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One Friday in April

Antrim, Donald

Last Updated: Feb-08-2022
Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As One Friday in April opens, we find Donald Antrim in an agitated state on the roof of his Brooklyn apartment building.  He paces, and alternately climbs down the fire escape, hangs from the railing, and lies on his stomach peering over the ledge.  Repeated outpatient courses of psychotropic medication and psychotherapy have done only so much for his deteriorating mental state, and the situation has come to a head. Disheveled and wild-looking, he manages to return home whereupon his friends take him to a psychiatric hospital.  

A MacArthur Fellow and author of several acclaimed novels, Antrim has previously published a memoir of his upbringing with his alcoholic mother.  In this new memoir, flashbacks of childhood neglect and chaos are juxtaposed with the present day as he takes the reader through the acute phase of his illness:  a lengthy hospitalization, a course of ECT, discharge from the hospital, rehospitalization, and eventual stabilization.   

The author considers his condition to be suicide, noting that “depression is a concavity, a sloping downward and a return.  Suicide, in my experience, is not that.  I believe that suicide is a natural history, a disease process, not an act or a choice, a decision or a wish…I will refer to suicide, not depression” (pp. 14-15).  

The book ends on a hopeful note. After several relationships that might be described as codependent, Antrim meets his current partner, whom he marries.  He sees the roof of his building through his window and remembers a certain Friday in April but is comforted by the sound of his wife playing Chopin and Bach on the piano.  

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Seeing Red

Meruane, Lina

Last Updated: Jan-31-2022
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Before it happened there was the dread of it. “They were brittle, those veins that sprouted from my retina and coiled and snaked through the transparent humor of my eye,” says Lina Meruane, the first-person narrator and main character. If those veins burst, Lina could go blind. All that can be done to prevent such a disaster she’s told, “is to keep watch day by day over its millimetric expansions...keep watch over the sinuous movement of the venous web advancing toward the center of my eye.” Adding to her dread are “impossible admonitions to follow.”
Stop smoking...don’t hold your breath, don’t cough, do not for any reason pick up heavy packages, boxes, suitcases. Never ever lean over, or dive headfirst into water. The carnal throes of passion were forbidden, because even an ardent kiss could cause my veins to burst. (p. 5)
And then, “it was happening. Right then, happening” (p. 3). She had only bent over to retrieve a syringe for her scheduled insulin injection. She’s paralyzed. “I didn’t straighten up or move an inch, didn’t even try to breath while I watched the show. Because that was the last thing I would see, that night, through that eye: a deep, black blood (p. 4).

Lina is in the dissertation stage of a PhD degree at a New York City university. The story veers from this pursuit to one of restoring her eyesight. The other primary characters are Lina’s Galacian love interest and fellow academic, Ignacio, who shepherds her through this journey, her New York retinal specialist, Dr. Lekz, and her parents who are both physicians—her father a cardiologist, her mother a pediatrician—practicing in Lina’s native country, Chile.

Soon after the bleeding incident, Lekz tells Lina that at least a month would be needed for her eyes “to clear up so I can take a look at this mess” (p. 32). “Weren’t you going to go to Chile to see your family? Go to Chile. Take a vacation” (p. 33). The story relocates from New York to Santiago, and from Lina’s medical problems to her familial dynamics—“I never wanted you to be my doctor, it’s enough for you to be my father” (p. 50). The visit also becomes a time for Lina—and Ignacio—to see what life might be like if she never regained full sight, and to contemplate options for such an eventuality. She had become “an apprentice blind woman” (p. 20).

Lina and Ignacio return to New York city for the hoped-for reparative surgery. The procedure produces promising signs, but Lina must wait at least the four weeks it takes for Helium gas bubbles to dissipate so Lekz can see the results. During this period, Lina tries to keep her head position down and her spirits up. Often the opposite resulted. Before four weeks passes, however,
Blood, again, in my eye. A fine thread of blood that comes from I don’t know where...I’m watching as the eye watches its thread of blood, looking at everything without ceasing my cries: I’m bleeding I’m bleeding again. (p. 142)
Futility looms, “knowing they were going to operate on me but that no cure existed” (p. 113).  Lina and Lekz consider their options. After Lina’s initial bleeding incident, Lekz had “dropped the phrase transplants in experimental stages” (p. 5). The idea stuck with her. She had spoken about it separately with her mother and Ignacio. Both were fraught conversations. Nevertheless, Lina and Lekz return to the topic.

