Showing 131 - 140 of 625 annotations tagged with the keyword "Power Relations"
A teenager with a learner's permit drives his father to the emergency room. The father is hemorrhaging from the nose--the result of blood that is too thin and a punch thrown by his son. The father is abusive, especially when he drinks. Feeling endangered when his father shoves him, the boy retaliates by hitting the man in the face.
The father has valvular heart disease caused by a bout of rheumatic fever. He also has a cardiac arrhythmia requiring treatment with anticoagulation, but the dose of blood thinning medication must frequently be adjusted. After a frenetic ride, they arrive at the hospital and the father immediately enters the emergency room. The boy remains in the car listening to the radio and hoping the noise will somehow expunge the ugly words and perilous sentiment in his head. He discovers too late that a bloody nose can kill a man.
A college professor who suffers from Tourette's disorder deals with two challenging students in his English 101 class. Having spent years in therapy, Professor Jorge is now fairly content with his life in spite of the frequent vocal and motor tics that he labors to suppress. Allen Ramsey is the freshman prodigy who induces Jorge to reassess the implications of his existence. Anna is an undergraduate who is preoccupied with death. She has a crush on Jorge and leaves a suicide note in his office box.
One day Allen is late for class because he has a seizure. His seizures increase in frequency, but Allen doesn't mind them. He relishes them. Allen acknowledges that "It's as though I can smell my thoughts" during a seizure and "the world just changes" (170). Jorge finds Allen on the campus ground in a postictal state. He summons an ambulance, and Allen is admitted to the hospital.
When Allen returns to class weeks later, he is no longer the same person. With the use of medication and possibly surgery, doctors have abolished his seizures along with his former personality. Allen receives an "Incomplete" grade for the class. The semester's experience has Jorge lamenting Allen's shocking transformation, attempting to convince Anna of life's worth, and mulling the magnitude of his words.
When oral antibiotics are no longer effective, the narrator grudgingly consents to begin a six-week course of intravenous antibiotic therapy with Rocephin (a powerful, broad-spectrum antibiotic). She has an infection caused by spirochetes. The illness has been festering for as long as ten years but has only recently been diagnosed. It causes joint pain and stiffness. Her daughter has already been successfully treated for the same infection.
Every morning in her kitchen, the narrator performs the same ritual. She cautiously infuses the antibiotic and imagines that the golden fluid is extinguishing the corkscrew-shaped microbes. At first she experiences a drug reaction, but the event only convinces her that the treatment is actually working.
She senses that her husband and her friend are repulsed by the treatment (especially the syringes and IV apparatus). A visiting nurse, Ginger, comes to the house to perform minor maintenance on the intravenous line. She upsets the narrator with grim information about the infection and an account of a patient suffering from the same disease who is currently in awful condition. Dr. Kennicott, the narrator's physician, has not been so forthcoming about the course of the illness or pessimistic about the prognosis. The narrator chastises Ginger. Both women are now distressed. The narrator's immediate goal is to control her emotions and avoid crying.
Robert Murphy was a professor of anthropology at Columbia University when he became progressively paralyzed by an inoperable spinal cord tumor. His book is a personal journey through profound physical disability, an exploration of the self, and a study of the social construction of disability ["Disability is defined by society and given meaning by culture; it is a social malady" (4)]. As he writes The Body Silent he is virtually quadriplegic, hitting the keys of his computer with the eraser end of a pencil held in place by a 'universal cuff' wrapped around his palm. He is still traveling to Columbia to teach his classes.
Murphy applies the metaphor of an anthropological field trip to his experience: "This book was conceived in the realization that my long illness with a disease of the spinal cord has been a kind of extended anthropological field trip, for through it I have sojourned in a social world no less strange to me at first than those of the Amazon forests. And since it is the duty of all anthropologists to report on their travels . . . this is my accounting" (ix). Drawing not only on his own experience but also on research for which he received funding, Murphy instructs his audience in the metaphysics of his situation, and in the social as well as physical challenges of disability.
