Showing 21 - 30 of 754 annotations tagged with the keyword "Grief"

Summary:

This engaging memoir describes Pearson's medical training at the University of Texas Medical Branch (UTMB) on Galveston Island from 2009 to 2016. During these years her personal values become clear, and she finds fault in her training, in medicine as practiced in Texas, and even in her own errors in treating patients.

Having left a graduate writing program, Pearson took a "postbac," a year of pre-med courses in Portland, Oregon. She interviewed at medical schools "all over the country" and writes satirically about them; she concludes "nothing out of Texas felt quite right," having lived there and done her undergraduate work at University of Texas at Austin. She's a Spanish speaker with a working-class background. When her classmates provide the annual “white-trash”-themed party, she wonders, “do I go as myself?” (p. 21).

Pearson's education continues on three tracks: the formal UTMB courses in medicine, a simultaneous Ph.D. program at the Institute for the Medical Humanities at the University of Texas, and her volunteer work at the St. Vincent's Student Run Free Clinic. The Ph.D. program is off-stage, not mentioned, but the St. Vincent's Clinic becomes pivotal to her development as a doctor and a moral person.

As for medical school, she finds the relentless "truths of biochemistry and anatomy" so reductive that the suffering of people and surrounding politics seem "not to matter at all" (p. 70). Among the politics are: the lack of safety nets for poor people, the use of uninsured (including prisoners) for students to practice on, failures to extend Medicare, pollution (notably from the oil industry), losses of charitable care, and income disparities that include crushing poverty for many. Something of a rebel, she writes that medical school "felt like junior high" (p. 44). She does enjoy the "clinical encounters" with real patients.

St. Vincent's, by contrast, was “a relief.” Her pages sparkle with her conversation with clinic patients, some homeless, all poor, and all suffering. She reports--confesses, she even says--her errors that had consequences for patients. She writes that errors are an unavoidable part of medical education, but that it's wrong that they should routinely happen to the poorest members of society.  

Chapter 8 discusses depression, which she felt after the second year. She writes about high rates of suicide among medical students and doctors; indeed a close friend killed himself during the "post-doc" year. Because some states require doctors to report psychiatric care, some doctors avoid such care. This consequence “drives a suicide-prone population away from the help we may need" (p.92).

The last two years are the rotations through specialties: surgery, dermatology, trauma, rural medicine, neurology, internal medicine, and so on. These are clearly and insightfully described. In one case (internal medicine), she allows the reader to see the irony of a doctor providing hair removal by laser, diet foods, and Botox treatment for wrinkles, “a pure luxury transaction” (p. 183).

Pearson describes the storms, hurricanes, and floods that hit Galveston Island, also the pollution from the oil industry that causes a “cancer belt” along the Louisiana and Mississippi coasts (p. 104).
At last she finishes her program, understanding that her identity is simultaneously a person, a physician, and a writer (p. 248). 

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Augustown

Miller, Kei

Last Updated: Oct-03-2017
Annotated by:
McClelland, Spencer

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Set in the loosely fictionalized Jamaican town of Augustown (“loosely,” as it bears a strong resemblance to August Town, which was absorbed over time into the expansion of Kingston), the novel spans three generations of a single family.  The novel moves back and forth easily through different moments in time, from the birth of Rastafariansim in 1920 under British colonional rule, through the post-colonial division of the island and its citizens into turbulent threads, to the present day of 1982, where the same tensions run strong as ever.  

Ostensibly a family novel, the story centers on Ma Taffy, her niece Gina, and Gina’s son Kaia, and it boils down to several key moments in their lives.  But these moments are brief in the overall bulk of the novel, the majority of which is devoted to the fleshing out of the world that permits – and, as we ultimately realize, requires – that such moments come to pass.  There is the miracle of the preacher Alexander Bedward, who, as seen through the eyes of Ma Taffy, could have literally floated up to the Heavens; the comically doomed marriage and foiled aspirations of schoolteacher Emanuel Saint-Josephs; the errand run by Soft-Paw, a young gang member; the second chance that comes before the well-to-do Claudia Garrick; the friendship of Clarky and Bongo Moody, and their run-ins with the police.  As Miller moves between these characters, the forces pushing Ma Taffy, Gina, and Kaia to their conclusion become clearer and harder to resist.
 

Despite the complexity of the novel’s structure, Miller easily weaves all of the component parts together.  The result is absorbing and affecting, a novel that is as much a family drama as it is an exploration of the legacy of colonialism, religion, class conflict, and violence.

