Showing 71 - 80 of 219 annotations tagged with the keyword "Public Health"

The Oath

Baiev, Khassan

Last Updated: Nov-15-2009
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Baiev’s chronicle of medical life in wartime is full of incident—tragic, touching, and repeatedly traumatic:  his own life was threatened repeatedly by Russians who suspected him and Chechens who resented him for treating Russians.  Members of his extended family were killed and his father’s home was destroyed.  He straddled other boundaries:  trained in Russia, he fully appreciated how modern medicine may bring relief not available even in the hands of the most respected traditional healers, but he mentions traditional ways with the reverence of a good son of devout Muslims.  His perspective is both thoughtfully nationalistic and international.

Finally coming to the States where he couldn’t at first practice the medicine he had honed to exceptional versatility under fire, he lives with a mix of gratitude for the privilege of safety and a longing for the people he served, whose suffering was his daily work for years that might for most of us have seemed nearly unlivable.  Before writing the book, he struggled with his own post-traumatic stress, and continues to testify to the futility of force as a way of settling disputes.  Medicine is his diplomacy as well as his gift to his own people, and the Hippocratic Oath a commitment that sustained him in the midst of ethical complexities unlike any one would be likely to face in peacetime practice.

 

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Summary:

In four parts this book uses a wide variety of images--caricatures in newspapers, comic books, advertisements, and photojournalism of Life magazine--to explore attitudes to physicians and medical progress in the mass media from the late nineteenth century to the mid-twentieth century. Each section centers on a specific type of image and the analysis addresses change in perception of doctors and their achievements by privileging crucial moments of newsworthy events and discoveries.

Early in this history, the media portrayed doctors as frock-coat wearing fops.  Medical metaphors used in a political context proclaimed these attitudes well. The story of four little boys, bitten by a dog in 1885 and sent to Pasteur in Paris for the newly invented rabies vaccination, is used as a pivot point for a transition in perceptions of medicine: from a clumsy, suspicious craft to a useful, progressive science.

The third section is devoted to the public fascination with the history of medicine in the period from 1920 to 1950, Films, newspaper articles, and comic books chart the insatiable taste for scientific success and medical progress. The last section studies images of progress in Life and other magazines through a meticulous analysis of health-related articles. In this section, Hansen shows how the media participated in educating the public to a definition of science that enjoyed an enthusiastically optimistic spin.

An appendix lists American radio dramas about medical history from 1935 to 1953. A wealth of sources are documented in the notes and the whole is completed with an intelligent index.

 

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The Wall of the Plague

Brink, Andre

Last Updated: Aug-05-2009
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

South Africans, Paul and Andrea, are lovers living in France. Paul is fiftyish and white; Andrea is thirty and “coloured.” He has just asked her to marry him. She travels to Provence ostensibly to research sites for a film to be based on Paul’s endlessly forthcoming novel about fourteenth-century plague. But the real reason for the journey is to test her feelings about his proposal—she is leaning to ‘yes.’

As five days roll by, she relives the trajectory of her life: her impoverished parents, her thwarted education, her angry, imprisoned brother, and the previous affair with Brian, a British historian with whom she was captured ‘in flagrante,’ sent to trial, found guilty, and offered prison or voluntary exile. Brian and Andrea left South Africa together, but their relationship eventually crumbled. She had trouble understanding his passion for the past and his love of detail.

In Provence, Andrea avoids places that Paul had wanted her to go, finding strength in solitude and independence. But that feeling is shattered when he asks her to rescue their penniless, black friend, Mandla, an anti-apartheid activist who has been betrayed by a comrade who turned out to be a spy.

Andrea doesn’t like Mandla, his sanctimonious accusations, arrogance, and probing. He is a racist and a male chauvinist, given to violence. But his constant questioning finally unleashes deeper memories of the shocking abuses of her life in apartheid South Africa—memories she has suppressed or attempted to blame on class struggle rather than racial intolerance. She tries to provoke his empathy with the terrible tragedy of the long ago plague. He resists, being concerned far more with the present, but he relents a little and begins to see racism as a plague and walls as feeble, futile attempts to exclude others.

