Showing 561 - 570 of 872 annotations tagged with the keyword "Patient Experience"

Alias Grace

Atwood, Margaret

Last Updated: Nov-17-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

For more than fifteen years, Irish-born Grace Marks has been confined for the 1843 murder of housekeeper, Nancy Montgomery, and her employer, Thomas Kinnear, at their home north of Toronto. Her convicted accomplice was hanged, accusing Grace with his last breath, but her sentence was commuted to life in prison at the last minute. Because of her amnesia and outbursts of rage and panic, she was held in the Lunatic Asylum before being sent to the Kingston [Ontario] Penitentiary.

Beautiful, intelligent, and strangely poised, Grace intrigues worthy townsfolk, spiritualists, and some of her jailers, who grant her the privilege of outside work, believe in her innocence, and strive for a pardon. In looking for medical approbation, they consult Dr. Simon Jordan, a young American doctor who is interested in insanity and memory loss. Without explaining his purpose, he brings her vegetables and other familiar objects, hoping to stimulate recollection of her life.

Interspersed with Jordan's own problems, Grace's story unfolds in her own words, from her poverty-stricken childhood in Ireland and the emigration voyage that killed her mother, leaving her and her younger siblings to a neglectful father, through her short life in service, to the dreadful events of autumn 1843. She has suffered many losses, including the death of her mother to ship fever, and that of her friend and fellow servant, Mary Whitney, from an illegally procured abortion. After many weeks, Jordan abandons his project in frustration and ambiguity. The novel ends years later with forty-six year-old Grace's discharge from prison in 1872, nearly thirty years after the crime.

View full annotation

Equal Affections

Leavitt, David

Last Updated: Nov-17-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The first part of this novel presents a detailed picture of the Jewish Californian Cooper family, centering on the sixty-year-old Louise, who is dying of breast cancer. Her husband, Nat, is unfaithful, and, she suspects, only loves her when she is at her weakest and most sick. Her daughter, April, is a lesbian folk singer who becomes pregnant with the help of a gay male friend and a turkey baster. Danny, the son, is also gay, living in New York with Walter, his lover, who is becoming increasingly detached and obsessed with internet sex groups.

Louise considers herself lucky, though, compared with her younger sister Eleanor, partially disabled by childhood polio, disorganized and ill-groomed and married to Sid, whom Louise finds deeply unattractive. Eleanor's son is a sociopathic drug addict, and her daughter has ovarian cancer caused by Eleanor's taking DES (diethylstilbesterol) in pregnancy. She sends Louise newspaper cuttings about the causes of homosexuality and the dangers of AIDS.

The first part having established the complex dynamics and histories of the family's relationships, the second brings the entire family together in the crisis of Louise's final illness and death (a reaction to chemotherapy drugs causes severe chemical burns and she dies in a burn unit in a San Francisco hospital). After her death, the new dynamics of the family are established, and Louise's son and daughter conclude that their mother had "a terrible life" (p. 261).

The short third part shows that no such conclusion is possible, that even those closest to us remain terribly but fascinatingly unknowable. A flashback to a point just before Louise's final illness describes her attempt to convert to Catholicism and a brief moment in which she experiences a marvelous sense of complete harmony.

View full annotation

Bodily Harm

Atwood, Margaret

Last Updated: Nov-17-2003
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Rennie is a freelance magazine writer. She writes mostly about fashion trends or travel and spends her free time with her controlling but sensual boyfriend, Jake. Her life changes dramatically when she finds out she has breast cancer, then has one breast removed. She feels as if she is about to die, as if worms are eating away at her insides.

Her boyfriend pretends to feel fine about it, but Rennie senses his disgust and their relationship ends. She realizes that she is in love with her surgeon. After all, he has seen a part of her that even she herself has never seen--her inside. The married surgeon is guilt-ridden and Rennie decides to go on vacation.

She ends up on a small island near Grenada. While she is there, a coup breaks out. Rennie becomes a hostage. Upon her release, she returns home. Now, however, she feels lucky to be alive and feels more alive than many around her.

