Showing 21 - 30 of 198 annotations tagged with the keyword "Institutionalization"

Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sherwin Nuland has had a distinguished career as a surgeon on the faculty at Yale University and as an author with interests in history of medicine, medical ethics, and medical humanism. In this memoir we become acquainted with a different side of Nuland, that of son to a widowed, immigrant father with whom the author had a complex and difficult relationship.

We learn also that Nuland has suffered from depression on and off since he was preadolescent, experiencing a major breakdown in midlife. This book attempts to make sense out of the family dynamics and the depression. At the same time, it describes the insular world of Russian Jewish immigrants living in New York City's Lower East Side and Bronx in the first half of the 20th century.

Nuland explores, frankly and openly, his ambivalent relationship with his father, Meyer Nudelman, and contrasting adoration of his mother, who died when Nuland was 11. The young Sherwin (Sheppy) Nudelman lived in fear of his father's strict rules and unpredictable anger. Further, Sheppy was required to assist his father whenever he went out of the house because Meyer Nudelman had an unsteady gait that made walking difficult and that became increasingly severe. Although the boy initially enjoyed these neighborhood jaunts with his father, he was increasingly resentful of them as his father's condition deteriorated and as his own interests focused more on people and activities outside the home. His father's strong Yiddish accent, strange gait, and sloppy appearance were a major embarrassment.

The last third of Lost in America--chronologically the era of World War II, the Nazi atrocities, and after--concern Nuland's maturation and his path toward the profession of medicine. As he and his brother, Harvey, were contemplating a future in the world of Gentiles, they decided to change their last name from Nudelman to Nuland. Sherwin Nuland was accepted to medical school at "Waspy" Yale and chose to enroll there, deliberately distancing himself (on the surface) from his father and his culture.

In medical school Nuland realized that Meyer Nudelman's physical symptoms were caused by late stage syphilis. The initial shock and disbelief of that discovery dissipated; Meyer's growing helplessness and tremendous pride in the accomplishment of his son allowed for a measure of understanding and affection between the two.

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Ape House

Gruen, Sara

Last Updated: Dec-16-2010
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ape House is the fourth novel of Sara Gruen. It relates the story of a group of bonobos living in the Great Ape Language Lab in Kansas City under the immediate direction of scientist Isabel Duncan. These six apes are quite adept in using American Sign Language to express their thoughts, wishes and interactive relations with humans. When the Laboratory is the target of a violent explosion, apparently by animal rights activists, Isabel Duncan is severely injured. The six bonobos escape, soon resurfacing in New Mexico as the prime time stars of Ape House, a reality TV show produced by Ken Foulks, a stereotypically evil TV mogul. The bonobos and the show become a controversial hit and the immediate bane of a still recuperating Isabel.

Covering the Great Ape Language Lab pre-explosion as a feature story, print reporter John Thigpen follows them from their first home in the language lab to their TV residence. Meanwhile he is undergoing his own domestic turmoil with his wife Amanda, a frustrated novelist who is also less than happy with their marriage. The novel follows these twin threads - the trajectory of the bonobos from protected apes in a nourishing research environment to exploited animals, and the sturm und drang, both marital and career, of John and Amanda Thigpen. While millions of TV viewers watch the bonobos playing house and enjoying the "generous amounts of sex"? (as described by the book jacket), Isabel tries to regain ownership and protector status of her bonobos, whom she considers family.

Without divulging the denouement of the novel, suffice it to say that Isabel is successful in renewing her mater familias status of the apes, and John Thigpen gets a huge journalistic scoop as well. In the process, he and Isabel find true love and happiness, but not with each other, as coyly but falsely suggested earlier in the book. For everyone except Isabel's first love interest, Dr. Peter Benton, and Ken Foulks, the book ends on a very happy note.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

An engaging historical analysis of several aspects of the history of madness and art. It includes chapters on the history of

- the portrayal of mentally disturbed people;

- the idea that creative genius is enhanced by mental illness;

- architecture of psychiatric hospitals;

- art therapy; and

- the use of art as a semiotic tool for diagnosis.

