Showing 41 - 50 of 381 annotations tagged with the keyword "Cross-Cultural Issues"

Illness as Narrative

Jurecic, Ann

Last Updated: Jul-03-2012
Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

In Illness as Narrative, Ann Jurecic thoughtfully examines the unruly questions that personal accounts of illness pose to literary studies: What is the role of criticism in responding to literature about suffering?  Does the shared vulnerability of living in a body, which stories of illness intimately expose, justify empathic readings?   What is the place of skepticism in responding to stories of suffering?  Does whether or how we read illness narratives matter?  Jurecic's questions entice discussion at an interesting cultural moment.  The numbers of memoirs and essays about illnessand their inclusion in medical school and other humanities coursesmultiplied from the later decades of the 20th century to the present.   However, their increase, and their potential to encourage empathic readings, coincided with dominant literary theories that advocated vigorously skeptical, error-seeking responses to texts and their authors.  Jurecic reminds us that Paul Ricoeur called such responses "the hermeneutics of suspicion" (3). 

Jurecic's astutely researched, nuanced answers to those questions propose a corrective to the extreme skepticism of "disembodied criticism." Such criticism, she claims, dismisses testimonial writing from "a position of distance and privilege."  But her answers also affirm that intellectually "rigorous" responses to texts are central to the critical humanities (15).  To further her position, she offers attentive readings of accounts of illness by Virginia Woolf, Reynolds Price, and Jean-Dominique Bauby, as well as the theoretical writing of literary and other scholars.  For instance, Jurecic speculates that the condition of a reader's body aligns with his or her responses to texts.  In a chapter called "Theory's Aging Body," she observes that as skeptical scholarly readers ageStephen Greenblatt, Michel Foucault, Judith Butlerthey have turned their attention to "illness, vulnerability, and mortality" (93).  Jurecic also suggests that a function of criticism is to uncover the cultural conditions that memoirs and essays about illness respond to.  Living "at risk" is a recent one.  In stories of living with the risk of experiencing a particular illness in the future, potential patients create narratives of uncertainty to discover the "personal meaning of the impersonal statistics" that medical research now regularly delivers (18). 

 Jurecic also reflects on the ways theorists have understood the possibilities of representing and responding to pain in the varied approaches of philosophers Elaine Scarry, Martha Nussbaum, and Richard Rorty and of anthropologists Jean E. Jackson, Byron Good, and Veena Das.  In an exceptionally comprehensive and nuanced reading of Susan Sontag's theoretical, fictional, and journal writing about suffering, Jurecic uncovers Sontag's inconsistent, yet revelatory positions on the human capacity for responding to representations of pain.  The chapter on Sontag is enriched by Jurecic's reading of Annie Lebovitz's and David Reiff's responses to Sontag's suffering: in Lebovitz's controversial photographs of Sontag's final days (included in A Photographer's Life: 1990-2005) and Reiff's memoir about his mother's illnesses (Swimming in a Sea of Death). 

Illness as Narrative closes with examples of what Jurecic calls reparative writing and reading practices.  In the first instance, ill writers such as Jean-Dominique Bauby (The Diving Bell and the Butterfly) both recreate "a more coherent sense of themselves" and dislodge "fixed ideas and narratives" about illness (109).  In the second instance, Jurecic outlines the limits of two competing readings of Anne Fadiman's The Spirit Catches You and You Fall Down.  One assumes that readers will by nature empathically imagine those who are culturally different from themselves.  The other looks skeptically at the assumption that what medical educators call cultural competence can be acquired by reading a book.  Jurecic suggests that strategies for reading and teaching informed by Janelle S. Taylor, Eve Kosofsky Sedgwick, and Rita Felski can encourage more complex habits of response, such as Taylor's "'empathic curiosity'" (quoted 122).

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Corporate Decision

Tooker, George

Last Updated: Apr-26-2012
Annotated by:
Kohn, Martin

Summary:

The foreground of this painting is dominated by a "pieta" type grouping. One woman hovers closely over what appears to be a dying man, while another comforts a small child. This part of the canvas is underlighted. The colors are rich earth tones. The figures are non-Caucasian.

