Showing 71 - 80 of 381 annotations tagged with the keyword "Cross-Cultural Issues"

Suburban Shaman

Helman, Cecil

Last Updated: Feb-22-2010
Annotated by:
Nixon, Lois LaCivita

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.

Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.

Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).

Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.

By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.

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The Gift Nobody Wants

Brand, Paul

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

Dr. Paul Brand, who grew up son of English missionaries to South India, achieved world renown for his research on leprosy and related research on the dynamics of pain. This book, one of several of his reflections on physiology, combines autobiography, stories of research, and reflections on pain and pain management. The three topics roughly correspond to three discrete sections.

It opens with a story of the early death of a child with a rare neurological dysfunction that made her insensitive to pain. Brand's long work with victims of leprosy in India and then in Carville, Louisiana, gave him wide exposure to the consequences of life without adequate pain. Having spent 27 years in India, 25 years in England, and 27 years in the U.S. before writing this retrospective, many of his reflections include observations about cultural variables in perception of pain, how pain is communicated and managed, and how people deal philosophically with the problem of pain.

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The Distinguished Guest

Miller, Sue

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

At the age of 72, Lily Maynard finds herself suddenly famous for a memoir she has published about the disintegration of her marriage years before at the height of the civil rights movement, the women's movements, and the religious shifts of the 1960's. The book brings two young women into her life: one a journalist who wants to do a story on her, the other an African-American historian who takes an interest in the connections between her personal history and the pressures of the civil rights conflicts.

Simultaneous with her cresting notoriety is an exacerbation of the Parkinson's disease which makes it necessary for Lily to move in temporarily with her son and his wife while awaiting a place in a retirement home. Half her face is paralyzed; she has difficulty feeding herself; and her extreme fatigue makes it hard to conduct interviews without dissolving into a fog of incommunicable feeling.

Each of the younger people involved in her life is driven to come to terms with his or her own life in new ways, especially her son, who finds complex feelings surfacing after years of emotional estrangement. Ultimately, her story told, Lily quietly exits the family before relocation to a home by committing suicide with an overdose of medication. In the aftermath Alan's grief gives him a new understanding of his mother's life and his own.

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Summary:

This anthology is part of an emerging literature of HIV/AIDS in Africa. It offers individual stories about the impact of HIV/AIDS in Africa as a means of countering the mind-numbing statistics on infections and deaths. As the literature of the AIDS crisis in the United States in the 1980s and 90s brought to the general public the subjective experience of HIV/AIDS and thus strengthened the socio-political will to combat the virus, so this emerging literature of AIDS in Africa will deepen awareness about the crisis, engender sympathy for the individuals who suffer from it, and ideally help to shape an effective response to alleviate the devastation being wreaked by this epidemic.

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The Condition

Haigh, Jennifer

Last Updated: Feb-12-2010
Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

When Gwen is twelve, her parents, suspecting her failure to show signs of normal adolescent development may be more serious than they had thought, have her tested and learn that she has Turner syndrome, a chromosomal disorder that frequently manifests in short stature, broad chest, low-set ears, amenorrhea and sterility. The diagnosis brings a new source of discord into an already somewhat dysfunctional New England family.  Gwen's mother, Paulette, prefers not to talk openly about Gwen's condition, or even, for a time, to admit it is real.  Her father, a scientist at MIT, is deeply interested in finding out more about it, but the clinical nature of his interest offends his wife.

Eventually the parents divorce, each to cope with different kinds of loneliness and alienation from Gwen and her two brothers.  One of those brothers, the designated achiever, is gay, but remains closeted for some years, in keeping with his mother's family culture.  The other, after a somewhat rebellious youth, marries a girl from blue-collar California, takes a teaching job, and eventually finds himself identifying with his son who receives a diagnosis of ADD not available during Scott's own youth.  The novel follows the individual stories of the five family members, each of whom carries his or her own burden of suffering, and brings them together during an unusual holiday gathering at the end, not for magical closure, but for a remarkable moment of retrospective understanding and opportunity for each to do some self-assessment and self-disclosure.