Several case studies of individual artists, such as Richard Dadd or Adolf Wölfli are used to exemplify each theme. Special attention is given to artistic movements such as romanticism and expressionism. It is completed by excellent endnotes, a good bilbiography, and detailed annotated index.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The journalist author investigates the hidden lives of his father and his grandfather, both physicians. He is motivated by the mysterious silence that pervaded the ancestral home in a wealthy Toronto neighborhood, and by the frightening tendency to depression and suicide that stalks his family members like an Irish curse.

He uncovers many details of the early adventures of his parents, the failure of their marriage, and his father’s doomed career. From his beginnings as a debonair socialite, the father, Jack, embarks on a promising medical career as an allergist; however, he virtually sinks into taciturn misery and alcoholic self-destruction, unable to express affection or joy. Jack’s endless travails as a patient through shock therapy, analysis, and heavy psychiatric drugs are presented in merciless detail using hospital records and interviews with caregivers. The author’s self-indulgent anger with his self-absorbed father drives the research deeper into the earlier generation, to learn about the grandfather of whom his parents rarely spoke.

The author's grandfather, Irish-born John Gerald FitzGerald (1882-1940), son of an immigrant pharmacist and an invalid mother, strode through the exciting scientific world of the early twentieth century like a medical Forrest Gump. At first, he is drawn into the new fields of psychoanalysis, psychiatry, and neuropathology; cameo appearances of Freud, Ernest Jones and C.K. Clarke light up the story. But then this elder FitzGerald is swayed by the need to control infections and produce vaccines. He travels Europe and the United States for three years learning bacteriology.

Upon his return to Canada in 1913, he fearlessly launches a Canadian-made solution, outfitting a stable and a horse farm to produce rabies vaccine and diphtheria anti-toxin. The initiative evolves into the famous Connaught Laboratories and the School of Hygiene, its academic arm. Other luminaries enter the story– such as Banting and Best of insulin fame and C.B. Farrar of psychiatry. FitzGerald served as Scientific Director of the International Health Division of the Rockefeller Foundation and as Dean of the University of Toronto medical school.

Nevertheless in his late fifties, having accomplished so much, the grandfather crashes into doubt, depression and self-destruction, believing himself a failure and consumed with guilt for some never-disclosed transgression. Did his stellar achievements, his high expectations, and his baffling demise dictate the collapse of his son Jack?

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My Life as a Doll

Kirschner, Elizabeth

Last Updated: Oct-27-2010
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In this collection, which is really a poetry memoir or lengthy poetry sequence, the speaker develops her narrative of a tormented childhood and adolescence, psychological breakdowns, and ongoing struggle in a more "normal" present.  The poems are labeled only by section, of which there are four, and are separated simply by their spacing on the page.  Section 1, "Cuckoo," reveals the origin of the poet's "life as a doll": "After my mother hit the back /of my head with the bat's /sweet spot, light cried / its way out of my body. . . . I was  . . . a doll carved out of a dog's bones . . . my life as a doll / was a life of waiting" (4-5).  Mother was an abusive alcoholic (there seems to be no father ever on the scene).

Section 2, "An Itty Bitty Ditty," concentrates on the speaker's adolescence, which was one of promiscuity and parental neglect.  "Pretty, said Mom / on the night of the prom . . . Pretty, she said as though / I were a ditty, an itty bitty / ditty not even God would pity. / Ditty gone silent.  ditty gone numb" (27).  At age 19 the poet/speaker "took a razor to my wrists"; she was pregnant with an unwanted child at age 20: "Cold walked into me and through me . . . How do you undo someone who's / already undone?" (32-33).

