Showing 41 - 50 of 233 annotations tagged with the keyword "Anatomy"

Alison Lapper Pregnant

Quinn, Marc

Last Updated: Sep-26-2013
Annotated by:
Henderson, Schuyler

Primary Category: Visual Arts / Sculpture

Genre: Sculpture

Summary:

Alison Lapper is a friend of the sculptor, and a painter herself, who was born with phocomelia (defined in Stedman’s Medical Dictionary as a defective development of arms, legs or both, so that the hands and feet are attached close to the body, resembling the flippers of a seal). As suggested by the title, the 11 foot, 6 inch sculpture in Carrera Marble shows Lapper naked and pregnant, her severely shortened limbs apparent to all.

Her body, with her heavily pregnant belly, is exposed and elevated in milky marble, subject to the stares of passersby, as well as the elements and pigeons. Its formidable mass, the creamy marble, and the dignified composition support the contention that it celebrates a woman’s pregnancy, her health and her sexuality in the context of a society and a tradition that would rarely assign these values to someone so obviously "disabled".

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

F. González-Crussi, professor emeritus of Pathology at the Feinberg School of Medicine at Northwestern University, has written several books on medicine and the human body. Carrying the Heart deals with five basic organ systems; he styles them as Digestive, Scatology, Respiratory, Reproductive, and Cardiovascular.

In his Foreword, he rejects a mechanical view of the body and medicine that treats patients as passive protoplasm. He seeks to engage the imagination of his readers so that they can become active participants in health care.

For each system, González-Crussi assembles an eclectic wealth of materials: views of authors from classical times onwards, scientists who changed perceptions of the body, his own hands-on view as a pathologist, parallel organs in other mammals, and, usually, an extended narrative of a person with an unusual anatomical history. These are highly personal essays, “rhapsodies,” we might say, which stitch together unusual and interesting facts, observations, and interpretations. It’s impossible to guess what will be on the next page, and the discoveries are many. A gifted stylist, González-Crussi writes with both erudition and wit. 

For “Digestive,” he cites Livy, Paracelsus, Joan Baptista van Helmont, and others before turning to Thomas Bartholin, who questioned the notion that the stomach was somehow the “king” of the body and the seat of the soul. González-Crussi writes, “the gastric cardia admits and stores impure food, without this having any discernible effect on the soul. Nor is the soul damaged by performers at circuses and country fairs who lower swords and knives into the stomach” (p.7). The text marches on through Réamur, Spallanzani and others, before turning to the well-known story of Dr. William Beaumont and his patient Alexis St. Martin, who had a hole in his side (from a gunshot). Beaumont experimented with materials placed directly into the stomach.

Next in the digestive process are the bowels, discussed on “Scatology,” literally the study of scat or excrement. González-Crussi is fascinated by cultural values of “death, putrescence, and dissolution” that attach to our scat. He draws on Rabelais, Luther, the Gnostics, Chuang-tzu, and the Aztecs for the views on the contents and process of the bowels—more than the nature of the actual bowels themselves. The next 30 pages deal with enemas, including the modern (and discredited) notion of “auto-intoxication” a justification bruited about even today for colonics.

Oddly enough, the enema theme continues in the “Respiratory” essay, because there were “smoke enemas” for some 200 years. Page 104 shows a French illustration of interlocked tubes for this purpose; indeed the same illustration graces the slipcover for the book. González-Crussi draws on Anaximenes, Pirandello, Plutarch, Hawthorne, and others. Some 15 pages describe a famous tuberculosis patient, Frederic Chopin, although perhaps he was actually a cardiac patient.

Part I of “Reproductive” is “Female.” We quickly learn that “The uterus is placed between the bladder and the rectum. As a piece of real estate, the uterus would be much devalued by the condition of the neighborhood” (p. 152). Nonetheless, the uterus is “immunologically privileged,” fending off germs that might infect a fetus (which in itself is “half foreign” because of the father’s genes). Drawing on many commentators, González-Crussi discusses menstruation, and pregnancy, although not genital pleasure or orgasm. Some insightful pages explore the normal death of cells within our body.

