Showing 31 - 40 of 382 annotations tagged with the keyword "Abandonment"

The Beautician

Gunn, Thom

Last Updated: Nov-06-2017
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

"Beautician" is a short poem about a beautician visiting a dead friend in the morgue, her sorrow at seeing her friend dead and not looking her best, even dead, and the beautician's attempts to rectify the situation. It is fifteen lines long, in three stanzas of five lines each, in iambic pentameter with a rhyming pattern of abbab. The rhyming is best described as approximate, e.g., "skill" with "beautiful" with "all".

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Summary:

This engaging memoir describes Pearson's medical training at the University of Texas Medical Branch (UTMB) on Galveston Island from 2009 to 2016. During these years her personal values become clear, and she finds fault in her training, in medicine as practiced in Texas, and even in her own errors in treating patients.

Having left a graduate writing program, Pearson took a "postbac," a year of pre-med courses in Portland, Oregon. She interviewed at medical schools "all over the country" and writes satirically about them; she concludes "nothing out of Texas felt quite right," having lived there and done her undergraduate work at University of Texas at Austin. She's a Spanish speaker with a working-class background. When her classmates provide the annual “white-trash”-themed party, she wonders, “do I go as myself?” (p. 21).

Pearson's education continues on three tracks: the formal UTMB courses in medicine, a simultaneous Ph.D. program at the Institute for the Medical Humanities at the University of Texas, and her volunteer work at the St. Vincent's Student Run Free Clinic. The Ph.D. program is off-stage, not mentioned, but the St. Vincent's Clinic becomes pivotal to her development as a doctor and a moral person.

As for medical school, she finds the relentless "truths of biochemistry and anatomy" so reductive that the suffering of people and surrounding politics seem "not to matter at all" (p. 70). Among the politics are: the lack of safety nets for poor people, the use of uninsured (including prisoners) for students to practice on, failures to extend Medicare, pollution (notably from the oil industry), losses of charitable care, and income disparities that include crushing poverty for many. Something of a rebel, she writes that medical school "felt like junior high" (p. 44). She does enjoy the "clinical encounters" with real patients.

St. Vincent's, by contrast, was “a relief.” Her pages sparkle with her conversation with clinic patients, some homeless, all poor, and all suffering. She reports--confesses, she even says--her errors that had consequences for patients. She writes that errors are an unavoidable part of medical education, but that it's wrong that they should routinely happen to the poorest members of society.  

Chapter 8 discusses depression, which she felt after the second year. She writes about high rates of suicide among medical students and doctors; indeed a close friend killed himself during the "post-doc" year. Because some states require doctors to report psychiatric care, some doctors avoid such care. This consequence “drives a suicide-prone population away from the help we may need" (p.92).

The last two years are the rotations through specialties: surgery, dermatology, trauma, rural medicine, neurology, internal medicine, and so on. These are clearly and insightfully described. In one case (internal medicine), she allows the reader to see the irony of a doctor providing hair removal by laser, diet foods, and Botox treatment for wrinkles, “a pure luxury transaction” (p. 183).

Pearson describes the storms, hurricanes, and floods that hit Galveston Island, also the pollution from the oil industry that causes a “cancer belt” along the Louisiana and Mississippi coasts (p. 104).
At last she finishes her program, understanding that her identity is simultaneously a person, a physician, and a writer (p. 248). 

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The Story of Beautiful Girl

Simon, Rachel

Last Updated: Aug-07-2017
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

On a stormy night in 1968 a retired, widowed schoolteacher in rural Pennsylvania opens her door to find a young couple, she white, he African American, wrapped in blankets, drenched, and silent.  Letting them in changes her life.  They have escaped together from a nearby mental institution most locals simply call "The School."  The young woman has recently given birth.  When Martha lets them in, her life changes forever.   Supervisors from "the School" show up at the door, the young man escapes, and the young woman, memorably beautiful, is taken back into custody.  The only words she is able to speak out of what we learn has been a years-long silence are "Hide her."  Thus she leaves her newborn baby to be raised by a stranger.  The remaining chapters span more than forty years in the stories of these people, linked by fate and love and the brutalities of an unreformed system that incarcerated, neglected, and not infrequently abused people who were often misdiagnosed.  Homan, the young man who loved Lynnie, the beautiful girl from the institution, was deaf, not retarded.  Lynnie was simply "slow," but a gifted artist who recorded many of the events of her life in drawings she shared only with the one attendant who valued and loved her.  Though her pregnancy resulted from being raped by a staff member, the deaf man longs to protect her and care for the baby.  Years separate them; Homan eventually learns signing; Lynnie's sister befriends her and an exposé results in the closure of the institution.  Over those years Lynnie and Homan witness much cultural change in treatment of people like them who were once systematically excluded.  They find social identities that once would have been entirely unavailable to them.  And eventually, after literal and figurative journeys of discovery, they rediscover each other.   

