Showing 131 - 140 of 629 annotations tagged with the keyword "Survival"

My Sister's Keeper

Picoult, Jodi

Last Updated: Nov-22-2009
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel follows, in a roughly temporal manner with flashbacks, the evolution of the illness of a child afflicted with promyelocytic leukemia and her family's attempt to save her. At core is the issue of conceiving a child with the hope that she (Anna) will be able to provide what her older, ill sister (Kate) needs to survive. The initial need is met by cord blood transfusion, however, as time passes, Kate relapses, and technology makes new demands on the obligatory donor.

Eventually Anna, at age 13, requests emancipation from the health care control of her beleaguered parents. The reader is introduced to the dilemma as the adolescent donor seeks legal help. Over the course of the novel, which is structured with a revolving first person viewpoint, the reader becomes acquainted with the personal perspectives of many characters, but with no warning of the ultimate outcome of the family drama.

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In Dirty Details, Marion Deutsche Cohen writes about the unrelenting labor entailed in caring for her husband Jeffrey at home as multiple sclerosis turns his symptoms from "mere inconveniences" (11) to extraordinary demands, which can disturb her sleep as frequently as twenty times a night.  The premise of her unsparing narrative is that "we have got to spill the dirty details" (26) of such arrangements before the endurance-draining responsibilities of home care such as hers can be understood and redressed.  In a culture that favors narratives of seemingly heroic individual effort, Cohen's brutally forthright descriptions of the effects of Jeff's needs on her life can be mistaken for a self-pitying complaint, rather than an urgent, revelatory, political call to action.  Like her husband, a well-published physicist at the University of Pennsylvania when diagnosed with MS at age 36 in 1977, Cohen is an accomplished professional.  With a PhD in mathematics, Cohen teaches college students as well as publishes poetry and prose.  She and her husband also shared, with increasing asymmetry, the parenting of their four children.                 

Cohen captures the wearying routine of her days in her narrative's echoing refrain, "nights, lifting, and toilet."   The nights refer to Cohen's dangerously disrupted sleep.  Her husband's respirator can sound every half hour or so, inciting her to worry "about the psychological effects of seldom being allowed to finish my dreams" (23).  (When she asks if the machine can be fixed, she's told that it's supposed to behave that way.  By implication, so is she, despite the toll on her well-being.)  Yet she daily rallies the strength to lift her husband on and off the toilet, a feat, among others, that sometimes defied the powers of several hospital nurses working together.   Toilet also means responding to Jeffrey's regular calls to her to drop what she's doing, run upstairs, and bring him a jar.  The jar at least relieves her from lifting.  She experiences only intermittent relief, however, from finding and keeping home health aides who are able to show up reliably and behave civilly during the few hours per day they can be funded.  What results from these tests of human stamina, Cohen tells us, is not "ordinary stress" that some optimistically believe can be managed by taking stress reduction workshops, but rather "dire straits."  "Calling dire straits stress," she corrects, "undermines well spouses and makes us feel alienated and confused about where we stand" (32). 

It's that standing in the broadest sense of the word that Cohen's book most searingly addresses.  While Dirty Details contains one woman's account of caring for a disabled husband at home, the book's wider purpose is to make the labor of family caregivers visible with all its strains, conflicts, messiness, failures, anger, and, at times, humor.   As the straights become increasingly dire, though, Cohen writes about what happens to love as she moves from sustaining tenderness, candor, and their physical intimacy to diminishing her compassion for Jeff and saving herself:  a "pure survival instinct" (87).   After sixteen years in his family's care, Jeff at first reluctantly enters Inglis House, a residence that provides as much independence as possible for those who cannot live independently, where he continues to write and publish.  Cohen's professional life, social life, and beloved parenting once again flourish.  The story she is freed to write (illustrated with photographs by Anna Moon taken with Jeff's consent) lead readers away from her particular circumstances toward a comprehensive interrogation of social and medical systems that operate by leaving the most chronically ill and disabled citizens in their families' care by default.   And leave the families in dire straits.

