Showing 71 - 80 of 122 annotations contributed by Shafer, Audrey

First Operation Under Ether

Hinckley, Robert

Last Updated: Jun-30-2006
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

The dentist, William Thomas Green Morton, gave the first successful public demonstration of anesthesia on October 16, 1846 at the Massachusetts General Hospital. This painting depicts the patient, Gilbert Abbot, sitting in a chair in the surgical amphitheater, eyes closed and neck exposed for the excision of a small vascular tumor of the jaw.

The surgeon, John Collins Warren, a distinguished Professor of Surgery at Harvard Medical School is leaning slightly forward, delicately holding a surgical tool vertically at the hidden point of incision. Morton holds his specially designed glass apparatus used to contain the anesthetic agent, ether.

Eleven other men watch the proceedings from the floor of the amphitheater, with varying levels of surprise and concentration. One is rising, as if in amazement, from a chair, and another steps up on a chair to see better. Two attend the patient: one holds his head and the other holds the right hand and checks the pulse at the wrist. Numerous men are seated in the gallery, and are painted with less and less detail, the higher the row.

The men are all dressed formally in dark suits, some with fur lapels, except for the patient, who is in white shirt with tan pants and dark shoes. This operation occurred before antisepsis and germ theory were discovered.

Hinckley used light and line to focus attention on the surgery. A strong diagonal line from the side wall of the gallery ends at Warren’s head. Light reflects off Morton’s ether inhaler, such that one can even see the sponge inside. The white of the patient’s shirt and the cloth and bowl on the instrument table in the foreground also serve to direct attention to the operation. Light glints off the surgeon’s head, although not as dramatically as in Thomas Eakins’s The Gross Clinic (see this database). Warren’s pronouncement at the end of the surgery, "Gentlemen, this is no humbug," paved the way for the rapid acceptance of anesthesia for surgery.

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Summary:

Shannon Moffett, a medical student at Stanford University School of Medicine, became fascinated with the brain during her anatomy and neurobiology courses. She set off across the country to interview people--scientists, doctors, patients, ethicists, and religious leaders--who devote their careers trying to understand the brain and cognition. With infectious enthusiasm and energy, Moffett brings the reader to meet these dedicated people, their work, their theories and their lives.

The book contains eight chapters and hence eight mini-biographies: 1) neurosurgeon Roberta Glick, 2) cognitive neuroscientist and brain imagist John Gabrieli, 3) Francis Crick (of DNA double helix fame) and Christof Koch--scientists studying consciousness, 4) sleep researcher Robert Stickgold, 5) Judy Castelli who has dissociative identity disorder (multiple personality disorder), 6) philosopher Daniel Dennett, 7) neuroethicist Judy Illes, and 8) Zen monk Norman Fischer.

Separating the chapters are "interludes" that map neural and brain development from conception to death. The book has a reference list for each chapter and a complete index, as well as a web resource (www.shannonmoffett.com) to which the reader is directed for graphics.

The writing is compelling, direct, fresh and insightful. For example, in "Touching the Brain," we follow the exhausting lifestyle of an academic neurosurgeon who works at Cook County Hospital in Chicago as she performs surgery, teaches, attends services at a temple, drives her car, takes care of her family including two young children, rounds on patients, hosts a potluck dinner, and simultaneously discusses her reading, travel and spirituality.

Moffett aptly describes Glick with her "waist-length red hair, ... beaten-metal earrings dangling almost to her shoulders and a saffron batik dress" as someone you'd "expect to find reading storybooks to kindergartners in a public library" (8). In fact, it is Moffett's eye for accessible detail that makes not only the people, but also neuroscience come alive. Artfully woven into the text are lessons on the history of brain research and current understanding (and questions) about the brain, its meaning and function.

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Your Sightless Days

Monette, Paul

Last Updated: Aug-26-2005
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Poem

Summary:

Paul Monette wrote about his partner's life and death with AIDS in both prose (Borrowed Time: An AIDS Memoir, see this database) and poetry. This poem, a lyric elegy to Roger Horwitz, concerns Roger's loss of sight despite treatments for cytomegalovirus infection. It is a love poem; Monette's devotion to Roger is unbounded. If Roger cannot see, then the poet wishes not to see--this is empathy to the fullest degree.

When, in the up and down course of the visual problems, Roger can suddenly, temporarily see, then Monette gleefully cries, "I toss my blinders and drink the world like water." The poem contains numerous references to sight, light, and eyes, such as "blacked out windows / like an air raid," "peer impish intent as a hawk," and "I'm shut tight Oedipus-old."

