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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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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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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Rob Morrow of "Northern Exposure" fame portrays Lyle Maze, a very sweet artist/sculptor with Tourette's syndrome. Even though early scenes demonstrate the challenges presented by involuntary shoulder shrugs, arm twitches, popping sounds, and vocalizations associated with Tourette's, the story quickly evolves into a fairly predictable tale of love. Mike (Craig Sheffer) is engaged to Callie (Laura Linney), but spends months of time incommunicado--practicing medicine in Burundi and other remote locations.

For different reasons, both Lyle and Callie are cast into lives defined by isolation and loneliness. Shortly after Mike has left for his most recent assignment, Callie learns that she is pregnant. Alone and confused by Mike's long absences, she turns increasingly to Lyle for friendship and support. Not surprisingly, they fall in love.

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Ethan Frome

Wharton, Edith

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

Primary Category: Literature / Fiction

Genre: Novella

Summary:

Sometimes overlooked by those attracted to Wharton's longer, more ironic novels, this novella is one of stark simplicity set against a bleak New England countryside at the beginning of the 20th century. With characteristic economy, Wharton tells a compelling story about the human need for passion and affection in a situation where only abject coldness exists.

Ethan Frome is introduced by the narrator in this way: "It was there that, several years ago, I saw him for the first time; and the sight pulled me up sharp. Even then he was the most striking figure in Starksfield, though he was but the ruin of a man" (3). Determined to learn more about Ethan, while temporarily located in an appropriately-named village, the narrator manages to gather pieces of information about the figure who seemed an "incarnation of frozen woe in the melancholy landscape" (11).

The spark of hope that might have led young Ethan toward education and escape expired when care for his chronically-ill mother fell first to him and then to a cousin named Zenobia. Unable to abandon his mother and their needy homestead, he was easily attracted to Zenobia, the kindly young woman who assisted in his mother's care. They married, the mother died, and Zenobia inexplicably assumed a sick-role that would make Ethan's life loveless and tragic. Permanently stuck in Starksfield, his years become emotionally and economically depressed. Barely able to eke out a living hauling lumber and subjected to his bed-ridden wife's petty and constant demands, Ethan's impoverishment seems unending.

Miraculously, a third person, Mattie, enters the narrative. A distant cousin with no resources, she has been summoned by Ethan's increasingly mean-spirited wife to do chores within the house. The scene is set for two lonely and isolated people, despite age differences, to discover small bits of warmth in stolen moments together. Walks through the snow or gentle kindnesses in the dull household routine sustain the otherwise desolate pair of innocent lovers. An unexpected turn of events transforms a hopeless set of circumstances into permanent desolation and trauma. The conclusion is one of unimaginable horror.

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

This unusual story, beautiful and overwhelmingly sad, is set in Sicily on the craggy and barren island of Lampadusa surrounded by the bluest of seas. Everyone in the small fishing and canning village may be related; certainly, this is a place where secrets are not possible. Grazia (Varria Golino) appears to be the loveliest and most loving mother and wife, although her carefree, even childlike behavior is foreboding. The camera loves her and so do viewers who are ravished by her beauty and innocence.

With children positioned on the back of her Vespa, she and they escape to a deserted beach where she swims topless with her children; later, she releases hundreds of howling stray dogs from their inhumane confinement. Not surprisingly, spied-upon actions such as these produce critical response from more conservative neighbors whose norms are less capricious.

When signs of instability and manic depression become apparent, the community joins together to suggest hospitalization to her very supportive and heart-broken husband (Vincenzo Amato). She, like the caged-up dogs, seems to deserve the kind of freedom epitomized by her trips to the beach and will not, we sense, survive medical "imprisonment."

At this juncture, just as her wings are to be clipped, the story’s unexpected turn forces the mourning village to wonder about human frailty and reality. The ending, ultimately unclear and haunting, is a celebration of imaginative madness and ephemeral beauty. Visually stunning.

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Annotated by:
Nixon, Lois LaCivita

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The story is based on an actual 1950's trip by two university friends, Ernesto 'Che' Guevara (Gael Garcia Bernal) and Alberto Granado (Rodrigo De la Serna). Guevara is studying medicine, Granado biochemistry. They plan to travel from Buenos Aires across the Andes Mountains to Chile, Peru, and, then, to Venezuela. Before too many miles their derelict 1939 motorcycle fails, and the two young men continue by whatever means is available. The journey intent is one of adventure--drinking, meeting women, seeing the world.

