OCD (psychotherapy and Prozac), completion of his education, a fulfilling "career" in mental health recovery, and a happy family life. He is currently an associate of the Yale Program for Recovery and Community Health at Yale University School of Medicine.

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The Story of Beautiful Girl

Simon, Rachel

Last Updated: Aug-07-2017
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

On a stormy night in 1968 a retired, widowed schoolteacher in rural Pennsylvania opens her door to find a young couple, she white, he African American, wrapped in blankets, drenched, and silent.  Letting them in changes her life.  They have escaped together from a nearby mental institution most locals simply call "The School."  The young woman has recently given birth.  When Martha lets them in, her life changes forever.   Supervisors from "the School" show up at the door, the young man escapes, and the young woman, memorably beautiful, is taken back into custody.  The only words she is able to speak out of what we learn has been a years-long silence are "Hide her."  Thus she leaves her newborn baby to be raised by a stranger.  The remaining chapters span more than forty years in the stories of these people, linked by fate and love and the brutalities of an unreformed system that incarcerated, neglected, and not infrequently abused people who were often misdiagnosed.  Homan, the young man who loved Lynnie, the beautiful girl from the institution, was deaf, not retarded.  Lynnie was simply "slow," but a gifted artist who recorded many of the events of her life in drawings she shared only with the one attendant who valued and loved her.  Though her pregnancy resulted from being raped by a staff member, the deaf man longs to protect her and care for the baby.  Years separate them; Homan eventually learns signing; Lynnie's sister befriends her and an exposé results in the closure of the institution.  Over those years Lynnie and Homan witness much cultural change in treatment of people like them who were once systematically excluded.  They find social identities that once would have been entirely unavailable to them.  And eventually, after literal and figurative journeys of discovery, they rediscover each other.   

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Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Volck’s memoir describes his medical practice and learning in a variety of settings (Cleveland, Baltimore, Cincinnati), but, more importantly, in non-metropolitan places, such as Tuba City on the Navajo Reservation in Arizona and rural clinics in Honduras. He suggests that his knowledge of medicine has largely come as he has practiced it and not from his formal education. Further, he believes that best medical practice is not primarily high-tech, urban, or industrial. Each of the 15 chapters has a title—a topic, a person, or a theme—but also one or more locations specified. For example, we have “Chapter One, A Wedding, Navajo Nation, Northern Arizona,” suggesting the importance of culture and locale. Further, the chapters include personal associations from several realms beyond the topic and place as Volck seeks to understand medicine, healthcare, and how we live in the world.           

Of the first seven chapters, five are set in Navajo land, where Volck is an outsider by his cultural heritage and his profession, a doctor with a pediatrics specialty. From time to time he reflects on his training, the English verb “to attend,” and specific patients, such as two-year-old Alice in Tuba City and eight-year-old Brian in Cleveland. Both children died while in his care. Working on the front-line of medicine, he considers the weaknesses of our modern attitudes toward death and our wishes for control. He also wrestles with personal lifestyle issues of balancing medicine, family, and an urge to write.
 
           
Other chapters describe restlessness in his profession, the growth of his family (including the adoption of a Guatemalan baby girl), hiking in the Grand Canyon, camping in the rain, and a retreat with Benedictine monks. Chapter 11 “Embodying the Word” discusses literature and medicine, lectio divina (a Benedictine reading practice), and the need to listen carefully to patients’ stories.
           
The final chapter returns to Cincinnati, Honduras, and Tuba City. Volck has found more projects in the Navajo Nation, including a youth service project from his church. With permission, he conducts interviews and plans a book on the Navajo, “drawing on cultural history, anthropology, history, medicine, and politics” (p. 201).

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Annotated by:
Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Ethnography

Summary:

Written by successful Australian journalist Geraldine Brooks, Nine Parts of Desire recounts her experiences living among and working with Muslim women throughout her time as a correspondent in the Middle East. Brooks delves into topics as varied as non-marital sex, female genital mutilation, the different types of veiling (and the reasoning behind veiling at all), women’s participation in the Iranian military, the Qur’an, and the life and teachings of the Muslim Prophet, Muhammad. Brooks presents various perspectives and interpretations of certain Muslim practices, such as the wearing of the veil (hijab). She looks at the specific Qur’anic passage that prescribes the veil: “And when you [men] ask his [the Prophet’s] wives for anything, ask it of them from behind a curtain (hijab).” (p. 84)  Brooks intelligently analyzes, “What is so puzzling is why the revelation of seclusion [veiling], so clearly packaged here with instructions that apply only to the prophet, should ever have come to be seen as a rule that should apply to all Muslim women.” (p. 84)  It is often difficult to find alternative interpretations of Islamic requirements, but Brooks presents them here without filter and speculates why an apparently individually prescribed veil would become so widespread that it now practically symbolizes Islam. 

