Showing 41 - 50 of 94 annotations tagged with the keyword "Tuberculosis"

The Magic Mountain

Mann, Thomas

Last Updated: Aug-31-2006
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Hans Castorp makes a visit to the International Sanitarium Berghof in the Swiss Alps to rest and visit his cousin, Joachim Ziemssen. There he meets other patients from around Europe, all with different opinions about life and its meaning. Before his three week visit is up, Hans develops tuberculosis and ends up staying seven years. He leaves only when the Sanitarium gets news of the assassination of the Archduke that will begin World War One.

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

In their introduction to this anthology, the editors write that their goal is "to illustrate and to illuminate the many ways in which medicine and culture combine to shape our values and traditions." Using selections from important literary, philosophical, religious, and medical texts, as well as illustrations, they explore, from a historical perspective, the interactions between medicine and culture. The book is arranged in nine major topical areas: the human form divine, the body secularized, anatomy and destiny, psyche and soma, characteristics of healers, the contaminated and the pure, medical research, the social role of hospitals, and the cultural construction of pain, suffering, and death.

Within each section, a cluster of well-chosen (and often provocative) texts and drawings illuminate the topic. Specifically, literary selections include poems by W. D. Snodgrass ("An Envoi, Post-TURP"), William Wordsworth ("Goody Blake and Harry Gill: A True Story"), and Philip Larkin ("Aubade"); and prose or prose excerpts by Robert Burton ("The Anatomy of Melancholy"), Zora Neale Hurston (My Most Humiliating Jim Crow Experience), Sara Lawrence Lightfoot ("Balm in Gilead: Journey of a Healer"), William Styron (Darkness Visible: A Memoir of Madness), George Orwell ("How the Poor Die"), Ernest Hemingway (Indian Camp), and Paul Monette (Borrowed Time: An AIDS Memoir). (The full texts of the pieces by Hurston, Styron, Hemingway, and Monette have been annotated in this database.)

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Medicine Stone

Coulehan, Jack

Last Updated: Aug-31-2006
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Jack Coulehan’s fourth poetry collection brings together new and previously published poems in a well-organized and handsome volume. As a reader who has long followed this author’s career, I found some of my favorite poems here (Irene, "Lima Beans," "For Oysters Only," "Six Prescriptions," "Sir William Osler Remembers His Call on Walt Whitman," "Cholera," and Medicine Stone) as well as compelling newer work: "The Shoe," "Work Rounds: On Lines by Tomas Transtromer," "Definitions," and "Decatur in Winter."

The collection is divided into three sections: the first presents poems about "doctoring" and, a Coulehan trademark, poems from a patient’s point of view; the second is a remarkable assembly of Coulehan’s poetic commentaries on Chekhov’s life and writing; the third features poems about a variety of personal relationships.

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Annotated by:
Willms, Janice

Primary Category: Literature / Plays

Genre: Play

Summary:

A theatre classic about a dysfunctional family, whose summer on the shore is flawed by alcohol, tuberculosis, drug addiction, and denial of all of the above. Considered by biographers to be highly autobiographical, the plot of the play centers about the progressive retreat by wife and mother into drugs as her husband and sons pretend they do not see. Alcohol abuse among the men of the family contributes to the rising tension in the work, as does increasing concern about one son’s tuberculosis. The action and psychological power of the play accelerate steadily through the first three acts, then climax with recognition of the brutal realities in the final act.

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Illness as Metaphor

Sontag, Susan

Last Updated: Aug-29-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Sontag argues against the use of illness as metaphor. She states her main point on the first page of this long essay : "The most truthful way of regarding illness--and the healthiest way of being ill--is one most purified of, most resistant to, metaphoric thinking."

Tuberculosis and cancer serve as her two central examples of the human tendency to use metaphoric thinking about illness. In the 19th century, tuberculosis was considered a disease of passion, of "inward burning," of the "consumption" of life force. Sufferers were thought to have superior sensibility; the illness purified them of the dross of everyday life. The romantic image of the TB sufferer became "the first widespread example of that distinctively modern activity, promoting the self as an image" (p. 29). Metaphoric thinking about TB declined in the early part of the 20th century as the disease succumbed to science and public health measures.

