Showing 121 - 130 of 937 annotations tagged with the keyword "Suffering"

Annotated by:
Bruell, Lucy

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Extremely Loud and Incredibly Close, directed by Stephen Daldry, features an all star cast including Tom Hanks, Sandra Bullock, Max Von Sydow, Zoe Caldwell and John Goodman, but the true star is Thomas Horn as ten year old Oskar Schell who loses his father on 9/11.  The film opens at his father's funeral; Oskar refuses to leave the limousine-- the coffin is empty, and without his father's body to mourn, death remains an abstraction.

Oskar refers to 9/11 as the "worst day."  First to arrive home on 9/11 from early dismissal at school, he hears the last phone messages from his father who is waiting for the firemen to rescue him.  Before his mother comes home, he swaps the answering machine to keep the messages hidden from his mother and grandmother, possibly to protect them from hearing the anguish in his father's voice or to preserve the special relationship he had with his father.  In a flashback we learn that Fred Schell, an amateur scientist, is concerned about his son's timidity. To help Oskar overcome his shyness, he invents searching expeditions that require Oskar to talk with others. One involves a search in Central Park for clues to the lost sixth borough of New York City.  Oskar's skill at tracking clues comes into play when he finds a key labeled "Black" in his father's belongings and begins a search that he hopes will lead him to discover something his father meant for him. 

The film is adapted from the novel of the same title by Jonathan Safer Foer.  The storyline has been streamlined for the screenplay, but the emotional turbulence that permeates the lives of the Schell family is exquisitely portrayed.  Sandra Bullock as the grieving widow must deal with her son's rage that it was she who was spared instead of her husband.  Despite her overwhelming grief, she watches over Oskar in a way that allows him to experience the search on his own, and it is only later that he discovers that she watched his every move, out of love.  Oskar will never get his father back, but he is able to come to terms with the loss and to move ahead with his father's silent encouragement always close at hand.

Max von Sydow plays Oskar's long lost grandfather, a character that was fully developed in the novel but not in the film. For instance, his refusal to speak, answering questions with a "yes" and "no" tattooed on either hand and writing on a pad for more explicit responses, remains a mystery that begs for further explanation.

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Blue Nights

Didion, Joan

Last Updated: Dec-22-2011
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Joan Didion's memoir, The Year of Magical Thinking, chronicled the overlap of two catastrophes: the critical illness of her adopted daughter Quintana Roo and the sudden death of her husband of forty years, John Dunne. Between the writing of that memoir and its publication in 2005, Quintana died at age 39. She had suffered a 20 month illness which started as a flu, advanced to pneumonia and sepsis, with intracranial hemorrhage and other complications necessitating 5 surgeries and extended intensive care unit stays. Blue Nights is a meditation on Quintana, and her mother's consuming sense of loss over the tragedy of her only child.

Blue nights refer to the quality of the light during evenings around summer solstice, a time of year which the author feels starts the whole cycle of diminishment and death. The memoir begins with a reminiscence of Quintana's wedding in July 2003 (the same year she falls ill and Dunne dies), as seen 7 years on by Didion. Throughout the description of the wedding are particulars of dress, flowers, design choices and locale which are not only precise, but also hold tremendous meaning to Didion. The branding of clothing, furniture, dishware, hotels etc, is dominant in many parts of the book - the Didion-Dunnes' family life was filled with movie stars, glamorous restaurants, and the hard work of writing. We see Didion on book tours and backstage during the Vanessa Redgrave one woman show of A Year of Magical Thinking.

Although Quintana's death and dying are prominent in the book, her whole life is explored. Issues of her adoption, her mental illness(es), her precociousness and talents, and above all, her relationship with her mother are intimately explored. The reader is given her childhood poems and descriptions of her nightmares and toys.

Another prominent theme is aging. The author was born in 1934, the same year, she notes, as Sophia Loren. Didion experiences neuromuscular problems and describes a particularly frightening episode of loss of consciousness and bleeding. She fears the deterioration of her cognitive abilities and laments she is unable to gain weight. She has a supportive and loving family and network of friends, but ultimately she ponders her aloneness, the lack of someone's name to write down on hospital forms as her emergency contact.  

