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The Father

Zeller, Florian; Hampton, Christopher

Last Updated: Jul-12-2016
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Plays — Secondary Category: Performing Arts / Theater

Genre: Play

Summary:

This annotation is based on a live performance presented by the Manhattan Theater Club at the Samuel J. Friedman Theater  in New York City that ran between April and June of 2016. The play was nominated for a 2016 Tony Award for best play, and Frank Langella won the 2016 Tony Award for best performance by an actor in a leading role in a play. In supporting roles were Kathryn Erbe, Brian Avers, Charles Borland, Hannah Cabell, and Kathleen McNenny.
 
The Father is the story of an older man with Alzheimer’s disease (André) and his progression through first living on his own, then living with his daughter (Anne), and finally living in a nursing home. Or, is it? It’s hard to tell, and that is the intention of the playwright, Florian Zeller, who told The Guardian (2015), “The Father is about an old man lost in the labyrinth of his mind.” The objective of the play is to bring audience members into the actual dementia experience so that rather than witnessing André’s disorientation they feel his disorientation.  

The director, Doug Hughes, creates the audience experience through an interplay among set designs, lighting effects, repeated scene sequences, and time loops as contexts for various symptom manifestations like memory loss, paranoia, anger, and lasciviousness. All the scenes take place in one room that serves at different times as André’s flat, Anne’s flat, and a nursing home room. The furnishings of the room change based on the supposed setting, but the walls are exactly the same for all of them. In different scenes, André is not always sure where he is, and neither is the audience.  

Early in the play, André hears Anne tell him she’s relocating from Paris to London with her lover, but she is present to him in most of the scenes thereafter and until the end of the play when he’s told by a nurse that Anne had moved to London some time ago. Had she really left Paris and was never actually there in all those other scenes? He wonders and so does the audience. In other scenes, the way characters from the past and present enter and exit distorts time for André, and so while audience members know the linear trajectory of the disease course, they can’t be sure of where they are in that course during a given scene. With the last scene taking place in André’s nursing home room with the same walls seen in his flat and Anne’s flat, the audience can’t be faulted for wondering whether all that came before was just one of André’s hallucinations.  

The play does not keep audience members in a perpetual state of confusion and despondency. Farcical elements are peppered throughout that produce occasional laughs, such as when Anne contests André’s account of a previous conversation, he suggests it’s she who has the memory problem: “You’ve forgotten. Listen, Anne, I have a feeling you sometimes suffer from memory loss. You do, I’m telling you. It’s worrying me. Haven’t you noticed?”

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Summary:

The aim of these reflections on uncertainty in medicine is not to discredit evidence-based medicine or to incite suspicion of the careful and caring processes by which most clinicians arrive at the advice they give.  Rather it is to change conversations among practitioners and between them and their patients in such a way as to raise everyone’s tolerance for the inevitable ambiguities and uncertainties we live with.  If the public were more aware of the basic rules of mathematical probabilities, how statisticians understand the term “significance,” and of how much changes when one new variable is taken into account—when a new medication with multiple possible side-effects is added to the mix, for instance—they might, Hatch argues, be less inclined to insist on specific predictions.  He goes on to suggest that there is something to be gained from the challenge of living without the solid ground of assurances.  When we recognize the need to make decisions with incomplete information (a condition that seems, after all, to be our common lot) we may refocus on the moment we’re in and see its peculiar possibilities. Changing the conversation requires a critical look at medical education which, Hatch observes, “measures a certain type of knowledge essential to medical practice, but it consequently engenders a conception of medicine best described as overly certain . . . .” 

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Little Angel

Sesow, Matt

Last Updated: Jun-28-2016
Annotated by:
Lam, Gretl

Primary Category: Visual Arts / Painting/Drawing

Genre: Painting

Summary:

Two harshly drawn figures make up this painting, an adult cradling a baby. Both figures stare out and confront the viewer with round bulging eyes. Their wide red mouths are drawn into grimaces, displaying long rows of teeth. Their bodies are pale, but are outlined roughly in black, and marked by gashes of blue, pink, and red. They stand, highlighted in yellow, against an angry and energetic backdrop of red and orange.  

A small black halo sticks out stiffly from the head of the baby, while two sharp black horns protrude from the crown of the adult. The adult’s disproportionately large thick hand presses the baby close to their body. Is this an adult or is it a monster or a devil? The viewer is left to decide. Whoever or whatever the figure is, it holds the baby in a way that is protective and menacing at the same time.

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We Are Not Ourselves

Thomas, Matthew

Last Updated: Jun-20-2016
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1951, Eileen Tumulty, the novel’s main character, was nine years old and living with her Irish immigrant parents in the Woodside section of Queens, New York. The novel follows Eileen straight through the next 60 years, but concentrates on the years covering the time of her husband’s Alzheimer’s disease.    

Eileen was forced to learn how to manage a household at a very young age when first her mother was kept in a hospital for 8 months after a hysterectomy, and then again when her mother became incapacitated by alcoholism. Eileen had reason to think this life was her destiny until she accompanied her father to a better part of Queens. There she saw “places…that contained more happiness than ordinary places did.” She concluded, “unless you knew that such places existed, you might be content to stay where you were.” (pp. 15-16) Eileen’s ambition was ignited. While continuing to manage the household and care for her mother, she does well in school, becomes a nurse, and eventually moves up the nursing management at various hospitals.  