Brooks recalls several encounters that she had with fellow Westerners living in the Middle East for various reasons, from work to having married a Middle Easterner and re-located there. Some of the most sympathy-inducing moments are in these situations where Westerners are forced to live under the rules of strict, conservative, Muslim societies.  In one anecdote, Brooks relays the case of her friend, Margaret, an American woman who married an Iranian man. When Brooks asks Margaret why she does not go home to America to visit her family, Margaret replies, “My husband doesn’t want me to,” and Brooks then clarifies, “It was up to him to sign the papers that would allow her to leave the country.”
(p. 106)  This situation shows that being an American woman or an educated woman does not prevent one from being held to the same standards as local women in certain Muslim societies.

The final chapter is entitled, “Conclusion: Beware the Dogma” and serves to share Brooks’s personal opinions on the lives and faith that she had so objectively presented in journalist fashion until this point. Her opinion is summarized: 

“Today, the much more urgent and relevant task is to examine the way the faith [Islam] has proved such fertile ground for almost every antiwomen custom it encountered...When it found veils and seclusion in Persia, it absorbed them; when it found [female] genital mutilations in Egypt, it absorbed them; when it found societies in which women had never had a voice in public affairs, its own traditions of lively women’s participation withered.”
(p. 232)

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Annotated by:
Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir follows the journey of Nujood Ali, a young, Yemeni child bride from a rural village. She was later named Glamour's Woman of the Year in 2008. 

The memoir begins with Nujood’s escape from her husband’s house and how she made her way—alone—to a courthouse in the country’s capital where she was determined to win a divorce.

Nujood’s father pulled her of school when she was in the second grade and forced her to marry a man much older than she. At this time, the minimum legal age of marriage for girls was 15, but many families—especially in rural areas—continued to engage in marrying off daughters much younger than this. Nujood’s father’s reasoning (which echoes the reasoning of many others who engage in this practice) included having one less child to feed, preventing Nujood from being raped by strangers, and protecting her from becoming the victim of “evil rumors.” (p. 54) 

In a practice common in Yemen, her father moreover stipulated that Nujood’s husband would not have sex with her until she had begun to menstruate; the husband did not wait and instead raped Nujood after they were wed. 

Throughout the book, Ali and French journalist Delphine Minoui skillfully explain how women are not given choices in Nujood's part of Yemen: 

“In Khardji, the village where I [Nujood] was born, women are not taught how to make choices. When she was about sixteen, Shoya, my mother, married my father, Ali Mohammad al-Ahdel, without a word of protest. And when he decided four years later to enlarge his family by choosing a second wife, my mother obediently accepted his decision. It was with that same resignation that I at first agreed to my marriage, without realizing what was at stake. At my age, you don’t ask yourself many questions.”
(p. 23)

Ali was connected with her lawyer, Shada Nasser, at the courthouse, and her case garnered both international attention and outrage. After a hearing, Ali was granted her divorce and took trips out of Yemen, including to the United States, even meeting with then Secretary of State Hillary Rodham Clinton. The memoir ends on a happy note, with Nujood starting her education again, at a new school, and definitively deciding to become a lawyer who is committed to raising the legal age of marriage in Yemen. The authors even discuss two cases of girls who were granted divorces in Yemen after Nujood and were able to use her case as legal precedence. 

An article in the Huffington Post explains that while Nujood’s memoir ends on a happy and inspiring note, there is still much more work to be done. It points out that Nujood insisted on remaining in Yemen, while her American advocates believed it would be best for her and her future to remove her from her family. Nujood’s family put pressure on her to demand more and more financial compensation for her international fame. Even though her co-author and other advocates begged her to go to school, she did not complete her education. Her father used a (likely large) portion of her book proceedings to marry a third wife. The most recent update is that Nujood remarried (circumstances and consent unclear) and mothered two daughters of her own.

