Showing 11 - 20 of 38 annotations in the genre "Collection (Essays)"

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This collection of essays by surgeon-writer Atul Gawande (author of Complications: A Surgeon's Notes on an Imperfect Science --see annotation) is organized into three parts (Diligence, Doing Right, and Ingenuity) and includes an introduction, an afterword entitled "Suggestions for becoming a positive deviant," and reference notes. Each part is comprised of three to five essays, which illustrate, as Gawande explains in the introduction, facets of improving medical care - hence the title of the collection: Better: A Surgeon's Notes on Performance. In typical Gawande style, even the introduction contains tales of patients - a woman with pneumonia who would have fared far worse had the senior resident not paid close and particular attention to her well-being, and a surgical case delayed by an overcrowded operating room schedule. Such tales are interwoven with the exposition of themes and the detailing of the medical and historical contexts of the topic at hand.

The essays, though loosely grouped around the improvement theme, can easily be read as individual, isolated works. The concerns range widely both geographically (we travel to India and Iraq as well as roam across the United States) and topically. For instance, we learn about efforts to eradicate polio in rural south India and the dedicated people who devise and implement the program. Another essay, far flung from the plight of paralyzed children, is "The doctors of the death chamber," which explores the ethical, moral and practical aspects of potential physician involvement in the American system of capital punishment (from formulating an intravenous cocktail ‘guaranteed' to induce death to the actual administration of such drugs and pronouncement of death).

In sum, the topics of the eleven essays are: hand washing, eradicating polio, war casualty treatments, chaperones during physical examinations, medical malpractice, physician income, physicians and capital punishment, aggressive versus overly-aggressive medical treatment, the medicalization of birth, centers of excellence for cystic fibrosis treatment, and medical care in India. The afterword comprises five suggestions Gawande offers to medical students to transform themselves into physicians who make a difference, and by including this lecture in the book, what the reader can do to lead a worthy life.

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Bedside Manners

Watts, H. David

Last Updated: May-25-2007
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

The subtitle to this collection of insightful and compassionate essays by gastroenterologist David Watts is: "One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer." Watts provides 48 narratives, most of which concern his patients and are written in the first person. In the preface Watts states "The stories in this book are true" (xv), that he has received permission from his patients, and that he has "disguise[d]" his patients to respect their right to privacy.

The stories cover a range of settings, from Watts's home and locations in the San Francisco Bay area, to the clinic and hospital. They also cover a range of his experience from medical school ("Sylvester" and "Love is Just a Four-letter Word") to his current position as a practitioner and an attending physician at a teaching hospital.

Stories in which Watts clearly situates himself with the patient and details the encounter are most compelling. For example, in the opening essay, "White Rabbits" and later, in "Flu Shot," Watts allows the reader to discover that patience and listening are required to in order for the patient to expose why he or she is truly there. In that space, Watts becomes present for his patient, and one learns that what may initially appear tangential is central to the patient's concern.

Watts writes of some very difficult patients and families, such as a woman who stalks him ("The Stalker's Bridegroom"), a woman who obsesses over caring for her elderly mother ("Home Remedy"), and a woman who demands narcotics ("The Third Satisfaction"). In one of the longer pieces, "Codger," Watts describes an irascible, elderly Jewish patient who skewers just about anyone with his critiques, including Watts's young son, and yet who later exposes his vulnerability by unfolding the tale of his World War II service and discovery of a Nazi death camp. It is because Watts spends time with the Codger and recognizes that the doctor-patient relationship is above all a human relationship that the doctor receives the gift of the story: this terrible experience which informed the rest of the Codger's life.

A few of the vignettes explore the therapeutic potential of poetry. For instance, in "Annie's Antidote" a piano teacher, fearful of endoscopy, asks Watts to recite one of his poems. The poem concerns the tender relationship between Watts and his son and is a metaphor for Watts's patient encounters as well: "for this is one of those moments / that turns suddenly towards you, opening / as it turns, as if we paused / on the edge of a heartbeat. . . " The poem works, the moment opens, and the woman has her endoscopy.

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Sister Outsider

Lorde, Audre

Last Updated: Jan-08-2007
Annotated by:
Wear, Delese

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Sister Outsider is a collection of essays focusing on race/racism, gender/sexism, sexual identity, and social class as these are enacted in a white-supremist, heterosexist, capitalist patriarchy (i.e. the United States). As a Black woman, lesbian, feminist, mother, poet, essayist, and political activist, Lorde's essays in this collection include her often quoted "The Master's Tools Will Never Dismantle the Master's House," an essay that radically challenges how white people "learn about" racism, or how men "learn about" women: "Women of today are still being called upon to stretch across the gap of male ignorance and to educate men as to our existence and our needs. This is an old and primary tool of all oppressors to keep the oppressed occupied with the master's concerns . . . ."

