Showing 71 - 80 of 130 annotations tagged with the keyword "Drug Addiction"
Having previously described his seven years as a family practitioner in rural Minnesota (Healing the Wounds, Pantheon Books, New York, 1985) Hilfiker now has turned his attention to a decade in inner-city Washington, D.C., where he practiced what he calls "poverty medicine." These introspective essays are written in a style similar to that of his first book and detail the profound struggles of the overwhelmingly African-American community he serves and lives with.
Also examined are his and his family's battle to live with their white middle-class privileges in the midst of this impoverished community. This book very effectively alternates between the numerous stories of his personal encounters with patients and deeply reflective commentary about those encounters. Prescriptions are not offered other than that a new art of caring for the poor is needed.
Peter Selwyn spent the first ten years out of medical school at Montefiore Medical Center in the Bronx, caring for HIV-positive patients--mostly intravenous drug users and their families--in the early years of the AIDS crisis. As he worked with dying young men and women and their families, Selwyn returned to his own unexplored pain surrounding the loss of his father, who fell or (more likely) jumped from a 23-story building when Selwyn was a toddler. Mirroring their function in Selwyn’s life, the stories of the five patients who most affected him serve in this book as the threshold to the narrative of how Selwyn investigated, mourned, and commemorated his father’s death, finally revaluing it as central to the person and doctor he became.
"My mother danced all night and Roberta’s was sick. That’s why we were taken to St. Bonny’s." Thus begins Twyla’s narrative of her long-term, intermittent relationship with Roberta, another eight-year-old who shares her failing grades and "not real orphan" status at St. Bonaventure’s, the shelter where they live for a few months.
The two girls become fast friends despite the discomfort occasioned by the situation, their problematic mothers (Roberta’s is hyper-religious and unfriendly; Twyla’s is pretty but childlike, an embarrassment to Twyla because of her casual clothing and behavior), and their racial differences (one is white, one African-American). They also share a defining moment, in which they watch bigger girls assault Maggie, a disabled woman who works in the institution’s kitchen.
The girls meet by accident four more times; as young adults in a Howard Johnson’s, where Twyla works and Roberta stops in with two young men on the way to the coast for "an appointment with Hendrix"; in a grocery store in Newburgh, the blue-collar town on the Hudson river where Twyla lives (Roberta lives in white-collar Annandale); at a picket line against a busing plan (Roberta is protesting the busing; Twyla ends up picketing for it); and finally in a diner on Christmas Eve. Each time they meet, they piece together what has happened in their lives, but also return to the defining moment of Maggie, arguing about what really happened and what role they played in the abuse.
The text explores the experiences of a nurse practitioner in an inner city OB-GYN (Obstetrics & Gynecology) clinic and four of her women patients, from a fifteen-year-old homeless pregnant child to a mature woman struggling with cancer. Another of her patients is pregnant and drug addicted; a fourth suffers from pains that come from buried memories of sexual abuse. The stories of all four patients weave in and out of the narrator's own stories about herself, her own health and illness experiences, her own respectful appreciation of the female body.
The title of this collection of poems recalls the formulaic statement by which a physician introduces a patient's medical problem or chief complaint. For example, "The patient presents with a history of fever, abdominal cramps and diarrhea for the last 24 hours." Or, "The patient presents with a long history of hypertension and diabetes." In this case, though, Dr. White's patients' presentations are poems, rather than chunks of sanitized medical jargon; and, while the patient remains a key character in most of these works, they also present the doctor's story.
Domestic violence, child abuse, and sexual abuse figure prominently in these poems. In "365" (p. 1) a five year old girl presents with "a foul smelling vaginal discharge"; she was a victim of rape. Baby "John Brown" (p. 9) has 47 fractured bones and was "dipped in boiling water" for soiling himself. In "Ironing" (p. 18) a first grade girl has the impression of an iron burned into her thigh. And the two-year-old girl in "Peek" (p. 49) is admitted to the Intensive Care Unit (ICU) with cigarette burns and a liver fracture.
Dr. White also writes of babies left behind by their mothers ("Autumn Angels," p. 3), homeless mothers and children ("Numbers," p. 42), and complex multigenerational family pathology ("Riddle," p. 50). All in all, these stories carry the reader very close to "Looking at the Gates of Hell" (p. 32).
Yet, a still, small voice of calm, maybe even of salvation, can appear in the most unlikely places. In "Belly" (p. 4) the physician lays her face against a baby's belly and "the warm brown skin calms my forehead. / All stiffness melts." In "Maplewood & Greene" (p. 36) she revels in seeing "three little girls on roller skates." And in the Whitmanesque poem called "Oh" (p. 45), she gloriously affirms, "Oh to laughter, oh to sorrow / Oh to a better day, oh tomorrow."
This fine collection of writings by women involved in health care stems largely from a writing group cosponsored by the Nebraska Humanities Council and the Creighton University Center for Health Policy and Ethics. However, other writings also appear in this volume: in all there are 40 pieces by 16 authors. Writing genres include essay, short story, and poetry. The works are divided into three sections: Power and Powerlessness, Vulnerability and Voice, Connection and Disconnection. As noted in the introduction, these are "major themes in feminist perspectives in ethics" and the works are offered as reflections on modern ethical dilemmas in health care.
