Showing 171 - 180 of 624 annotations tagged with the keyword "Power Relations"

Summary:

This study sets forth the mystery of scurvy  which devastated the British Navy during the eighteenth century. Among several diseases common on board, including yellow fever, typhus, or typhoid fever, syphilis, tuberculosis, and dysentery, scurvy was the most devastating. Caused by a lack of vitamin C, scurvy’s symptoms appear as swollen and bleeding gums, livid spots on the skin, and prostration. Untreated, the illness results in agonizing death. When Commodore George Anson’s flagship, Centurion, sailed from Plymouth in 1741, rounded Cap Horn and returned to Britain, his ship carried home only two hundred of the two thousand men he set out with. A deadly combination of voyages lasting a year or more, unhealthy conditions on board, including malnutrition, filth, crowding, ignorance about basic facts of biology, as well as inexperienced sailors pressed into crewing on ships managed by violent officers using harsh physical punishment resulted in millions of deaths at sea from the age of Columbus to the nineteenth century, when scurvy remedies were finally found.

Bown credits three men with discovering a solution to the mystery of scurvy: a surgeon, James Lind (1716-1794), sea captain James Cook (1728-1779), and a  physician, Gilbert Blane (1749-1843). Lemon juice had been known to prevent and cure scurvy since the 17th century, but 18th century medical men disregarded empirical knowledge in favor of the theory of humours.

James Lind entered the Royal Navy as a surgeon’s mate in 1739 under appalling conditions similar to those described by Tobias Smollett in Roderick Random (1748). He initiated a two-week controlled experiment where he separated the afflicted sailors into 6 groups who each received a different diet: cider, vitriol, vinegar, sea water, oranges and lemons, and nutmeg paste. The group receiving the oranges and lemons obtained the best results. Lind published his treatise on scurvy in 1753. However, he was unable to explain the causes of scurvy and why oranges and lemons led to its cure.

James Cook circumnavigated the world 3 times. On his lengthy voyages, he stopped for fresh fruits and antiscorbutics wherever he could, as he noticed these kept the seamen free of scurvy. Cook showed that scurvy was curable, but not why.

During the War of American Independence, Gilbert Blane served as a physician on board several warships in the British Navy. He instituted a diet of fresh fruits and better hygiene on board ship. He published Observations on the Diseases Incident to Seamen, in which he advocated using oranges and lemons to cure scurvy. He advised that lemon juice be mixed into the sailors’ grog.

The British Navy encountered an historic ordeal in 1805 with the Battle of Trafalgar. Admiral Nelson, commander of the British Navy, had nearly died from scurvy in 1780. Now he faced Napoleon Bonaparte and the French fleet. Bown argues that the near- elimination of scurvy on board their ships contributed mightily to the British victory.

A timeline, from 1492 to 1933, concludes the volume. Recommended readings, a bibliography and an index are provided.

 

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Summary:

This collection of stories offers a sidelong view of medicine from the perspective of a thoughtful, experienced doctor of internal medicine at a teaching institution (UCSF) in an urban setting that brings a wide variety of types of patients to his door.  In a context of evident respect and admiration for even the quirkiest of them, Watts admits to the kinds of personal responses most have been trained to hide-laughter, anger, bewilderment, frustration, empathetic sorrow.  The cases he recounts include several whose inexplicabilities ultimately require action based as much on intuition as on science.  He includes several stories of illness among his own family and friends, and makes it clear in others how his professional decisions affect his home life and his own state of mind.  

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Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Twenty-one stanzas of couplets spin out stereotypes of Native Americans promulgated by white American culture.  Among those stereotypes that Alexie develops: the tragic Indian; Indian women as sexual objects for white men; Indian men as secretly desirable to white women; Indians as violent, alcoholic, childlike, mystical, and members of a "horse culture."  But in addition, Alexie emphasizes how American whites have co-opted Indian culture: "white people must carry an Indian deep inside themselves" until finally, "all of the white people will be Indians and all of the Indians will be ghosts."

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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The Kite Runner

Hosseini, Khaled

Last Updated: Apr-16-2009
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In his debut novel, Dr. Khaled Hosseini tells a tale that begins in his homeland, Afghanistan, and ends in his adopted country, the United States. Amir, son of a wealthy Pashtun merchant, narrates the story. Amir and his father, Baba, are attended by two Hazara servants, Ali and his hare-lipped son, Hassan. Amir and Hassan are friends, but Amir is troubled by a guilty conscience over multiple slights and sly insults aimed at Hassan. The burden of guilt intensifies over an incident at a kite-flying contest when Amir is twelve years old.

Kite flying in Afghanistan is an intricate affair involving glass-embedded string that contestants use to slice the strings of other kites. The winner is not only the one with the last kite flying, but also the one who catches the last cut kite--the kite runner. At the close of the contest, Amir witnesses the traumatization of his friend Hassan, the finest kite runner, at the hands of an evil youth, Assef. Too shamed to help Hassan, Amir is nearly swallowed by his cowardice: the rest of the story follows the consequences of his guilt.

