Showing 161 - 170 of 827 annotations tagged with the keyword "Communication"

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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Ape House

Gruen, Sara

Last Updated: Dec-16-2010
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ape House is the fourth novel of Sara Gruen. It relates the story of a group of bonobos living in the Great Ape Language Lab in Kansas City under the immediate direction of scientist Isabel Duncan. These six apes are quite adept in using American Sign Language to express their thoughts, wishes and interactive relations with humans. When the Laboratory is the target of a violent explosion, apparently by animal rights activists, Isabel Duncan is severely injured. The six bonobos escape, soon resurfacing in New Mexico as the prime time stars of Ape House, a reality TV show produced by Ken Foulks, a stereotypically evil TV mogul. The bonobos and the show become a controversial hit and the immediate bane of a still recuperating Isabel.

Covering the Great Ape Language Lab pre-explosion as a feature story, print reporter John Thigpen follows them from their first home in the language lab to their TV residence. Meanwhile he is undergoing his own domestic turmoil with his wife Amanda, a frustrated novelist who is also less than happy with their marriage. The novel follows these twin threads - the trajectory of the bonobos from protected apes in a nourishing research environment to exploited animals, and the sturm und drang, both marital and career, of John and Amanda Thigpen. While millions of TV viewers watch the bonobos playing house and enjoying the "generous amounts of sex"? (as described by the book jacket), Isabel tries to regain ownership and protector status of her bonobos, whom she considers family.

Without divulging the denouement of the novel, suffice it to say that Isabel is successful in renewing her mater familias status of the apes, and John Thigpen gets a huge journalistic scoop as well. In the process, he and Isabel find true love and happiness, but not with each other, as coyly but falsely suggested earlier in the book. For everyone except Isabel's first love interest, Dr. Peter Benton, and Ken Foulks, the book ends on a very happy note.

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Legend of a Suicide

Vann, David

Last Updated: Dec-09-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A series of interrelated stories that include a novella (Sukkwan Island), the book is a semi-autobiographical tale of the impact of a father's suicide on his teenage son.  The author, David Vann, represents his fictional self as Roy Fenn, and his father as Jim.  In the first story, "Ichthyology," Roy is born on an island "at the edge of the Bering Sea" of Alaska and then he and his family move to Ketchikan, on an island in southeastern Alaska.  Roy's father is ever restless and that includes an interest in women other than his wife.  When Roy is about five years old the marriage breaks up and Roy moves to California with his mother.  At the end of this chapter, Roy's father kills himself with one of his own guns.

"Rhoda" is the story of Jim's second marriage to Rhoda who becomes Roy's stepmother, until that marriage also ends in divorce.  "A Legend of Good Men" relates how Roy's mother was courted by various suitors following her divorce.  These narratives are told from Roy's perspective.  The next and largest section of the book is "Sukkwan Island."  It is on this Alaskan island that Roy spends an extended visit with his father, in a simple, isolated cabin where their only other human contact is with a supply plane that comes periodically.  Life is primitive and difficult and reflects the relationship of father and son, which is uneasy and foreign to Roy.  Jim is depressed, obsessed with his former wife Rhoda and often cries at night, which Roy finds sad, scary, and eventually despicable.  Life on the island takes a bizarre turn, which I will not reveal here.

In "Ketchikan" Roy at age 30 returns to the town of his early childhood "the place where my dead father had first gone astray [with Gloria, his dental receptionist], the place where this father and his suicide and his cheating and his lies and my pity for him, also, might finally be put to rest" (209).  The last story, "The Higher Blue," is a mixture of fantasy and narrative reality; comments about Jim made by Roy's mother serve to bookend the novel.

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The Office

Munro, Alice

Last Updated: Nov-28-2010
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

A woman writer, frustrated by attempts to carve out space and time for her craft at home, tells how she decided to rent an office. It had to be simple and inexpensive. She finds a suitable room owned by a couple who occupy the apartment below. The wife, who will clean, seems delicate, defeated, but kind. The small upstairs bathroom is shared with unoccupied offices along the corridor and cannot be locked.

The writer sets up a card table and chair, and savors her few weekly hours of solitude. But her landlord keeps interrupting to offer things that she doesn’t want--conversation, a chair, a plant, a teapot, tales of himself, salacious details about her predecessor tenant, a chiropractor.