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is a huge and wonderful book about cancer, the collection of diseases that sickens people all over the globe and kills many of them. An epigraph to the book states, “A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer,” but the book also describes medical advances that now heal, prevent, or palliate most forms of cancer.

Mukherjee, a cancer physician and researcher, has several strong themes. He sees cancer as an affliction with a long history, a story worthy of a biography; indeed recent discoveries show it to be rooted in our genes (although external factors such as viruses, asbestos, and tobacco smoke can cause genetic disruption). The story of cancer implies a surrounding triangle, the stories of sick people, treating physicians, and biological researchers, all of which Mukherjee artfully weaves across 472 pages. Cancer has Rohrschach blot qualities: depending on time, place, and role in life, humans have perceived different attributes of cancer. As the book ends, however, there is a coalescence of scientific understanding that is satisfying—although there is certainly more to be learned and we are all still vulnerable to genetic errors and, of course, we are intractably mortal.

Another strand is the nature of stories themselves, their twists and turns, presumed early solutions, and personal and social values embedded in them. Mukherjee threads throughout the book the case of a contemporary kindergarten teacher, Carla Reed, who has a leukemia. He bookends his text with ancient Persian Queen Atossa with (presumably) breast cancer. Reed, healed by the end of the book, was Mukherjee’s patient; Atossa was described by Herodotus: both suffered emotional turmoil because of their disease.  Mukherjee understands the affective dimensions of disease for patients and caregivers alike; literature represents these in various ways, and he quotes in his chapter epigraphs and in his prose many writers who describe human experience deeply: Aleksandr Solzhenitsyn, Susan Sontag, Charles Dickens, Thomas Mann, William Carlos Williams, Carlo Levi, and Italo Calvino, to name a few.

The primary story, however, is the interplay of cancer and a large cast of observers, investigators, doctors, scientists, activists, and government officials. Sidney Farber and Mary Lasker dominate the first 100 pages with their two-decade war against cancer. While surgery—historically dramatic and disfiguring—had been a mainstay for treatment of cancer, Farber pursued a biochemical route, which elaborated into chemotherapy, the second major approach of the late 20th century.

Mukherjee also explains ancient views, Hippocrates’, Galen’s humors, Vasealius’ anatomy, Hunter’s stages, Lister’s antisepsis, and Röntgen’s X-rays, which became the third major approach. By 1980, however, the American “War on Cancer” had not been won.

Further advances in cellular biology and genetics would be needed to make targeted molecular therapy possible.  Mukherjee tells this complicated story clearly and engagingly, showing the human investigators to be personable and dogged in their pursuits.  

Another important approach is prevention. The biostatistical work of Doll and Hill, for example, showed the links between tobacco and lung cancer. Screening, such as Pap smears and mammograms, also saved lives, but the basic cellular understanding still eluded investigators.

The final 150 pages explain the search for and discovery of genetic factors, specifically oncogenes. Harold Varmus and J. Michael Bishop were the leaders, winning a Nobel Prize in 1989. Bert Vogelstein, Judah Folkman, Robert Weinberg and Douglas Hanahan took the work further, opening the doors for such drugs as Herceptin, Gleevec, and Avastin. 

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Haunted by his past actions and wartime experiences, the narrator empties his soul to a silent stranger - a woman sitting and drinking with him at a bar in Lisbon. He tells her about his participation in the colonial war between Portugal and Angola in the early 1970's. He admits to the conflict that still rages inside him. Six years earlier, as a physician in his twenties, he was drafted and shipped 6,000 kilometers from home for a slightly more than two year stint as an army doctor. He left behind a pregnant wife.

While in Africa, he witnessed the waging of a crazy war and was called upon to patch up its many casualties. He describes the maiming, inhumanity, and death that he observed. Questions about political power and morality trouble him. In the midst of this horror, he becomes increasingly cynical and skeptical. On his return home, the narrator acknowledges that he has lost part of himself in Africa. He gets divorced, feels hopeless, and is incapable of shrugging off loneliness.

