Showing 81 - 90 of 298 annotations contributed by Aull, Felice

Before the Operation

Gervex, Henri

Last Updated: Nov-14-2008
Annotated by:
Aull, Felice

Primary Category: Visual Arts / Painting/Drawing

Genre: Oil on canvas

Summary:

Also called "Dr Péan Teaching His Discovery of the Compression of Blood Vessels at St Louis Hospital," the scene takes place in a room in which the walls are interrupted by tall windows.  Daylight shines through the windows, illuminating an attractive naked young woman in the right foreground who lies seemingly anesthetized -- her eyes are closed although there is no sign of anesthesia -- on a bed of some kind that is draped loosely with sheets.  Her body is pointing away from the viewer, her head facing away from us, her long hair falling casually over the near edge of the bed.  Her breasts are fully visible, especially her right breast, while her lower body is covered.  A seated man grasps the wrist of her bent right arm, perhaps taking her pulse. His hand and arm rest directly on the woman's body -- on her abdomen and groin area.  He appears to be reading from a paper.

In the left foreground is the edge of a table that holds some surgical instruments and a glass jar containing what may be anatomic specimens.  An imposing sideburned man stands to the left, above the head of the bed and the woman.  Holding a surgical instrument in his right hand, he gesticulates with his left-hand, his mouth partly open: he is lecturing to the people in the room, some of whom are looking directly at him while others talk to each other.  Two in the audience are women -- a nun barely visible in the far background, and a nurse standing behind two men who are near the bed.  The men are all dressed in street clothes.

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The Abortion

Sexton, Anne

Last Updated: Apr-24-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poem begins, "Somebody who should have been born / is gone" and this phrase is a refrain intercalated between two sets of three tercets, with a final closing tercet. Each tercet has a rhyme scheme of a, b, a. The speaker narrates a journey that takes her south to an abortionist in the mountains of Pennsylvania, and then, after the abortion, back home to the north. The situation and the speaker's perception of it are rendered in metaphors that draw on the natural environment through which the journey proceeds. At the beginning, the earth puffs buds, and the drive proceeds toward blue-green mountains -- metaphors of fecundity. The description of the mountains as "humps" might imply the sex act that initiated pregnancy.

Soon, however, there is foreboding as dark images of tearing and splitting appear: "the ground cracks evilly," "and me wondering how anything fragile survives." Then "a little man . . . took the fullness that love began" and the speaker returns north, physically and emotionally reduced as the sky grows thin and the road is "flat as a sheet of tin."

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Silvie's Life

Rogoff, Marianne

Last Updated: Apr-01-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This book chronicles a tortured parenthood during the birth and brief life of a severely brain-damaged female infant, Silvie. Doctors predict that the child will live only a few days but instead she survives for seven months. The story is told in first person by the mother, beginning with her arduous labor during a home delivery in the presence of an experienced midwife and the family physician. The baby does not cry when she is born and turns blue even with oxygen that the doctor administers. An ambulance is summoned; "a bigger, better oxygen machine" restores the baby's color and she is brought to a hospital neonatal intensive care unit where she is artificially ventilated and fed.

In the hospital Silvie "fails" all the tests of normalcy. The doctors recommend removing artificial ventilation. "I feared, even more than I feared her death I think (and harder to admit), that they would remove the oxygen pump and the baby would live on and on and never be able to do anything at all" (14). Yet when the child does in fact breathe independently, "I took the fact that she could sustain her own breathing to mean that the baby wanted to live. It was all right to love her" (15). A few days later, however, the medical team concludes that there is nothing further they can do for the baby, that the parents should take the child home, where she will likely die within a couple of days. Upon being prodded, one physician suggests the parents give her an overdose of phenobarbital, which she is receiving for continual epileptic seizures.