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Mijito

Berlin, Lucia

Last Updated: Nov-28-2016
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

It is a strange and cruel world that Amelia finds herself in. The 17-year-old woman from Mexico who speaks very little English travels to Oakland, California to marry her boyfriend Manolo. Soon after, he is sentenced to 8 years in prison. Amelia is already pregnant. She and her newborn son, Jesus Romero, move in with Manolo's aunt and uncle. Amelia refers to the baby as "mijito" (an affectionate Spanish term for "little son"). He cries constantly and has a hernia that requires repair. But the teenage mother is overwhelmed and frightened. She receives little support.

Amelia and Jesus go to the Oakland Children's Hospital where they meet a cynical but kind nurse who works with a group of 6 pediatric surgeons. Most of the surgical practice consists of Medi-Cal welfare patients and lots of illegal aliens. The nurse encounters crack babies, kids with AIDS, and plenty of disabled children. When the surgeon examines Jesus, he notes bruises on the baby's arms. They are the result of Amelia squeezing him too hard to stifle his incessant crying. Surgery is scheduled but doesn't get done.

Later, the uncle makes sexual advances and, while drunk, rapes Amelia in the bathroom. The aunt insists Amelia and Jesus leave the apartment. She deposits them at a homeless shelter. Amelia spends her days riding buses and her nights at the shelter where she is harassed and robbed. All the while, Jesus cries. Amelia notices his hernia is protruding and she is unable to push it back in place as she was instructed. After office hours, the same nurse evaluates the situation and accompanies them to the emergency room where surgery is performed.

Amelia and Jesus return to the ER. She has been sedated and is staring blankly. Jesus is dead with a broken neck. The nurse from the surgical clinic is at Amelia's side and learns that Jesus was crying in the homeless shelter and keeping others there awake. Amelia shook the infant to try to quell the crying. She didn't know what else to do.

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Primary Category: Literature / Fiction

Genre: Novel

Summary:

This ambitious novel presents unusual events ten years after an international adoption.  Because of the Chinese one-child policy, Chinese peasant woman Xiao Lu abandons her second daughter Chun in a rural market, knowing that the child will be sent to an orphanage. An American couple adopt the child, calling her Katie. As a celebration for Katie’s tenth birthday, they return to southwest China, hoping to meet the birth mother.  

In a series of unusual events, they find Xiao Lu, and it is, at first, a joyous event. Troubles mount, however, as the birth mother wants Katie to stay with her, and Katie feels a mystical bond between them. Xiao Lu, having left her husband, now lives as a hermit in a hut on the slopes of The One Hundred Mile Mountain. She sweeps the 100 steps of The Elephant Temple daily and practices calligraphy in her hut.  

Pep and Clio Macy, having married late, could not get pregnant. The novel satirizes them as aging Yuppies, spoiled and materialistic. Clio wears a Movado watch worth hundreds if not thousands of dollars. The family’s cockerpoo has been boarded at home. Katie dislikes being the only Chinese American in her private school.  

After the birth mother has been found, the mood of the book changes. Xiao Lu wants her child returned, and the Macys fear that they are in danger. In the last 100 pages, nature itself attacks the Americans with snakes, monkeys, bats, a huge millipede, and even the weather. Pep is injured and receives rough, traditional medical treatment from a monk; it appears to be effective, however, in healing his heart physically and spiritually—a resonance with the book’s title. Katie becomes more and more like Xiao, learning calligraphy and some Chinese language. When Xiao is grievously injured by the monkeys, the Macys effectively care for her, and previous conflicts are resolved.

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Archangel

Updike, John

Last Updated: Sep-13-2016
Annotated by:
Clark, Mark

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The speaker of this dramatic monologue in prose is an archangel.  He attempts to tell his listeners—mortals, presumably—of the beauty to be treasured in the extraordinary ordinary of the everyday world.  The Archangel speaks in nothing less than glorious diction, baroque syntax, and enchanting rhythm: he labors, rhetorically, to communicate in a language congruent with the complex, extravagant beauty of the world he describes.  He pleads with his audience to listen to him and share in the profound aesthetic experience so readily available—but he pleads to no avail: his audience will not listen.  In response to his audience's attempted departure, the Archangel implores, “Wait.  Listen.  I will begin again.”