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Summary:

Mysterious Medicine:  The Doctor-Scientist Tales of Hawthorne and Poe is one in a series of books called Literature and Medicine dedicated to the exploration and explication of the intersection of the two titled disciplines.  This volume, edited by L. Kerr Dunn, looks at the short stories (mostly—it includes one sonnet) of Nathaniel Hawthorne and Edgar Allan Poe from the viewpoint of each author’s use of, and in some cases experiences with, doctors, diseases, and the medical profession.  The volume begins with an Introduction that situates the writings within the medical and social milieu of the period (the authors were contemporaneous) and illustrates the way in which the tales reflect the times.

The stories are grouped by author and arranged chronologically.  Among the nineteen entries included are “The Minister’s Black Veil,” “Lady Eleanore’s Mantle,” “The Birthmark,” and “Rappaccini’s Daughter” for Hawthorne, and “The Black Cat,” “The Fall of the House of Usher,” “Berenice,” and “Some Facts in the Case of M. Valdemar” for Poe; each entry is preceded by a brief introduction and followed by discussion questions.  An extensive list of scholarly references closes out the volume. 

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Daughter

Davis, Cortney

Last Updated: Jan-17-2022
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Davis, a nurse practitioner, chronicles her daughter’s life, illness and death at age 54 from cancer. The book consists of three sections, with poems unevenly divided such that of the 30 poems, only one rests in section II. Titled Windmill, this poem forms a fulcrum between the relationship of mother and daughter to one of mother and ill daughter. The windmill is a small gift from her daughter – a reminder of Kansas where the daughter, her husband and children live, thousands of miles from Davis. The collection begins with her ‘soon-to-be born daughter’ (page 15) and ends with The Sacrament of Time, dated months before her daughter’s death from, at this point, a widely metastatic breast cancer. The final poem holds within it an entire world – the birth of the daughter, the fraught frantic mother-to-be pleading for help, the birth of a healthy baby girl, the wonder of the new addition to their family, the travel with the newborn to home, and a reflection on what poems can and cannot do. “Poems cannot // save us, Amichai said, but all I have are these poems” (page 58).  

If the first section details the many ways unconditional love for a child unfolds, through wonders of babyhood, delights of childhood, the harsh lessons of adolescence, and the successful launch, the final section underscores how deep that love runs. As the cancer illness progressed during the pandemic, issues of separation became more acute. Davis marks the numbers affected (illness and death) by coronavirus (SARS-CoV-2, COVID-19) during the pandemic, as her poems follow her daughter’s cancer. These numbers, along with brief quotations from her daughter’s scans and reports, lend a contrast to the evocative imagery and experience of illness in a loved one. Medical mistakes are chronicled as well (see What a Terrible Mistake).  

The collection is dedicated to Davis’ daughter and her daughter’s children. Even the title, Daughter, calls to her, as if addressing her daughter directly. The title also serves to universalize the parenting of a daughter, even as the particulars of this family are detailed.

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Dopesick

Strong, Danny

Last Updated: Jan-12-2022
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: TV Program

Summary:

The eight-part TV miniseries, Dopesick, is a nonfiction, scripted drama inspired by Beth Macy’s nonfiction book of the same title. The creator, Danny Strong, was a writer of all but one episode, director of two, and an executive producer of them all. Beth Macy served as an executive producer and contributed to the writing and updated the reporting. 

In a Kaiser Health News (KHN) panel discussion about the series with Danny Strong, Beth Macy, and three KHN staff members, Strong said his original goal “was to dramatize all this, was to create a clear record of what Purdue Pharma did.” But when Macy joined, his goal expanded “to show the victims and to hopefully redefine the stereotype of addiction...[and] ultimately our goal was to show a path forward.”

The miniseries conforms to these goals. Across the eight episodes, the drama mostly swirls around the direct connections among Purdue Pharma, one physician, one particular patient (and family), one small town in coal mining country, a Drug Enforcement Agency (DEA) investigator, and a U.S. Attorney (Western District of Virginia). In hewing to Strong’s original goal of portraying Purdue Pharma’s responsibility for igniting and fanning addiction to its product OxyContin® (oxycodone HCl), the drama reaches its climax when the company agrees to criminal charges for named executives and a financial settlement in 2007. 

Different episodes touch on other goals about the stigma associated with addiction and access to medication-assisted treatments. While Strong met his goals, he acknowledges the real-life drama didn’t end with the 2007 settlement. He previews what was to come: Purdue Pharma redoubling its sales efforts, the addiction crisis worsening over the subsequent fourteen years, and the continuing efforts to bring Purdue Pharma and its owners (the Sackler family) to their knees.

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The King's Anatomist

Blumenfeld, Ron

Last Updated: Jan-03-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Brussels mathematician Jan van den Bossche, (fictional), single, and fifty years old, is devasted to learn of the death of his lifelong friend, the brilliant (and very real) anatomist Andreas Vesalius.  Companions since childhood, shorter, sturdy Vesalius was the outgoing exuberant leader of the duo, snubbing authority, taking risks, and seizing every opportunity to explore the anatomical structure of animals and humans. He constantly dragged the quiet, shy Jan in his exploits.  

