Showing 241 - 250 of 666 Nonfiction annotations
This is another wonderful book from Dr. Sacks. The subtitle, “Tales of Music and the Brain,” is accurate: we have a charming and informative mixture of stories of patients and the neurophysiology that interprets how music is processed and performed. The book is synthetic in combining cases from his practice, other clinical reports, letters from correspondents, references to medical literature, and even Sacks’s own personal experiences with music.
Sacks finds that humans have a “propensity to music,” something “innate” in human nature, perhaps like E. O. Wilson’s biophilia. “Our auditory systems, our nervous systems,” he writes, “are indeed exquisitely tuned for music” (xi). Although humans have been involved with music for millennia, it is only in the last few decades that medical imaging (functional MRI, PET) has shown what areas of the brain are active when music is heard.
While humans routinely enjoy music, the book emphasizes unusual events and neurological patients, in short, departures from the norm. Sacks—himself a lover of music—reports on his own experiences with hallucinatory music and anhedonia (loss of pleasure) in hearing music. He describes going to hear the great baritone Dietrich Fischer-Dieskau but finding that he could not, on that day, perceive the beauty of the music. Another condition “amusia,” or loss of musical ability, can be chronic, acquired, or temporary.
Some patients have had injuries or diseases of the brain that change how music is perceived. A man hit by lightning is suddenly obsessed with piano music. Another man (who survived a brain infection) has amnesia about many things but can still make and conduct music at a professional level. The concert pianist Leon Fleisher visits Sacks to discuss his dystonia, or loss of muscle function in one hand (with implications for the brain). Rolfing and Botox helped him heal and he returned to two-handed performances.
Sacks discusses other phenomena that involve brain structures, for example, perfect pitch; persons with this ability have “exaggerated asymmetry between the volumes of the right and left planum temporale” (128). People who experience synesthesia (perceiving notes as colors) have cross activation of neurons in different areas of the brain. Professional musicians (and patients with Tourette’s) demonstrate cortical plasticity, that is they have expanded areas of the brain for particular uses. Children with Williams syndrome have brains influenced by a microdeletion of genes on one chromosome; they have some cognitive deficits and also a great responsiveness to music. For some conditions, the brain determines all; for others, behavior components are also important.
Summary:Janis Caldwell, who practiced emergency medicine for five years before getting her Ph.D. in English, examines the philosophy and practice of nineteenth-century British literature and medicine in this book. In an erudite introduction, she explains what she means by the "double vision" of "Romantic materialism," "Romantic because [physicians and authors] were concerned with consciousness and self-expression, and materialist because they placed a particularly high value on what natural philosophy was telling them about the material world" (1). These writers' intellectual context, influenced by natural theology, was dualist, including both the Book of Scripture and the Book of Nature. Their methodology "tacked back and forth between physical evidence and inner, imaginative understanding" (1), giving rise to the two-part "history and physical exam" familiar to physicians today.
Summary:This book could perhaps have been called "Pathology and Identity in the Medical Case History and the British Novel." Tougaw here examines the mutual fascination of both nineteenth-century medicine and the British novel with pathology: that both "novels and case histories require a suffering body at narrative's center" (8), and that both "put into circulation a model of identity whereby the subject is always caught in a double bind... between health and pathology" (9). He examines developments in the medical case history, as a narrative, and argues that both this and the novel permitted an escape from "the nineteenth-century zeal for classification" (2). He reads the doctor-patient relationship as analogous to the reader-novel relationship, and argues that both genres must balance competing modes of approach: diagnosis and sympathy.
Summary:Two hospice nurses describe their work with dying patients, especially with the special forms of communication typical of dying patients. The authors define "Nearing Death Awareness" as patients' knowledge and expression about their own dying. What doctors and family members may assume is the patient "losing it" or "hallucinating" actually is often a kind of symbolic communication dying patients typically use, either to describe their dying experiences or to request something they need for a peaceful death (such as seeing a loved one). By dismissing the patient as "confused," caregivers miss the opportunity to help the patient and may also alienate and frustrate both patient and family. By being aware of what is going on, caregivers can be more responsive and comforting to the patient and the family.
Summary:In 1999, eighteen years after Project HOPE began publishing the journal "Health Affairs," the founding editor, John Iglehart, began a new column: Narrative Matters. This book contains 46 of the 80 essays published to date, and an inspiring foreword by Abraham Verghese. The essays are contained in eight chapters-- "Writing to Change Things: Essays on the Policy Narrative," "Dollars and Sense: Hard Financial Realities," "Bearing Witness: Patient's Stories," "The Maddening System: Frustrations and Solutions," "Trouble in the Ranks: Professional Problems," "Drug Resistance: Battling Undue Influences," "Disparity Dilemmas: Stories on Race and Ethnicity," and "Values and Choice: Stories of Practical Ethics." Familiar voices include those of Fitzhugh Mullan (one of the editors), Abigail Zuger, Howard Brody, Richard Lamm, John Lantos, Danielle Ofri, and Carol Levine. The essays in the first section strike an important cautionary tone, reminding readers that the plural of anecdote too often is taken for policy and that the repetition of anecdote should not be seen as evidence.
John Grogan's best selling memoir of his and his family's life with an exuberant, loving Labrador retriever pup that grew into an overly boisterous ninety-seven pound member of the family chronicles the joys and tribulations of dog ownership. Particularly, of Marley ownership. Marley flunked obedience school, required tranquilizers to tolerate thunder storms, destroyed possessions and jumped on people, to name a few traits.
