Showing 191 - 200 of 801 annotations tagged with the keyword "Communication"

A Stone Woman

Byatt, A. S. (Antonia Susan)

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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Summary:

When Mary Lennox (Kate Maberly)’s parents die in an earthquake, she is sent from India to live with her uncle, Lord Archibald Craven (John Lynch) at Misslethwaite Manor, his large and lonely estate on the Yorkshire moors. A neglected, lonely, and disagreeable child, Mary changes through encounters with the gregarious maid Martha, an elderly gardener as irritable as she is, and Martha’s brother Dickon (Andrew Knott), a boy at home with nature who helps her rejuvenate a walled, neglected garden she finds on the estate.

Mary also unravels the mysteries associated with Misselthwaite Manor and her aunt and uncle’s family. A depressed widower with a spinal deformity, Lord Craven has locked the garden after his wife’s accidental death. Mary discovers the key to the garden in her aunt’s closed-up boudoir. She also finds her cousin Colin (Heydon Prowse), who has been hidden away because his father thinks he has inherited his bodily and psychiatric illnesses. Mary provokes Colin to leave his bedroom, join her and Dickon in caring for the garden, and finally to summon his father, via a quasi-pagan ritual around a bonfire in the garden, to return from Europe. Lord Craven returns to find his sickly son walking and healthy, and a new family consisting of Colin, Mary, and Lord Craven is formed.

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Summary:

This DVD, a documentary of a medical student retreat to a museum, illustrates an approach to cultivating empathic understanding in medical students and residents by using the visual arts.  Florence Gelo, D.Min, created the arts program and the video. She is Behavioral Science Coordinator, Family Medicine Residency, Drexyl University College of Medicine. Students observe closely four paintings and are encouraged to experience their feelings about what they are seeing, and to express those feelings. The paintings are Prometheus Bound (Peter Paul Rubens 1618), Massacre of the Innocents (Pacecco de Rosa 1640), Rachel Weeping (Charles Wilson Peale 1618), and The Agnew Clinic (Thomas Eakins 1889; see annotation in this database).

Prometheus Bound is a disturbing scene of an eagle ripping the liver out of Prometheus. Students comment on the nakedness. the vulnerable position and the helpless expression on the face of this strong man, and on the eye contact between the eagle and Prometheus. In Massacre of the Innocents Dr. Gelo calls our attention to the faces of the mothers, helpless to save their children from the swords. In Rachel Weeping Gelo asks the students if they noticed the vials of medicine before the days of allopathic medicine.  Did they notice the one tear dropping from Rachel's face? (Peale added the medicine vials and his wife weeping to the original portrait of his infant daughter Margaret who died of smallpox.)

Two physician speakers, Horace DeLisser, and Rhonda Soricelli provide additional commentary about how engagement with a painting is similar to engaging with a patient, and how learning technology-focusing on the scientific and the medical- detracts students from learning to look at the big picture and the humanistic side of medicine.  Traditional medical education does not teach doctors to be present to patients, to sit by their sides, to listen and invite dialogue of suffering and to not deny those aspects of what it means to be ill.  Dr. DeLisser further acknowledged his personal struggles with feelings of frustration, anger and grief when patients died in the ICU.  The importance of talking about the vulnerability of physicians, the concerns about what else they might have done, propelled him to develop Grieving Rounds.

A cancer survivor contrasts a "callous" physician's response to her care with  another physician who exemplified someone who has the expertise not only around the disease, but  has the ability to acknowledge the whole person and offer his companionship to be there to the very end: "...what we're going to do is....We'll take this step by step."


 

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The Diagnosis

Lightman, Alan

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

While riding on a commuter train, Bill Chalmers suddenly forgets who he is and where he is headed. His amnesia is accompanied first by a numbness of his hands and then later his legs. Eventually he is confined to a wheelchair and dependent on his family and a home nurse to care for him. Despite extensive testing and consultations with a variety of doctors, no one can make a definitive diagnosis of his illness.

Chalmers is subjected to many empirical treatments including antidepressants, steroids, plasmaphoresis, and psychotherapy, but his health continues to deteriorate and he loses his job. His wife and son become victims of his predicament. By the end of the story, Chalmers gains insight into his life and discovers that only his dignity still remains in his control.

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The Pearl Diver

Talarigo, Jeff

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Leprosy looms large in this story about transformation and loss set in post World War II Japan. A nineteen-year-old pearl diver notices a numb red spot on her forearm. Later on, another blemish appears on her lower back. These two lesions are manifestations of a mild case of leprosy. Her infection will be arrested by medication and never get any worse. The girl is forcibly transported to the Nagashima Leprosarium, an island where she will spend the rest of her life except for a few brief excursions and one extended "escape" at the age of sixty-four.

Despite the introduction of new and effective drugs--Promin (sulphone) and dapsone--authorities still fear allowing the leprous patients to return to society. Inhabitants of the sanatorium are admonished on arrival that their past is erased. Each individual must begin a new life and select a new name. The protagonist chooses the moniker Miss Fuji. She is a kind and sensitive young woman who eventually functions as a nurse and caregiver for the other patients incarcerated in the sanatorium. As a punishment, Miss Fuji is required to attend abortions and dispose of the dead fetuses.

As the decades pass, conditions on the island improve. The number of residents with leprosy still living there dwindles from about two thousand people to six hundred. Even a bridge connecting Nagashima to the mainland is constructed. It no longer matters. Emotional and psychological barriers remain. When Miss Fuji has an opportunity to create a new life for herself away from the sanatorium, she still returns to the place and the people that have been her home and family for so many years.

