Showing 221 - 230 of 3444 annotations

Summary:

In 2006, Emergency medicine trainee, Damon, and his wife, Trisha, have two boys, Thai (age 4) and Callum (age 2.5).  All is well in their lives until Callum begins vomiting for no apparent reason.  He is found to have medulloblastoma, an aggressive brain tumour, for which the only possible hope for a cure comes from surgery and six cycles of ever more arduous chemotherapy with stem cell recovery at Toronto’s Hospital for Sick Children. The little family moves to Toronto and commits to supporting Callum as best they can, ensuring that he is never alone even during his long weeks of reverse isolation. They also try to keep Thai nearby, involved and aware, with the help of a local school and grandparents. But Callum dies during the last cycle of treatment.  

Saddened, exhausted, and bereaved, Damon and Trisha go back to their home town and try to (re)construct their lives, slowly returning to studies and work. They find meaning in creating tangible and intangible memorials to their lost son, and they find purpose in the more difficult task of moving forward, never losing the pain of grief. They adopt a little girl. Damon knows that Callum is always with him and the experience of his illness and death has dramatically infused his work as a physician.

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Taking Care of Time

Davis, Cortney

Last Updated: Jan-02-2019
Annotated by:
Kohn, Martin

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

In this volume by the esteemed nurse-poet/writer, Cortney Davis, are 43 previously published poems (some revised for this collection), assembled in 3 sections-- the middle section featuring her long poem, "Becoming the Patient," that recounts through 10 shorter poems her time "in the hospital."

The poems in the surrounding sections describe in beautiful and intimate detail her patients' lives and the call to and practice of nursing. Featured throughout are battles won and lost-- with disease, with the medical staff, and as the title-- taking care of time-- suggests, the finitude we all face. No matter the difficulties of hospital life-- whether as practitioner or patient-- its familiarity  provides grounding and comfort in these poems as, for example, heard through the speaker of "First Night at the Cheap Hotel" who tells us:

"Being here is like being sick in a hospital ward
without the lovely, muffling glove of illness.
In hospital, I would be drowsy, drugged into a calm
that accepts the metal door's clang,
the heavy footfall right outside my door.
All these, proof of life,
and there would be a nurse too, holding my wrist,
counting and nodding, only a silhouette in the dark" (p.67)

And if sometimes the experiences and images become too hard to bear, the skillful nurse-poet can, as Cortney Davis does in "On-Call: Splenectomy," "tame them on page” (p.52).

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A Mind Unraveled: A Memoir

Eichenwald, Kurt

Last Updated: Jan-02-2019
Annotated by:
Miksanek, Tony

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Kurt Eichenwald shares his experiences living with epilepsy in an electrifying narrative. Beginning with staring spells as a child and then later on generalized convulsions with loss of consciousness, he experiences as many as 4 seizures a week between the ages of 18 to 30. After that, the seizures become milder and less frequent. Coincidentally, his wife, father, and older brother are physicians and his mother a nurse.

Eichenwald describes his encounters with multiple neurologists, the best of them being Dr. Naarden. Unfortunately, other health professionals are portrayed as incompetent, careless, lacking empathy, or even unscrupulous. Multiple mishaps with prescribed anticonvulsant medications are chronicled – drug side effects, toxic levels of medicines, and a bout of bone marrow suppression. He suffers broken ribs, cuts and wounds, burns, and is even blanketed by deep snow due to seizures.

Eichenwald acknowledges the toll that epilepsy exacts on roommates, friends, and family. He admits to lots of fear and guilt. At one point, he seriously considers suicide by overdosing. Everyday life is hardly ever ordinary: “Now I was scared every day, checking where I stood for dangers, wondering when consciousness would disappear” (p157). A large section of his account details the discrimination he encounters at Swarthmore College in Pennsylvania in the early 1980’s. The school dismisses him because of his uncontrolled epilepsy. He successfully fights their decision and returns to graduate. Obtaining and holding a job is complicated by his illness, but Eichenwald becomes a journalist who works for the New York Times.




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Annotated by:
Field, Steven

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Yuval Noah Harari’s best-selling book “Sapiens” is subtitled “A Brief History of Humankind.”  While this may seem to bespeak a bit of hubris—it would seem that 414 pages might be, despite the modifying adjective of the subtitle, a little too condensed to cover 2.5 million years (albeit only the last 70,000 or so in any kind of detail)—the impression after finishing is that he may have done it, or at least, done the effort proud.  Mustering a combination of data and insights from the domains of history, archeology, genetics, biology, paleobiology, economics, and sociology, among others, Harari weaves an organized narrative that attempts to answer the questions of who we are and how we got here.

