Showing 551 - 560 of 690 Nonfiction annotations
In 1988, having suffered for years from major depression and borderline personality disorder, and now also showing symptoms of obsessive-compulsive disorder, the twenty-six-year-old Lauren Slater is prescribed a new drug: Prozac. In this "diary," a series of meditations and progress reports on her experience, Slater traces ten years on Prozac, providing a remarkable before-and-after picture of the drug's effects.
She is "hobbled" by her illness: has dropped out of college, has been fired from most jobs, has been hospitalized five times. By the end of the book, she has received a doctorate from Harvard, has a successful career as writer, teacher, and psychologist, and is in a happy marriage.
Despite these unquestionable positives, Slater is ambivalent about the drug, describing the shock of becoming "normal," of being assaulted by health. She describes the sexual dysfunction, her anxiety about losing the need and ability to write the kind of poetry she had written before, and the terrifying moment when the drug suddenly stops working, and she must confront the possibility that it may not be a reliable and permanent solution.
She comes to fear that, healthy, she is no longer herself but something the drug has created. At the same time, though, it is only because of the drug that she is even able to ask these questions. Finally, she thanks her doctor for his ambiguous gift: she has become like a beautiful fish, her "skin all silver," her "mouth pierced" on Prozac, "this precious hook."
Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.
In this journal, Murray traces a month-long rotation he spends as attending physician in the ICU (Intensive Care Unit) of San Francisco General Hospital. For each of the 28 days, Murray presents the patients he sees, both new and ongoing, along with commentary on the care of each patient and on broader issues raised by their cases.
In the course of the month, we encounter sixty patients, fifteen of whom die in the ICU. The patients are apparently quite typical for the hospital: cases are dominated by HIV, pneumonia, tuberculosis, and drug abuse, or all four. The ICU is not a very safe place: there are twelve cases of iatrogenic pulmonary edema, and several of hospital-acquired infections.
Murray candidly presents both the triumphs and the limitations of contemporary intensive care while giving us vivid glimpses into the lives of both patients and staff. In his epilogue, Murray asks some tough questions about the value of intensive care units, and discusses palliative care, patients' rights to the withholding and withdrawing of life-sustaining therapy, and even physician-assisted suicide, as "more humane"--and economically responsible--alternatives to intensive care in cases of advanced terminal illness (270).
He describes the ICU as a "battleground" where people who are "clinging to life" can "fight for it" (275). This is its value. But the battles need to be better understood and winning must be carefully evaluated. Murray concludes that the last few decades' medical and technical advances in critical care now need to be matched by ethical ones.
This collection of 20 essays continues and expands upon the theme--how we living care for our dead and incorporate them into memory--that Thomas Lynch, a poet and undertaker, introduced in his first book, The Undertaking: Life Studies from the Dismal Trade (see this database).
In this new book, Lynch writes rambling pieces that begin with some observation about his funereal trade then blaze off into musings about religion ("The Dead Priest"), love and divorce ("The Blindness of Love," "Y2Cat"), poetry ("Reno," "Notes on 'A Note on the Rapture to His True Love'"), and the interplay of mortality and morality ("Wombs," "The Bang & Whimper and the Boom"). In his first book, Lynch wrote scathingly of abortion and mercy killing, and here he continues his thought provoking considerations of both.
In what might be the most interesting and radical essay in this collection, "Wombs," Lynch walks a precarious line between pro-life and pro-choice rhetoric; ultimately, he asserts a woman's right to abhor decisions about her body that "leave her out." At the same time, he asks if the reproductive choices available to women, "when considered for men," might not seem "irresponsible, overly indulgent, and selfish." What if, he writes, men could declare (without stating their reasons) their interest in their unborn children "null and void, ceased and aborted?" Lynch, who spends most of his time in the contemplation of the deceased, seems to find in death a spark of life; then he fans it into flame with language.
This memoir of a clinical psychologist (also a professor of psychology) chronicles her own depression over a period of a year and a half, from early symptoms, through near despair, electroconvulsive therapy, and hospitalization to recovery. The journey is detailed, not only in its treatment of her emotional states, but of her struggle to maintain family and professional life, keep her house and office organized, and attend to a dying friend.
As her bouts of panic and disorientation grow more apparent, first to herself and finally to others, she seeks refuge in spiritual retreats and in conversation with colleagues, ultimately submitting to treatment. She names the emotional "undercurrents" suggested in the book's title with moving precision: panic over sudden disorientation, anxiety about what to keep secret, frustration with her own unreliability, dread of small duties and ordinary appointments, heartache over her faltering efforts to be a good and present mother.
The consent to hospitalization costs a great deal in humility, in risking a controversial treatment, and in letting go of a professional persona she doesn't know whether she'll be able to retrieve. But clearly the book is written by a woman whose clarity is a testimony to regained mental health and exceptional intellectual clarity. It is not a professional record, but an intensely personal memoir of what was both an encounter with serious mental illness and a spiritual journey.
A 199-page collection of twelve essays by undertaker and poet Thomas Lynch, superficially about his mortuary trade, but actually about much more--life and death; the process of mourning; how we human beings pass though our common lives with grace or desperation; how the graveside ritual serves memory, family, and society. In the preface, Lynch says that early on he came to understand that the undertaking trade he would inherit from his father had little to do with what was done to the dead, but everything to do with how the living responded to the deaths of loved ones, neighbors, and friends.
