Showing 31 - 40 of 48 annotations tagged with the keyword "Obesity"

Riding the Flume

Pfitsch, Patricia Curtis

Last Updated: Oct-22-2004
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Set in 1894 and based on a history of the logging projects among the California sequoias, this is a story of Francie, whose sister died in an accident six years earlier. She chafes under her parents' excessive protectiveness since Carrie's death. She loves the woods, and longs to do something to keep the loggers from cutting down the ancient sequoias, especially the oldest and largest, a tree over 2500 years old. Through a little sleuthing based on her sister's diary, she finds out that the property on which the ancient tree sits actually belongs to an old hermit, not to the logging company.

In an effort to get the company to stop before cutting the oldest tree, she rides the dangerous log flume into town to alert the one journalist she knows will support her cause. They arrive in time to save that tree and some of the others, and, perhaps as importantly to Francie, her mother and father begin to see her not only in terms of their loss of Carrie, but as a young woman independently interesting, daring, and very much alive.

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Annotated by:
Kennedy, Meegan

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

St. Luke’s Hospital was founded in 1750 to provide free care to the impoverished mentally ill. It mixed benevolence with "unconscious cruelty" in the treatments used by the "practitioners of old," from restraints and drugs to swings and a key to force-feed recalcitrant patients. Dickens describes this gloomy edifice as he saw it on December 26, 1851, although he notes a "seasonable garniture" of holly.

The inhabitants of St. Luke’s largely sit in solitude. Dickens decries the absence of "domestic articles to occupy . . . the mind" in one gallery holding several silent, melancholy women, and praises the comfortable furnishings--and the relative "earnestness and diligence" of the inmates--in another. He uses statistics to show the prevalence of female patients, "the general efficacy of the treatment" at St. Luke’s, and the unhealthy weight gain of the inhabitants due to inactivity. Dickens describes the behavior of various distinctive inhabitants during the usual fortnightly dance, the viewing of a Christmas tree, and the distribution of presents.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.

The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.

Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."

This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.

Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.

Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).

These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.

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Love and Modern Medicine

Klass, Perri

Last Updated: Apr-03-2002
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In this collection of 11 short stories, pediatrician-author Perri Klass primarily explores the world of women and their multiple and complex roles as mother, mother-to-be, friend, spouse, lover and professional. Parenthood--its glories, heartaches, tensions and mysteries--plays a prominent role in many of the stories. There is also a close look at woman-woman friendship--at what women say to their best friends and the nuances of the emotional responses to what is said or left unsaid.

Several stories feature single mothers: "For Women Everywhere" (a woman is helped through labor by her best friend), "Rainbow Mama" (a woman cares for her son during his diagnosis and initial treatment of leukemia), and "City Sidewalks" (a woman finds a baby on the sidewalk on Christmas Eve as she rushes to pick up her child from day care).

"In Necessary Risks," an anesthesiologist deals with work and her high energy preschool daughter while husband and easy-to-raise son head out to a dude ranch. In "The Trouble with Sophie," another high energy, dominant daughter wreaks havoc in kindergarten as well as with her concerned parents. In addition to the anesthesiologist, two other physician-mothers are featured in "Freedom Fighter" and "Love and Modern Medicine."

Parenting a newborn whilst handling other tasks is a theme featured in "Intimacy" (a high school biology teacher celebrates her first night of uninterrupted sleep as she both enjoys and envies her single friend's sex life) and in "Dedication" (a writer takes his stepson to a chess tournament while his biologist wife and newborn enjoy breastfeeding at home). Woman friendships are prominent in "For Women Everywhere," "Freedom Fighter," and "The Province of the Bearded Fathers." Grief and sudden infant death syndrome are themes of "Love and Modern Medicine."

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Washing Your Feet

Ciardi, John

Last Updated: Mar-05-2002
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

From the mundane to the profound, from the body as physical preoccupation to the body as sacred, the poet explores in 21 highly personalized lines the significance and symbolism of the human body. Washing your feet without giving it a thought means you are in good health; struggling to do it because of overweight is a reminder of mortality. This (any) physical act "should be ritual . . . memorial, meditative, immortal." It conjures up an image of the Degas ballet dancers washing their feet, and then, remarkably, that " . . . they also seemed to be washing God’s feet."

