Showing 211 - 220 of 354 annotations tagged with the keyword "Abandonment"

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.

Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.

Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?

One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).

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Opera Therapy

Evison-Griffith, Traicee

Last Updated: Mar-29-2006
Annotated by:
Aull, Felice

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This documentary video follows the making of an opera, based on the illness experiences of four Australians who have been diagnosed and treated for cancer. Their feelings about these experiences are translated into music (with lyrics) as they work closely with music therapist/composer, Emma O'Brien. As the three women and one man tell their stories of physical debility and emotional pain, the music therapist asks them to think in terms of color (they choose purple, black) and tones and rhythms that she plays for them on the piano.

When the narratives and their musical representations have evolved sufficiently, trained singers take on the roles "written" for them by the four former patients; the latter continue to be intimately involved in the opera's production, directed by David Kram. At the end of the project, which is also the conclusion of the film, the opera is performed in front of an audience (with musicians playing instruments, singing, and dramatic enactment) and the four people whose illness experience is performed take their bows together with the singers.

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The Year of Magical Thinking

Didion, Joan

Last Updated: Jan-30-2006
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Joan Didion has written a very personal, powerful, and clear-eyed account of her husband's sudden and unexpected death as it occurred during the time their unconscious, hospitalized daughter was suffering from septic shock and pneumonia.

Quintana, the couple's 24-year-old adopted child, has been the object of their mutual care and worry. That John Gregory Dunne, husband and father, writer and sometime collaborator, should collapse from a massive, fatal coronary on the night before New Year's Eve at the small dinner table in their New York City apartment just after their visit with Quintana can be regarded as an unspeakable event, beyond ordinary understanding and expression. "Life changes fast . . . in the instant. You sit down to dinner and life as you know it ends" (3).

As overwhelming as these two separate catastrophes are, the account provided by Didion evokes extraordinary descriptions of the emotional and physical disorientations experienced by this very lucid, but simultaneously stunned and confused wife, mother, writer dealing with the shock of change. Her writing conveys universal grief and loss; she spins a sticky filament around the reader who cannot separate him or herself from the yearlong story of difficult, ongoing adjustment.

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Wish

Goldsworthy, Peter

Last Updated: Aug-15-2005
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

J.J.’s parents are both deaf, so he grew up with Auslan (Australian sign language) as his native "tongue," although he is not deaf and speaks English perfectly. After a disastrous marriage, J.J. returns to live with his parents and to teach sign language at the Deaf Institute. Two students in his beginners’ class befriend him. They are Clive, an elderly man world renowned as a leader of the animal rights movement, and his much younger wife Stella, who is a poet. They soon present J.J. with a mysterious proposition: would he be willing to provide private lessons for their "step-daughter" at their home? We soon learn that their "step-daughter," Wish, is actually a young female gorilla, which they "rescued" from a research laboratory.

At first J.J. is reluctant because he is aware that the purported mastery of signing by non-human primates is not only controversial, but very limited, even if true. However, he discovers that Wish has remarkable cognitive abilities. She learns Auslan quickly and even begins to converse using metaphor and expressing complex topics.

Eventually her story is revealed. She had undergone fetal surgery to remove her adrenal glands, which evidently limit cortical growth in gorillas. Unconstrained by her adrenals (although receiving daily cortisone injections), Wish has developed intelligence far beyond that of other gorillas.

Nonetheless, she is still a sexually mature female gorilla. She falls in "love" with J.J. who, after initially rebuffing her, mates with her. J.J., by the way is quite obese, and so he is much more attractive to Wish than the other human males she encounters, who are all so un-gorilla-like. J.J. and Wish live in connubial bliss for a brief period, until Clive decides to prosecute J.J. for sexually abusing his gorilla, since presumably gorillas cannot give informed consent to sexual activity with humans. (Of course, Wish can and does, because of her super brain, but this concept is a bit too subtle for the frenzied media and the legal system.) After J.J. is arrested and she is removed to a local zoo, Wish becomes depressed and commits suicide. Clive drops the charges, after which the story lumbers to a generally unhappy ending.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Joseph takes a lengthy journey on a strange train to visit his father who resides in the Sanatorium. On the way, he meets a fellow with a swollen face who wears a tattered railwayman's uniform. That man eventually vanishes from the train. When Joseph arrives at his destination, he is informed, "Here everybody is asleep all the time" (115). The Sanatorium's physician, Dr. Gotard, provides a confusing explanation about the condition of Joseph's father. From the perspective of the natural world, Joseph's father is already dead. As a patient in the Sanatorium, however, time is manipulated for him. The past is reactivated allowing for the remote chance of recovery (or at least existence in a type of limbo).

