Showing 111 - 120 of 381 annotations tagged with the keyword "Cross-Cultural Issues"

The Good Physician

Harrington, Kent

Last Updated: Feb-05-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Spoiler Alert: The ending of this thriller is revealed in the final paragraph of the summary. The threat of terrorism and the moral code of a physician place Dr. Collin Reeves in a very difficult position. The young American doctor is a specialist in parasitology and tropical diseases. He has trained and worked around the world - London, Kuwait, Brazil, and Africa. He presently practices in Mexico City. The U.S. Embassy refers sick American tourists to him. Dr. Reeves is also a CIA operative who enlisted after 9/11 to fight terrorism. After two years as an employee of the U.S. Intelligenge Service, he is disenchanted and wants out. Dr. Reeves is appalled by the brutal handling of terrorist suspects. It is his job to treat them and keep them alive long enough to obtain information or a confession.

Dr. Reeves loves Mexico, painting, and living day to day. He hates arrogance, disease, and human misery. His boss, Alex Law, is the chief of the CIA station in Mexico. He and his pal, Butch Nickels, have been in the spy business a very long time. Law is an alcoholic. His wife finds a lump in her breast that proves to be malignant. Dr. Reeves and his father (a surgeon practicing in San Francisco) arrange treatment for the woman in California where she undergoes a double masectomy.

Law has some clues that a group of al Qaeda in Mexico are plannning an attack. He worries they intend to bomb a city in California. Law's intuition is pretty good. A husband (Mohammad) and wife (Fatima) from Baghdad are set on revenge. Their young son was killed by an American bomb in Iraq. The husband, a physician, was mutilated by the same bomb. Unaware of her true background and her mission of destruction, Dr. Reeves falls in love with the beautiful woman who calls herself Dolores Rios. At one point, he kills a policeman and wounds another to rescue the woman. When her husband is bitten by scorpions, Dr. Reeves saves his life.

Members of the al Qaeda cell eventually capture Dr. Reeves and some of his friends. They plan to crash a stolen airplane into a California city. Dolores has a change of heart, but her husband is intent on revenge and becoming a martyr. Dr. Reeves offers to accompany the terrorists in exchange for Dolores being left behind. Still recovering from the effects of the scorpion bites, Mohammad figures it might be wise to have some medical expertise readily available. Shortly after take-off, Dr. Reeves manages to crash the plane but he is killed by gunfire in the process. The terrorist attack is averted. When Alex Law locates Dolores, he allows her to go free and start a new life. The doctor would have wanted it that way and Law allows him that much.

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Annotated by:
Aull, Felice

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

As the film opens, Joe Buck (Jon Voight) is exuberantly preparing to leave his run-down Texas hometown to head for New York City. He has outfitted himself as a spiffy cowboy, intending to "hustle" wealthy New York women who will beg for his sexual favors, and pay him in the bargain. As he interacts with the bus passengers during the long journey to the Big City, we see that underneath the bravado, Joe is anxious for friendship and haunted by memories of a lonely childhood. Abandoned by his mother (a father is never in the picture), Joe was raised by his grandmother, who spoiled him, yet neglected him, and whose assorted boyfriends competed with him for her attention.

In New York, Joe is naive and out of place. His attempts to hustle women are rebuffed or backfire ludicrously--he ends up paying them. In a Times Square bar, he runs into a crippled con-man, "Ratso" Rizzo (Dustin Hoffman), who offers to be his "manager" but steals his money in a scam. As his funds run out, Joe resorts to selling himself in a homosexual encounter; even this backfires--he picks up a student who has no money.

As Joe is becoming quite desperate--homeless, with only his portable radio for company--he runs into Ratso again. Partly to make amends, and partly out of his own loneliness, Ratso invites Joe to his "home," a room in an abandoned building, without electricity or heat. Warily at first, and then with increasing mutual respect, the two set up housekeeping. Theirs is a daily struggle for survival--petty thievery, selling blood, and fantasies of a gigolo's life in warm Miami sustain them.