But the creative power of Degas is yet another reminder of the author’s limitations. He is vulnerable, mortal and not creative enough to gain immortality by producing a masterpiece: "It is sad to be naked and to lack talent."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Children's Literature

Summary:

Harry Potter and the Goblet of Fire is the fourth book in a planned series of seven (see annotation of Harry Potter and the Sorcerer's Stone for an introductory summary). Unlike previous books, this one opens with the murder of a Muggle, Frank Bryce, the elderly gardener for the Riddle estate--a home where Tom Riddle Sr. and his elderly parents had been found dead many years before. Voldemort, although still weak and requiring much assistance from his simpering servant Wormtail and his snake Nagini, is positioning himself for a return to full power.

Harry's distinctive scar is burning with pain as he awakes from a dream of the previous scene. This scar had hurt once before, in book one, when Voldemort was on Hogwarts property. Harry alerts his godfather via owl post and joins the Dursleys for breakfast. Breakfast is meager because Dudley, always obese and obnoxious, has now grown to outrageous proportions and is on the diet ordered by his school nurse. His mother, to make him feel better, puts everyone on the same diet. Harry is once again saved from the Dursleys by the Weasley family, although Dudley and his appetite are the objects of a prank by the Weasley twins.

Arthur Weasley (the father) who works for the Ministry of Magic in the Misuse of Muggle Artifacts Office has secured top notch tickets for all to attend the World Quidditch Cup. This fantastic event is marred by the appearance of signs of support for Voldemort by his followers, the Death Eaters, and Arthur hurries home with his charges in tow via Portkey transit.

Harry, now fourteen, enters Hogwarts for his fourth year. This year is different for all of the students due to the resurrection of the Triwizard Tournament, a dangerous international competition for a selected champion from each of three schools, Durmstrang, Beauxbatons, and Hogwarts. Although underage, Harry is selected by the Goblet as an extra competitor from Hogwarts. Everyone is concerned for the competitors' safety (the famous Viktor Krum, the enticing Fleur Delacour, and the decent Cedric Diggory). In particular, Harry's life is in danger from suspected foul play.

Adolescent love, the nastiness of poison-pen reporter Rita Skeeter, the ever-vigilant nature of Mad-Eye Moody (an Auror who caught Death Eaters in the past and who now teaches Defense Against the Dark Arts), spells that cause loss of control, excruciating pain or death, enslavement of house-elves, money, and variable degrees of professionalism by members of the Ministry of Magic, such as Cornelius Fudge, Bartemius Crouch, officious Percy Weasley, and Ludo Bagman are some of the themes and subplots in the novel. The traumatic end to the competition and follow-up lead Harry to witness and participate in some horrific events. Dumbledore, however, refuses to allow Harry to bottle-up the experience--Dumbledore understands that talk, openness, support, and rest are the first steps towards healing.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Children's Literature

Summary:

Harry Potter and the Sorcerer's Stone is the first in a planned series of seven books. Harry's wizard and witch parents, James and Lily, have just been killed by Voldemort, an evil wizard who was thwarted and severely weakened when he tried to kill one-year-old Harry. The murder attempt leaves Harry with a lightning-shaped scar on his forehead. Harry is whisked off to live with his Muggle (non-magical) suburban middle-class aunt and uncle (Petunia and Vernon Dursley) and their bullying overweight son, Dudley.

Fast-forward nearly ten years and chapter two begins when Harry is almost eleven and suffering a Dickensian childhood, forced to live in the cupboard under the stairs at 4 Privet Drive, the home of the Dursleys. Harry has not been told of his heritage, and is unaware of his own fame in the wizard world. He is punished when any hint of the out-of-ordinary appears, such as when he communicates with a snake at the zoo.

