Showing 51 - 60 of 72 annotations tagged with the keyword "Eating Disorder"

Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

In 1869, national and medical attention was focused on a poor family in Wales. The daughter, twelve year-old Sarah Jacob, was bedridden with a strange ailment characterized by paralysis, staring fits, and anorexia. Yet she did not waste away. On the contrary, she seemed to survive comfortably with only few drops of water daily. Credulous folk came to visit, knowing that such abstinence had been the practice of many Christian saints; they would leave a few coins as an offering, although the family protested that money had never been requested. Others claimed it was a hoax.

Eventually the doctors and vicars became curious. An initial investigation upheld the family’s position that the girl did not eat. A more rigorous second investigation was designed by medical professors from Guy’s Hospital in London and carried out by trained nurses who sat knitting at the bedside. It resulted in the girl’s death.

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Annotated by:
Donley, Carol

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem, told in the voice of a troubled, angry teenager, describes her determination to control her eating and her body. The eight, eight-line stanzas each repeat the same words at the end of the lines, in a modified sestina form, so that emphasis falls on the same eight words: "disappear," "smile," bones," "fat," "mother," "touch," "person," "guts." By the end of the poem, the girl is clearly suicidal and unable to control her anorexia.

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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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Love and Modern Medicine

Klass, Perri

Last Updated: Apr-03-2002
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Collection (Short Stories)

Summary:

In this collection of 11 short stories, pediatrician-author Perri Klass primarily explores the world of women and their multiple and complex roles as mother, mother-to-be, friend, spouse, lover and professional. Parenthood--its glories, heartaches, tensions and mysteries--plays a prominent role in many of the stories. There is also a close look at woman-woman friendship--at what women say to their best friends and the nuances of the emotional responses to what is said or left unsaid.

Several stories feature single mothers: "For Women Everywhere" (a woman is helped through labor by her best friend), "Rainbow Mama" (a woman cares for her son during his diagnosis and initial treatment of leukemia), and "City Sidewalks" (a woman finds a baby on the sidewalk on Christmas Eve as she rushes to pick up her child from day care).

"In Necessary Risks," an anesthesiologist deals with work and her high energy preschool daughter while husband and easy-to-raise son head out to a dude ranch. In "The Trouble with Sophie," another high energy, dominant daughter wreaks havoc in kindergarten as well as with her concerned parents. In addition to the anesthesiologist, two other physician-mothers are featured in "Freedom Fighter" and "Love and Modern Medicine."

Parenting a newborn whilst handling other tasks is a theme featured in "Intimacy" (a high school biology teacher celebrates her first night of uninterrupted sleep as she both enjoys and envies her single friend's sex life) and in "Dedication" (a writer takes his stepson to a chess tournament while his biologist wife and newborn enjoy breastfeeding at home). Woman friendships are prominent in "For Women Everywhere," "Freedom Fighter," and "The Province of the Bearded Fathers." Grief and sudden infant death syndrome are themes of "Love and Modern Medicine."

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Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Motivated at first by an attachment to her strict and demanding ballet teacher, as well as frustration and disgust with her own body compared to other dancers', Francesca develops an obsession with weight loss and increasingly ritualized forms of self-discipline in eating and exercise that lead to severe anorexia nervosa. It takes her family several months to see and acknowledge what is happening in front of them, during which she has trained herself to eat less and less, to throw up after meals, and to push herself to the point of exhaustion.

She becomes secretive, isolates herself from friends, and puts up a wall between herself and her parents, who are unable fully to understand the degree to which her behavior has gone beyond her control, but are worried. A compassionate male therapist with clear boundaries and a non-judgmental approach finally succeeds in disengaging Francesca from the mutually destructive downward spiral of family conflict around her illness;

he helps her to envision and desire her own health and to take responsibility for recovery. The story is told in the third person, but from Francesca's point of view.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Children's Literature

Summary:

Harry Potter and the Goblet of Fire is the fourth book in a planned series of seven (see annotation of Harry Potter and the Sorcerer's Stone for an introductory summary). Unlike previous books, this one opens with the murder of a Muggle, Frank Bryce, the elderly gardener for the Riddle estate--a home where Tom Riddle Sr. and his elderly parents had been found dead many years before. Voldemort, although still weak and requiring much assistance from his simpering servant Wormtail and his snake Nagini, is positioning himself for a return to full power.

Harry's distinctive scar is burning with pain as he awakes from a dream of the previous scene. This scar had hurt once before, in book one, when Voldemort was on Hogwarts property. Harry alerts his godfather via owl post and joins the Dursleys for breakfast. Breakfast is meager because Dudley, always obese and obnoxious, has now grown to outrageous proportions and is on the diet ordered by his school nurse. His mother, to make him feel better, puts everyone on the same diet. Harry is once again saved from the Dursleys by the Weasley family, although Dudley and his appetite are the objects of a prank by the Weasley twins.

Arthur Weasley (the father) who works for the Ministry of Magic in the Misuse of Muggle Artifacts Office has secured top notch tickets for all to attend the World Quidditch Cup. This fantastic event is marred by the appearance of signs of support for Voldemort by his followers, the Death Eaters, and Arthur hurries home with his charges in tow via Portkey transit.

