Showing 11 - 20 of 987 annotations tagged with the keyword "Suffering"

Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

After 65 years of marriage, two life-partners face the prospect of final separation, as one of them develops multiple myeloma. This is the crisis that led Irvin Yalom, eminent psychiatrist, novelist, and pioneer of existential psychotherapy, and his wife Marilyn, acclaimed feminist author and historian, to collaborate in writing the story of their journey through Marilyn’s final months of life. In the resulting book, Irvin and Marilyn write alternating chapters until Marilyn becomes unable to write. After her death, Irvin continues with the story of his bereavement.  

Marilyn’s chapters include reflections on love and illness, ranging from Emily Dickinson and Henry James to Paul the Apostle. She frequently expresses her gratitude: “I can still talk, read, and answer my emails. I am surrounded by loving people in a comfortable and attractive home.” (p. 20) Most of all, she is thankful for her husband, “the most loving of caretakers.” (p. 15) Yet, as her disease progresses, she comes “to the understanding that I would never be the same again—that I would pass through days of unspeakable misery while my body would decline and weaken.” (p. 76) She decides to pursue the option of physician-assisted suicide, which is legal in California, when her suffering becomes overwhelming.  

In his chapters, Irvin resists this decision, maintaining hope for additional “good” life, despite all evidence to the contrary. Near the end, Marilyn’s pain and other symptoms become so severe that she cries out, “It’s time, Irv. It’s time. No more, please. No more.” (p. 139) Her physician arrives, confirms her intention, and surrounded by her whole family, Marilyn sucks the liquid through a straw and quietly passes away.

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The Steel Windpipe

Bulgakov, Mikhail

Last Updated: Jun-02-2022
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 herself 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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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In the opening dialog, the author, Samantha Harvey, tells a friend what this book is about. 
Friend:    What are you writing?
Me:         Not sure, some essays. Not really essays. Not essays at all. Some things. 
Friend:    About what?
Me:         Not sure. This and that. About not sleeping, mainly. But death keeps creeping in. (p. 1)
That’s as good a description of the book as could otherwise be offered.

As unstructured as the book’s content is, so is the book’s format. The only breaks in the text are distinguished by infinity signs. Time stamps are placed within the text between some of these breaks. The times are sequenced during a night (or a composite of nights) when Harvey is awake between midnight and 7:30 am. Texts following the time stamps describe the acute effects of insomnia on her at those particular moments and could be read as diary or journal entries. 

Harvey’s insomnia came suddenly at the age of forty-three and morphed into an unrelenting assault that at times made her wonder if the only sleep available to her is the sleep of the dead. 
When I don’t sleep and don’t sleep and don’t sleep, I don’t want my life; neither do I have in me the propulsion (courage? know-how?) to take it. So I have to endure my life when it’s unendurable, and this is an impasse. (p. 33)

Can I escape this? The sword hangs. There is nothing to put my mind at rest – every day presents a new threat: the night. Every night is a battle, most often lost, and any victory is one day long, until its challenger comes along: the next night. I understand why people kill themselves, or break down. (p. 82)
Throughout the book, across all the text sections, and following all the time stamps, Harvey details what insomnia does to her physically, psychologically, and existentially. She desperately explores the possible causes such as menopause, fear, traffic noise, and Brexit among others, and heartbreakingly tells of all she has done to get sleep such as seeing doctors, smiling more, counting blessings, and changing behaviors. None come to any effect, as she reports to her unhelpful doctor. 
I do these things, they don’t help.
Over time they will.
Over time they haven’t.
I feel unhelpable.
Nobody is unhelpable.
I am.
Nobody is. (p. 139)
Just as Harvey had informed her friend, she takes up other topics in other forms that directly or indirectly relate to her insomnia, and sometimes do not relate at all. Among the various forms are vignettes; thoughts and obsessions; meditations; and a short story. Topics include deaths in the family (including a dog’s); peculiarities of different languages; why so many TV shows have the word “secret” in their titles (she spends “nights spent thinking about this”) (p. 67); what fuels insomnia; how worry, anxiety, and fear differ from one another; writing; time; and the relationships between science and religion, and between reason and faith. Harvey’s  background in philosophy shows. 