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Annotated by:
Aull, Felice

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

This anthology of poems, short stories, and essays derives from the literary magazine, Bellevue Literary Review, which began publication in 2001. The editor of the magazine and her staff have selected what they consider to be the best literary pieces from the Review's first 6-7 years of publication. Like its parent magazine, the anthology focuses on work that addresses the illness experience, health, healing, and the experiences of health care professionals and other caregivers. The anthology is divided into three parts, each of which has several subsections. Part I, "Initiation," looks at patients' introduction to illness and introduction of doctors to medical education and medical practice. Part II, "Conflict: Grappling with Illness," divides into sections on disability, coping, madness, connections, and family. Part III: "Denouement," addresses mortality, death, loss, and aftermath.

Among the 81 authors represented, seven are physicians, and another half dozen or so are in other caregiving professions such as nursing, social work, counseling. Some writers are well recognized in the literary world (for example James Tate, Amy Hempel, Alicia Ostriker, Rachel Hadas, Sharon Olds, Philip Levine, Floyd Skloot, Julia Alvarez, David Lehman, Rafael Campo, and Abraham Verghese -- the latter two are physicians); most of the less well-known others have published in a variety of venues.

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Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

In-Between Days: A Memoir about Living with Cancer is an accurate and suggestive title. At 37, Teva Harrison was diagnosed with Stage IV breast cancer with metastases to her bones. She lives between hopes for new treatments allowing a useful life but also fears about debility—some already caused by her treatments—and death. An artist, she has created a hybrid of a graphic novel with comic-book style drawing on the left page and traditional prose facing on the right, with variations of this format now and then.     
       
The imaginative world of the book ranges widely in mood, topic, and subject matter, and there is a helpful organization to group the material.
Her Preface tells us how drawing helped her gain some power over “the bogeyman that is my cancer” (p. 1). In her Prologue, she tells of “living in the shadows,” or “liminal spaces,” but choosing to occupy these as best she can (p. 3).            

Part One lays out the medical facts and dilemmas. The sections are Diagnosis, Treatment, and Side Effects. The author describes the turmoil of being sick with no clear cause, the emotional impact of the serious diagnosis on her and her family, also nausea, loss of fertility, dilemmas of pain management, and many side effects of treatment, including weight loss as well as sudden and torturous menopause.
  
Part Two explains her social status, her marriage, her “mixed-bag inheritance” (including high-risk Ashkenazi genes), and social aspects, including feeling invisible as a patient, accepting help from friends, being in a support group, and what does a likely “early demise” mean for her, an atheist?
         

Part Three explores the many emotions in sections for hope (using clinical trials, for example), gratitudes (“At least I’m wasting, not bloating”), wishes, fears, and “Managing Anxiety at Home” (pictures of yoga, gardening, long walks, house cleaning), self-blame, and—nonetheless—dreams. The final section “Incurable” names her current status: “In treatment for the rest of my life,” but the facing picture shows her as a large powerful bird flying among dramatic clouds with the words “I mean what do I have to lose?” Her prose affirms: “Live like a tornado, when I can.” 

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Annotated by:
Clark, Mark

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

Wandering in Darkness is an intricate philosophical defense for the problem of suffering as it is presented by medieval philosopher Thomas Aquinas.The work addresses the philosophical / theological problem of evil, which might be expressed as follows:  if one posits an all-good, all-powerful God as creator, yet suffering exists in the world, then (a) God must be evil, since he created it; (b) God is less than all-powerful, since suffering came to be in his creation, and he could not stop it; (c) God is evil and weak, since suffering came to be in his creation, and he did not want to stop it; or (d) suffering is an illusion.  No alternative is, of course, very satisfying. In her book,   Eleanore Stump augments Thomas Aquinas’s theodicy by reflecting upon what she calls “the desires of the heart,” a dimension of human experience that Aquinas leaves largely untreated in his consideration.  Stump explores this dimension by breathtaking exegeses of Biblical narratives as narratives: the stories of Job, Samson, Abraham, and Mary of Bethany.  “Understood in the contexts of [these] narratives,” Stump argues, “Aquinas’s theodicy explains in a consistent and cogent way why God would allow suffering" (22).

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Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The subtitle is accurate enough: “A Memoir of a Family and Culture in Crisis,” although the author J.D. Vance is, in fact, the focal point of view throughout, from his childhood to his success as an adult. Few young people made it out of the hills to enjoy stable and successful lives, but J.D. was one of them, earning a degree at Ohio State University, then a law degree at Yale. While recounting his life, he also describes his relatives and neighbors, and he interprets the many dilemmas of his hillbilly culture. 
 