The young men do discover South America's impressive natural beauty but more strikingly, their eyes and sensibilities are directed to abject poverty and shocking injustices. These blatant inequities, as well as an extended period of time in a leper colony, contribute to the reframing of their original happy-go-lucky adventure and explain, in part, the impulses that eventually would shape Guevara's role in the Cuban Revolution.

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Leaning Together in the Storm

Smith, Larry

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

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Summary: This very welcome poem concerns "twelve older men in shirt sleeves," a group of men with prostate cancer. The narrator, one of the men in this "private brotherhood" suggests the difficulty and reluctance of many men to recognize out-loud their mutual circumstances: "Ever notice how no one parks / in the Cancer Center zone." This line sets the tone; the men are vulnerable and afraid. From time to time they gather for support from one another and from the meeting's scheduled speaker. The reader has little difficulty imagining the collective angst and the grasping of hope shared by the participants leaning together in their mutual storm.

Any expectation of supportive discourse is shattered by this evening's guest speaker, a careless surgeon, who strides confidently into the room with his tray of slides. The remainder of the poem demonstrates a worst-case scenario:

I interrupt his gay delivery,
"What about orgasm...?"
"Forget orgasm," he grins,
"You don't have a prostate."

Some smile nervously and bravely ask questions that really matter. Each time the physician exhibits his caustic brand of insensitivity. The narrator, surely expressing the feelings of his colleagues, wants only to "drive / this witch doctor from the room."

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The Incalculable Life Gesture

Lasdun, James

Last Updated: Feb-16-2010
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Richard Timmerman doesn't see eye-to-eye with his sister, Ellen. After their parents die, the siblings inherit the house. Richard wants to sell his share of it, but Ellen won't budge. She and her son continue to live in the home. As an elementary school principal in upstate New York, Richard already has a lot on his mind.

He notices a swelling under his chin. Three weeks later, the lump is still there. He visits Dr. Taubman, but the family physician is uncertain of the diagnosis. It might be a benign enlarged lymph node but a lymphoma cannot be ruled out. Richard focuses only on the possibility of cancer. A CAT scan is scheduled along with a referral to an ENT specialist for a biopsy.

Richard questions the radiologist supervising the scan about the results. She will not tell him. He suspects that she is holding back the truth. He next sees Dr. Jameson, the ENT specialist. The young physician examines Richard and then reviews Richard's CAT scan. The doctor's verdict is a salivary gland stone (sialolithiasis) that will likely pass on its own.

At first, Richard is angry with his family physician for not making the correct diagnosis. Soon his irritation gives way to relief. Richard has received a medical reprieve. There is no lymphoma. No treatment is necessary. Life is suddenly glorious. Richard's joy is transient. He telephones his sister to announce the good news and to patch things up with her. Ellen is unimpressed by Richard's recent scare and his magnanimity. The phone call leaves Richard uncertain and fearful about his future.

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Because of Anya

Haddix, Margaret Peterson

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

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Keely, whose three "best friends" are a dominant clique in their class, notices that a classmate, Anya, appears to be wearing a wig. The girls confer about it at lunchtime, wonder whether to ask about it, and theorize that she may have cancer and be undergoing chemotherapy. Stef, long the most aggressive among the four friends, suggests that Keely talk with Anya and find a way to determine whether it is a wig, but Keely refuses, recognizing in Anya, whom she rarely notices, a quality of loneliness she hadn’t seen before.

Their curiosity is satisfied when Anya’s wig comes off during a gym exercise and she runs out and remains absent for several days. Keely decides to visit Anya and learns that she has a rare disease, alopecia areata, which is painless and otherwise harmless, but causes hair to fall out, sometimes all over the body. When she asks if she can help, Anya replies, "Not unless you want to give me your hair."

Keely researches the disease for class and finds that there is a foundation that collects long hair for wigs for patients suffering from Anya’s condition, so she cuts off her own long hair and encourages classmates to do the same in a gesture of solidarity with Anya, in the process defining a new independence from the clique of friends who have too long shaped and confined her judgments of others.

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The Resurrectionist

McCann, Richard

Last Updated: Feb-12-2010
Annotated by:
Garden, Rebecca

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

McCann’s essay is an account of his experience of liver transplantation. It describes his physical and psychic experience of liver failure while waiting on the list for an available organ, his experience in the hospital when the procedure was done, and the aftermath, in which he makes conceptual and emotional adjustments.

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