Andrea falls for Mandla, makes love with him near the plague wall, and decides to refuse Paul and return to South Africa. But Mandla rejects a future with her because he wants no vulnerability in his struggle. He is killed in the night by a car. Was the death deliberate? accidental? suicide? Andrea leaves anyway.

In a short second part, Paul writes to Andrea of his own growing doubts about their future together despite his love.

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Summary:

Born in 1921 in Belarus (White Russia), the author lost his father (a doctor) as a baby and was raised by his mother who worked as a surgical nurse and midwife. He excelled in school and was on the verge of entering medical school, but the political upheaval of World War II drew him away from studies.
 
Drafted to serve in the Polish army, the eighteen year-old became a sergeant in charge of a platoon by June 1939 fighting against Germany along its border with Poland. Three months later he was captured and imprisoned in cruel conditions. By November, he escaped and began a long walk home, helped by strangers, only to find that the Soviets had taken over. Arrested again, this time for being anti-Communist, he spent January to June 1941 in a Soviet prison, and narrowly avoided execution when the Russians retreated at the German invasion of Minsk. Another return home was met with the tragic news that his mother had been killed when German bombs hit the hospital in which she worked.

Enraged by the succession of destructive invaders, Ragula helped create a nationalist freedom army, the Eskradon, ironically with German support, and a Bulletin to inform citizens and lobby for better conditions. By the time World War II drew to an end he was married to Ludmila (in 1944) and on the move, seeking a medical education.

As refugees, the couple moved to Marburg, Germany in 1945, where Ragula began medical school. But money was always a problem and the post-war restructuring of Europe made them fearful. Hearing of a program for refugees in Louvain, Boris entered Belgium illegally in 1949 and finally completed his medical degree in 1951 at age thirty-one. In 1954, the couple settled in the medium-sized town of London Ontario, Canada. There Ragula interned and set up a family practice. He and Ludmila raised their family of four in peaceful security that contrasted starkly with their own upbringing.

Precocious in promoting health, Ragula campaigned tirelessly against smoking, inactivity, and overeating, and he worked in aboriginal communities, convinced that a doctor's role was to prevent disease as much as it was to treat it.  Here too he found enemies and friends.
 
In 1963, Ragula was involved in a non-related kidney donation between patients-a selfless act that touched him deeply. For him, it represented the pinnacle of scientific achievement and epitomized how humans should care for one another.

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Summary:

John Romulus (also known as Richard) Brinkley was a physician (in the diploma-mill sense of the word) who, in 1917, pioneered, in the U.S. at least, the notion of goat testicle transplant. "Transplant" must be understood in the loosest sense of the word since Brinkley simply removed the testicles from young goats and sewed them into the abdominal wall and scrotal tissues - without any attempt to connect blood or nervous tissues of either goat testicles or human  - of men for the alleged purpose of relieving impotence. From 1917 until his downfall at the hands of Morris Fishbein, a medical crusader esconced in the AMA, which organization Dr. Fishbein helped establish as the premier advocate of organized medicine in the U.S., Dr. Brinkley was perhaps the most recognizable physician in the U.S.

He ran for the office of Governor of Kansas in 1930 (losing by technicalities that today would have overturned the results), and established the most powerful radio station in the land, XERA, that promulgated his glandular chicanery all across the continental U.S. As a proponent of such skullduggery, Brinkley was continually in the sights of Dr. Fishbein, whose main reputation nationally was as an exposer of medical fakery. Eventually Fishbein lured Brinkley into a libel trial that resulted, in 1939, in the catastrophic downfall of an immensely talented and wealthy man who spiraled into bankruptcy and death in 3 short years.

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Annotated by:
Mathiasen, Helle

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Testifying to its author's "fascination with death" (324), this scholarly and abundantly illustrated work focuses on the history of the American idea of the Good Death as this concept took shape during the Civil War. Frederic Law Olmstead used the phrase "republic of suffering" to describe the many wounded and dying soldiers being treated at Union hospital ships on the Virginia Peninsula. Faust argues that the task of dealing with more than half a million dead during the War motivated Americans in the North and South to discover cultural and physical measures of interpreting and coping with the suffering and loss that occurred in thousands of families.