Vance was born in 1984 and grew up in Jackson, Kentucky, a poor town following the collapse of coal mining. His family was beset with poverty, alcoholism, mental instability, and more. His mother had nine miscarriages and suffered from addictions; she had multiple husbands. The culture around him suffered from domestic violence, drug abuse, hoarding, unemployment, honor defended by fists, knives, or guns, as well as bad financial habits, bad diets, obesity, lack of exercise, sugary drinks, dental problems, and what he calls “emotional poverty.”  There was welfare abuse and, in general “a chaotic life.”  He credits his grandparents, other relatives, various teachers and professors for supporting him, guiding him, and comforting him when he was hurt, angry, and/or confused.
 

Like many other hillbillies, J.D. moved some hundred miles north into southern Ohio, where steel companies provided jobs—that is, until they closed, like many other employers in the Rust Belt. There also, hillbillies were left without income and social problems increased. Stores and restaurants closed. Payday lenders and cash-for-gold shops took their place. Drug dealers and users took over empty houses.  

After high school, Vance joined the Marines. He credits the military for teaching him discipline, persistence, and for developing his self-respect. For his success at Yale, he thanks his professors, his girlfriend (later wife), and classmates for helping him understand customs of New England society. One example: he leaves a banquet to call his girlfriend; she instructs him on how to handle the nine pieces of unfamiliar silverware surrounding his plate.  

The last three chapters (11, 12, 13) and the conclusion analyze his experience on more conceptual terms, including the “social capital” prized by the the New England world, social instability of the culture he was raised in, and “adverse childhood experiences” (or ACEs), the psychologists’ phrase for the damaging events children experience in a culture of poverty, violence, and limited futures. He writes that governmental child services have policies that don’t understand the important roles of aunts, uncles, and grandparents in subcultures that rely on extended families.  Indeed, faithful to his mother, he, as an adult, provides specific help to her. 


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Manchester by the Sea

Lonergan, Kenneth

Last Updated: Jan-09-2017
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Lee Chandler is approaching middle age and working as a maintenance man for an apartment complex in Quincy, Massachusetts. We get a sense for his days as we watch him shovel snow from the walks, unclog toilets, fix leaks, and argue with tenants. We get a sense for his nights as we watch him at a bar drink himself into a fighting mood and then watch him fight. He returns to his sparse subterranean apartment that he shares with no one to sleep off the beer and the bruises. He’ll do it again the next day.  

Lee takes a call as he’s shoveling snow. His older brother Joe is in the hospital in Manchester. He would not get there before Joe dies. A few days later Lee finds out he’s now guardian to Joe’s teenage son Patrick. This is not a responsibility he knew about or welcomed, and one that anchors him to his hometown of Manchester. He doesn’t want to stay in Manchester. Through a series of flashbacks, we find out that it’s not the struggles that come with taking on the responsibility of a rambunctious teenager that makes him want to leave again, it’s the unspeakable tragedy he experienced there years before. He blames himself for this tragedy, as did his wife Randi, and many of the townspeople.  

Over the next few months, Lee is busy making burial arrangements for his brother, situating his nephew, and looking for work while being reminded regularly of what causes his profound suffering. He also experiences fresh assaults. One in particular is the reemergence of his now ex-wife Randi. She attends Joe’s funeral forcing him to bear the sight of her with a new husband and in the late stage of pregnancy. A little later he encounters her in town with her newborn child in a buggy. She wants to make amends for her contribution to his suffering. Lee’s response to Randi’s entreaties is gracious but lifeless, and explains how he gets through the days. He has no internal resource to muster responses to anything, good or bad. He’s hollowed out. “There’s nothin’ there,” he tells Randi.
 

We’re given no reason to expect there will ever be anything there again for the rest of Lee’s life through a conversation he has with Patrick. Lee has arranged for a family friend to adopt Patrick so that he could leave Manchester for a job in Boston. When Patrick pushes him to stay, Lee confesses: “I can’t do it. I can’t beat it. I can’t beat it.”