He divides the story into four assigned landmark periods in human history: The Cognitive Revolution (the earliest organization of humans into groups which evidence the use of tools and the beginnings of culture), The Agricultural Revolution (the impact of the learned ability to cultivate the land, with its shift from hunters and gatherers to farmers, and by necessity, from nomadic to settled tribes, and the beginnings of towns), The Unification of Humankind (the aggregation of people into larger groups and the emergence of money (and the earliest capitalism), religion, social expansion and conquest), and The Scientific Revolution (the development of science and the incredibly rapid acceleration of knowledge in the last five or six hundred years).  The titles of the periods are, however, only guideposts, for the sections are broader in scope than simply farming or science. The section on the scientific revolution, for example, interweaves scientific progress with economics and imperialism (which are themselves interwoven, after all), religion, and philosophy. And that same section leads Harari to speculate, at the end, as to where the digital revolution and the development of artificial intelligence might be leading us and what we might say about our future as a species.  




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Code Blues

Yuan-Innes, Melissa; Yi, Melissa

Last Updated: Dec-10-2018
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Hope Sze is a resident in family medicine aiming to qualify for the extra year in emergency medicine training. She has just moved from her medical school in London, Ontario, to begin residency in St. Joseph’s Hospital, Montreal. Her furniture and clothing have not yet arrived.

On orientation day, she meets her resident colleagues and takes a shine to Alex who clearly likes her too. But the excitement and anticipation of this new chapter in their lives is disrupted when the body of one of the attending physicians is found lying in the locker room. 

A “whodunnit” with medicine, romance, and suspense in which Hope makes a few mistakes but manages to identify the murderer and the motives.

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The Big Sick

Showalter, Michael

Last Updated: Dec-03-2018
Annotated by:
Jiang, Joshua

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Kumail Nanjiani is a Pakistani-born American living and working in Chicago. In addition to driving for the ride-sharing company Uber, Kumail performs as a stand-up comic at a local club, hoping to be noticed and land a big break. During one of his shows, he meets a graduate student named Emily Gardner, and the two quickly develop an intimate relationship.  

Kumail hides his relationship from his family, because they insist that he only date Pakistani women. Privately, Kumail struggles not only with the cultural expectation of intra-ethnic marriage, but also with other aspects of his heritage, such as devotion to Islamic religious law. He chooses to maintain appearances out of love for his family and fear of disownment. Emily eventually discovers Kumail’s double life and in anger, ends their relationship.  

Kumail and Emily’s estrangement is interrupted when Emily is hospitalized with a mysterious illness. Emily initially resists Kumail’s presence, but her sickness worsens and she is placed in a medically-induced coma. Under these increasingly uncertain circumstances, Kumail partners with Beth and Terry—Emily’s parents—to navigate a confusing medical system and chart the best course of care for Emily. The three of them clash over their differing perspectives on care and their interpersonal relationships. As he waits with bated breath for Emily’s recovery, Kumail is forced to confront his values and decide whether his desire to please his family and his ongoing affection for Emily can coexist harmoniously.

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Comfort Measures Only

Campo, Rafael

Last Updated: Nov-26-2018
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Physician Rafael Campo's collection of new and selected poems is a lovely look back (selected poems are from 1994 to 2016) and an exciting look at thirty-one new poems that continue his trademark use of a variety of poetic forms (the title poem "Comfort Measures Only" is a Villanelle, pg 135) and the moving and personal examination of his interactions with patients.   This collection begins with Campo's excellent introductory essay, "Illness as Muse" (pgs 1-9).  

As the essay opens, an audience member tells Campo that his poems are "really depressing." Even Campo's spouse advises him to lighten things up, a counsel I hope the poet never heeds--for it is precisely Campo's unwavering examination of sorrow, regret, death, and despair that set his poems apart from poems that find "butterflies or snowflakes or flowers as more suitable." Campo responds: "Try as I might to take all of this concern to heart . . . I keep finding myself drawn to write about illness" (pg 1).