Professor of performance studies at New York University, Peggy Phelan narrates the story of a vision disorder that began when she was 23 years old, caused by "open-angle glaucoma," a difficult-to-treat condition in which the vessels draining ocular fluid periodically constrict. The episodes are excruciatingly painful and disorienting: "I feel a staggering push behind my right eye. The right upper half of my face is on fire: I am certain that my eye has fallen out of its socket . . . " (508).
Phelan resists patienthood, beginning with her first visit to the doctor, in which she underplays what has happened to her. Rejecting surgery, coping with side effects of the drugs she must take, and concerned about her ability to continue as a visual arts scholar, she muddles through for several years. Then she experiences a frightening, vividly described episode of temporary blindness, which is followed by a migraine headache. Six months later she agrees to have surgery.
During the surgery, under local anesthesia, "my eye, which is frozen, can still see things as they pass over it . . . colors I have never seen before . . . I am seeing the roof of my own eye from the interior side. It is utterly breath stopping. I cannot speak" (521-522). Enabled to see her eye from a perspective that was not available to the physician, and grateful for this "visionary experience," Phelan finally accepts her situation. She is not cured, although her condition improves. "My story is finally the same as those of all the other patients . . . The only difference between me and them comes from the words I’ve suffered to find and the words I’ve suffered to flee" (525).
This is a vivid, partly autobiographical tale of clinical depression and the struggle for selfhood, written by an early feminist. The story is told by means of a journal which the narrator secretly keeps against the orders of her physician-husband, who believes this intellectual effort is contributing to his wife-patient's nervous condition. The narrator, a new mother, has been brought to a country house for a "rest-cure" by her husband; he selects for her the room with the yellow wallpaper, the (former) nursery, where the "windows are barred for little children" and the bed has been nailed to the floor.
Forbidden to write and think, prescribed for and infantilized, the narrator becomes increasingly dysfunctional. She obsesses about the yellow wallpaper, in which she sees frightful patterns and an imprisoned female figure trying to emerge. The narrator finally "escapes" from her controlling husband and the intolerable confines of her existence by a final descent into insanity as she peels the wallpaper off and bars her husband from the room.
This thought-provoking book is a collection of readings which the editors have found to be particularly useful for a course they teach, "What’s Normal?" It is their intent to facilitate consideration of how the world is experienced by those who are socially marginalized because of their physical appearance. The title of the anthology derives from an article written by the literary critic, Leslie Fiedler, and reproduced as the lead-off essay. Fiedler argues that the propensity of cultures throughout history to define the normal and to make political decisions about physical "abnormality" has reached a point where the rich will perpetuate the cult of normalcy (by paying for medical treatments that ensure it) while "the poor . . . will be our sole remaining Freaks."
The anthology is divided into several sections: Part I contains nonfiction articles, essays, and excerpts from books. Part II reproduces fiction, poetry, and drama and is further subdivided into "Abnormal Weight and Eating Disorders"; "Abnormal Height-Dwarfism"; and "Deformity and Disability." Many of the pieces have been annotated individually for this database (e.g. Fat by Raymond Carver, annotated by Carol Donley and also by Felice Aull and Irene Chen; Skanks by Rennie Sparks; The Fat Girl by Andre Dubus; Weight Bearing by Patricia Goedicke; Dwarf House by Ann Beattie; The Song the Dwarf Sings by Rainer Maria Rilke; The Dwarf by Ray Bradbury; The President by Donald Barthelme; The Birthmark by Nathaniel Hawthorne; The Elephant Man by Bernard Pomerance and others).
The author, who writes and teaches nonfiction writing, began research on the lawsuit that forms the fascinating subject of this book in February, 1986. While the book focuses on Jan Schlichtman, the lawyer for the plaintiffs, and on his strategy in the case, there is much here that is relevant for health care professionals.
