Showing 131 - 140 of 211 annotations tagged with the keyword "Psycho-social Medicine"

The Shrine at Altimara

L'Heureux, John

Last Updated: Dec-05-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Written in a style resembling religious litany, this is the tale of a disastrous teen-age marriage and its criminal consequences. The setting is California. Maria is a poor Mexican-American who meets and attracts Russell, a working class Anglo. Although ambivalent, Maria sees marriage to Russell as the path to American, white respectability. Her earlier hopes of achieving this status through her own efforts have been frustrated by the reality of poor academic performance. She is eager to get away from the household of her deeply religious mother. Russell is brooding, taciturn, and carries the physical and psychic wounds of an abused childhood--his father is a partially reformed alcoholic who deliberately burned Russell's hand.

The pair are ill-equipped for marriage or parenthood and Maria soon feels trapped. Their son, John, avoids provoking them by being a "good boy," hoping to prevent their frequent arguments. Russell's deprived childhood accounts, perhaps, for his obsessively jealous fixation on Maria. He is jealous even of the attention she gives their son.

The catastrophe that seems always close at hand finally occurs: Russell sets fire to his own child. The second part of the novel is told primarily from John's perspective as he undergoes a prolonged, painful rehabilitation and tries to find meaning in these events. It is also the story of the plastic surgeon who attempts to restore John's horribly scarred body and who has come to doubt the purpose of his profession (there is nothing he can do about destructive family relationships and psychic scars). Russell, who has been brutalized in jail, is released, seeking redemption. Fire, significant throughout the story, plays a final shocking (redemptive?) role.

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Still Waters in Niger

Hill, Kathleen

Last Updated: Dec-05-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Described as an autobiographical novel, this book is narrated in the first person and reads like a memoir. But it is a "memoir" charged with atmosphere, imagery, and longing. The narrator is an American woman, a mother of three children, and the wife of an academic. After an absence of 17 years she has returned to Niger--the country in northwestern Africa where she had lived with her three small children and husband, while the latter was completing his doctoral dissertation. Now she is visiting her oldest child, Zara, who has been living for the past two years in Niger, and working in a medical clinic.

As the narrator reacquaints herself with the culture and climate of the country, she re-visits--in memory--young motherhood, her relationship with the six-year-old Zara, and her interactions with the people and surroundings. The novel shifts back and forth between the past and the present Niger while the narrator attempts to integrate her experiences: she sees the country and her daughter through new eyes.

She is overwhelmed with guilt about what she calls her "inattention" (17 years ago) to the lives of the Nigerans around her; guilt about her failure to learn the native language; guilt toward her children, for her own self absorption. "After all, what was I doing the year we lived in Zinder [the city where they had lived]? That is the question that looms between Zara and me . . . Of what was I thinking? It is not enough to say that instead of working in a clinic [as Zara now does] I was spending my days with Lizzie and Tulu and herself. That doesn't answer it. All of Zinder waited beyond the gate." (71)

The narrator watches with admiration and envy as Zara interacts comfortably, even intimately, with the native women and their children, speaks the language fluently, and negotiates her way with self assurance in this foreign land. Not only does the narrator feel inept, she feels that she has "lost Zara to a world in which I am entirely a stranger." (73) Thus cultural dislocation becomes the trigger for intense reflections on the nature of parenthood, and the female experience of marriage, pregnancy, motherhood, and aging. These reflections are magnified by the narrator's loss of her own mother, who has recently died.

The native women that she meets through Zara help her to understand that some of these experiences transcend cultures, even though their surface manifestations may differ. For example, the often hyper-critical attitude toward first born children, and the refusal of native parents to even utter the name of the first born child relates to the shame associated with this evidence that the mother has lost her virginity. "Shame is the right word, exactly," thinks the narrator, "and I wonder now that I have not stumbled on this knowledge before." (77) But more than the "thorough and irrevocable . . . violation of the space around one's skin" it is the associated separation from the mother that the narrator recognizes as being at the core of sexual awakening; it is this inevitable separation from her own daughter that she is now trying to absorb.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is the second edition of Hawkins's groundbreaking work on illness narratives--autobiographical and biographical accounts of illness that she calls "pathographies." This edition preserves the text of the earlier (1993) work but updates it with a new preface and a new concluding chapter. This new chapter (chapter 6) surveys works written since 1992 and expands the discussion of mythic thinking and narrative.