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Lifeguard

Updike, John

Last Updated: Aug-17-2016
Annotated by:
Clark, Mark

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The narrator of this story is a lifeguard who contemplates his identity and life-roles as he lounges in his lifeguard chair, elevated above the crowd of beachgoers.  In the winter months, he is a student of divinity; in the summer months, he ascends the throne marked with a red cross in the hopes of guarding the lives of those at play before him.  While he remains vigilant for calls of help, those calls never come, and the lifeguard confronts the troubling insight of the limited contributions he’s devoting his life to make.

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A Little Life

Yanagihara, Hanya

Last Updated: May-17-2016
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

After first meeting as college roommates, Jude, Willem, JB, and Malcolm make their way through college and then onto New York City to pursue career interests. We follow them through the subsequent decades as Jude becomes a highly effective attorney, Willem a famous actor, JB an acclaimed artist, and Malcolm a prize-winning architect.  

What starts as a cluster of four eventually separates into an orbit of Willem, JB, and Malcolm around Jude at the center. The gravitational force pulling the three others towards Jude is the fidelity that can form among college roommates and a love that has bonded them together even more. But, there is also a strong sense among the three that Jude needs them for both physical and emotional support. At first, and for a good long time, it’s just a sense, but they later come to learn that their intuitions are right, that Jude does indeed need them and why. Over the years covered in the novel, a second orbit forms around Jude comprising a surgeon-cum-close friend, adoptive parents, a work colleague, and a neighbor. They, too, know Jude needs them, but only learn why late into their relationships. Until then, they are alternatively and often simultaneously worried, angry, flummoxed, and stymied about what’s at the root of his ambulatory limitations and severe leg pains, and why he cuts himself with terrifying frequency.  

Through a fractured narrative sprinkled with artfully-constructed subliminal hints, Yanagihara reveals Jude’s life before he arrived at college. She tells of Jude’s beginnings as a foundling taken in at a monastery. This hopeful start for Jude, however, becomes a childhood and adolescence of unrelenting, horrific, sexual assault and torture—when at the monastery, when on the road after being kidnapped by a monastery brother, when in protective custody, and even when he is able to escape. He arrives at college bearing the psychological and physical consequences of these experiences, but not openly displayed to a degree that yields more than a few hints of a traumatic past. With the support of the people surrounding him in  his adult life, he is able to become a highly accomplished attorney, and to achieve some measure of ease and happiness from time to time. The support he receives, however, is not enough to protect him from the consequences of further psychological and physical assaults, including his self-mutilation practices, and tragic losses. Ultimately, Jude engineers his own final tragedy.
 

Some of the people left behind suffer from more than Jude’s loss. His friend the surgeon wonders whether he enabled Jude’s self-cutting by always patching him up and never committing him to an inpatient psychiatric unit. Jude’s adoptive father relives the loss of his first son at a very young age to a rare, degenerative, neurological disease. Nearly all the figures in this novel experience suffering in some form or another, but this is more the story of Jude; how the people around him tried to get him past the horrors of his childhood and adolescence, but eventually and sadly to no avail. 

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The Heart

de Kerangal, Maylis

Last Updated: Apr-25-2016

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The story of The Heart is a simple, linear structure.  A car accident renders a young Frenchman, Simon, brain-dead. A medical team proposes harvesting organs, and his parents, after some turmoil, agree. That’s the first half of the book, the provenance of this specific heart. The second half describes its delivery for transplantation. Administrators find recipients, one of them a woman in Paris. Simon’s heart is transported there by plane and sewn into her chest. All this in 24 hours.  
            
The narration is complex, with flashbacks, overlapping times, and literary art that is compelling. There are 28 sections to the story but without numbers or chapter headings, and these are often broken up into half a dozen shorter sections. We have an impression of stroboscopic flashes on the action, with high intensity focus. These create a mosaic that we assemble into dramatic pictures. Even major characters arrive without names, and we soon figure them out.  
 

Simon.  He’s called the donor, although he had no choice in the matter. At 19 years of age he’s trying to find a path in life.  A Maori tattoo is a symbol for that search. He has a girlfriend, Juliette. He fades away as a character (except in others’ memories) and his heart takes center stage.  

