Showing 51 - 60 of 294 annotations tagged with the keyword "Surgery"

The Betrayal

Dunmore, Helen

Last Updated: Jun-11-2010
Annotated by:
Mathiasen, Helle

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In this novel medicine and  politics interface, with disastrous results. The time is the early 1950s, the place Leningrad, and the Soviet leader is Josef Stalin. Andrei Mikhailovich Alekseyev is a  conscientious young pediatrician in a city hospital.  Though Andrei has been warned to be careful, he chooses to take on Gorya, a patient with osteosarcoma, the only child of Volkov, an official high in the Ministry for State Security. Dr. Brodskaya, a Jewish woman surgeon, performs a biopsy and recommends amputation above the knee. Andrei recommends that she perform the surgery. But Gorya develops lung cancer. Brodskaya applies for a transfer to Yerevan, well aware that Volkov will take revenge if the boy doesn't improve, but Andrei decides to stay in Leningrad.

He lives a spartan existence with his wife, Anna, and Anna's younger brother, 16. They bicycle out to their country dacha to fish and  harvest fruits and vegetables. Suddenly, a phone call to his home tells Andrei he is suspended from his medical practice. The police arrest Brodskaya. Shortly thereafter, in the night, Andrei hears police  boots on the stairs. The officers raid Andrei's and Anna's home, breaking furniture, emptying pickle jars into the sink, and confiscating their English dictionary. They send Andrei to Lubyanka prison in Moscow, where he is tortured to get him to sign a confession. Andrei reflects on his situation: "If he dies here, he'll die alone. The last faces he will see will be the guards' faces. Outside, he would never have believed that three initials scratched into a piece of soap [from the shared lavatory] could be so precious. In here, to know that another prisoner has taken the risk of trying to communicate brings a kind of hope"(262). He forces himself not to think about his pregnant wife, instead naming the muscles of the hand, or bone after bone of the human skeleton.

Finally, he is confronted with Volkov who tells Andrei Comrade Stalin has begun a purge of doctors because doctors have been killing communist leaders: "We are uncovering an international conspiracy of Zionists working as tools of the Americans, who directed these criminal murderers and saboteurs" (277). Volkov tells Andrei the Jewish Dr. Brodskaya has ‘suffered a heart attack', that is, she has been executed. Volkov accuses Andrei of betraying his trust by amputating his boy's leg, an operation that did no good, as the boy is now dying of cancer. Volkov dismisses Andrei and goes to visit his son who is comatose. Then he shoots himself in a dark Moscow street. Andrei is sent to the Gulag for ten years.

Anna has moved to safety at their dacha with her brother, Kolya. There she gives birth to her daughter and names her Nadezhda. In March 1953, Stalin's death is announced. Beria, head of the NKVD, announces an amnesty of Gulag prisoners serving shorter sentences. Beria sets up an investigation into the Doctors' Plot and exonerates those doctors. In the following years, thousands of prisoners make their way back to the Soviet Union - one of them is Andrei.

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Summary:

This edited anthology, which includes poems, essays, short stories, and other creative forms (e.g., a radio diary, a letter to a social service agency), is organized into sections that include Body and Self, Diagnosis and Treatment, Womanhood, Family Life and Caregiving, Professional Life and Illness, and Advocacy. Most works found their way into this collection through a call for submissions, although a few selections are well known, such as Lynne Sharon Schwartz's "So You're Going to Have a New Body !," or an excerpt from Rachel Naomi Remen's Kitchen Table Wisdom (see annotations). In addition, the anthology also includes essays by scholars such as Arthur W. Frank and Rita Charon, who theorize gendered illness narratives.

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A Deathplace

Sissman, L. E. (Louis Edward)

Last Updated: Feb-22-2010
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry — Secondary Category: Literature / Poetry

Genre: Poem

Summary:

In "A Deathplace" the speaker recounts, with seeming nonchalance, the predictable sequence of his own death. He describes the hospital he knows so well, the details of surgery (down to "the buttered catheter goes in"), the "malignant plum," and finally "the hour / when the authorities shut off the power . . ." Sissman uses the power shut-off to signify his own death, but soon the lights go up and throughout the hospital the "business of life" resumes. Part of that business is to move his body to the morgue, then to the undertaker, then "That's all."