Particularly outstanding essays include "The Undertaking," in which Lynch divulges the practical and emotional secrets of his trade as he buries Milo, a man who owned a Laundromat; "Crapper," a humorous, rollicking essay that demonstrates our modern society's inability to deal either with the thought of dying or the actual dead body; "The Gulfatorium," a flight of fancy about building a graveyard in a golf course, but really about the nature of suffering and the afterlife; "Mary & Wilbur," about neighbors, about our fear of death and our impulse to memorialize; "Uncle Eddie, Inc.," about an uncle's "clean-up service" that sanitized rooms after messy suicides and about the natural order of life and death and the moral implications of our manipulation of that order through assisted suicide, abortion, and genetic manipulation. My personal favorite is the final essay, "Tract," in which Lynch says how he wants his own death and burial to be managed, how he, a witness to our final rituals, wants to be witnessed.
Peppered with a plethora of black and white stills, this book is a compilation of a physician's film reviews and reflections on how movies have mirrored the changes in medical care and in society's attitudes towards doctors and medicine over the last sixty years. Ten chapters blend a chronological approach with a thematic perspective: Hollywood Goes to Medical School; The Kindly Savior:
From Doctor Bull to Doc Hollywood; Benevolent Institutions; The Temple of Science; "Where are All the Women Doctors?"; Blacks, the Invisible Doctors; The Dark Side of Doctors; The Institutions Turn Evil; The Temple of Healing; More Good Movie Doctors and Other Personal Favorites.
The appendices (my favorite) briefly note recurring medical themes and stereotypes ("You have two months to live," "Boil the Water!"). Formatted as a filmography, the appendices reference the chapter number in which the film is discussed, the sources of the photographs, and a limited index.
Alan Shapiro, poet and professor of English at the University of North Carolina, Chapel Hill, chronicles the life and death of his sister, Beth, who died of breast cancer at the age of 49. Beth lived the last four weeks of her life at a hospice in Texas--this memoir traces those weeks in particular and refracts them against decades of family dynamics, turmoil and triumph. The memoir is composed of 14 tersely named chapters ("The Death," "The Joke") followed by "Afterwords": six poems about Beth.
Alan is the youngest of 3 siblings; Beth was the oldest and David, an actor is the middle child. Despite, or perhaps because of their age difference, Beth and Alan were very close. It was he whom she asked to write her eulogy and it was he who stayed the entire 4 weeks of hospice, save for a brief trip home. From Alan's love and devotion grows an admiration for Beth's integrity in life and death.
Beth married an African-American man, fought for liberal causes, and suffered complete estrangement from her parents due to her choices. Her husband, Russ, must deal not only with the loss of his wife and their daughter's loss of her mother, but also with the prejudice of the Shapiro parents and the medical establishment. At one point Shapiro describes how, whenever he accompanied his sister and her husband to the doctor's office, Alan, not Russ, was treated as the spouse and decision-maker.
Shapiro vividly depicts the poignancy of parent-child relationships. Gabbi, the seven-year-old daughter who loves horses, gallops through the house with grace and abandon not possible at the hospice. Alan's anger at his father's actions and his forgiveness of his mother's accomplice role are also strongly demonstrated. A great strength of this book is the choice of detail: the mother completes a book of crossword puzzles during the vigil; the brother becomes infatuated with a particular joke he wants to memorize; nurses leave a solitary rose on the bed of the newly dead at the hospice.
Shapiro is keenly interested in being with his sister right at the moment of her death. He describes the end: "one long, deep, and profoundly eerie moan . . . That moan, I'm certain, marked the end of Beth, the end of life, though the body went on breathing for another minute or so, each breath a little fainter, weaker, the body's electricity guttering down, dissolving, till there was no breath at all." (pp. 111-2)
He also analyzes whether this was "a good death." There had been many gifts: Beth's recognition of her importance, her reconciliation with her father, and her acceptance of her mother's devotion. However, Shapiro also keeps the reader cognizant of Beth's suffering and the now motherless child, the spouseless husband and the myriad other ways that Beth's death marked a void.
After a stressful trip to cold-war Russia in 1964, Saturday Review editor Norman Cousins tells how he developed a debilitating illness which confines him to bed. He is admitted to hospital for tests and treatments, and is diagnosed with ankylosing spondylitis, but his condition deteriorates and he is given a gloomy prognosis. He notices that the depressing routine of hospital life tends to produce side effects that aggravate his condition.
With the blessing of one of his doctors, he checks out of hospital and into a comfortable (yet less expensive) hotel where the food is better and he can watch funny movies while he medicates himself with high doses of Vitamin C. He is convinced that the slow improvement in his condition is owing to his individualized methods of therapy and his having taken charge of his own situation.
The purpose of this collection of essays written by teachers of literature and medicine is to serve as a guide for those who are preparing courses or seminars in the field. The collection is divided into four sections, each one approaching the theory and pedagogy of the discipline in a different way: one section is made up of model courses; a second views the subject matter from the standpoint of individual texts, authors, or genres; the third takes a broader look at some effects of literature on the practice of medicine and/or nursing and the role illness and medicine have played in the creation of literature; the fourth is a collection of resources available in the field. There is blurring of some of the boundaries of the sections, but read in the whole, the collection provides a good sense of the way medicine and literature is being taught in this country at this time.