Showing 91 - 100 of 517 annotations tagged with the keyword "Hospitalization"

Annotated by:
McEntyre, Marilyn

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

On July 5, 1998, physics Professor Alan Cromer suffered a heart attack on a plane, and survived after almost an hour of resuscitation efforts, but sustained brain injury from lack of oxygen.  In this chronicle of caregiving, his wife, a psychiatric nurse by training, gives a very personal, detailed account of the radical adaptations his disability required of both of them.  Her story includes reflection on his and her own emotional adjustments to loss of parity in communication and awareness, practical adjustments to physical limitations, and social adjustments to family, friends and professional colleagues.

Arduously, over time, Alan regained some ability to read and speak--indeed, he spoke to groups with Janet about their life together during the peak of his rehabilitation.  But the road to even partial recovery was bumpy, and the writer fully acknowledges the pain, grief, irritation, and deep frustrations that intersected moments of authentic pleasure, discovery, and mutual kindness.  Professor Cromer died September 3, 2005.

View full annotation

Annotated by:
Shafer, Audrey

Primary Category: Literature / Nonfiction

Genre: Anthology (Essays)

Summary:

As explained in the succinct yet thorough introduction by co-editor Kimberly Myers, an international conference on the topic of "The Patient" was convened at Bucknell University in Pennsylvania in 2006. This collection of essays, which range from personal experience to scholarly literary critique, results from the conference presentations.
 
Of the ten essays, four concern personal or familial experience of illness. These four cover a vast range: literature and disability specialist Kristin Lindgren describes her story of the elusive diagnosis of chronic fatigue syndrome and her coping skills; medical humanities and medical ethics expert Carol Schilling offers a poignant narrative of her experience as a mother of a previously healthy, athletic son who suffers a cervical spine injury from a skiing accident; Gayle Whittier places the story of her daughter's disability amongst a trio of nonfictional and fictional narratives of disability and illness; and renowned poet Tess Gallagher explores her relationship with and caring of her mother who has Alzheimer's disease. These essays, written as they are by women steeped in literature and writing, are not merely chronicles; rather they are infused with commentary on story and the meaning of life as story, journey and relationship.
 
The other six essays are likewise diverse and range from cultural/political studies from the Navajo to the Irish (which includes literary analysis of works by poets Eavan Boland and Nuala Ní Dhomhnaill), to insightful critiques of literary works such as  Hjalmar Soderberg 's Doctor Glas, Lauren Slater's Lying: A Metaphorical Memoir, Brian Clark's Whose Life Is It Anyway?, Alejandros Amenabar's film The Sea Inside (Mar Adentro), and George (Marian Evans) Eliot's Janet's Repentance.

Consistent with the nature of medical humanities, the essays cross boundaries. For example, Whittier weaves her experiences as a mother of a disabled child with reflections on embodiment and literary critique. Gallagher compares the notions of time in poem-making with the necessity to live in the moment when caring for a loved one with Alzheimer's. She notes: "Of the written arts, poetry is most responsive to the moment and so coincides with the condensed time frame of those with Alzheimer's - which oscillates between the distant past and the present moment." (p. 71) Schilling tenderly writes of her family (for an illness strikes not just the patient): "We live the best lives we can, folding each of our stories into one another's." (p. 40) Diedrich explores not just the (at times infuriating) play with deceit in Lying, but also examines the ways in which patients lie and medical language obfuscates illness. She further explores, with great insight, expectations: of literary reviewers, patients and physicians.

 

View full annotation

Wit

Edson, Margaret

Last Updated: Sep-07-2010
Annotated by:
Donley, Carol

Primary Category: Literature / Plays

Genre: Play

Summary:

Wit takes place in a University Hospital Comprehensive Cancer Center. The main character, Vivian Bearing, Ph.D., is a John Donne scholar who has stage IV ovarian cancer. Much of the action takes place in the last few days/hours of her life, although flashback scenes to weeks, months, even years before are interspersed effectively throughout the performance.