In the third section of the collection,"Tra-la-la," we are whisked ahead to the time when the poet is married and has an 11- year-old son.  At her son's birthday she has a psychotic break and her husband brings her to the hospital.  "When I / stepped out of the car, I sang, /  "tra-la-la," as if I were / Cinderella going to an enchanted ball"  (41).  This section is concerned with her institutionalization and psychotherapy with "Dr. Flesh."  The poet is not enamored of Dr. Flesh, who puts her on display for a group of students "who wanted to be  / just like Dr. Flesh  / who was special, / very very special / unlike me" (43) and who yawns during therapy sessions (44).  The poet also satirizes her diagnostic workup -- a 500 question survey:"Do you like golf? it asked / and when I wrote 'no' / I was diagnosed" (49).  The final section, "O Healing Go Deep," is both a railing and incomprehension about the way the poet's mother treated her, and a plea for sanity: "enough I say of my careening / craziness, of being /a thing in thin wind / running away from Mother" (59).

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Chronic Progressive

Cohen, Marion

Last Updated: Jul-29-2010
Annotated by:
Schilling, Carol

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In Chronic Progressive, a collection of 151 short poems divided into three parts, Marion Deutsche Cohen, a well spouse, continues her startlingly candid account of caring for her husband Jeff that began in her previous collection, Epsilon Country (1995, see annotation).  Part I of Chronic Progressive describes Cohen's frustrations during the last of the 16 years that she cared for Jeff at home, as multiple sclerosis left him almost completely dependent on her.  Mother of four, a prolific writer, a poet, and a mathematician, Cohen describes unrelenting stress when family services and insurance providers fail her, when she feels she must protect the sanctity of her home as health care aides and agencies treat it like a hospital or nursing home, or when she's exhausted, which is most of the time.  "It's a state, a / chronic state, a chronic progressive incurable state," she writes (55).

The middle section, the longest, follows Cohen during the ten years Jeff resides in Inglis House, a Philadelphia care facility.  These poems mix reflections on the past with working out the rhythms of life without Jeff in the house, but still unshakably on her mind.  In this section, she also writes "The Last Love Poem for Jeff" and anticipates his death in "A New Vow": "I will give you the best deathbed anyone ever had" (108).  In Part III, Cohen experiences relief and begins life with a new spouse after Jeff's death.  She recalls herself as ". . . the one he began with, the one he'll end with / the one who's been too much in the middle" (162).  But she quickly turns to "Wedding Preparations Former Well Spouse Style" and the "Love Poem for Her New Love."

Taken altogether, the poems reveal a profound effort to sustain vitality and remake ways of living-with integrity-at the edge of human endurance.  "Yes, how readily we reclaim our territories," Cohen observes near the end of her book (180).

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Holding Our Own: Embracing the End of Life is a documentary film that shows aging and dying as anything but morbid, and death as the final healing in the hospice way. Art and music are combined as a way to bring people into a subject that they'd rather resist.

The film begins with an art opening in New York City and with the commentaries of curator and others as they view Deidre Scherer's large fabric and thread paintings (see annotation of "Surrounded by Family and Friends")--of people at the last moments of their lives. The artist has captured for us, even in the midst of suffering, genuine moments of tenderness.

An interview with palliative care physician Ira Byock guides the conversation, presenting a most refreshing doctor's perspective. The commentaries of hospice personnel, artist, and members of the Hallowell singing group punctuate the profoundly intimate scenes, filmed in institutional settings and in homes. The singers, who sing to the dying patients, see beyond their own fears; they recognize and want to honor dying persons for who they are: "This is not about singing it right for an audience...its about being totally present for the people you're singing for...and wanting it to be a gift." They model the magic of human connection called by Byock "the ground substance of therapeutics" The healing is mutual: "I can feel sad, cry, I can feel a heavy heart...but it's not depressing....It's a wonder...you can feel love, joy, sorrow, but so alive.... you feel the blessing of your own life."

Two additional segments, "More about Deidre Scherer," and "More about the Hallowell Chorus, and a concise study guide are offered with the DVD.

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Annotated by:
Bertman, Sandra

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This groundbreaking international film documents the positive impact of art and other creative activities on people with Alzheimer's disease. The film's intention is to change the way we look at the disease.  It does just that.  Brilliantly.

