Showing 281 - 290 of 423 annotations tagged with the keyword "Pain"

Every Second Counts

Armstrong, Lance

Last Updated: Feb-11-2004
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.

View full annotation

Long for This World

Byers, Michael

Last Updated: Jan-19-2004
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Henry Moss is a medical geneticist specializing in Hickman syndrome, a fictitious disease resembling progeria. Children with Hickman syndrome experience premature aging and invariably die before the age of twenty. The physician meets Thomas Benhamouda, a teenager who genetically has Hickman syndrome but astonishingly has no physical manifestations of the disease. Dr. Moss identifies a protein that "corrects" Hickman syndrome in the blood of Thomas and proceeds to synthesize it.

Dr. Moss violates medical ethics by administering the experimental enzyme to his favorite Hickman patient, William Durbin, a dying 14-year-old boy. It is a last-ditch effort to save William's life even though the substance has not been tested for safety or efficacy in human beings. Dr. Moss also injects himself with the enzyme. He realizes the tremendous potential the drug has not only in curing Hickman syndrome but also in extending longevity in normal individuals. He is well aware of the great financial rewards he might reap from his discovery.

After a series of injections, William's deteriorating health stabilizes and even improves but he dies in his home. Dr. Moss has failed to save the doomed boy but in the process of breaking the rules and risking his career has learned how to understand and appreciate his own life as well as reconnect with his family.

View full annotation

The Tragedy

Picasso, Pablo

Last Updated: Nov-21-2003
Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on wood

Summary:

In a bleak setting, at an ocean's edge, a family grouping of three poor people, barefoot, huddled and shivering, are lost in contemplation. The figures' proportions are elongated. Imposing in their size, they take up the entire canvas. Rendered entirely in shades of blue, all other details are eliminated from the composition adding to the mood of blue empty coldness of sand, sky, and sea.

View full annotation

Children of Hunger

Iagnemma, Karl

Last Updated: Nov-20-2003
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In 1822, a young Canadian paddler named Guillaume Roleau is near death after suffering a gunshot wound to the stomach. His recovery is dramatic and scientifically important. The injury has resulted in a traumatic fistula--a porthole between the outside world and Guillaume's abdominal cavity and organs. The treating physician, Dr. William Barber, immediately recognizes the incredible opportunity for medical research and conducts a lengthy series of experiments on the process of human digestion.

Guillaume--patient, research subject, and guest in the doctor's cabin--is rowdy and frequently uncooperative. He continues to participate in the grisly experiments at least partially out of affection for the physician's wife, Julia, who helps nurse him back to health as well as providing emotional sustenance.

Julia ultimately makes a large, uncredited contribution to Dr. Barber's research. At her husband's request, she has sexual relations with Guillaume so that the unreliable man will remain with the doctor until the experiments are all completed. The efforts of this tragic trio result in a landmark textbook on gastrointestinal physiology authored by Dr. Barber and Julia's illegitimate son, Jacob, sired by Guillaume Roleau.

View full annotation

Plot

Rankine, Claudia

Last Updated: Nov-16-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Liv is pregnant. She is an artist, and married to Erland. She names the fetus, a boy, Ersatz (a replacement, a copy, a person not yet real?). This book-long poem, divided into short segments making up nine (month-like) chapters, reconstructs her pregnancy in words, often literally, using words-within-words (for instance in a section called "Proximity of Posed to Exposed"), echoing people-within-(pregnant)-people, ideas emerging from words, and life (and death) emerging from bodies.

The poem does not offer a simple coherent narrative, although it does follow the biological narrative form of gestation. Instead it circles around the experience of containing another person, and the dissonance Liv seems to find between biological and verbal or cultural creating. Liv's ambivalence about this tension is captured throughout the work, perhaps most notably in her exploration of a painting of the dead Virginia Woolf, the drowned body of a childless woman writer, now become "beached debris." The final part of the poem captures powerfully the experience of childbirth, and the afterword is in a new voice, that of Liv's son.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Children's Literature

Summary:

Note: I try not to reveal too much here. Nevertheless, I urge you to read the book first. I would not want the magic of reading this book to be diminished by too much foreknowledge--no matter when the book is initially opened.

Harry Potter and the Order of the Phoenix is the fifth book in a planned series of seven (see Harry Potter and the Sorcerer's Stone for an introductory summary). Harry is now fifteen years old. The opening chapter, "Dudley Demented," features a return of the Dementors (see Harry Potter and the Prisoner of Azkaban), who had been sent to Harry's neighborhood in Little Whinging to deliver their soul-sucking kiss. In order to repel the Dementors and save himself and his bullying cousin Dudley Dursley from the kiss's death-in-life, Harry uses magic. This transgression from rules on underage wizardry leads to Harry's near expulsion from his school, Hogwarts, and a trial by the full court, the Wizengamot, led by Cornelius Fudge, in the Department of Mysteries of the Ministry of Magic.