At the heart of the story is Gwen's "condition," recognized by all of them as the sadness that lies at the core of their family's chronic discomforts with one another.  Gwen herself finds her way into an authentic love relationship in her mid-thirties with a Caribbean diving guide she meets on a chartered excursion.  Though her mother is horrified and suspicious, and the rest of her family bemused, the experience of authentic love and friendship liberates Gwen from a history of self-defeating presumptions about her own limitations.

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Summary:

This study examines representations of feminine illness in American culture from 1840 to 1940. It argues that the figure of the invalid woman emerged in the 1840s amid significant changes in "American literature, medicine and culture," including the emergence of a specifically American literature, the professionalization and masculinization of medicine, and the "sometimes complementary, sometimes opposed" ideologies of feminism and domesticity (17).

The book discusses mid-nineteenth-century medical theories that articulated women as "biologically inferior . . . given to disease and pain" (34) before analyzing contemporary literary works by E.D.E.N. Southworth, Harriet Beecher Stowe, Nathaniel Hawthorne (see this database for annotations of The Birthmark and Rappaccini’s Daughter) Washington Irving, Edgar Allan Poe, and works by twentieth-century authors including Ellen Glasgow, Charlotte Perkins Gilman (see this database for The Yellow Wallpaper annotated by Felice Aull and also annotated by Jack Coulehan), Tillie Olsen, Edith Wharton, F. (Francis) Scott Fitzgerald (see this database for Tender Is the Night annotated by Jack Coulehan, also annotated by Pamela Moore), and Henry James. Art, advertisements, and the film, Dark Victory (see annotation) are other points of reference.

Price Herndl examines compliant and resistant uses of women as invalids; the surprisingly small changes in figures of feminine illness in response to changes in women’s rights; the links literature constructs between illness, money, work, and value; shifting theories of cure (from somatic to psychic); and the rise of germ theory in relation to fictional representations of illness. She argues that male and female fiction writers in the period she studies use feminine illness for different purposes: "What that figure signifies is kaleidoscopic, shifting to suit the political needs of its user" (218).

Invalid figures in literature and culture, Price Herndl asserts, can "divert political dis-ease into an overwhelming attention to the individual body and away from the body politic," locating people’s problems in their individual bodies and selves rather than in the oppressive aspects of their culture (220). Recurrent representations of sick women reflected the extreme unease attached to the position of women in American culture in the years 1840-1940. While her study stops at 1940, Price Herndl asserts that after World War Two and at other points when "masculine privilege seems threatened . . . illness is figured more and more often as male" (220).

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Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Anthology (Essays)

Summary:

Most of the twenty works in this anthology are first-person narrative essays. They represent a wide range of women’s experiences of embodiment, spanning both the average lifespan and the particularity of individual lives, focusing on puberty and menstruation, weight-consciousness and eating disorders, facial disfigurement, multiple sclerosis, infertility and pregnancy, cosmetic treatments and surgery, breast cancer, and aging. A few essays offer a valuable cross-cultural lens on the experience of embodiment.

Hanan al-Shaykh’s Inside a Moroccan Bath (see this database) explores her dual experiences of being stigmatized in Middle Eastern culture for her thinness, and then having her stigma recast as value when she moved to a European city. Judith Ortiz Cofer’s "The Story of My Body," which begins "I was born a white girl in Puerto Rico, but became a brown girl when I came to live in the United States," (299) offers another perspective on the cultural instability of the criteria for female beauty. Linda Hogan’s "Department of the Interior" positions her experience of embodiment within the intertwined contexts of American Indian culture and the physical landscape of the West.

Some of the contributors are well-known for their texts on embodiment ( Lucy Grealy, Nancy Mairs, and Naomi Wolf, for example), whereas others are well-known creative writers (Margaret Atwood and Linda Hogan). Pam Houston’s Out of Habit, I Start Apologizing is also annotated in this database.

