Showing 61 - 70 of 229 annotations tagged with the keyword "Anatomy"

Where is the Mango Princess?

Crimmins, Cathy

Last Updated: Nov-30-2009
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The lives of writer Cathy Crimmins, her lawyer husband Alan Forman, and their seven-year-old daughter were changed forever on July 1, 1996, at a lake near Kingston, Ontario. "Alan’s brain got run over by a speedboat. That last sentence reads like a bad country-western song lyric, but it’s true. It was a silly, horrible, stupid accident." (p. 5). While Alan steered a small boat back to dock at the end of their vacation, a teenager drove a speedboat literally over him, causing major traumatic brain injury (TBI) including seizures, coma, hemorrhage and paralysis.

Crimmins chronicles her husband’s remarkable recovery with a mix of humor, medical information, anger at HMO denial of benefits, and gratitude for the care of physicians, nurses, therapists, EMT, friends and family during this grueling, and in many ways, never-ending ordeal. Although Alan survived -- and is now capable of walking, speaking, reading, loving, working and driving -- he is a different person. The injury to his frontal lobes causes him to be disinhibited, erratic, angry, irrational, petulant, obsessive, devoted yet cruel to his daughter, and prone to severe "cognitive fatigue."

TBI is a bizarre, unpredictable illness. Crimmins notes that the degree of Alan’s recovery is atypical for the force of his trauma. In addition, TBI survivors say and do wacky things: "Where is the mango princess?" was one of Alan’s first utterances after emerging from his coma. Alan’s pre-accident sharp-edged humor was replaced by bland affability and a disturbingly vacant gaze. Yet some of what he says and does is heart wrenching and poignant.

The book clearly documents that the trauma is not limited to the patient. As Crimmins so eloquently and honestly recounts, she, her daughter, and all who knew Alan were traumatized by the accident and its aftermath.

Crimmins is an aggressive caregiver, thrust kicking and fighting into the caregiver role. Her advocacy for her husband, including research into the best rehabilitation facility, day hospital, vocational rehabilitation program, doctors, therapists, etc., was unwavering and crucial to his optimal care and outcome.

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Notes on Emphysema

Carruth, Hayden

Last Updated: Nov-19-2009
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This long poem is divided into 48 segments, each a meditation on the narrator's struggle to live with emphysema. Some sections consist of only one line (10: "How alone can you get?"), others are more lengthy; for example, section 37 is a primer on inhalers, "puffers, " how to use them and what happens if you don't.

Every observation in this poem is from a literate poet's point of view, one here focused on emphysema, and so the breath, the body, and the daily rituals of living become primary. The whole world breathes--even the computer, which "sighs" when it is turned off (section 34)--but the poet cannot catch his breath. Reading the poem, even silently, the reader becomes short of breath too, physically aware of the patient's limitations.

In section 24, Carruth laments that he cannot even negotiate the 500 yards up hill to his son's house; in section 29, he writes that even the dog seems "reproachful" when his owner is unable "to play" and throw the blue ball. The accumulated limitations of these taken-for-granted actions makes the author both "pissed and sorry" for the dog, for the man, for the world.

In spite of the physical rebellion of the lungs, the narrator continues to smoke, as many patients with chronic obstructive pulmonary disease (COPD) do, adding another dimension to this poem. Even facing death, the patient's addiction to tobacco is overwhelming; in section 11, the narrator says, "Now I am dying. Now I am afraid. Please give me a cigarette." In section 45, Carruth laments this "nonsense of misery."

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Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Art with Commentary

Summary:

One Breath Apart: Facing Dissection is a pictorial and narrative account of gross anatomy class in medical school. The book highlights the educational, moral and metaphysical opportunities anatomy courses afford those who dissect and learn from the cadaver. Educator and thanatologist Sandra Bertman has expanded on her work with medical students previously summarized in her book Facing Death: Images, Insights, and Interventions (see annotation).

Written with the first year medical student in mind, One Breath Apart is a compilation of drawings and writings by students from the University of Massachusetts Medical School between 1989 and 2002 in response to course assignments. The book is dedicated to the professor of the anatomy course, Sandy Marks - of note, the medical humanities module, including assignments and events were integrated into the course. Bertman describes the course and provides a plethora of student work.