Part II, “Male” discusses erections, side-curving penises, and the famous penises of Napoleon, Rasputin, and Jesus.

The last essay, “Cardiology” briefly explores two types of knowing (from the heart, from the brain) before a lengthy retelling of the Lay of Ignauer; this strange story ends with women whom he has seduced eating his cooked heart. The last section discusses Harvey’s discovery of the heart as a pump. The final two pages see a new consideration of the heart as a second brain.

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The Anatomy Lesson

Morley, John David

Last Updated: Jan-23-2013
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

One of two sons of a broken U.S.-Dutch family, Kiddo chooses to live off the Dutch welfare system spending his state alms on drugs. Although he realizes it is but the bleakest of efforts not to come to grips with a difficult relationship with his older brother, Morton, Kiddo perseveres, forming an uneasy alliance with Pietje, a woman who also knows Morton.

The novel is told by Kiddo with contributions to the multi-faceted story in the form of letters from Morton, who gives up a brilliant future as a genius in physics to travel around the world, and diary entries by Pietje, who has some unpleasant truths to tell about Kiddo's world. Morton, known as Mort, writes Kiddo that he has cancer and not long to live, returning home to die. Honoring the dying request of his brother, Kiddo attends Mort's autopsy (yes, the play on Morte/Mort proves irresistible to Morley, or is it Mor(te)ley), a fairly gruesome scene. This proves not to be the death of Mort/Morte/Death for Kiddo and he requires help from Pietje and more introspection before Kiddo can lay his brother's bones to rest.

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Two Views of a Cadaver Room

Plath, Sylvia

Last Updated: Jan-23-2013
Annotated by:
Belling, Catherine

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem is divided into two formally identical halves of eleven lines each. The first part describes a visit to a "dissecting room," a Gross Anatomy laboratory. The female visitor dispassionately observes the four male cadavers, "already half unstrung" by dissection, and the students, "white-smocked boys," who work on them. She observes the fetuses in bottles, "snail-nosed babies," which are given a kind of power and fascination absent from the cadavers. Finally, "he," one of the students, hands her the "cut-out heart" of his cadaver.

This disturbing valentine is indirectly elaborated on in the second half of the poem, which describes Brueghel’s painting The Triumph of Death (1562), a "panorama of smoke and slaughter." The speaker focuses on a pair of lovers who, in the lower right corner of the painting, seem entirely unaware of the horrors around them. Enclosed by their love, they form a "little country," admittedly "foolish" and "delicate," but spared from encroaching death--if not by love itself, then at least by the arresting effect of art’s image, for desolation is "stalled in paint."

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem builds by repetition to a climax: "if there is a river /more beautiful than this," if there is a river more faithful, braver, more ancient, more powerful. Each repetition begins a new stanza, a stronger stanza, ending finally in a prayer that, if there is such a river, it should flow "through animals / beautiful and faithful and ancient / and female and brave." (24 lines)

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Annotated by:
Schilling, Carol

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Open Wound is a novel crafted from the extensive documents of an unsettling, little-known, yet remarkable episode in the history of medicine.

In the summer of 1822, Dr. William Beaumont was practicing medicine at a rugged military outpost on Mackinac Island in Lake Huron, part of the Michigan territory.  His assignment as Assistant Surgeon, US Army represented about the best circumstances he could expect from his training as a medical apprentice without a university education.  In addition to soldiers and officers, Beaumont sometimes attended patients from the American Fur Company, whose warehouses shared the island's harbor.  On June 6, an accidentally discharged gunshot cratered the abdomen of an indentured, French-speaking Canadian trapper.  Fortunately for him, Beaumont served during the War of 1812 and knew how to care for devastating wounds.   With the surgeon's medical attention and willingness to house and feed the hapless trapper, Alexis St. Martin's body unexpectedly survived the assault.  But his wound didn't fully heal.  As a result, it left an opening in his flesh and ribs that allowed access to his damaged stomach.  Through the fistula, Beaumont dangled bits of food, collected "gastric liquor," and made unprecedented observations about the process of digestion.  

