Showing 191 - 200 of 667 Nonfiction annotations

Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: History

Summary:

This is the wrenching history of the development, evolution, and eventual obsolescence of the leper colony established in 1866 on the isolated and only sometimes accessible peninsula on the Hawaiian island of Molokai--and the lives of the people who were exiled there to die over a period of more than 100 years. The tale opens with the declaration by the Board of Health that all persons proven (or strongly suggested) to be afflicted with leprosy be exiled immediately to the site on Molokai.

The author dramatically describes the selection and separation of the exiles from their families and the tortuous and sometimes deadly sea voyage to their primitive new homeland. Mixed with the public policy and the individuals who made and implemented it, are the descriptions of the hospital in Honolulu where diagnoses and dispositions were rendered, as well as the poignant personal stories of the "detainees." The reader follows the colony from the arrival of its first 13 patients in 1866, through its peak population of 1,144, to its residual 28 in 2003.

View full annotation

Limbo: A Memoir

Ansay, A.

Last Updated: Nov-21-2009
Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Novelist A. Manette Ansay's beautifully crafted, emotionally complex memoir describes living with a chronic painful, debilitating condition that began mysteriously and has continued to elude both diagnosis and remedy. Without a clear inciting event or a healing resolution to frame her narrative, Ansay structures her memoir as a series of agile reflections in which scenes from the past and present dissolve into one another, mimicking the distortions of time that chronic illness issues. "Time doesn't pass," she writes. "It bleeds, blurs, washes me along" (27).

Ansay's narrative opens when, at age 36, she has returned to visit the somber rural Wisconsin town of her childhood in a body that has lost its "unselfconscious sense of movement" (10). She recounts how she insisted on beginning piano lessons when she was 7, persevering through years of pain and increasing fatigue that ultimately caused her to withdraw from the Peabody Conservatory of Music in Baltimore. The withdrawal ended her dedicated labor to become a performer. Instead, Ansay navigated medical systems in an urgent, but elusive search for a diagnosis.

Multiple Sclerosis, Chronic Fatigue Syndrome, and Lupus could not be verified. Neither could the possibility that playing the piano with nearly manic vigor (in her teachers' view) damaged her body. Ansay's matter-of-fact description of playing Hurricane with her friends in her grandparents' apple orchard-trucks full of pesticides doused the children as they hid in the branches-suggests another still unproven etiology.

View full annotation

Cockeyed: A Memoir

Knighton, Ryan

Last Updated: Nov-21-2009
Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Ryan Knighton writes in his irreverent memoir that his sometimes comical, sometimes dangerous clumsiness—he smashed his father’s car into a boulder and nearly backed a forklift over a co-worker—registered on others as an unfortunate character trait, the carelessness of a distracted teenager. On Knighton’s eighteenth birthday, a doctor offered another explanation: retinitis pigmentosa. The diagnosis of a degenerative eye disease that causes night blindness and tunnel vision before progressing to complete blindness rescued his moral standing. This rescue and the diagnosis seemed to increase rather than moderate his youthful drive for independence along with his search for strategies to make his disability less conspicuous. He tested his independence by attending Simon Fraser University and sharing an apartment with a deaf student, and he discovered that the chaos and flowing alcohol of the local punk rock clubs made him indistinguishable from other stumbling revelers. The clubs became a place where “blindness worked” (50).

Knighton's title Cockeyed: A Memoir captures and prepares readers for his humorous, never self-protective narrative stance and approach to making blindness work. Although he sustains his irreverence as the narrative unfolds, Knighton also makes tamer concessions to his diminishing vision, such as leaning to use the distinguishing white cane that offers "artificial sight" and a "rickety kind of freedom" (68, 154). He later reconsiders his headlong pursuit of independence when he meets his sighted partner Tracy. With her he discovers an "alarming and rewarding" dependent relationship, in which his disability enables an "intimacy few are given" (183). He also quietly reflects on the meaning of blindness after a family tragedy places his disability in a larger context. Here Knighton coaxes his readers to understand blindness as both an individual and a shared incapacity. The death of a loved one, he writes, blinds us from ever seeing him again. "Seeing," moreover, "is itself touched with elegy. . . The world we see is always gone" (181).



