Showing 361 - 370 of 473 annotations tagged with the keyword "Medical Ethics"

Inspired Sleep

Cohen, Robert

Last Updated: Aug-17-2001
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Sleep is a much sought-after prize in this novel. Bonnie Saks is a 39 year old woman whose life has spiraled out of control. Already divorced and the mother of two young boys, she is tormented by insomnia. Her life is further complicated when she discovers she is pregnant and struggles to complete her unfinished dissertation on American literature.

Ian Ogelvie is a 29 year old psychiatrist and sleep researcher experimenting with a breakthrough drug known as Dodabulax that greatly enhances REM sleep. While Ian helps Bonnie sleep, she in turn provides him with a wake up call of sorts. Ultimately, Bonnie becomes uneasy with the changes triggered by her blue pills. Despite suffering a miscarriage, her life becomes more tolerable and her insight much clearer.

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A Libation of Blood

Weldon, Fay

Last Updated: May-24-2001
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Alison, 39 years old, is twice-divorced, with three children, on the verge of moving in with a man called Bobby. Her breast is sore and she is afraid it's cancer. Her mother tells her it's more likely she's pregnant. She says she uses contraceptives; her mother tells Alison that she was conceived when a condom broke.

Alison considers abortion, recalling her last pregnancy. Having given birth to a child with Down's Syndrome who died at three months, she had had amniocentesis and was told that she was carrying twin boys, both normal. When the twins were born, though, one turned out to be a girl. One twin, it seemed, had been tested twice. Although the female twin did not have Down's Syndrome, Alison began at that point to worry about luck and the uncertainty of medicine (and of life).

So now, pregnant again, she asks her mother what she should do, and is told to "trust to luck." But she is afraid that her luck has run out and she must take control for herself. A scan shows that she is carrying twins again. Only now does her mother tell her that she is in fact a twin, that her sister had Down's Syndrome and died shortly after birth--in fact, her mother admits, the midwife "did away with" her. (The euphemism carries the senses both of euthanasia and of murder.)

Hearing this, Alison decides she wants to have an abortion right away. Her doctor, thinking the problem is that she wants only one child, gives her the option of selectively terminating one fetus and carrying the other one, but tells her she wouldn't be able to choose which to keep and which to abort. She rejects the idea, imagining how she'd tell the surviving twin about her decision later on, and decides instead to "have them both and trust to luck."

As she leaves the clinic, she begins to bleed and miscarries. Later her mother tells her that she, too, once miscarried twins, and tells Alison she'll have better luck next time, because of the bleeding: "Blood, " her mother says, "is the libation the God of Chance requires."

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Still Life in Milford

Lynch, Thomas

Last Updated: May-22-2001
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

In this collection, Thomas Lynch, a funeral director, examines many of the same topics he explores in his essays (see this database for annotations of The Undertaking: Life Studies from the Dismal Trade and Bodies in Motion and at Rest: On Metaphor and Mortality). In section one, he writes about sin and redemption ("Attende Domine," "Inviolata," "Panis Angelicus"), death and grief ("Late April," "Month’s Mind,"), love and sex ("O Gloriosa Virginum," "Casablanca," "Veni Creator Spiritus," "The Hammock"), and introduces his own point-of-view as one who tends the dead ("In Paradisum").

In the second section, Lynch delves more deeply into sin ("Byzance") and memory. In the section’s first poem, "Liberty," Lynch introduces himself as a man from a "fierce bloodline of men," and in the next five poems writes about "Argyle," perhaps a relative, perhaps an alter-ego. A long poem, "The Moveen Notebook," follows, relating the story of Lynch’s family home in Ireland and his relatives who lived and died there, ancestors who are also represented in Lynch’s essays. The rest of the poems expand upon family and memory and serve to complete the portrait of the narrator, a man who tends "toward preachment / and the body politic," who rages and who wants to "offer a witness" ("St. James’ Park Epistle").

The poems in section three serve as laments. Here Lynch addresses the failures of gods and men ("A Rhetoric upon Brother Michael’s Rhetoric upon the Window," "One of Jack’s") and the wonder of aging ("Loneliest of Trees, The Winter Oak"). But the main body of this section comprises stark poems about women and poems about Lynch’s work ("Heavenward," "The Lives of Women," "That Scream if You Ever Hear It," "These Things Happen in the Lives of Women," "How It’s Done Here," "At the Opening of Oak Grove Cemetery Bridge").

In "Couplets," Lynch speaks of teaching his sons the funeral business and the horrors they witness. In the brief poem "Aubade," he tells of an abused woman’s suicide. The last poem of the book, "Still Life in Milford--Oil on Canvas by Lester Johnson," is both a portrait of the town and of the author: "Between the obsequies, I play with words."

