Showing 111 - 120 of 625 annotations tagged with the keyword "Power Relations"

Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As Audrey Young describes her process of becoming a compassionate internist in a besieged public hospital, she simultaneously argues for turning the hospital's patient care and financial practices into a model for improving health care in America.  Young, a compelling storyteller, first entered Seattle's Harborview Medical Center in 1996 as a third-year medical student on trauma surgery service.  She completed a residency there in general internal medicine and stayed on as an attending for six more years.  She stayed, she tells us, because she met physicians "committed to a vision of equality" who were "the sort of people I hoped to become" (xiii).   She also "fell in love" with "the story of a unique place" (xiii).  Young's stories of that often chaotic place, where ambulances regularly transport homeless, indigent, addicted, and mentally ill refugees from neighboring private hospitals, emphasizes the ways the Harborview staff manages to treat patients with dignity and to choose an ethic of hope in the face of dire circumstances.           

We quickly learn that at Harborview compassion is expressed concretely as actions toward patients.  Michael Copass, known as "the mostly benign dictator of emergency operations," pronounced the core of these actions in what came to be known as his commandments:  "1. Work hard.  2. Be polite.  3. Treat the patient graciously, even if he is not the president of the United States" (9).  Politeness always meant asking "'How may I help you, sir?'" regardless of the patient's social status or addiction history.  Politeness sometimes meant finding a way to reach the patient who regularly threatened the staff.  Young finds ways and creates a therapeutic bond.  But working hard and treating patients considerately also took measurable forms, such as not allowing emergency patients to wait.  Facing a flurry of admissions, the Emergency Department (ED) staff interpreted a young Ethiopian's complaints about pain as a drug addict's ploy.  Because Young glanced at the admissions board and noticed that he remained unattended for three hours--far longer than Copass could tolerate--she jumped into action.  He suffered, she discovered, from a collapsed lung. 

However, Young moves her narrative beyond individual doctor and patient encounters and into the larger, interrelated social and financial structures in which medicine is practiced.  For instance, she links meager funding for drug and alcohol rehabilitation programs with expensive ED admissions and rising healthcare costs.  In the chapter "Bunks for Drunks," Young visits an experimental residence that houses homeless addicts in furnished studios with private baths and cooking appliances.  Although residents can keep alcohol in their rooms and elect not to participate in the home's social services, including counseling, alcohol consumption and ED admissions decrease.  While the chapter points out the cost savings of such arrangements, Young further urges readers to value the dignity residents experience there.

In "Black Friday," Young details the hospital's tense, but ingenious responses to a Mass Casualty Incident, the result of carbon monoxide poisoning, which almost depleted the resources of all of Seattle's medical centers.  The final chapter, "A Vision," outlines how Harborview has tried to succeed as both a charitable institution and a business, as a provider of both indigent and luxury care, with the hope that others will follow the medical center's example.  However, in presenting her recommendations for "health justice," Audrey Young also makes the case that "seemingly ordinary citizens" are implicated in healthcare reform (231).  To enable their informed participation in making changes, Young includes an appendix with further readings and another that lists strategies for effecting reform.  

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Autism and Representation

Osteen, M., ed.

Last Updated: Jun-02-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Anthology (Essays)

Summary:

The book's chapters derive from a conference entitled "Representing Autism: Writing, Cognition, Disability" held in 2005. Contributors are scholars of English, communication studies, psychology, and other disciplines; some are on the autism spectrum themselves or are parents of autistic people. The book attempts to address what editor Mark Osteen in his introduction cites as a deficit in the field of disability studies, namely that the field has ignored cognitive disabilities. Osteen notes that autism is a spectrum not only among people but within individuals: "any given autistic person's abilities will occupy different locations on [the spectrum] at different times" (7) but a severely autistic person is not merely "different." The editor also addresses the question of self- representation, arguing that "we must strive to speak not for but with those unable or unwilling to communicate through orthodox modes" (7).