Additionally, the book is enhanced by photographs by Meryl Levin, with writings by Cornell-Weill medical students, excerpted from Levin's marvelous study,  Anatomy of Anatomy in Images and Words. Also included is a foreword by Jack Coulehan, who writes of his experience with his cadaver ("We named him ‘Ernest,' so we could impress our parents by telling them how we were working in dead earnest." p. 7) and the lifelong impact of dissection on the student.

Of particular note is the variety of content included in this intriguing volume. Artistry is not a medical school admissions criterion, yet a number of the drawings have design components which are thought-provoking and profound. For example, on page 80 a female doctor adorned with white coat, stethoscope and bag stands beside an upright skeleton. They are holding hands.

Bertman concludes the book with photographs, drawings and text related to the annual spring memorial service for the body donors. The section includes eulogies by students and responses by donor family members. Writes medical student Nancy Keene: "Studying his body provided an opportunity which enhanced my education. But it was the giving of his body, which has remained with me as a lasting memory." (p. 87)

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The Abandoned Doll

Valadon, Suzanne

Last Updated: May-19-2009
Annotated by:
Nixon, Lois LaCivita

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

In this and other works, French artist Suzanne Valadon steps outside the boundaries established for women artists in the male-dominated world of art. Portrayal of the gazed-upon female nude was reserved for men who conventionally painted them as objects: ageless, beautiful, seductive, passive, and vulnerable. Women painted flowers and children, not nudes.

Not only does Valadon violate traditional expectations, she presents an adolescent nude who, like most adolescents, is self-absorbed with her appearance. She is not positioned for the viewer's gaze, but for her own self-appraisal. The pubescent child/woman sits at the edge of the bed intent upon her own image in a handheld mirror. In contrast, a fully clothed woman, probably her mother, sits behind her on the bed gently towel-drying the girl's shoulder and arm.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Triggered in part by a trip to the Galápagos Islands, the author interweaves two parallel narratives: Darwin's "journey toward evolution" along with the related work of Alfred Russel Wallace; and the author's own journey through life, partially disabled and dependent on the specially fitted shoes that help him to walk.  Together these two narratives develop "all I have come to understand about chance and change, fear and transformation, variation and cultural context, ideas about the body that question the definition and existence of difference in all of our lives" (xvii).

Born with an unnamed congenital condition in which his fibulae are absent along with other lower limb "abnormalities," Fries underwent five major reconstructive surgeries as a child, but after those, what helped him most were special shoes that were fitted to his special body, assisting him to walk.  As an adult, however, he begins to experience back pain and knee problems.  The memoir relates, both in flashback, and in the present day, Fries's quest for a proper pair of shoes that will help him avoid yet another surgery -- the shoes he has been wearing are 20 years old and no longer do the job.  We meet Dr. Mendotti, who treated him like a peculiar specimen and offered a pharmacologic way out of his pain; shoemaker Eneslow, in a dingy Union Square office, whose shoes not only fit Fries well, but were festive in appearance -- "I felt both normal and special" (17); other practitioners of orthotics who try but fail to construct shoes that relieve Fries's pain, and finally, the gifted, patient orthoticist, Tom Coburn, who persists until he is able to provide shoes that work.  The shoes have been adapted for Fries's body, just as man has constructed adaptations that allow him to live in a variety of climates and circumstances.  Conversely, Fries, convinced he "can adapt to the circumstances in which my body places me (169)," draws from Darwin, whom he quotes: "individual differences are highly important for us, as they afford materials for natural selection to accumulate" (169).
 
Darwinian connections are invoked throughout the narrative.  The peculiar configuration of Fries's feet and shoes help him to ascend a series of mountain ladders while his partner, Ian -- who usually has to assist Fries with such physical maneuvers -- suddenly becomes fearful of the height and exposure;  back problems might have developed even without his congenital abnormalities because evolution of the capacity to walk upright included the tendency toward back pain; the role of chance in natural selection and the role of chance in the physical fact of congenital conditions; the positive role that his partner Ian's attention deficit disorder (ADD) could have played in the days of hunter-gatherers and the cultural context in which ADD is now considered to be "abnormal."
 