The young married couple adopted Marley before they had children. The reader learns of the pregnancies and births of the Grogan's three children, including a miscarriage, ‘performance failure' during sex timed to ovulation, and an episode of post-partum depression, with an eye to what Marley was up to during that phase of family life, and especially how he responded to his owners' emotional states. Marley's protective stance towards not only the children, but also to a knifing victim in the neighborhood and to Grogan himself when he was struck by lightning, proved the dog's loyalty and devotion.
Marley lived a full life; as he aged, his hearing, sight and mobility worsened. He required emergency abdominal surgery at an old age, recuperated, but then suffered the same stomach bloat and twist problem again.
Grogan, a newspaper columnist, decided, after a period of intense grief, to write an article about Marley. "‘No one ever called him a great dog - or even a good dog. He was as wild as a banshee and as strong as a bull. He crashed joyously through life with a gusto most often associated with natural disasters...' There was more to him than that, however... ‘He taught me to appreciate the simple things...And as he grew old and achy, he taught me about optimism in the face of adversity. Mostly, he taught me about friendship and selflessness and, above all else, unwavering loyalty.'" (p. 279)
The column generated an avalanche of responses; fellow owners of bad yet lovable dogs wrote to the newspaper of their own experiences. These responses were cathartic to Grogan as he and his family learned to live without Marley, the dog who had taught them all so much: "the art of unqualified love." (p. 287)
Summary:Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.
In this compelling memoir, Grace, a writer, artist and teacher, unexpectedly finds herself attracted to a carpenter, Howard Staab, whom she meets when looking at a new home. Shortly after their relationship begins, Staab is told in a routine physical examination that he has severe mitral valve regurgitation and will require surgery. Staab, an active, otherwise healthy fifty-three year-old man, has no health insurance. The cardiac surgery will cost over $200,000. Thus Staab and Grace embark on a quest to find an affordable, but excellent surgeon and hospital. Grace details her efforts to find the best care possible, including correspondence with her son, Bryan, a Stanford medical student with interests in international health. These inquiries lead to the possibility of surgery in India.
After a useful, explanatory preface the book begins when Staab and Grace land in New Delhi and enter the Escorts Heart Institute. Staab undergoes a series of tests confirming the need for surgery, which is subsequently performed by Dr. Naresh Trehan. Through Grace's eyes, we also meet nurses, aides, other physicians, administrators and friends. The narrative follows the hospitalization, including dramatic complications and eventual recovery, and also backtracks to better detail the search for care and the predicament of un- and underinsured Americans. Grace also describes the post-hospital phase, including venturing out beyond hospital and hotel walls.
The book, highlighting the fact that Grace and Staab face more than one cultural challenge in this journey, contains both a medical terms glossary and a short list of Hindi terms. Ultimately, Grace concludes she would consider returning to Escorts or a similar hospital should she or a loved-one require surgery, even without the insurance issue. She states: "India, the land of contradictions. Organized chaos. A third-world country with first-world state-of-the-art medical care available for a fraction of the cost of the same procedures here in the U.S." (p. 259)
Summary:Author and teacher Peggy Shumaker was involved in an unexpected and terrible biking accident. Out of that accident and her following slow recovery she has crafted a remarkable memoir---one that both examines her interactions with the medical community and her family and charts her return from disability---in short essay-like chapters, individual memories that comprise and inform her life before and after illness. Reading these gem-like pieces, I could imagine her, in the process of recovery, having time and patience to look back at family, friends, custom and community in order to recreate who she was before and who she would be after her accident. The longest of these "chapters" is several pages; the shortest, only a few sentences. There is no table of contents guiding readers through the six sections of this book---and how could there be, as the book itself reflects the healing mind as it searches for continuity in the midst of disruption.
This memoir chronicles the pre-adolescent and adolescent years of the author, the son of an alcoholic, abusive mathematics professor father and a psychotic Anne Sexton-wannabe confessional poet mother. The only family member who does not abuse the boy in any way is estranged--an older brother with Asperger’s syndrome. Meanwhile, the amount of trauma to which young Burroughs is subjected boggles the mind. Just when one thinks it couldn’t get any worse, it does.
Burroughs, who loves bright, shiny, orderly things, also likes doctors--paragons of cleanliness, virtue and wealth. Unfortunately, his mother’s psychiatrist, Dr. Finch, described as a charismatic Santa Claus-look-alike, is unethical, bizarre and squalid. As Mrs. Burroughs becomes more and more dependent on Finch, she allows her son to be adopted into the crazy Finch household.
This family includes wife Agnes, who copes with her husband’s infidelity by sweeping madly; son Jeff, daughters Kate, Anne, Vickie, Hope and Natalie; grandson Poo; and adopted son, Neil Bookman, who is twenty years older than Burroughs and homosexual. When Burroughs is thirteen, and has told Bookman that he, too, is gay, Bookman forces the boy to have oral sex. They become lovers.
The Finches, meanwhile, exhibit their quirks and weird tendencies in multiple ways. "Bible-dipping" is popular to read the future, as is prophesying by examining Dr. Finch’s turds. A patient with agoraphobia, Joranne, lives in one of the rooms--in fact, she has not left the room in two years. Young Burroughs is allowed to smoke and drink. When Burroughs says he doesn’t want to return to school, Dr. Finch facilitates this desire by giving Burroughs alcohol and pills to fake a suicide gesture, then hospitalizes the boy.
Yet Burroughs manages to befriend a couple of the Finch daughters, and to survive his childhood. The book closes with his departure for New York City and with an epilogue outlining various people’s outcomes. Finch lost his license due to insurance fraud.