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Annotated by:
Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Dr. El Saadawi is an Egyptian feminist activist and a psychiatrist who originally published this book in Arabic in 1977. She has had a tumultuous relationship with the Egyptian government and was imprisoned after criticizing former President Anwar Sadat. During her career she worked at several universities in the United States. The Hidden Face of Eve: Women in the Arab World  has seamlessly incorporated elements of memoir and critical analysis of Arab culture and Islam. El Saadawi divides  the book into four sections: The Mutilated Half, Women in History, The Arab Woman, and Breaking Through. The book opens with Dr. El Saadawi recounting in the first-person her harrowing experience with female genital mutilation (a very common practice in her home country of Egypt) when she was 6 years old. She uses very descriptive, perhaps even graphic language, to describe the experience in all its horror. This early childhood memory sets the stage for the audience to bear witness to all the various types of misogyny that many Egyptian and Arab women inevitably experience. 

Dr. El Saadawi then skillfully relates memories of being told, for example, to not ask too many questions because she was a girl, and states that she has never heard the word “bint” (Arabic word for girl) used in a positive fashion. These nuggets of personal experiences are inserted into an overview of the complaints of stifled sexuality and associated sequelae with which her psychiatric patients struggled. She delves into the topics of Islam’s take on non-marital sex, illegitimate children, and prostitution thrown against the backdrop of her personal experiences seeing young, poor girls who work as maids being raped and impregnated by the men of the families who employ them and then being held as the sole accountable party.

After the first section, Dr. El Saadawi broadens her focus to include the status of women starting with Eve (whom the major monotheistic religions, including Islam, believe to be the first woman on Earth). Dr. El Saadawi investigates the historical designation of women as inferior in the Jewish faith and explains that as Christianity and Islam evolved against this backdrop, they also assigned women to a similar status. She insightfully points out how femininity did not evolve independently of society but rather that femininity and a woman’s place in society (all societies) are direct reflections of socioeconomic practices or goals of that society. 

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Infidel

Hirsi, Ayaan

Last Updated: Apr-13-2017
Annotated by:
Saleh, Mona

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

This is an autobiographical work that describes the remarkable life of Ayaan Hirsi Ali. The book begins in Somalia, where Hirsi Ali was born and spent the early part of her childhood. It is here that Hirsi Ali discusses the second-class status of girls and the harrowing practice of female genital cutting, which she describes as it happened to her and her younger sister. Although her parents were against the practice, Hirsi Ali undergoes female genital cutting by the arrangement of her maternal grandmother, who states that if the clitoris is not cut, it will grow and end up dangling between the knees of the girl. This situation speaks to the variety of immediate reasons why different cultures engage in female genital cutting. They all revolve, however, around the disempowerment of girls and women and denying their basic human right to bodily integrity and sexuality. 

Due to civil unrest, Hirsi Ali and her family move around quite a bit while she is growing up, in places as distant as Saudi Arabia (where Hirsi Ali describes her childhood horror at seeing women clad in all black from head to toe), Ethiopia, and Kenya. Throughout her travels as a child and then a teenager, Hirsi Ali vacillates between being a staunch believer in Islam to questioning her faith, all while experiencing emotional, verbal, and savage physical abuse at the hands of her mother and, at one point, her Qur’an teacher. 

The action quickens at an incredible pace when Hirsi Ali’s father and community arrange for her to marry a Somali man who lives in Canada, even though Hirsi Ali does not consent to the marriage. It is telling when, on the day of her wedding ceremony, Hirsi Ali has a normal day at home while her father, her new husband, and the other men in her community have a celebration without her. In the Islamic ceremony, the bride only needs to be represented by a male guardian (father, brother, uncle, grandfather, etc) and does not physically need to be present. Hirsi Ali’s husband goes back to Canada and sends for her to join him. Rather than meeting her husband in Canada, Hirsi Ali manages to make her way to Amsterdam and apply for asylum. It is here that the reader watches Hirsi Ali confront a great amount of cognitive dissonance between what her Islamic upbringing has taught her about right and wrong versus what she personally experiences in the Netherlands, 

“The next morning, I decided to stage an experiment. I would walk out of the door without a headscarf. I was in my long green skirt and a long tunic, and I had my scarf in a bag with me in case of trouble, but I would not cover my hair. I planned to see what would happen...Absolutely nothing happened. The gardeners kept trimming the hedges. Nobody went into a fit...Nobody looked at me. If anything, I attracted less attention than when I was covering my head. Not one man went into a frenzy” (p. 195). 

