Showing 11 - 20 of 3245 annotations

Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

In That Jealous Demon, My Wretched Health (subtitled “Disease, Death and Composers”), Jonathan Noble, a retired surgeon gives us the medical and psychiatric history of seventy classical music composers. Chapters are organized by illness, ranging from cancer to syphilis to alcoholism.  Famous composers such as Schubert and Shostakovich predominate, but many lesser-known composers, ranging from Jeremiah Clarke to Gerald Finzi, are also included.  

Mozart is one composer whose cause of death has long been the subject of controversy, and the various theories are comprehensively explored here. However, the author goes even further, developing a detailed medical case study of the composer beginning in childhood.  He examines the toll that Leopold Mozart’s exploitation took on his prodigy son’s constitution, what Wolfgang’s appearance in the surviving portraits has to say about his general health, and even whether he may have had Tourette’s Syndrome. Finally, the author ties all of this together, methodically refuting or confirming each diagnosis, offering far deeper analysis than one would expect to find in a standard biography.  

Another example, the case of Tchaikovsky, reads like a veritable whodunit. The composer’s activities during the last two months of his life are scrutinized, with the likely causes of death systematically disproven or confirmed.  

A list of composers who suffered accidental or violent deaths provides some surprises. You will learn that Lully accidentally stabbed himself with his conductor’s baton, and that Alkan may have been crushed to death by a bookcase upon pulling his Talmud off a shelf.

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Heart: A History

Jauhar, Sandeep

Last Updated: Feb-05-2019
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

The author, Sandeep Jauhar, attributes his “obsession” with the human heart to family history, which includes fatal heart attacks that took both of his grandfathers from him, and to the beginnings of his own coronary artery disease revealed on screening tests. That he became a practicing cardiologist, though after first becoming a PhD-level theoretical physicist, is no surprise then.  

It was this obsession with the heart and his chosen profession that drove him to write this book, which he says, “is about what the heart is, how it has been handled by medicine, and how we can most wisely live with—as well as by—our hearts in the future.” (p. 10) In form, the book is a series of brief accounts of selected events in the history of medicine involving the human heart and circulatory system, interwoven with personal anecdotes and reflections. 
 

Some of the historical events and developments include how the heart and circulatory system work, and the methods used to assess how well they are working such as echocardiography and coronary catheterization. How heart-lung bypass, first person to person then mechanical, made cardiac surgery possible is described, as are many of the surgical procedures it enabled to treat coronary artery disease and to replace malfunctioning valves. Nonsurgical procedures Jauhar explains encompass those for intervening during acute heart attacks (e.g., angioplasty, stents, thrombolysis), managing life-threatening heart rhythm disturbances (e.g., external and implantable pacemakers and defibrillators, radio-frequency ablation), and replacing parts or all of the heart (e.g., coronary artery bypass, heart valve replacement, left ventricular assist devices, heart transplant). Little mention is made about the use of drugs despite having contributed to both important advances and surprising failures in heart disease. 
 

Topics related to the heart indirectly include the effects of emotions and psychological problems (e.g., stress), social determinants of disease (e.g., social economic status), and wellness concepts (e.g., diet, exercise). Some history of heart disease and the reduction of deaths from it over the past several decades are also touched upon. Parts of the book take the form of memoir, which add to his previous two books (Intern: A Doctor’s Initiation and Doctored: The Disillusionment of an American Physician).

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Summary:

Geoffrey West sounds like the perfect dinner guest. He has lived a fascinating life and his professional persona has evolved over time from theoretical physicist to global scientist. He is a distinguished professor at the Santa Fe Institute and is one of those rare people who knows something interesting and worthwhile about just about everything.

In Scale, West examines networks that provide the basis for complex systems: biological systems like the human circulatory system, coastal ecosystems, and man-made systems like urban communities and global corporations. He identifies three defining features shared by each. First, the networks serve the entire system and fill the entire space that is available. Second the terminal units in the networks share common design features and are essentially the same, whether they are the capillaries that provide nutrients and oxygen to peripheral tissues or the electrical outlets that enable access to the grid for home appliances.First, the networks serve the entire system and fill the entire space that is available. Second the terminal units in the networks share common design features and are essentially the same, whether they are the capillaries that provide nutrients and oxygen to peripheral tissues or the electrical outlets that enable access to the grid for home appliances. Finally, there is a natural selection process at work that is constantly optimizing the network function. West emphasizes that these defining features of complex systems are present in biological systems like the human circulatory system, coastal ecosystems, and man-made systems like urban communities and global corporations.

