Showing 111 - 120 of 196 annotations tagged with the keyword "Psycho-social Medicine"

Jean Beicke

Williams, William Carlos

Last Updated: Dec-07-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Short Story

Summary:

The setting is the children's ward of a hospital in Paterson, N.J. during the Great Depression. Alternating between a cynicism born of desperation, and empathetic concern, the physician-narrator describes the sorry condition of his young patients, virtually abandoned by their parents. He muses that they would be better off left untreated so that they would not have to live the inevitably wretched lives ahead of them.

One child in particular has captured his attention. She is Jean Beicke, an eleven month old, malnourished, deformed girl suffering acutely from broncho-pneumonia. The nurses and he look after her, and she responds to their care by taking nourishment and gaining weight. This is tremendously rewarding and reinforces their interest in her, but to their consternation she continues to be very ill. "We did everything we knew how to do except the right thing." "Anyhow she died." The benumbed mother is persuaded to allow an autopsy; the physician wants to understand what went wrong although he "never can quite get used to an autopsy."

The postmortem uncovers an infection of the mastoid process which has spread to the brain. The narrator and the "ear man" berate themselves for having failed to take proper steps to identify and treat the infection. In the end, however, the physician is still unable to resolve the dilemma of wanting passionately to have saved his patient's life, and knowing that the life saved would have been one of misery.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Subtitled "My Journey through Autism," Prince-Hughes's memoir leads the reader through a poetic, at times mystical, journey from "being a wild thing out of context" (1) to finding a way to understand the world and live "in context" (11). The author, an anthropologist, has Asperger's syndrome. Prince-Hughes explains that Asperger's is a form of autism in which the individual develops "age-appropriate" language and cognitive skills as well as "self-help skills" and curiosity about the environment but has marked difficulties with social interaction and shows the obsessive, ritualistic behavior similar to other autistic individuals.

As the author relates, her poor social skills, discomfort with physical closeness, sensory sensitivities (to touch and odors for example) and other odd behaviors annoyed her instructors and triggered taunts and even physical abuse from classmates and acquaintances. She describes her misery one such day when she was confronted by an impatient teacher: "I often couldn't take in people as whole entities, even when I was relatively relaxed . . . I was caught in a whirlwind of horrible sensory information and unrelenting criticism" (43).

Getting through each day was filled with emotional pain and suffering, and required a tremendous expenditure of energy in usually unsuccessful attempts to "fit in." Complicating her social isolation was the gradual recognition that her adolescent sexuality was somewhat blunted or, if anything, inclined toward lesbianism. She began drinking (alcohol) in the seventh grade. At 16 she left school and home, embarking on a long period of alcoholism, drug dependence, a "hippie" lifestyle and outright homelessness.

Prince-Hughes had always found refuge in nature, but later she also took pleasure in the physical activity of dancing, becoming a club performer in Seattle. During time off one day, she packed lunch and ate it at the zoo. She spent three hours watching the gorillas. "It was so subtle and steady that I felt like I was watching people for the first time in my whole life . . . Free from acting, free from the oppression that comes with brash and bold sound, blinding stares and uncomfortable closeness that mark the talk of human people. In contrast, these people spoke softly, their bodies poetic, their faces and dance poetic, spinning conversations out of the moisture and perfume, out of the ground and out of the past. They were like me" (93).

Thus began the author's profound relationship and identification with gorillas, an interaction that changed her life, resulting eventually in scholarly work and a Ph.D. in interdisciplinary anthropology, a faculty appointment, and gradual understanding of her own neuroatypical condition, not diagnosed as Asperger's until she was 36 years old.

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Summary:

Will Hunting (Matt Damon) comes from Southie, a rough district of Boston, and works at night as a janitor at the prestigious Massachusetts Institute of Technology (MIT). Will writes on some math class blackboards when no one’s looking, and Professor Lambeau (Stellan Skarsgard) discovers that Will is a natural mathematical genius. Lambeau tries to bring Will out of his go-nowhere environment into the academic world where his talent will be appreciated.

