Showing 81 - 90 of 221 annotations tagged with the keyword "Public Health"

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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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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Cancer Vixen

Marchetto, Marisa

Last Updated: Apr-03-2008
Annotated by:
Holmes, Martha Stoddard

Primary Category: Literature / Nonfiction

Genre: Graphic Memoir

Summary:

Cancer Vixen is the graphic narrative of Marisa Acocella Marchetto’s eleven-month cancer experience in 2004. Marchetto, a successful forty-something cartoonist for Glamour magazine and the New Yorker, serialized Cancer Vixen in Glamour while undergoing treatment. As well as the narrative of Marchetto’s diagnosis, treatment, and remission, Cancer Vixen recounts the story of Marchetto’s romance and engagement to restaurateur Silvano Marchetto, a narrative embedded in the graphic novel despite preceding it in actual chronology. The narrative explores fears about the cancer's effect on the relationship and about the loss of the chance to be a biological mother, as well as developing the relationship between the engaged couple and between Marisa and her mother (or "(s)mother," as she calls her).

The culture of cancer is another focus, including the social dynamics of having hair during cancer treatment and thus leaving oneself open to critique for not undertaking a strong enough chemotherapy. While this New York story, full of cuisine, couture (including images of the specific shoes Marchetto wore to each chemo), and cappuccino may recall the episodes of the television show Sex in the City featuring cancer, the brightly colored frames of this “Cancer in the City” tale also engage political issues like environmental causes of cancer and the reduced survival rates of women with cancer and no insurance.

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This book chronicles four meals, tracked from the production of the food through to the preparation and consumption of the meals themselves. The first is a fast food meal eaten in the car, the quintessential American meal consisting entirely of industrially farmed produce. Pollan then goes on to have an industrial-organic meal, an organic pasture-grown meal, and finally a meal containing only products that he foraged, hunted, and cultivated himself. Throughout, he looks closely at how economic and commercial values have supplanted ecological ones in the cultivation and production of the food we ingest. In addition to attending to the social and political dimensions of the American diet, Pollan also notes the effects of this diet on public health, from rising levels of obesity through to the antibiotic resistances developing in herds of cattle living in pens in their own manure.

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Mother Superior

Mack, Alex; Montero, Diana

Last Updated: Dec-11-2007
Annotated by:
Jones, Therese

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The tag line for the documentary short film, Mother Superior, is: "This is your mom. This is your mom on drugs." Methamphetamine addiction has slowly and silently encroached into American suburbia, becoming the drug of choice for women who are struggling to balance the demands of family and career and to meet the expectations of a culture that prizes upbeat, thin, and sexy soccer moms. When the two filmmakers, Alex Mack and Diana Montero, learned that the tidy neighborhoods and wholesome lifestyles of their own hometown, Salt Lake City, ranks third in the United States for meth use among women and that thirty-seven percent of individuals in drug treatment programs are mothers addicted to meth, they set out to make an educational documentary. The twenty-two minute film combines animation, dramatization, information from public health officials and health care professionals, and personal testimony from women in recovery.

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In 1999, eighteen years after Project HOPE began publishing the journal "Health Affairs," the founding editor, John Iglehart, began a new column: Narrative Matters. This book contains 46 of the 80 essays published to date, and an inspiring foreword by Abraham Verghese. The essays are contained in eight chapters-- "Writing to Change Things: Essays on the Policy Narrative," "Dollars and Sense: Hard Financial Realities," "Bearing Witness: Patient's Stories," "The Maddening System: Frustrations and Solutions," "Trouble in the Ranks: Professional Problems," "Drug Resistance: Battling Undue Influences," "Disparity Dilemmas: Stories on Race and Ethnicity," and "Values and Choice: Stories of Practical Ethics." Familiar voices include those of Fitzhugh Mullan (one of the editors), Abigail Zuger, Howard Brody, Richard Lamm, John Lantos, Danielle Ofri, and Carol Levine. The essays in the first section strike an important cautionary tone, reminding readers that the plural of anecdote too often is taken for policy and that the repetition of anecdote should not be seen as evidence.

