Showing 621 - 630 of 805 annotations tagged with the keyword "Communication"

The Man in a Case

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story is told of Byelikov, "the man in a case." Byelikov, the Greek teacher at a provincial school, was extraordinarily orderly both in his personal and professional lives. A strict disciplinarian, he never made exceptions to the rules. He always did things the proper way, determined to avoid even the appearance of impropriety.

Although he and his colleagues had nothing to speak about, he would regularly visit each one of them because it was the accepted thing to do. Every time something slightly irregular came up, Byelikov would cry, "Oh, how I hope it doesn't reach the ears of the authorities!" Naturally, the other teachers hated him.

At one point, Byelikov became enamored of Varinka, the sister of Kovalenko, a new teacher at the school. Everyone encouraged this relationship, hoping that marriage would moderate Byelikov. However, someone drew a humorous caricature of Byelikov and Varinka.

Then, Byelikov saw Varinka and her brother bicycling in the park. Outraged, Byelikov went to the brother to complain about this scandalous behavior, but Kovalenko pushed him down the steps. Byelikov than became depressed, took to his bed, and died, thereby truly becoming a man in a box (i.e. a coffin).

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The Lady with the Dog

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Dmitri Dmitrich Gurov is lolling around on the beach at Yalta when he spies a lovely young woman with a Pomeranian dog. Gurov is a family man, nearly 40 years old, but his wife and children are home in Moscow, and he regularly dabbles in extramarital affairs. Thus, he sets out to make a conquest of Anna Sergeyevna, whose husband, it turns out, is a "good, honest man, " but a "flunkey" in the provincial town where they live.

They succumb to their passion and become lovers, but after a few weeks, Anna is called home, and Dmitri also returns home. Surprisingly, he cannot forget her. He is tortured by a desire to see her again, eventually arranging a trip to her hometown, where he encounters his lover at the opera. They fall into one another's arms again.

Anna Sergeyevna then begins to visit Moscow every few months so they can spend a few hours in a hotel room together. Their love has grown into tenderness: "They forgave each other for what they were ashamed of in the past, they forgave everything in the present . . . " In the end they decide to make a plan to remain together, realizing that "the most complicated and difficult" part of their road is just beginning.

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At Home

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story begins with Vera's arrival at her grandfather's estate on the steppe. The young woman has finished school, her father is dead, and now she must make a life for herself. The estate brings back pleasant memories of childhood, but country life is so boring! Vera would like to do something important with her life--become a doctor, or judge, or mechanic--but she feels paralyzed.

Neshtchapov, the local doctor, is a polished, handsome man, who has gone into management, although he still practices medicine. Certainly the most eligible bachelor in the region, the doctor falls in love with Vera, but she finds him vacuous and his conversation utterly boring. Vera sinks into irritability and depression, which culminates in an irrational outburst against her frightened maid. After this, she decides to take control of her life--by marrying Neshtchapov.

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The Teacher of Literature

Chekhov, Anton

Last Updated: May-27-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story begins with a group of young people on a riding party at the Shelestov estate. One of the guests is Nikitin, a young-looking man in his mid-20’s, who teachers literature at the local school, and loves Masha, the 18-year-old younger daughter of their host. Later, over dinner Varya, the older daughter, argues with Nikitin over some points of literature, and another guest scolds him for having never read the German writer, Lessing. But Nikitin glides through the evening on a cloud of love. A day later he returns and proposes to Masha.

In the second part of the story, the wedding occurs. Nikitin and Masha are deliriously happy--"’I am immensely happy with you, my joy,’ he used to say, playing with her fingers or plaiting and unplaiting her hair." But soon one of Nikitin’s friends and fellow teachers develops erysipelas and dies. After that, everything returns to normal, so much so that Nikitin has nothing to write in his diary.

Life seems to be closing in on him. He feels like trying to get away from his wife, "Where am I, my God? I am surrounded by vulgarity and vulgarity. Wearisome, insignificant people, pots of sour cream, jugs of milk, cockroaches, stupid women . . . There is nothing more terrible. I must escape from here, I must escape today . . . "

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The Topic of Cancer

Fromm, Pete

Last Updated: May-12-2003
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Mickey, widowed but one year, and his young son, Duncan, drive East from their home in Wyoming, to vacation with Mickey's family on the Jersey shore. As the story develops, the reader learns that Carol, who died from ovarian cancer, was a westerner, and that Mickey is being tempted to return to the east coast with Duncan and reestablish life there.

The two arrive at the vacation cottage very early in the morning; Mickey needs to be with the ocean and what it means to him; Duncan, who has never seen an ocean, rushes to the experience. The child becomes fearful, as he looks at the vast expanse, calls up the idea of sharks, asks if his Mom waits at the "topic" of Cancer for them. The tension develops when Mickey chooses to swim to assuage his own grief, not realizing that his venture terrifies Duncan. The reunion of father and son points to a new understanding of what it means and will mean to each to go forward without Carol.