Hirsi Ali is forthcoming about having lied on her asylum application to make her more likely to be approved. In the Netherlands, Hirsi Ali works as a Somali interpreter and, against all odds, goes on to attend college and obtain a degree in political science. While all of this is happening, Hirsi Ali is repeatedly impressed by Dutch society in their social order and equality between the sexes. She sees a glaring contrast between Dutch society and the lives of immigrant and refugee communities in the Netherlands. The Dutch, in an effort to be tolerant of immigrants and engage in multiculturalism, allowed Islamic religious schools to be established. Hirsi Ali, however, sees this as a way to sanction the systematic oppression of women in a democratic country. 

Hirsi Ali becomes politically active and becomes elected to the Dutch Parliament where she rails against this Dutch practice of allowing old-world religious edicts to coexist in a democratic land. As part of her fight against the sanctioning of hard-line Islam, Hirsi Ali writes a short film entitled Submission (which is the translation of the Arabic word “Islam”) that is produced by filmmaker Theo Van Gogh. The film speaks directly to the oppression of women in Islam.  At what is the climax of an already exciting book, Van Gogh is killed by a Muslim man who is clearly insulted by the film. Now, a publicly recognizable figure, Hirsi Ali’s life is in grave and immediate danger, and the Dutch parliament moves her from secure location to secure location (at one point, even as far as Boston) to protect her life. She is temporarily stripped of her Dutch citizenship on the basis of having lied on her asylum application, which effectively ends her political career in the Netherlands.  Hirsi Ali then re-locates to the United States. 

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The Bride Price: A Novel

Emecheta, Buchi

Last Updated: Apr-04-2017
Annotated by:
Saleh, Mona

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is a novel set in Lagos, Nigeria among a polygamous peoples and follows the formative years of protagonist Ibo Aku-nna as she experiences the death of her father, the horror of starting menstruation, and falling in love with her teacher, Chike, of whom the elders in her family do not approve because he comes from a family that was previously enslaved. 

Throughout the novel, the reader is introduced to several traditions, which speak to how women are valued less than men in this setting. For instance, when Aku-nna’s father dies, her mother must go through a special procedure for mourning, described here: 

“Ma Blackie was to remain alone in the special hut; not until the months of mourning were over could she visit people in their homes. She must never have a bath. No pair of scissors nor comb must touch her hair. She must wear continually the same old smoked rags” (p. 71). 

Another tradition is  the concept of the bride price, which is the sum of money paid by the groom’s family to the bride’s family in exchange for her hand in marriage. The more valuable a daughter is (whether in appearance or family status), the higher the bride price. Further, if a girl’s bride price is not paid, it was the belief that the bride would die during childbirth.

When Aku-nna is sixteen, she finishes her schooling and learns that she has passed an examination that qualifies her to be a schoolteacher. At the same time, a youth with a limp in her village, named Okoboshi, sets his sights on her to become his wife. His family then kidnaps  Aku-nna. When a bride is kidnapped, her bride price does not apply, and it does not have to be paid. Also, if a man cuts away a lock from a girl's hair, she becomes his wife and he, again, is not responsible for paying the bride price:

“Some youth who had no money to pay for a bride might sneak out of the bush to cut a curl from a girl’s head so that she would belong to him for life and never been able to return to her parents: because he had given her the everlasting haircut, he would be able to treat her as he liked, and no other man would ever touch her. It was to safeguard themselves against this that many girls cropped their hair very close; those who wanted long hair wore a headscarf most of the time” (p. 103). 

When Okoboshi tries to have sex with Aku-nna, she refuses and says that it is because she has already lost her virginity to Chike, even though she really had not.  In disgust, Okoboshi stops trying to have sex with Aku-nna and beats her savagely, vowing to keep her as his wife in name only but then marry other women, whom Aku-nna would have to serve. Through initiative and luck, Aku-nna escapes from Okoboshi’s house and elopes with Chike. Despite how much money Chike’s family tries to pay Aku-nna’s family as her bride price, they will not accept it.  

Meanwhile, Aku-nna finds work as a school teacher and Chike is also successful at his work. They are very happy together for a time, and Aku-nna becomes pregnant. She struggles very much with her pregnancy and becomes quite weak as a result. One night, Aku-nna becomes sick and is admitted to the hospital, where the doctor informs her and Chike that she must undergo a Cesarean section and have her baby prematurely.  A baby girl is born healthy, but Aku-nna perishes due to extreme anemia, according to her doctor. Thus, the novel ends in confirmation of the superstition that if a girl’s bride price is not paid, she will die in childbirth. 

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