View full annotation

Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In Dirty Details, Marion Deutsche Cohen writes about the unrelenting labor entailed in caring for her husband Jeffrey at home as multiple sclerosis turns his symptoms from "mere inconveniences" (11) to extraordinary demands, which can disturb her sleep as frequently as twenty times a night.  The premise of her unsparing narrative is that "we have got to spill the dirty details" (26) of such arrangements before the endurance-draining responsibilities of home care such as hers can be understood and redressed.  In a culture that favors narratives of seemingly heroic individual effort, Cohen's brutally forthright descriptions of the effects of Jeff's needs on her life can be mistaken for a self-pitying complaint, rather than an urgent, revelatory, political call to action.  Like her husband, a well-published physicist at the University of Pennsylvania when diagnosed with MS at age 36 in 1977, Cohen is an accomplished professional.  With a PhD in mathematics, Cohen teaches college students as well as publishes poetry and prose.  She and her husband also shared, with increasing asymmetry, the parenting of their four children.                 

Cohen captures the wearying routine of her days in her narrative's echoing refrain, "nights, lifting, and toilet."   The nights refer to Cohen's dangerously disrupted sleep.  Her husband's respirator can sound every half hour or so, inciting her to worry "about the psychological effects of seldom being allowed to finish my dreams" (23).  (When she asks if the machine can be fixed, she's told that it's supposed to behave that way.  By implication, so is she, despite the toll on her well-being.)  Yet she daily rallies the strength to lift her husband on and off the toilet, a feat, among others, that sometimes defied the powers of several hospital nurses working together.   Toilet also means responding to Jeffrey's regular calls to her to drop what she's doing, run upstairs, and bring him a jar.  The jar at least relieves her from lifting.  She experiences only intermittent relief, however, from finding and keeping home health aides who are able to show up reliably and behave civilly during the few hours per day they can be funded.  What results from these tests of human stamina, Cohen tells us, is not "ordinary stress" that some optimistically believe can be managed by taking stress reduction workshops, but rather "dire straits."  "Calling dire straits stress," she corrects, "undermines well spouses and makes us feel alienated and confused about where we stand" (32). 

It's that standing in the broadest sense of the word that Cohen's book most searingly addresses.  While Dirty Details contains one woman's account of caring for a disabled husband at home, the book's wider purpose is to make the labor of family caregivers visible with all its strains, conflicts, messiness, failures, anger, and, at times, humor.   As the straights become increasingly dire, though, Cohen writes about what happens to love as she moves from sustaining tenderness, candor, and their physical intimacy to diminishing her compassion for Jeff and saving herself:  a "pure survival instinct" (87).   After sixteen years in his family's care, Jeff at first reluctantly enters Inglis House, a residence that provides as much independence as possible for those who cannot live independently, where he continues to write and publish.  Cohen's professional life, social life, and beloved parenting once again flourish.  The story she is freed to write (illustrated with photographs by Anna Moon taken with Jeff's consent) lead readers away from her particular circumstances toward a comprehensive interrogation of social and medical systems that operate by leaving the most chronically ill and disabled citizens in their families' care by default.   And leave the families in dire straits.

View full annotation

Summary:

One day in the 1920’s, a newspaper reporter walked into the laboratory of Russian psychologist A. R. Luria and asked him to test his memory, which he recently had been told was unusual. It was not unusual. It was uniquely and astoundingly retentive. Luria gave him very long strings of numbers, words, nonsense syllables and could not detect any limit to his ability to recall them, generally without mistake, even years later. (Luria studied S., as he identifies him, for thirty years.)

Luria discovers that the man had some interesting characteristics to his memory. He experienced synesthesia, i.e., the blending of sensations: a voice was a "crumbly, yellow voice." (p.24) S.’s memory was highly eidetic, i.e., visual, a characteristic not unique to him but which he used as a technique to memorize lists and details. (He had become a performing mnemonist.) It was also auditory. He had trouble remembering a word if its sound did not fit its meaning. The remainder of the section on his memory involves fascinating aspects of his having to learn how to forget and his methods of problem solving.

