Showing 21 - 30 of 143 annotations tagged with the keyword "Drug Addiction"

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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Summary:

Samuel Shem's (Stephen Bergman) The House of God, first published in 1978, has sold over two million copies in over 50 countries (see annotation).  Its 30th anniversary was marked by publication of Return to The House of God: Medical Resident Education 1978-2008, a collection of essays offering historical perspectives of residency education, philosophical perspectives, literary criticism, and women's perspectives, among others. Contributors include such well-known scholars as Kenneth Ludmerer, Howard Brody, and Anne Hudson Jones, as well as physician-writers Perri Klass, Abigal Zuger, Susan Onthank Mates, and Jack Coulehan.  The closing section, "Comments from the House of Shem," includes an essay by psychologist and scholar Janet Surrey (Bergman's wife) and one by "both" Samuel Shem and Stephen Bergman. 

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What the Body Told

Campo, Rafael

Last Updated: Oct-06-2015
Annotated by:
Terry, James

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Many of these poems are confessional accounts of gay love and sexuality. Another group clearly draw on the author’s clinical experiences as a physician. A few poems (e.g. "For You All Beauty", "Her Final Show") mix those broad categories in talking about the care of AIDS patients.The 11 short poems under the sequence title "Ten Patients, and Another" are the most clinical. They mimic clinical presentations during rounds in several ways: individual poems under patient initials--Mrs. G, John Doe; opening lines with the patient’s age, race, and gender; even presenting complaints with hospital shorthand. For example, in "Kelly" Campo begins: "The patient is a twelve-year-old white female. / She’s gravida zero, no STD’s. / She’s never even had a pelvic. One / month nausea and vomiting. No change / in bowel habits. No fever, chills, malaise." But in this poem and others of the sequence, the clinical gradually turns to the personal: "Her pelvic was remarkable for scars / At six o’clock, no hymen visible, / Some uterine enlargement. Pregnancy / Tests positive times two. She says it was / Her dad. He’s sitting in the waiting room."The cumulative effect of the series is a kind of horror at hospital cases and how they get there: a three-year-old who’s ingested cocaine, a homeless man with eyelids frozen shut, one man beaten, another man shot, an abused wife, a suicide, a drug overdose. To feel empathy for these cases, and to turn them into poetry, Campo has practiced the art of medicine as a form of love.Campo also writes as a patient who has experienced a serious arm fracture and subsequent threat of cancer in the 16-poem sequence "Song Before Dying." This changes his perspective on care-giving, as he writes in "IX. The Very Self." " . . . more dying waits / Downstairs for me. I almost hear their groans. / Same hunger, bones. Same face we all consumed. / As I examine them, I find the tomb / Toward which they lead. I know it is my own."

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Freud's Mistress

Kaufman, Jennifer; Mack, Karen

Last Updated: Jul-31-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Minna Bernays is the younger sister of Martha, Sigmund Freud's wife. Her own fiancé has died and by 1895, she is reduced to joining her sister’s family in Vienna because she has abandoned her position as a companion to a demanding, prejudiced aristocrat. The six Freud children love her, but she finds them exhausting and undisciplined. Obsessed with order, housework, and social standing, and possibly suffering from psychosomatic ailments, Martha is happy to leave the care of the children to Minna. She disapproves of her husband’s theories about sexual frustration as a cause of mental distress and refuses to discuss his ideas. Nevertheless, Martha is well aware that growing anti-semitism hampers her husband’s career, and she is eager for him to succeed: he could consider a conversion of convenience, like the composer Gustav Mahler.

Minna finds herself drawn to Sigmund for his intellect and his novel ideas. She is also attracted to him physically, and he to her. She resists the temptation, but he does not and actively pursues her, inducing her to try cocaine too. He justifies it - the sex and the drugs - as necessities for mental and physical well-being and he rejects the guilt that, he claims, so-called civilization would impose.

She tries to leave by finding another job as a ladies’ companion in Frankfurt, but he follows her there. They escape for an idyllic holiday to a hotel in Switzerland, then he brings her back to the family home. But his ardor cools and she is wounded, displaced by his enthusiasm for Wilhelm Fliess and Lou Andreas-Salomé.

Soon she discovers that she is pregnant, and Freud sends her away to a “spa” for an abortion, but at the last moment, she decides to keep her baby. Sadly she miscarries and returns to the Freud family with whom she remains for more than four decades until her death in 1941.