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The Ninth Life of Louis Drax

Jensen, Liz

Last Updated: Nov-19-2009
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Louis Drax is a nine-year-old boy living in France with his stay at home mother and Air France pilot father. Such an apparently normal family description is the merest tissue of appearances. The father is probably an alcoholic and unfaithful; the son is "accident-prone" (a nearly fatal episode of SIDS at two weeks of age, a near fatal electrocution at age 6 after falling on the tracks of the métro in Lyon; salmonella, tetanus, botulism, meningitis, etc. [or, as Louis is fond of saying, "blah, blah, blah."]) and the mother has issues that only emerge as one becomes more deeply involved in what is a mystery story.

Like Gabriel Garcia Marquez’s A Chronicle of a Death Foretold, or Janet Lewis’s superb The Trial of Søren Qvist, one knows the ending early on (page 16 in Louis Drax), but not the details. The why and the how are the stuff of the novelist’s art in all three books.

With premonition of more danger, Louis goes on a family picnic (see below for the author’s biographical basis for this tale) and winds up at the bottom of a ravine, dead. Drowned and dead. A few hours later, in the morgue, he is found to be alive. Comatose and in a persistent vegetative state but alive. He is therefore transferred to the care of a neurologist specializing in comatose patients at the Clinique de l’Horizon (formerly l’Hôpital des Incurables).

It is here that the mystery unfolds. The questions are: How did Louis end up at the bottom of the ravine? Did his father, now missing, push him as his distraught mother alleges? What role does the clearly neurotic mother play in this tragedy? And who exactly is Louis Drax? Lastly, how do the mysterious letters allegedly from him, written while still in a coma, come to be?

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Summary:

Poets on Prozac contains sixteen essays written by poets about their individual struggles with a variety of psychiatric disorders. The editor, physician and poet Richard Berlin, has gathered these essays in order to examine, and shatter, the long-standing notion that madness, particularly madness in poets, enhances creativity---we need only think of the myths surrounding writers such as Sylvia Plath and Dylan Thomas to understand how the relationship between madness and creativity might foster both fear and longing in novice writers.

In his informative and comprehensive introduction, Berlin poses these, and other, questions: "Do poets need to be mentally ill to produce great work? What is the influence of substance use/abuse? Does a person have to be 'crazy' to write good poetry? What do poets themselves define as crucial elements in their creative process?" (p. 2). He goes on to site current evidence that madness actually impedes creativity, as well as evidence that "some forms of mental illness may enhance, or at least coexist, with creativity" (pp. 4-5); he reviews the findings of researchers who have looked at "The Myth of Inspiration" and "The Myth of Very Special Talent" in creative persons (pp 6-7).

But it is in the wonderful essays themselves that we take a privileged peek into the lives, the often tortured lives, of successful poets (Berlin only considered the essays of poets who had published at least one book). Reading the essays is somewhat like eavesdropping on the therapy sessions of highly articulate and self-aware patients. Clearly Berlin has created a safe place for these writers to look again at their creative lives and how those lives intertwine with, and sometimes have been overgrown by, mental illness. All the essays, happily, come to a place of resolution; the writers find, in various degrees, that understanding or relieving their emotional distress results in the possibility of increased creativity. Along the way, they give us writing alive with metaphors, images and intelligent musings on art, poetry, life and suffering.

In the first essay, "Dark Gifts," Gwyneth Lewis writes about her depression: "I became Woman in a Dressing Gown. At my worst, the duvet on my bed looked like a body bag and I was the corpse inside it" (p. 13). Finally she concludes, "I've learned that depression is one of the most reliable guardians of my life as a poet. It's like a fuse in a house with suspect wiring" (p. 22). In his essay, Andrew Hudgins describes cortisone psychosis this way: "I was a fire station in which the alarm bells seldom stopped clanging and the firemen were exhausted and indifferent" (p. 163). In "The Desire to Think Clearly," J. D. Smith says, "Being a poet in despair does not necessarily make one a poet of despair" (p. 23). As most of the poets do, Denise Duhamel uses examples of poems within her essay to demonstrate how her illness, in this case bulimia, variously inhibited or influenced her writing. The rawness of illness shows up, again and again, in her ability to be brave and resolute in her poems: "I'm still working it out, as they say, as therapists say, as my friends say, / as I guess I'm saying now in this poem" (p. 37).