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What Girls Learn

Cook, Karin

Last Updated: May-12-2003
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel for Young Adults

Summary:

Told from the perspective of a thirteen-year-old girl, this story about a single mother with two daughters who moves, marries, and dies of breast cancer handles a variety of difficult issues with sensitivity and spunk. A list of those issues--absent father, new stepfather, a thousand-mile move to a new social environment, first menstruation, sibling rivalry, an uncle with incestuous impulses, family secrets, sexual experimentation, cancer, and death--might make it sound like a catalogue of the trials of contemporary suburban young adulthood, but in fact the point of view of Tilden, the main character, keeps the story grounded in very believable, sometimes amusing, often poignant, recognizable truth about what it is to come into awareness of the hard terms of adult life.

The mother's cancer is narrated largely in terms of Tilden's experience of it: secrecy, eventual disclosure, partial information, losses of intimacy, feelings of betrayal, confusion about caregivers' roles, and in the midst of it all, the ordinary preoccupations of early adolescence. The generous and understanding stepfather and neighbors with limited but ready sympathies lighten some of the novel's darker themes.

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Annotated by:
Miksanek, Tony

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The 58 year old plastic surgeon who narrates this story has plenty of problems. He drinks too much and his surgical skills are deteriorating. His wife Maya, a neurosurgeon young enough to be his daughter, has a miscarriage not long after her father dies from a brain tumor. The narrator is plagued by an obsession with butterflies.

He seems to have inherited his unnatural interest in these insects from both his father and grandfather. Strangely, the pursuit of butterflies has brought only tragedy to these men. Maya believes her husband's butterfly collection is a curse so she destroys it. Her action seems insufficient to liberate the narrator from the burden of his ancestors. He is convinced that his destiny was dictated by his family years ago.

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Chocolates

Simpson, Louis

Last Updated: Mar-20-2003
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Poem

Summary:

One day some people were visiting Chekhov and they wanted to talk about him, about his genius. The author was embarrassed. He asked them, "Do you like chocolates?" Although the visitors were reticent at first, Anton P. Chekhov encouraged them to speak. Soon everyone was talking about his or her preference in chocolates, relishing the fine points of "almonds and Brazil nuts" and "the flavor of shredded coconut." Later, in the coach on the way home, the people felt that their conversation with Chekhov was very successful. [30 lines]

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This masterful collection of essays was written by Gawande while he was a general surgery resident. The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. Although some of the essays fall clearly within the boundaries of the section title (such as "When Doctors Make Mistakes" and "When Good Doctors Go Bad" in the Fallibility section), others cross boundaries or don’t fall as squarely in these general themes ("Nine Thousand Surgeons," an anthropological essay on the cult and culture of a major surgical convention, is also located in the Fallibility section). Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work.

The book begins Dragnet-style with an Author’s Note: "The stories here are true." (p. 1) And it is this attention to fidelity that makes the essays so compelling. Because even when the truths are hard--the terrible acknowledgment by the medical neophyte about lack of skill and knowledge, the mistakes in judgment at all levels of doctoring, the nature of power relations and their effects on medical pedagogy and on the doctor-patient relationship, the gnawing uncertainties about so many medical decisions--the author confronts the issues head on with refreshing rigor, grace and honesty.

Many of the essays reference scientific and medical research (historical and current) as part of the exploration of the topic. This information is imbedded within the essay, hence avoiding a dry recitation of statistical evidence. Typically, the reader’s interest in an essay is immediately piqued by a story about a particular patient. For example, the story of an airway emergency in a trauma patient, her oxygen saturation decreasing by the second as Gawande and the emergency room attending struggle to secure an airway, surgical or otherwise, sets the scene for "When Doctors Make Mistakes."

This leads to a meditation on not only the culture of the Morbidity and Mortality Conference, with its strange mix of third-person case narrative and personal acceptance of responsibility by the attending physician (see Bosk, Charles, Forgive and Remember: Managing Medical Failure, U. Chicago Press, 1981 for an in depth analysis of this culture), but also a positive examination of the leadership role that anesthesiologists have played in improving patient safety via research, simulator training and systems improvement.

Gawande’s journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). In addition, he visits his own post-operative patients at home ("The Man Who Couldn’t Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients’ perspectives.

Some of the most telling moments come with the introduction of his children’s medical problems into the text. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest).

These last two experiences are introduced to provide an angle on issues of choice. Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team.

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Annotated by:
Belling, Catherine

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Giovanni (Nanni Moretti) is a psychoanalyst. He has a beautiful wife, Paola (Laura Morante), and an adolescent son and daughter, Andrea and Irene. One Sunday morning, Giovanni gets a call from one of his patients, newly diagnosed with cancer and frantic. Instead of spending the day with his family, Giovanni attends to his patient. Andrea goes diving with friends, there is an accident, and he is killed.

The rest of the film examines the family’s bereavement. Giovanni finds his work increasingly difficult, and by the end of the film he has decided that he can no longer be a psychotherapist.

A love letter addressed to Andrea arrives from a girl called Arianna: it turns out Andrea had a secret girlfriend. Both parents become obsessed, in different ways, with contacting Arianna. Eventually she visits them, while hitchhiking with her new boyfriend, and the family drive all night along the Mediterranean coast, taking Arianna and the boy to France. Next morning, on the beach at Nice, in saying goodbye to Arianna, they seem to have made progress in continuing their life as a family without their lost son.

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