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On the Move: A Life

Sacks, Oliver

Last Updated: Jun-22-2015

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

On the Move:  A Life describes the extraordinary life of Oliver Sacks from his childhood during World War II to shortly before its 2015 publication.  Using his journals (“nearly a thousand,” he writes), correspondence, and memories—as well as his 14 or so books—Sacks has given himself free rein to describe and analyze his long, productive, and unusual life.

A dozen chapter headings nominally corral his wide variety of interests, adventures, and travels, including his medical career, his homosexuality, and diverse writing projects.

Sacks came from an English medical family, including some observant Jews, but not him. As a youth he loved (prophetically) writing and chemistry. He rode motorcycles then and for many years to come. He did poorly on his Oxford practical anatomy exam but immediately (and drunk on hard cider) sat for a competitive essay on anatomy and won a large prize.  Later, he was warned away from bench science and focused successfully on patient care, patient narratives, and personal essays of many sorts, including A Leg To Stand On, the account of his injured leg and recovery.

Sacks left England for Canada, then the US.  He quotes from some of the journals about his travels. In LA, he worked out at Muscle Beach (setting a California squat record) and did drugs, including amphetamines. A shy man, he thought of himself as Doppelganger: Dr. Sacks by day, a black-garbed biker by night. 

Fascinated by vision and photography, Sacks includes 58 photos from the ’50s to 2006; some black and white, some in color.  These are printed together on slick paper and well illustrate his text.   

Neurology training concluded, Sacks served various institutions in New York but read widely, ever eager to find theories of brain chemistry, anatomy, perception, behavior, and more. As readers of his books know, he enjoyed using his own interests in drugs, music, and travel, as well as personal medical experiences such as his injured leg and his lack of facial recognition. He describes his meetings with patients with unusual dilemmas: the postencephalics of Awakenings, as well as people with Tourette’s syndrome, deafness, colorblindness, autism, or migraines. He became fascinated—obsessed, one might say—with these and wrote so voluminously that cuts had to be made from his huge manuscripts to yield books.

Sacks describes interaction with editors, film crews, playwrights and others wishing to collaborate. His audiences grew as he became an intermediary to the non-medical public. We read about Peter Brook, W. H. Auden, Jonathan Miller, Bob Silvers (New York Review of Books), the cartoonist Al Capp (a cousin), Abba Eban (another cousin), Stephen Jay Gould, Temple Grandin, Francis Crick, and others. One striking passage describes taking Robert DeNiro and Robin Williams to see locked-in patients in preparation for the film version of Awakenings.

In his 70s, his robust health faded. He had a melanoma in his right eye, with more than three years of treatment before it became blind. Being Sacks, he observed interesting phenomena as his vision changed, “a fertile ground of enquiry” (p. 376). His left knee was replaced. He had sciatica.   

He fell in love again after 35 years of celibacy; he dedicates his book to his partner Billy Hayes.

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Summary:

Soldier Girls is an exhaustively researched, intimate report by a journalist of the lives and deployments of three women in the Indiana National Guard, who, through serving together in Afghanistan, become friends. Each of the women joined the Guard prior to 9/11/2001, mostly for economic reasons. Thorpe selected women who were vastly different in age and background.  Debbie Helton becomes a grandmother during deployment and has served in the guard for decades - she is eager to be deployed. Michelle Fischer (a pseudonym) is newly out of high school, has liberal political views and sees the Guard as a way to pay college tuition. Desma Brooks is a single mother of three with a fractured and unreliable support system. All three have alcohol and or drug dependency issues. Brooks and Helton are deployed a second time - to Iraq.

 As one of the women, Fischer, notes, the Bush wars were an ‘economic draft' (p. 374) The struggles to find adequate housing, reliable partners, good schools, decent jobs, and to avoid the morass of drug dealing, which particularly surround Fischer and Brooks, are paramount in their lives.   

The women bond not only due to their shared gender, but also due to their mutual sense of humor. For example, to distinguish her tent from the dozens of similar ones on the base in Afghanistan, Brooks orders 50 plastic pink flamingos to decorate the ‘lawn.'   

In Afghanistan, the women are part of the support troops, doing such jobs as fixing AK-47s for the Afghan National Army. Nonetheless, even there, they are in harm's way, with the potential for injury or death from mortars, buried bombs (landmines) and improvised explosive devices (IEDs). In Iraq, Brooks is exposed to danger daily, as she drives an armored vehicle  usually in the navigation spot of a long convoy, third in line. She suffers traumatic brain injury after driving too close to and detonating a large IED.    

