Showing 491 - 500 of 648 annotations tagged with the keyword "Disease and Health"

Typhus

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

An army lieutenant named Klimov is returning home to his sister and aunt in Moscow and falls ill while on the train. His mouth is dry, his brain turns to mush, and he keeps hearing a strange voice cry, "Is the mail ready?" When he finally arrives at the station, he collapses. During the next days or weeks, he thrashes around his bed in delirium, latching onto disconnected images of a cheerful doctor, a grave priest, and various acquaintances and events.

One morning Klimov awakens feeling well. His whole being is filled with a sensation of happiness. He learns from the doctor that he has survived a case of spotted typhus. But where is his sister Katya? His aunt groans, "Ah, Katya, Katya! Our angel is gone! Is gone!" Indeed, Katya had caught typhus from her brother and died. Her funeral had taken place the day before. Pavel's "heart ached, he burst into tears, and leaned his forehead against the window frame."

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Summary:

Penny (Michele Hicks), working as a prostitute, is called to a room in a seedy hotel where she finds her client is a pair of adult conjoined twins, Blake and Francis Falls (played by identical but not conjoined twins, Mark and Michael Polish, who also co-wrote the screenplay). Shocked, she flees but later returns and, when she learns that one of the twins is ill, calls a doctor friend of hers to examine them. She cares for the twins and they become friends. At Halloween, "the only night of the year they [can pass for] normal," she takes them to a party and then back to her apartment where she and Blake almost make love while Francis, evidently the weaker twin, is sleeping.

She tells her lawyer/pimp about the twins, and he tries to persuade them to sell him their story (which he imagines in terms of separation: "The greatest divorce of all time: not who gets the kid but who gets the kidney . . . "). Offended by her betrayal, they return to their hotel room, and, apparently for the first time, the twins fight. Blake wants to get away from his brother.

The next morning Francis is ill once more, and the twins are hospitalized. Michele visits them and learns that they are dying. Francis's heart is becoming weaker, straining Blake's, and the only way to save Blake will be by separating them. Francis cannot survive separation. Penny tracks down their mother (Lesley Ann Warren), who gave them up for adoption at birth. She visits them in hospital. It emerges that Penny herself has a "retarded" child who is being raised by others. Francis's heart fails, and the twins are taken to the operating room.

Later, Penny tracks Blake down where he is now living alone in the trailer where the twins had lived before, as circus performers. The film ends with Blake, now a man with one arm and one functioning leg, telling Penny that the "story of me is over," but also that stories continue after sad endings. What makes an ending sad, he tells her, is the knowledge that the storyteller is continuing without you.

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What Girls Learn

Cook, Karin

Last Updated: May-12-2003
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Told from the perspective of a thirteen-year-old girl, this story about a single mother with two daughters who moves, marries, and dies of breast cancer handles a variety of difficult issues with sensitivity and spunk. A list of those issues--absent father, new stepfather, a thousand-mile move to a new social environment, first menstruation, sibling rivalry, an uncle with incestuous impulses, family secrets, sexual experimentation, cancer, and death--might make it sound like a catalogue of the trials of contemporary suburban young adulthood, but in fact the point of view of Tilden, the main character, keeps the story grounded in very believable, sometimes amusing, often poignant, recognizable truth about what it is to come into awareness of the hard terms of adult life.

The mother's cancer is narrated largely in terms of Tilden's experience of it: secrecy, eventual disclosure, partial information, losses of intimacy, feelings of betrayal, confusion about caregivers' roles, and in the midst of it all, the ordinary preoccupations of early adolescence. The generous and understanding stepfather and neighbors with limited but ready sympathies lighten some of the novel's darker themes.

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Fever 1793

Anderson, Laurie Halse

Last Updated: May-12-2003
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

This historical novel for young adults details the horrors of the Philadelphia Yellow Fever epidemic in 1793 from the point of view of a fourteen-year-old, Mattie, who runs a coffeehouse with her widowed mother and grandfather. In the course of the story, her mother is taken ill, she herself falls ill on the way to the safety of the countryside, and her grandfather dies of heart failure after nursing her. Separated from her mother who is also removed from the city, Mattie finds herself scrabbling for survival in a mostly deserted town after the death of her grandfather, but relocates the free black woman, Eliza, who had worked for her family and who essentially becomes part of her family.

