Showing 461 - 470 of 740 Nonfiction annotations
Joan Didion has written a very personal, powerful, and clear-eyed account of her husband's sudden and unexpected death as it occurred during the time their unconscious, hospitalized daughter was suffering from septic shock and pneumonia.
Quintana, the couple's 24-year-old adopted child, has been the object of their mutual care and worry. That John Gregory Dunne, husband and father, writer and sometime collaborator, should collapse from a massive, fatal coronary on the night before New Year's Eve at the small dinner table in their New York City apartment just after their visit with Quintana can be regarded as an unspeakable event, beyond ordinary understanding and expression. "Life changes fast . . . in the instant. You sit down to dinner and life as you know it ends" (3).
As overwhelming as these two separate catastrophes are, the account provided by Didion evokes extraordinary descriptions of the emotional and physical disorientations experienced by this very lucid, but simultaneously stunned and confused wife, mother, writer dealing with the shock of change. Her writing conveys universal grief and loss; she spins a sticky filament around the reader who cannot separate him or herself from the yearlong story of difficult, ongoing adjustment.
This densely packed book follows Oschman's Energy Medicine: The Scientific Basis (2000, see annotation) with applications to medical treatment and--very briefly--human performance (athletics, dance, music). Oschman, a cell biologist, shows how electroencephalograms, electrocardiograms, and pulsing electromagnetic fields (which can heal broken bones) are accepted medical technologies, while theoretically related Healing Touch, Therapeutic Touch, Qi Gong, Reiki, Reflexology, massage, etc. are widely used and effective but generally (and inaccurately) considered to be alternative medicine.
According to Oschman, contributions from quantum physics explain that the energies of the body are subtle, instantaneous, and highly efficient in regulation and healing at the cellular level. The body is best understood as a living crystal, which can semiconduct energy, translate physical energy (such as touch) to piezoelectricity, and maintain coherence and continuity. Given our evolutionary heritage, we can sense from healers their intention, empathy, and healing energy. Our bodies heal themselves with energy provided by both standard and nonstandard medicine.
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.
This is a comprehensive social history of European (or "Western") attitudes toward death and dying over the last thousand years. Ariès organizes his history into five sequential cultural constructs, each of which conveys the meaning of death to the individual and community, as well as the social institutions around death and dying, during a different period of Western history, beginning in the Middle Ages.
Cultural responses to death must begin by acknowledging that death is mysterious and overwhelming; a wild beast; a meaningless monster. Death lurks at the edge of our consciousness, ready to destroy us and demolish whatever meaning we attribute to our lives. In medieval Europe Christianity had domesticated this monster by establishing a comprehensive set of beliefs and practices that Ariès calls the "tame death." Death was merely a transition to eternal life. The individual was understood as an integral part of the community and not as autonomous and isolated. Therefore, death and dying were communal events, supported by specific prayers and practices (i.e. ars moriendi) that "tamed" the unknown.
In the centuries that followed, Ariès's "tame death" evolved through five stages into the radically different cultural conception of death that characterizes Western society--especially in its American form--today. These changes result largely from the gradual replacement of community-oriented personal identity with today's radical individualism; and the gradual sequestration of death to a position behind the scenes, so that dying and death become remote from ordinary experience.
In today's world we encounter "invisible death," a somewhat paradoxical name because its invisibility allows the savage beast free rein. Death is no longer "tame" because we deny its existence so effectively we no longer develop personal and communal resources to give it meaning. Death's invisibility enhances its terror; our culture's loss of spirituality enhances death's meaninglessness.
A chronicle of the author's perceptions, thoughts, memories, and personal relationships during the months after he was diagnosed as having AIDS. Brodkey's mind and prose are as sharp as a knife's edge. Beginning with the desperate struggle for breath that signaled pneumonia and, retrospectively, "how my life ended. And my dying began," continuing with the reactions and decisions of himself and his wife, the first half of the essay spins out an observant, introspective, cerebral, even amusing account of his particular experience.