View full annotation

Holy Fire

Sterling, Bruce

Last Updated: Nov-16-2003
Annotated by:
Kohn, Martin

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Holy Fire's setting is America at the end of the 21st century. A gerontocracy is firmly in place and in many older persons are reaping the benefits of life-extending technology. Mia Ziemann, the protagonist of this "cybersuspense" novel, is a 94 year-old medical economist who has a life-altering visit with a dying ex-lover. Could she become the person she had wanted to become so many decades ago--someone much more adventuresome?

In order to do so, she needs to undergo an experimental treatment--NTDCD (Neo-telemeric Dissipative Cellular Detoxification)--that does not just halt the aging process, but reverses it. NTDCD involves numerous ordeals including clogging her digestive tract with a sterilizing putty, filling her lungs with a sterilizing oxygenating fluid, replacing her cerebrospinal fluid (producing profound unconsciousness), being fetally submerged in a gelatinous tank of support fluids where the bacteria in her body are removed, and then receiving DNA treatments. If she survives the treatment the question remains whether or not she'll be able to survive as a young person in a world that favors the old.

View full annotation

Middlesex

Eugenides, Jeffrey

Last Updated: Nov-16-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The narrator of this fictional autobiography is Cal Stephanides, an American of Greek descent with a hereditary 5-alpha-reductase deficiency that gives her the prepubertal anatomy (and thus the social upbringing) of a girl, but at puberty begins her transformation into ambiguity, then maleness, and then, gradually, masculinity.

The novel is a kind of biography, not just of Cal, but also of the mutant gene that causes her/his condition. It is transmitted from a small village in Smyrna, through his grandparents, who were also brother and sister and who married on the ship to America, apparently leaving behind family as well as national identity. Their Greekness and the gene come with them, and the consequences of their incest haunts Cal's grandmother, Desdemona, until the very end of the novel.

The family settles in Detroit, and a third biographical strand is the story of the Greek immigrant community in 20th century America, from Ford's assembly lines to bootlegging during the prohibition, through Detroit race riots and then to affluent suburbia.

Cal's family settles in the suburb of Middlesex, and the focus narrows to the individual. Calliope is raised as a girl, but in adolescence, Callie learns about hermaphroditism, narrowly escapes sex-assignment surgery, becomes a performer in a seventies sex show in San Francisco, and finally returns home to Middlesex, Grosse Point, Michigan, as a male. The story is framed by Cal's much later adult life as a man in Berlin, and his successful romance with a woman he meets there.

View full annotation

Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This chapbook by Kentucky poet Leatha Kendrick features a sequence of poems dealing with her experience of breast cancer and mastectomy. The "science" in the title moves from a little girl’s fascination with nature, and her insight that "all she learned was nothing / is only what you thought you saw" (p. 2); through her mature view of "these spiky shadows" on ultrasound (p. 10); to chemotherapy, where she feels "like the muck this stuff is supposed to make of the fast- / dividing cells" (p.18).

But the science of cancer fails to amputate the poet’s narrative. Early on, "My first love called them Skeeter and Bite. / Equal then, if small. Skeeter got / most of his attention." (p. 14) Later, during her treatment, "Excuse me while I grow bald and fat." (p. 21) Eventually she learns, "The map back is a flat / red road, underpinned with bone, / she must learn to dance upon." (p. 28).

View full annotation

The Ash Garden

Bock, Dennis

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Emiko a child survivor of Hiroshima, is now a documentary filmmaker. She has horrific memories of August 1945 when she lost her parents and little brother, and of the years of painful operations and homesickness in America where she was sent to restore her mutilated face. She is hoping to interview Anton Böll, a scientist who had fled Germany to work on the Manhattan project.

Böll contends that he had been unaware of human rights abuses; he left Europe because the Nazi regime had cramped his scientific style. As a consequence, his mother was imprisoned and killed. During the war, he met his Austrian-born Jewish wife, Sophie, at a displaced persons camp in Canada. Sophie had lost her whole family, but she does not speak of them and he does not ask.

Briefly they knew happiness, but soon Böll left for work on the bomb and on to Hiroshima in its aftermath. Their marriage would never be the same. For the rest of his life, Böll justified his involvement as a "dream" turned "nightmare" emerging from the imperative demands of a virtuous science. When Emiko approaches him, he hesitates. He does not want to risk blame. But his dying wife knows that absolution for unacknowledged guilt is what he craves.