In the background, in harsh light, is a group of identical looking starkly white men. In fact, their faces are almost skeletal. All are in suits, three are seated, with four others standing behind the seated figures. They look very much like a "tribunal."

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Jo Spence Archive

Spence, Jo

Last Updated: Apr-26-2012
Annotated by:
Metzl, Jonathan

Primary Category: Visual Arts / Visual Arts

Genre: Multimedia

Summary:

Unfortunately,the archive as described and annotated here is no longer available on line. The quotes, summary, and commentary below are nevertheless worth reading. Some images may be found as noted in Miscellaneous below.

Powerful series of self-portrait photographs documenting the artist’s fight against breast cancer, accompanied by a narrative describing her responses to the medical community. In early images, Spence undergoes mammography, lumpectomy, and finally, mastectomy (images 1-3, 5). These "clinical" images provide a temporal narrative of the course of Spence’s "illness," while concomitantly tracing the inter-relationship between the corporal/medical and the artistic body. In so doing, Spence calls into question medical notions of autonomy and ownership, while re-claiming her "right" to the representation of her body-parts.

In later images, Spence rejects Western medicine, in favor of alternative therapies such as acupuncture (image 4) and phototherapy (image 6). As Spence writes: "Women attending hospital with breast cancer often have to subject themselves to the scrutiny of the medical photographers as well as the consultant, medical students and visiting doctors. Once I had opted out of orthodox medicine I decided to keep a record of the changing outward condition of my body. This stopped me disavowing that I have cancer, and helped me to come to terms with something I initially found shocking and abhorrent."

Supporting text by Terry Dennett (Curator, Jo Spence Memorial Archive) at the end of the series of images provides additional excerpts from Spence’s writing, and several useful links to breast cancer awareness sites.

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Rosalind Franklin: The Dark Lady of DNA is the biography of the scientist whose research James Watson and Francis Crick needed to elucidate the structure of the DNA molecule.  Even though the discovery has had profound implications for modern medicine, Franklin's contribution to it almost remained obscure.

In 1968 Rosalind Franklin (1920-1958) became visible to the world beyond a small circle of scientists when Watson published The Double Helix (1968), his "personal account" of puzzling out DNA.  If not for Watson's self-incriminating candor about stealing glances at Franklin's research, we might not know how crucial her lucid x-ray diffractions of hydrated DNA were to him and Francis Crick.  However, the account that indirectly acknowledged Franklin's contribution to their work represented her in a patronizing caricature.  Since ovarian cancer took her life a decade before Watson's memoir appeared, others have been left to respond to his version of the DNA story and representation of his female colleague.  Among Franklin's defenders, Brenda Maddox offers the most complete and insightful restoration of the scientist, her research, and her life. 

Maddox's biography draws from not only the many scientific archives and personal papers of scientists Franklin worked with in England, Europe, and America, but also from previously undisclosed letters written by Franklin, her friends, and her family.  Maddox also interviewed Franklin's relatives.  Doing so allowed her to position Franklin's life within the history of her close, extended Anglo-Jewish family, generations of wealthy London publishers and bankers who experienced discrimination.  This history does more than belie some of Watson's hasty assumptions about Franklin's background.  It creates a biography of a complex woman who negotiated biases as a citizen and a scientist.     

The biography is divided into three parts.  The first narrates the story of Franklin's childhood, rigorous education, and successful career before accepting the fateful research post at King's College, London.  She's known for thinking skeptically and working mathematically.  Yet early on she showed an aptitude for three-dimensional thinking and for understanding crystalline structures.   As an undergraduate at Cambridge she speculated about a "'Geometrical basis for inheritance'" (56).

The second section concentrates on the 27 months at King's when she worked uneasily with Maurice Wilkins, who showed her revelatory x-rays of DNA to Watson.   This balanced account of a controversial episode in the history of science offers evidence that Franklin was close to drawing the same conclusion about the structure of DNA that Watson and Crick rushed into print.  This section also accessibly explains the molecular biology of her day and the painstaking physical and intellectual intricacies of making and interpreting x-rays of crystalline molecules. 

