Showing 171 - 180 of 261 annotations tagged with the keyword "Infectious Disease"
Orlov is a young playboy in St. Petersburg whose father is an important political figure. The narrator (the "anonymous man"), who is actually a political activist (perhaps even an anarchist), assumes a new fake identity and takes a job as Orlov's footman, in order to get inside information to use against his father. While working undercover in this way, the narrator ("Stefan") observes a domestic tragedy. Orlov charms and then seduces a beautiful young married woman, Zinaida Fyodorovna Krasnovsky, who subsequently leaves her husband, shows up on Orlov's doorstep, and moves in with him.
Zinaida bursts with romantic visions and loves Orlov passionately. However, Orlov thinks the whole thing is a bore. He can't bring himself to throw her out, yet he detests her assault on his freedom. Eventually, he begins spending weeks at a time away from the flat, supposedly on an inspection tour in the provinces, but he is simply avoiding Zinaida by staying at a friend's house in St. Petersburg. Meanwhile, "Stefan" experiences a growing compassion for the poor woman, who has given up her husband and family for love.
As a result of this situation, "Stefan's" political ideals sink into the background; for example, he gives up an opportunity to murder Orlov's father and, thereby, achieve his radical objectives. Eventually, he confesses the truth to Zinaida--that Orlov has deceived her and doesn't want her. "Stefan" also reveals his true identity (Vladimir Ivanitich) and entices her to flee with him to Europe.
They spend the next several months traveling together. At one point Vladimir has an acute exacerbation of "pleurisy" (actually tuberculosis) and, while nursing him back to health, Zinaida realizes that Vladimir is in love with her. This is a crushing blow to their relationship, because she was under the impression that he had been helping her for purely altruistic, idealistic reasons.
Meanwhile, Zinaida, who is ill herself and pregnant with Orlov's child, dies in childbirth. The baby (Sonya) survives, and Vladimir spends two happy years caring for her, until he, too, is about to die of tuberculosis. At the end of the story, Vladimir meets with Orlov, and they make arrangements for old Krasnovsky--Remember him? He was Zinaida's husband--to take the child and raise her as his own.
As the title denotes, each image of a person with AIDS is captioned with his or her own words and signature. Howard's juxtaposition of both images and words lends a special power and specific meaning to the collection: images are given a distinctive human voice, words a distinctive human face.
Each image tells a story, but the story is that of a singular life facing a singular death. Using a focused lens and realistic frame, Howard presents candid portraits of persons in ordinary surroundings engaged in daily activities. Light creates mood in this pictorial display of the entire range of human emotion.
This collection of over ninety photographs and their stories celebrates an "unsung army of great healers," caregivers of persons with AIDS. Herself infected with the HIV virus, mother and AIDS activist Mary Fisher chronicles painful, private, and precious moments of interaction between patients, families, lovers, friends, and "professionals," in home, hospital, clinic, and other settings (a women’s prison on Riker’s Island, a homeless shelter in Boston, a nursery in West Palm Beach). Interspersed with the photographs and commentary are excerpts from Fisher’s letters and addresses including her show-stopping televised speech at the 1992 Republican National Convention.
An army lieutenant named Klimov is returning home to his sister and aunt in Moscow and falls ill while on the train. His mouth is dry, his brain turns to mush, and he keeps hearing a strange voice cry, "Is the mail ready?" When he finally arrives at the station, he collapses. During the next days or weeks, he thrashes around his bed in delirium, latching onto disconnected images of a cheerful doctor, a grave priest, and various acquaintances and events.
One morning Klimov awakens feeling well. His whole being is filled with a sensation of happiness. He learns from the doctor that he has survived a case of spotted typhus. But where is his sister Katya? His aunt groans, "Ah, Katya, Katya! Our angel is gone! Is gone!" Indeed, Katya had caught typhus from her brother and died. Her funeral had taken place the day before. Pavel's "heart ached, he burst into tears, and leaned his forehead against the window frame."
This historical novel for young adults details the horrors of the Philadelphia Yellow Fever epidemic in 1793 from the point of view of a fourteen-year-old, Mattie, who runs a coffeehouse with her widowed mother and grandfather. In the course of the story, her mother is taken ill, she herself falls ill on the way to the safety of the countryside, and her grandfather dies of heart failure after nursing her. Separated from her mother who is also removed from the city, Mattie finds herself scrabbling for survival in a mostly deserted town after the death of her grandfather, but relocates the free black woman, Eliza, who had worked for her family and who essentially becomes part of her family.
Eventually the mother returns, an invalid but alive, and Eliza and Mattie undertake to run the reopened coffeehouse together and care for Eliza's nephews and an orphaned child Mattie has rescued. Hope reappears with the first frost in the forms of a reopened farmers' market, the return of George Washington to the town, and the reappearance from enforced isolation of Nathaniel Benson, a young painter who gives Mattie a vision of a future life with friendship and love.
This gripping narrative traces the history of the efforts to eradicate smallpox in the 1970s, the top-level decisions to keep a few vials of it for emergency purposes in American and Soviet freezers, and the reemergence of smallpox not only as a health threat, but as a potential bioweapon of unequaled destructive power. Preston details maverick natural cases that surfaced after worldwide eradication efforts, how it was discovered that undocumented reserves of smallpox were not only being kept, but researched and possibly "weaponized," and how hotly, in the US, teams of scientists and military intelligence personnel debated funding new smallpox research in the US with a view to developing a new vaccine as a defense.
The ethical issues in those debates are unprecedented in the scope of the possible public health threat and the variables that might make traditional vaccination ineffective against the weaponized virus. As in his previous books on biological threats, The Hot Zone and The Cobra Event (see annotation), Preston follows the work and lives of several key scientists and includes scenes from interviews with a variety of persons involved in confronting the political, ethical, and medical dilemmas posed by smallpox research and efforts to track and control it.
The 58 year old plastic surgeon who narrates this story has plenty of problems. He drinks too much and his surgical skills are deteriorating. His wife Maya, a neurosurgeon young enough to be his daughter, has a miscarriage not long after her father dies from a brain tumor. The narrator is plagued by an obsession with butterflies.
He seems to have inherited his unnatural interest in these insects from both his father and grandfather. Strangely, the pursuit of butterflies has brought only tragedy to these men. Maya believes her husband's butterfly collection is a curse so she destroys it. Her action seems insufficient to liberate the narrator from the burden of his ancestors. He is convinced that his destiny was dictated by his family years ago.
This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.
The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.
Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."
This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.
Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.
Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).
These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.
Another Dimension is an occasional feature of the journal, Emerging Infectious Diseases, published by The Centers for Disease Control and Prevention (CDC). These essays (and occasionally poems or stories) focus on human and philosophical issues related to medical practice, scientific research, and public health. The intention of this feature is to bring a new perspective to the journal’s coverage of medical science and public health. Some of the essays include a painting or other image that draws attention to the subject matter of the essay.
Managing editor, Polyxeni Potter, with the encouragement of Joseph E. McDade, founding editor of the journal, initiated and is guiding this feature (see also the annotation of Potter: Emerging Infectious Diseases cover art). Since this is a government site, its material is freely available on-line.
Sisters Elinor and Marianne Dashwood suffer similar reverses in appearing to lose the affection of their chosen suitors. But whereas Marianne indulges her exorbitant sensibility in her relationship with, and loss of, her suitor Willoughby, Elinor's quiet good sense enables her to bear up when it seems her suitor, Edward Ferrars, will marry another woman. Austen rewards Elinor with Edward's hand, while Marianne must be content to learn to love a steadier husband, Colonel Brandon.