The narrative then follows our bespectacled young protagonist as Hagrid, the huge groundskeeper of Hogwarts School of Witchcraft and Wizardry, informs Harry that he is invited to attend the school, takes him shopping for the necessary school equipment such as cauldron and wand, and offers the first sign of affection that Harry can remember. Uncle Vernon rants and tries to prevent Harry from attending the school.

But when Vernon ridicules the name of Albus Dumbledore, the wise and beloved headmaster of Hogwarts, Hagrid hexes Dudley who sprouts a pig's tail, necessitating a visit to a private hospital. The train for Hogwarts leaves from London's King's Cross station, where Harry befriends the wizard Weasley family, who show him how to enter the magical Platform Nine and Three-Quarters.

Hogwarts has four houses, and the new first year students are placed into the appropriate house (Gryffindor, Ravenclaw, Hufflepuff, and the sinister Slytherin) by a Sorting hat. Harry's life takes a definite upturn as he finds he is a natural broomstick flyer and is chosen for the Gryffindor Quidditch team. This high flying game with three kinds of balls and seven players per team does lead to injuries. Madam Pomfrey is the school nurse and runs the hospital wing. She cures with special spells and the magic of rest.

The year at Hogwarts is filled with adventure, friendship, and danger. There are characters who seem to detest Harry, such as Potions teacher Severus Snape and a Slytherin first year, Draco Malfoy, mysterious characters such as Defense Against the Dark Arts Professor Quirrell, as well as a colorful assortment of ghosts and magical creatures. Harry and his Gryffindor friends Ron Weasley and Hermione Granger enter a quest: to prevent the sorcerer's stone from falling into the hands of Voldemort and his allies. The stone offers eternal life and hence would be key to Voldemort's plans to return to power.

During part of the adventure, Harry finds the Mirror of Erised, and mourns the loss of his parents anew as he sees them in the reflection. As the astute headmaster Dumbledore teaches Harry, however, love is more powerful than evil and death may not be the worst outcome: "After all, to the well-organized mind, death is but the next great adventure." (p. 297)

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Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When Ruth's unfaithful and unappreciative husband Bobbo calls her a she-devil, she decides to appropriate that identity with a vengeance and take a different spot in the power relations of the world. She wants revenge, power, money, and "to be loved and not love in return"(49). Specifically, Ruth wants to bring about the downfall of her husband's lover, Mary Fisher, a pretty, blonde romance novelist who lives in a tower by the sea and lacks for neither love nor money nor power.

Ruth commences her elaborate revenge by burning down her own home and dumping her surly children with Mary and Bobbo. She continues on a literally shape-shifting quest in which she changes identities; gains skill, power, and money; and explores and critiques key sites of power and powerlessness in contemporary society, including the church, the law, the geriatric institution, the family home, and (above all) the bedroom.

By the end of the novel, Ruth achieves all four of her goals in abundance. Her success, however, raises complex ethical questions, not only because she uses the same strategies of manipulation and cruelty of which she was a victim, but also because of the painful physical reconstruction of her body that is the tool of her victory.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Diary

Summary:

Gottlieb, nearing thirty years old, discovered her childhood diaries in a closet in her parents' home as she searched for some chemistry notes to aid in her quest to attend medical school. This book is "based on diaries" she wrote when she was diagnosed with and underwent treatment for anorexia nervosa. It is the writing of a precocious, strong-willed preteen who enjoys chess, being unique, writing, and getting straight A's in school, yet who is lonely and desperate to fit in and be popular.

Lori is eleven years old, lives in Beverly Hills, California with her fashion-conscious, loves-to-shop mother, her somewhat distant stockbroker father, her older brother David who now is into music and friends and not-Lori, and her best friend Chrissy, a pet parakeet. Lori's diary entries are filled with astute observations of adults (teachers, parents, relatives, medical personnel, even a television star she meets, Jaclyn Smith) and classmates.