The remainder of the book is equally interesting since it relates the epiphenomena of S.’s prodigious memory: how he mentally saw everything in his past memory; how he was virtually paralyzed when it came to understanding poetry since metaphorical thinking was almost impossible for him, a mnemonist who lived in a world of unique particulars! As Luria wrote, "S. found that when he tried to read poetry the obstacles to his understanding were overwhelming: each expression gave rise to an image; this, in turn, would conflict with another image that had been evoked." (p. 120)

S. could control his vital signs by his memory and, last but not least, this human experiment of nature had such a vivid imagination that, probably more than the most creative of us, he engaged in "magical thinking": "To me there’s no great difference between the things I imagine and what exists in reality. Often, if I imagine something is going to happen, it does. Take the time I began arguing with a friend that the cashier in the store was sure to give me too much change. I imagined it to myself in detail, and she actually did give me too much--change of 20 rubles instead of 10. Of course I realize it’s just chance, coincidence, but deep down I also think it’s because I saw it that way." (p. 146)

View full annotation

Annotated by:
Davis, Cortney

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

In 1997, the author’s 14-year-old son, Ike, began a puzzling, progressive degenerative illness. Slowly, this undiagnosed disease claimed Ike’s ability to walk, to study, to participate in normal adolescent activities and, finally, to reason. Going from physician to physician, seeking if not a cure than at least a working diagnosis, the author became a self-taught expert in all things neurological.

As her son’s condition worsened, she also became an expert in grief and despair. In Blue Peninsula, her first book, McKeithen relates how she became, as well, a poetry addict--reading, devouring, tearing poems out of journals, buying volumes that she could carry to office or hospital, hiding poems in her purse or pocket. Using poems or pieces of poems--sometimes she could not bear to read a final stanza, one that perhaps ended in death or unrelenting despair--she cobbled together a survival plan.

Indeed, in this small book of short, to-the-point chapters (with titles such as "Crying in the Car," Open to It," Acquiring Losses," Sifting Questions," "Naming," "Shipwreck," and "Shelving Selves"), she reveals how she used poems to grieve, to question, to celebrate, to maintain, to curse, and to endure. The story of Ike’s illness, treatment and slow decline are interwoven with these poems and the author’s often surprising commentary on how she mined the poet’s metaphors. If a poem could put suffering into words, the author suggests, she needed that poem to survive.

The author’s choice of poems and poets is far-reaching, and her interpretations of what they mean and how they helped her along the path of her son’s illness are intimate, gritty and insightful. A brief listing of poets includes Emily Dickinson (whose poem "Blue Peninsula" supplied the book’s title), Billy Collins, Elizabeth Bishop, Diane Ackerman, Zbiginew Herbert, The Rolling Stones, Paul Celan, Molly Peacock, David Whyte and many others, known and lesser known.

View full annotation

Summary:

Poets on Prozac contains sixteen essays written by poets about their individual struggles with a variety of psychiatric disorders. The editor, physician and poet Richard Berlin, has gathered these essays in order to examine, and shatter, the long-standing notion that madness, particularly madness in poets, enhances creativity---we need only think of the myths surrounding writers such as Sylvia Plath and Dylan Thomas to understand how the relationship between madness and creativity might foster both fear and longing in novice writers.

In his informative and comprehensive introduction, Berlin poses these, and other, questions: "Do poets need to be mentally ill to produce great work? What is the influence of substance use/abuse? Does a person have to be 'crazy' to write good poetry? What do poets themselves define as crucial elements in their creative process?" (p. 2). He goes on to site current evidence that madness actually impedes creativity, as well as evidence that "some forms of mental illness may enhance, or at least coexist, with creativity" (pp. 4-5); he reviews the findings of researchers who have looked at "The Myth of Inspiration" and "The Myth of Very Special Talent" in creative persons (pp 6-7).