Her essay "Poetry is Not a Luxury" suggests that poetry is "illumination," and is a way to wed ideas and feeling, a way "we help give name to the nameless so it can be thought. The farthest horizons of our hopes and fears are cobbled by our poems, carved from the rock experiences of our daily lives." Other titles include "Sexism: An American Disease in Blackface," "Man Child: A Black Lesbian Feminist's Response" (on being the lesbian mother of a son), and "The Uses of Anger: Women Respond to Racism."

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Summary:

This collection is introduced with an essay by Suzanne Poirier (editor of the journal, Literature and Medicine). The collection, describes Poirier, looks at how such equations as "sex = disease, homosexuality = disease, promiscuity = disease, and, finally, homosexuality = promiscuity = disease" are, in fact, being challenged, resisted, and "rewritten in a healing way in today's writing about the epidemic [found] in the literary presses, obituary columns, and even freshman compositions." The book contains thirteen essays and an annotated bibliography of AIDS literature from 1982 through 1991.

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Living up the Street

Soto, Gary

Last Updated: Dec-07-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

In these "narrative recollections" poet Gary Soto reflects on his Mexican American childhood in the ethnically mixed laboring-class neighborhoods of Fresno, California. His was a life lived at the margins--economic margins and cultural margins. In these recollections of family relationships, youthful mischief-making, farm and factory jobs, adolescent rebellion, and the transition to professional writing Soto subtly and humorously draws our attention to the discontinuities between the lived lives of Chicanos and Anglos.

"The Beauty Contest" describes how young Gary entered his younger half-brother in a playground beauty contest. "Strong build, a chipped tooth, half Mexican and half white--he might win, I thought." (43) Gary knows that only a lighter complexioned child could meet the Anglo standards of beauty that prevail. In fact, he has internalized those standards himself: " . . . we were awed by the blond and fair skinned kids in good clothes. They looked beautiful, I thought." We are led to infer that the Anglo contestants come from a world of comfort and parental attentiveness whereas Gary has been left on his own to tend to his brother while his parents are away at their work of manual labor.

In "Looking for Work" Gary wanted to imitate the Anglo families of the television programs that he continually watched. He tried to convince his siblings to wear shoes to dinner and improve their appearance so that "[w]hite people would like us more." (26) In "1,2,3," Soto reconstructs the shocking vindictiveness of an Anglo father after his young daughter falls off of a swing that is being pushed by Gary's Chicana friend, Rosie. Soto ends this piece, "I wanted to . . . explain that it was a mistake; that we also fell from the swings and the bars and got hurt . . . ." (15)

Soto foregrounds violence as an integral part of his childhood. The lead-off sketch, "Being Mean," recounts childhood pranks involving the setting of fires and abuse of pets. But this violence also included and was a response to verbal violence from others, such as being called "dirty Mexicans." (3) "Bloodworth" chronicles the evolution from fisticuffs--"all through elementary and junior high school, it was bob and weave, jab and stick" (95)--to the more controlled violence of the high school wrestling team.

Soto tells of his back-breaking farm laboring and factory jobs in "One Last Time" and "Black Hair." There is no romance in these episodes, "no grace" (124) in the miserable conditions, and no comfort. Rather, there is always the fear that he will forever have to "work Mexican hours, and in the end die a Mexican death, broke and in despair." (123)

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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Annotated by:
Martinez, Richard

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

The New Medicine and the Old Ethics, in Albert Jonsen’s own words, is a "secular aggadah." Jonsen explains that one Talmud reviewer defined aggadah as "a magical rabbinic mode of thought in which myth, theology, poetry and superstition robustly mingle" (4). The book begins with a personal essay entitled "Watching the Doctor." Jonsen establishes his premise that the moral history of Western medicine is best understood as a paradox between altruism and self-interest, a paradox alive and well entering the 21st Century.

He then takes the reader on his "secular aggadah," blending history, myths, and stories that trace important moral developments in the practice of Western medicine. In "Askelepios as Intensivist," we learn of the early Greek values of competence in shaping medical practice. Through the influence of the Church in the medieval period, Western medicine incorporates the value of compassion through the Biblical Good Samaritan, struggles with problems of justice in the care of the poor, and further elaborates the meaning of benefit.