Cancer has now become the predominant disease metaphor in our culture. Cancer is considered a disease of repression, or inhibited passion. The cancer sufferer characteristically suppresses emotion, which after many years emerges from the unconscious self as malignant growth. As in Auden’s poem, Miss Gee, reproduced on page 49, (see annotation in this database): "Childless women get it, / And men when they retire . . . . " Sontag uses the 19th century view of insanity as another example of malignant metaphoric thinking, while metaphor related to syphilis was somewhat more benign. She concludes the essay with an eloquent prediction that, as we learn more about the etiology and treatment of cancer, its metaphorical system will die on the vine. (I wonder if Sontag would consider my "die on the vine" an appropriate metaphor here?)

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Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

This work is an adaptation and abridgment of a classic work of Chekhov scholarship by Vladimir Kataev published in Russia in 1979 and presented here in English for the first time. Professor Kataev is concerned primarily with Chekhov’s perspective and methodology, the manner in which Chekhov looks at the world and, hence, the kinds of stories he tells and the methods by which he tells them.

The characteristic Chekhovian perspective first appears in recognizable form in stories that Chekhov wrote in his breakthrough years of the mid-1880s, yet it continued to develop and deepen throughout his writing career. Thus, If Only We Could Know is arranged chronologically. In each chapter the author discusses one or more stories or plays, using them as grist for his topical mill, beginning with "Kashanka" (1887) and ending with The Bishop (1902) and The Cherry Orchard(1903).

According to Kataev, the key to understanding Chekhov is to understand his epistemology or philosophy of knowledge. Basically, in Chekhov’s world the characters do not have access to a privileged perspective or to ultimate truth. "The relative, conditional nature of ideas and opinions, and of stereotyped ways of thinking and behaving; the refusal to regard an individual solution as absolute; and the baselessness of various claims to possession of ’real truth’: these are constants in Chekhov’s world." (p. 164) Thus, the characters communicate poorly and often end up inadvertently causing pain, or sabotaging their own life projects.

Nonetheless, Chekhov’s vision is not pessimistic. Chapter 16, "Chekhov’s General Conclusions," summarizes Kataev’s analysis of the author’s overall approach. Chekhov’s conclusions "may be negative {no one knows the real truth), or affirmative (seeking the truth is an inalienable part of human nature), or they may take the form of indicating the criteria and conditions necessary for establishing real truth." (p. 168) Thus, Kataev expresses here, as well as in his analyses of individual works, the dialectical (my term--JC) relationship between the facts of Chekhov’s stories (i.e. failed beliefs, failed communication, missed opportunities) and his compassion for human nature that searches endlessly for love and meaning in life.

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Doctor Zhivago

Pasternak, Boris

Last Updated: Aug-09-2006

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This complex novel is difficult to summarize. The main characters are introduced separately. We meet Yurii Andreievich Zhivago (Yura) when he is ten, at his mother’s funeral. He goes on to study medicine, write poetry, and marry a young woman named Tonya. We first encounter Larisa Foedorovna (Lara) as the adolescent daughter of a widow who has been set up in a dressmaking business by Komarovsky. Komarovsky later harasses and seduces the young woman. In her anger and guilt, the impulsive Lara tries to shoot Komarovsky at a grand Christmas party, but she misses and inadvertently wounds another man. Subsequently, Lara marries Pavel Pavlovich (Pasha), her childhood sweetheart.

All this takes place against the background of social upheaval in pre-World War I Russia. When the war begins, Yura joins the Army medical corps. Pasha leaves Lara and their daughter Tanya to enlist in the army. When Pasha is reported lost behind enemy lines, Lara becomes a military nurse in order to search for him. Thus, Lara and Yura meet at a hospital where his wife Tonya has just delivered a baby boy. Lara and Yura feel attracted to one another, but neither one expresses it. At this point the Revolution breaks out in Petersburg.

As the fighting rages, Lara and Yura are posted to a hospital in a small town, where Yura struggles with his feelings. When he reports his friendship with Lara, Tonya assumes incorrectly that they have become lovers. Over the winter there are food shortages and the threat of a typhus epidemic. As the war ends, Yura returns home to Moscow, and to his old job at the hospital, but his co-workers are suspicious of him. Influenced by Bolshevism, they dislike his use of intuition instead of logic. The family resolves to travel to the Urals. Amidst Marxist rebellions, Yura's family finds room in a cargo train. During the long train ride, Yura reflects on the suffering of peasants and prisoners caused by the revolution. He shares the desire for equality and freedom, but is disenchanted by the revolutionaries' pedantic, insensitive opinions.