Hawkins posits that mythic thinking pervades illness writing. Mythic constructs, she argues, organize the way patients understand their illness, how they interact with the institution of medicine, and how they write their narratives. Myths are formulative in that they attempt to create order out of the disorientation of illness. In the texts selected, Hawkins identifies "archetypal" (transcultural, transhistorical) myths--myths of journey, battle, and death and rebirth (discussed in the first edition as well).

In this edition Hawkins introduces a new term: "ideological" myths. Ideological myths are "linked to a particular culture at a particular time" (xiii). In this category is the myth of healthy mindedness, a way of thinking that was labeled "mythos" in the earlier edition. Hawkins proposes two additional ideological myths, discussed in chapter 6: the Gaia myth (that links illness and environmental problems), and the "myth of narrativity" (xiii).

The book's chapters are organized around the myths enumerated above, with many examples. Most of the works discussed were written in the latter part of the 20th century, but there are several pages devoted to John Donne's Devotions upon Emergent Occasions (see annotation in this database). Hawkins determines how, in specific cases, the myths she has identified function--whether they are "enabling" or "disabling," and whether they are "medically syntonic or dystonic" (21-24). Myths that have an enabling function are adaptive, useful, help recovery or adjustment, ameliorate suffering. They are often medically syntonic--compatible with the belief system of Western medicine. One notable exception to this is Hawkins's paradigm of the ideological "myth of healthy mindedness," in which to be enabled often means to controvert traditional medical practices.

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Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Peter Selwyn spent the first ten years out of medical school at Montefiore Medical Center in the Bronx, caring for HIV-positive patients--mostly intravenous drug users and their families--in the early years of the AIDS crisis. As he worked with dying young men and women and their families, Selwyn returned to his own unexplored pain surrounding the loss of his father, who fell or (more likely) jumped from a 23-story building when Selwyn was a toddler. Mirroring their function in Selwyn’s life, the stories of the five patients who most affected him serve in this book as the threshold to the narrative of how Selwyn investigated, mourned, and commemorated his father’s death, finally revaluing it as central to the person and doctor he became.

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Annotated by:
Aull, Felice

Primary Category: Visual Arts / Visual Arts

Genre: Multimedia

Summary:

The journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC) in Atlanta, features artwork on its cover. Under the guidance of managing editor, Polyxeni Potter, these images are selected to enhance the journal's communication of its scientific public health content. Among the goals that govern the choice of its cover art are the editors' intention to illustrate ideas, stimulate the intellect, and fire the emotions (personal communication).

Acompanying each image is a one-page commentary on the artist, the topic depicted, and its relevance to infectious disease. Cover art (and commentary) from past issues can be accessed from the title page of each current issue.

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What if your mother

Arcana, Judith

Last Updated: Nov-30-2006
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In this collection, Judith Arcana brings together her long-standing feminist activism, especially for reproductive health and abortion rights, and her gifts as a poet. Although Arcana's activism dates back to the early seventies, most of the poems in the book were written between 1998 and 2004. They draw from "the lives of women and girls I know or have simply encountered" (xi).

The collection is divided into four sections: "Separating argument from fact," "Information rarely offered," "Don't tell me you didn't know this," and "Here, in the heart of the country." Spoken in first, second, or third person, these poems evoke the myriad individual situations in which women of childbearing age become pregnant, and the trajectories their lives may take as a result.

The title of the collection derives from one of its poems ("What if your mother") and the related, immediately preceding poem, "My father tells me something, 1973" (6-7). Arguing back to those who confront her with, "What if your mother had an abortion? . . . they mean me," the speaker/poet answers, "then I say she did . . . . "What if, what if. / What's the point of asking this phony question?"

From the preceding poem, the reader has learned, along with the speaker listening to her father in 1973, that the poet's mother had an abortion in the Depression era, early in marriage. With this juxtaposition of poems we are introduced early in the book to the complexity of the issues surrounding pregnancy, parenthood, and abortion and to the timeline of a continuing national and personal debate. This complexity is the subject of the collection.

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Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

In the book’s Introduction, Dr. Cleaveland explains his personal need for real and fictional heroes. Seeing himself often as a victim of cruel childhood peers, he sought protectors and savored particularly the exploits of World War II heroes. His heroes, he notes, delivered him safely through childhood and adolescence.