Fries discusses his fears -- both rational and irrational -- as well as his awareness of stigma, difference, and sameness.  The context of these discussions is usually a reminiscence about vacations in far-flung countries (Thailand, the Galápagos, Bali, Alaska, the Canadian Rockies) and physically challenging domestic locales (a Colorado River raft trip, the Beehive Mountain in Acadia National Park).  He  occasionally brings into the discussion his homosexuality, especially as his physical deformity affected sexual encounters.  The relationship between Fries and Ian is woven throughout the memoir as one of understanding, mutual need and benefit.  As the memoir ends, Fries worries about the likelihood he will need a wheelchair, but is at the same time gathering confidence in his ability to ride the Easy Flyer bicycle that Ian has discovered at the local bike shop.

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Summary:

John Romulus (also known as Richard) Brinkley was a physician (in the diploma-mill sense of the word) who, in 1917, pioneered, in the U.S. at least, the notion of goat testicle transplant. "Transplant" must be understood in the loosest sense of the word since Brinkley simply removed the testicles from young goats and sewed them into the abdominal wall and scrotal tissues - without any attempt to connect blood or nervous tissues of either goat testicles or human  - of men for the alleged purpose of relieving impotence. From 1917 until his downfall at the hands of Morris Fishbein, a medical crusader esconced in the AMA, which organization Dr. Fishbein helped establish as the premier advocate of organized medicine in the U.S., Dr. Brinkley was perhaps the most recognizable physician in the U.S.

He ran for the office of Governor of Kansas in 1930 (losing by technicalities that today would have overturned the results), and established the most powerful radio station in the land, XERA, that promulgated his glandular chicanery all across the continental U.S. As a proponent of such skullduggery, Brinkley was continually in the sights of Dr. Fishbein, whose main reputation nationally was as an exposer of medical fakery. Eventually Fishbein lured Brinkley into a libel trial that resulted, in 1939, in the catastrophic downfall of an immensely talented and wealthy man who spiraled into bankruptcy and death in 3 short years.

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Mind Talk: The Brain's New Story

Drake, Bob

Last Updated: Mar-10-2009
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This documentary film explores the interdisciplinary quest to understand the mind--its relationship to the brain, to the soul, to consciousness and sentience, and to the societal implications of free will. The film begins with the crisscrossing flow of people in a train station and an overvoice expressing the existential questions of "who are we?" and, ultimately, "who am I?"

This compelling image, filmed in black and white, serves as a representation of people as humanity and as individuals, as well as a metaphor for flow, such as of time or of impulses along a neural network. Hence, already in the introduction, the viewer is aware that this film will address some of the deep philosophical questions of all time complemented by visual imagery which enhances and enlarges on the dialogue.

The film is then divided into twelve sections: The Soul, The Body, Mental Disorder, Mind to Molecule, Bit to Brain, Consciousness, Free Will, Citizenship, The Moral Brain, The Brain on Trial, The Medical Mind, and Who Am I? Experts from multiple fields such as theology, neuroscience, psychiatry, law and justice, philosophy, sociology, history of medicine, physics, computer science, and filmmaking offer insights and questions either directly to the camera, or as voice-over for other imagery.

For example, to name just a few of the numerous eminent persons in the film, there are statements by mathematical physicist Roger Penrose (Shadows of the Mind: A Search for the Missing Science of Consciousness, and The Emperor’s New Mind: Concerning Computers, Minds and the Laws of Physics), philosopher Daniel Dennett (Darwin’s Dangerous Idea: Evolution and the Meanings of Life, and Brainchildren: Essays on Designing Minds), philosopher John R. Searle (Mind, Language and Society: Philosophy in the Real World) and neurologist Antonio Damasio (Descartes’ Error: Emotion, Reason and the Human Brain). The multiple experts all address the basic question posed by the film: "What will a science of the brain add to the human story?" but the approaches to the question, and what aspects of the question are most important, vary considerably in this far ranging journey through religion, history, ethics, medicine and science.

A few of the many interesting segments of the film include sections on cognitive neuroscientist Nancy Kanwisher who studies specialization by parts of the brain, such as a face-recognition center; developmental neuroanatomist Miguel Marin-Padilla, who has studied the motor cortex for over 25 years, which he demonstrates by dissection to be smaller than the tip of his finger; and Dennett’s one-armed robot, Cog, which is "learning" in developmental stages as an infant would. Eloquent commentary is also provided by computer scientist Jaron Lanier, sociologist Howard Kaye, psychologist Nicholas Humphrey, and filmmaker Ken Burns, among others.