News of Vesalius’s death sends Jan in two directions. First, he wanders back through many memories: their lives and travels together to Paris, Leiden, Padua, Spain; the rise of Vesalius’s fame in anatomy, medicine, and surgery; and his odd departure from academe to serve foreign crowned heads in France and Spain. Second, it propels him forward on a journey to his friend’s grave on the Greek island of Zante (now Zakynthos), in an effort to comprehend why the notorious skeptic would have embarked on a religious pilgrimage in the first place. Jan realizes that he can forgive Vesalius almost everything, including the theft by marriage of his beloved Alice. But he is incapable of pardoning the bewildering manner of his death.

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Bewilderment

Powers, Richard

Last Updated: Dec-20-2021
Annotated by:
Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Science is a fundamental part of modern reality. It is used to explain the workings of the world around us and is instrumental in making that world a more hospitable place to live in. There are those who assert that there is a fundamental conflict between science and religion. They advocate considering science and religion as parallel but not intersecting ways to understand the place and purpose of human beings. What about science and art?  Or science and literature? Can they peacefully co-exist? Richard Powers is an author who has dedicated his literary career life to the proposition that they can.

In his latest book, Bewilderment, he examines the question whether neurobiology can help people achieve empathy, potentially even merge with another person. Theo is an astrobiologist, someone whose job is to explore the conditions on the many planets in the universe and to determine if they are able to support any form of life, but especially human life. The underlying premise is that there are bacteria, fungi, and animals that can live under very extreme circumstances on Earth. So even if other planets have different atmospheres, ambient temperature, water, or chemical elements, Earth should not be the only planet with life.

Theo’s wife, Alyssa, has recently died in a car accident and he is still grieving the loss. She was pregnant at the time, and the accident occurred when she lost control of her car when trying not to run over an animal on the road (more on this in a minute).  Theo has one son, Robin, who is very bright but on the autism spectrum with significant anger issues. The father and son are fiercely connected and share their lives; the early part of the book beautifully describes a camping trip that they take together. But Theo has his hands full with Robin. In order to avoid medicating his son, Theo enrolls him in an experimental program, Decoded Neurofeedback  (abbreviated DecNef, like any DARPA-sounding program). The experimental study will enable Robin to control his emotions better. This would be accomplished by capturing his mother’s brain waves in a functional magnetic resonance imaging (fMRI) scanner. The pattern of her neural activity, which reflected her intense love of animals and nature, would provide a template that could be channeled into her son using feedback methods. The objective of the experiment  is to convert Robin into a more sensitive child who is more attuned to the world around him. Robin is remarkably responsive to the sessions, more so than any other participant, and he becomes someone who has the same warmth and protective feelings towards animals and the environment as his mother. But funding for the project is terminated, Robin’s fMRI sessions stop, and he gradually reverts back to the child he was. There is a final twist. But I leave that to those who are motivated by this annotation to read the book.

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Nervous System

Meruane, Lina

Last Updated: Dec-13-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Ella needs time for finishing her doctoral dissertation on black holes she has been writing for years and thinks an illness could provide the time: “Just enough to take one semester off, to not have to teach all those planetary sciences classes to so many distracted students whom she had to instruct evaluate forget immediately (p. 6). Before she can decide which illness would best suit her purposes, a mysterious illness finds her.
 A sudden cramp shoots down the spine and then, stillness... (p. 9)
An unbearable stinging had settled into her shoulder neck ember... (p. 10)
She felt an invisible wound wrapping her up and suffocating her... (p.10)
A slight numbness that starts in the shoulder and extends along the arm to the elbow until it reaches the back of her right hand, the fingers where it all started. (p. 12)
Inflammatio. In flames. En llamas. Ardor without romance. (p. 10)
Quickly, then, the story shifts from Ella’s dissertation odyssey to her diagnostic odyssey. As she makes her way along this journey during the first chapter, other characters come into the picture: El, Ella’s long-term boyfriend and forensic scientist, is one. The others in her family history are “the Father,” “the Mother,” “the Brother,” and “the Twins”—none are ever named (neither, really, is Ella or El because they are “she” and “he,” respectively in Spanish). Except for the Twins, each of the subsequent four chapters center on one of these characters and how they figure into the family history. Just as in the first chapter, the stories are told through and around the health challenges each character faced; all harrowing, many life-threatening, and some metaphorical.