Cleaveland describes seeing a documentary movie about Dr. Croydon Wassel in 1944; Dr. Wassel became his first personal hero. A book about Dr. Wassel was read by Cleaveland many times; later, as an adult, Cleaveland looked for the book again and set out to ascertain its authenticity. From extensive research he found Dr. Wassel to be far more courageous than he had anticipated--"studied, found not wanting."

The author was introduced to the story of Dr. Billie Dyer in 1992 through a collection of short stories. Dyer was a black physician who kept a diary during his eighteen months in service in the U.S. Medical Corp during the First World War. Cleaveland found a copy of the diary in the public library in Lincoln, Illinois and learned more about a new hero.

Other heroes he writes about were Dr. Woodrow Dodson, who served sixty years as a "domestic medical missionary"; and Dr. Lonnie Boaz, a black physician, the son of a victim of a hate crime, who became a well known ophthalmologist, husband, father, civic leader, and reformer after starting out as a painter, janitor, and army medic.

Cleaveland considers some of his patients to be heroes: Vera Gustafson, a World War II nurse whom he interviewed extensively, later adding historical information to her story; Paulette McGill, a childhood diabetic cared for by Dr. Cleaveland for twenty years; and an obese diabetic who became a "universal friend," teaching others about devotion and courage. Other patients were also deemed heroic, each for some special reason.

The longest story, saved till the last, is about Dr. Janusz Korczak, described by Dr. Cleaveland as the most heroic figure he knows of. Korczak was a Polish, Jewish pediatrician who devoted his life to improving the welfare of children in the Warsaw ghetto; he was deported to the Treblinka concentration camp with the children. (A movie that came out in 1990 dramatically tells this story.)

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Summary:

Nisbett, a professor of psychology at the University of Michigan, argues that thinking is not universally the same, in time or around the globe. Specifically, Asians and Westerners vary in what they perceive, how they process it, and what action they might take. Nisbett has studied seminal figures such as Aristotle and Confucius, the geographical and social origins of Greece and China, and clues from the languages involved.

He explains a series of polarities, which can be quickly sketched (Eastern first/then Western): relationships/action, choice; feelings/logic; interdependence/independence; circularity, cycles/linearity; field dependence/divisible categories; harmony/debate; ground/figure; context/focal object; setting/outcome; and multiple causes/single cause and effect. Nisbett has also conducted experiments with students of Eastern and Western backgrounds to demonstrate that such differences are still real.

Finally, he argues that, with globalization, the two traditions will merge.

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Summary:

The description on the cover of this collection of essays states that it is "candid firsthand accounts of the profound experiences that transform medical students into doctors". It is edited by a woman breast surgeon (Susan Pories) who teaches students in the Harvard Medical School Patient-Doctor Course; a MD/MBA candidate (Sachin Jain) who anticipates a career as a clinician , scholar and activist; and a psychiatrist (Gordon Harper) who is director of the Patient-Doctor III course at Harvard. The short forward is by physician-writer Jerome Groopman. The 44 essays are divided into sections by theme: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. I found it helpful to read the short biographies of each student in the back of the book, before reading that student's essay.

The diversity of the essayists is very wide which makes for a broad look at many important issues. There are several subjects that we tend to avoid (student response to the nude body, the presence of students when end of life decisions are being made, the tensions between caring for a patient and having to do something which causes pain, trying to think of patients a people as well as complex biomedical problems). One of the editors wishes that the book will help people understand the working of the hospital and the many ways in which new doctors learn. The book is certainly a personal look at the teaching hospital from the students' view.

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Of Mist, and Grass, and Sand

McIntyre, Vonda

Last Updated: Sep-05-2006
Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Novelette

Summary:

Although the setting is startlingly different, and the care provided is through highly unorthodox means, the healer in this science fiction story experiences in remarkably similar ways the everyday wear and tear of modern medical practice. Snake, a young female itinerant healer, has been asked to save the life of a young boy. Her attempts to do so, and her interactions with the boy, his family and community, and the tools of her trade (the snakes-mist, sand and grass) are detailed in the story. "Professional development" issues that this strong and complex character has to deal with include truth-telling, interfering and ignorant family members, self-sacrifice, and possible reprobation by her peers and teachers.

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