But it is in the wonderful essays themselves that we take a privileged peek into the lives, the often tortured lives, of successful poets (Berlin only considered the essays of poets who had published at least one book). Reading the essays is somewhat like eavesdropping on the therapy sessions of highly articulate and self-aware patients. Clearly Berlin has created a safe place for these writers to look again at their creative lives and how those lives intertwine with, and sometimes have been overgrown by, mental illness. All the essays, happily, come to a place of resolution; the writers find, in various degrees, that understanding or relieving their emotional distress results in the possibility of increased creativity. Along the way, they give us writing alive with metaphors, images and intelligent musings on art, poetry, life and suffering.

In the first essay, "Dark Gifts," Gwyneth Lewis writes about her depression: "I became Woman in a Dressing Gown. At my worst, the duvet on my bed looked like a body bag and I was the corpse inside it" (p. 13). Finally she concludes, "I've learned that depression is one of the most reliable guardians of my life as a poet. It's like a fuse in a house with suspect wiring" (p. 22). In his essay, Andrew Hudgins describes cortisone psychosis this way: "I was a fire station in which the alarm bells seldom stopped clanging and the firemen were exhausted and indifferent" (p. 163). In "The Desire to Think Clearly," J. D. Smith says, "Being a poet in despair does not necessarily make one a poet of despair" (p. 23). As most of the poets do, Denise Duhamel uses examples of poems within her essay to demonstrate how her illness, in this case bulimia, variously inhibited or influenced her writing. The rawness of illness shows up, again and again, in her ability to be brave and resolute in her poems: "I'm still working it out, as they say, as therapists say, as my friends say, / as I guess I'm saying now in this poem" (p. 37).

Many of the poets approach their illness histories with wry humor or pointed irony. Caterina Eppolito states that "Poetic form is an anorexic form of writing. So instead of restricting calories, I was restricting words" (p. 118). Ren Powell asks, "Maybe when it's all over I can ask my children if they think the days of dancing in the kitchen were worth the days I spent shut away in the bedroom" (p. 52). Powell, like most of the authors in this anthology, honors hard work at the craft as the measure of success, and says, "If I have any success at all as a writer it is as much despite my disorder as because of it" (p. 57). Other writers admit wondering, sometimes, if their writing success might be due to their disorders. Jesse Millner writes, "After all, wasn't it the melancholy that led me to write?" (p. 67). Most writers agree that abusing substances did not enhance but sidetracked their poetic energies, while prescribed medications often, as Jack Coulehan says, helped: "The obsessive traits softened, so I felt free to approach life in a more flexible manner. Despite this new experience of freedom, my productivity did not suffer; in fact, it increased" (p. 101).

The chemical basis for some mental disorders is acknowledged in many of the essays. In her discussion of postpartum depression, Martha Silano notes, "I'd simply woken up in a foreign country without a map, without a dictionary, with no way to understand this strange place" (p. 142). Silano, like others in this collection, found that once the chemical imbalance was corrected, something good happened to the writing---she moved from writing about her own personal experience to writing that reached beyond her fears: "Now I was writing poems with a more universal, all-encompassing vision" (p. 146). Liza Porter says it this way: "Voice comes from safety. Silence becomes words. The truth can be told" (p. 153). But the downside of medication is admitted as well. Chase Twitchell laments the loss of "metaphor-making," and compares it---in quite a fine metaphor---to someone turning "off the spigot" (p. 176). "It takes longer and requires far more doggedness than it did before medications" (p. 176). But medications also give many of these poets what Vanessa Haley names "the emotional insight and stamina to write" (p. 76). If these excellent essays are any indication, they are, and will continue to be, writing extraordinarily well.

 

View full annotation

Summary:

This volume belongs in the category of cross-cultural studies of medicine and the humanities. Its main audience is scholars of nineteenth-century American psychiatry and culture. The author divides his study into six chapters, each with a topic, including the simultaneous emergence of nineteenth-century public debate about improving the treatment of insanity and the movement to abolish slavery; cultural activities in asylums directed toward humanizing the patients; bardolatry in British and American medical circles; discussions of Emerson, Hawthorne, Poe, and Melville in the context of their literary and personal relationship with madness; a chapter on captivity narratives and popular novels by former female and male patients; and an epilogue.

