Showing 161 - 170 of 196 annotations tagged with the keyword "Psycho-social Medicine"

The Breast Cancer Wars

Lerner, Barron

Last Updated: Aug-28-2002
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Written by a medical historian who is also a physician, The Breast Cancer Wars narrates how breast cancer diagnostic methods and treatments have developed from the early twentieth century. More significantly, the book describes the debates and controversies that permeated this evolution and the ways in which not only clinicians and researchers, but, increasingly, women patients/activists shaped how we view, diagnose, and treat breast cancer today.

Individual chapters explore the influential (and ultimately contested) radical mastectomy procedure of William Halsted, the development of the "war" against breast cancer as a full-blown campaign developed and conducted within the public media and consciousness of the United States as well as within medical practice and research, the intertwined development of feminism and breast cancer activism, the "fall" of the radical mastectomy, and the continuing controversies surrounding mammography and genetic testing as modes of early detection and risk assessment. Lerner draws on a range of primary sources including texts from the archives of the American Cancer Society, the papers of doctors and patients, and advertisements from popular and professional magazines throughout the century.

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The Heavenly Ladder

Coulehan, Jack

Last Updated: May-02-2002
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The Heavenly Ladder is physician-poet Jack Coulehan's most recent chapbook, bringing together 48 poems, many of which have been published individually in various medical journals and literary magazines. The collection is divided into four sections.

Poems in the first section, "Medicine Stone," are written in the voice of patients or in the voice of the physician who treats them. The second section, "So Many Remedies," consists of five poems inspired by physician-author Chekhov. The poems of "The Illuminated Text" section reflect a wide-ranging interest in people who lived in distant times or in distant places. The final section, "Don't Be Afraid, Gringo," stays, for the most part, closer to home and includes a number of poems addressed to, or about, family members.

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The Cancer Match

Dickey, James

Last Updated: Mar-05-2002
Annotated by:
Chen, Irene
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The narrator is a patient with advanced cancer who has come home from the hospital after being told that "medicine has no hope." Yet, for one night, he strives to overcome his cancer with drink, his "Basic Life Force," and hope.

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The Use of Force

Williams, William Carlos

Last Updated: Mar-05-2002
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Short Story

Summary:

A physician is summoned to make a housecall on a family with whom he has had no prior contact. He quickly sizes up the situation: the household is poor but clean; the patient is a female child whose parents are nervously concerned, dependent on, yet distrustful of the doctor. The child's beauty and penetrating stare make an immediate impression on him.

Concerned that diphtheria may be the cause of illness, he uses his customary professional manner to determine whether or not the child has a sore throat. But the child will have none of it and "clawed instinctively for my eyes." The attempt at an examination rapidly escalates into a physical "battle" as the physician, convinced that it is crucial to see the child's throat "and feeling that I must get a diagnosis now or never," becomes ever more enraged and forceful while the girl continues to resist with all her strength, and the parents are in an agony of fear for her health and embarrassment over her behavior.

This is no longer a professional encounter. The doctor admits at the beginning of the struggle to having "fallen in love with the savage brat" and recognizes that he is behaving irrationally. The closing sequence could as easily be depicting a rape as a forced throat examination.

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Rain Man

Cruise, Tom; Levinson, Barry; Hoffman, Dustin

Last Updated: Dec-17-2001
Annotated by:
McEntyre, Marilyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Charlie Babbitt (Tom Cruise), a young businessman aggressively pursuing his fortune in collector automobiles, hears that the wealthy father from whom he has been estranged for years, has died. He attends the funeral planning to remain only long enough to hear the will and receive the fortune he believes is coming to him. He is shocked to learn that most of the fortune has been left in trust to someone whose name is not disclosed. Investigations lead him to a home for the mentally handicapped where he discovers he has a brother, Raymond (Dustin Hoffman), an autistic savant, who has been housed there since Charlie's early childhood.

