Showing 101 - 110 of 2975 Literature annotations

Summary:

The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
 
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   









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Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Pearl, a plastic surgeon and former CEO of a large medical group, writes powerfully and poignantly about the major role of physician culture - the customs and rituals, traits and beliefs of doctors. This culture is entrenched through years of medical training. He decides that physician culture "can be both a virtuous force and an equally destructive influence" (p70).

Some of that culture is readily on display: attire, tools of the trade, unique medical terminology, insensitive humor, frequent handwashing. Positive aspects of physician culture include self-confidence, integrity, compassion, and selflessness. Negative elements are ingrained to keep emotions and dread at bay: detachment, callousness, denial. This culture of medicine must navigate dual interests - healing (the mission of medicine) and profit (income, status, prestige).

Pearl suggests an evolutionary pathway for physician culture that he dubs "the five C's of Cultural Change" - confront, commit, connect, collaborate, contribute. He tackles issues of sexism, racism, and elitism in American healthcare. He explores the suffering of physicians and their need to seek forgiveness - often secretly and even in cases of perceived "failure" when everything possible was done correctly. His discussion is filled with agonizing, frustrating, and loving stories about patients, family members, and colleagues (including physician suicide).

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Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction — Secondary Category: Literature /

Genre: Biography

Summary:

Maria Callas, the most famous opera singer of the second half of the 20th century, continues to exert a fascination.  Critical consensus is that Callas fused a technically flawed voice with an extraordinary stage presence to create something unique.  More than forty years after her death, Callas’s recordings continue to be best-sellers, and her life has inspired dozens of biographies.  Prima Donna: The Psychology of Maria Callas appears in Oxford University Press’s Inner Lives series, which consists of psychobiographies of artists that make use of current psychological theory and research.  The focus of author Paul Wink, a psychology professor at Wellesley College, is adult development and narcissism.  

The facts of Callas’s life are well known. She is born in New York City to an ill-matched Greek immigrant couple.  Her father is barely able to keep a roof over their heads.  Her mother Litza struggles to get over the death of an infant son, requiring hospitalization for a suicide attempt. As the story goes, Litza cannot bring herself to look at her new daughter for the first four days of her life.  Litza, who imagines herself in a lofty social class, disdains their neighbors, and thus Maria is discouraged from playing with other children.  When Maria is discovered to have talent, Litza exploits her.   

As Litza’s marriage deteriorates, she brings Maria back to Greece.  With the onset of World War II, they endure hardships.  Yet, improbably, the overweight and awkward Maria shows a streak of brilliance.  She is the hardest working student at the conservatory, quickly outpacing her peers.  On Maria’s first day in Italy, where she gets her first big break, she meets a businessman who is more than twice her age.  Within weeks they are a couple.  For a time, she allows Litza to share in her success, even buying her a fur coat.  But soon, in response to a request for money, she tells her mother to “jump out of the window or drown yourself” (p. 78), and then never speaks to her again.  

Maria loses weight and transforms into the operatic counterpart to Audrey Hepburn.  She enjoys one operatic triumph after another. Nevertheless, she becomes as famous for her bellicose and imperious behavior as for her singing.  She kicks a colleague in the shin after a performance so she can take a solo bow. She is publicly fired from the Metropolitan Opera.  She incurs scandal by suddenly canceling a performance at which the president of Italy is present.   

When the fabulously wealthy Aristotle Onassis courts her, Callas unceremoniously rids herself of her husband.  Soon, her technical flaws catch up with her, and her career dwindles away.  Meanwhile, Onassis goes for a bigger trophy: Jacqueline Kennedy, and Callas is humiliated in the press.  Voiceless, she exiles herself to Paris with her two poodles, develops an addiction to sleeping pills, and dies a decade later, alone.  