The scale of this War was unprecedented due to rifles and railroads; however, Gilpin Faust reminds us that twice as many soldiers died of disease as died of wounds suffered in the conflict. The illnesses were epidemics of measles, mumps and smallpox, then diarrhea and dysentery, typhoid and malaria. Medical care was inadequate; consequently, soldiers and their families turned to spiritual consolation. The Good Death was identified as sacrificing your life for the cause; many  believed in the Christian idea of resurrection and the afterlife. Killing became work,  as African American soldiers fought for "God, race and country" (53), where  Southerners fought to preserve the status quo, including slavery.

Because of the War, public cemeteries and ceremonies, and government's identifying and counting the dead are now taken for granted. Because of the Civil War, bodies of the dead military are today brought back from foreign lands and honored with decent burial: "We still seek to use our deaths to create meaning where we are not sure any exists" (271).

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The Bridge

Steel, Eric

Last Updated: Jan-16-2009
Annotated by:
Jones, Therese

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

After reading Tad Friend's article, "Jumpers: The Fatal Grandeur of the Golden Gate Bridge" in an October 2003 issue of The New Yorker, filmmaker Eric Steel became so fascinated by the mystery of the final, dark moments of a human being who makes the long journey across the bridge to his or her death that he finagled $100,000 worth of equipment and moved from New York to San Francisco.  At 5:00 AM on a rainy New Year's Day in 2004, Steel and his ragtag crew set up their cameras, beginning a strange year-long vigil.  Training telephoto lenses on the mid-span of the bridge, they peered intently from dawn to dusk, watching for "suspicious behavior" or a "sense of despair" among the crowds passing back and forth.  During that year of filming, twenty-two people ended their lives, some caught on tape and some not; however, six attempts were thwarted by the film crew who became quite adept at indentifying potential victims and alerting the Bridge Patrol. 

Photographed from multiple perspectives, at all times of day, and in all kinds of weather, the Golden Gate Bridge is the main character of this documentary film.  It is formidable; it is magnificent; it is ominous; it is alluring.  According to the film:  "More people have chosen to end their lives [here] than anywhere else in the world."  The sublime images not only capture the many facets and features of the structure, but they also illustrate the emotions and represent the psychology of the other narratives intertwined in the film:  the stories of seven individuals who jumped from the bridge during the course of that year.

There is thirty-four year-old Gene, a haunting figure dressed all in black whose story begins and ends the documentary.  Like the film crew, we watch him prowl the bridge day after day, his long dark hair whipping in the wind until he makes that final leap, a dramatic backward dive.  There is forty-four year-old Lisa, who has suffered throughout her adult life with schizophrenia and who disappears off the bridge on Easter Sunday afternoon.  And there is twenty-two year-old Philip whose parents relate the history of their son's struggle with mental illness.

In addition to using footage of the bridge being obscured by fog as an evocative image of the progressive suffocation of self, the filmmaker employs long shots of the island of Alcatraz to symbolize the prison of mental illness.  Indeed, Philip's father describes his son's leap from the bridge as a release, "the only way he could get free."

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The Ballad of Typhoid Mary

Federspiel, J. F.

Last Updated: Jul-21-2008
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

The novel's narrator is a widowed 58-year-old Swiss-born physician, Howard J. Rageet, who lives in New York City. His son is a pediatrician, his daughter a medical student. Rageet himself is terminally ill. He is writing a "little biography," of Mary Mallon, the infamous "healthy carrier" also known as Typhoid Mary. Rageet's grandfather, also a doctor, had kept a journal about Mary and his rivalry with his friend, (the real) George A. Soper, whose life's work became tracking Mary and proving that she was responsible for the typhoid outbreaks. Elaborating on the journal, Rageet recounts Mary's life in America.

Born Maria Anna Caduff in the same part of Switzerland as Rageet's ancestors, she arrives in New York Harbor in 1868, aged 13, on a crowded immigrant ship, a fifth of whose passengers had died en route from Europe. The dead include Mary's family. She had been taken care of by the ship's cook, who evidently both taught her to cook and used her for sex. When the ship docks, Mary tries to jump overboard, but is stopped by a physician, Dorfheimer, who smuggles her through Ellis Island and takes her home with him. He is also a pedophile, and he has sex with her. Rageet calls this kidnapping a "humane, benevolent crime." Not long after, Dorfheimer dies of typhoid fever.