The third section reminds us that Franklin had a very productive, though short career after leaving DNA to others.  She directed research programs for the study of plant viruses, and she investigated the polio virus shortly before she died.  Respected scientists, including Crick, praised her research.   Many, unlike Wilkins, liked working with her.  More than 40 years after viewing what's known as Franklin's Photograph 51, Watson publicly acknowledged that seeing it "'was the key event'" in understanding the geometry of DNA (316).  (See the note on Photo 51 below.)        

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Suite Francaise

Nemirovsky, Irene

Last Updated: Jan-03-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Two novellas are brought together. In the first, “Storm in June,” a host of people flee Paris in June 1941- -as the Germans occupied the city. They gather their money and most precious belongings and leave their homes, reasoning that there will be more safety in the countryside. But everyone has the same idea. The crush results in shortages of fuel, food and accommodation that radiate in ever widening ripples around the city. Many are duped by employers or by lovers. Some are robbed and even murdered by unscrupulous fellow citizens, and new conventions of behavior and bureaucracy are forged in the stress of the situation. The fortunes of several different individuals are interwoven in short chapters to explore a wide variety of adventures--tragic, miraculous, and poignantly banal. Among the most memorable is the little saga of the Michaud’s – a couple driven out of Paris, then back – all the while anxious for news of their son at the front.

The second novella, “Dolce,” is the story of the unhappily married Lucile whose husband has gone to the front. She must bide time in the home of her austere mother-in-law, Madame Angellier, who treats her with frank hostility. They are forced to billet a German officer. Lucile soon finds that she and the German share many interests in art and music; gradually the two fall in love, although they act upon their sentiments in conversation only. The full extent of their involvement must be concealed, but the community is aware and Lucile understands the potential consequences of “sleeping with the enemy.” Her mother-in-law hates her all the more for growing close to the occupier; yet their neighbours shamelessly prevail upon her connections to obtain minor favors.

When a local Frenchman kills a German soldier for allegedly courting his wife, the uneasy calm is destabilized. Almost by default, Lucile agrees to hide the fugitive murderer in her attic in bold proximity to her German tenant. The brave act is discovered by her mother-in-law who then (wrongly) perceives Lucile’s friendship with the German as a clever plot; her hatred turns to grudging admiration. Using her influence and a lie to obtain a pass from her unsuspecting German friend, Lucile escorts the ungrateful murderer to safety in Paris. The deception drives a wedge into her new relationship. They part never to meet again as his company is transferred to another place.

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This is a huge and wonderful book about cancer, the collection of diseases that sickens people all over the globe and kills many of them. An epigraph to the book states, “A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer,” but the book also describes medical advances that now heal, prevent, or palliate most forms of cancer.

Mukherjee, a cancer physician and researcher, has several strong themes. He sees cancer as an affliction with a long history, a story worthy of a biography; indeed recent discoveries show it to be rooted in our genes (although external factors such as viruses, asbestos, and tobacco smoke can cause genetic disruption). The story of cancer implies a surrounding triangle, the stories of sick people, treating physicians, and biological researchers, all of which Mukherjee artfully weaves across 472 pages. Cancer has Rohrschach blot qualities: depending on time, place, and role in life, humans have perceived different attributes of cancer. As the book ends, however, there is a coalescence of scientific understanding that is satisfying—although there is certainly more to be learned and we are all still vulnerable to genetic errors and, of course, we are intractably mortal.

Another strand is the nature of stories themselves, their twists and turns, presumed early solutions, and personal and social values embedded in them. Mukherjee threads throughout the book the case of a contemporary kindergarten teacher, Carla Reed, who has a leukemia. He bookends his text with ancient Persian Queen Atossa with (presumably) breast cancer. Reed, healed by the end of the book, was Mukherjee’s patient; Atossa was described by Herodotus: both suffered emotional turmoil because of their disease.  Mukherjee understands the affective dimensions of disease for patients and caregivers alike; literature represents these in various ways, and he quotes in his chapter epigraphs and in his prose many writers who describe human experience deeply: Aleksandr Solzhenitsyn, Susan Sontag, Charles Dickens, Thomas Mann, William Carlos Williams, Carlo Levi, and Italo Calvino, to name a few.