The lawsuit, which lasted nine years, concerned the tragic consequences of exposure to toxic waste: deaths from childhood leukemia; skin rashes, nausea, burning eyes, and other ailments. It was brought by eight families who lived in Woburn, Massachusetts against two companies, W. R. Grace and Beatrice Foods. The lawsuit claimed that these companies were liable for illnesses and deaths attributable to trichloroethylene (TCE) contamination of the water supply.
The story of how the families and the lawyers pieced together the fragments of the puzzle to determine cause and effect is gripping. One gains an appreciation for environmental epidemiology and the difficulty of reaching conclusions when only a small number of individuals are affected. Medical experts, public health specialists, geologists, civil engineers, government agencies, and the intelligence and driving motivation of the affected families and their lawyers were all necessary to establish the credibility of the claim.
In the end, however, the financial power and stonewalling of the companies, and the partiality of the presiding judge for one of the defense lawyers resulted in a verdict that favored the defense. Jan Schlichtman, the plaintiff's lawyer, was forced to declare bankruptcy.
Only when the Environmental Protection Agency (EPA) decided to launch a clean-up and filed suit against W. R. Grace and Beatrice Foods to pay a share of the cost, was any semblance of justice obtained. The EPA project will take 50 years, and even so, "all parties agree that it will prove impossible to rid the site of TCE and perc [tetrachloroethylene] completely . . . . " (Afterword; p. 494) Nevertheless, most of the families have not moved.
Editor Helman is a physician and anthropologist as well as a published author of short stories, essays, and a medical anthropology textbook. For this anthology he has selected short stories, case studies, memoir and novel excerpts whose purpose is "to illustrate different aspects of [the] singular but universal relationship" between doctors and patients (1). In the introduction he discusses how these selections illustrate storytelling in medicine; the unique experience of individual illness; differences between fast-paced contemporary technological specialized medicine, and an older more leisurely medicine where the physician employed all his/her senses to diagnose illness, doctors made house calls, and patients recovered over time, or died.
The anthology is subdivided into three parts: "Doctors," represented by the work of Mikhail Bulgakov, Franz Kafka, Sir Arthur Conan Doyle, and Rachel Naomi Remen; "Patients," represented by authors Renate Rubenstein, Ruth Picardie, Rachel Clark, Clive Sinclair, W. (William) Somerset Maugham, and O. Henry; and "Clinical Encounters," with work by Oliver Sacks, Cecil Helman, William Carlos Williams, A. J. (Archibald Joseph) Cronin, Anton P.Chekhov, and Moacyr Scliar. (In total there are 16 selections.) Each piece is preceded by a paragraph of biographical information about its author and an introduction to the text.
In this superbly written essay, Nancy Mairs, a feminist writer who has multiple sclerosis, defines the terms in which she will interact with the world. She will name herself--a cripple--and not be named by others. She will choose a word that represents her reality, and if it makes people "wince," "[p]erhaps I want them to wince. I want them to see me as a tough customer, one to whom the fates/gods/viruses have not been kind, but who can face the brutal truth of her existence squarely. As a cripple, I swagger" (9). She muses on the euphemisms that are used by others, concluding that they describe no one because "[s]ociety is no readier to accept crippledness than to accept death, war, sex, sweat, or wrinkles."
Mairs describes the uncertainty of a (correct) diagnosis early on, the kind of person she was before, and how that has changed and not changed since her illness. She discusses her need for assistance, but balances that by saying that there are many people around her willing to help; she describes her dependence on her family and how lucky she was to have a husband and children before she was taken ill. Nevertheless, there "always is the terror that people are kind to me only because I'm a cripple" (15).
Mairs has many astute comments to make about how disability does not fit well in our youth-oriented, physical-fitness-obsessed culture, and on how social expectations influence whether she adapts or fails to adapt. She also understands what is at stake for the medical professionals who care for her: "I may be frustrated, maddened, depressed by the incurability of my disease, but I am not diminished by it, and they are" (20).