Showing 111 - 120 of 121 annotations contributed by Shafer, Audrey

Six Days

DeMaine, Mary

Last Updated: Oct-08-1998
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poem is divided into six stanzas, each titled by a successive day. The subject of the poem is a woman's reaction to mammography and the unexpected "spot" that is discovered. The woman is shown the spot on the mammogram, and the agony begins: does she have breast cancer? The exam occurs on Thursday; she must wait until the following Tuesday to find out.

Meanwhile, life and relationships take on new meanings and tenderness. For instance, at a large family reunion, she is determined to laugh with the family about childhood reminiscences, even though her laughter is now bittersweet (she keeps her torment private from all but her lover).

Other days are filled with worry and nightmare. At long last, during a perfunctory call from her physician, she finds out that the spot is merely a protein deposit. Relieved, she thanks the physician, who remains uninformed of the depth of her patient's recent torment.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In this book written for the layman, linguist George Lakoff and philosopher Mark Johnson cogently argue that metaphor is integral, not peripheral to language and understanding. Furthermore, "metaphor is pervasive in everyday life, not just in language but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature." (p. 3)

The authors adopt a broad definition of metaphor, examine common phrases for metaphorical interpretation, and offer a classification system of metaphor. For example, orientational metaphors are found in our ordinary language and are part of the spatial organization of our lives. When one says, "He dropped dead" or "He's at the peak of health," one is using the orientational metaphor that we live by: "Health and life are up; sickness and death are down." This orientation is not arbitrary; the authors point out that one lies down when one is ill.

Other types of metaphors categorized by the authors are structural and ontological (e.g., making a non-entity into an entity: "We need to combat inflation," or setting a boundary on a non-entity: "He's coming out of the coma"). The authors also differentiate metaphor from other figures of speech, such as metonymy, which relies more completely on substitution: "The ham sandwich wants his check."

The second half of the book address issues more philosophical in nature, such as theories of truth and how we understand the world, including the "myths" of "objectivism," "subjectivism," and "experientialism." These theories are reviewed with metaphor in mind. For example, objectivism relies on the separation of man from the environment and the subsequent mastery over the environment. Hence objectivism is rife with metaphors which confirm such ideas as "knowledge is power."

The authors conclude by stating that metaphors provide "the only ways to perceive and experience much of the world. Metaphor is as much a part of our functioning as our sense of touch, and as precious."

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Cold Mountain

Frazier, Charles

Last Updated: Mar-26-1998
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel chronicles the long journey home of a Civil War soldier, Inman, to Cold Mountain in North Carolina. The story begins in a military hospital, and Inman's neck wound, a long difficult-to-heal horizontal slice received in battle, is drawing flies. Inman is a moral man, and the brutality and killing he has witnessed on the battlefield lead him to leave the hospital AWOL and journey secretively, by foot, back to Ada, his love.

The trip is perilous; Inman is subject not only to the difficulties of near starvation and a poorly healing wound, but also the cruelties of people he meets along the way. However, every so often, he is also succored by compassionate people, such as the goat woman who provides the cure for his neck wound, if not for the wounds inside. Intertwined with Inman's story is Ada's: her preacher father dies of tuberculosis, leaving her utterly unable to provide for her own basic needs on the farm. Fortunately, a self-reliant young woman, Ruby, joins Ada on the farm, and helps transform both the farm and Ada.

The book details the ways of nourishment: physical (precise descriptions of food, its paucity and preparation) and nonphysical (themes of love, generosity, intellectual curiosity, and spiritual questing underpin the book). Cold Mountain itself provides both types of nourishment by offering hope, goals, shelter, food and a place where love and forgiveness are possible despite the savagery of man.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This history of western medicine focuses on British life in the eighteenth century. Williams begins his treatise by wondering if "we realize sufficiently what we have escaped by being alive in the twentieth, not the eighteenth, century." He then catalogues in the subsequent 12 chapters the agonies not only of illness but also of medical treatment in the 1700’s.

