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In Flanders Fields

McCrae, John

Last Updated: Feb-06-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

A short war poem of 15 lines in three verses, in the voice of dead soldiers who lie under the poppies that grow in the fields of Flanders.

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Human Voices Wake Us

Winakur, Jerald

Last Updated: Feb-06-2018
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The 55 poems in Human Voices Wake Us fall primarily into 3 categories: biographical poems, poems about the natural world, and poems about the worldly travels and travails of a man learning and practicing medicine. As I began to read this book, I started checking off all the poems that I thought might merit comment, but stopped early on since almost all called to me--each in their own voice. Thankfully—and skillfully--the poems were often placed in ways that, although drawing from the different aspects of the author’s life, they complemented each other. For example, “The Tyranny of Aging,” a poem about caring for a half paralyzed 95 year old whose last living child has died, is followed by “Redbud,” where the speaker of the poem walks “the ravines, the treed/windbreaks, the creek bottom/all the wooded places//searching for redbuds” (p.49). Another example is the poem “Shock and Awe in Comfort, Texas,” where a solitary walker confronts dive-bombing dragonflies and birds of prey doing what they need to do to stay alive followed by “What I Remember in Embryology,” a poem about being created and born: “Tethered/we are all waiting/fetuses suckling/our way//to heart and hair/teeth and bone/reaching grasping/limb buds into fingers” (p.25).  Winakur came to poetry after realizing that "coming and going in the rooms on daily rounds was not enough to sustain a life"(xiv). What the reader experiences in this book is Winakur’s inspired attempt of seeking—and then delivering through poetry-- more. 

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Spy of the First Person

Shepard, Sam

Last Updated: Jan-30-2018
Annotated by:
Glass, Guy

Primary Category: Literature / Fiction

Genre: Memoir

Summary:

Spy of the First Person is a short semi-autobiographical narrative about a man with a debilitating condition.  He spends most of his time sitting in a wheelchair on his porch, goes for tests to the Arizona campus of the Mayo Clinic, and has a “handicapped sign hanging from the rearview mirror of his car” (p. 15). The man’s illness is unnamed, but we learn that his motor skills are grossly impaired: “His hands and arms don’t work much.  He uses his legs, his knees, his thighs, to bring his arms and hands to his face in order to be able to eat his cheese and crackers” (ibid).   

The story is told from various, shifting points of view.  At times we are in the head of the protagonist.  At other times, the perspective is that of a nosy neighbor who peers at the sick man through binoculars, hence the book’s title. There is a parallel narrative about an elderly couple and the wife’s gradual decline in health.  The Southwest plays such an important role here one might even say that it too is a character. 
 

There are also frequent shifts of tense.  It is not always clear whether we are in the past or present.  We alternate between the central character’s fantasies, memories, and observations. The effect of intertwining voices and tenses is reinforced by the brevity of the chapters, many no longer than a paragraph.  The overall impression is that while he may no longer have full control over his body, the man has retained an active (one might say overactive) mind.
 

Spy of the First Person
concludes as the man’s children take him to a Mexican restaurant.  The vivid description of a meal shared with his loved ones provides a sharp contrast to the inner thoughts that provide the bulk of this book.

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Close But Not Touching

Sands, Jean

Last Updated: Jan-30-2018
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Jean Sands' second full-length poetry collection, "Close But Not Touching," was published a few months after her death in October, 2016.  Sands had been working on this volume for more than a year, a process slowed by debilitating illness.  This collection, like her first book, "Gandy Dancing," is autobiographical, raw, plainly written, and powerful.  Both books deal with sexual abuse, marital abuse, dysfunctional family dynamics, divorce, poverty, and a woman's struggle to survive.  And in Sands' case, to write about that survival.

The 47 poems in "Close But Not Touching" are divided into four sections.  The first examines Sands' childhood.  Her mother, born in Hungary, as a child terrified of German soldiers, is failing. In  the book's opening poem, "When Mother Stopped Remembering," Sands introduces her themes of human rights, sexual and physical abuses, and the need to speak out against them. The poem closes with Sands'  mother forgetting words, growing silent, and giving up books.
"In Germany, they emptied the shelves, /  burned the books, the men, the women, the children." (pp 4-5).  Sands' response to the loss of words, of power, is her poetry.