Some of the most powerful pieces are stories about being the newcomer--the student or junior trainee. For instance, "Washing Cora's Hair" by co-editor Amy Haddad is a poignant look at the struggle of two young nursing students to wash the long braids of a bed-bound elderly woman in her cramped home, and "The Story of David" by Ruth Purtilo, written as a memoir looking back to when she was a newly graduated physical therapist, concerns her interactions with a young, angry, depressed quadriplegic patient and with her superiors.
Another memorable piece is "The Things You Do" by Kelly Jennings Olsen. This story about being a new volunteer emergency medical technician masterfully controls the tensions of emergency medical care, the anguish of the father whose little girl slipped under his tractor, and the nuances of living in a small town. Several poems also deal with issues of the newcomer and witness to suffering (e.g., "As Ordered" by Ruth Ann Vogel--a poem about shaving the head of a neurosurgical patient on the pediatric ward)
As noted by the multiple keywords listed above, these pieces touch on many topics. Power relations play a key role, both between professionals and between patient and the health care team. For instance, in the polished story, "Procedures" the author Kim Dayton writes from the perspective of a young single mother with a critically ill neonate. This mother is repeatedly prevented from visiting her child because of "important" events like rounds and procedures, and she ironically only gets to hold her baby after the baby dies.
Throughout the collection the patients are described with honesty and vividness. Their suffering can haunt the health care worker ("Maggie Jones" by Veneta Masson) as well as teach ("Back to Square One" by Barbara Jessing). Many of the pieces remind us of our good fortune and the privilege we have in our lives and in providing health care services (e.g., "Spring Semester" by Amy Haddad). Ultimately in this volume our common humanity is emphasized--the connections between people and the remarkable grace that can be exhibited in the face of suffering.
This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.
Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.
This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.
After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.
Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.
Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.
In Especially Then David Moolten discovers his poetry in the ordinary, often painful, texture of childhood, adolescence, love, and marriage. Each memory becomes a small story-like poem that looks simple and straightforward at first, until suddenly the poem reveals its hidden truth. A sense of existential loss pervades these poems, as in “One morning as a man’s wife offers to fill / His empty bowl he feels suddenly desolate / For how plain he has become…” (“Cornflakes,” p. 31) But Moolten’s melancholy is sweet, rather than bitter; energized, rather than depleted; and cumulatively powerful, as “The tractor / Of memory drags on, churning its femurs, / Its numbers and dates.” (“Verdun,” p. 64)
Especially Then is ripe with traumatic events: A father’s abandonment, “During that proud, petulant year my father left / And I became a punk, nothing could touch me.” (“Achilles,” p. 17). A brother’s death: “in the shallow dark of years since / I buried my brother…” (“Pulled Over on I-95,” p. 23) Divorce, “despite the years between you / And a hard divorce, the unshrived recriminations…” (“Seen and So Believed,” p. 51) And a wife’s death, “As if his wife had always gone / By the name of death he thinks of her / Whenever he sees or hears the word.” (“In Name Only,” p. 49)
These ordinary tragedies play out against a panorama of tragedy, as evidenced in “Photograph of a Liberated Prisoner, Dachau (1945)” and “The War Criminal Gives His Testimony.” Most often, though, the world’s suffering has little impact on the way we live our lives, “Someone at the next table sighs / Over Guatemala, the tragedy / Of having read an article or watched / A TV special…” (“Who You Are,” p. 53) We go on as we always do.
Anne Lamott, a writer, recovered alcoholic, former addict and impassioned Republican-hater, finds herself pregnant in her mid-thirties, and decides to have the baby. This journal is a chronicle of her son Sam’s first year. She is fiercely self-deprecatory and funny and unafraid to talk about the dark side of parenting an infant: the fear, exhaustion, anger, emotional swings; that 4 a.m. inability to cope with the crying neediness of the baby.
She is a single parent barely able to pay the bills, but she has a tremendous support network of family, friends, and the people of her church--all of whom clearly love Sam and love her. And then, when Sam is 7 months old, crawling "like a Komodo dragon," the author’s best friend Pammy is diagnosed with metastatic breast cancer. The author, who discovers the depth and resonance of love because of the gift of Sam, must now learn loss. She questions her faith, which she cannot justify on a cerebral level, but still hopes that God loves and guides her the way a parent loves and guides a child.
A theatre classic about a dysfunctional family, whose summer on the shore is flawed by alcohol, tuberculosis, drug addiction, and denial of all of the above. Considered by biographers to be highly autobiographical, the plot of the play centers about the progressive retreat by wife and mother into drugs as her husband and sons pretend they do not see. Alcohol abuse among the men of the family contributes to the rising tension in the work, as does increasing concern about one son’s tuberculosis. The action and psychological power of the play accelerate steadily through the first three acts, then climax with recognition of the brutal realities in the final act.