Bearing has lived an isolated life. Her love is her teaching and research. She is a stern taskmaster, perhaps "non-humanistic" in her approach. Similarly, she faces doctors and a medical system that emphasize technique over caring. She does find, in the end, compassion from a nurse who prevents the medical team from carrying out a CPR (cardiopulmonary resuscitation) attempt that she did not want.

View full annotation

Annotated by:
Spiegel, Maura

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

The story follows the final twelve or so hours in the life of a 62 year old widow, emblematically named Dante Remus Lazarescu, (Ioan Fiscuteanu). Suffering with stomach distress and a terrible headache (eventually diagnosed as a subdural hematoma and late stage liver cancer), he spends his last night being shuttled by ambulance, or rather by an ill-equipped van serving as ambulance, from hospital to hospital, unable to secure the emergency surgery that would save him. The hand-held camera and long uncut takes -some are six or more minutes- give the movie the feel of unfolding in real time. In places, it has the look of a documentary, and it has been compared to Frederick Wiseman's Hospital (1970).

Before the odyssey begins, we meet Mr. Lazarescu in the cramped, unkempt Bucharest apartment he shares with his three cats. Of his circumstances we learn that he is a retired engineer whose only daughter has emigrated to Toronto, and that despite having had ulcer surgery years earlier, Mr. Lazarescu drinks heavily. In his every encounter -with neighbors and with a string of doctors- he is reprimanded for his drinking, implicitly or explicitly blamed for his ill-health. From the television blaring in his apartment we hear news of a truck gone out of control that has rammed a tourist bus. Casualties from the accident are taxing hospital resources, which accounts in part for why this ill-smelling elderly man who appears to be drunk (but turns out to be having a cerebral bleed) is a low priority, although this doesn't account for the callousness with which he is treated by much of the medical staff.

The most significant relationship in the film is between Mr. Lazarescu and the ambulance nurse, Mioara (Luminita Gheorghiu) who shepherds him throughout the night. Almost everything we know about her is what one knows from watching someone at her job; in Puiu's hands, this vantage turns out to be richly informative. (Ms. Gheorghiu's body language speaks volumes.) Mioara and Mr. Lazarescu hardly speak to one another; they don't "open up" to one another or have a "meaningful moment," nothing to compare, for example, to the Popsicle scene between the nurse, Susie, and patient, Vivian Bearing, in Wit (see annotation). The power of the relationship in this film is in what is not overt, but what is palpable nonetheless -that Mioara's presence means very much to Mr. Lazarescu, and that doing her job includes letting him know that she is standing by him, that he is the priority, the only priority. Mioara staunchly meets the irascibility and chastisement of various physicians in her efforts to advocate for her patient as he is passed off from one hospital to the next.

View full annotation

The Man with Night Sweats

Gunn, Thom

Last Updated: Jul-27-2010
Annotated by:
Coulehan, Jack

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

The theme of this book of poems is life in a time of deadly plague. The author depicts his world ravaged by illness. Some of the poems are quiet love songs for others, for the world and its delights, a world turned upside-down by the ravages of AIDS. Many of the poems are elegies for friends who have died in the epidemic.

View full annotation

Letters to a Stranger

James, Thomas

Last Updated: Jul-25-2010
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Collection (Poems)

Summary:

Letters to a stranger is a slim volume of poems by Thomas James ((1946 - 1974) posthumously collected and published in 2008 by an admiring reader/ critic, Lucy Brock-Broido. James died by suicide in 1974.

There are 54 poems in all. Forty-one of them were first published in 1973 as James's only published book of verse, Letters to a Stranger. Ms Brock-Broido has collected 13 more from various small magazines. Most have a faint formalistic ring to them with rhymed triplets (a-x-a) predominating.   Preceding the poems is an introduction by Ms Brock-Broido, an introduction that can only be called unusually confessional. (In his characteristically succinct diction, series editor Mark Doty calls it "a love letter, a biography and exorcism all at once".) For subjects, the bulk of the poems have, as we call a type of educational conference in medicine, morbidity and mortality. Indeed, the book might perhaps have been more appropriately entitled "Intimations of morbidity and mortality". Many of the poems are graphic.