The primary story, however, is the interplay of cancer and a large cast of observers, investigators, doctors, scientists, activists, and government officials. Sidney Farber and Mary Lasker dominate the first 100 pages with their two-decade war against cancer. While surgery—historically dramatic and disfiguring—had been a mainstay for treatment of cancer, Farber pursued a biochemical route, which elaborated into chemotherapy, the second major approach of the late 20th century.

Mukherjee also explains ancient views, Hippocrates’, Galen’s humors, Vasealius’ anatomy, Hunter’s stages, Lister’s antisepsis, and Röntgen’s X-rays, which became the third major approach. By 1980, however, the American “War on Cancer” had not been won.

Further advances in cellular biology and genetics would be needed to make targeted molecular therapy possible.  Mukherjee tells this complicated story clearly and engagingly, showing the human investigators to be personable and dogged in their pursuits.  

Another important approach is prevention. The biostatistical work of Doll and Hill, for example, showed the links between tobacco and lung cancer. Screening, such as Pap smears and mammograms, also saved lives, but the basic cellular understanding still eluded investigators.

The final 150 pages explain the search for and discovery of genetic factors, specifically oncogenes. Harold Varmus and J. Michael Bishop were the leaders, winning a Nobel Prize in 1989. Bert Vogelstein, Judah Folkman, Robert Weinberg and Douglas Hanahan took the work further, opening the doors for such drugs as Herceptin, Gleevec, and Avastin. 

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A Question of Power

Head, Bessie

Last Updated: Nov-18-2011
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In this autobiographical novel, written while the author was under severe mental strain and as she recovered from psychotic breakdown, Head tracks the protagonist Elizabeth’s struggle to emerge from the oppressive social situation in which she finds herself, and from the nightmares and hallucinations that torment her. Elizabeth, like Bessie Head, was conceived in an out-of-wedlock union between a white woman of social standing, and a black man--a union outlawed by her country of birth, South Africa.

Like the author, Elizabeth leaves South Africa with her young son--but without her husband, from whom she is fleeing--to live in neighboring Botswana, a country that has escaped some of the worst evils of colonial domination. But in rural Botswana she is once again faced with a constricting social system as the African villagers are suspicious of her urban ways and frown upon her individualistic behavior. Further, they bear her ill will on racial grounds because she is light skinned like the "bushmen" who are a despised tribe there.

Elizabeth suffers not only social isolation but intellectual deprivation as well. One of the few people with whom she can converse as an intellectual equal is the American peace corps volunteer, Tom, who acknowledges that "men don’t really discuss the deep metaphysical profundities with women" (24). During the four years in which Elizabeth is plagued by tribal suspiciousness, terrifying dreams, economic hardships, and two hospitalizations for mental breakdown, it is Tom, and her own love for and obligation to her young son that help her to survive this ordeal.

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The Story of San Michele

Munthe, Axel

Last Updated: Nov-14-2011
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

The author takes us on a highly colorful autobiographical tour of his medical career - his personal life never enters this account - from a classical medical education in Paris as a young expatriate Swede (he remains expatriate the entire book) to his internal medicine practice in France, including a tour of Naples as a volunteer during the cholera epidemic of 1881 and his finally settling in Italy. There are also anecdotes - many of them side-splitting and told with uncommon skill - about conducting a corpse back to Sweden, a truly thrilling journey to Lapland,  encounters with the legendary Charcot, his return to San Michele whence the book begins with a mythopoetic retelling of his first visit there, and his last years at San Michele as patron of a community (both local and international) and as collector and explorer of the nearby Mediterranean.        

