Showing 31 - 40 of 218 annotations tagged with the keyword "Public Health"

Syndrome E

Thilliez, Franck

Last Updated: Aug-26-2013
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

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.

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Fever

Keane, Mary

Last Updated: Aug-22-2013
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

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.

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Black Bag Moon

Butler, Susan

Last Updated: Apr-19-2013
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

Black Bag Moon is a collection (one is tempted to say a "mixed black bag") of short stories (but not clearly "short fictions" - clarified below) about medical patients. The reputed authors are identified as these patients' physicians, who recount these stories in first person. By my math, there are nine authors who narrate stories about 37 patients in 29 chapters. Most chapters have two patients in unrelated stories that sometimes share a theme. Several of the authors know each other as colleagues and two are a married medical couple. Most of the stories occur in Australia or New Zealand but some are in places are as far flung as England, Scotland and unidentified, possibly fictional, islands in the South Pacific. The practitioners are, for the most part, family physicians and care for people of all ages, providing care for everything from breast masses to congestive heart failure to trauma to occupational health to - almost overwhelmingly - mental illness threatening severe violence. The last - serious mental illness -  is, as are all the patients and their illnesses in this volume, almost exotically different from anything most readers of this database are likely to encounter as health care providers or readers. Think Crocodile Dundee or perhaps television's Dr. Quinn or ‘Doc' Adams of Gunsmoke. Or all the above but in the late 20th Century Outback.

Since most of the stories involve working men and women - mainly men - there is a decided flavor of  A. J. (Archibald Joseph) Cronin's The Citadel to the stories; but the peculiar aspect of Australia's frontier pervades each encounter with the patients in this book, whether they are being treated over the radio for breast lumps, being airlifted to the hospital for a badly broken elbow, or becoming demented from environmental toxins in a land and time wherein OSHA and DEP (and the principles underlying them) might as well be acronyms from Mars.

Curiously, for fiction, there are intermittent footnotes to literary (Honore de Balzac, Soubiran) sources, historical figures (Hippocrates) and relevant texts on subjects covered in the stories, e.g., petrol-sniffing, tropical diseases, and physical diagnosis. 

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Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

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). 

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Summary:

This book describes San Francisco’s Laguna Honda Hospital, where Victoria Sweet worked as a doctor for 20 years. In the tradition of the Hôtel-Dieu in Paris (literally “God’s Hotel”), Laguna Honda cares for the sickest and poorest patients, many staying there indefinitely because there is no alternative for them. Sweet learns from her long experience at Laguna Honda that “Slow Medicine” has benefits, that a holistic or unified view of patients works best, and that the reductionism and specialization of modern medicine has limitations and costs. During these years Sweet becomes fascinated by the medieval abbess Hildegard of Bingen and earns a Ph.D. focusing on medieval medicine. At the same time (and increasingly) various forces—economic, legal, political, bureaucratic—cause many changes at Laguna Honda, mostly contrary to Sweet’s vision of medicine.

            Part history, part memoir, part social criticism, the book is informative, entertaining, and important for its discussion of the care of our least-well-off citizens and for its perspectives on modern, Western medicine.         

            There are three intertwining strands to this engaging book: Sweet’s medical evolution as a physician, the changes in Laguna Honda, and her investigations of Hildegard of Bingen and other spiritual matters.

            Sweet joins up with Laguna Honda initially for only two months, but she finds the hospital and her work there so fascinating that she stays for 20 years. As an almshouse, Laguna Honda takes care of indigent patients, most with complicated medical conditions, including mental illness and dependencies on alcohol and/or drugs. Many of these cases come from the County Hospital with continuing (but not carefully reviewed) drug treatments. Every 15 or 20 pages, Sweet describes the dilemmas of a particular patient, and her medical (and personal) attention to that patient. The cases are vivid and instructive.

   Clearly Laguna Honda is a major figure on the book; we can even consider it (or “her”) a beloved character and a teacher to the young Dr. Sweet, who learns three principles from her work there: hospitality, community, and charity. 

Because Laguna Honda is old-fashioned in many ways, Sweet reads her own X-rays, goes the to lab to see results, and spends large amounts of time with each patient. Laguna Honda has an aviary, a farm with barnyard, and a solarium; such features help to heal the whole person. While respectful of modern medicine, Sweet slowly learns that a careful review of a patient through Slow Medicine is more accurate and more cost-efficient than standard, reductionist, high-tech medicine. She comes to respect approaches from “premodern” medicine, including that of Hippocrates and Hildegard.

  The second strand is the evolution of Laguna Honda itself. Sweet describes a variety of pressures: the recommendations of consulting firms, rulings from the Department of Justice, a lawsuit, financial difficulties (including fiscal mismanagement), administrators focused on a narrow concept of efficiency, a utilization review board, forms and more forms, and a pervasive sense that modern (including Evidence Based Medicine) is always good. All these and more create a “relentless pressure squeezing the hospital’s Old Medicine into the New Health Care” (p. 322). Sweet demonstrates that her Slow Medicine can actually save money in the long run. Confident that her way is better, she proposes an “ecomedicine unit” that she would match against the modern, “efficient” units in a two-year experiment. (For more information on her concept of ecomedicine proposal, see http://www.victoriasweet.com/.)

