Showing 601 - 610 of 805 annotations tagged with the keyword "Communication"

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.

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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.

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Plot

Rankine, Claudia

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

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Liv is pregnant. She is an artist, and married to Erland. She names the fetus, a boy, Ersatz (a replacement, a copy, a person not yet real?). This book-long poem, divided into short segments making up nine (month-like) chapters, reconstructs her pregnancy in words, often literally, using words-within-words (for instance in a section called "Proximity of Posed to Exposed"), echoing people-within-(pregnant)-people, ideas emerging from words, and life (and death) emerging from bodies.

The poem does not offer a simple coherent narrative, although it does follow the biological narrative form of gestation. Instead it circles around the experience of containing another person, and the dissonance Liv seems to find between biological and verbal or cultural creating. Liv's ambivalence about this tension is captured throughout the work, perhaps most notably in her exploration of a painting of the dead Virginia Woolf, the drowned body of a childless woman writer, now become "beached debris." The final part of the poem captures powerfully the experience of childbirth, and the afterword is in a new voice, that of Liv's son.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Children's Literature

Summary:

Note: I try not to reveal too much here. Nevertheless, I urge you to read the book first. I would not want the magic of reading this book to be diminished by too much foreknowledge--no matter when the book is initially opened.

Harry Potter and the Order of the Phoenix is the fifth book in a planned series of seven (see Harry Potter and the Sorcerer's Stone for an introductory summary). Harry is now fifteen years old. The opening chapter, "Dudley Demented," features a return of the Dementors (see Harry Potter and the Prisoner of Azkaban), who had been sent to Harry's neighborhood in Little Whinging to deliver their soul-sucking kiss. In order to repel the Dementors and save himself and his bullying cousin Dudley Dursley from the kiss's death-in-life, Harry uses magic. This transgression from rules on underage wizardry leads to Harry's near expulsion from his school, Hogwarts, and a trial by the full court, the Wizengamot, led by Cornelius Fudge, in the Department of Mysteries of the Ministry of Magic.

Headmaster Albus Dumbledore, concerned with Harry's safety as well as with leading the resistance efforts (The Order of the Phoenix) against the resurgent evil Lord Voldemort, not only prevents Harry's expulsion, but also organizes the guard for Harry's transfer from the Dursley home to the ancient house of Harry's godfather, the wonderfully moody and complex Sirius Black. Sirius, like Harry's parents, would risk anything for his godson, but the relationship is charged by Sirius' goading of Harry to be more cavalier like James Potter--Harry's father and Sirius' best friend--and by Sirius' antipathy towards being imprisoned in his ancestral home, filled with reminders of his pureblood wizard family.

These include a portrait of his raging, hate-filled, deceased mother and a malevolent house elf, Kreacher. Communication between Harry and Sirius is a key theme in the book, as Harry looks to Sirius for guidance on the tribulations of adolescence and to satiate Harry's continued craving for information about his father. Harry's emotional tether is short in this novel, and runs the gamut from frustration and envy that his two best friends, Ron and Hermione, were made prefects of Gryffindor House, to despising two teachers (potions teacher Snape, of course, and the new venomous, officious Defense of the Dark Arts teacher, Dolores Umbridge) and finally to absolute fear and hatred of Voldemort, his mortal, yet intimate, enemy.

Harry's scar pains him almost continuously now that Voldemort has returned in the flesh, and also now that Harry has dreams and visions of Voldemort's actions. With this ability, Harry envisions himself as a snake and witnesses the wounding of Ron's father, Arthur Weasley. This episode leads to two visits to the wizard hospital: St. Mungo's Hospital for Magical Maladies and Injuries. The reader is deliciously informed that the personnel in green robes are not doctors ("those Muggle nutters that cut people up" p. 484), but rather Healers: wizards and witches who passed a large battery of tests in a range of subjects to qualify for such training.

The hospital is a mix of the mundane (the irritable receptionist) and the arcane (patients suffering from bizarre spell damage). Mr. Weasley's recovery from the nearly lethal snake bite suffers a minor setback when Trainee Healer Pye (not the Healer-in-Charge, Hippocrates Smethwyck) tries some "complementary medicine . . .