Harry, now fourteen, enters Hogwarts for his fourth year. This year is different for all of the students due to the resurrection of the Triwizard Tournament, a dangerous international competition for a selected champion from each of three schools, Durmstrang, Beauxbatons, and Hogwarts. Although underage, Harry is selected by the Goblet as an extra competitor from Hogwarts. Everyone is concerned for the competitors' safety (the famous Viktor Krum, the enticing Fleur Delacour, and the decent Cedric Diggory). In particular, Harry's life is in danger from suspected foul play.

Adolescent love, the nastiness of poison-pen reporter Rita Skeeter, the ever-vigilant nature of Mad-Eye Moody (an Auror who caught Death Eaters in the past and who now teaches Defense Against the Dark Arts), spells that cause loss of control, excruciating pain or death, enslavement of house-elves, money, and variable degrees of professionalism by members of the Ministry of Magic, such as Cornelius Fudge, Bartemius Crouch, officious Percy Weasley, and Ludo Bagman are some of the themes and subplots in the novel. The traumatic end to the competition and follow-up lead Harry to witness and participate in some horrific events. Dumbledore, however, refuses to allow Harry to bottle-up the experience--Dumbledore understands that talk, openness, support, and rest are the first steps towards healing.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Diary

Summary:

Gottlieb, nearing thirty years old, discovered her childhood diaries in a closet in her parents' home as she searched for some chemistry notes to aid in her quest to attend medical school. This book is "based on diaries" she wrote when she was diagnosed with and underwent treatment for anorexia nervosa. It is the writing of a precocious, strong-willed preteen who enjoys chess, being unique, writing, and getting straight A's in school, yet who is lonely and desperate to fit in and be popular.

Lori is eleven years old, lives in Beverly Hills, California with her fashion-conscious, loves-to-shop mother, her somewhat distant stockbroker father, her older brother David who now is into music and friends and not-Lori, and her best friend Chrissy, a pet parakeet. Lori's diary entries are filled with astute observations of adults (teachers, parents, relatives, medical personnel, even a television star she meets, Jaclyn Smith) and classmates.

She is wry and witty. An early entry gives an English essay she rewrote to get an "A". These "power paragraphs" are generously and hilariously sprinkled with "proper transitions" such as "to begin with", "moreover", and "on the other hand" that her teacher insists are necessary for readability. This essay provides telling insights about Lori's perceptions of her family, particularly (note transition word) her mother's superficiality.

Lori is surrounded by messages of the glories of thinness for women. Every female she encounters, from peer to adult, is on a diet, counts calories, avoids desserts and gossips about how other women and girls look. The culture is not only anti-obesity, but pro-superthinness. Hence it is logical that Lori, angry about being taken from school to go on a family trip to Washington, D.C., begins her rebellion and search for control by skipping meals and dieting.

She gets the attention she craves from her parents. Her schoolmates ask her for diet advice and admire her weight loss. Self-denial, obsession with calories (that she believes can even be gained by breathing), and secret exercising lead to an alarming weight loss in this already skinny kid.

Her mother takes her to the pediatrician, who prescribes whole milk which Lori refuses. He refers her to a psychiatrist, who eventually hospitalizes her for behavior modification, observation, and a possible feeding tube. At the hospital, Lori meets medical students, nurses and fellow patients, but becomes progressively more depressed, dehydrated and lonely. She attempts to run away and makes a suicide gesture. Finally, she sees herself for what she has become--an emaciated stick figure.

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Snapshots

Martin, Kimbra

Last Updated: Jan-28-2000
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

In short chapters that alternate between remembered scenes of abuse, reflections upon those scenes, and tributes to the natural beauties and human kindnesses that tempered years of domestic violence, the author provides a galling, but not sensationalistic, record of what child abuse looks and feels like. Only when she was older and mostly beyond the reach of a father who routinely beat and sexually abused her and her siblings did the author find out that her father had been dismissed from a police force for gratuitous violence and had subsequently submitted to electroshock treatments for mental illness.

The title describes the nature of the narrative; in its deliberate discontinuities it testifies to the stated fact that there are places where memory has left a blank. Much of the telling is an attempt to piece together a story of recurrent violence, felt danger, and arbitrary rage that seemed at the time both regular and unpredictable.

The sanity of the narrative testifies to the possibility of healing. The writer makes no large claims for final or complete release from the effects of trauma, but does strongly testify to the possibility of a loving, happy, functional adult life as healing continues.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

The first-person narrative of Catherine who is desperate for her seemingly indifferent mother’s love. Raised from infancy by grandparents following her parents’ divorce, Catherine seeks her indifferent but devout mother’s affection by emulating her saintly namesake. She mortifies her flesh in the pursuit of thinness based on an ideal of purity as self-denial and on her mother’s esthetic expectations.

The obsessive behavior extends from anorexia to willful insomnia and severe illness. At college she recovers by discovery of a happier, more direct faith. The essay begins and ends in the narrator’s later life, as she contemplates her own revulsion and pain in caring for her mother who lies dying of breast cancer.

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Parents' Support Group

Allen, Dick

Last Updated: Aug-25-1999
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem of nine four-line stanzas reveals a father's observations as he sits in a support group for parents at the psychiatric hospital where his daughter is a patient. The poem moves from the nervous small talk shared by the parents to the half-heard sounds of a tennis match outside to the "hot potato" of pain that the parents, through their stories, pass around, bringing the reader into the immediacy of the blame, grief, and disbelief that these parents share. In this environment, words fail: "I don't know anything / That can help us all. Words alone / (How many words there were!) have come unstrung // And scatter everywhere."

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