In the heatless apartment Ratso's health deteriorates--he has a chronic cough, smokes constantly, and the weather is frigid. Underground movie-makers choose them as street curiosities for the camera, inviting them to an avant-garde party replete with food, drugs, and a rich woman (Brenda Vacarro), who takes Joe into her bed and pays him for it, arranging another "transaction" later in the week for a woman friend.

Joe thinks he has finally made it. Ratso, however, has a high fever, can no longer walk, and refuses medical attention. Joe makes the choice: he assaults and steals for the busfare to take Ratso to Miami. During the trip Joe tells Ratso, "I'm going to get some sort of job--outdoor work--I'm no hustler." But Ratso, seated next to him, has died. Joe puts his arm around the dead man, protecting him from the curious stares of the other passengers.

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Unaccustomed Earth

Lahiri, Jhumpa

Last Updated: Jan-06-2009
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

The unusual title is borrowed from Nathaniel Hawthorne's story, "The Custom House," to suggest a shift in fortune when immigrants "strike their roots into unaccustomed earth."  Set almost entirely in the United States (the unaccustomed earth), eight separate stories are connected most obviously by cultural dissonances affecting characters who are Indian or have Indian parents.  Three of the stories, however, are linked by a strong narrative connection that is unexpected, profound, and unforgettable.

For Indian readers, the narratives describe complexities about migration patterns, cultural issues, alienation, and generational differences. The stories deal with well-educated children of immigrants who become offspring their parents barely recognize.  For other readers, the stories reveal situations about families and customs that are strangely familiar, especially those stories dealing with relationships between parents and children.
 
The forces of globalization have created and accelerated shifts that can seem staggering to all parents intent on preserving cultural patterns and traditions. Whether Indian or not, most parents experience a sense of alienation while watching their children flourish in a world that increasingly appears unfamiliar and foreign.

Not surprisingly, the stories concern strains and challenges affecting mixed relationships and/or mixed marriages and stresses on disapproving and disappointed parents, while others focus on children succumbing to drugs and alcohol(for the latter, see annotation of "Only Goodness").  All deal with some kind of emotional loss, but provide connections to feelings experienced by children and their parents in life's quiet and more kinetic negotiations.
 
The first story is about Ruma, a well-educated woman who lives in Seattle with her work-alcoholic American husband, and child, Akash.  Generational and cultural contrasts are revealed in overt and more subtle ways when her recently widowed father arrives for a short visit. Even though Ruma's complete assimilation into her non-Indian home as well as her on-going worries about her father's loneliness are major considerations, another story thread is spun, one that quietly reveals the father's thoughts about himself and a new relationship made recently during a vacation in Europe. Ruma's assumptions about her father, his loneliness, his possible dependency on her, and the Seattle vacation as a possible signal for relocating to her household turn out to be entirely wrong. 
 
The last three stories follow a boy, Kaushik, and girl, Hema, into adulthood.  In the first story, "Once in a Lifetime," Hema recalls her first memory of Kaushik when he was 9 and she was 6. The occasion was a farewell party for Kaushik's parents who were returning from the United States to live in Calcutta. The mothers, who grew up in Calcutta, but met in Cambridge, Massachusetts had become very close and were saddened by this separation.

Seven years pass before Kaushik‘s parents return to the Boston area and stay with Hema's family. Hema found the now 16-year old young man appealing, but brooding and totally uninterested in her. Even though Hema expected Kaushik to be Indian-like in behavior, he was more Americanized than she was. That the family had flown first-class shocked Hema's conservative family as did their new smoking and moderate drinking habits.

After a long search, and to the relief of Hema's parents, Kaushik's family found a  modern house on the North Shore.  Before they moved to their new home, Kaushik surprised Hema with confidential information-- his family had left India to seek treatment in Boston for his mother's breast cancer.  All medical efforts had been unsuccessful and his mother had only a short time to live.  Hema promised to keep this disclosure secret and grieved for the woman she had come to admire and love.
 
The second story in the link, "Year's End," is narrated by Kaushik.  With the opening line, "I did not attend my father's wedding," readers know that Kaushik‘s mother has died.  His father, in Calcutta for a visit, had married Chitra, a woman with two young daughters, and all would be returning to the North Shore house to live. Most of the chapter recounts the ordeal of the mother‘s dying, Kaushik‘s tremendous sense of loss, and the loneliness experienced by him at Swarthmore College.  No mention is made of Hema by the desolate narrator except to remember he had hated every day spent under her parents' roof, but later had come to think of that time with nostalgia.  