His clever and meticulously documented experiments, conducted on the captive St. Martin over several years, corrected prevailing assumptions about digestion.  Once thought to depend on grinding and putrification, normal digestion, Beaumont observed, was a healthy chemical process.  Any signs of putrification or fermentation indicated pathology.  In 1833 Beaumont published his thesis on the chemistry of digestion in Experiments and Observations of the Gastric Juice and the Physiology of Digestion.  Shortly before completing the book, he received a temporary leave from his military service to restart his research in Washington.  But to carry on his project, Beaumont had to persuade St. Martin-who entered and exited his physician-researcher's life several times before-to leave his growing family in Canada and once again become a research subject.  St. Martin does return, with pay, and briefly accepts his role.  But he also confronts Beaumont about whether the long confinement on Mackinac Island was more necessary for the patient's survival or the doctor's research agenda.  Or for the doctor's subsequently improved station in life. 

Although some of Beaumont's academically trained colleagues found fault with his methodologies, the farmer's son and frontier doctor did achieve a gratifying level of professional accomplishment and wealth.  To enjoy them, he had to set aside humiliations he experienced along the way, accept his lot after military service as an ordinary practitioner in St. Louis,  and weather an unforeseen turn near the end of life.    

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Frida and the Miscarriage

Kahlo, Frida

Last Updated: Apr-26-2012
Annotated by:
Woodcock, John

Primary Category: Visual Arts / Painting/Drawing

Genre: Lithograph

Summary:

A female figure stands facing us, unclothed, her left side darker than her right, occupying the middle of the frame. She is surrounded with images from the process of human reproduction. The largest of the former is the well-formed male fetus in the frame’s lower left, which is connected by a thin umbilical cord wrapped around the figure’s right leg to a fetus in an early stage of development in the figure’s abdomen, which we see as if by x-ray.

Tear-shaped droplets of blood drip down the figure’s left leg and soak into a dark mass in the earth, where they nourish the roots of several plants. A tear rolls down each of the figure’s cheeks. Just above her to her left is a weeping crescent moon. Below it is an artist’s palette that the figure holds up with a second left arm.

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A Murderous Procession

Franklin, Ariana

Last Updated: Jan-04-2012
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1176, King Henry the II of England persuades the physician Adelia Aguilar to accompany his daughter, Princess Joanna, on her long journey from England to marry the King of Sicily. Adelia studied medicine in Salerno, but in the disbelieving, intolerant world of Northern Europe, she must hide her skills. She masquerades as the assistant of her own eunuch assistant, the Arab Mansur.  Her task is to protect and preserve the health of the princess. The King convinces her to make the journey by holding Adelia’s own infant daughter as a hostage.

The procession is troubled by a murderer, who could be trying to attack the princess or her doctor. Joanna falls ill, and Adelia diagnoses appendicitis, and then performs an operation to save her life. The question then arises whether or not her future husband will accept a bride with a surgical scar.

As in the other three novels, Adelia also uses her medical skills to solve the murders—a forensic pathologist avant la lettre. 

 

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This short, gripping book describes Taylor's massive stroke, a burst blood vessel in the left side of her brain. Ironically, she was at 37, a neuroanatomist at Harvard, well versed in the anatomy and function of the brain. Her knowledge allowed her to understand from the inside her rapid loss of mental function and, with treatment, her very long (some eight years) recovery to health and, once again, professional activity.

Taylor presents an overview of brain structure and function, emphasizing the different roles of the left and right hemispheres. Since her left hemisphere was damaged and needed to be "rebuilt," in her term (learning to read, to dress herself, to drive a car, to think), she had plenty of time to explore her right brain and understand its wisdom and peace. This is her insight: our culture prizes the admirable but often frantic work of the left brain, putting us in stressed, competitive modes of thinking and acting, often aggressive and argumentative. "My stroke of insight," she writes, "is that at the core of my right hemisphere consciousness is a character that is directly connected to my feeling of deep inner peace" (page 133). Both sides of the brain have their strengths and uses, but she especially enjoys the spiritual and humane aspects of the right brain and, by extension, invites her readers to consider these resources for themselves and for the larger society.