He and the woman leave the bar and go to his apartment where they have a sexual encounter. She has been an adept listener. The narrator's lengthy confession may have been therapeutic for him. But like everything else in this doctor's post-military service life, any solace is brief. The war has polluted him, and he struggles to clean up the mess.

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Summary:

As the film opens, Gianni (Kim Rossi Stuart) prepares to meet for the first time the child he fathered 15 years earlier. The boy, Paolo (Andrea Rossi), was born with cerebral palsy and is of below average intelligence as well as being physically handicapped. Paolo's 19-year-old mother died when he was born, and Gianni could not bear to see the baby, or to have any subsequent contact with him. Paolo has been raised by his uncle, the dead woman's brother. Now Gianni, who lives in Milan with his wife and baby, prepares to take Paolo to a rehabilitation facility in Germany.

Paolo is trusting and does not question Gianni's long absence from his life. He manages to walk with the help of a cane, and tries to function as independently as he is physically capable of. When Gianni tries to feed him with a fork, Paolo responds by feeding Gianni instead. Many such small gestures that Paolo makes towards Gianni loosen Gianni's reserve, and each begins to respond to the other with affection.

In Germany, neither Gianni nor Paolo understand the language--in this they are equally disadvantaged. Gianni meets Nicole (Charlotte Rampling), mother to a teenage girl whose palsied speech impairment makes her unintelligible to anyone except Nicole. From the way that Gianni interacts with Paolo, Nicole senses that Gianni is Paolo's father, although Gianni at first denies it, claiming he is a friend of the family. When Gianni finally is truthful with Nicole, and worries about how Paolo will survive as an adult, she warns him that suffering is inevitable for the parent of an impaired child.

Gianni is horrified by the intensive physical therapy regimen to which Paolo is subjected in the German rehab facility, and removes the boy from therapy. He decides to bring Paolo home with him, but as they are driving back to Italy, Paolo "acts out" and Gianni realizes to his great sorrow that Paolo wishes to return to his uncle and live as he has for the first 15 years of his life. He has the keys to the house he grew up in and doesn't want to give them up.

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A Question of Power

Head, Bessie

Last Updated: Nov-18-2011
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In this autobiographical novel, written while the author was under severe mental strain and as she recovered from psychotic breakdown, Head tracks the protagonist Elizabeth’s struggle to emerge from the oppressive social situation in which she finds herself, and from the nightmares and hallucinations that torment her. Elizabeth, like Bessie Head, was conceived in an out-of-wedlock union between a white woman of social standing, and a black man--a union outlawed by her country of birth, South Africa.

Like the author, Elizabeth leaves South Africa with her young son--but without her husband, from whom she is fleeing--to live in neighboring Botswana, a country that has escaped some of the worst evils of colonial domination. But in rural Botswana she is once again faced with a constricting social system as the African villagers are suspicious of her urban ways and frown upon her individualistic behavior. Further, they bear her ill will on racial grounds because she is light skinned like the "bushmen" who are a despised tribe there.

Elizabeth suffers not only social isolation but intellectual deprivation as well. One of the few people with whom she can converse as an intellectual equal is the American peace corps volunteer, Tom, who acknowledges that "men don’t really discuss the deep metaphysical profundities with women" (24). During the four years in which Elizabeth is plagued by tribal suspiciousness, terrifying dreams, economic hardships, and two hospitalizations for mental breakdown, it is Tom, and her own love for and obligation to her young son that help her to survive this ordeal.

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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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Townie

Dubus III, Andre

Last Updated: Oct-13-2011
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir spins out in detail the despair and violence that emerges from a childhood of poverty and parental absence. When Dubus was preadolescent, his writer father of the same name (see Andre Dubus), took up with a student of his, and the parents divorced. Andre's mother became a social worker, working full-time with no support system, exhausted. Although Andre's father lived nearby and paid child support, it was never enough to keep the four children and their mother out of poverty. They moved frequently, always to the rough sections of depressed Massachusetts towns on or near the Merrimack River. The memoir describes vividly the smells of the polluted river; garbage strewn lawns; smoky, raucous bars; afternoons and evenings spent aimlessly watching television and, in adolescence, neighborhood kids and punks doing drugs and sex in Andre's home - before his mother arrived back from work each evening  .