Headmaster Albus Dumbledore, concerned with Harry's safety as well as with leading the resistance efforts (The Order of the Phoenix) against the resurgent evil Lord Voldemort, not only prevents Harry's expulsion, but also organizes the guard for Harry's transfer from the Dursley home to the ancient house of Harry's godfather, the wonderfully moody and complex Sirius Black. Sirius, like Harry's parents, would risk anything for his godson, but the relationship is charged by Sirius' goading of Harry to be more cavalier like James Potter--Harry's father and Sirius' best friend--and by Sirius' antipathy towards being imprisoned in his ancestral home, filled with reminders of his pureblood wizard family.

These include a portrait of his raging, hate-filled, deceased mother and a malevolent house elf, Kreacher. Communication between Harry and Sirius is a key theme in the book, as Harry looks to Sirius for guidance on the tribulations of adolescence and to satiate Harry's continued craving for information about his father. Harry's emotional tether is short in this novel, and runs the gamut from frustration and envy that his two best friends, Ron and Hermione, were made prefects of Gryffindor House, to despising two teachers (potions teacher Snape, of course, and the new venomous, officious Defense of the Dark Arts teacher, Dolores Umbridge) and finally to absolute fear and hatred of Voldemort, his mortal, yet intimate, enemy.

Harry's scar pains him almost continuously now that Voldemort has returned in the flesh, and also now that Harry has dreams and visions of Voldemort's actions. With this ability, Harry envisions himself as a snake and witnesses the wounding of Ron's father, Arthur Weasley. This episode leads to two visits to the wizard hospital: St. Mungo's Hospital for Magical Maladies and Injuries. The reader is deliciously informed that the personnel in green robes are not doctors ("those Muggle nutters that cut people up" p. 484), but rather Healers: wizards and witches who passed a large battery of tests in a range of subjects to qualify for such training.

The hospital is a mix of the mundane (the irritable receptionist) and the arcane (patients suffering from bizarre spell damage). Mr. Weasley's recovery from the nearly lethal snake bite suffers a minor setback when Trainee Healer Pye (not the Healer-in-Charge, Hippocrates Smethwyck) tries some "complementary medicine . . .

[an] old Muggle remed[y] . . .

called stitches . . . " (pp. 306-7). The loving Mrs. Weasley, whose temper is notorious and hence humorous, shouts at her husband that even he "wouldn't be that stupid" as to allow his skin to be sewn together. (p. 307)

While in the hospital, Harry and his friends encounter schoolmate Neville Longbottom visiting his parents, who suffer dementia caused by dark magic performed by one of Voldemort's Death Eater followers. Mental illnesses prove far more difficult to remedy than bodily injuries and maladies. Indeed, late in the book, Madam Pomfrey, the Healer at Hogwarts, wisely advises that "thoughts could leave deeper scarring than almost anything else." (p. 847) As Dumbledore, the embodiment of sagacity, states, memories of old hurts, slights and abuses, make "some wounds run too deep for . . .

healing." (p. 833)

Other medically related items include the Skivving Snackboxes--an assortment of magical treats and their antidotes concocted to fake various illnesses in order to skip classes, and Umbridge's detention punishment which results in the painful etching of the required written phrases on the back of the hand of the miscreant student.

Professor Snape is charged with teaching Harry the subtleties of mind-reading (Legilimency) and its prevention (Occlumency), in an effort to prevent Voldemort's use of Harry's mind. "The mind is a complex and many-layered thing," says Snape, and hence the mind cannot be read like a book. (p. 530) Harry's failure at these lessons leads to the denouement of the book and ultimately to the loss of someone very dear to him. After the inevitable confrontation between Voldemort and Harry, Dumbledore gently coaches Harry through his guilt and anger to teach him about destiny, love and death.

View full annotation

The Ash Garden

Bock, Dennis

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Emiko a child survivor of Hiroshima, is now a documentary filmmaker. She has horrific memories of August 1945 when she lost her parents and little brother, and of the years of painful operations and homesickness in America where she was sent to restore her mutilated face. She is hoping to interview Anton Böll, a scientist who had fled Germany to work on the Manhattan project.

Böll contends that he had been unaware of human rights abuses; he left Europe because the Nazi regime had cramped his scientific style. As a consequence, his mother was imprisoned and killed. During the war, he met his Austrian-born Jewish wife, Sophie, at a displaced persons camp in Canada. Sophie had lost her whole family, but she does not speak of them and he does not ask.

Briefly they knew happiness, but soon Böll left for work on the bomb and on to Hiroshima in its aftermath. Their marriage would never be the same. For the rest of his life, Böll justified his involvement as a "dream" turned "nightmare" emerging from the imperative demands of a virtuous science. When Emiko approaches him, he hesitates. He does not want to risk blame. But his dying wife knows that absolution for unacknowledged guilt is what he craves.