Eileen’s ambitions encompassed ideas on her eventual mate. She chooses Ed Leary despite hoping for someone who was not quite so Irish and not quite so much of the same place. Ed was a promising neuroscience graduate student who she thought could be a high achiever with the right motivation: “If there was anything she could help him with, it was thinking big.” (p. 97) Her motivation was not enough and neither were the many offers he received from life science companies. He became a professor at a local community college. He had a passion for teaching students who attend community colleges and he could never see himself anywhere else—for love or money. Ed’s intransigence frustrated Eileen, but she accepted it and plowed ahead. She studied the possible ways of escaping the old neighborhood and also delivered a son she thought she’d never have after years of futile efforts.  

It doesn’t go smoothly. While she is getting surer of where they would go, Ed begins to exhibit disconcerting behaviors. For them to live in Bronxville, Eileen will have to accept a house that needs a lot of money and attention to rehabilitate. The remainder of the story is about how Eileen simultaneously manages Ed’s rapid deterioration from what eventually is diagnosed as Alzheimer’s disease, her job requirements, and a son progressing from adolescence through college.  

We Are Not Ourselves
touches on many of the aspects involved in prolonged illness including the daily struggles managing the care of someone with progressive dementia, complexities of health care delivery systems, frustrations with byzantine health care coverage, and threats to relationships among the individual family members with one another, and the grace that can manifest during the bleakest moments. The author does not dwell on all these issues, but gives them enough attention so that their effects will be recognizable to many readers who have experienced them. In doing so, he was able to draw from his own experiences with his father who was stricken with early onset Alzheimer’s disease.

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The Lady and Her Monsters

Montillo, Roseanne

Last Updated: Jun-10-2016
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

The Lady and Her Monsters is a companion monograph of literary, cultural and scientific history to Frankenstein , the masterpiece written by a 20 year old Mary Wollstonecraft Shelley (hereafter MWS). Starting, in its prologue, with late 18th Century Italian anatomists, it proceeds chronologically to add layers to the foundation on which MWS built her novel. Although many of these events and stories (grave-robbing, resurrectionists, infamous criminals like Burke and Hare, the setting of the composition of the novel in Switzerland) are well known to students of Frankenstein, the author adds less well known details and narrative flourish, ending with the 1831 edition and the remainder of Mary Shelley’s life following the death of her husband Percy Bysshe Shelley (hereafter PBS).  

The book begins with a prologue describing, narratively, the most proximate scientific influences on Mary Shelley.  The experiments of Aldini and his nephew Galvani form a significant portion of the backdrop for Shelley’s famous literary experiment approximately 30 years later, as famous for its product as it is for its lack of description of materials and methods.

Summary of chapters 1 through 9:

Chapter 1: “The Spark of Life”: biographical information about William Godwin, Mary Wollstonecraft and the early years of MWS

Chapter 2: “Waking the Dead”: a return, with more detail, to late 18th C Italian anatomists and scientists using electricity to stimulate dead animals and their tissues: Vesalius, Galvani, Volta, Aldini

Chapter 3: “Making Monsters”: more on Aldini and the rise of resurrectionists in late 18th C and early 19th C England

Chapter 4: “A Meeting of Two Minds”: Paracelsus and Agrippa as antecedent scientists of interest to PBS and MWS; the couple’s romance

Chapter 5: “Eloping to the Mainland”: the famous story of the trip of the Shelleys, Byron, and Polidori to Castle Frankenstein in Switzerland

Chapter 6: “My Hideous Progeny”: more on the literary history behind the creation of Frankenstein and the continuing soap opera of the lives of the Shelleys, Polidori, Claire Claremont and Lord Byron

Chapter 7: “Frankenstein, or the Modern Prometheus”: suicide of Fanny Imlay (half-sister of MWS), marriage of Shelleys, publication of Frankenstein

Chapter 8: “The Anatomy Act”: more 19th C body snatching; Burke and Hare; and the passage of the Anatomy Act of 1832 in the U. K., controlling the supply of bodies to anatomy labs

Chapter 9: “A Sea Change”: death of PBS and Lord Byron

Epilogue: modern day (2004) grave-robbing; remainder of MWS’s life

Following the epilogue are notes to the chapters, a bibliography and index.

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Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Painting

Summary:

Theodor Billroth, one of the most innovative and outstanding surgeons and educators of late 19th century European medicine, is depicted in this painting at the height of fame when he was about 60 years old. Billroth, in full white beard, stands in the center of the canvas, looking away from the patient--an assistant is handing him a surgical instrument. His visage is regal, his bearing composed.Seven white-coated assistants surround the patient, who lays supine with his head elevated. The patient's head is shaved, and according to the artist's notes, the operation is a neurotomy for trigeminal neuralgia--a painful condition of the face. The patient is receiving general anesthesia by open drop method. Billroth favored a mixture of alcohol, chloroform, and ether, anticipating a modern trend to administer multiple agents in anesthesia. Billroth is also using Lister's methods of sterilization and antisepsis. Note that rubber gloves were not yet used in surgery at this time.Light from a large window to the surgeon's right bathes the operating theater with brightness. A full gallery of onlookers includes the artist on the right side of the first row, and the Duke of Bavaria, seated at the opposite end, who came to the operations and lectures for entertainment. Billroth was a celebrated teacher, and thousands came to the Allgemeines Krankenhaus, the General Hospital of the University of Vienna, to observe and study his techniques.