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Extremis

Krauss, Dan

Last Updated: Dec-05-2016
Annotated by:
Redel-Traub, Gabriel

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Extremis, a Netflix documentary directed by Dan Krauss, follows Dr. Jessica Zitter a palliative care ICU physician at Highland Hospital in Oakland, California. The documentary begins with an exasperated Dr. Zitter trying to communicate with a patient on a ventilator: “Is this about the breathing tube? You want it out?” she asks. When the patient nods in affirmation, Dr. Zitter replies, “What if you die if I take it out?” The questions confronting the physicians, patients and their loved ones get no easier over the course of the film. The documentary is propelled by a dramatic tension between its protagonists: on one side Dr. Zitter, who is compassionate but dogmatically pragmatic, on the other side the family members of patients who are driven above all by hope and faith. This tension manifests itself in palpable ways. In one particularly powerful scene, a patient’s daughter says to Dr. Zitter: “it would feel like murder to pull that life support. That’s what it would feel like to me…I feel like maybe as a doctor, you know, being as smart, and being as knowledgeable, and being inside medical journals, it can dwindle your optimism a little bit.” Dr. Zitter replies simply, “I’m just trying to help you make a decision that’s right for your Mom.”  Of course, for Dr. Zitter there does appear to be a categorically appropriate decision in all of these cases. In most of her conversations, she is transparently trying to get family members to see that there is no realistic chance of meaningful recovery for their loved ones. That is not to say that she is insensitive to the family’s wishes or the complex bioethical conundrums which arise around her. In fact, her bravery and deftness in broaching these serious and difficult topics is on full display throughout the film. 

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Emergency Room Notebook, 1977

Berlin, Lucia

Last Updated: Nov-28-2016
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator Lucia works in a California city emergency room. Her job title is not specified - possibly a registration clerk or triage nurse. She enjoys working in the ER and marvels at the human body: "I am fascinated by two fingers in a baggie, a glittering switchblade all the way out of a lean pimp's back" (p90). Death, however, is a regular visitor.

All day, ambulances back up to the emergency room, gurneys rumble by, and charts accumulate. The staff is too busy. Patients are restless, frightened, and angry. She notes how everything associated with the ER appears gray - patient's skin, blankets, emergency vehicles. And perhaps the prognosis of patients as well: "Everything is reparable, or not" (p90).

Lucia describes Code Blues, the deaths of gypsies, an encounter with a blind man whose wife was DOA, drunks, and suicide attempts. She wonders why the elderly fall down so frequently. She's frustrated by the large number of people who come to the ER without an actual emergency and longs for "a good cut-and-dried stabbing or a gunshot wound" (p93). But Lucia worries that she has become too desensitized working in the emergency room, maybe even inhuman. Yet the flow of patients doesn't slow down - those with true life-threatening conditions and those who probably don't need to be there.

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Mijito

Berlin, Lucia

Last Updated: Nov-28-2016
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

It is a strange and cruel world that Amelia finds herself in. The 17-year-old woman from Mexico who speaks very little English travels to Oakland, California to marry her boyfriend Manolo. Soon after, he is sentenced to 8 years in prison. Amelia is already pregnant. She and her newborn son, Jesus Romero, move in with Manolo's aunt and uncle. Amelia refers to the baby as "mijito" (an affectionate Spanish term for "little son"). He cries constantly and has a hernia that requires repair. But the teenage mother is overwhelmed and frightened. She receives little support.

Amelia and Jesus go to the Oakland Children's Hospital where they meet a cynical but kind nurse who works with a group of 6 pediatric surgeons. Most of the surgical practice consists of Medi-Cal welfare patients and lots of illegal aliens. The nurse encounters crack babies, kids with AIDS, and plenty of disabled children. When the surgeon examines Jesus, he notes bruises on the baby's arms. They are the result of Amelia squeezing him too hard to stifle his incessant crying. Surgery is scheduled but doesn't get done.

Later, the uncle makes sexual advances and, while drunk, rapes Amelia in the bathroom. The aunt insists Amelia and Jesus leave the apartment. She deposits them at a homeless shelter. Amelia spends her days riding buses and her nights at the shelter where she is harassed and robbed. All the while, Jesus cries. Amelia notices his hernia is protruding and she is unable to push it back in place as she was instructed. After office hours, the same nurse evaluates the situation and accompanies them to the emergency room where surgery is performed.

Amelia and Jesus return to the ER. She has been sedated and is staring blankly. Jesus is dead with a broken neck. The nurse from the surgical clinic is at Amelia's side and learns that Jesus was crying in the homeless shelter and keeping others there awake. Amelia shook the infant to try to quell the crying. She didn't know what else to do.

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