Showing 471 - 480 of 606 annotations contributed by Coulehan, Jack
This is a collection of stories and sketches by a practicing neurologist. Most of the material is clinical and autobiographical. In "Mrs. Bachman" a new patient enters the doctor's office, carrying a thick stack of medical records. It all started in 1946 and no doctor has ever found the explanation of her condition. Meanwhile, the doctor is wearing contact lenses for the first time. His eyes begin to tear. Mrs. Bachman thinks that he is crying over her misfortune. She consoles him, "I want you to know that you are the kindest, most sympathetic man I have ever met."
In "Intensive Care" an elderly woman is agitated after a seizure. The staff try unsuccessfully to calm her. Finally, her husband approaches and kisses her. She settles peacefully and they hold hands.
The doctor in "Continuing Medical Education" finally discovers metastatic breast cancer as the cause of a psychotherapist's neck pain, long after he and other physicians had told her again and again that the "driving mechanism" of her chronic pain was "unresolved anger and frustration." In a longer essay, "The Narrow Bridge," the author reflects on the meaning of healing, "Healing helps us find a place in this world for ourselves and for each other."
Lol Stein is 19 years old and engaged to be married. At the town ball, her fiance leaves her and runs away with a beautiful stranger. Lol withdraws into herself, but seems not to feel much pain. In fact, she subsequently lives her life in a dull, almost-numb state, never really interacting with people nor experiencing feelings (pain or joy). She falls into a loveless marriage and has children.
After ten years she encounters a school friend, Tatiana Karl, who had been with her at the town ball. Tatiana also has a loveless marriage, but has taken a lover, the young doctor Jacques Hold. There is a strong attraction between Lol and Jacques and they have an affair, but she remains peculiarly abstracted and estranged from life.
William Morton first introduced ether anesthesia in 1846. This was followed shortly by nitrous oxide and chloroform. Within a few years, surgical anesthesia was being used throughout the United States. However, widespread acceptance did not mean universal usage. Physicians and surgeons debated the risks and benefits of anesthesia. Anesthesia was thought to be dangerous. Some argued that pain was a necessary part of life, that it made people stronger, and/or that it was a punishment from God. Others argued that anesthesia constituted an abuse of medical power.
Surgeons took care to select appropriate patients for anesthesia, while performing surgery without anesthetics on others. Women, people of higher social and economic classes, and people of the white race were thought to be more sensitive to pain than men, the poor, and Negroes and American Indians. Likewise, the young experienced pain more than the elderly. Certain procedures (e.g. major limb amputations and prolonged tissue dissection) were also thought to require more anesthetic than others (e.g. natural childbirth or ENT surgery). These beliefs carried over into practice, as evidenced by records from the Massachusetts General Hospital and other hospitals in the mid-19th century.
Consuelo Camacho Ramos (Connie) was placed in Bellevue Hospital because she abused drugs and alcohol after the police killed her blind, African-American lover. She was accused of child abuse and her daughter was put up for adoption. When the novel opens, Connie has been released and is living in New York with little money and no hope of a job.
She begins to be visited by an individual from the year 2137 who calls "himself" Luciente. He communicates with Connie mentally and she visits his world in the same way, experiencing everything without moving her body. Luciente’s community is not divided along gender lines. Indeed, "he" turns out to be what Connie calls "female," though the name means nothing in this future world.
Reproduction takes place in an artificial environment in which fetuses are delivered at ten months to improve their strength. Every child has three "mothers," but is raised by the entire community. Luciente’s community is fighting a war against forces that want people to live in a hierarchical system in which women all become prostitutes, victims of a larger, manipulating force, a battle Connie also fights in her world.
When Connie breaks the nose of her niece’s pimp, he takes her back to Bellevue. No one believes that she did not provoke the attack. They assume she is mad. In an exemplary moment, the nurses who attend to Connie talk over her head about how dirty these mad people are. Left tied to a bed for many hours, Connie has urinated on herself and has been unable to wipe her nose. The nurses ignore every word she says.
Connie learns to manipulate the system, not swallowing her pills and telling her counselor that indeed she was sick but now feels much better. She draws the line, however, when she is chosen to be a subject in an experiment. The doctors plan to implant electrodes into the patients’ brains to control the patients’ emotions. Connie kills the doctors by slipping poison into their coffee.
As a young woman, Fermina Daza kept a lengthy and passionate correspondence with Florentino Ariza, who was socially her inferior, but was desperately in love with her. They became engaged through their letters, exchanged through hiding places and telegrams in code.
But one day, when Fermina Daza comes close to Florentino Ariza in the market, she feels suddenly ill and tells him it was all a mistake. Instead, she marries Dr. Juvenal Urbino, a European-educated perfectionist, who falls in love with her on a medical visit. Their tumultuous but affectionate marriage lasts over fifty years, through a civil war, cholera outbreaks and the Doctor's brief affair with a patient. Juvenal Urbino distinguishes himself by instituting policies to combat cholera. He dies, falling from a tree as he attempts to catch his pet parrot.
Florentino Ariza comes to the wake. He is now about seventy and controls a wealthy shipping operation. After the other guests leave, he approaches Fermina Daza, saying, "I have waited for this opportunity for more than half a century, to repeat to you once again my vow of eternal fidelity and ever-lasting love."