Much of the film deals with psychopathology and implications for morality, behavior, and responsibility for behavior (free will and crime). Segments include an interview with a patient with manic-depressive disorder, a historical note on Phineas Gage (whose dramatic wound of his frontal lobe so altered his behavior), and a lawyer, psychiatrist and judge discussing free will, diminished capacity, and the legal system.

The film concludes with some concerns about reductionism to the biologic model of the mind, the growing haziness of borders between human and artificial intelligence, and the role of psychoactive medications. Although full mapping of the brain may not lead to complete understanding of the mind, still, the film concludes, the quest is fun.

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Cutting for Stone

Verghese, Abraham

Last Updated: Mar-08-2009
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.

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Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

This book in large-format (11 1/8  x  8 3/4 in.) is made up primarily of wonderful illustrations but there is also clear and clever text; both media clearly explain the structures and systems of the human body.  Although nominally listed as “Juvenile Literature,” The Way We Work is sophisticated and detailed enough to educate and entertain adult readers, without losing the interest of intelligent young readers.

The drawings, in pencil and watercolor, are dazzling: large, colorful, with a variety of layouts and perspectives. Many go across double-page spreads, and many include a witty image of one or more small observers. In “Mapping the Cortex,” for example (pp. 158-159), an enormous, multicolored brain takes up most of two pages; it is partially exploded into 11 areas, labeled by name and function, and coded (sensory, motor, or association). A tiny (one-inch) man below with a question mark over his head looks at a dangling rope (I think) hanging from the brain. A small text block fits in the lower left-hand corner.

The book is organized by seven chapters, each for a body system, such as “Let’s Eat” (digestive system), “Who’s in Charge Here?” (nervous system), and “Battle Stations” (immune system). While the parts of the body (anatomy) are clearly shown, the book stresses biological process (physiology), truly “the way we work,” and in considerable detail. In “Let’s Eat,” for example, there are 50 pages, starting from what foods we eat, our sense of smell, taste receptors, teeth, chewing muscles, salivary glands and saliva, the entire alimentary canal, including biochemical and molecular activity, the roles of pancreas, liver, and kidney, and urinary and fecal outputs.

Children of all ages will enjoy “Journey’s End,” which shows a gigantic rectum miraculously suspended over a cityscape, with dump trucks arriving below it to receive stupendous loads.  Indeed, there is much humor in the book, both in the drawings and in the text blocks. 

 

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Assassination Vacation

Vowell, Sarah

Last Updated: Feb-12-2009
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Investigative Journalism

Summary:

Obsessed with the history of presidential assassinations and captivated by the power of places and objects to evoke the past, the author writes about her travels to the sites commemorating the lives, illnesses, deaths, and burials of Presidents Lincoln, Garfield, and McKinley and of their murderers. The greatest attention is given to Lincoln.

The context of the killings is presented in atmospheric detail and goes well beyond the individual deaths to the political tensions in which they occurred: slavery, the Civil War, the Spanish American War, partisan manipulation, economic strife. Special attention is given to wounds and body parts and to chattels, pus, and bits of bone.

The quirky research method of inveigling a sister and several long-suffering acquaintances (invariably introduced as “my friend XXX”) to drive the author to her desired destinations generates a counterpoint. Perhaps, the spiciest commentary on her investigations comes from the ever reliable insights of Owen, a four-year-old nephew.

This past is also about the physical objects--guns, tombs, statues, letters, plaques, buildings, furniture, and clothing--that memorialize and are fetishized by their contact with greatness. And it is about the people who care for it in the present--the curators, volunteers, collectors, and writers.

An encounter with the marvelous, stunningly beautiful (but now late) Gretchen Worden, curator of Philadelphia’s Mutter Museum, as she speculates on the future of her own corpse, will be a poignant surprise for those who knew her in person or through her many appearances on the Letterman Show (p. 93-99). As Vowell wrote in her acknowledgements (p. 258): “The world is a little less interesting without her in it.” Indeed.

The result is a highly readable set of interconnected chapters that blends extensive knowledge of American history with a fanatic’s zeal to get at the true story, sense, and emotions, especially those investing objects and places with what is called—"wie es eigenlicht gewesen [ist]"--as it really was.

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