A year on, Harvey discerns a cure for insomnia. Using a metaphor involving swimming against waves and currents or with waves and currents, the cure is to be derived from the “wisdom in knowing that we are sometimes the cause and influencer of our own currents and tides, which we make in otherwise still waters.” She further elaborates on this idea and how it leads to a moment when “you’ll drop each night into sleep without knowing how you once found it impossible” (p. 175).


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One Friday in April

Antrim, Donald

Last Updated: Feb-08-2022
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As One Friday in April opens, we find Donald Antrim in an agitated state on the roof of his Brooklyn apartment building.  He paces, and alternately climbs down the fire escape, hangs from the railing, and lies on his stomach peering over the ledge.  Repeated outpatient courses of psychotropic medication and psychotherapy have done only so much for his deteriorating mental state, and the situation has come to a head. Disheveled and wild-looking, he manages to return home whereupon his friends take him to a psychiatric hospital.  

A MacArthur Fellow and author of several acclaimed novels, Antrim has previously published a memoir of his upbringing with his alcoholic mother.  In this new memoir, flashbacks of childhood neglect and chaos are juxtaposed with the present day as he takes the reader through the acute phase of his illness:  a lengthy hospitalization, a course of ECT, discharge from the hospital, rehospitalization, and eventual stabilization.   

The author considers his condition to be suicide, noting that “depression is a concavity, a sloping downward and a return.  Suicide, in my experience, is not that.  I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish…I will refer to suicide, not depression” (pp. 14-15).  

The book ends on a hopeful note. After several relationships that might be described as codependent, Antrim meets his current partner, whom he marries.  He sees the roof of his building through his window and remembers a certain Friday in April but is comforted by the sound of his wife playing Chopin and Bach on the piano.  

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Daughter

Davis, Cortney

Last Updated: Jan-17-2022
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Davis, a nurse practitioner, chronicles her daughter’s life, illness and death at age 54 from cancer. The book consists of three sections, with poems unevenly divided such that of the 30 poems, only one rests in section II. Titled Windmill, this poem forms a fulcrum between the relationship of mother and daughter to one of mother and ill daughter. The windmill is a small gift from her daughter – a reminder of Kansas where the daughter, her husband and children live, thousands of miles from Davis. The collection begins with her ‘soon-to-be born daughter’ (page 15) and ends with The Sacrament of Time, dated months before her daughter’s death from, at this point, a widely metastatic breast cancer. The final poem holds within it an entire world – the birth of the daughter, the fraught frantic mother-to-be pleading for help, the birth of a healthy baby girl, the wonder of the new addition to their family, the travel with the newborn to home, and a reflection on what poems can and cannot do. “Poems cannot // save us, Amichai said, but all I have are these poems” (page 58).  

If the first section details the many ways unconditional love for a child unfolds, through wonders of babyhood, delights of childhood, the harsh lessons of adolescence, and the successful launch, the final section underscores how deep that love runs. As the cancer illness progressed during the pandemic, issues of separation became more acute. Davis marks the numbers affected (illness and death) by coronavirus (SARS-CoV-2, COVID-19) during the pandemic, as her poems follow her daughter’s cancer. These numbers, along with brief quotations from her daughter’s scans and reports, lend a contrast to the evocative imagery and experience of illness in a loved one. Medical mistakes are chronicled as well (see What a Terrible Mistake).  

The collection is dedicated to Davis’ daughter and her daughter’s children. Even the title, Daughter, calls to her, as if addressing her daughter directly. The title also serves to universalize the parenting of a daughter, even as the particulars of this family are detailed.