At home, the parents feed Silvie by tube, medicate her, change her diapers, hold her, and learn from a friend how to swaddle her. The child never cries, does not focus her eyes on anything, rarely responds to sound or touch, and gains no weight. Whatever random responsiveness there seems to be gives the author a sense of motherhood: "I was able to survive because of my faith in these intermittent chance meetings, believing that Silvie did know when I was here and that I was holding her close in a way that meant love" (37). The parents brace themselves for Silvie's death. The husband's sister visits and councils them to actively put an end to Silvie's life, which they refuse to do. But they do not plan to take extra measures (CPR) if Silvie seems to be dying at home and when they articulate this to a social worker whom they consult to obtain respite care, it becomes clear that she would report them to Child Protective Services.

The husband quits his job as a residential counselor of emotionally disturbed teenagers to do part-time carpentry work -- he is too preoccupied to care about other people's problems. When a friend accidentally breaks the phenobarbital bottle, the parents together with the family physician decide to see how Silvie will get along without the drug. To their amazement, the baby appears slightly more alert and is able to suck from a bottle -- no more feeding tube required. But the husband reminds his wife, "The doctors warned us she might do this. This is the one and only thing she can ever learn. They said when this happened to other parents they started to believe that the baby was getting better" (59).

The parents live in limbo, attempt to live a "normal" life. When Silvie starts to lose weight at age 4 months, the doctor advises to resume tube feeding; they don't see the point, but when hospital physicians use the word, "murder," and threaten to "take over" Silvie's care, the parents relent. The baby lives but "it was the sameness of Silvie that drove you crazy . . . She slept and woke, but was awake that much different? She did not change, she did not change. Her sameness was a stone I wore, an emblem of failure, failed life" (96).

The final act for Silvie begins when the author's mother-in-law is dying of cancer in New York and a decision is made to leave the baby at home in California for several days in the care of a retired nurse. The nurse has been shown how to do the tube feeding, but while the parents are in New York she experiments with spoon feeding, then discontinues tube feeding for three days before the parents return. The parents see that Silvie has deteriorated in their absence and resume tube feeding. For the remaining couple of months the parents wait, investigate institutionalizing Silvie, and finally determine that "the way we loved Silvie meant we loved her enough to let her die" at home, with "a certain amount of fluid and nourishment for comfort, but a gradual withdrawal of excessive food. Replaced with a lot of touching and holding, stroking and whispering" (122). Silvie dies and the author is four months pregnant with the baby she and her husband have decided not to abort.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

Sandeep Jauhar, M.D., Ph.D. is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York. Thus, one can assume that he is an accomplished cardiologist and administrator. It was not always so. This memoir flashes back to 10-15 years earlier when the author was casting about for a career, finally settling on medicine almost by default; it follows him to medical school (at Washington University in St. Louis) and then centers on his first year of residency training at Cornell's New York Hospital in Manhattan -- the internship year.

We learn in the introduction to the book that the author will speak freely of self-doubt about career choice, constant anxiety and feelings of inadequacy, exhaustion, and disillusionment. Which indeed he does. But Jauhar first discusses his family background: born in India and emigrating with his family to the USA at age 8; father holding a Ph.D. in plant genetics, now writing academic textbooks and still regretting that he had not been able to afford his dream of becoming a doctor; mother helping to support the family as a lab technician; older brother, Rajiv, a mentor and competitor, charming, self-assured, and unquestioningly headed for a medical career; sister, Suneeta. Sandeep (the author) undertakes graduate work in theoretical physics but as he nears completion of his doctoral degree, realizes that he probably does not have what it takes to be successful in the field. When his girlfriend, Lisa, becomes seriously ill, he begins to (re)consider medicine as a career. Against the advice of his parents who are now convinced he is a dilettante, he applies to medical school and is accepted.