During his stay, Joseph sleeps with his father since no other bed is available at the Sanatorium even though he suspects they may be the only two guests there. He discovers that his father--pale, emaciated, and nicely dressed in a black suit--has two different lives. In the Sanatorium, the man is moribund. Outside the facility, he is vibrant and runs a small cloth shop in a peculiar nearby town. Joseph finds himself "mortally tired" [p 125] and often overpowered by sleep.

A ferocious watchdog guards the Sanatorium, but up close Joseph notices that it is not a canine but rather a man (or perhaps a dog in human guise) so he unchains the creature. Feeling an urgent need to escape his situation, Joseph races to the railroad station where he boards a departing train. He is convinced he will never see the place again. Joseph makes the train his home. Nonstop travel becomes his future. Joseph now has a swollen cheek that is bandaged. He is attired in a worn out railwayman's outfit. When he is not wandering on the train or dozing, Joseph sings and people lob money into his hat.

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Cast of Shadows

Guilfoile, Kevin

Last Updated: Aug-11-2005
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Set sometime in the near future, Cast of Shadows has as its protagonist Davis Moore, a successful private practice physician specializing in cloning human babies for infertile couples. Early in the book, Anna Kat, his high school senior daughter, is murdered and raped. (For a while a likely suspect is Mickey the Gerund, a right wing extremist member of the Hands of God with a fascinating grammatical moniker never explained, who shoots cloning physicians, including Dr. Moore, in the abdomen, a short time before his daughter, Anna Kat, is brutally killed. However, Mickey is only a shadow of a suspect and quickly becomes supplanted by another much more likely villain. Mickey goes on to kill, by various methods, dozens of cloning physicians and staff by book's end.)

After a year of unsuccessful detective work, the local police return Anna Kat's belongings, including a plastic vial with the suspected murderer-rapist's semen. In an act never fully explored by Dr. Moore or the author, an otherwise rational and ethical physician surreptitiously uses the suspect's semen to fertilize a married woman patient.

The offspring, a clone of the suspected killer-rapist, is Justin, who becomes a formidable presence in the book. He is very intelligent--at his psychologist's advice, his parents provide him at an early age with advanced reading materials like Plato (hence one of the allusions to shadows, i.e., Plato's cave, in the book's title and referenced directly on page 118 and indirectly on page 208) and other philosophers. By the time he is a senior in high school, Justin has become a dominant player in the affairs of Dr. Moore; Sally Barwick, a private investigator-turned journalist; and the suspected killer-rapist--his origin of the species as it were.

This book has a number of subplots all of which radiate from the initial cloning and the various members of the extended family and professional staff involved in it, some knowingly, most not. There are narrative threads involving the suspected murderer rapist-now-prominent attorney, Sam Coyne; the triangle of Dr. Moore and Jackie, his alcoholic wife, and Joan, his attractive pediatrician associate; Mickey the Gerund's various murderous and obsessional religious activities and reflections; Justin's life in school and involvement with Sally Barwick's investigation of a serial killer called The Wicker Man; and, most especially, the development of Shadow World, a computer game and a virtual replica of the real world--the world as Justin, Sally, Sam Coyne, and Dr. Davis Moore know it.

Since this is a thriller, it would be inappropriate to divulge more of the plot, which is intricate, often a little far-fetched but always engaging, highly readable and more labyrinthine than most medical thrillers.

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A Time to Keep Silent

Whelan, Gloria

Last Updated: Aug-11-2005
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

At thirteen, Clair's mother has died, her father has withdrawn, and she suddenly stops speaking. Uncertain what to do with or for her, her father, a pastor, opts for complete change and follows his own dream, leaving an upscale suburban parish for a remote one among the rural poor in the northern Michigan woods. Furious, Clair strikes a deal with him that if she doesn't like it in six months, they'll return.

In the course of that time, while her father builds new kinds of relationships and trust among the local people, Clair discovers and becomes friends with a girl her age who lives mostly alone in a makeshift shelter, avoiding the attentions of her laissez-faire chain-smoking grandmother and, more importantly, her violent father who is temporarily in prison and therefore unable to hurt her.

From this girl, Dorrie, Clair learns a great deal about survival, both physical and psychological, and ultimately, surprised by an emergency into the necessity, learns to speak again. As the six months draw to a close, she finds her sisterly bond with Dorrie, whom her father has invited to live with them, and a growing appreciation of the natural setting and local people have made her not only willing, but eager to stay and make a new life where she is.

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Sorry I Worried You

Fincke, Gary

Last Updated: Jul-11-2005
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When Ben Nowak reached the age of fifty, his primary care physician for the past fifteen years, Dr. Ellen Parrish, began performing annual digital rectal examinations on him. Ben is still embarrassed by the female physician checking his prostate gland. He finds the younger Dr. Parrish attractive and available. She divorced her husband because the man was abusive.