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The Flight Portfolio

Orringer, Julie

Last Updated: Jan-29-2021
Annotated by:
Field, Steven

Primary Category: Literature / Fiction

Genre: Novel

Summary:

It’s 1940, and France has fallen to the Nazis, leaving the country divided between occupied France in the north, and so-called “Free France,” with its government at the spa town of Vichy, in the south.  The Vichy government is headed by Marshall Phillippe Petain, a collaborationist puppet of the Germans running a collaborationist puppet state.  But unlike the north, the south is still technically unoccupied, and people fleeing the Nazis from all over Europe make their way there in the hope of finding a way off the European continent, and so a kind of black market in emigration develops, centered in the port city of Marseille.

Among the groups working out of Marseille is the Emergency Rescue Committee, an organization set up by the journalist and editor Varian Fry and his friends, and with the support of Eleanor Roosevelt.  The ERC has sent Fry to Marseille with a list of names of people to be assisted to emigrate, and the list is a Who’s Who of the European cultural elite:  artists, writers, philosophers, and the like, many of whom are Jewish and/or have opposed the Nazis and are thus wanted by the Gestapo.  It is Fry’s job to shelter them, get them fake transit visas, and ultimately smuggle them out, usually to neutral Spain or Portugal, or even directly to the States.   The Vichy government, which has an agreement with Germany to surrender any identified fugitives, knows this is going on, and together with their German allies, is always hot on the trail of these now stateless refugees, and thus hot on Fry’s trail also. 

The Flight Portfolio is based on several of the thirteen months Fry spent in Marseille as the representative of the ERC.  Along with his staff, he “brings in” (and successfully gets out) Marc Chagall and his wife, Franz Werfel and Alma Mahler Gropius Werfel, Max Ernst, Lion Feuchtwanger, a young Hannah Arendt (“Name?”  “Johanna Arendt.  My friends know me as Hannah”), and others.  All the while, he and his staff are but one step ahead of the agents of Vichy and the Gestapo. And during this time, Chagall has been compiling the flight portfolio, a collection of artworks which testify to the humanitarian crisis in Europe, to be smuggled out as a warning to the free world. 

Complicating the issue—and a major part of the story line—is the fact that Fry, whose wife Eileen had stayed behind in New York City, has reconnected with a Harvard classmate named Elliot Grant with whom he had been romantically involved as an undergraduate.  Grant has come to Marseille to be with Gregor Katznelson, a fellow Columbia University professor who has returned to Europe to find his son Tobias who has disappeared.  Tobias is a brilliant young Berlin physicist and is wanted at all costs by the Gestapo for his scientific acumen and his value to weapons development. Gregor is desperate to secure his safe passage to New York.  Fry promises Grant that he will get Katznelson’s son to safety.  When the elder Katznelson returns to the United States, Fry and Grant resume their relationship, and Varian finds himself becoming increasingly emotionally involved with Grant and distanced from Eileen, although he still loves her.  Ultimately Tobias shows up in Marseille; but there is another fugitive, a world-renowned and respected artist, who has been waiting, is in immediate danger, and needs to get out of Europe.  And only one can leave on the waiting ship.  

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Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor. 

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.           

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123). 

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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Carlo Cipolla chronicles the 1630 bubonic plague outbreak in Northern Italy. At various places in the text, he refers to his compact volume as an “essay,” a “tale,” and a “book.” Readers during the 2020 coronavirus pandemic could call it a “prologue,” a “warning,” or a “horror story foretold.”  

The plague ravaged much of Northern Italy from 1630 to 1631. Cipolla focuses on a particular village, Monte Lupo, because “so exceptionally rich is the documentation of [its] story that it allows the historian to recapture emotions, attitudes, and behavior of common people.” The documentation led him to uncommon detail “on the relationship between Faith and Reason, Church and State at a social level” (p. ix). 