In "The Nobility of Medicine," Jonsen describes the contribution of Sir William Osler and other knighted medical men of the 19th Century who established the ethics of noblesse oblige in the medical profession. He traces this noble tradition to the medieval Knights Hopitallers of Saint John of Jerusalem, a group of religious who provided hostels for pilgrims to the Holy Land and cared for the sick. With essays on John Locke and Jeremy Bentham, Jonsen brings us to the 20th Century and the play of individual rights and utilitarian values in the moral life of Western medicine.

In the final essays, Jonsen describes the mingling of these traditions as a means to establish a moral frame for Western medicine in our current times where technology and science have achieved and threatened so much. Ethics, he argues, "is disciplined reflection on ambiguity" (130). In the last essay, "Humanities Are the Hormones," Jonsen brings his "secular aggadah" full circle.

He argues that the paradox of altruism and self-interest that runs through the moral history of Western medicine must continually be vitalized and examined through the Humanities. The Humanities are "the chemical messengers that course through the complicated institution of medicine and enable it to respond to the constantly changing scientific, technological, social, and economic environment" (147).

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Gardening in Clay

Valdiserri, Ronald

Last Updated: Aug-22-2006
Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

A collection of twenty-six short essays about AIDS from two primary perspectives. Approximately one-third of the essays reflect on this physician-author’s personal response to his identical twin brother’s deterioration and eventual death from AIDS. The remaining essays reflect this pathologist/public health educator’s interest in confronting the epidemic on a societal/cultural level.

The author’s love of nature and gardening provides a sense of continuity throughout the book. The gentle yet strong voice of the author is very moving when sharing his personal experience. His voice, on occasion, becomes pedantic when addressing societal and public health concerns.

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Summary:

Shannon Moffett, a medical student at Stanford University School of Medicine, became fascinated with the brain during her anatomy and neurobiology courses. She set off across the country to interview people--scientists, doctors, patients, ethicists, and religious leaders--who devote their careers trying to understand the brain and cognition. With infectious enthusiasm and energy, Moffett brings the reader to meet these dedicated people, their work, their theories and their lives.

The book contains eight chapters and hence eight mini-biographies: 1) neurosurgeon Roberta Glick, 2) cognitive neuroscientist and brain imagist John Gabrieli, 3) Francis Crick (of DNA double helix fame) and Christof Koch--scientists studying consciousness, 4) sleep researcher Robert Stickgold, 5) Judy Castelli who has dissociative identity disorder (multiple personality disorder), 6) philosopher Daniel Dennett, 7) neuroethicist Judy Illes, and 8) Zen monk Norman Fischer.

Separating the chapters are "interludes" that map neural and brain development from conception to death. The book has a reference list for each chapter and a complete index, as well as a web resource (www.shannonmoffett.com) to which the reader is directed for graphics.

The writing is compelling, direct, fresh and insightful. For example, in "Touching the Brain," we follow the exhausting lifestyle of an academic neurosurgeon who works at Cook County Hospital in Chicago as she performs surgery, teaches, attends services at a temple, drives her car, takes care of her family including two young children, rounds on patients, hosts a potluck dinner, and simultaneously discusses her reading, travel and spirituality.

Moffett aptly describes Glick with her "waist-length red hair, ... beaten-metal earrings dangling almost to her shoulders and a saffron batik dress" as someone you'd "expect to find reading storybooks to kindergartners in a public library" (8). In fact, it is Moffett's eye for accessible detail that makes not only the people, but also neuroscience come alive. Artfully woven into the text are lessons on the history of brain research and current understanding (and questions) about the brain, its meaning and function.

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Summary:

The aim of this collage of anecdotes from medical history is largely to entertain, though it is pointedly instructive in its focus on reasons for and results of medical mistakes, misapprehensions, and serendipitous breakthroughs. Gordon's dryly humorous skepticism and general irreverence is balanced by an obvious delight in the intellectual play that characterizes the history of science.

The stories he tells range from Hippocrates to the present with a heavy focus on the 18th and 19th centuries. The book includes a good representative collection of visual art and photography documenting moments in medical history upon which Gordon casts a cold but twinkling eye. Chapter titles such as "Discoveries in the Dark," "Sex and its Snags," "Odd Practices," and "Freud, the English Governess and the Smell of Burnt Pudding" give a bit of the book's flavor.

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