Disillusionment began during the first two years of medical school: "In graduate school I had never learned to memorize . . . But now I couldn't rely on logic and reasoning; I had to commit huge swaths of material to memory" (32). He considered quitting to become a journalist, a profession that had always intrigued him, but which had been discouraged: "my father made it clear that journalism and writing were never to be considered career options because they offered no security" (33). Yet, amazingly, he was awarded a summer fellowship just before starting medical school that placed him in the Washington, DC office of Time magazine; the contacts he made then allowed him to work as a student reporter for the St. Louis Post-Dispatch during medical school and led ultimately to his ongoing and current position as a contributing medical essayist for the New York Times.

Internship for Jauhar unfolds as a series of anxiety-provoking encounters with patients and humiliating encounters with his physician superiors. Feeling inept and inadequate, he stumbles along and worries that he is harming patients. There is too much to keep track of, too many "little things that I find burdensome" (91). "Having so much to do was bad enough, but not knowing why you were doing what you were doing was terrifying . . . Patients were needy, their demands overwhelming . . . Everyone seemed to know how the place worked except me . . . The ecology on the wards was hostile; interactions were hard-bitten, fast paced" (112-113). He is in constant doubt and conflict about his career choice. Even his private life is affected -- his girlfriend Sonia, still a medical student, comes from a medical family, is strongly motivated and secure in her career choice, which aggravates his own sense of insecurity. (Reader, he married her.)

Midway through internship Jauhar suffers a herniated disk. He tries to tough it out without taking time off but his stint as "night float" at Memorial Sloan-Kettering hospital, which specializes in treating cancer patients, proves too difficult-- up all night trying to tend to the severely ill and "taking care of patients about whom you knew next to nothing" (154). He takes a brief leave followed by a reduced schedule. He recognizes that his problems are emotional as well as physical -- he is depressed. But gradually, as his neck problem improves, as he recognizes that medical professionals are actually able to help patients feel better -- his neurologist and physical therapist had "provided hope and comfort to me at a vulnerable time" (181)--, as he makes a house call to a dying patient, as his essays are published in the New York Times, and as the season moves to Spring, his depression lifts and he looks forward to his work.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

The author's mission is to investigate, understand, explain, describe, and puzzle over the nature of phobias -- his own, and that of other sufferers. Allen Shawn is a composer, pianist, and teacher, and is a member of a gifted family: his brother, Wallace Shawn, is a playwright and actor; his father was William Shawn, for many years editor of the New Yorker Magazine. As a musician and academic, Allen Shawn is "successful." And yet, his life is severely limited by agoraphobia, "a restriction of activities brought about by a fear of having panic symptoms in situations in which one is far from help or escape is perceived to be difficult" (13). The author interweaves sections that summarize his extensive readings on the fight-flight reaction, evolution, brain and mind, Freud's theories on phobia--with his personal history, especially as he believes it relates to his phobia.

Shawn's descriptions of how he experiences agoraphobia are vivid and informative, detailing the situations that trigger his physiologic symptoms of panic and disconnectedness: driving on unfamiliar roads, any kind of travel that is unfamiliar, walking across or on the edge of open spaces, traveling across long bridges, being in enclosed spaces (claustrophobia). The agoraphobe, he writes, "feels at risk, as if at risk of sudden death or madness" (14). Shawn tells about what he must do in order to strike out on unfamiliar trips, that is, when he gathers up the courage to take them. He must venture up to the point where panic sets in, turn back, then on another occasion repeat the process but attempt to go further, pushing through the panic, until, one day, he can make the entire journey without turning back. Sometimes he never makes it to the desired goal.

The author points to several different factors that seem to predispose people to phobias: heredity, unconscious imitation of a phobic parent, upbringing. In his own case, in retrospect, his father showed symptoms of agoraphobia. Shawn discusses the underlying repression that was pervasive in his household -- his father carried on a long-term relationship with a woman while remaining married. Shawn's mother knew about the relationship from early on but any discussion of it was forbidden, even after it became common knowledge.