Campo recalls how singing and praying consoled his grandmother and seemed to lessen her physical ills: "No wonder I have come to believe in the power of the imagination if not to cure, then to heal" (pg 4).  On page five he notes "To write about illness, to heed this terrible muse, is to reject distancing and to embrace empathy, for which there is no reward or claim on greatness other than perhaps the perverse joy of recognizing oneself as being susceptible to the same foibles and neuroses as anyone."  Indeed it is this vulnerability--the ability to see physician and patient on the same plane, as equal players in a moment in time--that has become another hallmark of Campo's poetry.
Selected poems from previously published collections follow the essay: nine poems from "The Other Man Was Me" (1994); eight poems from "What the Body Told" (1997); nine poems from "Diva" (200); five poems from "Landscape with Human Figure" (2002); seven poems from "The Enemy" (2007); and twenty poems from "Alternative Medicine" (2013).  Of these collections, all but "Landscape with Human Figure" and "The Enemy" have been reviewed in the database.

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Summary:

Beth Macy has been a newspaper reporter in the Roanoke, Virginia area for three decades. In this book, she provides extensive reporting on the opioid crisis, how it developed and wreaked havoc in Appalachia, and how it grew into a national crisis across the United States.  

“Dopesick” is the colloquial term people who are addicted and addiction medicine specialists use to describe the constellation of wrenching and violent symptoms opioid withdrawal causes. As one of Macy’s subjects describes it:

You’re throwing up.You have diarrhea. You ache so bad and you’re so irritable that you can’t stand to be touched. Your legs shake so bad you can’t sleep. You’re as ill as one hornet could ever be. And believe me, you’ll do anything to make the pain go away.” (p. 41)
As a result, not long after a person is addicted to opioids, drug seeking behaviors are not motivated by the urge for the next and best high, but instead are driven “to avoid dopesickness at any cost” (p. 9). 

Macy divides her reporting into three major parts: 1) the ways Purdue Pharma fueled the explosion of opioid addiction beginning with the introduction of its product Oxycontin in 1996; 2) the ways in which people get addicted to opioids and how they get their supplies; and 3) the ways the U.S. health care system, criminal justice system, Congress, state legislatures, and regulatory agencies have failed in preventing and fixing the addiction crisis. 
 

As a journalist, Macy weaves the stories of individuals into the larger story of the opioid addiction crisis: people who became addicted to opioids and the effect it had on their families, and the stories of health care professionals who pulled alarms about the rapidly rising rate of opioid addiction and tried as best they could to treat addicted patients and protect the public. We read about the Purdue Pharma executives who were blamed and prosecuted for the marketing campaigns that turned localized opioid addiction patterns into a national opioid addiction epidemic. And we read about individual sheriffs, investigators, prosecutors, judges, and community activists who were trying to stem the tide of addition and death. These stories intersect throughout the book.

Embedded among the individual story lines are digressions Macy uses to elaborate on certain aspects of the opioid addiction crisis. She provides historical perspectives on drug addiction, and how this crisis differs from those of the past. She puts an emphasis on how trends in medical practice to liberalize the use of opioids in the management of all types of pain—minor and major, acute and chronic—converged with Purdue Pharma marketing campaigns for its proprietary opioid products. She cites statistics to show how fast the epidemic was worsening, how widely it was spreading across the United States, and how deadly it had become with mortality rates exceeding those of AIDs mortality at its peak. Other digressions cover how illicit opioid supply chains are created and maintained, and how different levels of governments reacted to the crisis. 

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Three Identical Strangers

Wardle, Tim

Last Updated: Nov-08-2018
Annotated by:
Thomas, Shawn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The world is a big place – 7.4 billion people and counting. As much as we all enjoy the game of finding our doppelganger in a crowd, there probably isn’t anyone in the world who is exactly like us. With a genetic code of over 3 billion base pairs, of which there are innumerable permutations, we would be hard pressed to find a clone of ourselves even if the world had 7 trillion people. The exception is if you were born with an identical sibling. But then again, you would know if you had a twin. Wouldn’t you?

The documentary Three Identical Strangers tells the unbelievable story of Bobby Shafran, Eddy Galland, and David Kellman – three identical triplets who were separated at birth and serendipitously reunited at the age of 19. The film takes us through the circumstances of their reunion, highlighting the brothers’ instant rapport over their similarities and the ensuing fame resulting from the public fascination with their extraordinary story. It began as a euphoria-filled saga complete with talk show interviews, movie cameos, and even a successful restaurant which they called “Triplets”.