These common features enable West to identify fairly simple mathematical formulas that predict the relationship between changes in size and efficiency of complex systems. In general, in biological systems size and energy consumption are scaled sublinearly, i.e., metabolic rate does not increase to the same extent as size. The limits to growth occur because of the increased demands for maintenance of the system. What makes Scale an innovative work is West’s effort to apply the scaling laws derived from observations in nature to man-made complex systems such as cities and companies. He identifies two distinct components in these human systems, the materials that constitute the infrastructure and the creative work that is produced. West then demonstrates that while the physical demands of these complex human systems, such as roads, electricity, and water supply, which mirror the metabolic requirements of biological  systems, increase sublinearly, the productive output  like wages, theaters, and patent activity, which have no parallel in non-human biological systems, increase supralinearly. Moreover, this inventive works requires a proportionately increasing input of resources as size increases. West tries to draw lessons about the rational limits to growth by extrapolating from the scaling laws that underlie biological complex systems to the two components of the artificial systems created by mankind. West cautions against blind reliance on “big data” alone to solve the pressing social problems confronting mankind. Instead, he advocates for delineation of underlying mathematical principles to guide the analysis of the growth of cities and companies and rational future planning.

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Electricity

Fisher, Sukey; Higgins, Bryn

Last Updated: Jan-14-2019
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Lily O’Connor is 30 something and working at a seaside arcade in northeastern England. She inherits some money from her mother’s small estate and wants to give her brother Michael his share. But, Lily lost track of Michael during their childhood after they were placed in separate new homes to protect them from the severe abuse their mother was inflicting on them. Michael has become a ne’er-do-well in adulthood, and so Lily’s search for him takes her through the dark alleys of London and puts her in the company of its dodgier inhabitants. 

A bigger challenge to Lily in her search and in her life more generally is her epilepsy. How she experiences epilepsy forms the more interesting and dramatic elements of the story. We see Lily have several seizures  in a variety of scenarios: before a date, on the subway, at a friend’s house, in a hotel room, and in a nightclub. We see how Lily senses them coming on as she says to herself:

Here’s the breath, 
here’s the breeze, 
here’s the shimmer…and I’m falling down the rabbit hole.

We see the ground in front of her becoming fuzzy but closer, then what looks to be her hand reaching out in front of her to lay a sweater down on the ground where she thinks she will land, and then the ground getting fuzzier still as she hits it. From the ground, we see that she can still make out some people bending down to help and others averting their gazes. As Lily loses all focus, hallucinations start, and we see her body floating among patterns of electrical bursts as she experiences them. Next we hear her scream before all goes dark and violent shaking starts. As she regains consciousness, we see what she sees, blurry at first and then as her surroundings come into focus. It may be the inside of an ambulance, a hospital room, or her apartment, where in anticipation of that possibility, she has painted on her walls: Don’t Worry Lily Home Bed Sleep SAFE NOW

As Lily goes into recovery after a seizure, the director takes us from Lily’s point of view to the point of view of bystanders. We see that as a result of these seizures, Lily often sustains bone fractures, lacerations, abrasions, puncture wounds, and bruises among other injuries. She goes about cleaning herself up in a manner that suggests a routine, something she expects. Nevertheless, the loss of time frustrates her.

I just lost 2 days. Chop it up. Chop it out of my life. All the outtakes. What would they look like if you put them all together.

Lily’s adaptation to her seizures and their consequences vexes the physicians she consults, which she does only when her medications are stolen and she needs new prescriptions, and when she is taken to the hospital after particularly bad seizures. These physicians want to get Lily onto newer and presumably better medications. She resists, saying to one of them,

All I want is my old meds back.You know when my scripts change, it messes with my head every time. If you wanna know why I’ve stayed on the old meds, it’s ‘cause I know who I am…You have no idea how new drugs change me, they make me feel like a ghost. Words fall out of my mouth like vomit. My brain, a lump of cold meat. Nah, I’m not doing it.

She decides to forgo all medications if she must move to a new regimen, but it doesn’t go well. Eventually she capitulates, adapts to new medications, and goes on with her life, or as she says, “Thrash, get up, get on with it.”

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Summary:

In 2006, Emergency medicine trainee, Damon, and his wife, Trisha, have two boys, Thai (age 4) and Callum (age 2.5).  All is well in their lives until Callum begins vomiting for no apparent reason.  He is found to have medulloblastoma, an aggressive brain tumour, for which the only possible hope for a cure comes from surgery and six cycles of ever more arduous chemotherapy with stem cell recovery at Toronto’s Hospital for Sick Children. The little family moves to Toronto and commits to supporting Callum as best they can, ensuring that he is never alone even during his long weeks of reverse isolation. They also try to keep Thai nearby, involved and aware, with the help of a local school and grandparents. But Callum dies during the last cycle of treatment.  

Saddened, exhausted, and bereaved, Damon and Trisha go back to their home town and try to (re)construct their lives, slowly returning to studies and work. They find meaning in creating tangible and intangible memorials to their lost son, and they find purpose in the more difficult task of moving forward, never losing the pain of grief. They adopt a little girl. Damon knows that Callum is always with him and the experience of his illness and death has dramatically infused his work as a physician.

