Showing 81 - 90 of 188 annotations tagged with the keyword "Psychiatry"
A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).
Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).
Witty Ticcy Ray tells the story of Dr. Sacks’s treatment of a 24-year-old man with disabling Tourette’s syndrome. The first half of the essay is mainly medical-historical, with some technical language. When Sacks first tries treating Ray with a minute dose of Haldol, Ray finds that even that low dose too effective. It breaks up the rhythms that have determined his life since the age of 4, and he doesn’t like it. Later, a second trial using the same dose succeeds, Sacks believes, because Ray had by that time accommodated mentally to a change in self-image.
Still, over time Ray missed his old wildness and speed, and he and Sacks agree on a compromise: During the week, Ray takes Haldol and is the "sober citizen, the calm deliberator." On weekends, he is again "’witty ticcy Ray,’ frenetic, frivolous, inspired"--and a talented jazz drummer. This, according to Ray, offers Touretters an acceptable artificial version of normals’ balance between freedom and constraint.
This video depicts Robert Coles, noted author, psychiatrist, documentator and humanist, teaching his popular undergraduate course, "The Literature of Social Reflection," at Harvard University in 1990. The film begins with a bell tolling in a steeple and students entering the lecture hall. Excerpts from his lectures are presented in 4 parts: I: Ruby; II: Seeing--The Paintings of Edward Hopper and The Stories of Raymond Carver; III: Praying; and IV: Potato Chips and Tolstoy.
Some additional documentary clips are shown, such as footage of six-year-old Ruby Bridges being escorted into a previously all-white New Orleans school amidst a screaming mob during forced integration of schools. In between segments, brief interviews of Coles’ students let the viewer know that his message is getting through: it matters how you live your life--it matters a great deal.
Coles teaches with stories and these stories are riveting. In 1960, while in the Air Force and assigned to a psychiatric detail, he befriends young Ruby after he witnesses her courage in entering the school building. He comes to know her family and teacher.
Several months later, during the morning escort, Ruby stops in front of the school and says something which makes the mob even more frenzied. Coles is asked by the teacher to tell Ruby not to do that again. Upon gentle questioning, it turns out that Ruby was not talking to the mob, but to God: "Please God, try to forgive those people because they don’t know what they’re doing."
It was a prayer she said every morning, usually a couple of blocks away from the school, but that morning she had forgotten to do it earlier. Coles discusses the remarkable gift of forgiveness instilled in this brave child by her parents, who despite poverty and lack of opportunity to advance in life, were able to love and teach their children values and grace.
In Part II, Coles uses paintings by Edward Hopper, a poem by Raymond Carver ("What the Doctor Said" (annotated by Felice Aull and Irene Chen, also annotated by James Terry) and Carver short story (Cathedral) to illustrate how difficult it can be to truly communicate with and know another person. And how magical the moments are when we do.
In Part III, Coles shows some of the children’s drawings that he has collected during his documentary work. Coles delights in describing what the children said about their drawings at the time they created them. He clearly respects them and their ideas.
The last part ends with the story of the death of Coles’s mother at Massachusetts General Hospital. In her dying days she befriended an African-American woman, whose job was at the bottom of the hierarchy of the hospital: an orderly. After Coles’s mother died, it was this woman--not any doctor or nurse--who taught Coles how to take the time and be with his mother, rather than rush off as he was preparing to do. Coles asks, "Who was the doctor, the healer, the wise person?"
He notes that these twists are characteristic of many stories, such as those by Flannery O’Connor. He then concludes before a standing ovation: "Let us be good to one another, live on behalf of one another . . . . We are lucky to have these writers . . . and to have the lives that can include them."
In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.
Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.
His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.
In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.
It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.
The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.
The spirit of St. Francis of Assisi presides over the garden in spring. Hyacinths bloom, and abandoned bird nests are tucked away in the nooks and crannies. Young couples embrace: "St. Francis forgive them / and all lovers / whoever they may be." The scene then fast forwards to summer, when the lovers find themselves bewildered and "incredulous / of their own cure / and half minded / to escape . . . "
The idyllic garden has turned menacing, yet St. Francis continues to have compassion for the lovers who "resemble children / roused from a long sleep." One lover stands up unafraid in the sunlight "as her heart / beats wildly / and her mind / drinks up / the full meaning / of it." [139 lines]
Ten months after being burned over 68% of his body, Dax Cowart was interviewed on videotape at the University of Texas Medical Branch in Galveston by Dr. Robert B. White. Blind, disfigured and helpless, Dax had consistently asserted his right to refuse medical treatment, including further corrective surgery on his hands (useless, unsightly stumps) as well as the daily, excruciatingly painful baths in the Hubbard tank.