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Bringing Out the Dead

Connelly, Joe

Last Updated: May-18-2001
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Frank is an emergency medic and ambulance driver working night shifts for Our Lady of Mercy hospital in Hell's Kitchen, New York City. The novel begins with Frank's resuscitation of an elderly man called Mr. Burke, who has had a heart attack, and ends a couple of days later with Mr. Burke's death in the hospital. Frank is haunted by the patients he has failed to save, some of whom inhabit his experience like kinds of ghosts.

Most insistent is a teenage girl called Rose who died during an asthma attack, in part because Frank was unable to intubate her in time. He is also unable to forget his marriage, which ended because of the deadening effects of his work. And now Frank is also haunted by doubts about the value of restoring life.

He has successfully started Mr. Burke's heart, but the man is brain dead. Frank thus watches as Mr. Burke's family is first given hope and then must learn that there is none. Frank almost falls in love with Mr. Burke's drug-addicted and disillusioned daughter, Mary, perhaps seeing in her an opportunity for a mutual restoration to health.

But when her father finally dies--when the attending realizes that the patient's struggle hasn't been the "survival instinct" but rather a "fight to die"--she blames Frank, who recognizes that his purpose is not simply to keep people alive (or to bring them back from the dead), but rather that "saving lives" means preserving their value, somehow, in his memory. He walks away from the hospital, and when he gets home, Rose--her ghost, and Frank's own symbol for all the patients he hasn't resurrected--is waiting there, to forgive him.

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Annotated by:
Moore, Pamela

Primary Category: Literature / Poetry

Genre: Poem

Summary:

A man walks through the countryside after a night of rain. The creatures around him are lively and refreshed. At first, he shares their joy, but his mood soon turns as he reflects that care and pain are the inevitable balance to the care-free life he has lead so far: "We poets in our youth begin in gladness; But thereof come in the end despondency and madness."

He comes upon an old man staring into a muddy pond. The man seems weighed down with care; he is so still he seems dead. He greets the man and asks what he is doing. The old man is a leech-gatherer, leeches being needed by eighteenth-century doctors. He wanders the moors, sleeping outside, and thus makes a steady living. The wanderer resolves not to give in to misery, but to think instead of the courage and firm mind of the leech gatherer.

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The Use of Force

Williams, William Carlos

Last Updated: May-03-2001

Primary Category: Literature / Fiction — Secondary Category: Literature / Fiction

Genre: Short Story

Summary:

A doctor is called to the home of a poor, immigrant family. A beautiful little girl is quite ill. As diphtheria has been going around, the doctor attempts to examine her throat. The girl, however, won't open her mouth. She fights him off and all attempts to cajole her into compliance fail. Yet, the doctor is resolved to see that throat. He forces the girl's father to hold her down, while he manages to wrest open her mouth after a long battle. She does, in fact, have diphtheria.

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Summary:

The film covers two days in the life of Frank Pierce (Nicolas Cage), a burned-out EMT (emergency medical technician) working the socio-economic underside of Manhattan. From the beginning, Frank is upset because recently all his patients have been dying on him, and he is haunted throughout by the hallucinated ghost of Rose, a young woman who collapsed on the street and died, apparently because he could not intubate her correctly.

Frank is highly stressed, he has no life outside his work, and he is self-medicating with alcohol. He tries to quit, but his boss keeps him on by promising time off in the future. In the film's first action, Frank does manage to miraculously resuscitate Mr. Burke, a heart-attack victim, but the patient winds up in the hospital with a very bad prognosis, so even that "saving" works against Frank.

Frank has encounters with numerous patients, many of them street people whose lives are out of control, some of whom are ER (Emergency Room) regulars, such as the demented young Noel (Marc Anthony). He also deals with (and is dealt with by) several highly idiosyncratic EMT partners in his ambulance rounds (John Goodman and others). Frank gets to know Mary Burke (Patricia Arquette), the daughter of the heart-attack victim, and they tentatively move toward being a couple who might help each other survive their lives.

Near the end, Frank, who knows Mr. Burke had tried to tear out his tubes during a brief moment of consciousness, and who feels he has been getting pleading messages from him to end his agonies, surreptitiously takes him off life support long enough for him to die. The physician who responds to the code decides not to attempt resuscitation of this patient who had already been resuscitated 14 times that day. Frank goes to tell Mary that her father has died (but not how), and exhaustedly falls asleep on her breast, apparently having forgiven himself because he has in some sense finally "saved" Mr. Burke.

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Summary:

This is the second anthology from Donley and Buckley derived after many years of teaching "What's Normal?"--a literature and medicine course at Hiram College where they explore the cultural and contextual influences upon the concept of normality. With the first anthology, The Tyranny of the Normal, the editors focused on physical abnormalities (see this database for annotation). In this second anthology, the focus is exclusively on mental and behavioral deviations from societal norms. With this edition, Donley and Buckley present their case that, as with physical abnormalities, there is a similar tyranny of the normal that "dominates those who do not fit within the culture's norms for mental ability, mental health and acceptable behavior (xi)".