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Metamorphosis

Updike, John

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The protagonist, Anderson, has a skin cancer growing dangerously close to one of his tear ducts. An aging "idler and playboy," he has spent too many years in the sun (67). Anderson consults and promptly becomes infatuated with his facial plastic surgeon, Dr. Kim, "who turned out to be a woman, a surprisingly young Korean-American who even in her baggy lab coat evinced considerable loveliness" (67). Anderson is fascinated with Dr. Kim's body, her visible pregnancy, her way of moving and speaking, and her face. He enjoys the "bliss of secure helplessness" of the surgery itself, performed by Dr. Kim and two female nurses who "rotate[]" around him conversing as they work (67).

While successful, the surgery leaves a small bump on his face that Anderson asks Dr. Kim to correct surgically. The second surgery achieved, Anderson returns a third time for the much more ambitious project of tucking his somewhat saggy eyelids. His goal, however, is not just to tighten slack skin but to make his lids look like Dr. Kim's, "with an epicanthus" (69). The six-hour surgery is both successful and satisfying to Anderson--until he sees a photo of Dr. Kim's husband.

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A Stone Woman

Byatt, A. S. (Antonia Susan)

Last Updated: Feb-11-2010
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

The story opens with the death of the protagonist’s beloved mother, with whom she lives. Ines, a dictionary researcher, is soon jolted from her grief by the excruciating pain of a “twisted and gangrenous gut” (112). After a hospital stay and emergency surgery, she returns home to recuperate from the physical trauma and revisit her mourning. On the day when she can remove the wound dressings, Ines discovers a surprising change in her body: it seems to be turning to stone. Her incision has become a “raised shape, like a starfish, like the whirling arms of a nebula in the heavens” that gradually spreads to the rest of her body, forming "ruddy veins" across her belly and "greenish-white crystals sprouting in her armpits" (119).

Ines assumes that this process is fatal and that she will "observe [death's] approach in a new fantastic form" (121). Deciding to write a record for those who will find her after her demise, she studies the names and nature of minerals in order to understand and describe her metamorphosis. From her new, mineralizing perspective, she realizes that stones can be dynamic and living as well as fixed and dead; minerals are memorials to the relationships and reciprocities between living creatures and dead ones.

Unable to write the record of her transformation, Ines finds herself passionate to be outdoors. She explores the city, looking for "a place to stand in the weather before she became immobile" (127). In an old graveyard, she meets and gradually forms a bond with Thorsteinn, an old Icelandic stonecutter who may also be mourning the death (apparently of a child). The Ines shares the secret of her metamorphosis with the stonecutter and eventually travels with him to his homeland, a geologically young country, where stones are alive and myths tell of “striding stone women.” Thorsteinn sketches here in this landscape and creates a standing stone image of Ines that reflects his ability to see her as she is and find her beautiful: "Petra faction saw that she existed, in there" (150).

Ines's metamorphosis culminates in her inability to see or speak as a human and her ability to perceive a whole new realm of living creatures, "earth bubbles and earth monsters" (151) and other stone people who are "flinging their great arms wide in invitation" (156). She joins their wild dance.

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Summary:

When Mary Lennox (Kate Maberly)’s parents die in an earthquake, she is sent from India to live with her uncle, Lord Archibald Craven (John Lynch) at Misslethwaite Manor, his large and lonely estate on the Yorkshire moors. A neglected, lonely, and disagreeable child, Mary changes through encounters with the gregarious maid Martha, an elderly gardener as irritable as she is, and Martha’s brother Dickon (Andrew Knott), a boy at home with nature who helps her rejuvenate a walled, neglected garden she finds on the estate.

Mary also unravels the mysteries associated with Misselthwaite Manor and her aunt and uncle’s family. A depressed widower with a spinal deformity, Lord Craven has locked the garden after his wife’s accidental death. Mary discovers the key to the garden in her aunt’s closed-up boudoir. She also finds her cousin Colin (Heydon Prowse), who has been hidden away because his father thinks he has inherited his bodily and psychiatric illnesses. Mary provokes Colin to leave his bedroom, join her and Dickon in caring for the garden, and finally to summon his father, via a quasi-pagan ritual around a bonfire in the garden, to return from Europe. Lord Craven returns to find his sickly son walking and healthy, and a new family consisting of Colin, Mary, and Lord Craven is formed.

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