Showing 111 - 120 of 829 annotations tagged with the keyword "Patient Experience"

City Hospital

Neel, Alice

Last Updated: Feb-18-2012
Annotated by:
Bertman, Sandra

Summary:

In 1953 Alice Neel created a series of ink and gouache drawings depicting the last weeks of her mother's life, which were spent in a New York city hospital. One of these is at the Robert Miller website linked to this annotation. In the drawing, a black nurse comforts a prone elderly lady. The pale hues of the painting--blue, black, white--evoke a somber mood and imply sickness. This sense of despair is augmented by a harsh cityscape background beyond a dark river, which the viewer sees through a window.

Compassion counters these desolate surroundings, however, for a bond is apparent between the nurse and elderly patient. The nurse's hands rest on the patient in a partial cradling gesture, and the trajectory of the lines made by the nurse's arms and hands and the elderly patient's flowing hair establishes a visual and emotional link. The connection between the two figures is supplemented by the thin smiles on both women's faces.

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Sailing

Kenney, Susan

Last Updated: Feb-12-2012
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A few years into their marriage, while their children are still young, Sara and Phil discover that he has an aggressive form of cancer.  He undergoes grueling surgery, but the cancer returns.  For Sara the prospect of Phil's death reawakens the trauma of losing her father when she was twelve.  Phil does his best to live a normal life between chemotherapy treatments and further surgeries, and even enters an experimental treatment in hope of seeing his children grow up.  His greatest pleasure in life is sailing, and one of his deepest hopes for his remaining time with his family to enjoy sailing with them in the ocean near their New England home.  But Sara finds it scary, even though she gamely learns to crew, and the kids never take to it.  So Phil sails with friends, and sometimes alone.  After learning that the cancer has continued to spread despite every medical effort, Phil decides to take one last sailing trip, this time alone, on the ocean.  There he has to make a decision:  his intention is simply to sail until his body gives out and die on the boat he loves, sparing Sara, he thinks, having to watch him die a slow and painful death.  But he begins to realize that letting her see him through might, after all, be a better way to go.  As the novel ends, he turns the boat, now quite far from land, toward home.  

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Summary:

This is an anthology of poetry by poets who have disabilities. The book's sections are ordered more or less chronologically, although the editors have identified other groupings as well: "The Disability Poetics Movement," "Lyricism of the Body," and "Towards a New Language of Embodiment." Also included is a well organized preface by editor Jennifer Bartlett and an informative "Short History of American Disability Poetry" by editor Michael Northen. An essay by or about each poet prefaces that poet's work. The book makes no pretense at being comprehensive but offers a large selection of poets with a variety of physical impairments (e.g. cerebral palsy, rheumatoid arthritis, dystonia, blindness, deafness, Parkinson's disease, multiple sclerosis, stroke). It presents important figures who have contributed to current thinking about the disabled body and social and physical constraints imposed on it, as well as poets who do not/did not identify themselves as disabled in their work.

The first section, "Early Voices" presents poets no longer alive who wrote in the mid to late 20th century and rarely forefronted their disability (Larry Eigner, Vassar Miller, Robert Fagan, Josephine Miles-- and  Tom Andrews, who DID write about his hemophilia). Their work took place mostly during a time when disability was stigmatized and kept hidden. Michael Davidson's essay on Larry Eigner's work is particularly informative, showing how the poet's severe cerebral palsy, which kept him housebound, pervaded his work although he made no overt reference to his condition.

"The Disability Poetics Movement" highlights poets ("crip poets") who openly celebrate their unusual bodies. These are poets who emerged shortly after passage of the Americans With Disabilities Act in 1992. Some, such as Jim FerrisKenny Fries, Petra Kuppers became disability rights advocates and educators in the field of disability studies. Editor Michael Northen speculates that Fries "may be the single most powerful representative of this group" because he rejects both the medical and social models of disability and is "asking instead for a redefinition of beauty and of the way that disability is perceived" (20-21). Other poets in this section are Daniel Simpson, Laura Hershey, Jillian Weise, Kathi Wolfe, and John Lee Clark.

Ten poets contribute to the section, "Lyricism of the Body," most of them unknown to me (Alex Lemon, Laurie Clements Lambeth, Brian Teare, Ona Gritz, Stephen Kuusisto, Sheila Black, Raymond Luczak, Anne Kaier, Hal Sirowitz, Lisa Gill). Their prefatory essays are particularly helpful in providing context for their work. The final section, "Towards a New Language of Embodiment," is more experimental than the rest of the collection. "Rather than explaining an individual story, bodily condition is manifested through the form" (17). Poets are Norma Cole, C. S. Giscombe, Amber DiPietra, Ellen McGrath Smith, Denise Leto, Jennifer Bartlett, Cynthia Hogue, Danielle Pafunda, Rusty Morrison, David Wolach, Kars Dorris, Gretchen E. Henderson, Bernadette Mayer.

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Poetry

Chang-Dong, Lee; Jung-Hee, Yun

Last Updated: Jan-05-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Mija, a 66 year-old woman, is raising her daughter's grumpy teenaged son and trying to make ends meet with a part-time job as a maid for an elderly, wealthy man who has suffered a stroke.