The book is divided into four sections: Clinical Constructions, Autistry, Autist Biography, and Popular Representations. Clinical Constructions includes a chapter on Virginia Axline's work with the boy, Dibs (see Dibs: In Search of Self in this database), a child who is now thought to have been autistic; and a chapter on how Bruno Bettelheim convinced the world of science and the public that autism was caused by parental behavior, especially that of mothers ("refrigerator mothers") and that he knew how to cure it. The essayists show how these two psychologists constructed a persona of omnipotence that enabled them to appear to "save" autistic children. Chapter 3 reviews the history of autism as a named condition and contextualizes it.

Chapters in the section on Autistry discuss the mental world of people with autism. Patrick McDonagh (chapter 4) postulates that "the capacity to perceive autism in the 1940s may be connected to the proliferation of modern, and modernist, notions of the self" (102) -- for example, isolation and alienation, and "the removal of referential and conventionally communicative functions from language" (111) that appear in the works of Gertrude Stein, Virginia Woolf, James Joyce. Subsequent chapters apply theories of information processing (chapter 5), metaphor and metonymy (chapter 6), and narrative (chapter 8) to an understanding of the mental world of autistic individuals, and chapter 7 discusses poetry written by autistics.

The section on Autist Biography concerns memoirs written by parents of autistic children. Deborah Cumberland contrasts the memoirs of several mothers with one written by a father (chapter 9) and Sheryl Stevenson (chapter 10) writes about the rhetorical strategies that mothers use "to negotiate contradictions of motherhood that are exacerbated by autism and their own privileged abilities" (199).

The essays in the section, Popular Representations, concern several films and Mark Haddon's novel, The Curious Incident of the Dog in the Night-Time (see annotation). Anthony Baker presents an "autistic formula" used in films and notes that the plots hinge on the way a central character who is not autistic uses the "special powers" of the autistic character, thereby robbing the latter of agency (Chapter 12). Stuart Murray is also critical of how films portray autistic people (Chapter 13). Phil Schwarz, father of a child with Asperger's and an Asperger's adult himself writes about four films ( Thirty-Two Short Films About Glenn GouldSmoke Signals, Breaking the Code, The Secret of Roan Inish) he uses to raise the consciousness of autistic peers and to promote self-esteem in the face of society's attitudes toward autistic individuals (Chapter 14).

The authors of chapters 15 and 16 come to different conclusions about the novel, The Curious Incident of the Dog in the Nighttime. Gyasi Burks-Abbott, "a 34 year-old African-American male on the autism spectrum" (303), criticizes the novel for perpetuating stereotypes and for "relegat[ing] the autistic to otherworldliness while establishing a non-autistic author like himself as the necessary medium between autistic and non-autistic reality" (295). James Berger, on the other hand, argues that Haddon uses the protagonist Christopher to "explore questions about language and social relations" (fn1, 286) and observes that Haddon understands human neurological features as a continuum.

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The Family

Bak, Samuel

Last Updated: May-24-2010
Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

A number of expressionless faces blindfolded, bandaged, many eyeless, some with hats of the 1930s, glasses, masks, bullet-ridden helmets, comprise three fourths of the canvas.  Anything but a group portrait, these totally disconnected faces staring straight ahead are all on different planes. None are connecting with another. Remnants of crematorium smoke stacks and a burned city are the only visible detail in the upper fourth of the canvas, from which a series of tired male refugees, painted in a much smaller scale, appear to be walking down into the portrait.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In 1818, the newly trained physician, John Keats (1795-1821) (Ben Wishaw) is living with his well-off friend, Charles Brown (Paul Schneider), and they are trying to devote themselves to the art of writing. Keats cannot abide the idea of having to practice medicine. 

The uneducated, fashion-conscious Fanny Brawne (Abbie Cornish), notices Keats, moved by the care that he bestows on his dying brother. She offers a gift of a beautifully embroidered pillow, which soon finds it way into the lad’s coffin.