At the time of his admission to UTMB, he had become adamant that he be allowed to leave the hospital and return home to die--a certain outcome since only daily tankings would prevent overwhelming infection. Dr. White had been called in as a psychiatric consultant, and much of the twenty-nine minute documentary is a conversation between patient and psychiatrist.
Calm and coherent, Dax states his wishes clearly and presents his case compellingly. He does not "want to go through the pain"; he does not "want to go on as a blind and a crippled person"; and he does not understand or accept any physician’s "right to keep alive a patient who wants to die."
Will Farnaby, reporter and underground agent for an oil magnate, is shipwrecked on the island of Pala, where for 120 years an ideal society has flourished. In the mid 19th century, a Scottish doctor successfully treated the enlightened Raja of Pala and settled on the island. These two men then designed a perfect society in which (according to the book jacket's description), "sex lives are unabashed; children are carefully conditioned from infancy and none is at the mercy of one set of parents; jobs are assigned according to physique and temperament," and everyone uses "moksha medicine," a drug that sharpens and deepens powers of consciousness.
The Palinese also practice hypnosis, eugenics, and a form of sexual yoga that leads to virtually perfect sexual experience. While Pala has enormous oil reserves, the people are uninterested in developing them because they are happy with their way of life and do not feel the need to become wealthier or more Westernized. Pala's companion island of Rendang is ruled by a ruthless dictator, Colonel Dipa, who plans to develop its oil resources and industrialize the island, while, at the same time, enriching himself.
After his shipwreck, Farnaby is injured climbing a cliff from the beach. He spends time recuperating, during which he meets a number of Palinese people, including Dr. MacPhail (descended from the original Scottish physician) and Murugan, the young man who will soon become the new Raja of Pala. As he learns more about the society, Farnaby comes to respect it and turns away from his plans to promote oil development on the island.
However, Murugan (who was raised largely in Switzerland by a fanatic mother who runs a fundamentalist Christian movement) frowns upon the sexual freedom, drug use, and general lack of "ambition" among his countrymen. He secretly conspires with Colonel Dipa to sell-out Pala. At the end of the book, the army of Rendang has invaded Pala and declared a joint kingdom of Rendang and Pala with Murugan as king and Colonel Dipa as Prime Minister.
Ashdown, a beautiful but bleak manor on the English coast, is the main setting of this story. Initially, a group of university students including Sarah Tudor, Gregory Dudden, Robert, and Terry reside at Ashdown. Some of these same students return there years later as either patients or staff when the building is converted into the Dudden Clinic where individuals with all sorts of sleep disorders are treated.
Sarah is a disturbed young woman suffering from narcolepsy. She is sometimes unable to differentiate her dreams from the experiences of real life. Robert is infatuated with her and will do literally anything to please her. Gregory is Sarah’s first lover, later a psychiatrist in charge of the sleep clinic, and finally a man gone mad who decides to self-experiment. Dr. Cleo Madison is a sleep psychologist whose true identity is a surprise. In this novel, reality appears more surrealistic than most dreams.
I used to be able to think. My brain’s circuits were all connected . . . I had a memory and an intuition that I could trust. So begins Floyd Skloot’s memoir of living his life with "a scatter of white spots like bubbles" in his brain, as a result of a viral illness in 1988 that led to chronic fatigue syndrome and persistent brain damage. The first section ("Gray Area") consists of essays that re-create a texture of mistaken words and memory lapses, as well as the author’s creativity in discovering ways to minimize or bypass disability in his daily life. The temporal vector of this section begins with the onset of illness; continues through his marriage to Beverly and their settling on a hilltop in Oregon; and ends with an idyllic stay on Achill Island off the western coast of Ireland.
The second section draws us back in time to "The Family Story," a series of stories about childhood. In "Kismet," which begins section 3, the author returns to a description of his post-illness experience, in this case to his fateful final visit with an older brother, who is dying of diabetes and kidney failure. Later, in "A Measure of Acceptance," he tells of his encounter with a Social Security psychiatrist, whose task is to determine whether Floyd Skloot is "really" sick. The Social Security Administration provides one measure of acceptance; but the author creates a more important measure of acceptance for himself: "I can say that I’ve become adept at being brain damaged. It’s not that my symptoms have gone away: I still try to dice a stalk of celery with a carrot instead of a knife . . . Along the way, though, I’ve learned to manage my encounters with the world." (p. 196)