View full annotation

Annotated by:
Schilling, Carol

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Extraordinary Measures, based on events in the life of John Crowley and his family, dramatizes the father's quest to find a cure for Pompe disease, a relatively rare genetic condition that afflicts two of his three children.  The quest brings into play three powerful, often competing human motives:  a father's love for his children, a scientist's pursuit of knowledge and recognition, and a corporation's mandate for profits.  Crowley (Brendan Fraser), an energetic marketing executive, and his wife Aileen (Keri Russell) are told that their children Megan (Meredith Droeger), age eight, and Patrick (Diego Velazquez), age six, have reached the upper limits of their life expectancies.

When Megan, an affectionate, playful, and clear-sighted child, is rushed to the hospital with symptomatic heart and respiratory failure, a young physician empathically encourages the parents to think of their only daughter's immanent death as a "blessing" that will end her suffering.  However, Megan survives.  "So I guess you could say we dodged that blessing," Crowley echoes back to the doctor.  Seeing Megan's will to live reinforces John's wish to make her well, and he abruptly abandons his promising career to find a medical researcher who can reverse Pompe's effects. 

Immersing himself in medical journals and websites, John discovers the intriguing research of Robert Stonehill (Harrison Ford).  A cranky, renegade scientist who thinks to the beat of rock music blasting from a boom box, Stonehill has developed a cutting-edge theory about correcting the enzyme deficiency in the cells of people with Pompe, which gradually weakens skeletal, respiratory, and heart muscles.  However, to produce a treatment derived from his theory, he needs more funding.  John immediately creates a fund to support Pompe research, and he and Stonehill form a mutually exasperating partnership.  They lock horns with each other, venture capitalists, and finally a large genomic research corporation, Zymagen.

Despite the scientist's abrasive ways, Zymagen gives Stonehill a lab and creates employment for Crowley.  However, the two confront the company's culture of rigorous competition among its scientists and its focus on profit margins that ignore the fates of individual children.  When the Zymagen scientists develop a promising therapy, they decide to offer the treatment only to infants, who are most likely to experience benefits.  Disqualifying Crowley's children from the promising trials, this decision, combined with Crowley's obvious conflict of interest, creates the film's final obstacle.  Stonehill and the executives uncharacteristically collaborate to overcome it. 

This ending might seem implausibly neat, but it's consistent with the film's mostly evenhanded approach to the dilemmas of pursuing treatments for orphan diseases.  Toward the end, we witness even Crowley, albeit uncomfortably, reaching beyond his fatherly motives for the Pompe project and turning his argument for bringing the treatment to market from children to profits.  The longer the patients live, John assures the executives, the more treatments Zymagen will sell.  The film leaves space for viewers to ask to what extent Crowley's argument creates a fair compromise or opens an ethical quandary.  In a closing narration, the film moves beyond the fictionalized characters and plot to the real Crowley children and a tempered victory.  Yes, the Pompe treatment stopped the progression of the disease and improved Megan's and Patrick's hearts.  But it has not cured the Crowley children, and almost certainly it won't.   The treatments do, however, show more success when taken at the onset of symptoms.      

View full annotation

Summary:

McMurphy (Jack Nicholson) escapes work on a prison farm by feigning mental illness, but he finds himself in a far more coercive institution than the one he left behind. The other men, both sane and insane, are just like him: they hide in the locked ward from the law, their families, or the despair of their own lives.