Taylor credits her mother's care for much of the recovery, although it is clear between the lines that Taylor herself worked hard with various therapists (speech, massage, acupuncture). Despite the severity of her injury and the surgery, she appears to have returned to professional work at a high level, fully recovered and very grateful.

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Summary:

Johanna Shapiro, Director of the Medical Humanities Program at University of California Irvine School of Medicine, brings her considerable skills and experience as medical educator, writer and literary critic to this unique volume of medical student poetry. Shapiro collected over 500 poems by medical students not only from her home institution but also from other US medical schools and performed a content and hermeneutic analysis. As Shapiro carefully details in her methodology section, she treats "poetry as a form of qualitative data, and [therefore] techniques of analysis developed for other sources of qualitative data (such as interviews, focus groups, and textual narratives) can be applied to an understanding of poetry." (p. 42)

Relying on the work of Arthur W. Frank (see The Wounded Storyteller), Shapiro devises a typology of student poems: chaos, restitution (and anti-restitution), journey, witnessing, and transcendence (this last category was not Frankian in origin). These categories are developed and explicated in Chapter 2: Functions of Writing for Medical Students. As the author notes, poems traverse the boundaries between types; nonetheless, the framework of the analysis rests with this typology. Further, Shapiro explores the metaphors of topography (illness as a foreign land) and quest (student on a heroic, however tentative or confused, journey) throughout her study.

The book contains many fully reproduced medical student poems, contextualized with academic theory on medical education. Hundreds of references, particularly in the fields of narratology and medical education, are cited. After three chapters of theory and methods, eight topics are explored using the outlined analytic tools: anatomy class, becoming a physician, patient experience, doctor-patient relationship, student-patient relationship, social and cultural issues, death and dying, love and life. Prefacing each of these topics is a scholarly essay providing historical and research foundations; every chapter concludes with a summation.

Within the chapters are examples of poems, not only organized by typology, but also by content. For instance in the patient experience chapter, the topics are: "patient pleas for empathy and compassion," "patient fears and suffering," "stigmatized voices," "vulnerability/courage of child patients," and "personal experiences of illness." Within each topic/subtopic, different poems are highlighted and fully analyzed. Additionally, other poems, not reproduced, are quoted as illustrative examples. Summary arguments are provided at the conclusion of each chapter as well as in the final chapter: "Strangers in a Strange Land: What Matters to Medical Students on Their Journey and How They Tell About It."

Although Shapiro states that her purpose "is not to address the literary and aesthetic attributes and value of the poems", she also notes "when students write authentically about their own experience, the results are uniformly moving, compelling and impossible to ignore." (pp 44-5) Indeed many of the poems are rewarding to read not only for content but also for word choice, word play, imagery and narrative line. For instance, in "Ode to the Peach" Brian McMichael explores the senses Neruda or Pollitt-like: "you invite me with / your voluptuous curves / your feminine little cleft". (p 236) Another example is the humorous, self-deprecating "Piriformis" by Curtis Nordstrom relating an early clinical experience by a medical student who hopes against hope that the patient's presenting complaint will require the student to demonstrate his acumen. Unfortunately the sum total of the student's knowledge base is limited to the location of the piriformis muscle; both the student and patient are "so screwed" when, "Alas, the patient presents with / an upper respiratory infection." (p. 16)

Shapiro's sensitivity and generosity of spirit vis-à-vis the medical student experience are evident throughout the volume. She concludes that "what may be most noteworthy about the analysis of these poems is that, amidst their own difficulties and fears, time and again these students reported engaging deeply with their patients." (p 259) She hopes that medical educators will be encouraged to support "in solidarity" the "idealism and high aspirations" expressed in these student poems. (p. 260)

In a postscript, Shapiro reveals her own experiences as a poet-patient. After noting that "[m]edical students are mostly annoyingly healthy, energetic, smart, and capable young adults who like order, structure, and control", (p 261) she also acknowledges how frequently students grapple with the topic of death and dying in their poems. That her poems emerged from advising a student creative writing group demonstrates how poetry can be renewing and vital not just to the student, but to the educator as well.

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