Many of the poets approach their illness histories with wry humor or pointed irony. Caterina Eppolito states that "Poetic form is an anorexic form of writing. So instead of restricting calories, I was restricting words" (p. 118). Ren Powell asks, "Maybe when it's all over I can ask my children if they think the days of dancing in the kitchen were worth the days I spent shut away in the bedroom" (p. 52). Powell, like most of the authors in this anthology, honors hard work at the craft as the measure of success, and says, "If I have any success at all as a writer it is as much despite my disorder as because of it" (p. 57). Other writers admit wondering, sometimes, if their writing success might be due to their disorders. Jesse Millner writes, "After all, wasn't it the melancholy that led me to write?" (p. 67). Most writers agree that abusing substances did not enhance but sidetracked their poetic energies, while prescribed medications often, as Jack Coulehan says, helped: "The obsessive traits softened, so I felt free to approach life in a more flexible manner. Despite this new experience of freedom, my productivity did not suffer; in fact, it increased" (p. 101).

The chemical basis for some mental disorders is acknowledged in many of the essays. In her discussion of postpartum depression, Martha Silano notes, "I'd simply woken up in a foreign country without a map, without a dictionary, with no way to understand this strange place" (p. 142). Silano, like others in this collection, found that once the chemical imbalance was corrected, something good happened to the writing---she moved from writing about her own personal experience to writing that reached beyond her fears: "Now I was writing poems with a more universal, all-encompassing vision" (p. 146). Liza Porter says it this way: "Voice comes from safety. Silence becomes words. The truth can be told" (p. 153). But the downside of medication is admitted as well. Chase Twitchell laments the loss of "metaphor-making," and compares it---in quite a fine metaphor---to someone turning "off the spigot" (p. 176). "It takes longer and requires far more doggedness than it did before medications" (p. 176). But medications also give many of these poets what Vanessa Haley names "the emotional insight and stamina to write" (p. 76). If these excellent essays are any indication, they are, and will continue to be, writing extraordinarily well.

 

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The Oath

Baiev, Khassan

Last Updated: Nov-15-2009
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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Titicut Follies

Wiseman, Frederick

Last Updated: Nov-12-2009
Annotated by:
Jones, Therese

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Titicut Follies is the first major, full-length documentary by Frederick Wiseman, generally considered to be the most successful independent filmmaker in the United States.  Titicut Follies (the title of the film is taken from an annual talent show produced by inmates and staff) was filmed at the Massachusetts Correctional Institution in Bridgewater, Massachusetts, a sprawling facility of four divisions with four distinct populations.  Of the two thousand men warehoused there in the 1960s, only fifteen percent had ever been convicted of a crime, yet the institution was administered by the Department of Corrections rather than the Department of Mental Health--units representing very different and contradictory goals.  At the time of the filming, there were only two psychiatrists and one trainee caring for the six hundred men in the hospital section. 

Wiseman believed that public awareness of the terrible conditions at Bridgewater would create a demand for reform and improvement, and he gained unlimited access to the facility by representing the project to administration and staff as educational.   The result is a bitterly critical, shockingly brutal documentary account of the prison hospital, and despite giving Wiseman permission to make the film, the Commonwealth of Massachusetts quickly moved to ban its release.  In September 1967, just days before it was scheduled to be screened at the New York Film Festival, the attorney general filed an injunction that would permanently forbid Wiseman from showing the documentary to any audience.  In 1969, the Massachusetts Supreme Court permitted limited use for doctors, lawyers, health-care professionals, social workers and students, and in 1991, the courts finally allowed its release to the general public.  Titicut Follies is the only American film whose use has had court-imposed restrictions for reasons other than obscenity or national security.

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Not quite the familiar home-for-the-holidays genre of a dysfunctional family, this one has a twist.   April is a late-teen "problem" daughter who has run away to New York City where she lives with her boyfriend, Bobby (Derek Luke).  April, played by a grungy, pigtailed, and probably tattooed Katie Holmes, has invited her parents, siblings, and grandmother to Thanksgiving dinner.  This reunion, we gather, is the first since April left home.  The family is coming to her lower East Side tenement, a situation that bristles with possibilities.  

Moving back and forth from April's low rent apartment to tension in the crowded car as it moves from a scenic suburb to cityscape, viewers are able to watch both April's unskilled efforts as she struggles with the slippery turkey, a can of cranberry sauce, crepe paper decorations, a broken oven, etc. and an inexplicable drama slowly unfolding in the crowded car.  In spite of crisis situations in both settings, the separate family members do get together for a dinner that neither could have planned. 

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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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