Showing 351 - 360 of 419 annotations tagged with the keyword "Pain"
This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."
The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).
The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.
Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.
The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.
Consider the possibility of a man whose sense of hearing is so enhanced that he can discern the noise of the entire world and also mimic all the sounds made by men and beasts. Imagine a human being who can SEE sounds as well as hear them. It is little wonder that he would have an affinity and talent for music.
Johannes Elias Alder is such a musical genius born in 1803 with a preternatural gift of hearing. The illegitimate son of the village curate, Elias experiences a physical metamorphosis as a child and by the age of ten is already a man. He effortlessly composes magnificent music that he plays on the organ.
Although Elias falls in love with his cousin, Elsbeth, she marries another man. After this loss, he becomes tired of life. Elias commits suicide at the age of 22 by refusing to sleep and succumbing to starvation and an overdose of belladonna.
Margo Billis and her son, Matthew, barely endure a strained and rather twisted relationship. She is a 73 year old woman dying from cancer. Despite her illness, she continues to provide for her lazy, 40 year old son who still lives at home.
Matthew's condition might also be described as terminal in an emotional and psychological sense. He claims to suffer from endogenous depression and wastes most of his life sleeping for long periods of time in his garish green bedroom. His mother implores him to get a job but all he seems capable of is wallowing in self-pity.
Matthew has neither empathy nor sympathy for his mother's misery. One day he finds his mother dead in her bed. Her safe is open and contains $14,000, some undeposited but endorsed checks, a bottle of 200 morphine tablets along with a prescription for morphine, half a carton of cigarettes, and Hummel figurines. Matthew transports her corpse to the freezer in the garage where she will remain until he is ready to announce her death. Realizing he can co-sign her checks and forge her signature, he has finally found a job to his liking.
In short chapters that alternate between remembered scenes of abuse, reflections upon those scenes, and tributes to the natural beauties and human kindnesses that tempered years of domestic violence, the author provides a galling, but not sensationalistic, record of what child abuse looks and feels like. Only when she was older and mostly beyond the reach of a father who routinely beat and sexually abused her and her siblings did the author find out that her father had been dismissed from a police force for gratuitous violence and had subsequently submitted to electroshock treatments for mental illness.
The title describes the nature of the narrative; in its deliberate discontinuities it testifies to the stated fact that there are places where memory has left a blank. Much of the telling is an attempt to piece together a story of recurrent violence, felt danger, and arbitrary rage that seemed at the time both regular and unpredictable.
The sanity of the narrative testifies to the possibility of healing. The writer makes no large claims for final or complete release from the effects of trauma, but does strongly testify to the possibility of a loving, happy, functional adult life as healing continues.
The poet expresses pity for all the poor, poor animals--for dogs, for mice, for earthworms, even for the "protozoons / that sway their cilia / so desperately." On the other hand, "patients / with progressive amyotrophic lateral sclerosis can just / fuck off." They should go live in the world of Hieronymus Bosch. [21 lines]
This is a collection of partly fictional, partly autobiographical stories about a young Russian doctor sent to practice at a rural hospital immediately after graduating from medical school. Muryovo hospital serves the peasantry in a remote region lacking decent roads and amenities like electricity. The doctor works day and night, aided by a feldsher and two midwives. Sometimes he sees over 100 patients a day in his clinic while attending to another 40 in the hospital.
The stories reveal in a clear, engaging style the doctor's anxiety as daily he encounters new problems (his first amputation, his first breech presentation, his first dental extraction) and-- for the most part--overcomes them. They also reveal a constant tension between the peasants' ignorance and the doctor's instructions. Full of blizzards and isolation, the stories are also warm and companionable, with vignettes of friendship, gratitude, and nobility.
Julia Sweeney performs on film the dramatic monologue that she wrote and performed "live" on stage. The period of her life on which she focuses are the nine months of her brother's dying, when he and her parents moved into her home--an idyllic bungalow that she had set up for herself, following her recent divorce. Instead of having the opportunity to enjoy the freedom of being single again, she is thrust into the thicket of family relationships, the sadness of her brother's poor health, and the demands made by his treatment for lymphoma.
Her parents, she says, have always been for her a "source of comedy, or a reason to be in therapy." These are the resources Sweeney is able to tap as she comments with humor and insight on living like a child in her own home, as her mother takes over the household and bickers with her father, who is drinking too much. But even as she jokes about the clash in lifestyles between herself and her parents (after all, she hasn't lived with them for 16 years), she weaves into the narrative the nature of life with her brother, whom she accompanies for his daily radiation treatments and whom she ministers to as he undergoes chemotherapy.
While not minimizing the seriousness of her brother's illness, she (as well as he) can find the surreal humor in their medical encounters. Thus Julia Sweeney describes how, when scar tissue prevents further injection into his spinal fluid and the doctors recommend a brain "shunt" for that purpose, assuring them that other patients "love their shunts," brother Mike not only agrees to the procedure, but adopts the slogan, "I love my shunt" for every conceivable situation.
The surreal becomes the real when Julia learns that she too has cancer--a rare form of cervical cancer that will require a hysterectomy. Even as she describes her shock and horror at this new blow, Sweeney takes comfort in Mike's sense of humor: he accuses her of getting even with him for taking "the cancer spotlight." Her narration of picking up her own pathology slides and of making the decision not to have her ova ("eggs") harvested and fertilized are both funny and poignant.
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).
In my dreams, now, in my re-imaginings, I leap away as easily as a deer, and with as little hesitation. My spandex-covered legs scissor the ditch, and my feet ride the ground instinctively. My brown hair sways as I dart off into the forest . . . In real life, I got into the truck. (p.25)
A young woman retells the story of her rape--to herself, to the reader, and to a therapist who possesses "no startling answers--just a quiet ability to receive and transmute pain." The art of transcending pain through communication is at the heart of this story. The narrator survives by talking to her rapist and challenging his human core, by revealing everything to caregivers, by allowing herself to replay and dissect the details of this trauma.
The multiple plots of Our Mutual Friend, Dickens's last complete novel, twine around the miser John Harmon's legacy of profitable heaps of refuse ("dust"). Harmon dies and leaves the dustheap operation to his estranged son John, on the condition that he marry Bella Wilfer, a young woman unknown to him. When a body found in the Thames is believed to be the younger Harmon, travelling home to receive his inheritance, the dustheaps descend instead to Harmon's servant Noddy Boffin ("The Golden Dustman").
Boffin and his wife respond to their new status by hiring Silas Wegg, a "literary man with a wooden leg" to teach Boffin to read; arranging to adopt an orphaned toddler from his poor great-grandmother; and bringing the socially ambitious Bella Wilfer into their home, where she is watched and evaluated by John Rokesmith, a mysterious young man employed as Boffin's secretary.
Rokesmith is actually John Harmon, who has survived betrayal and attempted murder and is living incognito so that he can observe Bella. Boffin's negative transformation by his wealth, Bella's moral awakening as she witnesses the changes wealth produces in Boffin and in herself, and the developing love relationship between Rokesmith and Bella form one key sub-plot.
Another is the romance between gentlemanly idler Eugene Wrayburn and Lizzie Hexam, the daughter of the waterman who finds the drowned body. Class differences and the obsessive love and jealousy of schoolmaster Bradley Headstone threaten their relationship, but they are finally married with the help of the crippled dolls' dressmaker Jenny Wren. The smaller plots that interweave these sensation/romance narratives comment on the hypocrisy of fashionable life ("Podsnappery") and the destruction of the family lives of both rich and poor by an industrialized, materialistic society.