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Annotated by:
Lam, Gretl

Primary Category: Visual Arts / Photography

Genre: Photography

Summary:

In this series of black-and-white photographs, Hannah Wilke poses half-naked for the camera, mimicking the postures of female celebrities and models in magazines and advertisements. She is mockingly flirtatious in some images, playfully wearing a man’s tie, tousling her hair, smiling suggestively with her lips parted. In other images, her expression is cold and distant, as the viewer gazes at the sensuous curves of her neck, back, and breasts.

But there is more. Wilke has also stuck tiny chewing gum sculptures of vulvas to her body. These sculptures simultaneously confront and repel the viewer. The vulvas explicitly confront the viewer about their sexual thoughts and desires as they view photographs of a woman’s body. And the vulvas sprout from her face, back, and chest like warty or diseased growths, and causing the viewer to step back in revulsion, thus breaking their lascivious gaze.

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Annotated by:
Clark, Stephanie Brown

Primary Category: Visual Arts / Painting/Drawing

Genre: Painting

Summary:

In this famous group portrait, seven figures, situated in the anatomical theatre of the Surgeon’s Guild in Amsterdam in 1632, gaze intently in various directions--several look towards the cadaver of Aris Kindt, a criminal recently executed for robbery; others towards the 39-year old surgeon and appointed "city anatomist" (Praelator Anatomie) Nicolaes Tulp; several figures seem to look towards the large text at the bottom right of the painting, possibly the authoritative anatomical atlas by Andreas Vesalius, De Humani Coporius Humani [Fabric of the Human Body] published in 1543; several figures gaze out towards the viewer. Tulp himself appears to look beyond the guild members to an audience elsewhere in the anatomical theatre.Only the left forearm and hand of the cadaver have been dissected. With forceps in his right hand, Tulp holds the muscle which, when contracted, causes the fingers to flex (flexor digitorum superficialis). Tulp’s own left hand position seems to demonstrate this movement. The figure farthest from the cadaver appears to imitate this position. The palour and stiffness of the cadaver contrasts with the intensity and colour on the faces of the onlookers, and with the living hands of Tulp the dissector.

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A Streetcar Named Desire

Williams, Tennessee

Last Updated: May-24-2016
Annotated by:
Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

The play is set in 1947 (the year it premiered) in New Orleans. Having lost their ancestral Mississippi home to creditors, Blanche Dubois arrives at the shabby French Quarter flat of her sister Stella. When we first meet Blanche she explains she is on a leave of absence from teaching high school English on account of her “nerves.” From her first meeting with Stella’s husband Stanley Kowalski, a World War II vet, we detect class conflict and sexual tension between the two of them. As Blanche’s visit becomes more and more protracted, Stanley becomes increasingly suspicious of her motives and background. Meanwhile, she begins to date Mitch, one of Stanley’s poker buddies. Gradually we learn more about Blanche’s checkered past. She was once married to a young man who committed suicide after she discovered him in a sexual encounter with another man. Stanley uncovers rumors that she was fired from her teaching job for having sex with a student. As the play progresses, fueled by her surreptitious drinking, Blanche’s mental state unravels. When Stanley warns Mitch about Blanche’s notorious reputation, Mitch rejects her.  Adding insult to injury, while Stella is having a baby, Stanley rapes his sister-in-law. Blanche’s emotional deterioration is complete. In the final scene, a doctor and nurse arrive to take Blanche to a mental hospital. She initially resists them, but when the doctor helps her up she willingly surrenders: “Whoever you are - I have always depended on the kindness of strangers"(p. 178).

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Annotated by:
Kohn, Martin

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In this volume, Gonzalez-Crussi trains his sights on medical history, applying his lyrical writing skills to essays that he hopes will help preserve the humanistic core of the medical profession. Because of its brevity (250 pages), he apologizes for its focus on "Western medicine since the inception of the scientific method"(p.xi), but does note that he acknowledges "the continuity between ancient and modern medicine...[and] the contributions of the Orient, and of epochs predating the dominance of the rational spirit" (p.xi).What distinguishes this volume beyond the writing is the thematic organization. It begins with the Rise of Anatomy and Surgery, but then moves to Vitalism and Mechanism, The Mystery of Procreation,  and Pestilence and Mankind, before finishing with a look at Concepts of Disease, The Diagnostic Process and Therapy (including a brief focus on psychiatry). In the last section, Some Concluding Thoughts, Gonzalez-Crussi returns to his motivations for writing this short history, citing the mixed blessings of scientific progress whose gains, for example, are offset by those who "appear to try to 'medicalize' every aspect of human life" (p.210).

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