Showing 11 - 20 of 78 annotations tagged with the keyword "Anesthesia"

Propofol

Kirchwey, Karl

Last Updated: Jan-23-2013
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Poem

Summary:

"Propofol" is a 20 line poem of five quatrains each with an a-b-a-b rhyming scheme. Appearing in the June 30, 2008 New Yorker magazine, it is a description of the Classical allusions and hallucinatory experience surrounding the administration of the hypnosedative, propofol, to the speaker-patient for an undescribed medical procedure.

It involves a whimsical conversation, of sorts, between the patient and the physician. After the patient references many of the Greek and Roman materials (moly, mandragora), art ("Euphronios' famous calyx-krater" [http://en.wikipedia.org/wiki/Euphronios_krater]) and deities (Somnus, Hypnos, Morpheus) involved with sleep and death ("Sleep and Death were brothers"), the physician is made to ask why the patient is there - one presumes, and only hopes, he in fact knows!

The poem ends with the onset of what is known as procedural sedation ("A traveller/approached the citadel even while I was speaking,/seven seconds from my brain; then it was snuff."). The final two lines describe the image - apparently now in the hallucinating patient's head - of Félicien Rops' 1879 painting "Pornokrates", in the Musée provincial Félicien Rops, Namur, France (http://www.museerops.be/tech/drawing/pornokrates.html), the genesis of which Rops described thus in a 1879 letter to Henri Liesse:

"I did this in four days in a room of blue satin, in an overheated apartment, full of different smells, where the opopanax and cyclamen gave me a slight fever conducive towards production or even towards reproduction."[quoted at the Musée provincial Félicien Rops site.]

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One Breath

Clark-Sayles, Catharine

Last Updated: Sep-03-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This suggestively titled collection of poems provides a lyric record of a physician’s way of seeing.  The situations to which the poems bear witness are not only medical, though many are.  Some are cityscapes into which are woven surprisingly astute observations of homeless people or hitchhikers or ducks in the park.  Some explore the geography of a body where memories are held in “neuron chains.”  Some articulate bits of personal history from the point of view of a woman who has spent years in medicine, caring for the elderly, seeing bodies with the double vision of a clinician and a person whose spirituality clearly informs all she sees.

Titles like “ER Alphabet of Hurt” or “Looking for God On the Radio” or “Hippocrates Voyeur” or simply “Scars” may give some sense of the range of focus.  Her vision and voice are strongly local; those who know Marin County, north of San Francisco, will recognize the places that become the poet’s personal geography.  Those who don’t will still see in these poems a sensibility shaped and refined by the knowledge that comes from deep habitation.  

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The Gross Clinic

Eakins, Thomas

Last Updated: Jul-22-2010
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Professor Samuel D. Gross of Jefferson Medical College is demonstrating an operation for osteomyelitis of the femur in the surgical amphitheater in 1875 in this highly dramatic, powerful scene. Light glints off his forehead, and his visage is stern, calm, and surrounded by a halo of gray-white hair. The bloody fingers of his right hand hold a blood-tipped scalpel. He appears to have just made an incision and is turning away to demonstrate his work.

To the surgeon’s left is the patient, lying in right lateral decubitus position, with exposed leg and buttocks. Assistants are retracting the wound, further dissecting within it, and holding the patient’s legs. Blood is on their hands, instruments, and the patient’s leg. The patient’s face is obscured by the chloroform soaked towel that the anesthetist is using to administer general anesthesia. The white of this towel and the operating table’s sheet are the only other bright white values besides the surgeon’s head in this mostly dark painting.

Adding to the drama is the stricken pose of the patient’s female relative--to the surgeon’s right. For charity cases, a family member was required to be present during the surgery. She averts her head and raises her hands, clenched in a claw-like fashion, to block her view.

In the gallery are variously interested and disinterested observers--mostly medical students--in casual poses and dimly seen. The exception is the artist’s self-portrayal--he is studiously drawing in the front row. Dr. Gross’s son (also a surgeon) is standing in the entry tunnel.

