Showing 121 - 130 of 385 annotations tagged with the keyword "Narrative as Method"

How Doctors Think

Groopman, Jerome

Last Updated: Aug-06-2007
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In How Doctors Think, Jerome Groopman explores clinical decision making with a particular emphasis on the poor communication skills and cognitive errors that often lead to misdiagnosis and inappropriate treatment. He uses a narrative approach, filling the book with compelling stories that illustrate the world of patient-physician interactions. Why did a second doctor quickly conclude that Blanche Begaye suffered from aspirin toxicity, while her first doctor mistakenly diagnosed viral pneumonia? Why did several physicians fail to diagnose Maxine Carlson's ectopic pregnancy until the day it ruptured? Groopman's storytelling skill permits him to convey complex concepts (e.g. availability bias, anchoring, and Ockham's razor) through conversation and narrative.

Three major themes run throughout the book, and each is presented with several variations. The first theme is that doctors who don't listen to their patients are likely to make serious mistakes in diagnosis and treatment. The second is that doctors frequently don't have the self-awareness to understand their own errors, especially those that involve dealing with ambiguity and understanding the importance of emotions. The final theme is that that patients ought to be active participants in their own care. This is not a new message, but Groopman frames it in a new way. Given the complexity of clinical decision making, and the many cognitive errors physicians may fall prey to, patients can improve their own care by helping their doctors minimize or avoid such errors. Among other things this means asking thought-provoking questions like "What else could it be?", "What is the worst thing it could be?," or "Is it possible I have more than one problem?"

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When the Emperor Was Divine

Otsuka, Julie

Last Updated: May-25-2007
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This short novel tells the story of a Japanese-American family’s internment during World War II. They are living comfortably in Berkeley, California, when their nightmare begins. Soon after Pearl Harbor the husband/father is arrested by the FBI--taken away in his housecoat and slippers. We learn of this through the narration of the eight-year-old son, his ten-year-old sister, and their mother--who are rounded up several months later and sent to a camp in Utah. The father remains shadowy--a figure of memory, wishful thinking, and censored letters stamped "Detained Alien Enemy Mail." The reason for his arrest is never explained, as if there is no reason to question the man’s loyalty.

After her husband’s arrest, the mother is left to take care of her children and the house. A few months later she must pack up the household belongings, give away the family cat, kill and bury the family dog, tell her daughter to let loose the pet macaw. They are allowed to bring with them--where to they do not know--only what they can carry. They take an endless train ride through the Nevada desert to reach an internment camp in Utah, "a city of tar-paper barracks behind a barbed-wire fence on a dusty alkaline plane high up in the desert" (49).

Here they remain until the war ends, some three and a half years later. They learn to live in one room with a single light bulb; to stand on line for everything; to eat in the mess hall; to avoid rattlesnakes, scorpions, and the sun; and to "never say the Emperor’s name out loud" (52). They are unable to avoid the desert dust that covers and gets into everything. The children attend makeshift classes, play cards, are bored, lonely, and confused. The boy misses and has fantasies about his father, the girl reaches adolescence and becomes cynical, the mother is too depressed to eat or read.

At the end of the war, the three are allowed to go home "with train fare and twenty-five dollars in cash" (117). Their house has been vandalized; neighbors, teachers, and classmates either ignore them or are openly hostile. Finally their father is released from detention in New Mexico, a changed man both in appearance and spirit.

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Memoirs of Hadrian

Yourcenar, Marguerite

Last Updated: May-25-2007
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Memoirs of Hadrian is a historical novel in the form of a long letter written by the Roman Emperor Hadrian to his young friend and eventual successor, Marcus Aurelius. Alas, Hadrian is "growing old, and is about to die of a dropsical heart." The Emperor begins by describing his recent visit with his physician Hermogenes, who "was alarmed, in spite of himself, at the rapid progress of the disease" (3). In light of his physical deterioration, Hadrian begins to reflect on his life and work, and to share his wisdom with his young correspondent.

Hadrian tells of his early life as the protégé of the Emperor Trajan, his military and political victories, and his eventual adoption by Trajan, a move that guaranteed the succession when his adoptive father died. While Trajan, whose victories brought the Roman Empire to its greatest size, was a military man to the core, Hadrian considers himself essentially peace loving--his personal life devoted to simplicity and harmony; and his public life to prosperity and justice. Nonetheless, he has always recognized that, in order to govern effectively, ruthless action is sometimes required.

