Showing 31 - 40 of 366 annotations tagged with the keyword "Catastrophe"
Five Days at Memorial is the book length expansion of the New York Times Sunday Magazine article that the author, a Pulitzer Prize-winning physician-journalist, published in 2009. The book, the result of years of research and literally hundreds of interviews, chronicles the five days (August 28 to September 1, 2005) during which the medical staff remaining at Memorial Hospital in New Orleans tried to care for the patients -- over a hundred of them stranded, like the staff, in a hospital without water or electricity --following the flooding wrought by Hurricane Katrina.
After an 8 page prologue, the book is divided into two sections, "Deadly Choices" (228pp, the narrative of those five days) and "Reckoning" (256pp, the legal battles over the injections of midazolam (a sedative) and morphine by some of those staff and prosecuted as homicide -- what others called "euthanasia.") "Deadly Choices" relates almost hourly the five days inside Memorial from the viewpoint of patients, patients' relatives, physicians, nurses, administrators of Memorial, Tenet (the holding company owning and running Memorial) and LifeCare -- the long-term care area within Memorial devoted to the care of terminally ill and debilitated patients -- owned by a separate company. Ethical and legal questions of triage, DNR, record-keeping, accountability, communication (primarily the failure thereof) and leadership are on almost every page. At the heart of this book, however, is the mystery of the unexplained deaths of so many patients during those five days. (On September 11, 2005, a disaster mortuary team recovered 45 bodies from many different places in Memorial, page 234). The crux of the mystery of these deaths is the manner in which nine in particular died in the beleaguered hospital on the fifth and last day when, paradoxically, relief had become real and effective and inclusive, seemingly obviating such injections.
The final pages of "Reckoning" deal with the fallout - historical, ethical, political and medical -- and current events relevant to these five days and the almost two years following. (The final verdict of not guilty -- the actual wording was "Not a true bill" since it was a grand jury declining to indict the one physician, Anna Pou, and the two nurses, Cheri Landry and Lori Budo -- was rendered on July 24, 2007). There are a map of Memorial Hospital and a cast of characters at the front of the book and extensive notes, bibliography and index at the end.
Kitty Fane is a beautiful young woman whose mother has raised her to make a suitable match. But Kitty refuses a number of suitors; several years pass and eventually she is reduced to marrying Walter, the colonial bacteriologist in Hong Kong. Walter is a shy and awkward man who loves Kitty passionately, but has no idea how to express it; Kitty is charming and socially adept, but vacuous. In Hong Kong Kitty engages in a yearlong affair with Charles Townsend, the assistant colonial secretary, and a married man whose celebrity potential far eclipses Walter's stolid scientific work. The novel opens when Walter discovers his wife's infidelity.
Kitty believes that Townsend is madly in love with her and prepared to divorce his wife and sacrifice his career to marry her. Walter, who suffers from a broken heart, gives Kitty an ultimatum--either Townsend must promise to divorce his wife and marry her, or Kitty must accompany Walter to a city in the interior where he has volunteered to go to fight the cholera epidemic. Townsend demurs; Kitty is crushed; and the desperately unhappy pair travels to the cholera-ridden city, where they move into the house of the newly-dead missionary.
There, Walter (who is also a medical doctor) sets to work, day and night, to institute public health measures and care for dying patients. Meanwhile, Kitty meets Waddington, the British consul, a cynical alcoholic, who is at heart a good and honest person; and the French nuns, who labor tirelessly to care for orphans and the ill. Impressed by the nuns' selflessness, Kitty begins to devote herself to assisting them and trying to understand their spirituality.
When he learns that Kitty is pregnant, Walter asks if it is his child; Kitty responds, "I don't know." This completes the destruction of Walter's heart, and he soon dies of cholera--presumably as a result of experimenting on himself to find a cure. Kitty learns that the nuns, the soldiers, and all the people of the city consider Walter a saint, who has sacrificed himself for their welfare. However, while Kitty has learned to respect her husband, she could never love him.
Kitty stays only briefly in Hong Kong before returning home to London. Shortly before her arrival, she learns that her mother, whom she believes is responsible for her (Kitty's) shallowness, has died. The novel ends with Kitty vowing to bring up her daughter as a strong and independent woman, and preparing to move with her father to the Bahamas, where he has recently been appointed Chief Justice.