Perhaps more important in Allen Shawn's perception of repression is what happened to his twin sister, Mary, who was born with what is now considered to be autism, and mental retardation. Allen felt close to this girl, even though her behavior was unpredictable and baffling. When he was about eight years old, his parents sent her away to a special boarding school without warning Allen, or offering explanations. From then on he rarely saw her; 10 years later she was institutionalized. The family did not speak much about her and her "'exile' . . . added yet another layer of mystification to an already really mystifying atmosphere. It turned out that even in our temperate environment something extremely violent could occur" (177). Not long after that, Allen began to experience severe anxiety in certain situations.

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The Wellspring

Olds, Sharon

Last Updated: Mar-05-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This latest collection of poems by Sharon Olds is fittingly dedicated to "our daughter and son." Centered on the intense experiences of marital love and parenthood, the book can be read as a (yet unfinished) life-cycle story that begins with the poet narrator’s own conception, birth, and childhood bonds with mother and sister (Part 1). The overpowering awareness of her adolescent sexuality, romantic attachments, and the growth to womanhood, culminating in pregnancy--her daughter’s beginnings--are the subject of the poems in Part 2.

Part 3 describes the birth of her daughter and son, and the deep love and anxieties of parenting, expressed in the small details of daily life and child care. The short Part 4 is a celebration of married love, both erotic and transcendent, and of the powerful emotional connections which are the "wellspring" of human lives--that spawn the children we bring into the world and that help us to love and care for them as well.

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In the Next Galaxy

Stone, Ruth

Last Updated: Mar-05-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

This award-winning collection, published when the author was in her late 80s, contains 96 poems, most of them no more than one page in length. These poems are complex, interesting, surprising, and full of the pain of life. Stone has suffered and she does not hesitate to dwell on the causes of her suffering but she is not maudlin--she has lived and thought about life and she shows us how she lives and thinks.

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The Inhabited World

Long, David

Last Updated: Feb-25-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

As the novel opens in 2002 we learn that the protagonist, Evan Patrick Molloy, has been wandering through a particular house and its yard for ten years, passing through its walls, unperceived by any of the people who have occupied the house. Evan is a ghost. The house he wanders through is the one he lived in when he deliberately put an end to his life by gunshot ten years earlier. It is the house he had lived in for a while with his ex-wife, Claudia after he resumed his relationship with her. Claudia's 10 year old daughter from a second failed marriage, Janey, lived with them. Several individuals and families have occupied the house since Evan's suicide. The current occupant is Maureen, who has moved there as part of her attempt to break off a relationship with her married lover, Ned, a radiologist.

Evan's story is revealed as flashback, interwoven with Evan's present-day fascination with Maureen and his watchfulness over her. The flashback chronology is not sequential but Maureen's life in the house and her interaction with Ned, who tracks her down, unfolds chronologically. As Evan thinks back on his life he tries to reconstruct the events, relationships, and state of mind that culminated in his suicide. At the same time, he wants to understand what is going through Maureen's mind and what motivates her actions. These two narratives merge at the end of the novel.

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Beyond Harm

Olds, Sharon

Last Updated: Feb-21-2008
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poem

Summary:

The poem expresses the devastation that parental abusiveness inflicts and the rationalizations its recipients adopt for emotional survival. In a perverse way, childhood mistreatment by her father meant the narrator was being given his attention. His death has guaranteed that the loving relationship which she had with him at the end of his life is safe from harm. So precarious did she believe his love to be that she feared even now to offend him: "he could / re-skew my life."

 

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Summary:

Part of a series, "Letters to a Young . . . [fill in the career]," this collection of essays by pediatrician-author Perri Klass is addressed to her son Orlando during the recent period when he was applying to medical school. The essays follow a chronological sequence, beginning with the decision to apply to medical school, the first two years of medical school, learning how to examine and talk to patients, residency training, physicians as patients, making mistakes, grappling with the most fundamental human issues in medicine, and the mingling of professional work and life.

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