Marianne and Sean, Simon’s parents.  Her emotions, as we would expect, range widely, especially during discussion of whether Simon’s organs can be transplanted. Father Sean has a Polynesian origin and cultural heritage.


Pierre Révol, Thomas Rémige, and Cordélia Owl are respectively the ICU physician, nurse, and the transplant coordinator. These are vividly drawn, with unusual qualities. Skilled professionals, they are the team the supplies the heart.  

Marthe Carrare, Claire Méjan, and Virgilio Breva are a national administrator, the recipient, and a surgeon. Described in memorable language, they are the receiving team.              

The characters’ names give hints of de Kerangal’s range. S
ince the 1789 Revolution Marianne has been a well-known French national symbol for common people and democracy, but Virgilio Breva is from Italy and Cordélia (recalling King Lear) Owl (as in wise?) has a grandmother from Bristol, England. We learn of personal habits regarding tobacco, peyote, sex, and singing. Medicine is part of a larger world of people of many sorts.              

Even minor characters, such as Simon’s girlfriend Juliette and other medical personnel are touching and memorable.
             

These characters animate the story with their passion, mystery, even heroism. While we don’t know the final outcome of the implanted heart, the text shows the professionalism of the medical team, the French national system that evidently works, sensitive care of patients and families, and in the last pages, rituals of affirmation for medical art and for patients.
             

There is richness in de Kerangal’s style. At times it is direct, reflecting the thoughts of characters. At times it is ornate, even baroque. She uses many images and metaphors, often with large, epic qualities. A very long sentence about the over-wrought parents describes them as “alone in the world, and exhaustion breaks over them like a tidal wave” (p. 141).  The style uses many similes, often with dramatic and unexpected comparisons. There are references to geology, astronomy, even American TV hospital drama. The style is at times lyric…we might say “operatic.”  One page about Cordélia is very, very funny.
        
  
In a different tone, the details of medicine, law, and ethics are carefully presented, and visual imagery puts us in the hospital rooms, the OR, and crowded streets around a soccer game. Throughout it appears that translator Sam Taylor has done an admirable job. 
             

The text invites us to consider large visions of wholeness. All the major characters seek some comprehensive unity to their lives, and they avoid orthodoxies such as religion, patriotism, and economic gain. Sean has his Polynesian heritage and boat-building passion, which he has shared with Simon. Cordélia, at 25, is an excellent nurse, wise beyond her years in some ways, but is as dazzled by a man as any teenaged girl. Nurse Rémige has his master’s in philosophy, loves the song of rare birds, and is, himself, a serious singer.  

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Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Kozol tells a multilayered story about himself and his father, a distinguished physician who becomes increasingly demented by Alzheimer’s disease, starting at age 88. A neurologist, Dr. Harry Kozol is able to diagnose with great specificity his own disease.     
          
Son Kozol describes his father’s initial symptoms and the slow decline, a direction that is sadly and fatefully, clear. The son goes on walks with him, describes their conversations, arranges for paid companions, and puzzles about what must be “a life beneath the life” of his progressively inarticulate father.
           

Over the 14 years of this illness, there are some medical mishaps—including problems in continuity of care—depletion of the family’s money, and Jonathan’s hesitation to use a DNR (Do Not Resuscitate) order for his father or for his aging mother. He writes of his doubts, uncertainties, and mixed emotions. When his father is actively dying, Kozol dawdles elsewhere with lists and papers “obsessively.” He understands this, in retrospect, as denial. Nevertheless he arrives at the hospital and places his ear on his father’s chest, hearing breaths come slower and slower until death. Dr. Kozol dies in 2008 at the age of 102.
           

Alternating with this story are long passages about Dr. Kozol’s professional life, including his work with Eugene O’Neill and family, also Patty Hearst and Albert DeSalvo (“The Boston Strangler”). For the latter two, he is an expert witness in court cases. These passages illustrate his many skills, tenacity, and ideals.

A 25-page Epilogue written a half a dozen years later casts a different light on the father-son relationship. While the bulk of the book shows a loving, respectful relationship, the Epilogue describes tensions and disagreements between the two from Jonathan’s childhood to later years. The father criticizes what he perceives as failures, lack of ambition, poor choices, and the like. Kozol describes his own illustrious career, often in directions his father disapproves. In later years, however, Kozol accepts some of his father’s advice and understands their status more as equals. In another seven years, however, Dr. Kozol’s mind starts its difficult path, and the son becomes the caregiver to the father.  

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