But AIDS is often a disease associated with more emotional baggage than other fatal illnesses, and in Brodkey's case we learn that he traces both his dying and his homosexual experiences to "the major drama of [his] adolescence", daily sexual abuse by his adoptive father, with the implied knowledge and acquiescence of his mother. Writes Brodkey, "I experimented with homosexuality to break my pride, to open myself to the story." "Now I will die disfigured and in pain."
This is the last published entry in the journal kept by author Harold Brodkey, before he died of AIDS on January 26, 1996. Brodkey, ever the flamboyant writer, began a record of his diagnosis with AIDS and "my passage into nonexistence" in the pages of The New Yorker (see also earlier journal entry, Dying: An Update, annotated in this database).
In this last entry he focuses intensely on the end of consciousness that looms ahead. In spare poetic phrases he describes what he is attempting to grasp-- " . . . this wild darkness, which is not only unknown but which one cannot enter as oneself." He reflects also on memory, medication, creature comforts, family history, the legacy he leaves, and describes with amazement that he feels happy.
A desperate patient visits a renowned oncologist with hope for a miraculous cure of his kidney cancer. The patient, a venture capitalist, doesn't want to die--can't face his death. He is willing to take whatever risk is necessary to survive. After a grueling course of experimental treatment and an expected period of remission, the cancer returns, leaving the patient (according to the physician-author) with an awful ending to his life--a death filled with regret.
What is revealed as Groopman deliberately walks "along the milestones" of his patient's life is more than the patient's story, however. For in addition to a chronicle of the disease's effect on his patient, the physician himself, and his concerns about the proper use of his knowledge and powerful tools also are revealed.
Atul Gawande, a surgical resident at Harvard Medical School, asks in his well written essay, "when you see your patient making a grave mistake, should you simply do what the patient wants?" (p. 86) He answers this question by sharing a number of cases from his training that suggest that the orthodoxy of 'absolute respect for patient autonomy' may interfere with good patient care.
Gawande also gives the reader insight into the difficulties that young residents especially have in developing an artful approach to medical practice. He suggests that part of respecting autonomy is (at appropriate times) allowing patients to cede that autonomy to an authority figure. He argues further that, "patients frequently don't want the freedom that we've given them." (p. 89)
He also shares in his essay a personal experience with his youngest child. She was a premature baby who at eleven days old ended up in the intensive care unit. He was glad to put the ultimate decision(s) of how to care for his daughter in the hands of physicians--"they could live with the consequences, good or bad." (p. 90)
A chance meeting with her former and most compassionate fertility doctor brought Wendy Wasserstein (at age 48, and after 8 years of effort) back to his fertility clinic. Two weeks later she got the news that she was pregnant, and six months after that, just as she was getting ready to tell her friends "that the twenty pounds I had gained were not the result of bad habits and anxiety," she developed preeclampsia and was hospitalized.
What follows in this ’Annals of Motherhood’ memoir is an account of her hospitalization; her subsequent delivery 16 days later of 1lb., 12oz. daughter, Lucy Jane (Lucy’s waving hand sonogram picture reminded Wasserstein of "Lucy in the Sky With Diamonds"); and her separation from Lucy, who spent two months in the neonatal intensive care unit.
The italicized sentence under the title of this New Yorker essay summarizes it well: "Wanted: Highly accomplished young women willing to undergo risky, painful medical procedure for very large sums." Mead traces the phenomenon of women selling their eggs through the experience of Cindy Schiller, a 26-year-old law student who was "donating" her eggs for the third time.
In addition to Schiller's observations, the article is full of information about the clinical dimensions of egg donation--the donor shuts down her ovaries so that none of her eggs ripen and none of her follicles develop, followed by injections of follicle-stimulating hormones, followed by eggs that are "sucked out, one by one," and whisked away to be fertilized in a petri dish. Most of the article addresses the legal and ethical dimensions of egg donation, the hopes and expectations of those seeking donors, and the new-found marketing strategies of the American fertility industry.