The honeymoon phase ended in horrific fashion once the parents of the respective siblings began asking questions as to why the brothers were separated in the first place. A journalist who had been investigating the triplets’ adoption agency, Louise Wise Services, helped to uncover the details of an elaborate study performed by a child psychiatrist named Dr. Peter Neubauer. In this study, each brother was placed into a home which had another adoptive sister, and specifically assigned to a family of lower, middle, and upper-class backgrounds. While the exact details of the study objective remain unknown, it appears that the study was trying to determine whether psychiatric illness was correlated more strongly with genetics or with developmental environment; this is referred to colloquially as a “nature vs. nurture” experiment.

The implications were earth-shattering. The brothers struggled to cope with the realization that they had been marionettes in some sort of sick experiment, with Dr. Neubauer pulling the strings the whole time. Even worse was the fact that there were possibly several more identical siblings with the same story who were deprived of their biological soul mate, all at the behest of Neubauer and his associates. In fact, other sets of identical siblings were eventually made aware of the experiment, and did have the chance to meet, albeit many years after their birth.

The triplets also learned that their biological mother had serious psychiatric problems – hence their inclusion in the study. All three brothers had behavioral difficulties as adolescents, and it was distressing to consider whether their issues may have been exacerbated by the separation anxiety they experienced upon being separated at birth. In particular, Eddy suffered from worsening episodes of bipolar disorder throughout his life. In 1995, at the age of 33, he committed suicide. He is notably absent for the duration of the documentary, with Bobby and David narrating much of the film. Today, they are still trying to uncover the particulars of Dr. Neubauer’s study, but the research records remain under seal at Yale University until 2066. They may never know the full extent of what was done to them and why.

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This intelligent and compelling book invites us to evaluate the losses pertaining to “modern death” and to consider better ways—whether from the past or in the future—to care for the dying, their families, and all care-givers.   
            
Some chapters, such as “How Life (and Death) Were Prolonged,” are historical, describing changes in inoculations, living conditions, and medical care that extended the human life span but also changes in dying, now often prolonged by technology. Another chapter, “How We Learned Not to Resuscitate,” relates how CPR, initially lauded and popularized, is now widely understood as futile care, especially in older people. Warraich discusses various attempts to define death (brain-based, heart-based, American Bar Association, Harvard Criteria, Uniform Determination of Death Act, even NASA) and some of the issues that still remain. 
 

Other chapters are more physiological:  “How Cells Die” explains natural processes of cell death (necrosis, autophagy, and apoptosis). Most non-medical readers haven’t heard of these and perhaps some medical personnel as well. Unaware of them as regular and usual processes, we resolutely expect people to live some four-score and ten, perhaps even more. The next-to-last chapter, “When the Plug is Pulled” discusses “terminal sedation” (a legal dosage that eases pain but is not strictly speaking euthanasia or murder) and statutes that allow for assisted death and removal of life-sustaining machines. The Nancy Cruzan case and others illustrate many difficulties. (Cruzan was in a persistent vegetative state and supported by a feeding tube. A 1990 U.S. Supreme Court 5-4 decision allowed the removal of the tube.) Warraich argues further for “patients’ right to demand and acquire the means to end their suffering with the aid of a physician” (p. 263).              

Lack of resolution of these difficulties leads to problems for families of the dying and all medical personnel attending them, especially in ICU situations. Living wills are often of no help and “the end of life has become a battleground” (p. 211).
He argues that surrogate roles for decisions at the end of a life often do not represent what the patient actually wanted because the surrogate's values may be different from the patient's and family members may not reach agreement on decisions. He concludes, “All in all, overinvolved family and underinvolved doctors unsurprisingly make for a particularly caustic combo” (p.214).                      

In “When Death Transcends” we read that spiritual and religious matters are often ignored in medical settings. Such resources, however, “may be the only means that patients have of finding comfort” (p. 148). Warraich surveys various religions, including his own, Islam. This is one of the longest chapters in the book and carefully considers the wide range of faiths people have and the regrettable lack of training for doctors in this area.
           

Warraich concludes, “Death needs to be closer to home, preceded by lesser disability and less isolation” (p. 278). For deaths to be “truly modern,” we need to push past taboos and misunderstandings about death. 

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