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Clinician's Guide to the Soul

Masson, Veneta

Last Updated: Nov-06-2007
Annotated by:
Davis, Cortney

Primary Category: Literature / Poetry

Genre: Poetry and Art

Summary:

Veneta Masson's latest poetry collection is a clinician's guide not to illness and disease but to the souls touched by illness, both the patient's and the caregiver's. In 45 poems, she reviews her life in caregiving, from her early days in nursing to her work as a nurse practitioner in a community clinic and finally to her decision to use her hands "to write and to bless" (p. 93). Her poems are enhanced by the artwork of Rachel Dickerson, whose woodcuts and etchings are paired with poems to provide another voice, another way of looking into the soul of caregiving. For an example of this wonderful pairing, see the print that accompanies "The Screamer in Room 4" (p. 24). The print allows us to see the frustration of the screaming child, the child's mother, and the caregiver.

As always, Masson's poems center on the patient-caregiver experience; in this volume, as we follow her through her various adventures in nursing we also travel with her through the changes she has witnessed in healthcare and the politics that continue to affect its delivery. "Rx" (p. 22) examines Medicare and Medicaid and the political decisions that often deny medications to the elderly who need them most. "Gold Standard" (p.34) looks again at medicine and money, juxtaposing the medical pill against the placebo of the caring healer. One of my favorite poems, "The Doctor's Laptop" (p. 40) laments how technology might deprive patients of the doctor's time, attention and touch.

Other themes that are central to this collection are the unexpected presence of humor in caregiving (see "Conga! at the Rio," page 50), of spirituality (see especially "Rescue," page 36, "Refuge," page 45, and "Prevention," page 82), and of the personal. In several moving poems Masson looks at her own sister's death and her reaction to it, writing about her conflicting roles as sister and nurse (see, among others, "Matinee," "Hilda and Snow White," and "The Nurse's Job," pages 70, 72 and 74). In an excellent final poem, "Winter Count," Masson takes us through her own nursing history, a chronicle of work, joy, disappointment and survival that any caregiver will recognize.

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First published in 1991, and available in reprint edition, this is a compendium of selected artworks and excerpts of diverse medical and literary writings from pre-Hippocratic times to the end of the 20th C. Each chapter integrates selections from medical or scientific treatises, with commentaries written by historians, essays by physicians and writers, and prose and poetry by physicians and by patients. The 235 images in this book include illustrations from medical textbooks and manuscripts, as well as cartoons, sculptures, paintings, prints and sketches. The colour illustrations are stunning and copious, and provide a visual narrative that resonates with each chapter of the book.

The first part of the book, Traditional Medicine, includes chapters on Ancient, Medieval, Renaissance, and Enlightenment medicine. These serves as a preamble for the second part, Modern Medicine, which includes art, medicine and literature from the early 19th century to the end of the 20th century.

The chapter “From the Patient’s Illness to the Doctor’s Disease” illustrates the rise of public health and scientific research with excerpts from works by Edward Jenner, John Collins Warren, René Laënnec, and John Snow, together with experience of epidemic diseases described by writer Heinrich Heine in his essay on “Cholera in Paris”. The chapter on “Non-Western Healing Traditions” includes botanical research by Edward Ayensu, a short story by Lu Hsun and the writing and paintings of George Caitlin on North American Indian healing.

In the patient-focused chapter, “Patient Visions: The Literature of Illness,” are stories of sickness by Thomas DeQuincey, Leo Tolstoy, Giovanni Verga, Katherine Mansfield, André Malraux, and Robert Lowell. The chapter which follows, “Scientific Medicine: the Literature of Cure,” provides the medical counterpoint with personal correspondence by Freud, medical treatises by Wilhelm Roentgen and Louis Pasteur, an essay on surgical training by William Halsted, and an excerpt from George Bernard Shaw's play, Too True to Be Good, in which a microbe takes centre-stage.

There are chapters on “Medicine and Modern War,” which includes personal writing by nurses Florence Nightingale and Emily Parsons, and poems by Walt Whitman, and Emily Dickinson, and “Art of Medicine,” with works by Arthur Conan Doyle, Anne Sexton, James Farrell and W.P. Kinsella.