Reading like an historical essay, Cipolla first sets up the tensions arising between the Church and State Church during the plague epidemic. The “scientific revolution” had advanced enough by 1630 that regional Health Magistrates acted based on experience rather than faith. Most clergy and their followers still “preferred to believe rather than observe…[and] had not the slightest doubt: processions and similar ceremonies were the only way to placate divine wrath and put an end to the scourge” (p. 7). But, the divide between Church and State in this case is not so clear as that, Cipolla notes, because some of the senior Health Magistrates served as high-ranking church leaders themselves. 

Cipolla points to public health measures taken in Northern Italy before the 1630 plague outbreak that might have, ironically, heightened tensions, even though they were born from the terror and suffering epidemics caused during the previous two centuries. The changes that resulted were, in Cipolla’s view, “a strange mixture of brilliant intuition, sound common sense, and absurd prejudice” (p. 12). However rational these measures seemed, “they caused great misery and severe privations [through] the segregation of entire families in their homes, the separation of kindred in the horror of the pesthouses, the closing of markets and trade, the consequent lack of work and wide-spread unemployment, the burning of furnishings and goods” (p. 13). By the time the plague took hold in 1630, necessary public health measures were already unpopular.
 

Cipolla uses the walled-village Monte Lupo as his case study. Around 150 families lived inside its walls when the plague struck during the summer of 1630. He details how Health Magistrates struggled to gain control of the outbreak while facing open rebellion fueled by “ignorance, egoism, avarice, and bullying” (p. 14). He names and profiles key figures and describes various events. 

The central event in Cipolla’s tale is a “procession” in Monte Lupo featuring a crucifix people believed had “miraculous properties” (p. 41). The Health Magistracy took aggressive actions to prevent and then stop the procession. Alas, Cipolla reports: “All this was in vain. It was like preaching to the wind: the church was soon packed with men and women, boys and girls, who had come to gaze at and adore the crucifix,” (p. 47). Festivities carried into the evening and on to a neighboring town (San Miniatello). Mayhem, illness, and death ensued. 
 

The last death in Monte Lupo occurred on August 11. Cipolla follows the subsequent investigations searching for people encouraging exposure to a lethal, contagious disease, and for people who became infected and died as a result. He reflects on the juxtaposition of epidemiological methods used to stop the epidemic and the fight religious leaders and followers waged against them. He muses about “emotions, attitudes, and behavior of all segments of a society in a period distant in many ways from our own” (p. 85). Written in 1977, the objects of his musing were only four decades distant from becoming evident again. 

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Global Healing

Thornber, Karen

Last Updated: Dec-14-2020
Annotated by:
Bruell , Lucy

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Karen Thornber is the Harry Tuchman Levin Professor in Literature and Professor of East Asian Languages and Civilizations at Harvard. In this expansive nearly 700 page book, she draws on work from global literature to explore the many ways societies view illness, stigma and healing.  She defines global literature as “narratives that grapple with challenges and crises that have global implications or counterparts globally, whether at present, in the past, or likely in the future” (p.10). 

The book is divided into three sections: Shattering Stigmas, in which she looks at Leprosy, AIDS, and Alzheimer’s disease; Humanizing Healthcare; and Prioritizing Partnerships.  Among the topics she addresses are patient-focused care as an imperative, the need to advance partnerships in caregiving, and support that extends beyond family and friends to the patient’s relationships with health professionals.  Healing, she notes, involves “changing the circumstances that exacerbate or even trigger a health condition, enabling the individual to obtain long-term wellbeing liberated from as much distress, if not disease, as possible.” (P331).

Thornber has selected literature that addresses the illness experience and the need to reduce suffering and promote healing, which she places within three interwoven  frameworks:  “Societies/communities, healthcare settings, and families/ friendships” (p.583).  She looks at both positive approaches to care as well as the negative impact of suffering, whether from stigma, inaccessibility to care, or dehumanized care. The book considers literary works from Africa, Asia, Europe, the Middle East, and Oceania, many that will be new to readers.  