She is wry and witty. An early entry gives an English essay she rewrote to get an "A". These "power paragraphs" are generously and hilariously sprinkled with "proper transitions" such as "to begin with", "moreover", and "on the other hand" that her teacher insists are necessary for readability. This essay provides telling insights about Lori's perceptions of her family, particularly (note transition word) her mother's superficiality.

Lori is surrounded by messages of the glories of thinness for women. Every female she encounters, from peer to adult, is on a diet, counts calories, avoids desserts and gossips about how other women and girls look. The culture is not only anti-obesity, but pro-superthinness. Hence it is logical that Lori, angry about being taken from school to go on a family trip to Washington, D.C., begins her rebellion and search for control by skipping meals and dieting.

She gets the attention she craves from her parents. Her schoolmates ask her for diet advice and admire her weight loss. Self-denial, obsession with calories (that she believes can even be gained by breathing), and secret exercising lead to an alarming weight loss in this already skinny kid.

Her mother takes her to the pediatrician, who prescribes whole milk which Lori refuses. He refers her to a psychiatrist, who eventually hospitalizes her for behavior modification, observation, and a possible feeding tube. At the hospital, Lori meets medical students, nurses and fellow patients, but becomes progressively more depressed, dehydrated and lonely. She attempts to run away and makes a suicide gesture. Finally, she sees herself for what she has become--an emaciated stick figure.

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Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Anthology (Poems)

Summary:

Editors Angela Belli, professor of English at St. John’s University in New York, and Jack Coulehan, physician-poet and director of the Institute for Medicine in Contemporary Society at the State University of New York at Stony Brook, have selected 100 poems by 32 contemporary physician-poets for this succinct yet meaty anthology. The book is subdivided into four sections, each of which is prefaced by an informative description and highlights of the poems to follow.

Section headings take their names from excerpts of the poems contained therein. There are poems that describe individuals--patients, family members ("from patient one to next"), poems that consider the interface between personal and professional life ("a different picture of me"), poems that "celebrate the learning process" ("in ways that help them see"), and poems in which the poet’s medical training is brought to bear on larger societal issues ("this was the music of our lives").

Several of the poems have been annotated in this database: Abse’s Pathology of Colours (9); Campo’s Towards Curing AIDS (13) and What the Body Told (94); Coulehan’s Anatomy Lesson (97), I’m Gonna Slap Those Doctors (21), The Dynamizer and the Oscilloclast: in memory of Albert Abrams, an American quack (129); Moolten’s Motorcycle Ward (105); Mukand’s Lullaby (33); Stone’s Talking to the Family (79) and Gaudeamus Igitur (109).

Other wonderful poems by these authors are also included in the anthology, e.g. Her Final Show by Rafael Campo, in which the physician tends to a dying drag queen, finally "pronouncing her to no applause" (11); "Lovesickness: a Medieval Text" by Jack Coulehan, wherein the ultimate prescription for this malady is to "prescribe sexual relations, / following which a cure will usually occur" (131); "Madame Butterfly" by David N. Moolten, in which the passengers in a trolley car are jolted out of their cocoons by a deranged screaming woman (142).

Space prohibits descriptions of all 100 poems, but each should be read and savored. Some others are particularly memorable. "Carmelita" by D. A. Feinfeld tells of the physician’s encounter with a feisty tattooed prisoner, who ends up with "a six-inch steel shank" through his chest as the physician labors futiley to save him (23). In "Candor" physician-poet John Graham-Pole struggles with having to tell an eight-year old that he will die from cancer (27). Audrey Shafer writes of a Monday Morning when she makes the transition from the "just-awakened warmth" of her naked little son to tend to the patient whom she will anesthetize "naked under hospital issue / ready to sleep" (72).

In "The Log of Pi" Marc J. Straus muses about being asked "the question / I never knew" that he "pretend[s] not to hear" whose "answer floats on angel’s lips / and is whispered in our ear just once" (113). Richard Donze wants to know why "Vermont Has a Suicide Rate" (132). Vernon Rowe remembers the "hulk of a man" who shriveled away from an abdominal wound and begged, " ’Let me go, Doc,’ / and I did" (44).

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