Will half-agrees, but he still hangs out with his tough crowd in Southie (including Ben Affleck as Chuckie), and he winds up getting arrested after a fight. Lambeau keeps Will out of jail through an arrangement that includes his mentoring plus Will’s going for psychotherapy with Sean McGuire (Robin Williams). That course of psychotherapy is the core of the film.

Sean’s treatment of Will in therapy involves lots of risks, but through a combination of empathy, rule-giving, self-revelation, and provocation, Sean manages to bring Will to understand that the severe physical abuse he suffered as a child at the hands of his foster parents is not his fault, and that he really is a good person who has a lot to offer. (This can sound corny unless you are the one who is making the discovery.)

Sean gains some credibility with Will when he admits that he, too, had suffered abuse as a child. Will’s realization makes possible a much more positive self-image and a whole new vision of life. He decides to stop denying his talents and to recognize that he might be good enough after all for brilliant and charming (and independently wealthy) MIT student Skylar (Minnie Driver), who loves him, and whom he finally leaves Southie to follow as she heads west for graduate school.

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Set in 19th-century Japan, the film’s action centers on the experience of the young doctor Yasumoto (Yuzo Kayama) in his work as an intern at a hospital-clinic for the poor run by the experienced and wise Dr. Kyojo Niide (Toshiro Mifune), nicknamed "Red Beard." Coming from a wealthy and influential family, and fresh from a Western-influenced medical education at Nagasaki, Yasumoto had believed he was on the path to become physician to the shogun (equivalent to a king).

He is initially insulted and deeply unhappy with conditions at the distinctly inglorious clinic. The poverty and suffering (and smell) of the clinic’s patients disgust him, and he tries his hardest to get fired. The mysterious Red Beard, however, is extremely patient, and simply waits. While he waits, we see Dr. Yasumoto slowly being converted as he is brought into close contact with the suffering in the lives of several patients.

Initially rebellious and emotionally unable to watch patients die or assist in surgery, Yasumoto gradually becomes a seasoned and enthusiastic member of the clinic’s medical team and announces that Red Beard is his idol. At the end, when Yasumoto is actually offered the position of physician to the shogun, he refuses, in order to continue his work at the clinic.

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My Body Politic

Linton, Simi

Last Updated: Dec-06-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Simi Linton, a major voice in disability rights activism, has written the story of her journey from car accident "victim" to college professor, disability studies scholar, and political activist. Her memoir of personal experience is interwoven with the evolution of her thinking about disability as social construct and the development of the disability studies movement and political engagement.

In 1971, Linton was a young married hippie--a college dropout hitchhiking her way to a protest march against the Vietnam War, together with her husband and best friend. Suddenly there was a car crash: her husband and best friend were killed and Simi sustained a spinal cord injury that left her legs paralyzed. There followed a year of hospitalization, surgeries, and in-house rehabilitation.

Although forced to be a recipient of attention and care, Linton even then was not inclined to play a passive role. "Even in this forest of overseers, where every move I made was scheduled . . . I had opinions. . . . Doctors . . . had saved me, and saved all my new friends, but I was outraged when they spoke for me or spoke down to a nurse I liked" (15). While still institutionalized, Linton took on the cause of petitioning the medical staff to educate patients like her about leading a sexual life as a disabled person. She determined to return to college as a psychology major so that she could eventually implement sexuality programs in rehab centers.

Linton details the activities of daily life that she had to adjust to and the strategies she adapted to maneuver, with her wheelchair, in her home, to go shopping, to travel, to attend classes. Family and friends and some social services were helpful but everywhere, life was designed for the abled body. This was a "fact of life"--"I had a feeling it could be different, but didn't know where to begin. I was having enough trouble just getting around" (28). She kept from thinking too much about her situation and her losses by staying busy and trying to be as independent as possible, but eventually needed the support of a therapist "who could bear my weight" (37).

It was in 1975 that Linton's disability rights "consciousness" was first stirred. On her own, she left her New York apartment to live in Berkeley, California for awhile. There she discovered "The Center for Independent Living" where the employees and volunteers were themselves disabled and whose goal was to assist disabled individuals to find ways of living independently. "I had been so tentative about my disability, and had, up to now, only ascribed a very personal meaning to it--this is what happened to me, this is the effect on me--that their forthright ownership of disability and their drive to take action based on the collective experience set my mind racing" (53).