In "Becoming Helen" (pp 7-9), Sands pays tribute to an older woman writer who became a mentor. "Forty years later the keyboard clicks under my fingers, / unseen hands hover above mine." The specter of sexual abuse is raised in "The Peach Farmer's Daughter" (p 15).  Abused by her father, even after his death the daughter can't forget "his liquor breath, his fingers inside." In other poems in this section, Sands addresses aggression ("Pigs" p 16), loss of innocence ("Plum" p 17), humiliation ("The Music Lesson" p 18), and desire ("Danbury Fair" p 19).

The second section takes a loving and yet brutally forthright look at Sands'  four sons and how her marriages and divorces affected them.  She doesn't spare herself--her poor choices--or the sons' fathers.  Especially strong poems include "Night Sounds," "Suicide," "Swimmer," "The Policeman Is Your Friend," and "Father Poem" (pp 26-30).

The poems in section three chronicle the author's divorce from her abusive second husband, specifically, but also her hard-to-shake feelings of entrapment and helplessness in the face first of childhood sexual abuse and then of marital physical abuse.  In "Car Ride" she writes "I can't do this anymore, // I can't do this, // I can't" (pp 38-39).  Forced from her home by police pounding at her door in the dark, she writes "You set me up / ex-husband with greed on your mind. / Money hungry at anybody's expense but your own" (p 40).  Divorce leads to poverty for the author.  "Divorce Settlement," "Working in a Discount Store after the Divorce,"  and "Saving the Universe" will ring true for many who must struggle for subsistence from day to day (pp 46-48).

Section Four brings this collection full circle, offering hope and resolution.  The author has met another man, a good man.  In poems such as "Rain" (p 60) and "As Evening Comes" (p 64) there is a softening, a willingness to open to this new life and new love.  In perhaps the most moving poem in the collection, "At the Vet's Office" (p 65-66), Sands looks back at her marriages ("The first one was a hitter-- / open palms, threatening fists . . . The second one, worse.  A handsome man / with no past.  I should have known / his clamming up was covering up") and compares her past with her present: "I am overwhelmed with gratitude / for the sweet man who will pick up the cat / and pay the bill without a word" (p 66).   This "sweet man" was married to Sands for more than 25 years, became her writing partner, a father to her four sons, and served as her caretaker through many years of her  illness.

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Hag-seed

Atwood, Margaret

Last Updated: Jan-22-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Haunted by grief over the loss of his young daughter, Felix is a gifted director at a theatre festival. He plans an inspired interpretation of The Tempest, but is unfairly ousted from his beloved position by a jealous and inadequate rival.

As his fortunes dwindle, he accepts a position to promote literacy in a local prison—and hits upon the idea of using his newfound but incarcerated protégés to mount his long-planned Tempest. The project encounters financial difficulties that begin to seem insurmountable as his hostile rival assumes an influential government position.
 

The result exceeds all expectations, helps to heal his grief, and with its unorthodox staging, provides a delicious revenge.

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So Much For That

Shriver, Lionel

Last Updated: Jan-18-2018
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The book opens with Shep Knacker packing his bags for his long-dreamed of “Afterlife”—his word for retirement—in Pemba, an island off the coast of Tanzania. He plans to take his wife, Glynis, and his high school aged son, Zach. This plan is not unexpected because Shep and Glynis have made many “research” trips during their 26-year marriage to find the right place (though never to Pemba). But, there were always reasons not to act on their research. An intervention was needed. Glynis is not home while he is packing because she is at some “appointment.” When she gets home, Shep informs her of his plans for the three of them to leave for Pemba, and he further informs Glynis that he’s going whether she comes or not. In response, she informs him that she has cancer—a bad one (mesothelioma); he unpacks, so much for that.

What unfurls from there is more complicated than just the challenges Glynis’s disease produces, though these are monumental challenges. Other people, too, are in need of Shep’s attention. His father’s decrepitude is advancing, his sister is on the brink of homelessness, and his teenage son is detaching from him and life in general. Shep eventually loses his job as an employee at the handyman company he once owned (“Knack of All Trades”) then sold to fund his Afterlife. There’s more. 