The family safely arrives in the Urals and set up a farm. During the long winters, Yura returns to writing poetry. While visiting the local library, he re-encounters Lara. They begin an affair, sharing a common joy in a fully-lived existence. Lara is aware that her husband is still alive, having become a feared member of the Red faction under another name (Strelnikov). Yura resolves to tell his wife about his unfaithfulness and to ask forgiveness, but as he rides home, he is kidnapped by a faction in the Civil War (the Reds) and forced to serve as their doctor.

After some years, Yura escapes from the Reds and walks back to find Lara, who still lives in the same place.  To escape being informed upon, Lara and Yura flee to the farm house where Yura and his family once lived. Again, Yura turns to his poetry, expressing his fears, courage, and love for Lara. He learns that Tonya and a new baby daughter have been deported from Russia. One night, Lara's old lover, Komarovsky, appears and tells them that the triumphant revolutionaries know where they are and will inevitably kill them both. He offers to take them abroad, where Yura could rejoin his family. Yura refuses to accept help from Komarovsky. To save Lara's life, though, he tells her that he will follow them out of the country, but actually remains behind. Alone, he turns to drink.

One night Lara's husband, Strelnikov (Pasha), who is fleeing the new government, arrives. When he learns of Yura and Lara’s love, he leaves the house and shoots himself. Yura then goes to Moscow where he strikes up an affair with Marina and becomes a writer of literary booklets.  His brother finds him a job at a hospital, but on his way to his first day at work, he dies, presumably of a heart attack. Lara, who had been living in Irkutsk, has returned to Moscow and wanders accidentally into the house where his body lies waiting for burial. After several days, Lara disappears, presumably captured and sent to a concentration camp.

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The Dead Mother

Munch, Edvard

Last Updated: Jun-28-2006
Annotated by:
Bertman, Sandra

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

With her back turned to her mother who lies in bed, dead, a young girl, eyes wide in disbelief, holds her hands to her ears as if to block out the reality and the stillness. An aura of suspension, incomprehensibility, or unearthly silence begs the question: is she truly calm, or screaming on the inside?

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Wishbone Dance

Downie, Glen

Last Updated: Apr-24-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Subtitled "New and Selected Medical Poems," this volume includes poems on illness and healing from Downie's three previous collections, along with several new poems. A longer piece called "Learning Curve Journal" serves as a framework for the book.

Beginning with the desperate voice he hears on his first night as a "suicide line" volunteer, the poet reveals the shape of his own medical learning curve, moving poem by poem from "Orientation" through the realm of "Patient Teaching" and "Teaching Rounds" to "Pronouncing Death." Among the many strong poems in this collection are "Diagnosis: Heart Failure," "Louise," "Sudden Infant Death," "Wishbone," "Living with Cancer," and "Ron and Don."

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What Patients Taught Me

Young, Audrey

Last Updated: Jan-17-2006
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This collection of stories describes "a medical student's journey" (the subtitle) through the difficult terrain of clinical education. In Audrey Young's case, this is also a geographical odyssey from Seattle to Swaziland to Pocatello, Idaho, as she completes her University of Washington clinical rotations and electives. In one sense the main characters of these narratives are the patients the author encounters in clinics and hospitals. As she writes in the Preface, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book."

In another sense, of course, Dr. Young herself is the central character of these stories; this is an account of her journey into doctoring. The author first takes us to Bethel, a Yupik Eskimo town on the Bering seacoast of Alaska, where she had her initiation into clinical experiences in the form of a summer preceptorship. There she learns that patients are far different from textbook examples, as she confronts the social and cultural factors that influence illness and its amenability to treatment. We follow the author to assignments throughout the WWAMI network. WWAMI is the University of Washington's decentralized clinical training program (Wyoming, Washington, Alaska, Montana, and Idaho).

In Spokane she delivers a baby for the first time, supervised by an opera-loving attending physician. In Pocatello she takes care of her first critically ill neonate. In Missoula her life becomes "one of resigned solitude" in her internal medicine clerkship, where she experiences sleep deprivation and experiences sunlight only "through dusty windows."

During her fourth year, the author finds herself treating desperately ill AIDS patients without a supervising physician (he had gone to Zaire for a funeral and might be back the following week) and also without anti-retroviral drugs. However, it is in Swaziland that she learns the deep power and dignity of medicine, as exemplified by a patient who invites her to a dinner in her honor that requires killing one of his precious chickens.

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