"Going Ashore" brings Hema and Kaushik together in Rome where she has a study grant and a visiting lectureship and he is on vacation from his work as an award-winning photo journalist.  Hema's parents have arranged for her to marry Navin in Calcutta.  Navin has accepted a teaching position at MIT. Until her unexpected reunion with Kaushik and the intense love affair that follows, neither had experienced any real connection with another person.  The story about them in Rome seems to represent an independence from the cultural forces that have shaped their lives, but this independence is short lived.  Ultimately, she is unable to set aside the expectations imposed by her parents.  The consequences of their final separation are more than any reader might imagine.

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Summary:

Body of Work is a cleverly crafted memoir - or, rather, the first chapter of a memoir - of the author's medical school experience at Brown University School of Medicine in Providence, Rhode Island. Ms Montross relates the chronological course of her team's dissection of a female cadaver with no discernible umbilicus and whom they therefore name Eve. (She neglects to comment on Eve's ribs and whether she has the normal complement or a supernumerary, more masculine, rib.) As she and her team of four (later three as one student drops out of school) proceed with the orderly dismantling of Eve, bone by bone, nerve by nerve and blood vessel by blood vessel, she uses this experience as a springboard to analyze her and her team's emotional reactions to the often unnatural process of deconstructing, literally (at times with a saw), a former person now cadaver, as well as the gradual, almost imperceptible acculturation that transmogrifies medical students into doctors. In fact, she devotes the final pages to this metamorphosis and what it means to the person undergoing the transition from caring student to detached physician, and whether one can retain enough caring, while remaining sufficiently detached to function as one must as a clinician, to become both a whole person and competent physician: "How much of becoming a doctor demands releasing the well-known and well-loved parts of my self?" (page 209)

Although it primarily revolves about the axis of her gross anatomy (cadaver dissection) course, the author's narrative includes tangents that have variably relevant relationships to this course, e.g., a trip to Italy to inspect first hand the anatomy theater of Vesalius in Padua and the Basilica of St. Anthony; another trip to the anatomical wax sculptures museum in Bologna, where the author also observes the "incorrupt corpse of Santa Caterina" in a "small church called Corpus Domini" (pages 223-224); interspersed histories of the traffic of corpses for dissection, including the infamous Burke and Hare story; some flash-forwards to her second and third years; and a prolonged narration of the final illnesses of her grandmother and grandfather. This last bit of family history is worth the price of the book alone. Despite the apparently incongruous collection of such asides, the author makes it work smoothly, if not seamlessly.

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Summary:

This book chronicles four meals, tracked from the production of the food through to the preparation and consumption of the meals themselves. The first is a fast food meal eaten in the car, the quintessential American meal consisting entirely of industrially farmed produce. Pollan then goes on to have an industrial-organic meal, an organic pasture-grown meal, and finally a meal containing only products that he foraged, hunted, and cultivated himself. Throughout, he looks closely at how economic and commercial values have supplanted ecological ones in the cultivation and production of the food we ingest. In addition to attending to the social and political dimensions of the American diet, Pollan also notes the effects of this diet on public health, from rising levels of obesity through to the antibiotic resistances developing in herds of cattle living in pens in their own manure.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sandeep Jauhar, M.D., Ph.D. is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York. Thus, one can assume that he is an accomplished cardiologist and administrator. It was not always so. This memoir flashes back to 10-15 years earlier when the author was casting about for a career, finally settling on medicine almost by default; it follows him to medical school (at Washington University in St. Louis) and then centers on his first year of residency training at Cornell's New York Hospital in Manhattan -- the internship year.