Another defining moment came when Linton took a course on the psychology of women at Barnard College. "We examined the myths inherent in the so-called objective knowledge base" (64). Simi drew a parallel between knowledge generated from the male perspective and knowledge presented from the perspective of the abled body. "Unlike the [classroom] readings . . . which challenged traditional conceptualizations of women's roles and framed issues from an insider's perspective, the rehab literature recounted clinicians' views about disabled women's needs and experiences that seemed far removed from the way that I and the disabled women I had been meeting actually felt. It looked at us, and, it felt, through us, and I mistrusted all of it" (64).

The memoir continues with Linton's decision to work outside the realm of institutional medicine, her co-organizing the National Coalition of Sexuality in Disability, her falling in love with and marrying the man who is her (second) husband, her growing awareness of the silence surrounding disability and questions of access, and her dedication to change individual and society's discriminatory practices and to bring awareness of what we now call "the social construction of disability."

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The Shrine at Altimara

L'Heureux, John

Last Updated: Dec-05-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Written in a style resembling religious litany, this is the tale of a disastrous teen-age marriage and its criminal consequences. The setting is California. Maria is a poor Mexican-American who meets and attracts Russell, a working class Anglo. Although ambivalent, Maria sees marriage to Russell as the path to American, white respectability. Her earlier hopes of achieving this status through her own efforts have been frustrated by the reality of poor academic performance. She is eager to get away from the household of her deeply religious mother. Russell is brooding, taciturn, and carries the physical and psychic wounds of an abused childhood--his father is a partially reformed alcoholic who deliberately burned Russell's hand.

The pair are ill-equipped for marriage or parenthood and Maria soon feels trapped. Their son, John, avoids provoking them by being a "good boy," hoping to prevent their frequent arguments. Russell's deprived childhood accounts, perhaps, for his obsessively jealous fixation on Maria. He is jealous even of the attention she gives their son.

The catastrophe that seems always close at hand finally occurs: Russell sets fire to his own child. The second part of the novel is told primarily from John's perspective as he undergoes a prolonged, painful rehabilitation and tries to find meaning in these events. It is also the story of the plastic surgeon who attempts to restore John's horribly scarred body and who has come to doubt the purpose of his profession (there is nothing he can do about destructive family relationships and psychic scars). Russell, who has been brutalized in jail, is released, seeking redemption. Fire, significant throughout the story, plays a final shocking (redemptive?) role.

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Still Waters in Niger

Hill, Kathleen

Last Updated: Dec-05-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Described as an autobiographical novel, this book is narrated in the first person and reads like a memoir. But it is a "memoir" charged with atmosphere, imagery, and longing. The narrator is an American woman, a mother of three children, and the wife of an academic. After an absence of 17 years she has returned to Niger--the country in northwestern Africa where she had lived with her three small children and husband, while the latter was completing his doctoral dissertation. Now she is visiting her oldest child, Zara, who has been living for the past two years in Niger, and working in a medical clinic.

As the narrator reacquaints herself with the culture and climate of the country, she re-visits--in memory--young motherhood, her relationship with the six-year-old Zara, and her interactions with the people and surroundings. The novel shifts back and forth between the past and the present Niger while the narrator attempts to integrate her experiences: she sees the country and her daughter through new eyes.

She is overwhelmed with guilt about what she calls her "inattention" (17 years ago) to the lives of the Nigerans around her; guilt about her failure to learn the native language; guilt toward her children, for her own self absorption. "After all, what was I doing the year we lived in Zinder [the city where they had lived]? That is the question that looms between Zara and me . . . Of what was I thinking? It is not enough to say that instead of working in a clinic [as Zara now does] I was spending my days with Lizzie and Tulu and herself. That doesn't answer it. All of Zinder waited beyond the gate." (71)

The narrator watches with admiration and envy as Zara interacts comfortably, even intimately, with the native women and their children, speaks the language fluently, and negotiates her way with self assurance in this foreign land. Not only does the narrator feel inept, she feels that she has "lost Zara to a world in which I am entirely a stranger." (73) Thus cultural dislocation becomes the trigger for intense reflections on the nature of parenthood, and the female experience of marriage, pregnancy, motherhood, and aging. These reflections are magnified by the narrator's loss of her own mother, who has recently died.