Matt leaves a swim meet, happy with his performance, to drive home on a snowy road with his mother and sister. On the way their car is hit by a drunk driver who swerves out of his lane. His mother is killed instantly, his sister badly injured. When he has received treatment in the hospital for an injured shoulder, his best friend’s family comes to pick him up. He isn’t allowed to see his sister for days, and when he finally does, she looks lifeless and unfamiliar, tubed up in the ICU. At home with his friend Jamie, he remembers a time when he and his sister rescued a robin, only to see it die. The story traces the days and weeks following Matt’s loss—his mother’s funeral, his friend’s family’s decision to adopt him, and eventually his sister’s death. Despite his struggle with grief, anger, and bewilderment, Matt also has times of hope and pleasure in his new relationship to a family he already loved. Readjusting to school is one of the many challenges he faces. When he does return to school, he finds himself and his perspective changed, and realizes loss has grown him up in unexpected ways.
A movie buff in northern France goes blind after watching a short anonymous horror film. He calls on Lucie his ex-girlfriend and a cop in Lille, to take the film to an expert film analyst. The expert demonstrates that the film, made in Canada in 1955, contains subliminal images and a whole other hidden movie of little girls torturing rabbits. He is soon found brutally murdered and the film stolen.
Four bodies missing part of their skulls, their eyes, and hands are found buried by a crew laying a pipeline and the profiler Sharko is brought in to explore the crime. They make a connection to a triple murder of girls in Egypt in 1994—the three girls who did not know each other were found in different places with their brains and eyes missing.
Sharko and Lucie begin to unravel the mystery by tracking the people in the film and those who made it. Sharko goes to Egypt; she goes to Canada –both nearly lose their lives as a result. Their research brings them closer to linking the seemingly disparate murders to occult military operations, involving the French Foreign Legion and the CIA.
They solve the crime, but the ending is disturbing.
In 1907, Mary Mallon, an Irish-born cook, is identified as the source of typhoid fever outbreaks in several of the households where she has been employed. Deemed a healthy carrier, she nevertheless cannot comprehend her role in the tragedies and rejects her responsibility. How could she harbor the germ that causes the disease and not be ill herself?
Led by Dr. George Soper, the authorities ensure that she is incarcerated on North Brother Island in the Hudson River – until a lawyer takes an interest in her case. An important part of her defence comes from the growing knowledge that many other people are also healthy carriers of the germ and they have not been incarcerated. Finally in 1910, she regains her freedom on condition that she never cook for others again.
But Mary loves cooking, and it is a far more lucrative occupation than her work as a laundress. In addition, she needs to support her common-law partner, Alfred, who has a serious drinking problem and is chronically unable to find work. Alfred had left her for another woman during her incarceration and succeeds in giving up alcohol. But he still loves Mary and abandons the other woman; he vanishes out west and is injured in a horrible fire that leaves him deformed and in chronic pain. Mary finds him and tries to help him, but Alfred now slowly slips into drug addiction.
The temptation to start cooking again is too great. The inevitable happens and Mary is caught. This time, however, she does not protest and ends her days as a captive of New York City.
This collection of 16 short stories focuses on doctors and patients in San Francisco, where a wide variety of wealth and culture impact the delivery of medical care. Further, there are many restrictions—financial, bureaucratic, ethical, and legal —that limit what doctors can do, especially in cases of patients near death.
The author, Louise Aronson, is a geriatrician who knows this terrain very well, having trained in San Francisco and worked as a physician there. A skilled writer and close observer, she has created dramatic and often funny stories that reveal social and bioethical complexity. About half the stories describe end-of-life issues for the aged and the dilemmas for their physicians and families.
In ‘The Promise,” Dr. Westphall orders comfort care only for an elderly patient who has suffered a massive stroke, but a hospital gives full treatment because there was no advance directive and the daughter told the attending to do “what he thought best.”
When Dr. Westphall sees this barely functioning patient in a skilled nursing facility seven months later, he tenderly washes her face and hair—although the text teases us that he might have been prepared to kill her.
In “Giving Good Death,” a doctor is in jail charged with murder; he has fulfilled the request of Consuela, a Parkinson’s patient, to help her die. When it appears that she may have died for other reasons, he is released, his life “ruined.” He leaves San Francisco, and, we surmise, medicine. In three other stories, doctors also leave the profession: the cumulative stresses of work and family and/or a sense that it’s not the right path bring them to that choice.
On the other hand, one of the longer pieces “Becoming a Doctor” celebrates the profession, despite all the rigors of training including sexism against women.
The stories bring multicultural insights; we read of people from China, Cambodia, Latin America, India, Russia, and the Philippines. Some are African-American; some Jewish, some gay. These different backgrounds color notions of health, death, and medical care. There are also pervasive issues of poverty and, at another extreme, professionalism that is hyper-rational and heartless.