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Annotated by:
Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

House on Fire:  The Fight to Eradicate Smallpox is a memoir written by William H. Foege, the physician best known for developing the strategy of ring-vaccination in the eradication of smallpox.  Concisely put by New Scientist, his book is “a mixture of memoir, dry public health guide, and riveting tale of an all-consuming mission.”   

Though a brief read, House on Fire is comprehensive on each of these fronts.  Foege walks us through his life, starting first with his upbringing in Washington state and ending with his role in India as part of the smallpox eradication team there.  Notably, the book’s narrative ends before Foege’s tenure as CDC Director in the late 1970s and early 1980s, focusing explicitly on his involvement in combating smallpox.  Using his career in public health as a framework, he details how he became involved in global health and how each deployment around the world, whether for the CDC, WHO, or Peace Corps, added to his understanding of contagious disease and of how to better approach smallpox containment.  Ever the epidemiologist, Foege does not shy away from including graphs and charts to emphasize his points, especially as they relate to public health data collection.  He takes the reader behind the scenes of conferences, regular meetings, and everyday discussions to show the collaboration necessary for global health work, the planning needed, and the good-natured humor and guile it often requires.  At times, his interactions seem like a who’s who of American public health:  throughout his career, he works with D.A. Henderson, Alexander Langmuir, David Sencer (who also writes the book’s foreword), and Don Francis.  

Outside of his own history, Foege acknowledges that in order to understand smallpox and to understand the mission of eradication it is necessary to understand the disease’s complex history.  He begins the book with the history of smallpox and details the development of the vaccine from its crude precursor, variolation, to Edward Jenner’s early version derived from cowpox.  As he progresses through his story, he notes important historical moments in the battle against smallpox:  the development of the jet injector and bifurcated needle as ways to better administer the vaccine, the elimination of the virus first from countries and then whole continents, and, most poignantly, the final cases of smallpox ever recorded.  

Though the book necessitates some level of public health knowledge, or at least a comfort with viral disease and baseline public health interventions, it consolidates its role as a basic public health guide at the appendix.  In the last pages, Foege reflects on what to do if there were ever a bioterror attack with smallpox, complete with a diagram on how to administer the smallpox vaccine.  

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The City We Became

Jemisin, N.K.

Last Updated: Dec-07-2020
Annotated by:
McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This is the first in an intended trilogy of speculative fiction (read: what we used to struggle to label as sci-fi or fantasy). by author N.K. Jemisin.  It tells the story of a world where cities can come alive, not in the corporeal sense, and not in this universe, but in a way that intersects nonetheless with our reality.  The trouble is, not all cities distinguish themselves enough to be born, and those that do often are interrupted in the process and suffer a stillbirth.  We are plopped down in New York City at the moment of its intended birth, in a struggle between the city, its six human avatars (one for each borough, and one for the city as a whole) and the otherworldly force that is trying to destroy it.  

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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The author, Ezekiel J. Emanuel, says his book title “is a terrible question” (p. 1), because “it is not possible to select the best health care system overall.” However, he continues, “it is possible and reasonable to make judgments about better and worse systems” (p. 351), such as considering “which country has the best consumer choice,…the most innovative health care system,…or best addresses the needs of chronically ill patients” (p. 7). And, that’s what he does.

Emanuel and his research partners compare eleven, high-income countries: United States, Canada, United Kingdom, Netherlands, Norway, France, Switzerland, Canada, Australia, Taiwan, and China. They examine eight content areas: history; coverage; financing; payment; the delivery of care; prescription drug regulation; human resources; and future challenges. These content areas serve as the subject headings for the chapters covering each country. In the penultimate chapter, “Who’s the Best?,” Emanuel assesses and judges each content area across countries. (Spoiler alert: the United States does not fare well.) The concluding chapter is built around “six lessons for improving the US health care system” (p. 385), followed by a coda where Emanuel considers how his findings relate to the coronavirus pandemic.

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