Charlie kidnaps him, planning to keep him "hostage" until the institution delivers the half of Raymond's inheritance he believes rightly to be his. On the road, two things happen: 1) he is baffled, angered, and confused by the paradoxical behavior of this genius with no emotional vocabulary and no social skills and 2) he uncovers early memories of Raymond as the "Rain man" who comforted him when he was very small. He takes Raymond to Las Vegas to exploit his card-counting skills, wins enough at blackjack to get kicked out of the casino, and ends up calling Raymond's guardian out to California, hoping to be entrusted with his guardianship.

He is finally convinced, however, that Raymond is indeed incapable of progressing in relationship much beyond where he is, and that he, Charlie, is not sufficiently equipped to care for him. He sends him back to the institution, committed to maintaining relationship not for the money, but for its own sake. Mystified as he is by the brother whose humanity he can't quite fathom, something like love has been awakened in him in the course of his painful journey in caregiving.

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Annotated by:
Woodcock, John

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This essay provides a rich and detailed critique of the medical view of women in 19th-century America. As the keywords suggest, the authors cover many topics. To mention a few: the coming of male dominance in medicine; the patronizing and disabling characterization of women as "weak, dependent, diseased," and naturally patients; S. (Silas) Weir Mitchell and his treatment of Charlotte Perkins Gilman; the social role of female invalidism in upper middle class culture; the "scientific" view of woman as evolutionarily devolved; and what the authors call "the expert-woman relationship."

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Motivated at first by an attachment to her strict and demanding ballet teacher, as well as frustration and disgust with her own body compared to other dancers', Francesca develops an obsession with weight loss and increasingly ritualized forms of self-discipline in eating and exercise that lead to severe anorexia nervosa. It takes her family several months to see and acknowledge what is happening in front of them, during which she has trained herself to eat less and less, to throw up after meals, and to push herself to the point of exhaustion.

She becomes secretive, isolates herself from friends, and puts up a wall between herself and her parents, who are unable fully to understand the degree to which her behavior has gone beyond her control, but are worried. A compassionate male therapist with clear boundaries and a non-judgmental approach finally succeeds in disengaging Francesca from the mutually destructive downward spiral of family conflict around her illness;

he helps her to envision and desire her own health and to take responsibility for recovery. The story is told in the third person, but from Francesca's point of view.

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Stevie in the Mirror

Wittlinger, Ellen

Last Updated: Aug-13-2001
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Short Story for Young Adults

Summary:

This first-person narrative of a runaway girl's short stay in a residential mental health center develops her impressions, resistances, and accommodations from her admission ("I can see right away it's a nuthouse") to her release. These include reluctant interviews with the staff counselor, uncomfortable encounters with nurses, observations of other patients' erratic behavior, and efforts, finally, to communicate with a very detached roommate.

"Stevie" speaks from a place of anger and mistrust. She attempted suicide in the girl's bathroom by slicing her wrists, but regards herself as otherwise quite competent. A turning point comes for her when her silent roommate sings a song she's written which ends with the words, "Don't forget to cry." This moment of vulnerability, which also unveils surprising talent and beauty, moves Stevie from anger toward curiosity and sympathy.

She takes steps toward friendship with her roommate, and finally toward reconciliation with her mother who, she realizes, really wants her home. As she leaves, Zena really addresses her for the first time, reminding her, "Don't forget to cry."

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Kaddish

Ginsberg, Allen

Last Updated: Aug-09-2001
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Dedicated to the poet's mother, Naomi Ginsberg, the poem is a narration and a lament arising from Ginsberg's memories, three years after Naomi's death, of her life and of his life with her. This long poem is subdivided into 5 sections that address the dead woman directly.