Topics are wide-ranging and include blood-letting, parturition, infant malnutrition, rampant infectious diseases, maltreatment of the insane, surgery prior to anesthesia, water therapy, and military medicine. Primary source quotations interspersed in the narrative add to the drama. For example, the deposition of a widower (his wife died while pregnant) is quoted: " . . . Being taken ill of a paine in her right side under her short ribb together with a great difficulty of breathing having but 14 weeks to go with Child Mr Hugh Chamberlen Senr was sent for to take care of her, who thereupon gave her in the space of nine days four vomitts, four purges, and caused her to be bled three times to the quantity of eight ounces each time: Then gave her something to raise a spitting after which swellings and Ulcers in her mouth followed . . . . " (p. 31)

A few medical advances at the close of the century are also described, notably the smallpox vaccine developed by Jenner and the administration of First Aid to wounded soldiers at the frontlines (developed by Larrey). The text is accompanied by black and white illustrations, such as an inside view of Bedlam (Bethlehem Hospital) by William Hogarth (A Rake’s Progress, plate VIII).

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This thoroughly researched book helps us understand John Keats's life and work in terms of his medical training. Goellnicht argues that, contrary to some critics' view that Keats was "anti-scientific" or "anti-intellectual," Keats incorporated much of the knowledge gained from his six years of medical training into his poetry.

The book begins with a chapter of biographical information about Keats, emphasizing the nature of medical training in the early nineteenth century, but includes Keats's self-diagnosis of tuberculosis. The heart of the book consists of four chapters, organized by scientific topic, which relate the specifics of Keats' s medical training to his writing: Chemistry, Botany, Anatomy and Physiology, and Pathology and Medicine.

Excerpts of Keats' poetic and epistolary writing are examined in each of these chapters in light of Keats' scientific and medical knowledge. For instance, in the chapter on Botany, the uses of specific botanical species in his writing are examined in terms of what was known of materia medica (see annotation for Ode on Melancholy. Furthermore, the author explores Keats's interest in plants and trees as metaphors for life, such as his interest in "the flower as a vital, but passive, being that exists in a state akin to negative capability."

The author concludes the book with a summary statement about each of the chapters (e.g., " . . . from pathology he adopted the approach of viewing aspects of life, in particular love and poetic creativity, in terms of morbid and healthy states . . . ") and also the caveat that the book is not meant to in any way diminish other profound influences on Keats, such as his interactions with other Romantic poets. Goellnicht notes, however, that Keats himself united the worlds of medicine and poetry in his poem, "The Fall of Hyperion," in which he describes the poet as a physician.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Papper, a revered figure in the field of anesthesiology, questioned why it took so long for anesthesia to be "discovered": after all, pain and suffering existed long before the mid-nineteenth century. This book is a result of Papper’s graduate studies in literature and history and explains his thesis that "societal concern with pain and suffering, and the subsequent development of surgical anesthesia in the Romantic era . . . are outgrowths of Romantic subjectivity."

The book provides biographies of scientists, physicians and poets, such as Humphry Davy, Thomas Beddoes, Sr., Samuel Taylor Coleridge and Percy Bysshe Shelley, along with analyses of Romantic poetry as related to pain and suffering. Papper theorizes that the exchange of ideas amongst these intellectuals and the political upheavals of the time paved the way for society to recognize that the pursuit of happiness could include the relief of pain.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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The Lost Art of Healing

Lown, Bernard

Last Updated: Jan-31-1997
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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Sea Creatures and Other Poems

Rowe, Vernon

Last Updated: Jan-30-1997
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Sea Creatures is Dr. Vernon Rowe's first collection and contains forty-eight poems divided into two sections: "Creatures of the Inland Seas" and "Out Far and In Deep." The poems are succinct and focused. Much of the imagery is derived from nature, as in the title poem, where the poet-neurologist-helicopter pilot likens his descent through the sky to a dive into a deep and ancient ocean. Poems in the first section are directly related to the poet's life as a physician; works such as "Paralyzed" "Brahms' First, First Movement" and "Wasted" are empathic portrayals of patients.

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Summary:

This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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