She finds herself searching for nouns, and after consulting a doctor, is told bluntly that she has early Alzheimer's disease.

Perhaps because of her preoccupation with language, she joins a poetry class and strives to write, listening carefully to the poet-instructor's philosophical advice on vision and creativity. Throughout the film, she carries a little notebook with her and pauses to write her thoughts about flowers, beauty, birds, and apples.

A young girl in the grandson's class has committed suicide by drowning and Mija witnesses the mother's grief. From the girl's diary, the teachers and family learn that she had been repeatedly raped by six boys, one of whom is Mija's grandson.

The fathers of the other boys try to make a monetary settlement with the bereaved mother; they urge Mija too find an extraordinay amount money. In despair, she extorts the money from her employer as a "favour"-but the boy is utterly indifferent to her action, and in the end, is taken by the police anyway. Mija summons her daughter. She leaves a bouquet of flowers and the one poem that she managed to compose for her instructor to find at the last class. The daughter arrives to an empty home and we assume Mija has drowned herself.

 

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New Finnish Grammar

Marani, Diego

Last Updated: Jan-01-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

During World War II, a man is found beaten and unconscious in the streets of Trieste and brought to a German hospital ship. The Finnish-born doctor serving the German naval forces recognizes the name on his uniform as that of a vessal originating in Helsinki, the “Sampo Karjalainen." When the man wakes up, he has total amnesia; his memory loss has extended to language. In a crazy gesture of compassion, the doctor arranges for the man to be conveyed across war-torn Europe and home to Helsinki to be tended by a specialist. The doctor hopes that exposure to his homeland, its culture, and especially its language, will help the recovery of the man now called Sampo. They never see each other again.

Isolated and confused, Sampo, is given a bed in an empty visitors' ward of the hospital. The much awaited specialist never appears and Sampo never understands why. His closest friend is a tippling priest who teaches him Finnish through a reading of the Kalevala legends, libated with shots of Kosenkorva. He befriends some Russians who are housed briefly in his ward and he contemplates the hostilities between the nations. He wanders the city of Helsinki looking for triggers that may hand him back his identity – his past, a narrative. One of the nurses takes an interest in his case, shows him a special memory tree in a Helsinki park – and accepts his rejection of her affection with good grace. She is transferred to another place, but writes to him. He is unable to respond. She is angry.

In desperation Sampo joins the Finnish army and leaves for the eastern front. An epilogue tracks his demise and the doctor’s later discovery of his massive error. 

 

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Wings

Kopit, Arthur

Last Updated: Nov-17-2011
Annotated by:
Kohn, Martin

Primary Category: Literature / Plays

Genre: Play

Summary:

In the well-written preface, Arthur Kopit describes how he came to write Wings, a play about stroke and language disorder. And he explains there how his fictional account of strokes and their aftermath, "is a work of speculation informed by fact." One fact important to Kopit was that his father suffered a major stroke seven months before Kopit was commissioned by National Public Radio to write an original radio play.

Wings, (which has been sucessfully staged as well) however, is not based on Kopit's father, but on the life of a character, Emily Stilson, who is an amalgam of people, both stroke victims and their stroke-recovered caregivers, from the rehab center caring for Kopit's father. The title of the play refers to an early career of Emily Stilson--she was an airplane wingwalker. Kopit deftly employs the sounds of an airplane in the scenes in which Emily is experiencing a stroke. In fact, the sounds and sights inside and outside of Emily as well as her private dialogue are combined masterfully by Kopit to bring about a high degree of verisimilitude to the chaos produced by stroke.

The play is divided into four sections: "Prelude," the moments before her first stroke; "Catastrophe," her trip to and stay in an institution; "Awakening," a longer section dealing primarily with her struggle to reorient and regain language skills; and "Explorations," where further therapy, including group therapy, and her eventual demise are portrayed.

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The Story of San Michele

Munthe, Axel

Last Updated: Nov-14-2011
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The author takes us on a highly colorful autobiographical tour of his medical career - his personal life never enters this account - from a classical medical education in Paris as a young expatriate Swede (he remains expatriate the entire book) to his internal medicine practice in France, including a tour of Naples as a volunteer during the cholera epidemic of 1881 and his finally settling in Italy. There are also anecdotes - many of them side-splitting and told with uncommon skill - about conducting a corpse back to Sweden, a truly thrilling journey to Lapland,  encounters with the legendary Charcot, his return to San Michele whence the book begins with a mythopoetic retelling of his first visit there, and his last years at San Michele as patron of a community (both local and international) and as collector and explorer of the nearby Mediterranean.        