Narrated by the actress Olivia de Havilland, the film opens with a 96 year old woman reading classical music as she's playing at the piano. Her music becomes gentle background sound track for the first vignette, a group of people intently viewing and commenting on Seurat's canvas, "Sunday in the Park."  From their intense concentration and voiced observations, one would never believe this was a group of nursing facility residents on an outing to the Chicago Art Museum.

Throughout the film--at the circus, visiting museums, or in painting workshops conducted at day care centers, nursing homes and assisted-living facilities in Europe and the US-- the hopeless, fatalistic, nobody's there stereotypes of Alzheimer's sufferers is unequivocally denied.  We continually witness people with serious memory problems being brought back into active communication and a rich quality of life.  This is more than busywork arts and crafts: trained professionals knowledgeable about both art and Alzheimer's are providing essential treatment "just as effective if not more so than the drugs."  The benefits of the non-pharmacological along with the pharmacological not only extend life, but create a life worthwhile, where people find meaning and connection.
 
In direct interview, voice-overs and interacting with "patients" and their family members, eminent experts from multiple medical fields - neurology, gerontology, psychiatry- punctuate the film reviewing the latest technologies and concurring that the essence of the person lives on. The latest brain research provides evidence that the parts of the brain related to emotions and creativity are largely spared by the disease and that our technologies for assessing dementia --dealing with sequencing things, dates in order, and what one did this morning--rely on short term memory which is totally irrelevant when enjoying a masterpiece or listening to a symphony.  The documentary also includes comments from art therapists, occupational therapists, directors of specialized care facilities, but the film is anything but talking heads.  The cutaways and extensive footage of the care giving staff and specialists interacting emotionally and physically, visibly bonding with the residents and family members is sincere, loving and inspiring professionalism.

The inspiration for the film and project is filmmaker Berna Huebner's mother, Hilda Gorenstein, once an accomplished painter known as Hilgos.  In one of Huebner's visits to the nursing home, she asks "Mom, would you like to paint again?"  Quite unexpected came the reply, "Yes, I remember better when I paint."  Learning this, the staff psychiatrist who had been prescribing small doses of a tranquilizer for her apathy, anxiety and agitation suggested Huebner enlist art students from the Chicago Museum school to help her mother to begin painting again.  We are not spared the slow and sometimes discouraging process as Mrs. Gorenstein comes alive regaining mobility and communication skills and interacting--bonding-- with the art students.  The film is replete with her colorful paintings created in the next few years until her death at age 93.

"The creative arts are a doorway.  Once that doorway is opened ... things are tapped ... that are genuine and active and alive that don't get tapped in our normal day social interactions when we sit at a table and make conversations over a meal or we read a newspaper article and then talk about the headlines of the day.... The creative arts bypass the [cognitive] limitations and simply go to the strengths. People still have imagination in tact all the way to the end of their disease."

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Summary:

McMurphy (Jack Nicholson) escapes work on a prison farm by feigning mental illness, but he finds himself in a far more coercive institution than the one he left behind. The other men, both sane and insane, are just like him: they hide in the locked ward from the law, their families, or the despair of their own lives.

McMurphy animates the dull monotony with fractious games, pranks, and excursions, but he encounters stiff opposition from the head nurse, Mildred Ratched (Louise Fletcher), whose system provides her with pills and electroshock to maintain control. When the nurse discovers that McMurphy has smuggled two women into the ward, she threatens to tell the mother of young Billy (Brad Dourif). Billy commits suicide and an enraged McMurphy tries to strangle Ratched. McMurphy is lobotomized and returned to the ward only to be smothered by his friend Bromden, who then escapes.

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Annotated by:
Henderson, Schuyler

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In 1954, a United States Marshal (Leonardo DiCaprio) and his partner (Mark Ruffalo) take the ferry to Ashecliff Hospital, a forbidding asylum for the criminally insane located on Shutter Island.  Their mission is to investigate the disappearance of an inmate who has apparently escaped without a trace.  Under the supervision of the chief psychiatrist, Dr John Cawley (Ben Kingsley), they become increasingly entwined in a twisting tale of fear and suspicion.

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