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This novel takes place during the Ice Age at a time when modern humans (Cro-Magnon) have immigrated into northern Europe and begun to interact with the Neanderthal people, who have already been successful inhabitants of Europe for perhaps 100,000 years. Within several thousand years of this fateful encounter, which took place about 35,000 years ago, the Neanderthal people had completely died out. Early mitochondrial DNA evidence indicated that modern humans are unrelated to the Neanderthal--their gene pool simply disappeared--although more recent studies show that perhaps 2 to 3% of our mitochondrial DNA was inherited from the Neanderthals, who prbably died out as a result of modern humans' greater success in competing for food and other resources.

In this scenario modern humanity originated from a version of the Biblical story of Cain and Abel, of brother "killing" brother, except in the paleontological case the younger brother was responsible for the demise of the elder. Bjorn Kurten, an eminent European paleontologist, used this novel to present his ingenious theory to explain what happened.

The story is told from the perspective of Tiger, a young black (Cro-Magnon) man whose father is killed in a raid by men from another band of blacks. Later, he devotes his life to searching for his father's killer. In the process he travels widely and encounters a band of whites (Neanderthal), a seemingly primitive form of humanity known to Tiger's folk as "trolls." The trolls have a high-pitched, bird-like language that Tiger is eventually able to learn, even though it is virtually impossible for whites (trolls) to learn the black language, because they are unable to articulate the broad range of vowel sounds it includes.

The whites are also different in that their bands are equalitarian, with women playing major leadership roles, while black tribes are strictly hierarchical and patriarchal. Tiger travels with the white band and mates with Veyde, one of its prominent members. However, one day the band is decimated by a marauding black tribe led by the warrior, Shelk.

In the story's climax Tiger carries out a scheme to infiltrate the "bad" tribe and kill Shelk, who he believes is his father's murderer. In fact, ther real murderer was Shelk's twin brother, also called Shelk. The two had used the same name to make it appear that "Shelk" could be in two places at once, thus proving he had supernatural powers. We learn that the Shelk twins had mixed black-white parentage. Children of such unions seem god-like in that they are stronger and more attractive and creative than "normal" people of either group. The "good" Shelk finally finds the white father he has been searching for all his life. And, Tiger lives happily ever after with his white mate Veyde, but their children, though strong and resourceful, will inevitably be sterile. 

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sherwin Nuland has had a distinguished career as a surgeon on the faculty at Yale University and as an author with interests in history of medicine, medical ethics, and medical humanism. In this memoir we become acquainted with a different side of Nuland, that of son to a widowed, immigrant father with whom the author had a complex and difficult relationship.

We learn also that Nuland has suffered from depression on and off since he was preadolescent, experiencing a major breakdown in midlife. This book attempts to make sense out of the family dynamics and the depression. At the same time, it describes the insular world of Russian Jewish immigrants living in New York City's Lower East Side and Bronx in the first half of the 20th century.

Nuland explores, frankly and openly, his ambivalent relationship with his father, Meyer Nudelman, and contrasting adoration of his mother, who died when Nuland was 11. The young Sherwin (Sheppy) Nudelman lived in fear of his father's strict rules and unpredictable anger. Further, Sheppy was required to assist his father whenever he went out of the house because Meyer Nudelman had an unsteady gait that made walking difficult and that became increasingly severe. Although the boy initially enjoyed these neighborhood jaunts with his father, he was increasingly resentful of them as his father's condition deteriorated and as his own interests focused more on people and activities outside the home. His father's strong Yiddish accent, strange gait, and sloppy appearance were a major embarrassment.

The last third of Lost in America--chronologically the era of World War II, the Nazi atrocities, and after--concern Nuland's maturation and his path toward the profession of medicine. As he and his brother, Harvey, were contemplating a future in the world of Gentiles, they decided to change their last name from Nudelman to Nuland. Sherwin Nuland was accepted to medical school at "Waspy" Yale and chose to enroll there, deliberately distancing himself (on the surface) from his father and his culture.

In medical school Nuland realized that Meyer Nudelman's physical symptoms were caused by late stage syphilis. The initial shock and disbelief of that discovery dissipated; Meyer's growing helplessness and tremendous pride in the accomplishment of his son allowed for a measure of understanding and affection between the two.

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