The anthology is divided into two parts. Part I is a collection of essays that introduce various clinical and bioethical perspectives on the subject of mental illness. These essays bring philosophic and analytic voices to the topic. Stephen Jay Gould's terrific essay on Carrie Buck and the "eugenic" movement in the United States in the early part of the 20th century illustrates one of the major themes that can be found throughout the anthology.

Oliver Wendell Holmes wrote the majority opinion in the 8-1 Supreme Court decision that sealed Buck's fate. Gould begins his essay reminding his readers of the often referenced Holmes quote, "three generations of imbeciles are enough." He then takes us on a fascinating historical adventure that uncovers a deeper and more complicated drama that led to this unfortunate period in American history, and the tragic incarceration and sterilization of Carrie Buck.

This essay, as with other stories, poems, and drama in the anthology, contemplates the relationship between societal values and mental illness, and illustrates how society through medicine can turn to the myth of "objective" diagnostic labels as a way to compartmentalize and control behavior and imaginations that are "abnormal." D. L. Rosenhan's essay from "On Being Sane in Insane Places" further illustrates the failure of the mental illness label. Irvin Yalom's story from Love's Executioner and Other Tales of Psychotherapy provides an example of what is possible when diagnostic labels are avoided, when health care professionals with power turn with humility, curiosity, and kindness toward others, substantiating that these qualities are far more powerful than statistical notions of "normal."

Part II is a collection of fiction, poetry and drama. Intended as a complement to part I, part II engages the reader in the lived experience of the narrators. It is divided into six sections. Section one considers children and adolescent experience of mental illness. Included are Conrad Aiken's "Silent Snow, Secret Snow," an excerpt from Susanna Kaysen's Girl, Interrupted (see annotation in this database), and an excerpt from Peter Shaffer's Equus (see annotation).

Section two includes stories that capture the world of mental disability and retardation. An excerpt from Of Mice and Men and Eudora Welty's short story Lilly Daw and the Three Ladies are included. Charlotte Perkins Gilman's The Yellow Wallpaper (annotated by Felice Aull; also annotated by Jack Coulehan) is in section three where women's experiences with mental disorders is the theme (these are annotated in this database).

Section four and five focus on men and mental illness. War experience is considered in the works of Toni Morrison and Virginia Woolf. Section six concludes the anthology. Alzheimer's disease and dementia are examined in Robert Davis's My Journey into Alzheimer's Disease, and in the story, "A Wonderful Party" by Jean Wood.

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Lives of Moral Leadership

Coles, Robert

Last Updated: Mar-20-2001
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In this book Robert Coles elucidates the nature of moral leadership by presenting a series of narratives about moral leaders. These are individuals who have made significant contributions to the author's moral development, mostly through personal interaction, but in some cases through their writings or their influence on other people.

The subjects include public personages like Robert Kennedy, Dorothy Day (of the Catholic Worker), Danilo Dolci (a Sicilian community organizer), Dietrich Bonhoeffer, and Erik Erikson; writers who have influenced Coles, such as Joseph Conrad and Ralph Waldo Emerson; and "ordinary" persons whom he encountered over the years in his studies of the moral lives of children.

The "ordinary" person category is most extraordinary. Coles draws heavily on personal interviews that reconstruct the courageous narratives of people like Andrew Thomas, a young Mississippian who worked on the voter registration project during the summer of 1964; Donita Gaines, one of the first black teenagers to "integrate" an all-white high school in Atlanta in 1961; and Albert Jones, a parent who volunteered to drive the school bus that carried black children in 1967 from Roxbury to a previously all-white school in South Boston.

However, the clearest and most powerful narrative that emerges from this book is that of the author himself, as he develops from young, socially conscious child psychiatrist to a middle-aged man seeking to understand what it means to be a moral leader in today's world.

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The Forbidden Zone

Borden, Mary

Last Updated: Dec-20-2000
Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

By the author's own admission, this memoir is a collection of fragments taken from her memory of bits and pieces of her four year experience as a nurse in an evacuation hospital unit following the front lines up and down the European theatre during World War I. The work is fragmented because this experience was fragmented.

The first few chapters are dream-like descriptions of the men marching into battle and crawling back, or being carried back. The second collection of short vignettes dips--just a wee bit--into some of the individual soldiers' immediate stories. The latter segment of the book deals in more detail with the operations of the field hospital, some of its personnel, and some of the patients. Finally, the author treats the reader to a handful of poems, perhaps unnecessary, since the entire memoir is like one giant poem.

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