Showing 641 - 650 of 661 Nonfiction annotations

The Culture of Pain

Morris, David

Last Updated: Jan-31-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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The Lost Art of Healing

Lown, Bernard

Last Updated: Jan-31-1997
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This autobiographical account of Dr. Lown's five decades of practice and research in cardiovascular medicine is both a history of the field and a history of a man passionately interested in people and healing. The book is divided into six sections: Hearing the Patient: The Art of Diagnosis; Healing the Patient: The Art of Doctoring; Healing the Patient: Science; Incurable Problems; The Rewards of Doctoring; and The Art of Being a Patient.

The first three sections comprise the bulk of the book: Lown chronicles his early medical training and career through stories of memorable patients, anecdotes about key role models (particularly Dr. Samuel A. Levine), and histories of medical mistakes, diagnostic acumen, and his remarkable research innovations. These achievements include the introduction of intravenous lidocaine, cardioversion and defibrillation, and development of the coronary care unit.

The core of the book, however, is about how deeply Lown cares for his patients. He states, “This book is a small recompense to my patients, ultimately my greatest teachers, who helped me to become a doctor.” The book contains many reflections on medical practice, such as this definition of medical wisdom: “It is the capacity to comprehend a clinical problem at its mooring, not in an organ, but in a human being.”

In a thoughtful chapter on death and dying, Lown muses on his emotional and spiritual responses to encounters with death, and bemoans the medical profession's increasing tendency to “put technology between us and our patients, to spare us the grief of failing to confront our own mortality.” In the final chapter, Lown takes an unusual twist, and writes a treatise to patients on how to get the doctor to truly pay attention to them and what are reasonable expectations to have of one's doctor.

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The Medical Detectives

Roueche, Berton

Last Updated: Jan-30-1997
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Collection (Case Studies)

Summary:

The 22 short stories in this volume are lively, economically written accounts of medical and epidemiological investigations over a thirty year time span from the mid-1940's to the late 1970's. Similar to the "clinical tales" Oliver Sacks (see this database) and others have more recently popularized, these stories are full of medical detail interspersed with dialogue, and are narrated in the manner of popular mysteries.

Even technical medical problems are made comprehensible to a lay audience without oversimplification. "Eleven Blue Men," the opening story details an investigation of eleven simultaneous cases of cyanosis traced to a particular salt shaker. "The Orange Man" traces the investigation of a rare case of carotenemia-lycopenemia. "The Dead Mosquitoes" recounts a strange outbreak of reactions to organic-phosphate poisoning traced to a batch of blue jeans. All the stories are notable for the relative rarity of the cases on record.

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Recovering

Sarton, May

Last Updated: Jan-30-1997
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Journal

Summary:

In this journal of her 66th year (one of several volumes of her widely-read journals) May Sarton reflects on the depression of losing a long, intimate friend to acute senility, on living with waves of loneliness in a life of chosen and beneficent solitude, and on a mastectomy which followed quickly upon diagnosis. She weaves together themes of friendship, especially friendship among women, mental and physical health, speculating on psychosomatic dimensions of illness, living with an aging body, and the ongoing issues of self-esteem that aging and solitary women confront in a particular way. Each of the 2-3 page entries is a complete and complex reflection, beautifully developed, and often pithy and poetic.

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Summary:

Jordanova posits that medicine and science "contain implications about matters beyond their explicit content." Namely, they have historically made assumptions about women and their relation to science/medicine. Jordanova explores this relation through seven chapters.

Particularly interesting is Chapter Three, "Body Image and Sex Roles." Here Jordanova discusses the wax models used by medical students in the nineteenth century to learn about anatomy. These models were almost always female and sometimes even had flowing hair, pearl necklaces, and other realistic details. Jordanova argues that this gendering was no accident. The route to knowledge is historically associated with looking deep into the bodies of women.

Chapter Five pursues this theme, commenting on how nature is often configured as a female whose secrets will be revealed by masculine science. The final two chapters address twentieth century representations, including the gendered nature of drug advertisements in in-house medical magazines.

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Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Laqueur writes about his experiences as a volunteer at the Home for Jewish Parents. The elderly he meets there have lived fantastically broad lives, many having fled from eastern Europe in front of the German armies of World Wars I and II. Laqueur explains how different their impressions of world events are from his.

He notes the variety of responses the residents have to their own aging process and that of others. Those who are still mobile and mentally alert avoid those who are not. Some residents cling to life and self-respect, others abandon it. Over all, Laqueur is reassured by his visits. If these people have made it this far through such a crazy century, certainly he, too, can go on.

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Annotated by:
Wear, Delese

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Part of Patricia Foster's collection, Minding the Body: Women Writers on Body and Soul, Houston's essay is a cynical, self-deprecating, painfully honest, and wryly humorous observation of contemporary American women's obsession with their bodies, most notably thinness. Musing on her own lifelong fixation with weighing less, she admits that "for a good part of my life I would have quite literally given anything to be thin . . . a finger, three toes, the sight in one eye." Her essay is a collection of snapshots in her life, moments that bring into focus her displeasure with her body shape and size: walking down Fifth Avenue sizing up other women's bodies; the dinner habits of her family of origin that prohibited bread, dessert, or seconds; her husband's (thin) women employees who eyeball her body; her ongoing relationship with mirrors.

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Summary:

This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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Raising the Dead

Selzer, Richard

Last Updated: Jan-28-1997
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Selzer developed Legionnaire's disease and was comatose for 23 days in 1991. In this short book, he describes his illness and prolonged convalescence. The time of his stay in the ICU is lost to him, so he invents the story of what (might have) happened when he was comatose and delirious. In fact, he invents his own death and resurrection.

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