She throws him out of the house, but continues to think of him. He becomes a regular visitor. Finally, they take a boat ride together, down the rivers that are being slowly drained and poisoned, listening for the cries of the manatees. They do not return, but prepare to sail on forever.
Jules, the Prince of Bramante, has been disappointed in his hopes of having a male heir. His oldest son and wife produced only a girl child, then died. Jules decides to have their child, Gabriel, raised as a boy. She is to be instructed that women are mindless slaves to men, born to suffer, so that when, at adolescence, her sex is revealed to her, she will decide to accept instead the sex her grandfather has given her.
When she is told the truth, Gabriel does not abandon her male costume or demeanor, but she does want to make sure that Astolphe, her cousin who should rightfully inherit the family fortune, has all the money he needs. She sets out to find him. They meet in a bar and before Astolphe learns her identity, they fight with some thieves and are taken to prison. In prison, they swear life-long affection and decide to travel together, winding up in Venice for the carnival.
Astolphe, who has long been disturbed by his attraction to the gentle Gabriel, asks her to dress as a woman to attend a masquerade. She agrees, and he is dumb struck by her appearance. Every man at the ball falls in love with her and when Astolphe reveals that (as he believes) she is really a man, many are astonished. When Astolphe returns home that night, he catches a glimpse of Gabriel undressing and realizes that she is a woman. They become lovers.
Gabriel dresses as a woman and becomes submissive. But Astolphe is unable to achieve the higher love to which Gabriel aspires. He is consumed by jealously, finally locking Gabriel in her room. She escapes and leaves him, returning to her male identity. The story ends when Gabriel is murdered by a man hired by her grandfather to cover up her disobedience. Sand revised the play in 1850 and made Gabriel into a much less independent character named Julia.
The story takes place in the men's cancer ward of a hospital in a city in Soviet Central Asia. The patients in Ward 13 all suffer from cancer, but differ in age, personality, nationality, and social class (as if such a thing could be possible in the Soviet "classless" society!). We are first introduced to Pavel Rusanov, a Communist Party functionary, who enters the hospital because of a rapidly-growing neck tumor.
We soon learn, however, that the book's central character is Oleg Kostoglotov, a young man who has recently been discharged from a penal camp and is now "eternally" exiled to this particular province. Only two weeks earlier, he was admitted to the ward in grave condition from an unspecified tumor, but he has responded rapidly to radiation therapy. Among the doctors are Zoya, a medical student; Vera Gangart, a young radiologist; and Lyudmila Dontsova, the chief of radiation therapy.
Rusanov and Kostoglotov respond to therapy and are eventually discharged; other patients remain in the ward, get worse, or are sent home to die. In the end Kostoglotov boards a train to the site of his "eternal" exile: "The long awaited happy life had come, it had come! But Oleg somehow did not recognize it."
This book, which is subtitled "Seven Paradoxical Tales," contains seven of Oliver Sacks' clinical stories of persons whose unusual neurological deficits teach us something about the way the brain (and, therefore, the mind) works. In "The Case of the Colorblind Painter" an artist learns to adapt to a completely black-and-white world after sustaining trauma to his occipital lobe.
"The Last Hippie" portrays a man whose ability to form new memories was destroyed by a massive midline brain tumor; he still "lives" in the 1960's. "A Surgeon's Life" depicts a Canadian surgeon with Gilles de la Tourette Syndrome, showing how he is able to live as a respected member of the community and practice surgery despite this disabling condition. "To See and Not See" tells the tale of a man in his 50's who is suddenly able to see after being blind since early childhood.
In "The Landscape of His Dreams" Sacks introduces a painter who, after a serious illness in the 1960's, apparently developed extraordinary and persistent "waking visions" of Pontito, his hometown in Italy. For many years he has obsessively painted remarkably accurate scenes of Pontito. "Prodogies" and "An Anthropologist on Mars" both deal with autism. The first tells of an autistic boy from England who has remarkable skill in visual memory and drawing; the second is about an autistic woman with a Ph.D. in animal science, who teaches at Colorado State University.
In 1938 a 13-year old boy lives through a late summer day in a small town in Tidewater, Virginia. As he delivers the day’s newspapers for Quigley, the local drugstore owner, his mother lies at home dying of cancer. She screams in unrelenting pain, but Dr. Beecroft won’t allow her to have a higher dose of morphine--"Jeff, I just don’t think I can give her any more." He does offer to try a bit of cocaine, but she soon sinks into a terminal coma.
Through the boy’s eyes and memory, we learn of the tension between husband and wife (both well educated people) and about their life in his home town among ignorant Rednecks. As German troops are massing along the border of Czechoslovakia, the boy’s mother dies. His father greets the sympathy of the local clergyman and his wife with a violent tirade against God (if he exists).
This study explores the history of physician-patient relationships, especially as it relates to the ascendancy of science in medicine. The book begins by describing traditional physician-patient relationships in the 18th century. The focus, however, is on the "modern" doctor (beginning in the 1880's) and the "postmodern" doctor (beginning in the 1950's).
The author describes the transition from modern to postmodern doctor and a corresponding transition from modern to postmodern patient. A "sympathetic alliance" between physician and patient was essentially a development of the modern period (1880's - 1950's).