At school, in bars, and around the neighborhood, kids and adults beat each other up - violence was a constant. Andre was slight and fearful but also drawn to watch the frequent fights. He avoided direct involvement when he could, was beaten up when he couldn't, and loathed himself in either case. He felt like a non-person: "There was the non-feeling that I had no body, that I had no name, no past and no future, that I simply was not. I was not here" (78). Finally, after being unable to help his brother during a fight, Andre resolved to build himself up physically--lifting barbells, bench pressing, and eventually taking boxing lessons.

Now when there was the threat of a fight, he plunged in quickly, inflicting damage. He could defend himself and those he cared about. But always there was the need for vigilance and the need - frequently actualized - to explode in rage. Later, he came to realize that being quick to jump into fights was a way "to get out what was inside him. Like pus from a wound, it was how [I] expressed what had to be expressed" (191). Gradually Andre came to think there might be other ways "to express a wound."

In the second part of the memoir, Dubus writes of how that other way evolved into creative writing. Training for physical prowess had imposed some discipline in his life, which meant being able to concentrate in school, do homework, and read. There were stints in and out of college (eventually he graduated from the University of Texas in Austin), making ends meet as a gas station attendant, construction worker, fast food manager, bartender, and later-- halfway house counselor. At the local Massachusetts college he attended for a while, he overheard himself being called a "townie." He navigated at the interface of the old neighborhood where he still lived and the life of the more privileged. He became more self-aware, more interior, and at the same time, more interested in the larger world. Threaded throughout this period is a developing relationship with his father, whose writing he admired and whose approval he craved.

In spite of the author's ambivalence toward his father - "where were you when I needed you?" (333)--one probably cannot overestimate the role that the senior Dubus played as a writer model for his son. Dubus read and admired his father's stories. He saw the discipline required to write, even though Dubus senior's weekends were often spent unwinding in bars (sometimes with the younger Dubus). Andre met his father's academic colleagues, met other writers, met writers who had stable relationships with a spouse.

He even learned that a writer can be a sports fan (Boston Red Sox), and avid sports participant (jogger). One of the most moving chapters in the book describes the first baseball game Dubus ever attended or watched - at age 13 - (with two tickets from his father), to see the Red Sox play the Yankees in Boston. Dubus went with a friend who explained the game to him as it unfolded. Dubus was stunned: "Every time one of them walked up to home plate with his bat, hundreds of men and boys would yell insults at him I couldn't quite make out, just the tone, which I knew well, but it wasn't directed at me or anyone I would have to try to protect, and I felt relieved of everything, part of something far larger than I was, just one of thousands and thousands of people united in wanting the same thing, for those men from our team to beat the men from the other team, and how strange that they did this by playing, that one beat the other by playing a game" (161-162).

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Annotated by:
Bruell, Lucy

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Extremely Loud and Incredibly Close takes the reader inside the mind of nine year-old Oskar Schell who lost his father in the collapse of the Twin Towers.  Oskar lives with a terrible secret − on that day he arrived home from school shortly after the planes hit the towers and listened to messages from his father on the answering machine.  Hoping to protect his mother from the awful truth and not wanting to face his own helplessness − after all, his father was usually at his jewelry store, and it was just a tragic coincidence that he was attending a meeting at Windows on the World − Oskar hides the machine and replaces it with a new one.  In the days that follow, he accompanies his mother and paternal grandmother to the cemetery with his father’s empty coffin and vows to find out all he can about his father’s death.

Oskar begins by searching his father’s closet.  In a blue vase he finds an envelope with the name “Black” written on it and a small key inside.  Determined to find the lock that this special key will open, Oskar sets out on a journey through the city, contacting all of the Blacks in the telephone book.  As he searches for clues about his father and tries to make sense of a world transformed by terrorism, he connects with people who are enveloped in their own grief and overwhelmed by the world outside themselves. 

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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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