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Gilead

Robinson, Marilynne

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

John Ames narrates this story in the form of a lengthy letter to his young son. Ames is a 76-year-old minister suffering from angina pectoris and heart failure. He has spent almost all of his life in Gilead, a small town in Iowa. His first wife died during childbirth along with a baby girl. Ames remarried a younger woman who is now 41. They have a son almost 7 years old.

Because Ames believes his death is close at hand, he pens a missive to the boy. Its purpose is to teach his son about all the important things in life Ames may not be around to share with him. During the course of composing the letter, Ames reflects upon his own existence. He recalls the experiences of his father and grandfather who were also ministers.

Reverend Ames likes to think, read, and pray. Born in 1880, he has lived through three wars, the Great Depression, a pandemic of influenza, and droughts. His hope is that his young son will grow into a brave and useful man.

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Saint Ursula and Her Maidens

O'Connell, Mary

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Five women find fellowship and comfort in the swimming pool at a community center managed by Ursuline nuns. Each woman suffers from a chronic disease--lupus, multiple sclerosis, Crohn's disease, and rheumatoid arthritis. One is also being treated for ovarian cancer. The diverse group includes a pregnant woman, an elderly nun, and a retired nurse who currently peddles Avon products. On Tuesdays and Thursdays, they participate in aquatic therapy. The one-hour sessions temporarily soothe the body and boost morale. It is a welcome reprieve from the burden of disease and the complications of life.

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The Treatment

Robinson, Roxana

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When oral antibiotics are no longer effective, the narrator grudgingly consents to begin a six-week course of intravenous antibiotic therapy with Rocephin (a powerful, broad-spectrum antibiotic). She has an infection caused by spirochetes. The illness has been festering for as long as ten years but has only recently been diagnosed. It causes joint pain and stiffness. Her daughter has already been successfully treated for the same infection.

Every morning in her kitchen, the narrator performs the same ritual. She cautiously infuses the antibiotic and imagines that the golden fluid is extinguishing the corkscrew-shaped microbes. At first she experiences a drug reaction, but the event only convinces her that the treatment is actually working.

She senses that her husband and her friend are repulsed by the treatment (especially the syringes and IV apparatus). A visiting nurse, Ginger, comes to the house to perform minor maintenance on the intravenous line. She upsets the narrator with grim information about the infection and an account of a patient suffering from the same disease who is currently in awful condition. Dr. Kennicott, the narrator's physician, has not been so forthcoming about the course of the illness or pessimistic about the prognosis. The narrator chastises Ginger. Both women are now distressed. The narrator's immediate goal is to control her emotions and avoid crying.

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Thoreau's Laundry

Harleman, Ann

Last Updated: Jan-21-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Celia has her hands full. The maxillofacial prosthetist is overwhelmed by the demands of caring for her ill husband at home. Her job - crafting replacement parts for people whose faces are damaged - is truly art but involves interacting with distraught patients and angry families. Her mother constantly telephones to offer unsolicited advice. Celia's husband, Simon, has multiple sclerosis. He has been treated in the emergency department many times and recently has been on a ventilator. Celia realizes that she unintentionally hurts Simon just by caring for him. She has never developed the knack of painlessly administering his injections. When she attaches the feeding pump to his G-tube (a feeding tube permanently set in the stomach), she induces pain by yanking too hard. Her mother, Bess, and best friend, Leslie, try to convince Celia that Simon would be better off in a nursing home, and her life would be less stressful. Although she has a lover, Celia cannot face losing her husband.

One of Celia's clients is an 8-year-old boy, Junius Jones. Most of his left ear was torn off after he was struck by a van. Celia constructs a silicone ear for the boy. She is deeply troubled when the boy's mother cancels his prosthetic fitting twice. Celia's mother is reading a biography of Henry David Thoreau and shares an inspiring quote by Thoreau with her daughter: "Live the life you've imagined" [p 120]. Perhaps Celia is incapable of imagining a hopeful future. Maybe Junius Jones and his mother are unable too.

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The Tennis Partner

Verghese, Abraham

Last Updated: Jan-20-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

A Doctor's Story of Friendship and Loss, this book is, in a sense, a sequel to Verghese's earlier memoir, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (see this database). The Tennis Partner tells the parallel stories of Verghese's disintegrating marriage as he establishes new roots in El Paso, Texas and of his new deep friendship with a (male) medical student who shares his passion for tennis. Both men are struggling to re-establish order in their personal lives: Verghese, in easing himself out of a dying marriage while trying to maintain a close relationship with his two sons; David (the tennis partner), in remaining drug-free and successfully completing medical training, which had been interrupted by his addiction.

Verghese, an experienced physician trained in infectious disease and an expert on AIDS treatment, relishes his role as David's mentor; David, a former tennis "pro," enjoys teaching Verghese how to play better. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other, seeking solace in a difficult time. Through it "we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost." (339)

While the reader suspects that David must have a drug problem because the Prologue to the book, narrated in the third person, describes a "young doctor from El Paso" in drug treatment, Verghese the biographer has no inkling of the problem until one-third into his first person narrative. He is shocked, but in some ways the bonds of their friendship are strengthened. Each has only the other as a confidant.

David, however, has another addiction: women. The friendship becomes increasingly complicated as Verghese tries to remain both supportive and objective. Eventually David resumes "using" and Verghese must decide how to respond, both professionally and on a personal level. The turmoil in both lives ends tragically for David and causes profound grief in Verghese.

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