Shep's best friend, Jackson, who also worked with him at Knack of All Trades has two girls, and one of them has familial dysautonomia. This progressive genetic disease of the nervous system produces a constellation of medical problems that are bizarre, intense, and serious, before it ultimately produces a tragic end. The trauma and tragedy this disease inflicts in this story (and in life) encompass the entire family, in spite of the heroic efforts of Jackson’s wife, Carol. 
 
The many plot lines in this novel at times proceed independently of one another, and at other times intersect. They concern serious illness experiences and the effects they have on families and also how the American health care system can place burdens on those who need it. Nevertheless, the two families, beaten down by illness, fatigued from encounters with doctors and hospitals, and exasperated from fights with insurance companies, rally enough to make it to Pemba. The trip becomes financially affordable as the result of some narrative gimmickry involving a financial settlement of $800,000 from the company that put asbestos in equipment Glynis had used years before. They would spend the rest of their lives there, longer for some than for others.   

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Calcedonies

Nisker, Jeffrey

Last Updated: Jan-17-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Plays

Genre: Play

Summary:

The play has two characters: Ruth and Friend (who is a male doctor).Ruth is an engaging, straight-talking quadriplegic who can zip and dance with her chin-operated wheelchair and takes delight in terrorizing medical staff both physically and verbally. She wants to write poetry and is waiting for a device to make it possible for her to use a computer. She keeps developing bedsores that threaten her life and require long admissions to the hospital before they will heal. She desperately wants to live no matter what happens, as she feels that having no mind would be worse than having no body.Friend is a male doctor with children who is ashamed of having examined her while she was unaware. Burdened with his guilt, he asks to be her “friend.” Ruth is skeptical and runs circles around him, but eventually comes to trust him and believe in his sincerity.She makes him a witness to her advance directive to instigate all heroic measures, as she is afraid of the kindly "ethical" and cost-effective arguments not to treat the disabled. But Ruth dies horribly from sepsis, and Friend is helpless to prevent it. She never obtains the device that would have allowed her to put her poems into printed words.

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Patiently Waiting For…

Nisker, Jeffrey

Last Updated: Jan-17-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

An artist, Ruth, lives with quadriplegia and manages to drive (and dance) with a special wheelchair that she controls with her chin. She also enjoys terrorizing doctors in the hospital corridors, where she is seen on a regular basis because of frequent bouts of infected bedsores. She has a new computer and is “patiently waiting for” a biomedical engineer to set it up to manage, like her chair, with her chin. She wants to write, to draw, to create. But the wait list is long, technicians scarce, and every candidate deserving.

On one of her admissions, Ruth meets the physician-narrator who is appalled by a medical resident’s lack of empathy in relating her case as if she were not present. Distressed by the encounter, the doctor is all the more disturbed when he notices that Ruth’s birth date is the same as his own.

He tries to make it up to her by withdrawing from her care in order to be her “friend,” one who tries to understand and will defend her strong desire to live despite her disability. Driven by curiosity about her past, her sharp wit, and how she faces each day, the doctor never quite achieves his goal and constantly feels guilty for letting her down as an advocate and a friend, and possibly also for being able-bodied himself.  He never visited her in her group home, and when she comes to hospital in florid sepsis, he is unable to prevent his colleagues from letting nature take its course. His own bout with severe illness, possibly MS—more likely a stroke--resonates with Ruth’s plight. Long after her death, he can imagine the acid remarks that she would make about his foibles.

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Summary:

Hillel D. Braude, a physician and a philosopher, has written an important, albeit dense and narrowly circumscribed, study. While “Intuition in Medicine” is the main title, the subtitle, “A Philosophical Defense of Clinical Reasoning” is a more accurate description of the book, which originated as a doctoral dissertation.  While some of the prose will appeal only to specialists, there are important and thoughtful analyses of such topics as Evidence-Based Medicine, modern dehumanized medicine, the relation of beneficence and automony, and principalist ethics in general. Throughout, intuition is narrowly conceived and in the service of clinical reasoning, as it applies to standard, Western physicians and not to other healers (or nurses), and the emphasis is on interventive medicine to cure illness and relieve suffering more than on health promotion.
 
