Showing 141 - 150 of 1260 annotations tagged with the keyword "Death and Dying"

The Art of Racing in the Rain

Stein, Garth

Last Updated: Jan-06-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The story of race-car driver Denny Swift, as told by his appealing dog, Enzo, is his death-basket memoir. Denny’s tale of woe seems endless. His wife, Eve, dies of a brain tumour and he is in a struggle with her parents for custody of his daughter Zoë. Making matters worse, he is falsely accused of raping a minor by a 15 year-old who has a crush on him.

Enzo would love to intervene. However, he is frustrated by his inability to speak and his lack of opposable thumbs—but he sees clearly the worth of his master and the need for careful perseverance—like racing in the rain.

 

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Suite Francaise

Nemirovsky, Irene

Last Updated: Jan-03-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Two novellas are brought together. In the first, “Storm in June,” a host of people flee Paris in June 1941- -as the Germans occupied the city. They gather their money and most precious belongings and leave their homes, reasoning that there will be more safety in the countryside. But everyone has the same idea. The crush results in shortages of fuel, food and accommodation that radiate in ever widening ripples around the city. Many are duped by employers or by lovers. Some are robbed and even murdered by unscrupulous fellow citizens, and new conventions of behavior and bureaucracy are forged in the stress of the situation. The fortunes of several different individuals are interwoven in short chapters to explore a wide variety of adventures--tragic, miraculous, and poignantly banal. Among the most memorable is the little saga of the Michaud’s – a couple driven out of Paris, then back – all the while anxious for news of their son at the front.

The second novella, “Dolce,” is the story of the unhappily married Lucile whose husband has gone to the front. She must bide time in the home of her austere mother-in-law, Madame Angellier, who treats her with frank hostility. They are forced to billet a German officer. Lucile soon finds that she and the German share many interests in art and music; gradually the two fall in love, although they act upon their sentiments in conversation only. The full extent of their involvement must be concealed, but the community is aware and Lucile understands the potential consequences of “sleeping with the enemy.” Her mother-in-law hates her all the more for growing close to the occupier; yet their neighbours shamelessly prevail upon her connections to obtain minor favors.

When a local Frenchman kills a German soldier for allegedly courting his wife, the uneasy calm is destabilized. Almost by default, Lucile agrees to hide the fugitive murderer in her attic in bold proximity to her German tenant. The brave act is discovered by her mother-in-law who then (wrongly) perceives Lucile’s friendship with the German as a clever plot; her hatred turns to grudging admiration. Using her influence and a lie to obtain a pass from her unsuspecting German friend, Lucile escorts the ungrateful murderer to safety in Paris. The deception drives a wedge into her new relationship. They part never to meet again as his company is transferred to another place.

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Stone's Fall

Pears, Iain

Last Updated: Jan-03-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The wealthy financier, John William Stone, is found dead beneath the window of his home, having fallen, jumped, or been pushed. The will charges his widow, Elizabeth Lady Ravenscliff, with finding Stone’s lost child. She had known nothing about this episode in his life, but she is determined to honour his wish.

The story centers on a financial mystery told in three parts that move further back in time: London 1909, Paris 1890, and Venice 1867. Each story gives a different version of Elizabeth – none refutes any of the others.

In the first part, Elizabeth is cool, superior and in charge, but her grief is genuine. She hires Matthew Braddock to look for the missing child, suggesting that he pose as a hired biographer. The writer is smitten with Elizabeth and concludes that there was no lost child.

The second part is narrated by a spy, Henry Cort. In this version, Elizabeth began as a waif who became a high-class prostitute, involved in affairs of state. Addicted to drugs, she was dangerous and selfish, but Cort never realizes that she is his sister.

The last (but earliest) part is told by Stone himself about an affair he once had in Venice and its sorry end. The last few pages draw the disparate threads together and account cleverly for all the mysteries.

 

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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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Summary:

Candice Millard portrays several figures in the 19th century whose lives came together to change history: newly-elected President of the U.S. James Garfield; the insane would-be assassin Charles Guiteau; Doctor Bliss, the arrogant physician who claimed control of Garfield's care; Alexander Graham Bell, who invented a device to find the bullet; and major political figures of the time. Ironically, Garfield attended the Centennial Exhibition in Philadelphia in 1876 where Joseph Lister was displaying his germ theory of infection and Alexander Graham Bell demonstrated his telephone. But when Guiteau shot Garfield in 1881, the bullets did not kill him.  What killed him after months of suffering was the massive infections caused by the doctors' probing without clean hands or clean instruments. At the autopsy, the doctors saw evidence of massive infections, but the bullet was encysted and harmless. All the probing by the doctors created a tunnel, but it was not the path of the bullet.  "Gentlemen, we have made a mistake," said the doctor.

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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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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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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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Summary:

Creation tells the story of Charles Darwin (Paul Bettany) at home with his family in Down House during the last decade he researched and wrote, but hesitated to publish, The Origin of Species (1859).  The film represents the sorrow of those intellectually ripe years when he worked out his insights into the process of natural selection as his "radiant," beloved daughter Annie-Anne Elizabeth-(Martha West) became fatally ill.  These events were compounded by Darwin's own mysterious chronic illness, which he attempted to relieve through laudanum and trips to Great Malvern for Gulley's cold water cures.

In 1851 he took a very sick ten-year-old Annie with him to the waters and, inconsolable, left her to be buried in the local churchyard.  Through his physical and emotional suffering, he continued to dissect barnacles, breed and skeletonize pigeons, engage the village parson and local farmers alike, consult with supporters Thomas Hooker and Thomas Huxley, exchange hundreds of letters, and remain an affectionate father and husband. 

The loss of "the joy of the Household" strengthened his wife Emma's (Jennifer Connelly) religious beliefs, as it exhausted whatever might have existed of his. The story, artfully told in beautifully sequenced flashbacks, keeps the tensions and accommodations between Charles and Emma on the subject of religious faith in balance, emphasizing their loving partnership as spouses and parents.  Emma supported his work, read his manuscript, and understood its importance, even as she disagreed with its implications for her spiritual life.  Darwin contributed to the local parish church Emma attended.    

Some of the most compelling moments in the film occur during Darwin's joyous outings with his children when they suddenly witness the demise of woodland creatures.  In these scenes, the ineluctable struggles between life and death that Darwin's theory of natural selection eloquently describes resonate with his personal experience.  We see a fledgling fall from its nest near a sheep's skull and decay before our eyes.  We hear Annie explain to her horrified siblings that if the fox they encounter didn't kill the screeching rabbit in its jaws, its pups would die.

These scenes, along with the earlier view of the captive Fuegian child Boat Memory dying of small pox in an English hospital, suggest the fragility of the young that Annie's death makes devastatingly personal for Darwin.  The film simultaneously acknowledges Darwin's empirically derived logic of such deaths in his scientific treatise and his suffering from the brutal manifestations of that logic in the life of his family.  While scientific explanation fails to console him for the loss of Annie, the film suggests human affection as the best, though still potentially painful response.     

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