Affected by the young man’s death and the mystery of poetry, Fanny flings herself at Keats, undeterred by Brown’s open disapproval of her lack of class, education and bearing. Flattering his work, she asks Keats for lessons in literature and then reveals herself to a reasonable judge of poetry. In spite of himself Keats is drawn to her and declares his love.

But the poet’s health is fragile. Funds are raised to send him to Italy, and Keats announces that he must go, because his friends have decided. He seems to know that he will die. Fanny is brave and hopeful. Chastened, Charles Brown comes to Fanny’s home to announce the death of Keats in Rome.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Séraphine (Yolande Moreau) is a housekeeper, ill-treated by her employers, but she finds solace in painting naïve images of flowers, fruit, and birds, using vivid colours that she makes herself from plants and animals. Her mistress rejects the art as junk.

Séraphine sympathizes with the apparent loneliness of the German tenant Uhde (Ulrich Tukur) who is a connaisseur of art. He admires one of her tableaux and is astonished to discover that the artist is his housekeeper. He encourages her and buys some paintings.  But war in 1914 forces him to return to Germany.

Spiralling downward deeper into poverty and mental alienation, Séraphine continues to paint works that grow larger, bolder, and more colorful. Finally her bizarre behavior leads to her arrest and commital in an insane asylum, and her painting ceases.

Uhde eventually returns to France and organizes the first Naïve Art exhibition featuring work by Henri Rousseau and Séraphine. But only years later does he bother to look for her. She is miserable. He arranges for her to be given a more comfortable room, but he doesn’t speak to her and she never paints again.

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Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The author, a young physician, guides the reader in temporal sequence through her years as a medical student, medical resident at several levels, and into the final days of her formal training. The format of the work is anecdotal, that is, a series of memorable patient encounters that seem to shape the writer's developing attitude toward her chosen profession. The precise time frame of the experiences is not clear, but this is an acknowledged story of growing into the practice of medicine as a trainee at Bellevue Hospital.

In describing her interactions with her patients, Dr. Ofri reveals her own doubts about her ability to accomplish some of the things expected of her as "healer." As she grows more confident with experience, she begins to challenge some of the rituals in which medical education seems mired. Each of the chapters is a self-contained story focused on a particular patient, some of which have been published previously as free standing essays. The composite is the physician-writer's personal narrative of her own growth and change.

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Annotated by:
Aull, Felice

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The film opens on the Coeur d'Alene Indian Reservation -- called "the rez" by its inhabitants -- in 1998. Immediately there is a flashback to July 4, 1976 when the community was celebrating "white man's Independence Day" in drunken abandon. Accidentally Arnold Joseph (Gary Farmer) sets an uncontrollable fire to his neighbor's house, killing the couple who live there. But Joseph catches the baby, Thomas, when he is thrown out of a second story window from the burning house. The rescued Thomas (Evan Adams) is brought up by his grandmother and along side of Victor (Adam Beach), Arnold Joseph's son of about the same age. Joseph keeps on drinking but is in despair about the conflagration and its consequences.

12-year-old Victor watches sullenly while his parents drink until one night he smashes all their beer bottles. This action is a wake-up call for Victor's mother, Arlene (Tantoo Cardinal), who insists that she and Arnold both stop drinking. She chases Arnold out of the house; he leaves, never to return, while Victor watches, sobbing. These elements of the story occur in flashbacks while the 20-year-old Victor and Thomas travel by bus to retrieve whatever they can of Arnold Joseph, who has died outside of Phoenix. The remaining story unfolds in that forsaken spot where Joseph lived in a trailer and befriended Suzy Song, a young Indian woman originally from New York.

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Summary:

The title refers to a Veteran’s Administration hospital regulation concerning the withholding of full medical benefits if an ailment is not specifically related to military service. In an oftentimes comic battle between the forces of good--physicians and vulnerable patients--and those of evil--the administrators and their minions--the story has currency and direct appeal to viewers.