This constant stream of images and the unpunctuated, no-place-to- relax-and-catch-your-breath rhythm of the poem leads the reader through the suffering and uncertainties and into the final lines--the mourning for Roger. Grief is loneliness; it is the desperate ache of MISSING someone. Monette feels isolated from "the sighted fools"--he yearns for Roger, who, through it all and despite feeling like Job, could "hoot on the phone / and wrestle the dog so the summer was still / the summer."

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Summary:

This film by Danish filmmakers focuses on two Scots, Wilbur (Jamie Sives) and his older, considerate brother Harbour (Adrian Rawlins), who own a family buy-and-sell bookshop, North Books, in Glasgow. The opening movie credits intersperse with Wilbur's suicide attempt by pills and gassing himself. Wilbur's attempt is thwarted first by the fact that he has to put more coins into the apartment gas meter, and then by his brother, whom Wilbur had telephoned just before losing consciousness. Wilbur continues suicide attempts throughout much of the movie, with methods that range from the absurd to the disturbingly tragic.

The brothers' father had recently died and several scenes occur at a hillside cemetery. Surrounded by imposing stone monuments, the brothers' parents are buried without markers, but with a view, if you cock your head and imagine, of the bookshop. The tragedy of the mother's death when Wilbur was only 5 years old, is invoked to explain much of Wilbur's disturbance.

Early in the movie, Alice (Shirley Henderson), a waif-like single mother who cleans the operating and trauma theatres and sells books she finds at the hospital to the bookshop, is introduced, along with her soon to be 9 year old daughter, Mary (Lisa McKinlay). Alice and Harbour wed, and Mary presciently plunks a penguin eraser she has just received atop the wedding cake next to the bride and groom: "That's Wilbur," she says.

Two hospital workers feature prominently in the film. Horst (Mads Mikkelsen) is a Danish ex-pat physician and "senior psychologist." He chain smokes, distances himself from the group therapy he supposedly supervises, and yet deftly discusses bad news with Harbour in several scenes. The psychiatric nurse, Moira (Julia Davis), however, who, with ever-changing hairstyles and inappropriate nurse-patient interactions, acts primarily as comic relief, delivers the same bad news with unthinking, devastating directness.

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Starting the I.V.

Watts, H. David

Last Updated: Apr-22-2005
Annotated by:
Shafer, Audrey

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of anesthesia or sedation. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."

It is this power, the fear of this power felt by both the doctor and the patient, and, by extension, the fear of anesthesia or sedation, that form the heart of the poem. The narrator states that he cannot let his own fears about anesthesia and "loss of control get in the way." Instead he accepts the power and control that the patient gives him and "bring[s] him down."

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Physician-scientist Lewis Thomas turns to pressing, threatening issues in this collection of 24 essays, many of which have been published in Discover magazine. The book opens and closes with meditations on nuclear warfare--the atom bombs of World War II and the escalation of worldwide tensions and technology that can combine to destroy the human race. In between, other essays, such as "On Medicine and the Bomb" and "Science and 'Science,'" also focus on these issues.

Less apocalyptic essays concern Thomas's experience with requiring a pacemaker, the state of psychiatry, lie detectors as evidence for essential human morality, and his abiding interest in language and scientific research.

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Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

This book contains 29 short essays by physician-scientist Lewis Thomas, originally published in the early 1970s in The New England Journal of Medicine. The essays center on science, and range in focus from the molecular (e.g., DNA) to the subcellular to the organism to social interactions and all the way up to the search for extra-terrestrial life. Some themes reappear in several essays: science as a grand, engaging enterprise worthy of the brightest minds; communication between organisms creating the intricate dance of the social organism; the relationship of man to both nature and the grand scheme of the universe.

Lewis is fascinated by communication not only at the cellular level, but also at the pheremonal and cerebral level: "Language, once it comes alive, behaves like an active, motile organism" (90). The ant and its colony, as an example of a simultaneous individual and integrated social organism, form a link for Thomas between the enclosed unit of a cell and the complex interactions of a society. Indeed, macro-micro comparisons continue throughout the essays, and even conclude the final essay, "The World's Biggest Membrane," which lauds the atmosphere as protector, filter, and provider: "Taken all in all, the sky is a miraculous achievement. It works, and for what it is designed to accomplish it is as infallible as anything in nature. . . it is far and away the grandest product of collaboration in all of nature" (48).