Braude writes in the introduction that intuition has long been understood to be “a direct perception of things,” but he resists a more precise definition: “Rather than defining and using a single concept of intuition—philosophical, practical, or neuroscientific—this study examines intuition as it occurs at different levels and in different contexts of clinical reasoning” (xviii).  Eight chapters explore these different levels in such topics as moral intuitionism, Aristotle’s phronesis (or practical reason), the rise of statistics (a basis for Evidence-Based Medicine), and C. S. Peirce’s notion of abduction. Braude’s careful analysis traces historical and theoretical developments in analytic philosophy and how these may be applied to clinical reasoning.  He uses an impressive range of thinkers: Achenwall, Albert, Allan, Andre, Ashcroft, Aristotle, Bacon, Barrow, Barton, Beauchamp, Bergson, Bernard, Bichat, Black, Bottero, Bourdieu, Brody, Browne—just to take names headed by A or B.  Throughout, Braude puts in dialectic two poles of a spectrum arguing that they both have contributions to make. He believes that between them is an “ethical space,” where discoveries and applications can be made.  One pole, which he clearly favors, includes the following qualities:  Aristotelian practical reasoning, naturalist approaches, primacy of beneficence, fact and value joined, case-based, individual patients, narrative experience, anthropocentric focus, and tacit/organic knowledge (Polanyi). The other pole, less desirable, includes Kantian abstraction, nonnaturalist approaches, primacy of autonomy, fact and value separated, Evidence-Based Medicine, large groups of patients, statistical correlations, mechanist/positivist foci, and Dualism (Descartes).

Braude believes intuition is a cognitive process but has other dimension, the corporeal and the social. While these provide a grounding, intuition for him is generally rational. He also argues for medical care at the personal, face-to-face level, not through applications of algorithms.   A brief conclusion, “Medical Ethics beyond Ontology” clarifies some of the arguments and sketches some valuable notions from Husserl and Levinas. He writes “intuition . . . does appear to be fundamental for human judgment” because “an intuition faculty” can “extract universals from the particular” (p. 170).  Drawing on Husserl, he defines phenomenological intuition as “the primary means through which objects are presented to consciousness.” This affirmation includes the basic human, which is also the focus for medicine. For Levinas (and my summary is much too brief), “interhuman solidarity” is a source for medical care, a form of responsibility that is different from Foucaultian power relationships, ethical rules and priniciples, or “an uncritical acceptance of medical authority” (p. 177).

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Leonardo da Vinci

Isaacson, Walter

Last Updated: Jan-09-2018
Annotated by:
Thomas, Shawn

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Leonardo da Vinci – the name alone evokes images of an artistic virtuoso, the Renaissance man, the mind behind the Mona Lisa. Though known best as an artist, his work extended beyond paintings into a myriad of disciplines, with notebook entries documenting his studies of optics, bird flight, comparative anatomy, hydraulics, and countless others. And yet what has been obscured by the shadow cast by his prolific career are the details of how a young man from a town called Vinci became Leonardo da Vinci. What did he do every day? What did he eat? Who were his friends? Did he even have any? We tend to immortalize Leonardo as a god, and yet he was human after all, not unlike the rest of us. This realization should encourage us to study one of history’s most celebrated humans, and see if we ourselves might be able unlock our own inner genius.

Walter Isaacson aids us in this study with his thoroughly researched biography of Leonardo da Vinci. He adds this to his growing portfolio of biographies of history’s great minds, including Benjamin Franklin, Albert Einstein, and Steve Jobs. In this most recent biography, Isaacson takes us through the life and times of Leonardo, highlighting milestones of his career, while also underscoring some of the seemingly trivial habits that were signatures of Leonardo’s personality and worldview.

Born of illegitimacy and openly gay, Leonardo was no stranger to defying convention. In fact, many of his grandest discoveries were a result of his willingness to challenge commonly accepted wisdom. Yet his greatest asset was his relentless curiosity and unquenchable thirst for knowledge, a recurring theme of Isaacson’s biography and of Leonardo’s life. Intertwined with this curiosity was his tendency to draw connections across disciplines, blurring the lines between art and science. Everything that Leonardo produced – whether his sketches of war machines, his treatises on anatomy, or his timeless portraits – was a manifestation of his desire for unifying knowledge.

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