Conscious of her inability to be rude to someone who is being rude to her, she lets him intrude, annoyed with herself for not being firm. Determined not to let him win by forcing her out of the office, she begins to express her wishes. He resents these attempts at honesty, and she worries that she has hurt his feelings.

Gradually she realizes that he is spying on her through his set notions of what a proper woman should be doing in such a space – or any space. One night she returns to find him peering at her work, hoping, she suspects, that she has written about him. He hints that she has been using the office for parties and sex, and then accuses her of defacing the open bathroom with obscenities scrawled in lipstick. He tells her that the mess could not possibly be cleaned by his wife who is a decent person who stays at home.

The man is insane. The salacious activities of her predecessor must have been a delusion—and he may well have lipsticked the bathroom himself. She gives up the office.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The journalist author investigates the hidden lives of his father and his grandfather, both physicians. He is motivated by the mysterious silence that pervaded the ancestral home in a wealthy Toronto neighborhood, and by the frightening tendency to depression and suicide that stalks his family members like an Irish curse.

He uncovers many details of the early adventures of his parents, the failure of their marriage, and his father’s doomed career. From his beginnings as a debonair socialite, the father, Jack, embarks on a promising medical career as an allergist; however, he virtually sinks into taciturn misery and alcoholic self-destruction, unable to express affection or joy. Jack’s endless travails as a patient through shock therapy, analysis, and heavy psychiatric drugs are presented in merciless detail using hospital records and interviews with caregivers. The author’s self-indulgent anger with his self-absorbed father drives the research deeper into the earlier generation, to learn about the grandfather of whom his parents rarely spoke.

The author's grandfather, Irish-born John Gerald FitzGerald (1882-1940), son of an immigrant pharmacist and an invalid mother, strode through the exciting scientific world of the early twentieth century like a medical Forrest Gump. At first, he is drawn into the new fields of psychoanalysis, psychiatry, and neuropathology; cameo appearances of Freud, Ernest Jones and C.K. Clarke light up the story. But then this elder FitzGerald is swayed by the need to control infections and produce vaccines. He travels Europe and the United States for three years learning bacteriology.

Upon his return to Canada in 1913, he fearlessly launches a Canadian-made solution, outfitting a stable and a horse farm to produce rabies vaccine and diphtheria anti-toxin. The initiative evolves into the famous Connaught Laboratories and the School of Hygiene, its academic arm. Other luminaries enter the story– such as Banting and Best of insulin fame and C.B. Farrar of psychiatry. FitzGerald served as Scientific Director of the International Health Division of the Rockefeller Foundation and as Dean of the University of Toronto medical school.

Nevertheless in his late fifties, having accomplished so much, the grandfather crashes into doubt, depression and self-destruction, believing himself a failure and consumed with guilt for some never-disclosed transgression. Did his stellar achievements, his high expectations, and his baffling demise dictate the collapse of his son Jack?

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Summary:

Edited by Victoria Tischler (a psychologist in the Division of Psychiatry at The University of Nottingham), with forewords by Dinesh Bhugra (Professor of Mental Health and Cultural Diversity at King's College London) and Allan D. Peterkin (who founded ARS MEDICA: A Journal of Medicine, The Arts and Humanities), this handbook is intended to provide guidance on medical humanities teaching in the field of mental health.  After a short, familiar introduction to the need for such teaching, Tischler offers concrete guidance on how to begin establishing a medical humanities course.  The subsequent chapters deal with topics, perspectives, and forms of art one might include in such a course.  There is a "brief history of psychiatry through the arts" by Allen Beveridge which is, as we are warned in the title, somewhat cursory, but also well-written and thought-provoking.

Following this are chapters on the use of cinema, poetry, literature, creative writing, drama and theatre, and music in medical humanities teaching for mental health, interspersed with essays on Hans Prinzorn, who collected paintings and pictures by the mentally ill; art psychotherapy; community arts (where, as the authors point out, there is no "interpretative component" but rather a focus on participatory creativity); and the blues.  The authors include psychiatrists, artists, mental health nurses, and counselors/therapists, and the book includes a lovely selection of color plates.

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

On July 5, 1998, physics Professor Alan Cromer suffered a heart attack on a plane, and survived after almost an hour of resuscitation efforts, but sustained brain injury from lack of oxygen.  In this chronicle of caregiving, his wife, a psychiatric nurse by training, gives a very personal, detailed account of the radical adaptations his disability required of both of them.  Her story includes reflection on his and her own emotional adjustments to loss of parity in communication and awareness, practical adjustments to physical limitations, and social adjustments to family, friends and professional colleagues.