Amir and Baba emigrate to the United States during the Soviet invasion of Afghanistan, but Amir, as a young adult, returns during the Taliban regime in order to redeem himself and help Hassan's son. The story is filled with plot twists and revelations of secrets and hidden relationships, which enable Amir to confront some of his shortcomings. The oppression, torture, and murder of Afghanis by the Taliban are graphically depicted.

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The Good Priest's Son

Price, Reynolds

Last Updated: Mar-23-2009
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Mabry Kincaid, a New York art conservator is flying home on September 11, 2001, when news comes to him on the plane of the attacks on the World Trade Center.  Unable to return to his apartment in the city, he decides to visit his aging father, an Episcopal priest, in his boyhood home in North Carolina. There he meets Audrey, an African-American seminary student in her forties, who has moved in to care for his disabled father.  In the ensuing weeks Mabry is led to reflect deeply not only on the fate of the country and of his career, but on how his father's apparently final illness compels him to come to new terms with their constrained relationship. The death of the brother Mabry always believed to be the favorite has left a painful chasm between father and son, made more so by his father's own admission of favoritism.

At the same time Mabry is coming to terms with his own diagnosis of multiple sclerosis and with the grief he continues to process since his wife's death from cancer.  Audrey and her son bring a new dimension to the life of the household and a widened sense of family to the two men as they struggle to lay the past to rest and to accept the radical uncertainties of the personal and national future. One interesting subplot involves Mabry's discovery of what is reputed to be a minor, uncatalogued Van Gogh painting, covered by the work of another artist, that he has brought home for his employer, now dead, and his musings about what to do with this undocumented treasure.  The question remains open for symbolic reflection as he leaves it behind in North Carolina and returns to New York for a very different kind of life than the one he left. 

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Annotated by:
Mathiasen, Helle

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Testifying to its author's "fascination with death" (324), this scholarly and abundantly illustrated work focuses on the history of the American idea of the Good Death as this concept took shape during the Civil War. Frederic Law Olmstead used the phrase "republic of suffering" to describe the many wounded and dying soldiers being treated at Union hospital ships on the Virginia Peninsula. Faust argues that the task of dealing with more than half a million dead during the War motivated Americans in the North and South to discover cultural and physical measures of interpreting and coping with the suffering and loss that occurred in thousands of families.

The scale of this War was unprecedented due to rifles and railroads; however, Gilpin Faust reminds us that twice as many soldiers died of disease as died of wounds suffered in the conflict. The illnesses were epidemics of measles, mumps and smallpox, then diarrhea and dysentery, typhoid and malaria. Medical care was inadequate; consequently, soldiers and their families turned to spiritual consolation. The Good Death was identified as sacrificing your life for the cause; many  believed in the Christian idea of resurrection and the afterlife. Killing became work,  as African American soldiers fought for "God, race and country" (53), where  Southerners fought to preserve the status quo, including slavery.

Because of the War, public cemeteries and ceremonies, and government's identifying and counting the dead are now taken for granted. Because of the Civil War, bodies of the dead military are today brought back from foreign lands and honored with decent burial: "We still seek to use our deaths to create meaning where we are not sure any exists" (271).

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Body Language

Studer, Constance

Last Updated: Mar-10-2009
Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Body Language, a beautifully crafted and expansive memoir by retired nurse Constance Studer, spans a range of issues within the narrative of the author's life: a childhood marred by a medical procedure--a hasty frontal lobotomy that left her father incarcerated in a mental institute-- and, in later years, by her own illness, one caused by the Hepatitis B vaccine.  These two events are the bookends that frame Body Language, a memoir that examines family life, nursing, medicine, medical ethics, personal survival and illness in language that is poetic and compelling.  Studer, a writer as well as a nurse, intersperses her own story--which is novel-like in its intensity--with literary allusions, research material and knowledge culled from her years as a nurse in Intensive Care.  In her memoir, she writes not only with the authority of one who has been on both sides of the bed, as professional caregiver and as suffering patient, but also as a family member who has witnessed how unwise and unchallenged medical decisions might affect generations. 

What I especially admire about this memoir is that it is not simply a "telling about."  Instead Studer brings us into the action of the narrative, for example giving us imagery and dialogue as her father prepares for the surgery that he doesn't know will deprive him of memory and sense ("Holy Socks" p. 21).  She also intertwines many narrative strands, giving us the fullness of her family history and her professional adventures, so that when we reach the narrative of her own illness we have a sense of a life, a full life, that has been forever altered.

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Cutting for Stone

Verghese, Abraham

Last Updated: Mar-08-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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Summary:

This survey of the history of women in medicine begins in the mid 19th century and moves forward to the late 20th Century.  The twelve historical studies are divided by the editors into three sections, largely chronological.  The first section focuses on the 19th century women best known for their breakthrough into the male bastion of regular medicine in America.  There is, in addition to the more traditional studies, a look at the role of a Chinese woman physician in Progressive Era Chicago.  Section two takes the reader into the early 20th century Womens' Health Movement, including a fresh look at the narrative forms of Our Bodies, Ourselves.  Section three examines the mid-late 20th century position of women in American medicine and an interesting discourse on the impact of Western women physicians on issues of childbearing in Asia during the early part of the same century.

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