Showing 111 - 120 of 338 annotations tagged with the keyword "Acculturation"

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Suzanne Poirier has studied over 40 book-length memoirs describing medical training in the United States. These texts vary in format from published books to internet blogs, in time (ranging from 1965 to 2005), and in immediacy, some reporting during medical school or residency while others were written later--sometimes many years later.

A literary scholar and cultural critic, Poirier analyzes these texts thematically and stylistically, finding pervasive and regrettable (even tragic) weaknesses in medical education. Her three major points are these: such training (1) ignores the embodiment of future doctors, (2) is insensitive to the power relationships that oppress them, and (3) makes it difficult to create a nurturing relationship--especially by tacitly promoting the image of the lone, heroic physician.

While some of these repressive features have improved in the last decade or so--in contrast to the momentous scientific progress--there is a general failure to deal with the emotional needs of persons in training as they confront difficult patients, brutal work schedules, and mortality, both in others and in themselves.

In her conclusion, Poirier describes some contemporary efforts to help medical students write about their feelings, but she also sees the negative consequences of "an educational environrment that is inherently hostile to such exercises" (169).  Her challenge is this: " "Emotional honesty is a project for all health professionals, administrators, and professional leaders" (170).

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The Ghetto

Bak, Samuel

Last Updated: Jul-18-2009
Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

A tightly walled cube-shaped block of buildings seemingly made of child’s building blocks looms in the midst of a barren foreground of stony rubble and a background of hazy nondescript sky. No sign of life, human or vegetation, anywhere. Entirely in shades of muted yellow, orange, ochre and brown, coloring suggestive of a crematorium, the canvas reeks of desolation.The only window into the tomb-like image, seen from above, is a carved cut-out star of David through which can be glimpsed a more detailed view of the abandoned ghetto. Barely visible, a pale yellow cloth remnant of the star of David stitched to their clothes to identify Jews sits atop one of the rooftop slates.

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Summary:

Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Mr. Pip

Jones, Lloyd

Last Updated: Jul-05-2009
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Thirteen-year-old Matilda lives on a south Pacific island with copper mines. Rebels and other more official warriors are tearing the place apart. A blockade has made resources scarce and communication impossible; fathers are absent at distant work. Along with everything else, the local school collapses. 

Mr. Watts, the only island white man, offers to take over the education of the children, but he has no experience, few materials and just one book: his treasured copy of Charles Dickens’s Great Expectations. He begins reading a few pages every day. Captivated by the story, the children repeat it to their mothers when they go home each night.  

Matilda believes that she loves Mr. Dickens more than anyone else and she is both bemused and irritated by her stern mother's suspicion of the strange, possibly godless, white man and her feigned disinterest in Pip. Parents are invited to the school to pass on their own expectations about learning. Students accept these moments with pride and embarrassment.

The political chaos deepens, homes are destroyed, and the book vanishes. But Watts (nicknamed Mr. Pip) turns the loss to advantage by helping the students to recover fragments in a lengthy effort of collective recollection.

The ever menacing warriors return. Little more than frightened children in an incomprehensible conflict, they indulge in senseless brutality and killing. With courage absorbed from her mother, Matilda escapes, rediscovers her father, and finds a scholarly future—a life she embraces because of Mr. Dickens and Mr. Pip.

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Deaf Sentence

Lodge, David

Last Updated: Jun-08-2009
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Desmond Bates is a retired professor of linguistics who lives with his second wife, "Fred," in a "northern" British town. He is becoming increasingly deaf, and, although he wears hearing aids (except when he doesn't), his social interactions--even those with Fred--are fraught with difficulty and occasional hilarious misunderstandings. His deafness is at the center of the novel, providing the title of this work of fiction, but also serving as an extended, often funny, but ultimately serious impetus to riff on aging, disability, and mortality. "Deafness is a kind of pre-death, a drawn-out introduction to the long silence into which we will all eventually lapse" (19).

Bates is at loose ends. His wife is busy with her successful interior decorating business, his adult children live elsewhere. He considers himself a "house husband" and does not really enjoy it. His aged, widowed father insists on living alone in London although he cannot be trusted to take care of himself without endangering his life (such as starting a fire in the kitchen during meal preparation). Bates visits him dutifully once a month with a mixture of dread, obligation, and guilty relief when it is over.

Desmond's hearing difficulty and boredom set him up for an encounter with a female graduate student and its unexpected complications. She is working on a thesis about suicide. Their interaction is threaded throughout the book and drives the "plot," but the details of life with hearing impairment, loss of professional involvement and purpose, and coping with an old, stubborn parent who is slipping into dementia are the main events of this clever, well-written, entertaining novel. And along the way are witty commentaries on contemporary life. The link between the narrator's profession of linguistics and his difficulty hearing the spoken word are also significant.

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Annotated by:
Mathiasen, Helle

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

At the request of a German editor, Charles Darwin (1809-1882) began his autobiography at the age of 67. His granddaughter and editor, Nora Barlow, tells us that he revised it over several years.