Thorpe weaves the three stories together of the women into a seamless whole. She chooses to follow the post-deployment lives of the women, and it is after demobilization that the heartaches truly develop. For example, Helton, who had always been upbeat and extraordinarily generous with her nurturing, turns inward and suffers depression. Fischer finds it difficult to relate to anyone without a military background, yet feels alienated from veterans who continue with a gung-ho attitude. And Brooks's children, who felt abandoned by their mother, act out in different and difficult ways.   

Issues of military sexual trauma are introduced, though none of the main characters experiences MST. However, all are harassed, to varying degrees. Sexuality is a prominent theme, both heterosexual and homosexual. "Don't ask, don't tell" was the policy during their deployments. Partners during deployment are different than those at home, and infidelity is common on base, further dividing military from civilian life.   

A particularly poignant side-story is that of the translator, Abkar Khan, introduced on page 171: "He was movie-star handsome, with a square jaw, high cheekbones, chiseled lips, and an aquiline nose." Abkar accomplished what no amount of cultural sensitivity training might - he gave a face and voice to the people the troops had been sent to help: soldiers would later relate "that getting to know Abkar was the single greatest thing that would happen to them in Afghanistan - he was what gave meaning to their deployment". (p. 172) Abkar marries his first cousin in an arranged marriage, temporarily realizes his dream to work in the United States, then returns for a lucrative but dangerous job of translating in interrogations.   

Posttraumatic stress disorder, post deployment risky behavior, traumatic brain injury, and bone and joint injury due to maneuvers required while wearing heavy equipment and protective clothing are discussed. Despite the large numbers of sexual partners, no sexually transmitted diseases are discussed, but one minor character does get an abortion after a relationship with a superior officer (these relationships, though forbidden, seem common). As noted in the book, the costs of the wars in Iraq and Afghanistan go far beyond the activities in the war theaters themselves, but continue on in the lives of the returned troops, and the families of all those who were deployed.       

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Up in Smoke

Pennie, Ross

Last Updated: Feb-28-2014
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The third novel in the series of Zol Szabo, who is a public-health doctor for the Hamilton Ontario region. He is also a single parent to ten year-old, Max, because his unstable wife, Francine, could not deal with Max’s mild physical disability. His partner in life and work is now Colleen, an attractive woman detective whom he met in the first novel and who looks "like Cameron Diaz in a ponytail” (p. 140).

Teenagers at a private religious school begin to sicken and some die of a mysterious liver ailment. School authorities categorically deny any use of drugs, tobacco, or alcohol—but Szabo’s team quickly discovers that not only do the kids smoke, they prefer a cheaper form of cigarette that is manufactured and sold at cut rates by the local native community.

In the background of this stressful situation, Zol’s mother is dying of cancer, his ex-wife is threatening to visit, and Zol is caught up in a violent break-in at a Toronto museum that resulted in the theft of a precious native artifact.

The team unravels a series of epidemiological clues that point to the interaction of pesticide-tainted tobacco reacting with liver cells to produce the dangerous disease. He must then convince the unscrupulous cigarette manufacturer to stop production before the problem spreads widely. Their methods are unorthodox because they lack support from the bosses who are afraid of public and political opinion. Using clandestine photography they prove that the owner has been lying about his distribution methods.

The investigation helps to solve the older murder of a native woman scientist who had uncovered the problem and been brutally silenced.

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Arena

Moore, Frank

Last Updated: Jan-29-2014
Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

This painting depicts what in some respects mimics an anatomy amphitheater, but the title, "Arena," tells us that what is going on here is more spectacle than instruction. Painted in 1992, early in the AIDS epidemic, when rapid decline and death from the disease was almost unavoidable, this complex artwork catalogs some of what was taking place in society at the time. A shaft of window light illuminates the center where a masked doctor is examining a Caucasian patient while a nurse, similarly masked, stands nearby. A large white plume of smoke or steam is emanating from the patient's head. The examination is being filmed and narrated.
 