The final chapter, “The Continuing Quest for Knowledge and Control,” contains no medical treatises but rather ends with personal reflections by the writer Paul Monette on AIDS, and by physician-writers, John Stone, Sherwin B. Nuland, Lewis Thomas, Dannie Abse, and Richard Selzer.

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The Syringa Tree

Gien, Pamela; Moss, Larry

Last Updated: Aug-22-2007
Annotated by:
Shafer, Audrey

Primary Category: Performing Arts / Film, TV, Video

Genre: Video

Summary:

This video is the film of the staged one-woman play written and acted by white South African Pamela Gien. The play begins in 1963, in a white suburb of Johannesburg, in the fenced yard of the Grace family and their black servants. Gien starts as six-year-old Lizzie Grace. Gien then fluidly shifts roles to enact twenty-eight different characters from newborn to age eighty-two, black and white, male and female--who talk, gesture, sing and dance in this tour-de-force performance.

The set contains only a large, plain swing; even the berry-bearing syringa tree to which the swing is attached is left to the imagination. Gien’s costume is similarly muted--she is barefoot and wears a beige jumper over a simple tee shirt. A sound system provides music of ethnically diverse origins at appropriate moments.

The play opens with Gien swinging and talking in a girlish voice and using exaggerated childlike gestures. Lizzie exclaims that she is "a very lucky fish": she proceeds to explain to the audience the meaning of her favorable white nailbed spots. Lizzie is, by self-definition, a "hyperactive," outspoken child with great imagination and energy. She is cared for by Salamina, a loving nanny and servant.

Lizzie’s father is Dr. Isaac Grace, who delivers Salamina’s baby in the home. The child, Moliseng, "has no papers" and is harbored illegally by the Grace family--a constant source of worry for all, including Lizzie. Isaac is a Jewish atheist, and Lizzie’s mother, Eugenie, is Catholic and of English descent. Their neighbors, however, are bigoted Afrikaners and create great tension for the Grace household. "Don’t ever make this place your home," advises Dr. Gien to his daughter after dealing with racist clients who do not want to be in the same examining room after a black patient.

Lizzie’s liberal, generous grandfather is brutally murdered by a Rhodesian freedom fighter shortly after the resolution of another crisis: Moliseng, suffering from malnutrition, is missing from the overcrowded hospital. The play then fast forwards through Lizzie’s college years, when Moliseng, at age fourteen, is murdered in youth riots. Lizzie leaves for America, land of the (she pounds her chest) "free and brave." She returns years later, with her infant son named for her grandfather, to visit her father, her demented mother, and, above all, her beloved Salamina.

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The Village Watchman

Williams, Terry Tempest

Last Updated: Aug-14-2007

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

This is a short piece, a scant twelve pages, in which Williams remembers Alan, an uncle who had mental deficits. During his breech birth, Alan’s brain was starved of oxygen. In the dominant American culture, Alan is called “retarded, handicapped, mentally disabled or challenged.” Williams concludes, “We see them for who they are not, rather than for who they are.” (p. 29) The title of the work refers to an Alaskan totem pole figure whose expression reminds her of Alan. In Tlingit culture, there’s a story of a kidnapped boy who lived with the Salmon People. When he returned twenty years later, he was seen as a holy man, not an “abnormal.”

To the young Terry Tempest, Alan demonstrated enthusiasm and spontaneity, for example bowling with reckless glee, regardless of where the ball went. When she asked him how he was feeling, he said, “very happy and very sad,” explaining that “both require each other’s company.” (p. 31) She liked his direct answers, those of a person we sometimes call a wise fool. Later, he lived in a “training school,” a joyless, ugly, and smelly place where abnormal children in Utah were sent and warehoused. Suffering from epilepsy, he wore a football helmet to protect him from sudden falls.

At age 22, Alan made the choice to be baptized into the Church of Jesus Christ of Latter-Day Saints. Williams describes the ceremony and how the family supported him through it (including yet another violent epileptic episode). When Alan died at age 28, Williams was 18. Looking at the totem pole, she remembers Alan, seeing him for who he truly was.

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