[an] old Muggle remed[y] . . .

called stitches . . . " (pp. 306-7). The loving Mrs. Weasley, whose temper is notorious and hence humorous, shouts at her husband that even he "wouldn't be that stupid" as to allow his skin to be sewn together. (p. 307)

While in the hospital, Harry and his friends encounter schoolmate Neville Longbottom visiting his parents, who suffer dementia caused by dark magic performed by one of Voldemort's Death Eater followers. Mental illnesses prove far more difficult to remedy than bodily injuries and maladies. Indeed, late in the book, Madam Pomfrey, the Healer at Hogwarts, wisely advises that "thoughts could leave deeper scarring than almost anything else." (p. 847) As Dumbledore, the embodiment of sagacity, states, memories of old hurts, slights and abuses, make "some wounds run too deep for . . .

healing." (p. 833)

Other medically related items include the Skivving Snackboxes--an assortment of magical treats and their antidotes concocted to fake various illnesses in order to skip classes, and Umbridge's detention punishment which results in the painful etching of the required written phrases on the back of the hand of the miscreant student.

Professor Snape is charged with teaching Harry the subtleties of mind-reading (Legilimency) and its prevention (Occlumency), in an effort to prevent Voldemort's use of Harry's mind. "The mind is a complex and many-layered thing," says Snape, and hence the mind cannot be read like a book. (p. 530) Harry's failure at these lessons leads to the denouement of the book and ultimately to the loss of someone very dear to him. After the inevitable confrontation between Voldemort and Harry, Dumbledore gently coaches Harry through his guilt and anger to teach him about destiny, love and death.

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Tom and Lily

Selzer, Richard

Last Updated: Nov-16-2003
Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Tom Fogarty is a sixteen-year-old boy who is introduced to both love and death in 1934. The object of his affection is Lily, the 14-year-old niece of a neighbor who lives across the street from Tom. Lily has tuberculosis and is waiting for a bed at the sanitarium where her parents are already being treated for the same disease. The relationship between the two adolescents is risky, passionate, forbidden, and ultimately transforming. Their romance is abruptly interrupted by Lily's death.

Tom's overwhelming grief over the loss of Lily coincides with torrential rain that cleans and nearly submerges the town of Troy, New York. Tom is further wounded when he fractures his clavicle during the flooding. His physician-father, a general practitioner, repairs Tom's injured collarbone but only time can mend the boy's broken heart.

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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)

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Annotated by:
Woodcock, John

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

In 1930s London, a doctor is visited by his wealthy and powerful patient Beatrice Glendenning, who demands an abortion. Although the doctor is an occasional guest of this woman and her husband at their country estate, the law requires that he refuse her request, and he advises her to have the child--and most certainly not to get a backstairs abortion. She tells him that it is not her husband's child, that bearing it would never do, and storms out of the office.

Ten days later her husband calls the doctor to ask if he could drop by the Glendenning townhouse and look in on Beatrice, who, he says, has the flu. The doctor goes, and discovers that she has gotten an infection from an undercover abortion. He feels trapped, but he treats Beatrice anyway, resenting her the whole time. The husband maintains his story that Beatrice has the flu, and the doctor leaves thinking that the husband never suspected. In the fall, as usual, he is invited to a pheasant shoot on the Glendenning estate.

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Before the Change

Munro, Alice

Last Updated: Oct-21-2003
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story, set in small-town Ontario in 1960, takes the form of letters to her ex-fiancé from a young woman who has returned to the home of her father, a widowed physician who lives with his housekeeper, Mrs. Barrie. She recalls growing up with her strict and remote father and realizes now that he had been performing illegal abortions all her life. He will not discuss it, will not allow the word "abortion" to be said in his house, though she tells him she believes abortion should be legalized.

We are led to suspect that she herself has recently been pregnant.

When Mrs. Barrie breaks her arm, the doctor is forced to ask his daughter to assist with one of his "special" patients. She helps the young woman throughout the procedure, and disposes of the aborted fetus afterwards. Later, trapped indoors by a heavy snowfall, she and her father are sitting together at the kitchen table when she tells him about her own pregnancy.