In the lower right-hand corner a dark skinned patient attached to an IV is lying on a gurney. An attendant has his back toward the patient, whom he seems to be ignoring as he speaks with another white clad hospital worker. If one follows a diagonal from the ignored patient through to the central figures, toward the upper left, another patient, covered completely by a sheet and apparently dead, is being wheeled out of the arena. Adjacent to this scene are people seated cross-legged on the floor, listening to a speaker reading from a book while a Buddha floats above him. [According to art critic Klaus Kertess, the reader is poet John Giorno, "who instructed Moore in Buddhist practice" (Toxic Beauty, p. 11)]. In the lower left, a vendor wheels his cart, selling soda and sausages, adding to the carnival atmosphere. Just ahead of him an elderly woman holds a flattened out body in her arms.
 
To the upper right, police barricades and struggling policeman attempt to hold back a group of protesters carrying a sign saying "Who's in Charge?". In the upper center, two skeletons stand in front of a screen and hold banners bearing Latin inscriptions. An instructor is pointing to drawings on the screen - molecules and cell membranes. Other skeletons are positioned at the edges of the painting, also bearing banners, and in the lower center two skeletons stand in front of a fruit tree. One of these skeletons holds what seems to be a heart dripping blood. Several figures dressed in costume are posing or dancing. The curved rows of the arena are sparsely populated and include skeletons of various animals as well as two men who are injecting themselves in the arm. Robotic figures appear here and there in the painting.

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Fever

Keane, Mary

Last Updated: Aug-22-2013
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1907, Mary Mallon, an Irish-born cook, is identified as the source of typhoid fever outbreaks in several of the households where she has been employed. Deemed a healthy carrier, she nevertheless cannot comprehend her role in the tragedies and rejects her responsibility. How could she harbor the germ that causes the disease and not be ill herself?

Led by Dr. George Soper, the authorities ensure that she is incarcerated on North Brother Island in the Hudson River – until a lawyer takes an interest in her case. An important part of her defence comes from the growing knowledge that many other people are also healthy carriers of the germ and they have not been incarcerated. Finally in 1910, she regains her freedom on condition that she never cook for others again.

But Mary loves cooking, and it is a far more lucrative occupation than her work as a laundress. In addition, she needs to support her common-law partner, Alfred, who has a serious drinking problem and is chronically unable to find work. Alfred had left her for another woman during her incarceration and succeeds in giving up alcohol. But he still loves Mary and abandons the other woman; he vanishes out west and is injured in a horrible fire that leaves him deformed and in chronic pain. Mary finds him and tries to help him, but Alfred now slowly slips into drug addiction.

The temptation to start cooking again is too great. The inevitable happens and Mary is caught. This time, however, she does not protest and ends her days as a captive of New York City.

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Black Bag Moon

Butler, Susan

Last Updated: Apr-19-2013
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Black Bag Moon is a collection (one is tempted to say a "mixed black bag") of short stories (but not clearly "short fictions" - clarified below) about medical patients. The reputed authors are identified as these patients' physicians, who recount these stories in first person. By my math, there are nine authors who narrate stories about 37 patients in 29 chapters. Most chapters have two patients in unrelated stories that sometimes share a theme. Several of the authors know each other as colleagues and two are a married medical couple. Most of the stories occur in Australia or New Zealand but some are in places are as far flung as England, Scotland and unidentified, possibly fictional, islands in the South Pacific. The practitioners are, for the most part, family physicians and care for people of all ages, providing care for everything from breast masses to congestive heart failure to trauma to occupational health to - almost overwhelmingly - mental illness threatening severe violence. The last - serious mental illness -  is, as are all the patients and their illnesses in this volume, almost exotically different from anything most readers of this database are likely to encounter as health care providers or readers. Think Crocodile Dundee or perhaps television's Dr. Quinn or ‘Doc' Adams of Gunsmoke. Or all the above but in the late 20th Century Outback.

Since most of the stories involve working men and women - mainly men - there is a decided flavor of  A. J. (Archibald Joseph) Cronin's The Citadel to the stories; but the peculiar aspect of Australia's frontier pervades each encounter with the patients in this book, whether they are being treated over the radio for breast lumps, being airlifted to the hospital for a badly broken elbow, or becoming demented from environmental toxins in a land and time wherein OSHA and DEP (and the principles underlying them) might as well be acronyms from Mars.

Curiously, for fiction, there are intermittent footnotes to literary (Honore de Balzac, Soubiran) sources, historical figures (Hippocrates) and relevant texts on subjects covered in the stories, e.g., petrol-sniffing, tropical diseases, and physical diagnosis. 

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