Hadrian's marriage to the Empress Sabina was simply a matter of convenience. The love of his life was a beautiful young man named Antinous. The two men were deeply committed to one another, but at the same time the middle-aged emperor had "a certain dread of bondage" ( 177) that kept him from fully giving himself to Antinous with the abandon of youth. They were visiting Alexandria when the despondent Antinous committed suicide in a way that mimicked a religious ritual, essentially sacrificing himself to the deified Emperor.

Hadrian was crushed with grief and descended into a long period of depression. However, he eventually overcame his depression through his love of literature and ideas, as well as his sense of duty to the Empire (no SSRIs being available at the time), although not before attempting to enlist his physician in assisted suicide. Unable to refuse his emperor's request, the physician himself commits suicide rather than violating his Hippocratic Oath.

Hadrian's final military engagements involve crushing Jewish insurgents in Palestine, completing the destruction of Jerusalem, and founding a new Roman city on its site. The aged Emperor reflects frequently on his tolerance for all religions, except for politically disruptive fanatics like the followers of a Jewish prophet called Christ. As to the Jews in Palestine, he cannot understand why they continue to engage in self-destructive rebellion, most recently with Bar Kokhba and Rabbi Akiva as their leaders.

In his final years Hadrian adopts Lucius, one of his former lovers (in this account), as his son and heir, but Lucius soon dies, presumably from tuberculosis. Eventually, the Emperor adopts Antinous Pius as his heir and further arranges for Marcus Aurelius to succeed Antinous Pius. At the end of his letter, Hadrian writes, "I could now return to Tibur, going back to that retreat which is called illness, to experiment with my suffering, to taste fully what delights are left to me, and to resume in peace my interrupted dialogue with a shade." [i.e. Antinous, his lost love (271)].

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Summary:

This remarkable collection of short writings, introduced by renowned poet Naomi Shihab Nye, who visited the Sutterwriters (of Sutter Hospital in Sacramento, California) to offer a workshop, provides a broad, compassionate, imaginative window into the life inside and around an urban hospital. Patients, staff, and all interested in healing through writing are invited to come and participate-with an accent on the latter: no one is invited who isn't willing to write.

Chip Spann, the editor, came to Sutter Hospital with a Ph.D. in English, and has the privilege of coordinating this fluid community of writers as part of his work as a staffmember. His conviction, voiced in an engaging introduction, is that literature is a powerful instrument of healing--both the literature we read and the literature we create--and that the experience of literature belongs in community. The individual pieces are accompanied by photographs and short bios of contributors.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A group of eight women gather for a joint consultation with Dr. Kailey Madrona who is a devotée and colleague of the research endocrinologist, Dr. Jerilynn Prior, a professor at University of British Columbia in Vancouver. Madrona explains that she has arranged for the unorthodox group encounter because she will be leaving practice to pursue graduate studies in medical history.

Dr. Madrona leads an open-ended discussion on the physiological changes associated with perimenopause. Following the controversial research of Prior, she emphasizes that the symptoms are owing to the unbalanced rise in estrogen levels during perimenopause—a period leading up to the cessation of menstruation and continuing for twelve months after the last flow.

Some women patients are skeptical, because they have been placed on estrogen ‘replacement” medication, or they have read that their symptoms are owing to the waning of estrogen. The doctor describes the results of various trials about supplmentary estrogen, including the 2002 Journal of the American Medical Association report. She invites them to keep detailed diaries of their cycles and symptoms.

One by one the women return for private consultation, physical examination, discussion and another follow up visit. Although they have reached roughly the same physiological moment in life, they are a diverse group with different symptoms and needs. Darlene, an angry nurse, is suspicious and non-compliant. Beverley, an Asian immigrant is still hoping to become pregnant. A lesbian wishes to control her moods and hot flashes. A very hard-working waitress needs to understand her strange lack of energy. A wiry, lean athelete wants to improve her performance and is irritated by the inexplicable alterations in her abilities. Others are plagued by sweats, nausea, or migraines. They all are confused about sex.

Dr. Madrona listens to them carefully, examines them with special attention to their breasts, not their genitalia, and recommends treatment with progesterone for everyone. She also urges weight gain for most and readily volunteers personal information about her own perimenopause. All but the nurse eventually comply and are relieved of their symptoms. At the end of a year they meet for a pot-luck dinner to celebrate their recovered health and thank their doctor. Beverley is pregrant.