Indeed, a recurring theme is care and love for people, no matter their background or current health status. A surgeon realizes (regrettably too late) that the secret of medical care is “caring for the patient—for anyone—just a little. Enough, but not too much” (p. 135).
Elie Wiesel, 82-years-old, has pain that he thinks is in his stomach or esophagus, perhaps caused by his chronic acid reflux. After tests, however, doctors diagnose cardiac illness and insist on immediate surgery. Reluctant to go to the hospital, Wiesel dawdles in his office. When he does go, doctors believe a stent will do the job. Instead, the intervention becomes a quintuple bypass.
This brief memoir—a scant 8,000 words—presents the “open heart” of a gifted writer as he contemplates his open-heart surgery, his past life, and the future. He asks himself basic, even primal questions about life, death, and the nature of God.
Although a man with an extraordinary career—prizes, fame, honorary doctorates, friends in high places, professorships—Wiesel experiences and describes ordinary feelings of anxiety, pain, and doubts about his cardiac emergency and possible death. His stylistic gifts describe frankly and vividly a patient’s fears. As many have observed, patients with a serious disease have two difficulties, the disease itself and their emotional responses to that disease. As Wiesel is wheeled into the OR, he looks back on his wife and son; he wonders whether he will ever see them again.
He writes that his “thoughts jump wildly; I am disoriented.” He recalls a friend undergoing similar surgery; she died on the table. He says he can’t follow the jargon of physicians. The texture of the prose is rhapsodic, jumping from the present to memories, many of them about war, his past surgeries, or important family events. This short book has 26 “chapters,” some just half a page; they are like journal entries.
As he slowly recovers, he feels pain and has visions of hell, including the concept of ultimate judgment. “Evidently, I have prayed poorly…; otherwise why would the Lord, by definition just and merciful, punish me in this way?” (p. 38). Because he has a “condemned body,” he feels he must search his soul. In the longest chapter of the book, he reviews several of his writings.
Wiesel asks some of the questions from his famous novel Night (La nuit, 1958). If there is a God, why is there evil? Auschwitz, he says, is both a human tragedy and “a theological scandal” (p. 67). Nonetheless, he affirms, “Since God is, He is to be found in the questions as well as in the answers” (p. 69).At the end, he still has some pain but feels much gratitude for his continuing active life and for his grandchildren.
This thought-provoking poem is best read with a representation of the painting to which it refers in view (the painting, Landscape with the Fall of Icarus by Pieter Bruegel, is reproduced in On Doctoring). Auden considers the nature of human suffering: "how it takes place / While someone else is eating or opening a window or just walking / dully along . . . . " For each individual life affected by personal catastrophe (in the painting, Icarus falling from the sky into the ocean), there is the rest of humankind which must go about its daily business, either oblivious or unable to assist (in the painting, Icarus might almost be overlooked, flailing in the lower corner of the picture while the ploughman in the foreground has his back turned). Life, and death go on although the sufferer, and sometimes those who are paying attention, find this inconceivable. And what about the ship "that must have seen / Something amazing" but "had somewhere to get to"? What is the context in which suffering is noticed, what obligations exist, what can and cannot be remedied?
Bucky Cantor is a young, athletic, Jewish javelin thrower who is acting as a coach for young boys in the sweltering New Jersey summer of 1944. He is ineligible for war service because of his weak eyes.
His coaching efforts are much appreciated by the children and their parents because a polio outbreak is on the rise, and sports help take their minds off their fears of death and permanent illness. One by one, boys fall ill and disappear. Some die. But the games continue in Bucky’s own private campaign against the epidemic.
No one really knows how polio is contracted and spread.
Bucky falls in love with Marcia Steinberg who urges him to leave the city to avoid exposure to the germs. She works at a summer camp in the Poconos far from the city and uses her influence to have him invited to fill a sudden vacancy when the sports instructor is called up to military service. After agonizing over his decision, Bucky accepts the position—admitting that he is running away from fear as much as he is going to Marcia. He is amazed that no one seems to blame him.
The camp life is idyllic, and he is reconciled to his choice. But soon one of the boys at camp shows signs of the dreaded illness, and Bucky believes that he must have brought it with him. Then, Bucky himself falls ill and develops a permanent disability that ends his athletic career.
Marcia rushes to his bedside more than willing to continue as his lover and wife, but he sends her away believing that she should not be saddled with a disabled lover. He thinks he did the right thing.