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A Deathplace

Sissman, L. E. (Louis Edward)

Last Updated: Feb-22-2010
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry — Secondary Category: Literature / Poetry

Genre: Poem

Summary:

In "A Deathplace" the speaker recounts, with seeming nonchalance, the predictable sequence of his own death. He describes the hospital he knows so well, the details of surgery (down to "the buttered catheter goes in"), the "malignant plum," and finally "the hour / when the authorities shut off the power . . ." Sissman uses the power shut-off to signify his own death, but soon the lights go up and throughout the hospital the "business of life" resumes. Part of that business is to move his body to the morgue, then to the undertaker, then "That's all."

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A Stone Woman

Byatt, A. S. (Antonia Susan)

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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To Suffer a Sea Change

Phelan, Peggy

Last Updated: Jan-20-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Professor of performance studies at New York University, Peggy Phelan narrates the story of a vision disorder that began when she was 23 years old, caused by "open-angle glaucoma," a difficult-to-treat condition in which the vessels draining ocular fluid periodically constrict. The episodes are excruciatingly painful and disorienting: "I feel a staggering push behind my right eye. The right upper half of my face is on fire: I am certain that my eye has fallen out of its socket . . . " (508).

Phelan resists patienthood, beginning with her first visit to the doctor, in which she underplays what has happened to her. Rejecting surgery, coping with side effects of the drugs she must take, and concerned about her ability to continue as a visual arts scholar, she muddles through for several years. Then she experiences a frightening, vividly described episode of temporary blindness, which is followed by a migraine headache. Six months later she agrees to have surgery.

During the surgery, under local anesthesia, "my eye, which is frozen, can still see things as they pass over it . . . colors I have never seen before . . . I am seeing the roof of my own eye from the interior side. It is utterly breath stopping. I cannot speak" (521-522). Enabled to see her eye from a perspective that was not available to the physician, and grateful for this "visionary experience," Phelan finally accepts her situation. She is not cured, although her condition improves. "My story is finally the same as those of all the other patients . . . The only difference between me and them comes from the words I’ve suffered to find and the words I’ve suffered to flee" (525).

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Autobiography of a Face

Grealy, Lucy

Last Updated: Jan-09-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Lucy Grealy, poet, tells the story of her childhood and young adulthood, a twenty year period of overwhelming physical and mental suffering. Yet the author is so resilient, so intelligent, so insightful, and such a good writer that her story transcends mere illness narrative. At age nine, first misdiagnosed and finally identified as having facial bone cancer (Ewing’s sarcoma), Lucy underwent several surgeries and more than two years of intensive chemotherapy and radiation treatments. Pain and nausea, anxiety and fear of more pain and nausea were only part of the ordeal.

The young Lucy became aware of what it is to be severely, chronically ill. Her sisters behaved differently toward her: they were polite. "Suddenly I understood the term visiting. I was in one place, they were in another, and they were only pausing." Even her father felt uncomfortable at her hospital bedside, and Lucy was relieved that he came infrequently.

But being at home was worse: in the hospital the other patients and the staff expected little from her and she felt no guilt or shame; amidst her family, she blamed herself for the tension, arguments over money, and her mother’s depression, even though these elements had existed prior to her illness. Her hair fell out and she became dimly aware that people were staring at her face. Nevertheless, "I . . . was naturally adept at protecting myself from the hurt of their insults and felt a vague superiority . . . . "

Well enough to return to school, Lucy’s disfigured face drew taunts from classmates; she understood finally that she was perceived as ugly and that she would not be loved. Only on Halloween, when she could mask her face, did she feel free and joyful, unconcerned about her appearance, "normal." Her moods now alternated between despair, determination, and escapism. She became convinced that only facial reconstruction and a restored appearance would make life bearable.

During years of reconstructive surgery Lucy evolved complex rationalizations to give meaning to her suffering. Two anchors had stabilized her existence throughout the misery: a passionate adolescent love of horses, and an adult love of poetry. Eventually outward appearance and inner life became harmonious. "The journey back to my face was a long one."