Ever present in these histories is the story of Ella’s birth mother,“genetic Mother”. She died giving birth to Ella. Ella’s stepmother, “the Mother,” is called at different times, “the volunteer Mother,” “the replacement Mother,” and “the living Mother.” The Brother, alternatively known as “the Firstborn,” shares with Ella her birth mother and was born nine years before her. The Twins, known separately as “the Boy Twin” and “the Girl Twin,” came after the Father remarried. Another dimension shaping the stories is both the Father and the replacement Mother work as practicing physicians. 

Ella’s prominence in each chapter makes her our witness to El’s recovery after an explosion rips through his mass grave excavation site, and his many surgeries for separate gastrointestinal troubles; the Mother’s aggressive and brutal breast cancer treatment; the Firstborn’s recurring bone fractures (an “osseous enigma”); and the Father’s bleeding ulcers and life-threatening hemorrhagic complications from prostate surgery. 

The author, Lina Meruane, structured the book in a somewhat unconventional form. She delineates sections within each chapter with asterisks centered on the page (“***”), and these sections rarely comprise more than two paragraphs. Dialog is neither separated from other text nor signaled with quotation marks. The text moves back in forth in time, from here to there in place (presumably somewhere in South America), and sometimes takes the form of pensées rather than plot narrative. But, overall, the book moves towards resolving some mysteries surrounding family history.

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Pandemic Haiku

Bordowitz, Gregg

Last Updated: Dec-06-2021
Annotated by:
Zander, Devon

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Pandemic Haiku is a collection of 52 haiku poems written by Gregg Bordowitz during the COVID-19 pandemic.  In this collection, he attempts to encapsulate some of what his experience was like during the events of 2020 in the traditional 5-7-5 syllable format.  

Bordowitz is best known as an artist and activist devoted to documenting the ongoing HIV/AIDS pandemic.  His voice in this collection is amplified by his long-term work devoted to understanding contagion, illness, and identity, and he uses the reflections formulated over his three-decade career to inform how to process, survive, and reflect on the COVID-19 pandemic.

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Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

In a 1976 Archives of Neurology essay, the neurologist Robert Katzman successfully argued for relabeling “senility” as “Alzheimer’s disease.” He urged rejecting various forms of dementia and senility as common consequences of aging, and accepting them as a disease requiring all the attention any other important disease deserves. Now medicine and society had a problem—"The Problem of Dementia,” the famed physician Lewis Thomas called it in a 1981 essay published by the popular magazine Discover, and he noted that, suddenly, “a disease of the century” had arisen (p. 3).

Forty years on, Jason Karlawish thinks there is still a problem, but in keeping with Katzman’s call, he refers to “The Problem with Alzheimer’s.” Based on the history he covers and the experiences he shares in this book, nothing of much significance has occurred since “The Problem of Dementia” became the “The Problem of Alzheimer’s.”

Karlawish is a physician who cares for people with Alzheimer’s and a researcher delving into “issues at the intersections of care, ethics, and policy” (p. 5).  He draws on his experiences in this book, which he describes as “the story of how once upon a time, Alzheimer’s disease was a rare disease, and then it became common, and then it turned into a crisis.” Karlawish wants to answer why during the time between Thomas’ essay and the year 2010, “nothing really changed,” and how that could be the case in “the richest and most powerful nation.” (p. 6) He tells this story in four parts.

The first part concentrates on efforts clinicians and researchers were making following Thomas’ call to distinguish Alzheimer’s disease from normal aging, other dementia types (e.g., frontotemporal, Lewy body), and precursor syndromes (e.g., minimal cognitive impairment). They were looking for definitive clinical patterns, imaging studies, diagnostic tests, and pathologic markers for the disease. 

In the second part, Karlawish goes back in time to when Alois Alzheimer first found what are known today as “plaques” in the brain of a patient who had an early onset of severe, progressive dementia. He traces the attention this finding drew to eventual advances in imaging and biochemistry aimed at diagnosis. Karlawish also covers how a cascade of events over the decades following Alois Alzheimer’s finding disrupted the pursuit of a pathophysiological basis for dementia. These events included the rise and dominance of Freudian psychology; followed by two world wars; the cold war; the overshadowing of AIDS; Medicare political and funding constraints; tussles among patient advocacy groups; loss of asylums where care and research had coexisted; clinical failure of the first drug; and the continued debate over whether dementia is a consequence of aging or is a disease. 

Karlawish moves on in the third and fourth parts to cover what “we will have to learn to live with the disease so as to improve the lives of persons...to provide the care they need to live well at home...and repair the broken system” (p. 171). Success in his view requires integrated biological, psychological, and social components. He reports the progress on each of these three fronts: some failed approaches continue to fail (such as drugs targeting amyloid); some psychological interventions show promise (though at times causing moral tension); some of the social configurations engineered for Alzheimer’s patients, families, caregivers, and society have produced triumphs and some disasters. He has much to say about why and how this search must go on, but with some much-needed course corrections. 

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