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Taking Care of Time

Davis, Cortney

Last Updated: Jan-02-2019
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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A Mind Unraveled: A Memoir

Eichenwald, Kurt

Last Updated: Jan-02-2019
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Kurt Eichenwald shares his experiences living with epilepsy in an electrifying narrative. Beginning with staring spells as a child and then later on generalized convulsions with loss of consciousness, he experiences as many as 4 seizures a week between the ages of 18 to 30. After that, the seizures become milder and less frequent. Coincidentally, his wife, father, and older brother are physicians and his mother a nurse.

Eichenwald describes his encounters with multiple neurologists, the best of them being Dr. Naarden. Unfortunately, other health professionals are portrayed as incompetent, careless, lacking empathy, or even unscrupulous. Multiple mishaps with prescribed anticonvulsant medications are chronicled – drug side effects, toxic levels of medicines, and a bout of bone marrow suppression. He suffers broken ribs, cuts and wounds, burns, and is even blanketed by deep snow due to seizures.

Eichenwald acknowledges the toll that epilepsy exacts on roommates, friends, and family. He admits to lots of fear and guilt. At one point, he seriously considers suicide by overdosing. Everyday life is hardly ever ordinary: “Now I was scared every day, checking where I stood for dangers, wondering when consciousness would disappear” (p157). A large section of his account details the discrimination he encounters at Swarthmore College in Pennsylvania in the early 1980’s. The school dismisses him because of his uncontrolled epilepsy. He successfully fights their decision and returns to graduate. Obtaining and holding a job is complicated by his illness, but Eichenwald becomes a journalist who works for the New York Times.




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Annotated by:
Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Yuval Noah Harari’s best-selling book “Sapiens” is subtitled “A Brief History of Humankind.”  While this may seem to bespeak a bit of hubris—it would seem that 414 pages might be, despite the modifying adjective of the subtitle, a little too condensed to cover 2.5 million years (albeit only the last 70,000 or so in any kind of detail)—the impression after finishing is that he may have done it, or at least, done the effort proud.  Mustering a combination of data and insights from the domains of history, archeology, genetics, biology, paleobiology, economics, and sociology, among others, Harari weaves an organized narrative that attempts to answer the questions of who we are and how we got here.

He divides the story into four assigned landmark periods in human history: The Cognitive Revolution (the earliest organization of humans into groups which evidence the use of tools and the beginnings of culture), The Agricultural Revolution (the impact of the learned ability to cultivate the land, with its shift from hunters and gatherers to farmers, and by necessity, from nomadic to settled tribes, and the beginnings of towns), The Unification of Humankind (the aggregation of people into larger groups and the emergence of money (and the earliest capitalism), religion, social expansion and conquest), and The Scientific Revolution (the development of science and the incredibly rapid acceleration of knowledge in the last five or six hundred years).  The titles of the periods are, however, only guideposts, for the sections are broader in scope than simply farming or science. The section on the scientific revolution, for example, interweaves scientific progress with economics and imperialism (which are themselves interwoven, after all), religion, and philosophy. And that same section leads Harari to speculate, at the end, as to where the digital revolution and the development of artificial intelligence might be leading us and what we might say about our future as a species.  




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Code Blues

Yuan-Innes, Melissa; Yi, Melissa

Last Updated: Dec-10-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Hope Sze is a resident in family medicine aiming to qualify for the extra year in emergency medicine training. She has just moved from her medical school in London, Ontario, to begin residency in St. Joseph’s Hospital, Montreal. Her furniture and clothing have not yet arrived.

On orientation day, she meets her resident colleagues and takes a shine to Alex who clearly likes her too. But the excitement and anticipation of this new chapter in their lives is disrupted when the body of one of the attending physicians is found lying in the locker room. 

A “whodunnit” with medicine, romance, and suspense in which Hope makes a few mistakes but manages to identify the murderer and the motives.

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The Big Sick

Showalter, Michael

Last Updated: Dec-03-2018
Annotated by:
Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Kumail Nanjiani is a Pakistani-born American living and working in Chicago. In addition to driving for the ride-sharing company Uber, Kumail performs as a stand-up comic at a local club, hoping to be noticed and land a big break. During one of his shows, he meets a graduate student named Emily Gardner, and the two quickly develop an intimate relationship.  

Kumail hides his relationship from his family, because they insist that he only date Pakistani women. Privately, Kumail struggles not only with the cultural expectation of intra-ethnic marriage, but also with other aspects of his heritage, such as devotion to Islamic religious law. He chooses to maintain appearances out of love for his family and fear of disownment. Emily eventually discovers Kumail’s double life and in anger, ends their relationship.  

Kumail and Emily’s estrangement is interrupted when Emily is hospitalized with a mysterious illness. Emily initially resists Kumail’s presence, but her sickness worsens and she is placed in a medically-induced coma. Under these increasingly uncertain circumstances, Kumail partners with Beth and Terry—Emily’s parents—to navigate a confusing medical system and chart the best course of care for Emily. The three of them clash over their differing perspectives on care and their interpersonal relationships. As he waits with bated breath for Emily’s recovery, Kumail is forced to confront his values and decide whether his desire to please his family and his ongoing affection for Emily can coexist harmoniously.

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