Arduously, over time, Alan regained some ability to read and speak--indeed, he spoke to groups with Janet about their life together during the peak of his rehabilitation.  But the road to even partial recovery was bumpy, and the writer fully acknowledges the pain, grief, irritation, and deep frustrations that intersected moments of authentic pleasure, discovery, and mutual kindness.  Professor Cromer died September 3, 2005.

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Annotated by:
Donley, Carol

Primary Category: Literature / Nonfiction

Genre: Investigative Journalism

Summary:

In 1951 when Henrietta Lacks was dying of cancer in the colored ward of Johns Hopkins, cancer cells taken from her without her knowledge "became the first immortal human cells grown in a laboratory"(4).  Known as HeLa cells, they are still reproducing today and are used world wide in research for cancer, cloning, genetics, Parkinsons, and many technologies. Henrietta's family did not know she was the source of these immortal cells until scientists began testing the family members too.  Poor and black, they were very angry to find the white establishment had made fortunes using HeLa cells while the family got nothing for it and couldn't even get good health care. In her thorough and careful investigation, Rebecca Skloot interviewed the Lacks family; scientists, doctors, and others who worked with HeLa cells; historians; journalists; ethicists. This book traces the complex stages of her search for the truth about what happened to Henrietta Lacks, her HeLa cells, and her family.

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Perillo's essays offer a lively, variegated view from the wheelchair of a woman with multiple sclerosis who is also a naturalist, an outdoorswoman, a wife, and an award-winning writer.  Not all of them focus on her condition, though observations about living with the disease occur in most, and are thematic to some.  Most are also laced with wry humor.  One comes to see in these sketches from the Pacific Northwest how full and rich a life it is possible to live while also fully acknowledging and even lamenting the loss of mobility.  She invokes Thoreau several times, and her work may be easily situated in his tradition of personal, reflective essays on the natural world.  For her, the natural world extends to the world of the body, linked as it is with the bodies of all living things.

            

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My Life as a Doll

Kirschner, Elizabeth

Last Updated: Oct-27-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In this collection, which is really a poetry memoir or lengthy poetry sequence, the speaker develops her narrative of a tormented childhood and adolescence, psychological breakdowns, and ongoing struggle in a more "normal" present.  The poems are labeled only by section, of which there are four, and are separated simply by their spacing on the page.  Section 1, "Cuckoo," reveals the origin of the poet's "life as a doll": "After my mother hit the back /of my head with the bat's /sweet spot, light cried / its way out of my body. . . . I was  . . . a doll carved out of a dog's bones . . . my life as a doll / was a life of waiting" (4-5).  Mother was an abusive alcoholic (there seems to be no father ever on the scene).

Section 2, "An Itty Bitty Ditty," concentrates on the speaker's adolescence, which was one of promiscuity and parental neglect.  "Pretty, said Mom / on the night of the prom . . . Pretty, she said as though / I were a ditty, an itty bitty / ditty not even God would pity. / Ditty gone silent.  ditty gone numb" (27).  At age 19 the poet/speaker "took a razor to my wrists"; she was pregnant with an unwanted child at age 20: "Cold walked into me and through me . . . How do you undo someone who's / already undone?" (32-33).

In the third section of the collection,"Tra-la-la," we are whisked ahead to the time when the poet is married and has an 11- year-old son.  At her son's birthday she has a psychotic break and her husband brings her to the hospital.  "When I / stepped out of the car, I sang, /  "tra-la-la," as if I were / Cinderella going to an enchanted ball"  (41).  This section is concerned with her institutionalization and psychotherapy with "Dr. Flesh."  The poet is not enamored of Dr. Flesh, who puts her on display for a group of students "who wanted to be  / just like Dr. Flesh  / who was special, / very very special / unlike me" (43) and who yawns during therapy sessions (44).  The poet also satirizes her diagnostic workup -- a 500 question survey:"Do you like golf? it asked / and when I wrote 'no' / I was diagnosed" (49).  The final section, "O Healing Go Deep," is both a railing and incomprehension about the way the poet's mother treated her, and a plea for sanity: "enough I say of my careening / craziness, of being /a thing in thin wind / running away from Mother" (59).

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