Showing 11 - 20 of 430 annotations tagged with the keyword "Cancer"
Summary:Paul Kalanithi, diagnosed with stage IV metastatic lung cancer when he was a neurosurgery resident at Stanford University, was faced with a decision. Should he truncate his career in neurosurgery in order to become a writer - a career he had always envisioned for himself after completing a couple of decades of neurosurgery practice? Married to Lucy Kalanithi, an internist he had met in medical school, Paul’s career and future had looked bright and promising. But as he entered his final year of a seven-year residency, symptoms of excruciating back pain and significant weight loss began. Garbed in a hospital gown, he examines his own CT scan – this is how we meet Paul at the beginning of the Prologue. He then writes of the relatively brief period of misdiagnosis prior to the CT scan. With the initial negative plain x-rays, he is started on nonsteroidal anti-inflammatory drugs. But breakthrough pain and continued weight loss leads to the CT. Paul the physician understands the death sentence the images portend; Paul the patient is just beginning his journey. The diagnosis and treatment cause him to reassess his decisions about his life, to decide to father a child even though he knows he will never see the child grow up, and ultimately to write a memoir, essentially for his daughter.
Summary:The book offers a detailed account by one of the nation’s leading cancer researchers of developments in chemotherapy over the past several decades, as well as the recent history of surgical and radiation treatments in the “war on cancer”—a term he resisted at first but finally embraced with full understanding of its implications. The narrative touches on many of the writer’s own struggles over economic, political, and moral implications of what a NYT reviewer described as a “take-no-prisoners” approach to cure. He also includes stories about disagreements with other researchers that give some insight into the acrimony that is part of high-stakes science. At the NIH and later as head of the National Cancer Institute, DeVita faced many decisions about distribution of resources, how much to put patients at risk, and whom to include in clinical trials. He provides his own point of view on those controversies frankly. Not much mention is made of the causes of cancer, of nutritional or other complementary approaches, or the environmental factors in the spread of cancer. The strong focus on the book is on the development of chemotherapeutic treatments that have succeeded in raising survival rates, though few current statistics are cited.
Summary:At 16, Alice is diagnosed with leukemia, and is given a dire prognosis. Assuming she has months to live, she undergoes chemotherapy with the support of her lifelong friend, Harvey, whose frank and deepening love she is uncertain about returning. On days when she has enough energy and the nausea abates, she works on a "bucket list" with Harvey's sometimes reluctant help, since the list includes revenge on two classmates who have hurt and humiliated her. When, months into treatment, she goes into unexpected full remission, Alice has to come to terms with the consequences of some of her revenge strategies and reassess the depth of a relationship with Harvey that may last far longer than she thought she had. Given an opportunity to choose life on new terms, she considers those new terms in a more adult way, chastened, focused, and grateful for a chance to make new choices.
Summary:Two individuals share a struggle that is grueling, depressing, and whose outcome is probably preordained. The Mother (divorced, constantly tired, and fearful of sickness) is "not a good choice for the parent of a chronic invalid" (p. 168). The Son (smallish, clever, and born with some kind of tumor) has previously had an organ transplant (most likely kidney).
Summary:A mother (termed Mother in the story) discovers a blood clot in her young son's diaper and wonders "so what is this thing, startling against the white diaper, like a tiny mouse heart packed in snow?" This discovery leads to a diagnosis of Wilms' tumor--a childhood malignancy of the kidney, and surgery to remove the diseased kidney.The parents are thrust into a new world--the world of pediatric oncology ("peed onk") and meet the Surgeon, the Oncologist, and the other anxious parents waiting in the Tiny Tim Lounge of the pediatric ward. Everyone is named by their relationship to the Mother or by their profession--Baby, Husband, Anesthesiologist.The reader is privy to the inner thoughts of the Mother--her anger, denial, protective instincts and dark ironic vision. The Mother is also a writer and advised to take notes of this odyssey in case they need money to pay the medical costs. She feels alien to the culture of the pediatric ward--only her artsy friends understand her hell. Notes one (Green Hair) "Everyone's so friendly here. Is there someone in this place who isn't doing all this airy, scripted optimism--or are people like that the only people here?"When the Mother is given the option of no post-operative chemotherapy for Baby, the Mother grabs the chance to leave the hospital, clutching Baby, and says "I never want to see any of these people again." The piece ends on the rhetorical and ironic question--where's the money for these notes, for the story?
Summary:Not God is a "play in verse" with two characters, a hospitalized patient and the patient's doctor. The scare quotes indicate the fluid quality of Not God, which the author originally conceived as a sequence of poems spoken in a patient's voice. Subsequently, he added the doctor poems (monologues) to create a "dialog" between the two voices. Once again, scare quotes suggest the atypical quality of this dialogue, since the two characters express different feelings and perspectives on the situation, but do not directly address one another. The play version has received several performances at colleges and small theaters.The patient speaks first in a monologue that begins "A man's cough bounces down the hallway / like pick up sticks... " and ends with "I am here two weeks." (p. 7) It soon becomes evident that he/she has cancer and is receiving chemotherapy. The doctor has changed this person's life by speaking "one word," after which "nothing / would ever be the same again." (p. 10). The patient is knowledgeable, accepting of his/her condition, a keen observer with a good sense of humor, as in "Doldrums" (p. 19) and "Cricket" (p. 23), and a person who affirms life in spite of adversity. The doctor is burdened with the power of medical knowledge. In particular, he understands the deadly meaning of signs and symptoms: "We say / excess water and swelling of the belly, knowing / full well... / an ovarian cancer is almost certain." (p. 33) But the meaning this represents is chaos: there is nothing humane or transcendent about cancer. Unlike his baseball card collection in childhood ("Shoebox," p. 35), cancer is neither confined nor orderly. In the second act, the patient sympathizes with the doctor whose "head is so cluttered / with obligatory data." Paradoxically, the doctor must be protected because he is "filled with dying." (p. 41) The doctor becomes angry with the burden, "Why / ask me a question that only God can answer?" (p. 49) and cries out that his work is "alchemy, / potions and witches' brews." (p. 54) In the end, while dying, the patient imagines "a bridge that can cross / the Atlantic." (p. 68), while the doctor speaks a prayer, "The word cure, dear God, is always / near my lips, though I have been constrained from / saying it aloud." (p. 66)
Summary:In this collection (80 pages), Marc Straus speaks of the inadequacy of communication and knowledge in medicine; the pauses, the distance, the hesitations. You think you know what you are doing, "But no, they always ask the question / I never knew." ("The Log of Pi") "The question / might be so simple, so clear / that you’re unprepared to answer." ("Questions and Answers") Though words are in one way inadequate, the medical word carries great power: " . . . I knew that moment / I would say one word for her and nothing / would ever be the same again." (One Word, annotated in this database.)The poet comes to understand that he represents both sides of medicine, both the detached and distant Dr. Gold, and the warm and trustworthy Dr. Green. (See annotation of Dr. Gold & Dr. Green) Unfortunately, this knowledge only comes about after the patient has died ("Dr. Gold & Dr. Green, II"). We learn from experience, sometimes too late.
Summary:The speaker reflects that "life is sometimes reduced / to a single word . . . . " He remembers one incident at a bus stop, another interviewing a man "for a job in my lab." Then there was the time a woman "walked / into my office for one thing . . . . " He discovered a "fullness" in her neck and knew that the word he would say to her, the one word, would change her life: "nothing / would ever be the same again."
Summary:The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.