Unlike today, "In mid-nineteenth-century America, the condition of the mentally ill seemed to demand-and to a large degree received-national attention and the full creative energy of a group of dedicated reformers" (p. 2). Reformers linked the emancipation of slaves with curing the delusions of the insane. Slaves and the mentally ill had in common deprivation of their civil liberties; however, the difference was that white mental patients could be expected to grow up eventually, whereas black slaves would always remain children, and hence could not be trusted with the right to vote, own property, or sign contracts.Some causes of insanity were deemed to be the individual's reaction to the stress of modern life, too much freedom and choice, religious fervor, masturbation, or excessive study. In their aggressive attempts to remake patients into proper gentlemen and ladies, the new asylums promoted cultural activities such as reading selected texts, theater performances and writing.

Most asylums housed males and females in approximately equal numbers; cultural activities for females stressed piety, fashion, and domestic activity while men could comment on politics, the temperance movement, and opposition to women's rights. Reiss refers to the French model of using cultural activities in asylums, f.ex., Philippe Pinel's staging of plays to educate patients, and Marquis de Sade's theater performances at Charenton. He ends with a discussion of patient narratives that depict some horrific abuses tolerated in nineteenth-century asylums; the degree of these abuses is familiar to us from One Flew Over the Cuckoo's Nest (see film annotation).

The work includes a few illustrations, the most important being an engraving from a painting by Tony Robert-Fleury titled: Pinel Freeing the Insane (1876). (Yale University). Philippe Pinel (1745-1826) was a French pioneer in the humane treatment of mentally ill patients. A Director of Bicêtre Hospital in Paris, he is depicted as a heroic physician, liberating, mostly female, patients there. However, scholars have shown that only 10 of the 270 patients were chained, and that Pinel '"accepted the traditional use of chains to restrain the violent insane as a matter of course"' (p. 160). Reiss's point is that the revolutionary nature of Pinel's treatment of the insane has been exaggerated.

View full annotation

Annotated by:
Mathiasen, Helle

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Subitled, Invisible Wounds of War. Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery, this monograph features 27 contributing researchers. Published by the RAND Corporation, it is funded by a grant from the Iraq Afghanistan Deployment Impact Fund. The study was conducted under the joint auspices of the Center for Military Health Policy Research, a RAND Health Center, and the Forces and Resources Policy Center of the National Security Research Division of the RAND Corporation.
 
The work deserves our full attention as it delineates and explains the economic, human, medical, political, public health, and social consequences of injuries suffered by returning veterans of US involvement in 8 years of continuous conflict in Afghanistan and Iraq. The introduction defines the three kinds of invisible wounds affecting thousands of the 1.64 million American troops deployed in Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (Iraq) since 2001. These combat related injuries are post traumatic stress disorder (PTSD), major depression, and traumatic brain injury (TBI). Upwards of 26% of returning troops may have mental health concerns, including drug and alcohol dependency, homelessness, and suicide.

The monograph analyses numerous studies of these issues, both governmental and non-governmental, and RAND has conducted its own study. The data collection is recent: from April 2007 to January 2008. RAND estimates that approximately 300.000 persons currently suffer from PTSD or major depression; in addition, 320,000 veterans may have experienced TBI during deployment.

The recommendations include evidence based care at the VA level, the state and community level, and on site in Afghanistan and Iraq. Adequate care would pay for itself and save money in the long run by improving productivity and reducing medical and mortality costs for members of the US armed forces.

View full annotation

Summary:

Written by a psychiatrist and historian, American Melancholy: Constructions of Depression in the Twentieth Century looks at how culture, politics and, in particular, gender have played a role in the development of a diagnosis.  Hirshbein moves between several different worlds, showing how they intercalate and, indeed, are very much part of the same world: psychiatric nosology and cultural attitudes to the gendered expression of emotion and feelings, medication trials and magazine advice to women about how they should deal with the blues, the relations between treatment paradigms and how society views suffering.

View full annotation