She had carried it to term, giving up the baby for adoption. She had ended the engagement because her fiancé, a theology student, had insisted that she have an abortion before their wedding because he feared the social consequences of rumors that she had been pregnant before marriage. She is about to ask her father about his own work, and about what might happen should the law change and abortion become legal, when she realizes that he is not listening. He has had a massive stroke, and dies later the same day. The daughter turns away the next patient who calls about having an abortion.

She learns from the lawyer that, mysteriously, her father had virtually no money saved. She gives Mrs. Barrie most of the small amount her father had given her, and then realizes that all his money has already been given to Mrs. Barrie, either because she was blackmailing him, or because he loved her. She cannot tell which, but is oddly exhilarated and is now able to say goodbye to her fiancé for good.

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Annotated by:
Woodcock, John

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Following the death of an aphasic hermit woman in the woods of North Carolina, it is discovered that she is survived by a daughter (Jodie Foster), a young woman who lives by herself as a kind of wild child, speaking a private language, and intensely fearful of human contact. The authorities decide that she must be normalized for her own good, but Dr. Jerry Lovell (Liam Neeson) disagrees, arguing that, although different, she is fine and has not asked for help. He insists on getting her informed consent before treatment. A judge agrees to give Lovell three months to observe the woman, whose name turns out to be Nell, and find evidence that she should not be treated against her will.

Lovell recruits a partner, psychologist Paula Olsen (Natasha Richardson), and together they set up an observation base on a houseboat with a view of Nell's cabin. From there Lovell makes a series of attempts to win Nell's confidence and understand her language. (Olsen for much of the film mainly represents a set of professional values more conservative that Lovell's unconventional therapeutic moves--which, for example, make her suspect that he is sexually attracted to Nell. Her own sexual presence, while downplayed, serves to defuse this potential.)

Lovell wins Nell's confidence (she calls him her "guardian angel") and the secrets of her speech and wounded psyche (a twin sister died young, and Nell has apparently at least witnessed sexual abuse). Following a court hearing in which Nell speaks in her own defense, the world gets word of her case and journalists descend on her remote cabin on foot and by helicopter.

Fearing that civilization will destroy Nell, Lovell arranges to have her hospitalized as the least available evil. However, when he finds her drugged, he sees that hospitalization is no solution, and he carries Nell out of the hospital and back to her cabin. He tries to make her understand that he is not her guardian angel.

The film switches to a warmly-lit lakeside scene five years later, when all problems seem to have been solved. Lovell and Olsen, who are married with a little girl, and several other sympathetic characters are picnicking with Nell near her cabin, and Nell is shown entranced and somehow emotionally fulfilled in being with the child, who is the age at which her twin sister died.

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Death on Request

Nederhorst, Maarten

Last Updated: Oct-21-2003
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

In this documentary film about euthanasia in the Netherlands, a man--Kees van Wendel de Joode--with amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) requests death in his home, to be performed by his doctor, Wilfred Sidney van Oijen. The film mostly consists of what appear to be unscripted discussions between Kees, his wife Antoinette, and the doctor; however, there are also interviews with the doctor and views of the doctor seeing other patients. The film shows the doctor performing euthanasia: we watch him inject a barbiturate and then a muscle relaxant and we see him supporting Antoinette during the bedside deathwatch.

Kees has had a rapid deterioration of his ability to function: he is unable to move his legs and right arm, he can no longer speak coherently, and he is having difficulty swallowing. His wife cares for him in their Amsterdam apartment. The film documents the legal requirements for euthanasia in the Netherlands: Kees's repeated requests for euthanasia, confirmation that he has an incurable disease, the second opinion doctor's visit, and reporting the death to the municipal coroner and public prosecutor.

The film's strength lies in the sensitive treatment of the impact of this request on the patient, his wife, and especially on his doctor. Dr. van Oijen is an introspective man who cares for his patients--he makes house calls, explains medical terms to his patients, touches his patients, and asks what they are concerned about. He allows his patients (Antoinette is, in many ways, his patient too) to weep and be emotional.

The religious and moral dimensions of euthanasia are explored mostly with the doctor, who does not view himself as a wanton killer, but rather a doctor whose duty includes the alleviation of suffering. The film concludes with a voice-over stating the doctor will not sleep this night, but still has a clinic full of patients awaiting him in the morning.

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