We learn in the introduction to the book that the author will speak freely of self-doubt about career choice, constant anxiety and feelings of inadequacy, exhaustion, and disillusionment. Which indeed he does. But Jauhar first discusses his family background: born in India and emigrating with his family to the USA at age 8; father holding a Ph.D. in plant genetics, now writing academic textbooks and still regretting that he had not been able to afford his dream of becoming a doctor; mother helping to support the family as a lab technician; older brother, Rajiv, a mentor and competitor, charming, self-assured, and unquestioningly headed for a medical career; sister, Suneeta. Sandeep (the author) undertakes graduate work in theoretical physics but as he nears completion of his doctoral degree, realizes that he probably does not have what it takes to be successful in the field. When his girlfriend, Lisa, becomes seriously ill, he begins to (re)consider medicine as a career. Against the advice of his parents who are now convinced he is a dilettante, he applies to medical school and is accepted.

Disillusionment began during the first two years of medical school: "In graduate school I had never learned to memorize . . . But now I couldn't rely on logic and reasoning; I had to commit huge swaths of material to memory" (32). He considered quitting to become a journalist, a profession that had always intrigued him, but which had been discouraged: "my father made it clear that journalism and writing were never to be considered career options because they offered no security" (33). Yet, amazingly, he was awarded a summer fellowship just before starting medical school that placed him in the Washington, DC office of Time magazine; the contacts he made then allowed him to work as a student reporter for the St. Louis Post-Dispatch during medical school and led ultimately to his ongoing and current position as a contributing medical essayist for the New York Times.

Internship for Jauhar unfolds as a series of anxiety-provoking encounters with patients and humiliating encounters with his physician superiors. Feeling inept and inadequate, he stumbles along and worries that he is harming patients. There is too much to keep track of, too many "little things that I find burdensome" (91). "Having so much to do was bad enough, but not knowing why you were doing what you were doing was terrifying . . . Patients were needy, their demands overwhelming . . . Everyone seemed to know how the place worked except me . . . The ecology on the wards was hostile; interactions were hard-bitten, fast paced" (112-113). He is in constant doubt and conflict about his career choice. Even his private life is affected -- his girlfriend Sonia, still a medical student, comes from a medical family, is strongly motivated and secure in her career choice, which aggravates his own sense of insecurity. (Reader, he married her.)

Midway through internship Jauhar suffers a herniated disk. He tries to tough it out without taking time off but his stint as "night float" at Memorial Sloan-Kettering hospital, which specializes in treating cancer patients, proves too difficult-- up all night trying to tend to the severely ill and "taking care of patients about whom you knew next to nothing" (154). He takes a brief leave followed by a reduced schedule. He recognizes that his problems are emotional as well as physical -- he is depressed. But gradually, as his neck problem improves, as he recognizes that medical professionals are actually able to help patients feel better -- his neurologist and physical therapist had "provided hope and comfort to me at a vulnerable time" (181)--, as he makes a house call to a dying patient, as his essays are published in the New York Times, and as the season moves to Spring, his depression lifts and he looks forward to his work.

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Black Mesa Poems

Baca, Jimmy Santiago

Last Updated: Mar-05-2008
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In the title poem, Jimmy Santiago Baca says: "To write the story of my soul / I trace the silence and stone / of Black Mesa." This collection of poems carries the reader into the mountains and valleys of northern New Mexico, and to the barrio where the poet and his family live. They are poems full of incident and experience, of the "twenty-eight shotgun pellets" that remain in "my thighs, belly, and groin" from an incident with Felipe in 1988 ("From Violence to Peace"), and the slaughter of a sheep to the tattoo of wild drums ("Matanza to Welcome Spring"), and the tragic story of "El Sapo," the Frog King.

Baca’s characters live close to the land, close to the mountains, and sometimes outside the law ("Tomas Lucero"). These poems witness to the violence and despair of barrio life, but also to its energy and joy. Baca’s hope continues "to evolve with the universe / side by side with its creative catastrophe."

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Consumption

Patterson, Kevin

Last Updated: Mar-04-2008
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In the Arctic, winter goes on for ten months every year. The cold temperatures penetrate every aspect of human life. Existence is a struggle. In the Canadian community of Rankin Inlet, an Inuit woman finds personal tragedy as abundant as the snow. Victoria is diagnosed with tuberculosis (puvaluq) as a child and sent to a sanatorium far south of home. Following treatment with medication and a thoracoplasty, she returns to her town years later. Victoria's experience has changed her view of the world but she quickly discovers that in her absence, the people and locale have transformed too.