The highly poetic Part I is a reflection on death, life ["all the accumulations of life, that wear us out" (p. 11)], mortality, the link between the dead and the living, the great unknown that lies beyond death--not in the abstract, but in the signs and symbols of Naomi's life/death and in the issues that remain for her son: "Now I've got to cut through--to talk to you / --as I didn't when you had a mouth." (p. 11)

Part II is a long narration of Naomi's life story, especially the history of her mental illness and of the role it imposed on Ginsberg himself. Ginsberg "was only 12" when he brought his mother to what was intended as a rest cure; instead, she became psychotic and was hospitalized, leaving Ginsberg with an everlasting sense of guilt. Separated from her husband, Naomi spent years of paranoia in chaos and institutionalization; son Allen vacillated between pity, disgust, escape in travel, and (homo)sexual exploration.

At the last meeting with his mother, in a mental hospital, she didn't recognize him. While living in San Francisco, two days after Naomi died, he received a letter from her: "Strange Prophesies anew! She wrote--'The key is in / the window, the key is in the sunlight at the window--I have / the key--Get married Allen don't take drugs . . . .' " (p. 31)

These passages give a vivid sense of mental disease and its impact on the family. Ginsberg is not self-pitying or self-indulgent in his description of the illness that laid siege to his mother's life and which so strongly influenced his own life for years. Modestly, he inserts: "I was in bughouse that year 8 months--my own visions unmentioned in this here Lament--" (p. 25)

The brief "Hymnn," is a blessing: "Blessed be you Naomi in Hospitals! Blessed be you Naomi in solitude! Blest be your triumph! . . . Blest be your last year's loneliness!" Part III (one page long) is a short recapitulation of Naomi's life, and uses her own cryptic words to try to make sense out of her life as well as of all life and death: "But that the key should be left behind--at the window . . . to the living . . . that can . . . look back see / Creation glistening backwards to the same grave . . . ." (p. 33)

Part IV, a chant, reaches beyond the personal to social history: "O mother / what have I left out"; (p. 34) "with your eyes of shock / with your eyes of lobotomy; " "farewell / with Communist party and a broken stocking"; "with your eyes of Czechoslovakia attacked by robots . . . ." (p. 35) Ending with the short part V, Ginsberg cries out to the shrieking crows circling in the sky above His mother's grave, "Lord Lord O Grinder of giant Beyonds my voice in a boundless / field in Sheol" (p.36) [Sheol is a Hebrew word meaning "the abode of death."]

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Summary:

The film covers two days in the life of Frank Pierce (Nicolas Cage), a burned-out EMT (emergency medical technician) working the socio-economic underside of Manhattan. From the beginning, Frank is upset because recently all his patients have been dying on him, and he is haunted throughout by the hallucinated ghost of Rose, a young woman who collapsed on the street and died, apparently because he could not intubate her correctly.

Frank is highly stressed, he has no life outside his work, and he is self-medicating with alcohol. He tries to quit, but his boss keeps him on by promising time off in the future. In the film's first action, Frank does manage to miraculously resuscitate Mr. Burke, a heart-attack victim, but the patient winds up in the hospital with a very bad prognosis, so even that "saving" works against Frank.

Frank has encounters with numerous patients, many of them street people whose lives are out of control, some of whom are ER (Emergency Room) regulars, such as the demented young Noel (Marc Anthony). He also deals with (and is dealt with by) several highly idiosyncratic EMT partners in his ambulance rounds (John Goodman and others). Frank gets to know Mary Burke (Patricia Arquette), the daughter of the heart-attack victim, and they tentatively move toward being a couple who might help each other survive their lives.

Near the end, Frank, who knows Mr. Burke had tried to tear out his tubes during a brief moment of consciousness, and who feels he has been getting pleading messages from him to end his agonies, surreptitiously takes him off life support long enough for him to die. The physician who responds to the code decides not to attempt resuscitation of this patient who had already been resuscitated 14 times that day. Frank goes to tell Mary that her father has died (but not how), and exhaustedly falls asleep on her breast, apparently having forgiven himself because he has in some sense finally "saved" Mr. Burke.

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