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

West coast dancer John Henry made his life the subject of his final performance. Choreographer Bromberg and film maker Rosenberg collaborate with Henry in the creation of a work for the theatre based on his desire to leave an autobiographic legacy. Filmed during the last few years of Henry's life with HIV/AIDS, the documentary examines the image of self as one individual prepares to separate from body and personhood, and continues after his death.

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Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Japanese American artist Henry Sugimoto depicted life in the Arkansas internment camps into which he and his entire family (including wife and child) and many others of Japanese descent were forced, following the Japanese attack on Pearl Harbor in 1941. Sugimoto's life and his painting were profoundly influenced by his incarceration experience during World War II. During and after this period his subject changed from landscapes to scenes of camp life and the Japanese emigration/immigration experience; these works often had social and political purpose.

In the foreground of this painting, her back to the viewer, a woman waves a handkerchief in farewell to her husband, who wears an army uniform. The children wave goodbye with her as their father turns around to wave back. The road on which the soldier walks is flanked by the barbed wire of the camp, and in the distance stands a watch tower. The woman and her children are separated from the husband/father by a sign that seems suspended in front of them and says in large letters, "STOP." A guard soldier with bayonet stands next to the woman and children, facing them and the viewer with a stern expression on his gray-white face.

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When Can We Go Home?

Sugimoto, Henry

Last Updated: May-17-2007
Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Japanese American artist Henry Sugimoto depicted life in the Arkansas internment camps into which he and his entire family (including wife and child) and many others of Japanese descent were forced, following the Japanese attack on Pearl Harbor in 1941. Sugimoto's life and his painting were profoundly influenced by his incarceration experience during World War II. During and after this period his subject changed from landscapes to scenes of camp life and the Japanese emigration/immigration experience; these works often had social and political purpose.

In the center of this painting stands a woman bending down toward a young girl who is facing her. Both are wearing colorful (yellow and red, respectively) dresses and the girl is wearing boots. The child stretches her right arm toward the woman while her left arm points upward toward structures --a suspension bridge, parts of buildings --that are angled, overlap each other, and are placed within a light blue background.

What appear to be two transparent light beams emanate at an acute angle from the right vertical border of the painting. The angled beams and the angled overlapping buildings simultaneously break up the picture and unite its various elements. In the lower left corner a coiled rattlesnake stretches its head toward the child, while in the lower right corner, a squirrel is sitting on a log viewed end on, an ax resting propped up against the log. A large sunflower stretches along the right vertical border of the picture toward the triangle of the upper right hand corner. In this triangle is the ubiquitous watch tower of Sugimoto's camp paintings, tilted (see "Send Off Husband at Jerome Camp" and "Nisei Babies in Concentration Camp" in this database); a camp building, green trees, and a dark blue-black sky through which a lightning bolts tears vertically.

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Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

A man wearing a dark suit and shirt with clerical collar, his head bowed, knees buckling, his forehead and cheek dripping blood, is being held from behind by a young man whose arms reach under the cleric's shoulders to restrain him. To the left of these two men, and moving into the center of the picture with his lifted outstretched leg, a third man, his sleeves rolled up to reveal his muscular arms, punches and kicks the cleric. All three have Asiatic features.

In the background is a drab gray wooden building that says "Mess" while in the foreground a small wooden stake carries a sign saying "Block." The cleric's hat and glasses have tumbled to the ground next to his feet, and a book that appears to be a bible also lies there. The ground, like the Mess Hall, is drab and colorless; the sky is a bleak darkish brown.

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Painting

Bacon, Francis

Last Updated: May-17-2007
Annotated by:
Bertman, Sandra

Summary:

The foreground of Painting features a man dressed in a black suit and holding an umbrella. His face, hoary and grotesque, is obscured above his moustache by the shadow of an umbrella. A yellow flower attached to the lapel of the man's jacket stands out clearly against the black of his clothing, and is the only yellow used in the painting.

The man sits or stands inside a round enclosure made either of white metal or wood. Around the perimeter of these circular bars, two pieces of meat--what appear to be shanks of beef--are penetrated and supported by the enclosure. In front of the man, a platform of some sort extends toward the viewer. Behind him hangs a massive carcass, its limbs suspended outwards to expose the ribcage.

Three rectangular shapes that seem to be window blinds hang with cords behind the suspended meat. In the middle of the painting, in the deep background, abstract shapes that may or may not be human forms stand around on a catwalk.

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