View full annotation

Annina

Dunmore, Helen

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When I had Annina, the narrator says, her first-born child was eight years old, frost covered the geraniums, and something "warm and wet" ran down her legs. She lost her second pregnancy at only nine weeks from a spontaneous abortion. Secretly, she names the tiny girl "Annina" and tucks her inside her heart and mind, where for years she nurtures her, protects her, dresses her, listens to her language, and watches her grow to a daring adventuress, though she is Thumbelina small, and carries a needle for a sword. Annina eventually moves on and the narrator will not dare to ask her to come home.

View full annotation

Death on Request

Nederhorst, Maarten

Last Updated: Oct-21-2003
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

In this documentary film about euthanasia in the Netherlands, a man--Kees van Wendel de Joode--with amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) requests death in his home, to be performed by his doctor, Wilfred Sidney van Oijen. The film mostly consists of what appear to be unscripted discussions between Kees, his wife Antoinette, and the doctor; however, there are also interviews with the doctor and views of the doctor seeing other patients. The film shows the doctor performing euthanasia: we watch him inject a barbiturate and then a muscle relaxant and we see him supporting Antoinette during the bedside deathwatch.

Kees has had a rapid deterioration of his ability to function: he is unable to move his legs and right arm, he can no longer speak coherently, and he is having difficulty swallowing. His wife cares for him in their Amsterdam apartment. The film documents the legal requirements for euthanasia in the Netherlands: Kees's repeated requests for euthanasia, confirmation that he has an incurable disease, the second opinion doctor's visit, and reporting the death to the municipal coroner and public prosecutor.

The film's strength lies in the sensitive treatment of the impact of this request on the patient, his wife, and especially on his doctor. Dr. van Oijen is an introspective man who cares for his patients--he makes house calls, explains medical terms to his patients, touches his patients, and asks what they are concerned about. He allows his patients (Antoinette is, in many ways, his patient too) to weep and be emotional.

The religious and moral dimensions of euthanasia are explored mostly with the doctor, who does not view himself as a wanton killer, but rather a doctor whose duty includes the alleviation of suffering. The film concludes with a voice-over stating the doctor will not sleep this night, but still has a clinic full of patients awaiting him in the morning.

View full annotation

Annotated by:
Martinez, Richard

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer argues that "the traditional western ethic has collapsed" as we enter "a period of transition in our attitude to the sanctity of life" (pp. 1). The book begins with the tale of Trisha Marshall, a twenty-eight year old woman, who in 1993 was seventeen weeks pregnant when a gunshot to her head left her in an intensive care unit, her body warm, her heart beating, a respirator supporting her breathing. However, she was brain dead.

Her boyfriend and her parents wanted the hospital to do everything possible so that the baby would be born. The ethics committee of the hospital supported the decision. For the next 100 days, Trisha Marshall continued to be supported in the ICU until her baby was delivered by cesarean birth. After a blood test showed that the boyfriend was not the father, and after three weeks in the intensive care unit, the baby went to live with Marshall's parents.

Singer uses this introduction to pose the many ethical questions that are raised because of medicine's ability to keep a "brain dead" body warm for an extended period of time. "How should we treat someone whose brain is dead, but whose body is still warm and breathing? Is a fetus the kind of being whose life we should make great efforts to preserve? If so, should these efforts be made irrespective of their cost? Shall we just ignore the other lives that might be saved with the medical resources required?

Should efforts to preserve the fetus be made only when it is clear that the mother would have wanted this? Or when the (presumed?) father or other close relatives ask for the fetus to be saved? Or do we make these efforts because the fetus has a right to life which could only be overridden by the right of the pregnant woman to control her own body--and in this case there is no living pregnant woman whose rights override those of the fetus?" (pp. 17-18).

In the chapters that follow, Singer argues that whether western society will acknowledge it or not, we have, in our actions and decisions, moved to an ethic where "quality of life" distinctions trump "sanctity of life" positions. Yet, many continue to raise the "sanctity of life" position when it is clear that our legal and ethical positions in western society have embraced the "quality of life" stance. For Singer, this paradox results in an incoherent and illogical approach to the ethical challenges presented by modern medicine.

Throughout his book, Singer presents evidence for his argument through ethical and historical analysis of brain death, abortion, physician assisted suicide and euthanasia, organ donation, and the nature of persons. For those uncomfortable with Singer's position on "infanticide," this book allows one to follow Singer's argument and his recommendations in the last chapter for a coherent approach to these "quality of life" decisions.

He closes his book with the recommendation that a new ethic should embrace five new commandments to replace the old "sanctity of life" commandments. His commandments are: 1) Recognize that the worth of human life varies; 2) Take responsibility for the consequences of our decisions (in end of life care); 3) Respect a person's desire to live or die; 4) Bring children into the world only if they are wanted; and 5) Do not discriminate on the basis of species.

View full annotation