She marries an outsider, John Robertson, who is a British businessman. His success and local influence allow him to arrange for a foreign-owned diamond mine to open in the area, and with it, a new hospital for the territory. The couple have three children - a son, Pauloosie, along with two daughters, Justine and Marie.

Victoria seems a magnet for misfortune. At age 16, she has a miscarriage. A fourth child dies during a complicated delivery. Her marriage is increasingly strained beyond repair. Victoria's father suffers a stroke and becomes demented. Her mother dies of lung cancer. Husband John is murdered - someone slits his throat. Marie commits suicide. Pauloosie leaves home and sails to the South Pacific.

The Robertson family frequently interacts with the American primary care physician stationed in the isolated region. Dr. Keith Balthazar is a middle-aged atheist who has toiled in the Arctic for more than 20 years and abuses morphine. He keeps a journal of his experiences and meditations and commiserates with the local priest, Father Bernard.

Escape appears to be the best chance at happiness. For Victoria and most everyone else living in this harsh and beautiful land, survival - both physical and emotional - is hard. Personal choices are confusing. Nature doesn't seem to care one way or another.

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Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Manuela (Cecilia Roth) a nurse who works in a transplantation unit, witnesses the accidental death of her romantic son, Esteban, as he chases a car bearing the famous actress, Huma Roja (Marisa Paredes), from whom he wants an autograph. Esteban had longed to know about his absentee father, but his mother had always refused to tell him. His heart is transplanted, and Manuela is shattered by grief, leaves her work, and sets out to recover her past.

Obsessed with her son’s obsessions, Manuela trails the famous actress, Huma, who gives her a job. She finds old friends in the underworld, and a beautiful nun, Rosa (Penélope Cruz), who works with the poor and plans to go abroad. Soon it emerges that Esteban’s father is "Nina," a transvestite prostitute, and that Rosa is not only pregnant by him/her, she has also contracted AIDS.

Rosa’s austere mother was unhappy about her decision to become a religious, but she is even more horrified by her daughter’s pregnancy and illness. Initially reluctant, Manuela nurses Rosa and after her death, she adopts the infant son who is of course named Esteban.

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Clinician's Guide to the Soul

Masson, Veneta

Last Updated: Nov-06-2007
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry and Art

Summary:

Veneta Masson's latest poetry collection is a clinician's guide not to illness and disease but to the souls touched by illness, both the patient's and the caregiver's. In 45 poems, she reviews her life in caregiving, from her early days in nursing to her work as a nurse practitioner in a community clinic and finally to her decision to use her hands "to write and to bless" (p. 93). Her poems are enhanced by the artwork of Rachel Dickerson, whose woodcuts and etchings are paired with poems to provide another voice, another way of looking into the soul of caregiving. For an example of this wonderful pairing, see the print that accompanies "The Screamer in Room 4" (p. 24). The print allows us to see the frustration of the screaming child, the child's mother, and the caregiver.

As always, Masson's poems center on the patient-caregiver experience; in this volume, as we follow her through her various adventures in nursing we also travel with her through the changes she has witnessed in healthcare and the politics that continue to affect its delivery. "Rx" (p. 22) examines Medicare and Medicaid and the political decisions that often deny medications to the elderly who need them most. "Gold Standard" (p.34) looks again at medicine and money, juxtaposing the medical pill against the placebo of the caring healer. One of my favorite poems, "The Doctor's Laptop" (p. 40) laments how technology might deprive patients of the doctor's time, attention and touch.

Other themes that are central to this collection are the unexpected presence of humor in caregiving (see "Conga! at the Rio," page 50), of spirituality (see especially "Rescue," page 36, "Refuge," page 45, and "Prevention," page 82), and of the personal. In several moving poems Masson looks at her own sister's death and her reaction to it, writing about her conflicting roles as sister and nurse (see, among others, "Matinee," "Hilda and Snow White," and "The Nurse's Job," pages 70, 72 and 74). In an excellent final poem, "Winter Count," Masson takes us through her own nursing history, a chronicle of work, joy, disappointment and survival that any caregiver will recognize.

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