            As the hospital is “modernized,” many important features of the old place are gone and many “new and improved” aspects don’t work. Somehow there are no rooms for physicians in the new building while there is plenty of space for administrators and managers. A sophisticated computer system doesn’t work. Sweet doesn’t say “I told you so” directly, but we get the picture.

            The third strand is Sweet’s investigations of spirituality and pilgrimage. She is fascinated by Hildegard’s notions of the healing power of nature, the ability of the body to heal itself, and wholeness as an aim for a person and for a community. Sweet attends a Swiss conference on Hildegard. She hikes the pilgrimage route from France to Santiago de Compostela in four installments and considers notions of pilgrimage. She feels called to pursue her ecomedicine project and to write this book.           

            By the end of the book, both Sweet and Laguna Honda have changed and are now headed in different directions. 

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The Dark Light

Newth, Mette

Last Updated: Aug-30-2012
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Tora lived happily on a mountain farm in Norway until her beloved mother's death  and her own subsequent diagnosis with leprosy, an illness common in early 19th-century Norway and one that drove her mother to suicide.  Upon diagnosis (at the age of 13) she is taken to the leprosarium in Bergen, from which very few emerge.  Most are left there by families whose fear of the disease leads them to abandon even much-loved children, parents, and spouses.  There, despite the misery of living among many who consider themselves the living dead, she finds a friend in Marthe, the chief cook and general caregiver, a woman of almost boundless kindness; and the "Benefactor," a pastor who is remarkably unafraid of the disease from which most flee, and who befriends Tora as she grows into an unpromising early adulthood.  Another unlikely friend is a noblewoman who has languished, embittered, behind a closed door with a trunk full of her old gowns and several cherished books, including the Bible, The Divine ComedyGulliver's Travels, and a popular Norwegian epic about the adventures of Niels Klim at the center of the earth.  She gradually softens toward Tora, who cares for her tenderly as the older woman teaches her to read.  Reading becomes not only Tora's consolation, but that of many of her fellow inmates.  Near the end of her own short, but surprisingly rich life, Tora's father shows up after years of neglect.  Forgiving him, almost against her will, she reaches a new level of acceptance of her own mysterious fate.  The book includes a short afterword about the actual leprosarium in which the story is situated and about Gerhard Armauer Hansen who in 1873 discovered the bacillus responsible for leprosy, the first bacterium proved to be the cause of a chronic human disease.

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For the Love of Babies

Last Updated: Aug-30-2012
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Collection (Case Studies)

Summary:

In this collection of "clinical tales," to use Oliver Sacks' term, Sue Hall, an experienced neonatologist who spent some years as a social worker before medical school, tells a remarkable range of stories about newborns in the NICU and their parents.  As memoir, the stories record moments in a life full of other people's traumas, disappointments, anxieties, and hard-won triumphs where her job has been to hold steady, find a balance point between professionalism and empathy as young parents go through one of the hardest kinds of loss.  Each story is told with clarity and grace, sketching the characters deftly and offering useful medical information along the way on the assumption that many who read the book will do so because they are facing similar challenges and decisions.  Each story is followed by a two- to three-page "Note" giving more precise medical background and offering further resources for those who have particular interest in the kind of case it was. 

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The Ghost Map

Johnson, Steven

Last Updated: Aug-23-2012
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Parts of medical history read like detective novels.  The discovery of the source of cholera by Dr. John Snow in London in 1854 is one of those episodes.  The Ghost Map tells the story of Snow's pioneering work in what have now become standard epidemiological methods.  Tracing a cholera outbreak to a local pump in a poor section of London involved many door-to-door visits working with people who weren't always cooperative, incurring the suspicion and/or ridicule of both them and the medical professionals with whom he worked.  In the course of the story the author offers reflections on the organization of cities and on public hygiene.  Snow, an out-of-the-box thinker, also helped develop surgical anesthesia. 

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Puncture

Evans, Chris; Kassen, Adam; Kassen, Mark

Last Updated: Aug-15-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Drug-addicted but high functioning lawyer Mike Weiss (Chris Evans) and his partner Paul Danziger (Mark Kassen) run a small personal injury firm in Houston.
They agree to represent an emerency room nurse who has sustained a needle-stick injury and become infected with HIV. Through this work, they discover that a new safety syringe could avoid such injuries in the future, but the innovators are unable to bring it to market because of legal opposition from giant corporations.
The young lawyers become more and more engaged with the case, but  they meet sinister opposition and the outcome is gloomy.

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Nemesis

Roth, Philip

Last Updated: Aug-15-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

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.

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