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Nervous System

Meruane, Lina

Last Updated: Dec-13-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ella needs time for finishing her doctoral dissertation on black holes she has been writing for years and thinks an illness could provide the time: “Just enough to take one semester off, to not have to teach all those planetary sciences classes to so many distracted students whom she had to instruct evaluate forget immediately (p. 6). Before she can decide which illness would best suit her purposes, a mysterious illness finds her.
 A sudden cramp shoots down the spine and then, stillness... (p. 9)
An unbearable stinging had settled into her shoulder neck ember... (p. 10)
She felt an invisible wound wrapping her up and suffocating her... (p.10)
A slight numbness that starts in the shoulder and extends along the arm to the elbow until it reaches the back of her right hand, the fingers where it all started. (p. 12)
Inflammatio. In flames. En llamas. Ardor without romance. (p. 10)
Quickly, then, the story shifts from Ella’s dissertation odyssey to her diagnostic odyssey. As she makes her way along this journey during the first chapter, other characters come into the picture: El, Ella’s long-term boyfriend and forensic scientist, is one. The others in her family history are “the Father,” “the Mother,” “the Brother,” and “the Twins”—none are ever named (neither, really, is Ella or El because they are “she” and “he,” respectively in Spanish). Except for the Twins, each of the subsequent four chapters center on one of these characters and how they figure into the family history. Just as in the first chapter, the stories are told through and around the health challenges each character faced; all harrowing, many life-threatening, and some metaphorical.

Ever present in these histories is the story of Ella’s birth mother,“genetic Mother”. She died giving birth to Ella. Ella’s stepmother, “the Mother,” is called at different times, “the volunteer Mother,” “the replacement Mother,” and “the living Mother.” The Brother, alternatively known as “the Firstborn,” shares with Ella her birth mother and was born nine years before her. The Twins, known separately as “the Boy Twin” and “the Girl Twin,” came after the Father remarried. Another dimension shaping the stories is both the Father and the replacement Mother work as practicing physicians. 

Ella’s prominence in each chapter makes her our witness to El’s recovery after an explosion rips through his mass grave excavation site, and his many surgeries for separate gastrointestinal troubles; the Mother’s aggressive and brutal breast cancer treatment; the Firstborn’s recurring bone fractures (an “osseous enigma”); and the Father’s bleeding ulcers and life-threatening hemorrhagic complications from prostate surgery. 

The author, Lina Meruane, structured the book in a somewhat unconventional form. She delineates sections within each chapter with asterisks centered on the page (“***”), and these sections rarely comprise more than two paragraphs. Dialog is neither separated from other text nor signaled with quotation marks. The text moves back in forth in time, from here to there in place (presumably somewhere in South America), and sometimes takes the form of pensées rather than plot narrative. But, overall, the book moves towards resolving some mysteries surrounding family history.

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How To Be Depressed

Scialabba, George

Last Updated: Nov-28-2021
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

How To Be Depressed  is a book with a most unusual structure.  It is introduced by an essay entitled “Intake” that was previously published in a literary magazine.  The bulk of the book, “Documentia,” is taken up by an edited selection of the author’s psychiatric records from 1969 to 2016. It is rounded out by an interview with the author and by his “Tips for the Depressed.”   

Author George Scialabba ascribes his “exceptionally flimsy…shock absorbers” to his “constantly worried” parents (p.3).  While studying at Harvard he becomes involved with a strict religious organization. After leaving that group he undergoes a crisis of faith and his first episode of depression. Paralyzed by self-doubt, he drops out of graduate school and begins a cycle of clerical jobs that are beneath his intellectual capability. After many years he gradually wins distinction as a freelance essayist.  However, due to his incapacitating symptoms he never has a steady writing job and has difficulty attaining financial security.  

In his introduction, Scialabba tells us that “the pain of a severe clinical depression is the worst thing in the world.  To escape it, I would do anything” (p.1).  As attested to by the notes of his well-meaning psychiatrists and psychotherapists, he has diligently applied himself to a wide variety of treatments.  Sadly, if anything he gets worse over time, and eventually requires electroconvulsive therapy. 