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Dry

Burroughs, Augusten

Last Updated: Jul-26-2004
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The events in Dry follow those in Burroughs's memoir of his bizarre childhood, Running with Scissors (see this database). Burroughs, at 24 years old and with no formal education beyond grade school, works in the high pressure advertising world of Manhattan. He's also an alcoholic, and his addiction definitely interferes with his work. Fortunately for Burroughs, he is not fired, but rather, his boss and co-workers set up an intervention. Burroughs--after telling his best friend, Pighead, who is HIV positive; his drinking buddy, the undertaker Jim; and his abusive, alcoholic father, of the plan--leaves for an inpatient rehabilitation program in Minnesota designed for gay people.

Thus begins Burroughs journey to sobriety. A journey that is replete with temptation, relapse (not only with alcohol, but also crack cocaine), love, success, loss, and grief. Burroughs experiences hallucinations, coma and life-threatening withdrawal. But ultimately, Burroughs achieves the title of his memoir. What he reveals is that, for an addict, remaining clean and dry is hard work. This daily, moment-by-moment work forces the addict to examine what is truly precious in life.

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Destiny

Parks, Tim

Last Updated: May-11-2004
Annotated by:
Shafer, Audrey

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Written as an interior monologue, Destiny begins as Chris Burton receives a phone call informing him of his schizophrenic son's suicide. Burton, a British ex-pat journalist in the final stages of writing his chef d'oeuvre--a cultural history on national character--is married to Mara, a provocative, capricious, flamboyant Italian. The vitriolic arguments and hurtful stratagems that characterize their discordant marriage intensify with the crisis of death and its aftermath--the identification, transport and entombment of Marco's body. Family relationships are further complicated by Mara's distrust and estrangement of her adopted daughter, Paola.

Burton reveals the chaos that schizophrenia imposes not only on the patient, but also on the entire family. In order to avoid prison following an attack on his family and home, Marco had been placed in a psychiatric institute, Villa Serena, and it was at this facility that Marco stabbed himself to death with a screwdriver. The onset of disordered thinking and erratic behavior, the search for therapies, the various repercussions of guilt and blame (including recriminations about the intense, border-blurring maternal love lavished on Marco), are re-examined by Burton as he travels from London to Rome, sits vigil by his son's body in the camera ardente, and confronts his wife at her family's tomb.

Burton's physical distress mirrors his mental anguish. Burton has heart disease and obsesses about lacking his anti-coagulant medication. In addition to the worry of clot formation, urinary retention prevents Burton from emptying his bladder. These physical ailments of containment, confinement, obstruction and blockage form resonances throughout the book: the tomb, the strictures of marriage and the leakage of adultery, the oppressive family 'house of ghosts,' the separateness of interior thought from observable behavior, the barriers of language, the herky-jerky redirections of emergency travel.

Furthermore, the will to create permanence, to make one's destiny more than a transient destination, informs Burton's moves. In the midst of his exploding marriage and tormented trek home, Burton agitates over his work, and in particular, his book, which "must serve to transform a respectable career into a monument" (p. 1).

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Every Second Counts

Armstrong, Lance

Last Updated: Feb-11-2004
Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

This book, a sequel to It's Not About the Bike: My Journey Back to Life, chronicles five-time Tour de France winner Lance Armstrong's personal and professional triumphs and agonies from late 1999 (after he won his first Tour and after the birth of his son Luke) to mid-2003, the 100th anniversary of the Tour. Armstrong defines himself by his cancer experience and survival; he devotes himself to both one-on-one connections with fellow cancer patients as well as his public persona to raise awareness and funds for cancer programs and survivors' needs.

There are many medically related themes in the book. Descriptions of cycling sports injuries and illnesses include a severe concussion, a broken cervical vertebra, dehydration, road rash, tendonitis and exhaustion. Armstrong experiences the loss of friends and acquaintances to cancer and trauma. He is the subject of an intense investigation into the possible use of recombinant erythropoietin and finally cleared of suspicion after nearly two years. As a world class athlete, he is subject to frequent, random drug testing.

His wife experiences a failed in vitro fertilization cycle, though a subsequent successful treatment leads to the birth of healthy twin girls. The Red Cross invites Armstrong to visit NYC firefighters soon after the devastation of September 11, 2001 in a successful effort to boost morale. Armstrong, though, describes encounters with some cancer patients in which he felt he did not succeed in providing the desired inspiration.

Despite reaching his five-year cancer-free milestone, Armstrong, like many other cancer survivors, wonders if the cancer will return. He is hyper-vigilant of his body not only because of his elite athlete status, but also because of his cancer history. Nonetheless, he is reckless and jumps from a steep cliff to sense the rush of fear and freedom.

Armstrong trusts and believes in modern medicine and technology, as well as the physicians, nurses and other health care practitioners dedicated to cancer treatments and health care. He also lauds complementary practices, particularly the team chiropractor who uses a variety of techniques to support the riders during the grueling Tour.

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