The native women that she meets through Zara help her to understand that some of these experiences transcend cultures, even though their surface manifestations may differ. For example, the often hyper-critical attitude toward first born children, and the refusal of native parents to even utter the name of the first born child relates to the shame associated with this evidence that the mother has lost her virginity. "Shame is the right word, exactly," thinks the narrator, "and I wonder now that I have not stumbled on this knowledge before." (77) But more than the "thorough and irrevocable . . . violation of the space around one's skin" it is the associated separation from the mother that the narrator recognizes as being at the core of sexual awakening; it is this inevitable separation from her own daughter that she is now trying to absorb.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is the second edition of Hawkins's groundbreaking work on illness narratives--autobiographical and biographical accounts of illness that she calls "pathographies." This edition preserves the text of the earlier (1993) work but updates it with a new preface and a new concluding chapter. This new chapter (chapter 6) surveys works written since 1992 and expands the discussion of mythic thinking and narrative.

Hawkins posits that mythic thinking pervades illness writing. Mythic constructs, she argues, organize the way patients understand their illness, how they interact with the institution of medicine, and how they write their narratives. Myths are formulative in that they attempt to create order out of the disorientation of illness. In the texts selected, Hawkins identifies "archetypal" (transcultural, transhistorical) myths--myths of journey, battle, and death and rebirth (discussed in the first edition as well).

In this edition Hawkins introduces a new term: "ideological" myths. Ideological myths are "linked to a particular culture at a particular time" (xiii). In this category is the myth of healthy mindedness, a way of thinking that was labeled "mythos" in the earlier edition. Hawkins proposes two additional ideological myths, discussed in chapter 6: the Gaia myth (that links illness and environmental problems), and the "myth of narrativity" (xiii).

The book's chapters are organized around the myths enumerated above, with many examples. Most of the works discussed were written in the latter part of the 20th century, but there are several pages devoted to John Donne's Devotions upon Emergent Occasions (see annotation in this database). Hawkins determines how, in specific cases, the myths she has identified function--whether they are "enabling" or "disabling," and whether they are "medically syntonic or dystonic" (21-24). Myths that have an enabling function are adaptive, useful, help recovery or adjustment, ameliorate suffering. They are often medically syntonic--compatible with the belief system of Western medicine. One notable exception to this is Hawkins's paradigm of the ideological "myth of healthy mindedness," in which to be enabled often means to controvert traditional medical practices.

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Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Peter Selwyn spent the first ten years out of medical school at Montefiore Medical Center in the Bronx, caring for HIV-positive patients--mostly intravenous drug users and their families--in the early years of the AIDS crisis. As he worked with dying young men and women and their families, Selwyn returned to his own unexplored pain surrounding the loss of his father, who fell or (more likely) jumped from a 23-story building when Selwyn was a toddler. Mirroring their function in Selwyn’s life, the stories of the five patients who most affected him serve in this book as the threshold to the narrative of how Selwyn investigated, mourned, and commemorated his father’s death, finally revaluing it as central to the person and doctor he became.

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Annotated by:
Aull, Felice

Primary Category: Visual Arts / Visual Arts

Genre: Multimedia

Summary:

The journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC) in Atlanta, features artwork on its cover. Under the guidance of managing editor, Polyxeni Potter, these images are selected to enhance the journal's communication of its scientific public health content. Among the goals that govern the choice of its cover art are the editors' intention to illustrate ideas, stimulate the intellect, and fire the emotions (personal communication).

Acompanying each image is a one-page commentary on the artist, the topic depicted, and its relevance to infectious disease. Cover art (and commentary) from past issues can be accessed from the title page of each current issue.

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