Showing 31 - 40 of 650 annotations tagged with the keyword "Loneliness"

Complications

Coulehan, Jack

Last Updated: Oct-06-2015
Annotated by:
Aull, Felice
Chen, Irene

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

This poem describes the deterioration of a man after the death of his spouse, as he ends up drunk, penniless, and in jail. The physician is asked to certify the cause of his death. He decides that the complex social factors leading to his death can only be summarized as "complications".

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

The subtitle of this collection is "A Voyage to the New World." In the first section, Campo begins his voyage to a new world of self-understanding by experimenting with the language of family, intimacy, healing, and magic. In "I Don’t Know What I Can’t Say, or, Genet on Keats," the poet writes: "There are two sides to life. The side where life / Remains unconsummated, reticent" and the other, which is "the act itself laid bare--a hand / Inside the lion’s mouth . . . . " Campo chooses the latter.In the next section, his voyage takes him through several connected series of 16-line sonnets; each of these series plumbs the depths of a different intimate relationship: Song for My Grandfather, for My Father, for My Lover, and for Our Son. Some of Campo’s finest poems are in this section, including (just a handful from the many) "Grandfather’s Will," "Anatomy Lesson," "Planning a Family," "My Father’s View of Poetry," "Translation," and "Political Poem."In the final section, Campo brings the insight of a seasoned voyager to his day-to-day life experience as a gay Latino physician: "To teach me my own life, to share my grief." ("Planning a Family," p. 49)

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The Burying Ground

Kellough, Janet

Last Updated: Sep-21-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Luke Lewis is the son of an itinerant preacher in Upper Canada and a recent medical graduate of Montreal’s McGill University. In 1851, he joins the practice of the aging, Edinburgh-trained Dr. Stewart Christie in Thornhill, Ontario. It is a small village a few miles north of Toronto (now the site of some of the most expensive property in Canada).  Christie is tired and leaves Luke alone to work.   

Luke hopes to consolidate his learning and earn enough to set up on his own elsewhere in Ontario, closer to his farming brothers. He rents a couple of rooms from the doctor and is able to accommodate his father Thaddeus Lewis on his occasional visits.   

Morgan Spicer, the custodian of the local Strangers’ Burying Ground, is an old friend of the family. He finds a grave disturbed, which raises the specter of grave-robbing, an all too common crime much abetted by medical schools. But in this case, the corpse is left behind and the grave was not fresh. Morgan is baffled but the police are indifferent. When it happens a second time, Luke and his father try to help solve the mystery. They wonder if Dr. Christie might be behind it. What does he do all day?   

Luke is lonely and he sorely misses his friend and lover, Ben, who died of tuberculosis back in Montreal. Luke has managed to keep his sexual orientation firmly in the closet, knowing it would be the end of his career and of his relationship with his beloved father.   

However, Luke’s gallant actions in rescuing the beautiful African, Cherub, from American slave-traders, result in an unwanted invitation from a somewhat too grateful society lady, Lavinia. Through her, he meets the clever Perry Biddulph and is plunged into a torment of attraction and despair, compounded by the fact that Lavinia’s husband is a scoundrel whom the Lewis’s have met before in the previous novel.   

Luke firmly resolves to avoid both Lavinia and Perry, but she uses his sexual secret to blackmail him into finding the means to leave her husband. Most problems are nicely resolved in the end. To say more would spoil it.  

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Atul Gawande’s Being Mortal is both ambitious and synthetic, qualities that well suit his difficult subject, death.  In Western culture, there are taboos against death because it fits neither into post-Enlightenment notions of progress and perfection nor into medical notions of control, even domination of human biology. A surgeon and an investigator, Gawande draws on his patients, his family, and travels to various hospitals and other caregiving places in order to confront death and see how approaches such as hospice and palliative care can improve our understanding, acceptance, and preparation for death.

Gawande has harsh words for contemporary medicine, the supposed caregiver for the dying and their families.  Relying heavily on technique and industrial models, it ignores the deep needs of the dying and provides, instead, versions of “warehoused oblivion” (p. 188), for example long, futile stays in ICUs.

As opposed to traditional societies like India, Westerners prize the independence of individuals, a status that is, of course, never permanent. In the chapter “Things Fall Apart,” Gawande describes how longer lives are now the norm but they include chronic illnesses and inevitable decline in vitality.  Our deaths are now routinely in hospitals, not at home, and often extended—sometimes brutally—by technical support and unwillingness of doctors and families to stop aggressive treatment.       
       
Also, sadly, there are fewer and fewer geriatricians at a time when there are more and more elderly.  A good geriatrician takes a long time with each patient, is not well paid, nor does s/he do income-generating procedures. Worse yet, some training programs are being discontinued.  

Gawande illustrates his ideas with case studies of patients and describes, from time to time in the book, the elderly journeys of his grandmother-in-law and his own father.  These passages make vivid the abstract ideas of the book. But it’s not just elderly patients who face death: health calamities can come to anyone, for example, a 34-year-old pregnant woman found to have a serious cancer. Various treatments are tried without success, but family and doctors act out “a modern tragedy replayed millions of times over” (p. 183) of a medically protracted death. Finally her mother calls a halt to treatment.
               
Family members often bear a heavy load in caring for a sick elder, but many nursing homes are often worse, designed for control, not support of the patients. 