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Annotated by:
Field, Steven

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Most of us are aware that the discipline of Palliative Care, with its focus on excellent pain management, other comfort measures, and psychosocial and spiritual counseling, has made a dramatic difference in the way patients are treated near or at the end of life.   However, for most of us, knowledge of Palliative Care is usually limited to how it functions in so-called “first world” countries.  What is Palliative Care like in areas around the world that have less-effective systems of health care delivery? 

Lucy Bruell’s documentary, Oli Otya:  Life and Loss in Rural Uganda, aims to tell this story.  Bruell, an award-winning documentarian (and coincidentally—and full disclosure—the Editor-in-Chief of the NYU Literature, Arts, and Medicine Database), follows a husband-and-wife team, an internist and a palliative care specialist, who travel each year to Uganda to volunteer with a small palliative care service based in a rural hospital.  Along with the team nurse, nursing assistant, and spiritual counselor, and a medical student who has accompanied them for this trip, they see patients in the hospital, the clinic, and most of the time, in the patients’ homes, often covering many miles in a day in this rural area of the country. 

It is the stories of these patients that constitute the heart of the film.  A woman who has been catastrophically burned in a revenge crime, a man with metastatic cancer who can no longer walk, a woman with end-stage rheumatic heart disease who insists on gifting the team with a live chicken for their work, a young man with a progressive neurodegenerative disease whose mother ascribes his behavior to demons—we meet these and other patients as the team makes its rounds, interacts with villagers and herbalists, and fights to overcome shortages of critical medicines.

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Practice

Berlin, Richard

Last Updated: Oct-26-2021
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Practice is Richard Berlin’s third book of poetry (two of which are chapbooks) in addition to two prose books. It contains 64 poems and is fronted by an essay, “Why Doctors Need Poetry”. A few pages of notes at the end helpfully explain the context for 15 of the poems. As Dr. Berlin explains at the beginning of his opening essay: “Most of the poems in this volume first appeared in my column, ‘Poetry of the Times,’ a feature of Psychiatric Times”, which, at the time of publication of this volume he had been writing for 16 years. This—and many more poems in other journals, anthologies, and books— all from a man who began writing poetry in “mid-life”. Evident in the poems in this collection is a person experiencing much more than medical/psychiatric practice, but a full cornucopia of life: his love of art, music, food, nature, and the people he shares this bounty with. The collection, presented in three sections, weaves through all of these rich encounters, with only the final section, the shortest of the three, having more of a focus on family, friends and late of the year poems.

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The Ministry of Bodies

O'Mahony, Seamus

Last Updated: Jul-26-2021
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Starting eight months before his retirement, a gastroenterologist chronicles a myriad of encounters between himself and others - patients and their family members, colleagues, administrators, hospital staff, and even drug reps. He has worked for many years at a large Irish hospital dubbed the "ministry." His professional work there is divided between the endoscopy unit (where he performs colonoscopies and EGDs), medical wards, an outpatient clinic, and the ER.

Given his specialty, the roster of patients tilts heavily towards gastrointestinal problems: alcoholic cirrhosis, GI bleeding, chronic diarrhea, and abdominal pain. But additionally, his days are filled with patients presenting with a variety of medical problems including pneumonia, mental health issues, heart failure, serious fractures, dementia, seizures, anemia, and cancer. He attends to many frail elderly folks in the emergency department. His interactions with patients range from intense to jovial, from unexpected to heart-wrenching. For example, a woman with chronic abdominal pain asks the doctor if she might be suffering from PTSD. When asked why she thinks that might be possible, her reply is "My son hung himself. I found him" (p191).

The doctor is beleaguered by frequent, and at times wacky, emails generated by the hospital bureaucracy as well as unproductive meetings. He must cope with his own health problems too (a vitreous detachment, arthritic hands, and unexplained nosebleeds). He decries the "foolishness" of excessive medical testing and overtreatment and cites the case of a young woman with irritable bowel syndrome who already had over 1,200 test results logged in the hospital lab. He describes the ministry as "an oasis of kindness and comfort" but "also a place of chaos and conflict, of institutional cruelty" (p8).

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