Eventually the mother returns, an invalid but alive, and Eliza and Mattie undertake to run the reopened coffeehouse together and care for Eliza's nephews and an orphaned child Mattie has rescued. Hope reappears with the first frost in the forms of a reopened farmers' market, the return of George Washington to the town, and the reappearance from enforced isolation of Nathaniel Benson, a young painter who gives Mattie a vision of a future life with friendship and love.

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Hot Springs

Hugo, Richard

Last Updated: May-12-2003
Annotated by:
Willms, Janice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poem tells the story of one who travels to the hot springs seeking a cure for his chronic illness/disability. For 25 years the subject faithfully visits what remains of the opulent dream of spa-builders--a bubble that burst for both the entrepreneurs and their visitants. In the nearly deserted town, the poet's character continues to seek relief without success, yet he remains. The writer seems to be asking if it has become the search itself that keeps the sufferer alive; if he were to suddenly be made well perhaps he would lose everything in losing his familiar identity.

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Demon in the Freezer

Preston, Richard

Last Updated: May-10-2003
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Investigative Journalism

Summary:

This gripping narrative traces the history of the efforts to eradicate smallpox in the 1970s, the top-level decisions to keep a few vials of it for emergency purposes in American and Soviet freezers, and the reemergence of smallpox not only as a health threat, but as a potential bioweapon of unequaled destructive power. Preston details maverick natural cases that surfaced after worldwide eradication efforts, how it was discovered that undocumented reserves of smallpox were not only being kept, but researched and possibly "weaponized," and how hotly, in the US, teams of scientists and military intelligence personnel debated funding new smallpox research in the US with a view to developing a new vaccine as a defense.

The ethical issues in those debates are unprecedented in the scope of the possible public health threat and the variables that might make traditional vaccination ineffective against the weaponized virus. As in his previous books on biological threats, The Hot Zone and The Cobra Event (see annotation), Preston follows the work and lives of several key scientists and includes scenes from interviews with a variety of persons involved in confronting the political, ethical, and medical dilemmas posed by smallpox research and efforts to track and control it.

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Summary:

When literature and cultural studies professor Michael Bérubé's son James was born in 1991, he was diagnosed with Down Syndrome. Negotiating various medical, social, and educational environments and the identities each assigns their son, Bérubé and Janet Lyon (his wife, a literature professor and former cardiac-ICU nurse), become effective advocates for Jamie and embark on a course of questions about the social systems that produce disabled identities and administer to those human differences termed significant ones. Bérubé engages these questions with a mixture of family experience (his own, and that of other families with disabilities), historical research, critical theory, and sophisticated critical analysis.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.

The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.

Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."

This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.

Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.

Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).

These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.

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Richard III

Shakespeare, William

Last Updated: Feb-22-2003
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Plays

Genre: Play

Summary:

This history play narrates the rise to power through treachery and murder of Richard Plantaganet, Duke of Gloucester and last king of the House of York. Set in England during the Wars of the Roses (1455-1485), the play opens after the Lancastrian King Henry VI and his son Edward have been killed and Richard’s brother has been crowned Edward IV.

In the course of the play, Richard woos and wins Prince Edward’s widow Anne Neville and engineers the murders of his other brother (George, Duke of Clarence), his nephews, his closest advisor, possibly his wife, and other members of the court. He is crowned king but later dies a violent death in the Battle of Bosworth, defeated by Henry Tudor, Duke of Richmond, who will become the first Tudor King Henry VII.

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Annotated by:
Davis, Cortney

Primary Category: Literature / Literature

Genre: Anthology (Mixed Genres)

Summary:

An anthology of poetry and prose by doctors, nurses, patients, and other authors, A Life in Medicine is divided into four sections: "Physicians Must Be Altruistic"; "Physicians Must Be Knowledgeable"; "Physicians Must Be Skillful"; and "Physicians Must Be Dutiful." Each section begins with the Association of American Medical Colleges' (AAMC) definition of the physician trait examined in that section, and short "explications" precede each individual poem and prose piece, linking them to the section's overall theme.

The anthology has a preface outlining the editors' goals and Robert Coles's introduction, "The Moral Education of Medical Students." These organizational touches make the anthology a classroom-ready text for medical students. The anthology's poems and prose--many of which are stunning--were taken from previously published works and exclude many well-known and often-used pieces. But those selections are readily available elsewhere, and the editors do readers a greater service by introducing many lesser-known, but equally important, poems and essays.

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