The Darth-Vader-like administrators are self-serving, inhumane bureaucrats with emotions that run the gamut "from A to B" (Dorothy Parker). Physicians, especially the character played by Ray Liotta, but also his dedicated colleagues, are imaginative and non-rule abiding in their central concerns: the patients. They listen to stories and sympathize; in addition, they turf, lie, steal, and do whatever is necessary to protect, serve, and treat their patients. When the government denies a heart bypass, for example, the docs schedule prostate surgery for the official record and do, instead, the needed heart surgery.

At times, it’s as if the Marx Brothers or the Keystone Cops have donned white coats to sneak around the hospital with patient-centered antics. In the absurd bureaucracy, viewers, perforce, must cheer enthusiastically for the merry band of renegade docs.

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Leaning Together in the Storm

Smith, Larry

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Summary: This very welcome poem concerns "twelve older men in shirt sleeves," a group of men with prostate cancer. The narrator, one of the men in this "private brotherhood" suggests the difficulty and reluctance of many men to recognize out-loud their mutual circumstances: "Ever notice how no one parks / in the Cancer Center zone." This line sets the tone; the men are vulnerable and afraid. From time to time they gather for support from one another and from the meeting's scheduled speaker. The reader has little difficulty imagining the collective angst and the grasping of hope shared by the participants leaning together in their mutual storm.

Any expectation of supportive discourse is shattered by this evening's guest speaker, a careless surgeon, who strides confidently into the room with his tray of slides. The remainder of the poem demonstrates a worst-case scenario:

I interrupt his gay delivery,
"What about orgasm...?"
"Forget orgasm," he grins,
"You don't have a prostate."

Some smile nervously and bravely ask questions that really matter. Each time the physician exhibits his caustic brand of insensitivity. The narrator, surely expressing the feelings of his colleagues, wants only to "drive / this witch doctor from the room."

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Summary:

This study examines representations of feminine illness in American culture from 1840 to 1940. It argues that the figure of the invalid woman emerged in the 1840s amid significant changes in "American literature, medicine and culture," including the emergence of a specifically American literature, the professionalization and masculinization of medicine, and the "sometimes complementary, sometimes opposed" ideologies of feminism and domesticity (17).

The book discusses mid-nineteenth-century medical theories that articulated women as "biologically inferior . . . given to disease and pain" (34) before analyzing contemporary literary works by E.D.E.N. Southworth, Harriet Beecher Stowe, Nathaniel Hawthorne (see this database for annotations of The Birthmark and Rappaccini’s Daughter) Washington Irving, Edgar Allan Poe, and works by twentieth-century authors including Ellen Glasgow, Charlotte Perkins Gilman (see this database for The Yellow Wallpaper annotated by Felice Aull and also annotated by Jack Coulehan), Tillie Olsen, Edith Wharton, F. (Francis) Scott Fitzgerald (see this database for Tender Is the Night annotated by Jack Coulehan, also annotated by Pamela Moore), and Henry James. Art, advertisements, and the film, Dark Victory (see annotation) are other points of reference.

Price Herndl examines compliant and resistant uses of women as invalids; the surprisingly small changes in figures of feminine illness in response to changes in women’s rights; the links literature constructs between illness, money, work, and value; shifting theories of cure (from somatic to psychic); and the rise of germ theory in relation to fictional representations of illness. She argues that male and female fiction writers in the period she studies use feminine illness for different purposes: "What that figure signifies is kaleidoscopic, shifting to suit the political needs of its user" (218).

Invalid figures in literature and culture, Price Herndl asserts, can "divert political dis-ease into an overwhelming attention to the individual body and away from the body politic," locating people’s problems in their individual bodies and selves rather than in the oppressive aspects of their culture (220). Recurrent representations of sick women reflected the extreme unease attached to the position of women in American culture in the years 1840-1940. While her study stops at 1940, Price Herndl asserts that after World War Two and at other points when "masculine privilege seems threatened . . . illness is figured more and more often as male" (220).

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