View full annotation

Annina

Dunmore, Helen

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

When I had Annina, the narrator says, her first-born child was eight years old, frost covered the geraniums, and something "warm and wet" ran down her legs. She lost her second pregnancy at only nine weeks from a spontaneous abortion. Secretly, she names the tiny girl "Annina" and tucks her inside her heart and mind, where for years she nurtures her, protects her, dresses her, listens to her language, and watches her grow to a daring adventuress, though she is Thumbelina small, and carries a needle for a sword. Annina eventually moves on and the narrator will not dare to ask her to come home.

View full annotation

The Thief

Dunmore, Helen

Last Updated: Nov-16-2003
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Sam and her partner are getting ready to go out. She is due to have a baby soon, and they need to acquire just a few more items to complete the nursery and baby wardrobe. Sam wants a Forever Baby duvet, but realizes that it may be difficult because duvets are large and hard to conceal. Slowly it emerges that her trendy baby supplies are stolen.

Sam stops by the clinic where an assistant makes the mistake of asking if this is her first pregnancy. The glance from a colleague silences her, but Sam notices. She has no baby now but she remembers her little girl who "ought to have kept out of his way" although she was hiding in her duvet.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This book, "a humanistically oriented sociocultural history of medicine" (p. x), focuses on the interactions between patient and doctor in western medicine from the nineteenth century through contemporary times. Furst, a Professor of Comparative Literature at the University of North Carolina at Chapel Hill, uses literary works to chronicle the changing patterns of medical practice, the social positions of doctors, and effects of medical education as they relate to "the doctor-patient alliance." (p. x) By "mapping cultural history in and through literature" (p. x), Furst enriches our understanding of the development of various roles and expectations of doctors and patients since approximately 1830.

The first chapter details the concept of the book and clarifies its purpose. Most histories of medicine concern famous discoveries, introductions of new technologies, and lives of renowned physicians and researchers, yet they neglect to examine patients' perspectives. Furst's mission is to reinstate patients into medical history and contemporary analysis. She chooses to focus on everyday-type of medicine, and more specifically, "to chart the evolution of the changing balance of power in the wake of the advances made in medicine in the nineteenth and twentieth centuries, drawing on literary texts as sources." (p. 17)

The other seven chapters are topic oriented and placed in general chronological order. The chapters vary in the number of sources examined. For example, Chapter 2, "Missionary to the Bedside" is a comparative analysis of Anthony Trollope's Doctor Thorne (see this database) and Elizabeth Gaskell's Wives and Daughters, and Chapter 3, "Seeing-and Hearing-is Believing" almost exclusively concerns Middlemarch by George Eliot (see this database).

Other chapters, however, include commentary on more sources. A chapter on twentieth century hospital-based practice and medical education, "Eyeing the Institution," begins with a review of various films, television shows, and novels and follows with an in-depth comparative analysis of three autobiographical accounts of medical education and training: A Year-Long Night by Robert Klitzman, A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass (see this database), and Becoming a Doctor by Melvin Konner.

Furst examines the effect of gender on patient and physician experiences and expectations. In Chapter 4, "A Woman's Hand," five novels about "doctresses" (a term used for women doctors in the late nineteenth century) are compared. How and why the protagonists became doctors, what sacrifices they made, how patients viewed having a woman doctor, the range of solutions to career and/or marriage choices, and the personalities of the protagonists are some of the comparisons made. These novels are placed in historical context with information about the lives and attitudes of physicians such as Elizabeth Blackwell and Mary Putnam Jacobi.

Other topics include evaluations of the nineteenth century hospital, the role of research and the laboratory (Sinclair Lewis's Arrowsmith annotated by Felice Aull, also annotated by Pamela Moore and Jack Coulehan --see this database--and A. J. Cronin's The Citadel), and the impact of contemporary changes in reimbursement and management on the power relations in medicine. A sensitivity to the effects of language on power relations is a theme throughout the book, and is more fully examined in the final chapter, "Balancing the Power." After an analysis of several books by Oliver Sacks , and his attempts to truly understand his patients' perspectives, Furst concludes, "The balance of power cannot be even, but it must at least strive to be fair." (p. 251)

View full annotation