Dr. Parrish's office receptionist happens to be the wife of Ben's friend, Jerry, who works at a landfill and brings home cases of expired beer. Once, Jerry found a dead newborn baby in the landfill. Dr. Parrish informs Ben that his prostate has gotten larger. The tests she orders come back "inconclusive" so additional tests are done. Ben concedes that he might have prostate cancer, but rationalizes that things could be "a hundred times worse" (29).

When his second set of test results are normal, Ben grasps that it is likely a temporary reprieve; he is only fine "until the next time" (34). He drives to the site of an illegal dump. The trunk of his car contains ten cases of expired beer (courtesy of Jerry). At the dump, he proceeds to drink one bottle of beer from each case and smashes the other twenty-three.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Handbook

Summary:

Professor Sandra Bertman founded the Medical Humanities Program at the University of Massachusetts Medical Center and holds certificates in grief counseling and death education. This handbook outlines how she uses the visual and literary arts to "improve our professional abilities to deal with death and dying." Her premise is that the arts provide a valuable vehicle for exploring and making bearable the prospect and fact of death.

Bertman illustrates her presentation technique (Chapter 2) of juxtaposing dual images around six central themes, here abbreviated: the chosen death; death and afterlife; existential aloneness; loss of control, unmentionable feelings, grief; the land of the sick vs. the land of the well; the moment of death. The book offers dozens of paintings, sketches, and photographs (reproduced in black and white), as well as many literary excerpts. Classic works are represented (David's painting, The Death of Socrates; Michelangelo's sculpture, "Pieta"; Tolstoy's novel, The Death of Ivan Ilyich) but there are many unusual representations as well--greeting card messages, epitaphs, cartoons.

In addition, some groups with whom she works (for example, medical students studying Gross Anatomy) have submitted their own drawings and commentary. These are shown in Chapter 3, along with written responses to a follow-up Death Attitude Questionnaire. Responses are from junior and senior high school students; college students; medical students; graduate nurses; hospice volunteers.

Chapter 4 gives suggestions for how to use images and texts and for how to approach discussions of loss and grief. The course syllabus for "Dissection, Dying, and Death," taught with Gross Anatomy, is appended, and there is an extensive bibliography.

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Wild Honey

Chekhov, Anton; Frayn, Michael

Last Updated: May-09-2005
Annotated by:
Coulehan, Jack

Primary Category: Literature / Plays

Genre: Play

Summary:

According to the Soviet version, in 1921 Russian scholars discovered the manuscript of a "lost" play by Chekhov among his papers in a safety deposit box in a bank in Moscow. In reality, the play wasn’t lost at all. During the turmoil of the Revolution in 1918, Maria Chekhov, Anton’s sister, had placed in the safety deposit box papers and manuscripts that she considered particularly valuable.

Subsequently, she was unable to travel to Moscow from her home in Yalta until 1921, because of the continuing Civil War in southern Russia. By the time she did return to Moscow, the Communists had "liberated" her brother’s safety deposit box and made their amazing discovery. The title page of the manuscript was missing, so scholars named the play "Platonov" after its major protagonist.

"Platonov" is a huge wreck of a play with numerous characters and subplots that would require about six hours to perform. It is obviously Chekhov’s earliest known play. The majority belief is that it was written between 1880 and 1882, during his first or second year of medical school. Most critics stress its many dramatic faults. However, as Michael Frayn points out in his introduction to "Wild Honey," the play is more remarkable for its strengths than its weaknesses, especially considering that a 21 or 22-year-old medical student wrote it. By carefully pruning the underbrush, Frayn has created a clearly Chekhovian comedy that takes perhaps two and a half hours to perform.

The story takes place in a provincial country estate (so what else is new?), where the widowed landowner returns for the summer after spending the winter months in Moscow. All the local friends and hangers-on gather to greet her, including among others two elderly suitors, the district doctor, and Platonov (the schoolteacher) and his wife. The widow wants to have an affair with Platonov--in fact, three women, one of them married, vie for Platonov’s attention; while Platonov, for the most part, tries to remain faithful to his wife.

The first scene of the second act is a classic comedy of errors. It takes place at night in the forest, just outside Platonov’s house where his wife is sleeping. Anna Petrovna, the landowner, appears out of the darkness and wants to spirit Platonov off to the summerhouse to make hay. But various other characters, some of them drunk and some sober, keep interrupting this rendezvous. One of them is Sofya, married to Platonov’s best friend, who wants to run away with him. The comings and goings in this scene are hilarious--reminiscent of one of Shakespeare’s comedies in which each character misinterprets what every other character says or does.

The play ends, though, on a dark note, or at least a sobering note. Platonov’s wife has left him due to these misunderstandings, and each of the three other women is closing in for the (metaphorical) kill. He decides to run away, and the play ends as he is running down the tracks distractedly, not paying any attention to the train that overtakes him from behind and kills him. This is not a tragic death; it’s funny, but also very sad. Platonov is, after all, a good man, even though weakness and indecision led to his downfall and meaningless death.

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