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Summary:

Johanna Shapiro, Director of the Medical Humanities Program at University of California Irvine School of Medicine, brings her considerable skills and experience as medical educator, writer and literary critic to this unique volume of medical student poetry. Shapiro collected over 500 poems by medical students not only from her home institution but also from other US medical schools and performed a content and hermeneutic analysis. As Shapiro carefully details in her methodology section, she treats "poetry as a form of qualitative data, and [therefore] techniques of analysis developed for other sources of qualitative data (such as interviews, focus groups, and textual narratives) can be applied to an understanding of poetry." (p. 42)

Relying on the work of Arthur W. Frank (see The Wounded Storyteller), Shapiro devises a typology of student poems: chaos, restitution (and anti-restitution), journey, witnessing, and transcendence (this last category was not Frankian in origin). These categories are developed and explicated in Chapter 2: Functions of Writing for Medical Students. As the author notes, poems traverse the boundaries between types; nonetheless, the framework of the analysis rests with this typology. Further, Shapiro explores the metaphors of topography (illness as a foreign land) and quest (student on a heroic, however tentative or confused, journey) throughout her study.

The book contains many fully reproduced medical student poems, contextualized with academic theory on medical education. Hundreds of references, particularly in the fields of narratology and medical education, are cited. After three chapters of theory and methods, eight topics are explored using the outlined analytic tools: anatomy class, becoming a physician, patient experience, doctor-patient relationship, student-patient relationship, social and cultural issues, death and dying, love and life. Prefacing each of these topics is a scholarly essay providing historical and research foundations; every chapter concludes with a summation.

Within the chapters are examples of poems, not only organized by typology, but also by content. For instance in the patient experience chapter, the topics are: "patient pleas for empathy and compassion," "patient fears and suffering," "stigmatized voices," "vulnerability/courage of child patients," and "personal experiences of illness." Within each topic/subtopic, different poems are highlighted and fully analyzed. Additionally, other poems, not reproduced, are quoted as illustrative examples. Summary arguments are provided at the conclusion of each chapter as well as in the final chapter: "Strangers in a Strange Land: What Matters to Medical Students on Their Journey and How They Tell About It."

Although Shapiro states that her purpose "is not to address the literary and aesthetic attributes and value of the poems", she also notes "when students write authentically about their own experience, the results are uniformly moving, compelling and impossible to ignore." (pp 44-5) Indeed many of the poems are rewarding to read not only for content but also for word choice, word play, imagery and narrative line. For instance, in "Ode to the Peach" Brian McMichael explores the senses Neruda or Pollitt-like: "you invite me with / your voluptuous curves / your feminine little cleft". (p 236) Another example is the humorous, self-deprecating "Piriformis" by Curtis Nordstrom relating an early clinical experience by a medical student who hopes against hope that the patient's presenting complaint will require the student to demonstrate his acumen. Unfortunately the sum total of the student's knowledge base is limited to the location of the piriformis muscle; both the student and patient are "so screwed" when, "Alas, the patient presents with / an upper respiratory infection." (p. 16)

Shapiro's sensitivity and generosity of spirit vis-à-vis the medical student experience are evident throughout the volume. She concludes that "what may be most noteworthy about the analysis of these poems is that, amidst their own difficulties and fears, time and again these students reported engaging deeply with their patients." (p 259) She hopes that medical educators will be encouraged to support "in solidarity" the "idealism and high aspirations" expressed in these student poems. (p. 260)

In a postscript, Shapiro reveals her own experiences as a poet-patient. After noting that "[m]edical students are mostly annoyingly healthy, energetic, smart, and capable young adults who like order, structure, and control", (p 261) she also acknowledges how frequently students grapple with the topic of death and dying in their poems. That her poems emerged from advising a student creative writing group demonstrates how poetry can be renewing and vital not just to the student, but to the educator as well.

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Summary:

In the eighteenth century, Europe began to take stock of the horrific infant mortality in foundling homes and hospitals. Infant feeding and care became a major preoccupation for charities and philanthropic doctors. Some organized systems of wet nurses in the communities and institutions to provide for motherless children. 

At the same time, syphilis was becoming a serious problem in newborns. The sexually transmitted disease, which swept the continent following the voyages of Columbus, was known to affect babies born to infected mothers. Since the early sixteenth century, doctors had been convinced that mercury was of benefit.

Founded in 1724, the Vaugirard Hospital of Paris was the city’s home for orphans. By 1780 it had made room for mothers with syphilis and their children.  Sometimes the mothers died, or well-off families would abandon their sick children. Healthy wet nurses were engaged to feed these babies.

Eventually, the wet nurses were viewed as a technology—a vehicle--for administering mercury to the babies through their milk. Many of these healthy women fell ill, either from the mercury or by infection from their charges. Nevertheless, the practice continued into the nineteenth century. The wet nurses did not know (or were not told) that the children were infected. The physicians in charge of this experiment also attempted unsuccessfully to vaccinate the wet nurses against syphilis. That experiment also spread the disease.

Remarkably, some wet nurses brought suits against the doctors or the birth families. Occasionally they won damages, and finally the law was changed to offer greater protection.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

An engaging historical analysis of several aspects of the history of madness and art. It includes chapters on the history of

- the portrayal of mentally disturbed people;

- the idea that creative genius is enhanced by mental illness;

- architecture of psychiatric hospitals;

- art therapy; and

- the use of art as a semiotic tool for diagnosis.

Several case studies of individual artists, such as Richard Dadd or Adolf Wölfli are used to exemplify each theme. Special attention is given to artistic movements such as romanticism and expressionism. It is completed by excellent endnotes, a good bilbiography, and detailed annotated index.

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