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Summary:

The title refers to a Veteran’s Administration hospital regulation concerning the withholding of full medical benefits if an ailment is not specifically related to military service. In an oftentimes comic battle between the forces of good--physicians and vulnerable patients--and those of evil--the administrators and their minions--the story has currency and direct appeal to viewers.

The Darth-Vader-like administrators are self-serving, inhumane bureaucrats with emotions that run the gamut "from A to B" (Dorothy Parker). Physicians, especially the character played by Ray Liotta, but also his dedicated colleagues, are imaginative and non-rule abiding in their central concerns: the patients. They listen to stories and sympathize; in addition, they turf, lie, steal, and do whatever is necessary to protect, serve, and treat their patients. When the government denies a heart bypass, for example, the docs schedule prostate surgery for the official record and do, instead, the needed heart surgery.

At times, it’s as if the Marx Brothers or the Keystone Cops have donned white coats to sneak around the hospital with patient-centered antics. In the absurd bureaucracy, viewers, perforce, must cheer enthusiastically for the merry band of renegade docs.

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Suburban Shaman

Helman, Cecil

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.

Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.

Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).

Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.

By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.

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Souls Raised from the Dead

Betts, Doris

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This story details several months in the life of a thirteen-year-old with incurable kidney disease and of her extended family--the policeman father who has cared for her since her mother ran off, the mother who reappears in time to learn she is the most likely donor, two sets of grandparents and several of the father's close friends. Two women in the father's life find their romantic attachments to him complicated by his role as his daughter's caretaker.

As Mary Grace's health deteriorates, her maturing accelerates. Each of the principal characters has to come to terms not only with impending loss, but with how this crisis reconfigures old patterns of family conflict and dependency. The story continues after her death as focus shifts to the father's grief, mourning, and new empathy with victims of accident and loss.

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Mr. Right and My Left Kidney

Saltzman, Joan

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This memoir by Joan Saltzman recounts her marriage, in her forties, to a man whose kidney disease was progressing to a point of choice between dialysis or transplant.  The first half of the book is a lively account of their somewhat stormy courtship, layered with memories of her childhood and reflections on tensions with and loss of her parents.  The second half focuses largely on the difficult decision to donate one of her own kidneys to her husband.  Even undergoing tests to determine she was a match required some wrestling with fear and resistance.  The chronicle continues through bumpy recoveries to a new level of intimacy and understanding of ongoing shared life in new terms.  Her idea of "complete recovery" had to be modified once she recognized that even a successful transplant doesn't restore a former state of health, but does restore a new range of possibilities.

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Metamorphosis

Updike, John

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The protagonist, Anderson, has a skin cancer growing dangerously close to one of his tear ducts. An aging "idler and playboy," he has spent too many years in the sun (67). Anderson consults and promptly becomes infatuated with his facial plastic surgeon, Dr. Kim, "who turned out to be a woman, a surprisingly young Korean-American who even in her baggy lab coat evinced considerable loveliness" (67). Anderson is fascinated with Dr. Kim's body, her visible pregnancy, her way of moving and speaking, and her face. He enjoys the "bliss of secure helplessness" of the surgery itself, performed by Dr. Kim and two female nurses who "rotate[]" around him conversing as they work (67).

While successful, the surgery leaves a small bump on his face that Anderson asks Dr. Kim to correct surgically. The second surgery achieved, Anderson returns a third time for the much more ambitious project of tucking his somewhat saggy eyelids. His goal, however, is not just to tighten slack skin but to make his lids look like Dr. Kim's, "with an epicanthus" (69). The six-hour surgery is both successful and satisfying to Anderson--until he sees a photo of Dr. Kim's husband.

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Learning Sickness

Lang, James

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

James Lang was diagnosed with Crohn's disease in 1996, when he was twenty-six years old. Five years later, however, a particularly severe bout with Crohn's, including a hospital stay, dramatically changed his relationship to the disease. Lang's memoir explores his ongoing relationship to Crohn's disease, both in the context of medical reassessments and diagnostic adjustments and in relation to his personal and professional development in his first year as a tenure-track professor of college English.

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A Stone Woman

Byatt, A. S. (Antonia Susan)

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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