Darwin remembers little about his mother who died when he was 8, but talks at length about his forceful physician father, who measured 6 foot 2 inches, and weighed over 336 pounds. His father's success guaranteed that Charles would never have to work for a living. Darwin was a naughty boy schooled in humaneness and manners by his loving sisters. Early on, he showed a passion for collecting, mostly beetles, but also coins, shells, and minerals. He hated boarding school; he enjoyed running in the open air and shooting snipes with his dogs. He quotes his father's characterization of him as a young boy: "You care for nothing but shooting, dogs, and rat-catching, and you will be a disgrace to yourself and all your family" (28).

As a medical student at Edinburgh University, he witnessed operations without anesthesia which caused him to revolt against his father's wish that he become a doctor; he couldn't take the sight of blood.  At Cambridge, he found most of his classes and professors dull, except for his botany professor, John Stevens Henslow, his mentor and hiking companion. The paternal plan for him to become a clergyman foundered at Cambridge, as Darwin questioned the Thirty-nine Articles of the Church of England.

From 1831, he sailed with Capt. Fitz-Roy on board  The Beagle for 5 years and 3 days (again, against his father's wishes). He quarrelled with  Fitz-Roy whose mood swings required Darwin's tact. They disagreed about slavery, FitzRoy defending it, and Darwin abominating it. He carried Lyell's Principles of Geology with him, read Milton, and collected numerous specimens which he sent back to Britain.

28 months after his return, Darwin married his cousin, Emma Wedgwood. The marriage was happy and produced 10 children.

In the chapter on his religious beliefs, Darwin gives 4 reasons for believing the Old Testament to be false; as he has studied the laws of nature, he has ceased to believe in miracles. He rejects Bishop Paley's argument for intelligent design: "Everything in nature is the result of fixed laws" (87). The Christian god is cruel, as he causes innocent animals to suffer and condemns non-believers to hell. Darwin confesses he does not understand "the mystery of the beginning of all things" (94), calling himself an agnostic. He outlines the great Victorian men he has known, though his ill health has long  prevented him from traveling or seeing friends. He discusses his publications, including Origin of Species, stating he did not care whether he or Wallace got the credit for the theory of evolution. He attributes his success to his moderate abilities. He has been methodical, industrious, and commonsensical.

The appendix includes Darwin's list of pro and con arguments about marriage, Mrs. Darwin's papers on religion, and a short chapter on his illnesses.

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The Kite Runner

Hosseini, Khaled

Last Updated: Apr-16-2009
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In his debut novel, Dr. Khaled Hosseini tells a tale that begins in his homeland, Afghanistan, and ends in his adopted country, the United States. Amir, son of a wealthy Pashtun merchant, narrates the story. Amir and his father, Baba, are attended by two Hazara servants, Ali and his hare-lipped son, Hassan. Amir and Hassan are friends, but Amir is troubled by a guilty conscience over multiple slights and sly insults aimed at Hassan. The burden of guilt intensifies over an incident at a kite-flying contest when Amir is twelve years old.

Kite flying in Afghanistan is an intricate affair involving glass-embedded string that contestants use to slice the strings of other kites. The winner is not only the one with the last kite flying, but also the one who catches the last cut kite--the kite runner. At the close of the contest, Amir witnesses the traumatization of his friend Hassan, the finest kite runner, at the hands of an evil youth, Assef. Too shamed to help Hassan, Amir is nearly swallowed by his cowardice: the rest of the story follows the consequences of his guilt.

Amir and Baba emigrate to the United States during the Soviet invasion of Afghanistan, but Amir, as a young adult, returns during the Taliban regime in order to redeem himself and help Hassan's son. The story is filled with plot twists and revelations of secrets and hidden relationships, which enable Amir to confront some of his shortcomings. The oppression, torture, and murder of Afghanis by the Taliban are graphically depicted.

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Machine

Adolphsen, Peter

Last Updated: Apr-09-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novella

Summary:

In the early Eocene period, a small horse (Eohippus) accidentally dies in the depths of a lake. Over time, the body of the mare decays. Heat and pressure convert the remains of the animal into oil. Thousands of feet beneath the surface of Utah and millions of years later, that oil is tapped. As it travels through a pipeline, a nearby worker is injured. As a result of the accident, the man loses part of his arm.

The worker, Djamolidine Hasanov, was born in Azerbaijan. Before coming to the United States, he changed his name to Jimmy Nash. As a boy, he loved to bicycle. As an adult in America, his pastimes include drinking beer and writing haiku. After he is injured at work, Jimmy becomes a drifter and lives off his disability benefits.

The oil derived from the matter of the prehistoric horse continues its journey through time and space. It is refined into gasoline and transported to a gas station in Austin, Texas. On June 23, 1975, some of that gasoline is pumped into the tank of a Ford Pinto. One drop of the fuel comes from the once-pumping heart of the ancient equine.

The car is driven by Clarissa Sanders, a college student who is enthralled by biology and genetics. Later that day, she picks up a hitchhiker on a highway leading to San Antonio. The man has an accent and is missing his lower right arm. Jimmy Nash shares some LSD with Clarissa. He even drives her automobile. On the same day, Clarissa inhales some soot particles emitted in the car's exhaust fumes. They contain a carcinogen - benzapyrene. Thirty years later, she is diagnosed with metastatic adenocarcinoma of the lung. Three months after receiving the diagnosis, Clarissa dies.

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Cutting for Stone

Verghese, Abraham

Last Updated: Mar-08-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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Summary:

This survey of the history of women in medicine begins in the mid 19th century and moves forward to the late 20th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

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