Rageet's "ballad" then traces Mary's various positions as a cook (and, often, sexual object), most of which end quickly when the household is infected. She has two relationships that do not lead to the disease. One is with a small girl who has Down Syndrome. Once her connection to typhoid is suspected, the child's family hire Mary to live alone with the child and care for her, hoping the child will be infected and die. The child never becomes ill. The other is with a disillusioned anarchist, Chris Cramer. She lives with him and falls in love with him, but he is not sexually interested in her.

Soper encounters Mary when he is asked by a wealthy Oyster Bay family, her former employers, to investigate a typhoid outbreak in their household. He manages to track her down and eventually, after much resistance, she is arrested, tested, and quarantined. She escapes and continues to work as a cook until her re-arrest. Promising to try and imagine Mary's motives, Rageet breaks off his narrative. He is dying. The novel ends with a postscript written by Rageet's daughter. Implying that her father committed suicide, she tells of Mary's stroke and the last years of her life as a paraplegic, and she provides a final document, the menu for one of the very elaborate meals Mary would have cooked.

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The Last Town on Earth

Mullen, Thomas

Last Updated: Jul-14-2008
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This tale narrates one town's attempt to isolate itself from the rapidly spreading influenza of 1918. Commonwealth is a fictional lumber mill town in western Washington state. The owner of the mill that is the economic center of this small village proposes, and sells to the residents, the plan for keeping the rest of the infected world from bringing disease into their midst. The single road into the relatively remote area is blocked and guarded by a rotating cadre of armed volunteers. The plan begins to fail as a stranger, a soldier claiming to be from a nearby military encampment, appears begging for food and shelter. He attempts to cross the barrier and is shot by one of the civilian guards.

The reader is introduced to the key players and the role of each in the town and in the evolving drama. The local medical practitioner struggles to advise the people, encouraging them to go along with the hardships created by not having access to supplies or the pleasures of visiting neighboring villages. Underlying the isolation is a history of political battles with the union and with competing timber companies, which bubbles to the surface as Commonwealth begins to lose its internal solidarity.

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Summary:

Body of Work is a cleverly crafted memoir - or, rather, the first chapter of a memoir - of the author's medical school experience at Brown University School of Medicine in Providence, Rhode Island. Ms Montross relates the chronological course of her team's dissection of a female cadaver with no discernible umbilicus and whom they therefore name Eve. (She neglects to comment on Eve's ribs and whether she has the normal complement or a supernumerary, more masculine, rib.) As she and her team of four (later three as one student drops out of school) proceed with the orderly dismantling of Eve, bone by bone, nerve by nerve and blood vessel by blood vessel, she uses this experience as a springboard to analyze her and her team's emotional reactions to the often unnatural process of deconstructing, literally (at times with a saw), a former person now cadaver, as well as the gradual, almost imperceptible acculturation that transmogrifies medical students into doctors. In fact, she devotes the final pages to this metamorphosis and what it means to the person undergoing the transition from caring student to detached physician, and whether one can retain enough caring, while remaining sufficiently detached to function as one must as a clinician, to become both a whole person and competent physician: "How much of becoming a doctor demands releasing the well-known and well-loved parts of my self?" (page 209)

Although it primarily revolves about the axis of her gross anatomy (cadaver dissection) course, the author's narrative includes tangents that have variably relevant relationships to this course, e.g., a trip to Italy to inspect first hand the anatomy theater of Vesalius in Padua and the Basilica of St. Anthony; another trip to the anatomical wax sculptures museum in Bologna, where the author also observes the "incorrupt corpse of Santa Caterina" in a "small church called Corpus Domini" (pages 223-224); interspersed histories of the traffic of corpses for dissection, including the infamous Burke and Hare story; some flash-forwards to her second and third years; and a prolonged narration of the final illnesses of her grandmother and grandfather. This last bit of family history is worth the price of the book alone. Despite the apparently incongruous collection of such asides, the author makes it work smoothly, if not seamlessly.

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