The chapter “A Better Life” describes the first in a series of places that offer much improved settings for the elderly, with birds, animals, gardens, and, in general, richer lives that have a sense of purpose.  Gawande describes hospice care, palliative care, and advanced directives (including Do Not Resuscitate orders) as improvements needed to break the norms of “treat at all costs.” The old roles of Dr. Knows-Best and Dr. Informative need to give way to physicians and others who talk with patients and families about their values, their wishes for the last days, and their preparations for death. In short, aggressive treatment should no longer be the “default setting” for hospital care.     
        
The book ends with a dozen moving pages about the death of Gawande’s father. The “hard conversations” have clarified his wishes, and hospice care has provided “good enough” days.  Pain control has done well. Then, finally, “No more breaths came.” The family travels to India to spread his ashes on the Ganges. 

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Lament

Millay, Edna St. Vincent

Last Updated: Jun-11-2015
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Lament is a twenty-two line dirge in free verse with one rhyme, at the end of the poem, which is almost certainly intentional. The poem represents a mother’s terse lament over the death of the father of the two children whom she is addressing. More of a soliloquy than a dialogue, one receives the distinct impression that the children may not even be present as the mother announces matter-of-factly that their father is dead, that they must soldier on, and describes the manner in which she will distribute the coins and keys in his pocket to them. The final couplet succinctly sums up the poem’s sentiment:


Life must go on,
And the dead be forgotten;
Life must go on,
Though good men die;
Anne, eat your breakfast;
Dan, take your medicine;
Life must go on;
I forget just why.

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Carol Levine began a roiling odyssey as a caregiver when a car accident left her husband paralyzed and in need of 24-hour care. She regards her husband’s survival as “a testament to one of American medicine's major successes — saving the lives of trauma patients.” But once he returned to their home, Levine encountered a healthcare system that was fragmented, chaotic, and inequitable. Unprepared to address chronic care, it remained oblivious to her needs as her husband’s primary medical “provider,” as they would say. Written nine years after the accident and eight years into her care giving, Levine’s essay recounts the stress and isolation she experienced attempting to navigate that system, to perform unrelenting chores, and to sustain her employment. Her job was, after all, the source of her husband’s managed care insurance, which regularly managed to leave Levine with unpaid bills. Even her work in medical ethics and healthcare policy could not help her locate the assistance she needed to assure the well being of her husband or herself.  Or of other care-giving families.

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Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians.   Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few. 

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334).
  The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185)  The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor. 
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field.  Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul".
 Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151) 

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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Annotated by:
Donley, Carol

Primary Category: Literature / Fiction — Secondary Category: Visual Arts / Painting/Drawing

Genre: Graphic Memoir

Summary:

A nurse-poet well-known for her empathic descriptions of patients, Cortney Davis suddenly found herself in the hospital bed with a life-threatening condition.  Although she is a masterful writer, she could not find words to capture what she experienced as a patient.  Instead, she started painting her emotions—fear, suffering, and loneliness expressed through color, line, and tone.  The first of 12 paintings in this pathography shows her lying naked on a white slab, not literally what happened but expressive of how vulnerable and helpless she felt.  Each of the 12 paintings carries an emotional and spiritual truth—often raw and miserable.  Davis accompanies each painting with a brief commentary about how and when the painting was done, explaining, for instance, why some of the figures have no facial features. But the vivid paintings speak for themselves, and they add a different way of knowing not available through words.

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Summary:

The elegant widow Hélène (Edith Scob) lives alone with her faithful housekeeper in the cherished family home – a rambling country property outside of Paris. For her seventieth birthday, all her children and grandchildren come for a brief visit. Emphasizing their perpetual absence, they give her a portable telephone the mechanics of which baffle her. “You must set it up for me, before you go.”Hélène takes aside her eldest, Frédéric (Charles Berling) to explain her wishes for the estate, pointing out the most valuable art objects and emphasizing that the family should not feel tied to the old and costly house. Frédéric doesn’t want to listen; she is too young, he claims. He loves the house and assures her that the family will keep it. Moments later, the families pile into cars and race off. With the new phone still unconnected, Hélène is alone again, smoking in the evening gloom. Six months later, they gather once more for Hélène’s funeral. Single and living in the United States, Adrienne (Juliette Binoche) is sulky and rootless. Jérémie (Jérémie Renier) is entrepreneurial and is planning to live in Asia. Neither want to keep the house, and both could use the money from its sale. Frédéric is shattered by their indifference to the family and its traditions, but he cannot afford to buy them out. His wife sympathizes and waits. He loses the negotiatons. Yet, being the eldest and the only sib in France, he is forced to preside over the sale and dismantling of the property he loves. 

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Summary:

Originally intended as a frontispiece, El sueño de la razon produce monstruos is number 43 in the series Los Caprichos (1799) by Francisco José de Goya y Lucientes. Also one of his roughly 40 self-portraits, this ambiguous picture shows a seated male figure with his ankles crossed leaning over to his right as he rests his elbows and head on a desk. The male figure wears an ankle-length coat, breeches, stockings, and shoes. His hair is long, his face invisible. On top of the desk, under his right elbow, we see a paintbrush or writing instrument. The side of the desk, in the lower left corner, bears the title of the work. On the floor to the man's right crouches a lynx. Owls with huge wings and expressive eyes surround him. The owl on his right holds out a paintbrush. A cat with watchful eyes perches behind his back. Above the human figure large bats are flying; the largest one at the top right has a goat-like head.

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