McMurphy animates the dull monotony with fractious games, pranks, and excursions, but he encounters stiff opposition from the head nurse, Mildred Ratched (Louise Fletcher), whose system provides her with pills and electroshock to maintain control. When the nurse discovers that McMurphy has smuggled two women into the ward, she threatens to tell the mother of young Billy (Brad Dourif). Billy commits suicide and an enraged McMurphy tries to strangle Ratched. McMurphy is lobotomized and returned to the ward only to be smothered by his friend Bromden, who then escapes.

View full annotation

Annotated by:
Henderson, Schuyler

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

In 1954, a United States Marshal (Leonardo DiCaprio) and his partner (Mark Ruffalo) take the ferry to Ashecliff Hospital, a forbidding asylum for the criminally insane located on Shutter Island.  Their mission is to investigate the disappearance of an inmate who has apparently escaped without a trace.  Under the supervision of the chief psychiatrist, Dr John Cawley (Ben Kingsley), they become increasingly entwined in a twisting tale of fear and suspicion.

View full annotation

Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

As Audrey Young describes her process of becoming a compassionate internist in a besieged public hospital, she simultaneously argues for turning the hospital's patient care and financial practices into a model for improving health care in America.  Young, a compelling storyteller, first entered Seattle's Harborview Medical Center in 1996 as a third-year medical student on trauma surgery service.  She completed a residency there in general internal medicine and stayed on as an attending for six more years.  She stayed, she tells us, because she met physicians "committed to a vision of equality" who were "the sort of people I hoped to become" (xiii).   She also "fell in love" with "the story of a unique place" (xiii).  Young's stories of that often chaotic place, where ambulances regularly transport homeless, indigent, addicted, and mentally ill refugees from neighboring private hospitals, emphasizes the ways the Harborview staff manages to treat patients with dignity and to choose an ethic of hope in the face of dire circumstances.           

We quickly learn that at Harborview compassion is expressed concretely as actions toward patients.  Michael Copass, known as "the mostly benign dictator of emergency operations," pronounced the core of these actions in what came to be known as his commandments:  "1. Work hard.  2. Be polite.  3. Treat the patient graciously, even if he is not the president of the United States" (9).  Politeness always meant asking "'How may I help you, sir?'" regardless of the patient's social status or addiction history.  Politeness sometimes meant finding a way to reach the patient who regularly threatened the staff.  Young finds ways and creates a therapeutic bond.  But working hard and treating patients considerately also took measurable forms, such as not allowing emergency patients to wait.  Facing a flurry of admissions, the Emergency Department (ED) staff interpreted a young Ethiopian's complaints about pain as a drug addict's ploy.  Because Young glanced at the admissions board and noticed that he remained unattended for three hours--far longer than Copass could tolerate--she jumped into action.  He suffered, she discovered, from a collapsed lung. 

However, Young moves her narrative beyond individual doctor and patient encounters and into the larger, interrelated social and financial structures in which medicine is practiced.  For instance, she links meager funding for drug and alcohol rehabilitation programs with expensive ED admissions and rising healthcare costs.  In the chapter "Bunks for Drunks," Young visits an experimental residence that houses homeless addicts in furnished studios with private baths and cooking appliances.  Although residents can keep alcohol in their rooms and elect not to participate in the home's social services, including counseling, alcohol consumption and ED admissions decrease.  While the chapter points out the cost savings of such arrangements, Young further urges readers to value the dignity residents experience there.

In "Black Friday," Young details the hospital's tense, but ingenious responses to a Mass Casualty Incident, the result of carbon monoxide poisoning, which almost depleted the resources of all of Seattle's medical centers.  The final chapter, "A Vision," outlines how Harborview has tried to succeed as both a charitable institution and a business, as a provider of both indigent and luxury care, with the hope that others will follow the medical center's example.  However, in presenting her recommendations for "health justice," Audrey Young also makes the case that "seemingly ordinary citizens" are implicated in healthcare reform (231).  To enable their informed participation in making changes, Young includes an appendix with further readings and another that lists strategies for effecting reform.  

View full annotation