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The Steel Windpipe

Bulgakov, Mikhail

Last Updated: Jan-04-2010
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A little girl is brought to the rural hospital by her mother, who throws himself at the feet of the young doctor, “Please do something to save my daughter!” It seems that she has been suffering from a sore throat and is now having difficulty breathing. The doctor looks into her throat; diphtheria is evident.

At first he scolds the mother for not having brought the girl earlier. Then he suggests surgery: a tracheotomy. The doctor knows this is the only way he might save the child, but he is consumed by anxiety because he has never performed the procedure. At first the mother objects to surgery, but then relents. The tracheotomy is successful and the child survives.

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Morphine

Bulgakov, Mikhail

Last Updated: Dec-29-2009
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Bomgard, a young doctor recently transferred from a rural area to a small town hospital, receives an urgent message from Polyakov, the doctor who replaced him. Polyakov has become ill; he needs medical help. Before Bomgard can respond, however, Polyakov arrives at the hospital, dying of a self-inflicted wound. In his last moments, he gives Bomgard a notebook, on which is recorded the story of Polyakov's addiction to morphine.

Polyakov first took morphine to relieve an abdominal pain. He found that it also relieved his despair over the loss of his lover, an opera singer in Moscow. Morphine relieved his loneliness and improved his work. He gradually increased the dose until he became hopelessly dependent on the substance. He failed in his attempts to break the habit at a clinic in Moscow. Eventually there is nothing in life but the drug and Polyakov suicides.

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Annotated by:
Mathiasen, Helle

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

At the request of a German editor, Charles Darwin (1809-1882) began his autobiography at the age of 67. His granddaughter and editor, Nora Barlow, tells us that he revised it over several years.

Darwin remembers little about his mother who died when he was 8, but talks at length about his forceful physician father, who measured 6 foot 2 inches, and weighed over 336 pounds. His father's success guaranteed that Charles would never have to work for a living. Darwin was a naughty boy schooled in humaneness and manners by his loving sisters. Early on, he showed a passion for collecting, mostly beetles, but also coins, shells, and minerals. He hated boarding school; he enjoyed running in the open air and shooting snipes with his dogs. He quotes his father's characterization of him as a young boy: "You care for nothing but shooting, dogs, and rat-catching, and you will be a disgrace to yourself and all your family" (28).

As a medical student at Edinburgh University, he witnessed operations without anesthesia which caused him to revolt against his father's wish that he become a doctor; he couldn't take the sight of blood.  At Cambridge, he found most of his classes and professors dull, except for his botany professor, John Stevens Henslow, his mentor and hiking companion. The paternal plan for him to become a clergyman foundered at Cambridge, as Darwin questioned the Thirty-nine Articles of the Church of England.

From 1831, he sailed with Capt. Fitz-Roy on board  The Beagle for 5 years and 3 days (again, against his father's wishes). He quarrelled with  Fitz-Roy whose mood swings required Darwin's tact. They disagreed about slavery, FitzRoy defending it, and Darwin abominating it. He carried Lyell's Principles of Geology with him, read Milton, and collected numerous specimens which he sent back to Britain.

28 months after his return, Darwin married his cousin, Emma Wedgwood. The marriage was happy and produced 10 children.

In the chapter on his religious beliefs, Darwin gives 4 reasons for believing the Old Testament to be false; as he has studied the laws of nature, he has ceased to believe in miracles. He rejects Bishop Paley's argument for intelligent design: "Everything in nature is the result of fixed laws" (87). The Christian god is cruel, as he causes innocent animals to suffer and condemns non-believers to hell. Darwin confesses he does not understand "the mystery of the beginning of all things" (94), calling himself an agnostic. He outlines the great Victorian men he has known, though his ill health has long  prevented him from traveling or seeing friends. He discusses his publications, including Origin of Species, stating he did not care whether he or Wallace got the credit for the theory of evolution. He attributes his success to his moderate abilities. He has been methodical, industrious, and commonsensical.

The appendix includes Darwin's list of pro and con arguments about marriage, Mrs. Darwin's papers on religion, and a short chapter on his illnesses.

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